ABSTRACT
OBJECTIVES: While the association between pregestational obesity and perinatal complications has been established, it is necessary to update the current understanding of its impact on maternal and foetal health due to its growing prevalence. Thus, this study aimed to investigate the association between pregestational obesity with the leading perinatal complications during the last 6 years. STUDY DESIGN: A cross-sectional study was performed in San Felipe, Chile. Anonymised data of 11,197 deliveries that occurred between 2015 and 2021 were included. METHODS: Pregestational body mass index was defined according to the World Health Organisation during the first trimester of pregnancy. The association between pregestational obesity and perinatal complications was analysed by calculating the odds ratio (OR), which was adjusted for confounding variables. Statistical differences were considered with a P-value of <0.05. RESULTS: The prevalence of pregestational obesity was 30.1%. Pregestational obesity was related to a high incidence of perinatal complications (≥3 complications; P < 0.0001). The main perinatal complications were caesarean section, large for gestational age (LGA), gestational diabetes (GD), macrosomia, hypertensive disorders of pregnancy (HDP), premature rupture of membranes (PROM), intrauterine growth restriction, and failed induction. Pregestational obesity was shown to be a risk factor for macrosomia (OR: 2.3 [95% confidence interval {95% CI}: 2.0-2.8]), GD (OR: 1.9 [95% CI: 1.6-2.1]), HDP (OR: 1.8 [95% CI: 1.5-2.1]), LGA (OR: 1.6 [95% CI: 1.5-1.8]), failed induction (OR: 1.4 [95% CI: 1.0-1.8]), PROM (OR: 1.3 [95% CI: 1.1-1.6]), and caesarean section (OR: 1.3 [95% CI: 1.2-1.4]). CONCLUSIONS: Pregestational obesity has been shown to be a critical risk factor for the main perinatal complications in the study population. Pregestational advice is imperative not only in preventing pregestational obesity but also in the mitigation of critical perinatal complications once they arise.
Subject(s)
Obesity , Pregnancy Complications , Humans , Female , Pregnancy , Cross-Sectional Studies , Adult , Pregnancy Complications/epidemiology , Obesity/epidemiology , Obesity/complications , Chile/epidemiology , Prevalence , Risk Factors , Body Mass Index , Infant, Newborn , Fetal Macrosomia/epidemiology , Cesarean Section/statistics & numerical data , Young Adult , Diabetes, Gestational/epidemiologyABSTRACT
PURPOSE: It is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI. DESIGN: Multicenter prospective international cohort study. SETTING: Fourteen university hospitals in Spain and the United Kingdom. PARTICIPANTS: We studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland scoreâ¯≥â¯4 points, from July to December 2017. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: AKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (≥7â¯mg/dL) and AKI. Elevated preoperative AUS (≥7â¯mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81-3; Pâ¯=â¯.17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95%CI 0.93-1.19, Pâ¯=â¯.37). CONCLUSIONS: Hyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.
Subject(s)
Acute Kidney Injury , Cardiac Surgical Procedures , Hyperuricemia , Postoperative Complications , Uric Acid , Humans , Acute Kidney Injury/etiology , Acute Kidney Injury/epidemiology , Acute Kidney Injury/blood , Prospective Studies , Male , Female , Cardiac Surgical Procedures/adverse effects , Uric Acid/blood , Aged , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/blood , Middle Aged , Hyperuricemia/epidemiology , Hyperuricemia/blood , Risk Factors , Propensity ScoreABSTRACT
OBJECTIVE: To evaluate with an animal model of osteoarthritis (New Zealand rabbits) the effectiveness of treatment with active viscosupplements (hyaluronic acid loaded with nanoparticles (NPs) that encapsulate anti-inflammatory compounds or drugs. MATERIAL AND METHODS: Experimental study composed of 5 groups of rabbits in which section of the anterior cruciate ligament and resection of the internal meniscus were performed to trigger degenerative changes and use it as a model of osteoarthritis. The groups were divided into osteoarthrosis without treatment (I), treatment with commercial hyaluronic acid (HA) (II), treatment with HA with empty nanoparticles (III), treatment with HA with nanoparticles encapsulating dexamethasone (IV) and treatment with HA with nanoparticles that encapsulate curcumin (V). In groups II to V, the infiltration of the corresponding compound was carried out spaced one week apart. Macroscopic histological analysis was performed using a scale based on the Outerbridge classification for osteoarthritis. RESULTS: We observed that this osteoarthritis model is reproducible and degenerative changes similar to those found in humans are observed. The groups that were infiltrated with hyaluronic acid with curcumin-loaded nanoparticles (V), followed by the dexamethasone group (IV) presented macroscopically less fibrillation, exposure of subchondral bone and sclerosis (better score on the scale) than the control groups (I) (osteoarthritis without treatment), group (II) treated with commercial hyaluronic acid and hyaluronic acid with nanoparticles without drug (III). CONCLUSIONS: The use of active viscosupplements could have an additional effect to conventional hyaluronic acid treatment due to its antioxidant and anti-inflammatory effect. The most promising group was hyaluronic acid with nanoparticles that encapsulate curcumin and the second group was the one that encapsulates dexamethasone.
ABSTRACT
Trypanosomatids are an important group of parasites that predominate in tropical and subtropical areas of the planet, which cause diseases that are classified as forgotten and neglected by the world health organization. In this group of parasites, we find Trypanosoma cruzi, Trypanosoma brucei, Trypanosoma brucei rhodesiense and Leishmania spp, for which there is no vaccine available, and its control has focused mainly on pharmacological treatment. Due to the poverty situation where these diseases are found and the biological complexity of these parasites, there are multiple variables to control, including the diversity of species, the complexity of their life cycles, drug resistance, cytotoxicity, the limited use in pregnant women, the high costs of treatment and the little-known pharmacological mechanisms of action, among others. It is therefore necessary to find new strategies and approaches for the treatment of these parasitic diseases. Among these new approaches is the rational search for new targets based on the allosteric inhibition of protein kinases, which have been little studied in trypanosomatids. Among these kinases, we find Glycogen Synthase Kinase-3 (GSK-3), a kinase of great pharmacological interest, which is under intense basic and clinical research by pharmaceutical companies for the treatment of cancer. This kinase, highly studied in the PI3K/AKT/mTOR pathway signaling in humans, has an orthologous gene in these parasites (GSK-3 s), which has proven to be essential for them in response to different challenges; Therefore, it is notable to increase research in this kinase in order to achieve a broad structural and functional characterization in the different species of trypanosomatids.
Subject(s)
Glycogen Synthase Kinase 3 , Glycogen Synthase Kinase 3/antagonists & inhibitors , Humans , Animals , Trypanosomatina/enzymology , Trypanosomatina/drug effects , Trypanosomatina/geneticsABSTRACT
Introducción y objetivos: Los vástagos primarios con cuellos modulares fueron introducidos con la ventaja teórica de restaurar la anatomía de la cadera de forma más precisa. Sin embargo, la presencia de un segundo encaje se ha asociado a una mayor corrosión y liberación de detritos metálicos. El objetivo de nuestro estudio es cuantificar los valores séricos de cromo y de cobalto, y analizar su evolución temporal durante cinco años. Material y métodos: Se presenta una serie prospectiva de 61 pacientes intervenidos de artroplastia total de cadera primaria mediante la implantación del vástago HMAX-M® (Limacorporate, San Daniele, Italia) en los que se realizó una determinación sérica de cromo y cobalto a los seis meses, a los dos años y a los cinco años. Resultados: Nuestra serie presenta una elevación progresiva de los niveles de cromo, con una diferencia significativa entre los valores de cromo a los seis meses (0,35±0,18) y los cinco años (0,52±0,36), p=0,01. Respecto al cobalto, se observa una elevación estadísticamente significativa entre los seis meses y los dos años y una posterior estabilización hasta los cinco años, siendo la media de cobalto a los seis meses (1,17±0,8) significativamente menor que a los dos años (2,63±1,76) y a los cinco años (2,84±2,1), p=0,001. Conclusión: Se ha observado una elevación de los niveles séricos de cobalto en aquellos pacientes a los que se les implantó un vástago con cuello modular. Los resultados obtenidos en este estudio han limitado el uso de vástagos con cuello modular en nuestra práctica habitual.(AU)
Introduction and objectives: Modular neck primary stems were introduced with the theoretical advantage of restoring the hip anatomy more precisely. However, the presence of a second junction has been associated with increased corrosion and release of metal debris. The objective of our study is to quantify of chromium and cobalt serum values, and to analyze their temporal evolution during five years. Material and methods: We present a prospective series of 61 patients who underwent primary total hip arthroplasty by implantation of the HMAX-M® stem (Limacorporate, San Daniele, Italy). Serum chromium and cobalt determinations were performed at six months, two years and five years. Results: Our series shows a progressive elevation in chromium levels with a significant difference between chromium values at six months (0.35±0.18) and five years (0.52±0.36), P=.01. Regarding cobalt, a statistically significant elevation is observed between six months and two years and a subsequent stabilization of values between two and five years, with a cobalt mean at six months (1.17±0.8) significantly lower than at two (2.63±1.76) and five years (2.84±2.1), P=.001. Conclusion: Elevated serum cobalt levels have been observed in patients who underwent modular neck stem implantation. The results obtained in this study have limited the use of stems with a modular neck in our clinical practice.(AU)
Subject(s)
Humans , Male , Female , Chromium/administration & dosage , Cobalt/administration & dosage , Arthroplasty, Replacement, Hip , Hip/surgery , Ions , Iron/blood , Prospective Studies , Traumatology , Orthopedics , Orthopedic Procedures , Hip Injuries , ItalyABSTRACT
Introducción y objetivos: Los vástagos primarios con cuellos modulares fueron introducidos con la ventaja teórica de restaurar la anatomía de la cadera de forma más precisa. Sin embargo, la presencia de un segundo encaje se ha asociado a una mayor corrosión y liberación de detritos metálicos. El objetivo de nuestro estudio es cuantificar los valores séricos de cromo y de cobalto, y analizar su evolución temporal durante cinco años. Material y métodos: Se presenta una serie prospectiva de 61 pacientes intervenidos de artroplastia total de cadera primaria mediante la implantación del vástago HMAX-M® (Limacorporate, San Daniele, Italia) en los que se realizó una determinación sérica de cromo y cobalto a los seis meses, a los dos años y a los cinco años. Resultados: Nuestra serie presenta una elevación progresiva de los niveles de cromo, con una diferencia significativa entre los valores de cromo a los seis meses (0,35±0,18) y los cinco años (0,52±0,36), p=0,01. Respecto al cobalto, se observa una elevación estadísticamente significativa entre los seis meses y los dos años y una posterior estabilización hasta los cinco años, siendo la media de cobalto a los seis meses (1,17±0,8) significativamente menor que a los dos años (2,63±1,76) y a los cinco años (2,84±2,1), p=0,001. Conclusión: Se ha observado una elevación de los niveles séricos de cobalto en aquellos pacientes a los que se les implantó un vástago con cuello modular. Los resultados obtenidos en este estudio han limitado el uso de vástagos con cuello modular en nuestra práctica habitual.(AU)
Introduction and objectives: Modular neck primary stems were introduced with the theoretical advantage of restoring the hip anatomy more precisely. However, the presence of a second junction has been associated with increased corrosion and release of metal debris. The objective of our study is to quantify of chromium and cobalt serum values, and to analyze their temporal evolution during five years. Material and methods: We present a prospective series of 61 patients who underwent primary total hip arthroplasty by implantation of the HMAX-M® stem (Limacorporate, San Daniele, Italy). Serum chromium and cobalt determinations were performed at six months, two years and five years. Results: Our series shows a progressive elevation in chromium levels with a significant difference between chromium values at six months (0.35±0.18) and five years (0.52±0.36), P=.01. Regarding cobalt, a statistically significant elevation is observed between six months and two years and a subsequent stabilization of values between two and five years, with a cobalt mean at six months (1.17±0.8) significantly lower than at two (2.63±1.76) and five years (2.84±2.1), P=.001. Conclusion: Elevated serum cobalt levels have been observed in patients who underwent modular neck stem implantation. The results obtained in this study have limited the use of stems with a modular neck in our clinical practice.(AU)
Subject(s)
Humans , Male , Female , Chromium/administration & dosage , Cobalt/administration & dosage , Arthroplasty, Replacement, Hip , Hip/surgery , Ions , Iron/blood , Prospective Studies , Traumatology , Orthopedics , Orthopedic Procedures , Hip Injuries , ItalyABSTRACT
INTRODUCTION AND OBJECTIVES: Modular neck primary stems were introduced with the theoretical advantage of restoring the hip anatomy more precisely. However, the presence of a second junction has been associated with increased corrosion and release of metal debris. The objective of our study is to quantify of chromium and cobalt serum values, and to analyze their temporal evolution during five years. MATERIAL AND METHODS: We present a prospective series of 61 patients who underwent primary total hip arthroplasty by implantation of the HMAX-M® stem (Limacorporate, San Daniele, Italy). Serum chromium and cobalt determinations were performed at six months, two years and five years. RESULTS: Our series shows a progressive elevation in chromium levels with a significant difference between chromium values at six months (0.35±0.18) and five years (0.52±0.36), P=.01. Regarding cobalt, a statistically significant elevation is observed between six months and two years and a subsequent stabilization of values between two and five years, with a cobalt mean at six months (1.17±0.8) significantly lower than at two (2.63±1.76) and five years (2.84±2.1), P=.001. CONCLUSION: Elevated serum cobalt levels have been observed in patients who underwent modular neck stem implantation. The results obtained in this study have limited the use of stems with a modular neck in our clinical practice.
ABSTRACT
INTRODUCTION AND OBJECTIVES: Modular neck primary stems were introduced with the theoretical advantage of restoring the hip anatomy more precisely. However, the presence of a second junction has been associated with increased corrosion and release of metal debris. The objective of our study is to quantify of chromium and cobalt serum values, and to analyse their temporal evolution during five years. MATERIAL AND METHODS: We present a prospective series of 61 patients who underwent primary total hip arthroplasty by implantation of the H MAX-M® stem (Limacorporate, San Daniele, Italy). Serum chromium and cobalt determinations were performed at six months, two years and five years. RESULTS: Our series shows a progressive elevation in chromium levels with a significant difference between chromium values at six months (0.35±0.18) and five years (0.52±0.36), p=.01. Regarding cobalt, a statistically significant elevation is observed between six months and two years and a subsequent stabilisation of values between two and five years, with a cobalt mean at six months (1.17±0.8) significantly lower than at two (2.63±1.76) and five years (2.84±2.1), p=.001. CONCLUSION: Elevated serum cobalt levels have been observed in patients who underwent modular neck stem implantation. The results obtained in this study have limited the use of stems with a modular neck in our clinical practice.
ABSTRACT
OBJECTIVE: Hypertension and smoking during pregnancy have been linked to various adverse maternal and fetal outcomes. The objective of this work is to study how the smoking influences the development of hypertension, its effects on the pregnant woman, and on the newborn. MATERIALS AND METHODS: An observational study in two phases was carried out: the descriptive first phase allows characterization of the sample and the analytical second phase is a case-control nested in a retrospective cohort corresponding to pregnancy. RESULTS: A total of 712 women were included in the study. Of the 672 (94.4%) non-hypertensive women, 533 (79.3%) were non-smoking and 139 (20.7%) smoking. For the 40 (5.6%) hypertensive women, 30 (75.0%) were non-smoking and 10 (25.0%) smoking. The prevalence of hypertension was of 5.6%. Women who quit smoking before pregnancy saw a reduced risk of hypertension. For women who smoke during pregnancy, those of younger ages, with a normal body mass index, who are primiparous, employed and with a low-medium level of education have higher risk of hypertension. The risk of hypertension according to the level of physical activity during leisure time follows a "U" shape, with those who perform light physical activity at the lowest risk of hypertension. Hypertensive women have a higher risk of small for gestational age newborns. Smoking does not pose an additional risk for adverse outcomes once hypertension is diagnosed. CONCLUSIONS: Future studies should aim to determine the role of smoking habit in the appearance of hypertension in pregnancy in order to establish adequate intervention guidelines that may aid in reducing the prevalence of hypertension.
Subject(s)
Hypertension , Pregnancy Outcome , Smoking , Humans , Pregnancy , Female , Adult , Retrospective Studies , Smoking/epidemiology , Smoking/adverse effects , Infant, Newborn , Case-Control Studies , Prevalence , Spain/epidemiology , Hypertension/epidemiology , Hypertension/etiology , Hypertension, Pregnancy-Induced/epidemiology , Hypertension, Pregnancy-Induced/etiology , Young Adult , Risk Factors , Exercise , Smoking Cessation/statistics & numerical data , Cohort StudiesABSTRACT
The human head lice is a cosmopolitan ectoparasite that causes pediculosis. The main way of spreading lice is through direct head-to-head contact. It is popular knowledge that some individuals are more susceptible to contracting head lice than others. Reports of individuals who have never been affected by the disease are common, even living in the same environment and under the same conditions as people who regularly have lice infestations. Previous research has been carried out on the risk of this infection associated with different human factors like gender or age. However, studies on the influence of the individual hair characteristics are scarce. The objective of the study was to analyze the pediculosis risk using geographical location, gender, age and individual hair characteristics as variables. Pediculosis was diagnosed through the detection of living lice in the hair. This cross-sectional school-based epidemiological study was conducted in 310 schoolchildren aged 1 to 13 years of schools in 4 municipalities situated in the State of Paraná, Brazil. The prevalence of head louse infection in primary school students was 49.35 %. The Odds Ratio of presence of pediculosis (OR) was estimated using multivariate logistic regression analysis. The results obtained indicate that hair length and thickness increase the risk of infection. Furthermore, the inclusion of hair color, hair shape, kind of hair-scale as covariates increases the risk of pediculosis, indicating that these variables partly explain this susceptibility and that pediculosis is independent of gender. A smaller hair diameter may favor insect fixation to the hair in the nymphal phases. These results may explain why girls are a greater risk as they let their hair grow for cultural reasons, i.e., being of female gender is an agglutinating variable. The conclusions drawn may explain the discrepancies obtained in previous analyses.
Subject(s)
Lice Infestations , Pediculus , Animals , Humans , Female , Child , Lice Infestations/epidemiology , Lice Infestations/parasitology , Cross-Sectional Studies , Risk Factors , Hair , PrevalenceABSTRACT
ABSTRACT Trypanosomatids are an important group of parasites that predominate in tropical and subtropical areas of the planet, which cause diseases that are classified as forgotten and neglected by the world health organization. In this group of parasites, we find Trypanosoma cruzi, Trypanosoma brucei, Trypanosoma brucei rhodesiense and Leishmania spp, for which there is no vaccine available, and its control has focused mainly on pharmacological treatment. Due to the poverty situation where these diseases are found and the biological complexity of these parasites, there are multiple variables to control, including the diversity of species, the complexity of their life cycles, drug resistance, cytotoxicity, the limited use in pregnant women, the high costs of treatment and the little-known pharmacological mechanisms of action, among others. It is therefore necessary to find new strategies and approaches for the treatment of these parasitic diseases. Among these new approaches is the rational search for new targets based on the allosteric inhibition of protein kinases, which have been little studied in trypanosomatids. Among these kinases, we find Glycogen Synthase Kinase-3 (GSK-3), a kinase of great pharmacological interest, which is under intense basic and clinical research by pharmaceutical companies for the treatment of cancer. This kinase, highly studied in the PI3K/AKT/mTOR pathway signaling in humans, has an orthologous gene in these parasites (GSK-3 s), which has proven to be essential for them in response to different challenges; Therefore, it is notable to increase research in this kinase in order to achieve a broad structural and functional characterization in the different species of trypanosomatids.
ABSTRACT
BACKGROUND: Targeted next-generation sequencing (NGS) is recommended to screen actionable genomic alterations (GAs) in patients with non-small-cell lung cancer (NSCLC). We determined the feasibility to detect actionable GAs using TruSight™ Oncology 500 (TSO500) in 200 consecutive patients with NSCLC. MATERIALS AND METHODS: DNA and RNA were sequenced on an Illumina® NextSeq 550 instrument and processed using the TSO500 Docker pipeline. Clinical actionability was defined within the molecular tumour board following European Society for Medical Oncology (ESMO) guidelines for oncogene-addicted NSCLC. Overall survival (OS) was estimated as per the presence of druggable GAs and treatment with targeted therapy. RESULTS: Most patients were males (69.5%) and former or current smokers (86.5%). Median age was 64 years. The most common histological type and tumour stage were lung adenocarcinoma (81%) and stage IV (64%), respectively. Sequencing was feasible in most patients (93.5%) and actionable GAs were found in 26.5% of patients. A high concordance was observed between single-gene testing and TSO500 NGS panel. Patients harbouring druggable GAs and receiving targeted therapy achieved longer OS compared to patients without druggable GAs. Conversely, patients with druggable GAs not receiving targeted therapy had a trend toward shorter OS compared with driver-negative patients. CONCLUSIONS: Hybrid capture sequencing using TSO500 panel is feasible to analyse clinical samples from patients with NSCLC and is an efficient tool for screening actionable GAs.
Subject(s)
Adenocarcinoma of Lung , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Male , Humans , Middle Aged , Female , Carcinoma, Non-Small-Cell Lung/diagnosis , Lung Neoplasms/drug therapy , Feasibility Studies , GenomicsABSTRACT
Scaphanocephalus is a small trematode genus belonging to the family Opistorchiidae. The genus currently contains only three species associated with marine fish as intermediate hosts and fish-eating birds as definitive hosts. Here, specimens of Scaphanocephalus were collected from the Osprey, Pandion haliaetus, and the White mullet, Mugil curema in the Yucatán Peninsula, Mexico. We report for the first-time DNA sequences of adult specimens of Scaphanocephalus, particularly S. expansus, as well as a sequence of a different species sampled as metacercaria. Morphological comparisons of Scaphanocephalus expansus confirmed the identity of the adult specimens, with minor morphological variations; Scanning electron photomicrographs were included, and the species was re-described. Phylogenetic analysis based on 28S rDNA sequences showed that Scaphanocephalus is monophyletic within Opisthorchiidae and consists of three independent lineages. Sequences of adults are identical to those of S. expansus. Instead, the sequence of the metacercaria sampled from the mesentery of Mugil curema nested with specimens reported as Scaphanocephalus sp. from a labrid fish in the Mediterranean Sea, herein named it as Scaphanocephalus sp. 2.
Subject(s)
Falconiformes , Fish Diseases , Heterophyidae , Smegmamorpha , Trematoda , Trematode Infections , Animals , Mexico , Phylogeny , DNA, Helminth/genetics , Heterophyidae/genetics , Fishes , Metacercariae , Trematode Infections/veterinaryABSTRACT
Objetivo: Describir y analizar la mortalidad de los pacientes que ingresan en nuestra UCRI, tanto durante el ingreso en dicha UCRI, como a lo largo de toda la estancia hospitalaria, y a los 3 y 6 meses del alta hospitalaria. Metodología: Estudio prospectivo de 380 pacientes, no Covid, ingresados en nuestra UCRI, destinada al tratamiento del fallo respiratorio agudo con VMNI, a lo largo de año y medio de actividad. Se recogieron datos demográficos, índice de Charlson modificado (m), tipo de fallo respiratorio, servicio de pertenencia, días de estancia en UCRI y la mortalidad tanto en UCRI como hospitalaria, y a los 3 y 6 meses del alta del hospital. Resultados: El 55% eran varones con una edad media de 71 años y un índice de Charlson (m) de 6,4. La mortalidad en UCRI fue del 16.4% y la intrahospitalaria del 27%, relacionándose ambas con la edad, el índice de Chalson (m), el servicio de pertenencia y el fallo respiratorio hipoxémico. Tras el alta hospitalaria, la supervivencia a los tres meses fue del 83,6% y a los 6 meses del 75,5% relacionándose ambas con la edad y el índice de Charlson (m). Conclusiones: Las UCRIs son útiles en el tratamiento del fallo respiratorio agudo en pacientes con alta carga de comorbilidad, permitiendo a tales pacientes tener una elevada supervivencia a medio plazo tras el alta hospitalaria. (AU)
Objective: describe and analyze the mortality of patients admitted to our IRCU, both during admission to said IRCU, and throughout the entire hospital stay, and 3 and 6 months after hospital discharge. Methodology: prospective study of 380 non-Covid patients admitted to our IRCU, intended for the treatment of acute respiratory failure with NIV, over a year and a half of activity. Demographic data, modified Charlson index (m), type of respiratory failure, service affiliation, days of stay in the IRCU, and mortality both in the IRCU and in hospital, and at 3 and 6 months after hospital discharge were collected. Results: 55% were men with a mean age of 71 years and a Charlson index (m) of 6.4. Mortality in the IRCU was 16.4% and in-hospital mortality was 27%, both being related to age, the Chalson index (m), the service to which they belong, and hypoxemic respiratory failure. After hospital discharge, survival at three months was 83.6% and at 6 months was 75.5%, both related to age and the Charlson index (m). Conclusions: IRCU are useful in the treatment of acute respiratory failure in patients with a high burden of comorbidity, allowing such patients to have a high medium-term survival after hospital discharge. (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Respiratory Care Units , Noninvasive Ventilation , Mortality , Prospective Studies , Respiratory Insufficiency , Respiration, ArtificialABSTRACT
Objetivo Identificar el estado de sedentarismo durante el embarazo y los factores asociados a este comportamiento, los posibles factores, su situación de salud y del recién nacido. Material y métodos Este estudio observacional transversal de 2 fases se desarrolló en el Hospital Universitario y Politécnico de La Fe, y participaron 228 mujeres embarazadas. Las características sociodemográficas maternas se obtuvieron mediante cuestionario estructurado e información de salud de la historia clínica electrónica, así como los resultados perinatales del recién nacido. Para evaluar el sedentarismo se valoró el ejercicio en el tiempo libre y el ejercicio en horario laboral, categorizándolos en función de la intensidad (sedentarismo, actividad leve, actividad moderada e intenso). Resultados En total, la prevalencia de sedentarismo fue del 31,14%. El perfil de este grupo tiene menor nivel educativo y desempleo (p<0,05), presentando una mayor prevalencia de problemas durante el parto, que requirió cesárea, así como problemas posparto en el recién nacido (p<0,05). Conclusiones La inactividad física es altamente prevalente entre las mujeres embarazadas. Debido a los beneficios (o no daños) atribuidos al ejercicio durante el embarazo. Se deben realizar mayores esfuerzos para superar las barreras para promover actividades entre las mujeres embarazadas que son más jóvenes, menos educadas y desempleadas, y aquellas con varios hijos y menores ingresos tienen menos probabilidades de participar en una cantidad adecuada de actividad física, conscientes de la importancia de hacerlo, resolviendo dudas y disipando temores que puedan surgir por una mala comprensión del mecanismo de su beneficio (AU)
Objective Identify the state of sedentary lifestyle during pregnancy and the factors associated with this behavior, the possible factors of your health situation and that of the newborn. Material and methods This two-phase, cross-sectional observational study was developed at the La Fe University and Polytechnic Hospital and 228 pregnant women participated. Maternal sociodemographic characteristics were obtained using structured questionnaire and health information from the electronic medical records, as well as perinatal results of the newborn. To assess sedentary lifestyle, exercise in free time and exercise during working hours were assessed, categorizing them based on intensity (sedentary lifestyle, light activity, moderate and intense activity). Results In total, the prevalence of physical inactivity was 31.14%. The profile of this group has a lower level of education and unemployment (P<.05), presenting a higher prevalence of problems during childbirth, which required a caesarean section, as well as problems after birth in the newborn (P<.05). Conclusions Physical inactivity is highly prevalent among pregnant women. Due to the benefits (or non-harm) attributed to exercise during pregnancy. Further efforts should be taken to overcome the barriers to promote activities among pregnant women who are younger, less well educated, and unemployed and those with multiple children and a lower income are less likely to engage in an adequate amount of physical activity, aware of the importance of doing it, resolving doubts and allaying fears that may arise from a poor understanding of the mechanism of its benefit (AU)
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Pregnancy Complications , Sedentary Behavior , Maternal and Child Health , Socioeconomic Factors , Cross-Sectional Studies , PrevalenceABSTRACT
Objective The objective was to evaluate the consumption of fish in pregnant women and its association with maternal and infant outcomes. Material and methods In this observational study carried out at the La Fe University and Polytechnic Hospital in Valencia, 300 pregnant women participated. The participants were divided into 2 groups according to their fish consumption during pregnancy for comparison. The χ2 test or ANOVA test were applied for comparisons for qualitative and quantitative variables respectively. Results It was observed that 49% of women consumed adequate amounts of fish during pregnancy (2 or 3 weekly servings). Significant differences were observed for iron supplementation (higher in women with inadequate fish consumption), threatened pregnancy loss (higher in women with inadequate fish consumption), infant size (better in women with adequate fish consumption), and arterial O2 pressure (better in women with adequate fish consumption). In regard to the other components of the dietary pattern, no differences were observed but the adequacy of intake for grains and white meat was very poor (less than 5.0%). Conclusions Half of the women met the recommendations for fish intake during pregnancy and presented an overall healthier eating pattern but without statistical significance (AU)
Objetivo Evaluar el consumo de pescado en mujeres embarazadas y su asociación con la salud materno-infantil. Material y métodos En este estudio observacional llevado a cabo en el Hospital Universitario y Politécnico La Fe de Valencia participaron 300 mujeres embarazadas. Las participantes se dividieron en dos grupos según su consumo de pescado durante el embarazo para comparar. Para las comparaciones de variables cualitativas y cuantitativas se aplicaron la prueba de χ2 o la ANOVA, respectivamente. Resultados Se observó que el 49% de las mujeres consumieron cantidades adecuadas de pescado durante el embarazo (2 o 3 raciones semanales). Se observaron diferencias significativas para la suplementación con hierro (mayor en mujeres con consumo inadecuado de pescado), amenaza de pérdida del embarazo (mayor en mujeres con consumo inadecuado de pescado), tamaño del bebé (mejor en mujeres con consumo adecuado de pescado) y presión arterial de O2 (mejor en mujeres con consumo adecuado de pescado). En cuanto a los demás componentes del patrón dietético, no se observaron diferencias, pero la adecuación del consumo de cereales y de carnes blancas fue muy pobre (menos del 5,0%). Conclusiones La mitad de las mujeres cumplían con las recomendaciones de consumo de pescado durante el embarazo y presentaban un patrón alimentario globalmente más saludable, pero sin significación estadística (AU)
Subject(s)
Humans , Female , Pregnancy , Adult , Feeding Behavior , Fish Products , Maternal and Child Health , Retrospective Studies , Socioeconomic FactorsABSTRACT
OBJECTIVE: Identify the state of sedentary lifestyle during pregnancy and the factors associated with this behavior, the possible factors of your health situation and that of the newborn. MATERIAL AND METHODS: This two-phase, cross-sectional observational study was developed at the La Fe University and Polytechnic Hospital and 228 pregnant women participated. Maternal sociodemographic characteristics were obtained using structured questionnaire and health information from the electronic medical records, as well as perinatal results of the newborn. To assess sedentary lifestyle, exercise in free time and exercise during working hours were assessed, categorizing them based on intensity (sedentary lifestyle, light activity, moderate and intense activity). RESULTS: In total, the prevalence of physical inactivity was 31.14%. The profile of this group has a lower level of education and unemployment (P<.05), presenting a higher prevalence of problems during childbirth, which required a caesarean section, as well as problems after birth in the newborn (P<.05). CONCLUSIONS: Physical inactivity is highly prevalent among pregnant women. Due to the benefits (or non-harm) attributed to exercise during pregnancy. Further efforts should be taken to overcome the barriers to promote activities among pregnant women who are younger, less well educated, and unemployed and those with multiple children and a lower income are less likely to engage in an adequate amount of physical activity, aware of the importance of doing it, resolving doubts and allaying fears that may arise from a poor understanding of the mechanism of its benefit.
ABSTRACT
OBJECTIVE: The objective was to evaluate the consumption of fish in pregnant women and its association with maternal and infant outcomes. MATERIAL AND METHODS: In this observational study carried out at the La Fe University and Polytechnic Hospital in Valencia, 300 pregnant women participated. The participants were divided into 2 groups according to their fish consumption during pregnancy for comparison. The χ2 test or ANOVA test were applied for comparisons for qualitative and quantitative variables respectively. RESULTS: It was observed that 49% of women consumed adequate amounts of fish during pregnancy (2 or 3 weekly servings). Significant differences were observed for iron supplementation (higher in women with inadequate fish consumption), threatened pregnancy loss (higher in women with inadequate fish consumption), infant size (better in women with adequate fish consumption), and arterial O2 pressure (better in women with adequate fish consumption). In regard to the other components of the dietary pattern, no differences were observed but the adequacy of intake for grains and white meat was very poor (less than 5.0%). CONCLUSIONS: Half of the women met the recommendations for fish intake during pregnancy and presented an overall healthier eating pattern but without statistical significance.
Subject(s)
Diet , Pregnant Women , Female , Humans , Pregnancy , Health StatusABSTRACT
BACKGROUND: The addition of junctions in modular stems implies a greater susceptibility to corrosion. PURPOSE: The aim of this study is to compare serum chromium and cobalt levels after using a bimodular stem and its monoblock counterpart in primary total hip arthroplasty. Postoperative clinical scores were also compared. PATIENTS AND METHODS: A prospective cohort study between 2012 and 2015 was designed. One arm of the cohort included patients with the cementless modular neck stem H-Max M® and the other with the cementless monoblock stem counterpart H-Max S®. RESULTS: No statistically significant difference was found in chromium value between groups (p = 0.621) at two years postoperative. Cobalt value was higher in the modular group (p = < 0.001). No statistically significant difference was found in clinical postoperative scores except for the Harris Hip Score, with better results at six months in modular group (p = 0.007). CONCLUSIONS: Higher serum cobalt level in the modular group has limited the use of modular stems in our daily practice. Advantages of modular stem were not found. LEVEL OF EVIDENCE: II.
Subject(s)
Arthroplasty, Replacement, Hip , Hip Prosthesis , Humans , Arthroplasty, Replacement, Hip/methods , Hip Prosthesis/adverse effects , Chromium , Cobalt , Prospective Studies , Prosthesis Failure , Prosthesis DesignABSTRACT
Members of the genus Strigea Abildgaard, 1790 are endoparasites of birds distributed worldwide. Adults of an undescribed species of the genus Strigea were collected from the intestines of two hawk species (Rupornis magnirostris and Accipiter coperii). Other species identified as Parastrigea macrobursa that were described in Argentina were also recovered from two hawk species (Buteogallus urubitinga and Buteogallus anthracinus) in three localities along the coasts of Mexico. Specimens of the two species were sequenced for three molecular markers, the internal transcribed spacers locus (ITS1-5.8S rDNA- ITS2) and the domains D1-D3 from the large subunit from nuclear ribosomal DNA and the cytochrome c oxidase subunit 1 from mitochondrial DNA. The newly sequenced specimens were aligned with other strigeids sequences downloaded from GenBank. Maximum likelihood and Bayesian analyses inferred with each molecular marker revealed that our specimens of Strigea sp. formed an independent lineage, which is recognized herein as a new species, Strigea magnirostris n. sp., representing the first species in Mexico and the 16th in the Neotropical region. Morphologically, the new species is distinguished from other congeneric species from the Americas by having an oral sucker with several papillae around it, well-developed pseudosuckers (118-248 µm), a tegument covered with tiny spines, a larger cone genital (193-361 × 296-637) and a larger copulatory bursa (247-531 × 468-784). Our phylogenetic analyses revealed that P. macrobursa is not closely related to other members of the genus Parastrigea and is nested within Strigea, suggesting that P. macrobursa should be transferred to Strigea to form Strigea macrobursa n. comb., expanding its distribution range from Mexico to Argentina. Finally, the analyses also revealed that the taxonomy and systematics of Strigea should be re-evaluated, combining morphological and molecular characteristics.