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1.
J Environ Manage ; 351: 119769, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38147766

RESUMEN

Bridging the gap between the micro and the macro scale in modelling food security to inform context-specific regionalised policies remains a major scientific challenge. A better understanding of the relations between global and local drivers impacting local food self-sufficiency (LFSS) is essential. We applied to the whole Mediterranean environmental area (Southern and Northern) a modelling framework for structural estimates (PLS-PM) using qualitative and quantitative methods to combine local-level information from field surveys and participatory workshops with global-level data. Our findings show that farmland expansion and intensification spatially disconnected from urban consumption areas do not appear to foster LFSS. On the other hand, public policies appear key to enhancing LFSS in the Mediterranean area if appropriate to the particular regional context. We outline how this multi-level modelling methodology can contribute to a place-based approach by informing context-specific regionalised policies aimed at food security.


Asunto(s)
Agricultura , Política Pública , Granjas , Alimentos , Abastecimiento de Alimentos
2.
Ind Eng Chem Res ; 62(47): 20412-20426, 2023 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-38045734

RESUMEN

A deep eutectic solvent was formed by considering the mixtures of tetrabutylammonium chloride and levulinic acid, and it is studied via a combined theoretical and experimental approach. Physicochemical properties were measured as a function of temperature, providing a macroscopic characterization of the fluid. Quantum chemistry and classical molecular dynamics simulations were carried out for the nanoscopic characterization, providing attention to the nature, extension, and dynamics of the hydrogen bonding network, which is at the root of the properties of the fluid. The reported study allows multiscale characterization of this fluid as an archetypical example of a natural, low-cost, and sustainable fluid.

3.
Aten. prim. (Barc., Ed. impr.) ; 55(5): 102597, May. 2023. tab
Artículo en Español | IBECS | ID: ibc-220350

RESUMEN

Actualmente las infecciones de transmisión sexual (ITS) son un problema de salud pública importante debido a su elevada prevalencia y a que precisan de un diagnóstico y un tratamiento precoces para evitar complicaciones. En los últimos años se está observando un aumento exponencial de los casos de infecciones causadas por Chlamydia trachomatis y gonococo en población menor de 25años. También se ha detectado un aumento de la incidencia de sífilis y de hepatitisC (VHC), sobre todo en hombres que tienen sexo con hombres (HSH). El herpes genital sigue siendo la segunda ITS más frecuente en el mundo, por detrás del condiloma acuminado, y la primera causa de úlcera genital en España en la población sexualmente activa. Durante el año 2020 se observó un descenso de los casos notificados de VIH, pero casi la mitad de estos nuevos casos presentaban un diagnóstico tardío (<350CD4cel/μl). Las guías actuales recomiendan ofrecer anualmente el cribado de ITS a las poblaciones de riesgo y más frecuentemente en función de dicho riesgo. Las ITS pueden presentarse, entre otras, en forma de síndromes, como son el síndrome secretor (uretritis, proctitis, cervicitis) o el síndrome ulcerado (úlceras). Las ITS que pueden cursar con síndrome secretor están causadas principalmente por Neisseria gonorrhoeae y C.trachomatis, que infectan conjuntamente hasta en el 40% de los casos, y que producen uretritis, cervicitis o proctitis según el lugar en que se localizan. El gonococo tiene un periodo de incubación de 2 a 7días y la clamidia de 2 a 6semanas, y se diagnostican a través de PCR y/o cultivo (este último solo válido para gonococo) de las muestras recogidas según prácticas sexuales...(AU)


These days sexually transmitted infections (STIs) are important public health problems not only due to their high prevalence, but also because they require early diagnosis and treatment to avoid complications.In recent years, there has been an exponential increase in cases of infections caused by Chlamydia trachomatis and gonococcus in the population under 25years of age. In addition, an increase in the incidence of syphilis and hepatitisC (HCV) has also been detected, especially in men who have sex with other men (MSM). Genital herpes continues to be the second most frequent STI in the world, behind condyloma acuminata, and the first cause of genital ulcer among Spain in the sexually active population. A decrease in reported HIV cases was observed during 2020, but almost half of these new cases had a late diagnosis (<350CD4cell/μL). Current guidelines recommend offering STI annual screening to populations at risk or more often depending on the risk. STIs can appear in the form of syndromes, such as secretory syndrome (urethritis, proctitis, and cervicitis) or ulcerated syndrome (ulcers). The STIs that can cause secretory syndrome are mainly caused by Neisseria gonorrhoeae and C.trachomatis, which co-infect up to 40% of cases, and also cause urethritis, cervicitis or proctitis depending on where they are located. Gonococcus has an incubation period of 2-7days and Chlamydia 2-6weeks, and they are diagnosed using PCR and/or culture (the last one only valid for gonococcus) of samples collected according to sexual activities...(AU)


Asunto(s)
Humanos , Enfermedades de Transmisión Sexual , Epidemiología , Proctitis , Uretritis , Cervicitis Uterina , Atención Primaria de Salud , Enfermedades Transmisibles
4.
Aten Primaria ; 55(5): 102597, 2023 05.
Artículo en Español | MEDLINE | ID: mdl-36934472

RESUMEN

These days sexually transmitted infections (STIs) are important public health problems not only due to their high prevalence, but also because they require early diagnosis and treatment to avoid complications. In recent years, there has been an exponential increase in cases of infections caused by Chlamydia trachomatis and gonococcus in the population under 25years of age. In addition, an increase in the incidence of syphilis and hepatitisC (HCV) has also been detected, especially in men who have sex with other men (MSM). Genital herpes continues to be the second most frequent STI in the world, behind condyloma acuminata, and the first cause of genital ulcer among Spain in the sexually active population. A decrease in reported HIV cases was observed during 2020, but almost half of these new cases had a late diagnosis (<350CD4cell/µL). Current guidelines recommend offering STI annual screening to populations at risk or more often depending on the risk. STIs can appear in the form of syndromes, such as secretory syndrome (urethritis, proctitis, and cervicitis) or ulcerated syndrome (ulcers). The STIs that can cause secretory syndrome are mainly caused by Neisseria gonorrhoeae and C.trachomatis, which co-infect up to 40% of cases, and also cause urethritis, cervicitis or proctitis depending on where they are located. Gonococcus has an incubation period of 2-7days and Chlamydia 2-6weeks, and they are diagnosed using PCR and/or culture (the last one only valid for gonococcus) of samples collected according to sexual activities. Empirical treatment to cover both germs will be accomplished with ceftriaxone, 1g single intramuscular dose plus doxycycline 100mg every 12h orally for 7days, or azithromycin 1g single dose orally (we will use azithromycin only if we suspect a poor compliance with treatment, difficulty in going to the control or in pregnancy). Likewise, whenever we diagnose an STI firstly, we must offer advice and health education in order to promote the adoption of safe sexual behaviours and the correct use of barrier methods. Secondly, we must also screen for other STIs (HIV, syphilis, hepatitisB, and hepatitisA andC depending on the risk), offer HBV and HAV vaccination if it is appropriate, and finally study and treat all sexual partners from the previous 3months.


Asunto(s)
Infecciones por VIH , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual , Sífilis , Uretritis , Cervicitis Uterina , Masculino , Embarazo , Femenino , Humanos , Azitromicina , Homosexualidad Masculina , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/terapia , Neisseria gonorrhoeae , Infecciones por VIH/prevención & control , Atención Primaria de Salud
5.
Front Psychol ; 13: 906072, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36389475

RESUMEN

From March to September 2020, researchers working at a biomedical scientific campus in Spain faced two lockdowns and various mobility restrictions that affected their social and professional lifestyles. The working group "Women in Science," which acts as an independent observatory of scientific gender inequalities on campus launched an online survey to assess the impact of COVID-19 lockdowns on scientific activity, domestic and caregiving tasks, and psychological status. The survey revealed differences in scientific performance by gender: while male researchers participated in a larger number of scientific activities for career development, female researchers performed more invisible scientific tasks, including peer review or outreach activities. Mental impact was greater in researchers caring for children or dependents, and this was aggravated for women. Results spot a disproportionate impact of COVID-19 lockdowns on female scientific career development, and urges for equity measures to mitigate the consequences of an increase in the gender gap in biomedical sciences for current and future pandemics.

6.
J Chem Phys ; 156(9): 094504, 2022 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-35259877

RESUMEN

Type V natural deep eutectic solvents considering menthol, thymol, and levulinic acids are studied considering a combined experimental and theoretical approach to develop a multiscale characterization of these fluids with particular attention to intermolecular forces (hydrogen bonding) and their relationships with macroscopic behavior. Density, viscosity, refraction index, and thermal conductivity were measured as a function of temperature, providing a thermophysical characterization of the fluids. Quantum chemistry was applied to characterize hydrogen bonding in minimal molecular clusters, allowing us to quantify interaction strength, topology (according to atoms in a molecule theory), and electronic properties. Classical molecular dynamics simulations were also performed, allowing us to characterize bulk liquid phases at the nanoscopic level, analyzing the fluid's structuring, void distribution, and dynamics. The reported results allowed us to infer nano-macro relationships, which are required for the proper design of these green solvents and their application for different technologies.

7.
J Hypertens ; 40(3): 453-461, 2022 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-34654792

RESUMEN

AIMS: The objective of this study was to examine the validity of 1 h automated office blood pressure measurement for the diagnosis of hypertension. METHODS: We included patients requiring a hypertension diagnostic test. Participants underwent ambulatory blood pressure monitoring, 1 h automated office blood pressure measurement, office blood pressure measurement and home blood pressure monitoring. The prevalence of hypertension and subtypes were calculated. Mean values of ambulatory blood pressure monitoring were compared with 1 h automated office blood pressure measurement using the correlation coefficient and Bland-Altman graphs. The Kappa concordance index, sensitivity, specificity and diagnostic accuracy were calculated, and the area under the receiver operating characteristic curve was used to establish the diagnostic threshold of the 1-h measurement. RESULTS: Of 562 participants, 438 (87.6%) completed the four diagnostic methods. The 1-h method had a sensitivity of 76.6 [95% confidence interval (95% CI): 71.1-81.5], a specificity of 64.8% (95% CI: 57-72.1) and the best diagnostic accuracy (72.1%, 95% CI: 67.7-76.3) compared with the office and home measurements. Moderate-high correlations were observed between DBP (r = 0.73) and SBP (r = 0.58) readings. The 1-h method classified more patients as normotensive (24.4%) and fewer patients with white-coat hypertension (13.3%). A diagnostic threshold of at least 133/83 mmHg for the 1-h method could improve diagnostic accuracy by 2.3%. CONCLUSION: One-hour automated blood pressure measurement is a valid, reliable method for the diagnosis of hypertension in undiagnosed patients. The diagnostic accuracy permits detection of white-coat and masked hypertension. To diagnose hypertension, the 1-h method or conventional home blood pressure monitoring should be used rather than office measurements. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03147573.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Hipertensión , Presión Sanguínea , Determinación de la Presión Sanguínea/métodos , Monitoreo Ambulatorio de la Presión Arterial/métodos , Humanos , Reproducibilidad de los Resultados
8.
Phys Chem Chem Phys ; 24(1): 512-531, 2021 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-34904590

RESUMEN

Type V natural deep eutectic solvents based on monoterpenoids (cineole, carvone, menthol, and thymol) are studied using a combined experimental and molecular modeling approach. The reported physicochemical properties showed low viscous fluids whose properties were characterized as a function of temperature. The theoretical study combining quantum chemistry and classical molecular dynamics simulations provided a nanoscopic characterization of the fluids, particularly for the hydrogen bonding network and its relationship with the macroscopic properties. The considered fluids constitute a suitable type of solvents considering their properties, cost, origin, and sustainability in different technological applications and sow the possibility of developing type V NADES from different types of molecules, especially in the terpenoid family of compounds.

9.
Autoimmun Rev ; 20(9): 102887, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34237422

RESUMEN

OBJECTIVE: Cardiovascular (CV) morbidity is a well-established problem in systemic lupus erythematosus (SLE). Antimalarial (AM) therapy has been seen as a potential atheroprotective agent. The aim was to assess the impact of AM therapy on traditional and novel atherosclerosis (AT) biomarkers in patients with SLE. METHODS: A search of MEDLINE, EMbase, and Cochrane library for studies evaluating the impact of AM on AT biomarkers in SLE was conducted. Data extraction included serum, functional and structural traditional and novel biomarkers. A narrative synthesis of the findings and a meta-analysis with random effects was conducted estimating mean differences (MD), OR, HR and 95% CIs. RESULTS: The search strategy produced 148 articles, of which 64 were extracted for analysis. The MD in VLDL-cholesterol (-10.29, 95% CI -15.35, 5.24), triglycerides (-15.68, 95% CI -27.51, -3.86), and diastolic BP (-3.42, 95% CI -5.62, -1.23) differed significantly in patients on AM therapy compared with those without AM therapy. Patients on AM had a lower prevalence and incidence of diabetes mellitus than patients not on AM (HR: 0.39, 95% CI 0.17, 0.88). HCQ use was associated with lower blood pressure (BP) variability. Structural markers like carotid intima-media thickness (IMT), carotid plaque (CP) and coronary artery calcification (CAC) were not influenced by AM. For functional markers like endothelial and arterial stiffness the benefit was unclear. The GRADE approach showed a very low-to-low quality of evidence (QoE) per outcome. CONCLUSIONS: There is some evidence on the associations between AM therapy and some AT markers. However, the data on which this conclusion was based was of low to very low evidence.


Asunto(s)
Antimaláricos , Aterosclerosis , Lupus Eritematoso Sistémico , Antimaláricos/uso terapéutico , Aterosclerosis/diagnóstico , Aterosclerosis/epidemiología , Biomarcadores , Grosor Intima-Media Carotídeo , Humanos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Factores de Riesgo
10.
Elife ; 102021 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-33475496

RESUMEN

After nerve injury, myelin and Remak Schwann cells reprogram to repair cells specialized for regeneration. Normally providing strong regenerative support, these cells fail in aging animals, and during chronic denervation that results from slow axon growth. This impairs axonal regeneration and causes significant clinical problems. In mice, we find that repair cells express reduced c-Jun protein as regenerative support provided by these cells declines during aging and chronic denervation. In both cases, genetically restoring Schwann cell c-Jun levels restores regeneration to control levels. We identify potential gene candidates mediating this effect and implicate Shh in the control of Schwann cell c-Jun levels. This establishes that a common mechanism, reduced c-Jun in Schwann cells, regulates success and failure of nerve repair both during aging and chronic denervation. This provides a molecular framework for addressing important clinical problems, suggesting molecular pathways that can be targeted to promote repair in the PNS.


Asunto(s)
Envejecimiento , Regeneración Nerviosa , Proteínas Proto-Oncogénicas c-jun/genética , Células de Schwann/metabolismo , Animales , Femenino , Masculino , Ratones , Proteínas Proto-Oncogénicas c-jun/metabolismo
11.
Mar Pollut Bull ; 161(Pt A): 111722, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33039790

RESUMEN

During the southern summer of 2020, large phytoplankton blooms were detected using satellite technology in Chile (western Patagonia), where intensive salmonid aquaculture is carried out. Some harvesting sites recorded massive fish mortalities, which were associated with the presence of the dinoflagellate species Cochlodinium sp. The bloom included other phytoplankton species, as Lepidodinium chlorophorum, which persistently changed the colour of the ocean to green. These blooms coincided with the government-managed emergency lockdown due to the COVID-19 pandemic. Local in situ sampling was slowed down. However, imagery from the Copernicus programme allowed operational monitoring. This study shows the benefits of both Sentinel-3 and Sentinel-2 satellites in terms of their spectral, spatial and temporal capabilities for improved algal bloom monitoring. These novel tools, which can foster optimal decision-making, are available for delivering early alerts in situations of natural catastrophes and blockages, such as those occurred during the global COVID-19 lockdown.


Asunto(s)
COVID-19 , Dinoflagelados , Animales , Chile , Floraciones de Algas Nocivas , Humanos , Pandemias , Fitoplancton , SARS-CoV-2
12.
Trends Pharmacol Sci ; 41(9): 598-610, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32711925

RESUMEN

Acute respiratory distress syndrome (ARDS) caused by SARS-CoV-2 is largely the result of a dysregulated host response, followed by damage to alveolar cells and lung fibrosis. Exacerbated proinflammatory cytokines release (cytokine storm) and loss of T lymphocytes (leukopenia) characterize the most aggressive presentation. We propose that a multifaceted anti-inflammatory strategy based on pharmacological activation of nuclear factor erythroid 2 p45-related factor 2 (NRF2) can be deployed against the virus. The strategy provides robust cytoprotection by restoring redox and protein homeostasis, promoting resolution of inflammation, and facilitating repair. NRF2 activators such as sulforaphane and bardoxolone methyl are already in clinical trials. The safety and efficacy information of these modulators in humans, together with their well-documented cytoprotective and anti-inflammatory effects in preclinical models, highlight the potential of this armamentarium for deployment to the battlefield against COVID-19.


Asunto(s)
Antiinflamatorios/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Factor 2 Relacionado con NF-E2/metabolismo , Neumonía Viral/tratamiento farmacológico , COVID-19 , Citoprotección , Granulocitos/efectos de los fármacos , Granulocitos/virología , Homeostasis , Humanos , Oxidación-Reducción , Pandemias
13.
MethodsX ; 7: 100819, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32195137

RESUMEN

We present two new methods for simultaneous smoothing and sharpening of color images: the GMS3 (Graph Method for Simultaneous Smoothing and Sharpening) and the NGMS3(Normalized Graph-Method for Simultaneous Smoothing and Sharpening). They are based on analyzing the structure of local graphs computed at every pixel using their respective neighbors. On the one hand, we define a kernel-based filter for smoothing each pixel with the pixels associated to nodes in its same connected component. On the other hand, we modify each pixel by increasing their differences with respect to the pixels in the other connected components of those local graphs. Our approach is shown to be competitive with respect to other state-of-the-art methods that simultaneously manage both processes.•We provide two methods that carry out the process of smoothing and sharpening simultaneously.•The methods are based on the analysis of the structure of a local graph defined from the differences in the RGB space among the pixels in a 3 × 3 window.•The parameters of the method are adjusted using both observers opinion and the well-known reference image quality assessment BRISQUE (Blind/Referenceless images spatial quality Evaluator) score.

14.
Rev Esp Salud Publica ; 932019 Dec 11.
Artículo en Español | MEDLINE | ID: mdl-31823963

RESUMEN

OBJECTIVE: Epidemiological surveillance of HIV infection allows monitoring its incidence as well as possible epidemiological changes, allowing specific interventions to be planned and their impact monitored. The objective of this article is to describe the results of the monitoring and evaluation of the response to the HIV epidemic in Catalonia, based on data included in the Integrated System of Epidemiological Surveillance of AIDS/HIV and Sexually Transmitted Infections of Catalonia (SIVES). METHODS: A descriptive analysis of the data from the different sources of information of the SIVES was performed. The time period was defined based on the availability of data from each of the sources of information included in the analysis. The information was structured according to the conceptual representation of the cascade of HIV care, as described in the World Health Organization consolidated strategic information guidelines for HIV. RESULTS: Of the total of 4,849 new diagnoses notified (2012-2018), 86% were men, of these; the most frequently reported transmission group was men having sex with men with 65%. The trend in the number of new diagnoses decreased in all transmission groups. It is estimated that in 2018 there were 32,429 people living with HIV in Catalonia, of which 89% were diagnosed, of these, 83% were under follow-up in a specialized unit and 78% of them were under treatment. 73% of people in treatment had suppressed the viral load. CONCLUSIONS: SIVES as an integrated system of different sources of strategic information allows monitoring the HIV epidemic in Catalonia and evaluating the response to it, identifying key populations and determinants to acquire HIV, as well as the barriers to which people living with HIV they face to achieve viral suppression.


OBJETIVO: La vigilancia epidemiológica de la infección por el VIH permite monitorizar su incidencia así como eventuales cambios epidemiológicos, permitiendo planificar intervenciones específicas y monitorizar su impacto. El objetivo de este artículo fue describir los resultados de la monitorización y evaluación de la respuesta a la epidemia del VIH en Cataluña, a partir de los datos incluidos en el Sistema Integrado de Vigilancia Epidemiológica del Sida/VIH e Infecciones de transmisión sexual de Cataluña (SIVES). METODOS: Se realizó un análisis descriptivo de los datos de las diferentes fuentes de información del SIVES. El periodo de tiempo se definió a partir de la disponibilidad de los datos de cada una de las fuentes de información incluidas en el análisis. La información se estructuró de acuerdo a la representación conceptual de la cascada de diagnóstico y tratamiento de VIH, tal y como se describe en las directrices de información estratégica consolidada de la Organización Mundial de la Salud para el VIH. RESULTADOS: Del total de 4.849 nuevos diagnósticos notificados (2012-2018), el 86% eran hombres. De estos, el grupo de transmisión informado más frecuente fueron los hombres que tiene sexo con hombres con un 65%. La tendencia del número de nuevos diagnósticos descendió en todos los grupos de transmisión. Se estima que en 2018 había 32.429 personas viviendo con el VIH en Cataluña, de las cuales el 89% estaban diagnosticadas. De estas, el 83% estaban en seguimiento en una unidad especializada, y el 78% de ellas estaban en tratamiento. El 73% de las personas en tratamiento tenían la carga viral suprimida. CONCLUSIONES: El SIVES, como sistema integrado de diferentes fuentes de información estratégica, permite monitorizar la epidemia del VIH en Cataluña y evaluar la respuesta a la misma, identificando poblaciones claves y determinantes para adquirir el VIH, así como las barreras a las que se enfrentan las personas que viven con VIH para lograr a supresión viral.


Asunto(s)
Infecciones por VIH/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Continuidad de la Atención al Paciente , Diagnóstico Precoz , Epidemias , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/terapia , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Vigilancia en Salud Pública , España/epidemiología , Adulto Joven
15.
Autoimmun Rev ; 18(10): 102371, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31415907

RESUMEN

Systemic lupus erythematosus (SLE) is associated with a high burden of cardiovascular disease (CVD), which is in part imputed to classical vascular risk factors such as hypertension. Hypertension is frequent among patients with SLE and studies show it is more prevalent in SLE patients than in people without SLE. Despite the high frequency of hypertension in SLE patients, the pathophysiological mechanisms underlying the development of hypertension remain poorly understood. 24-h ambulatory blood pressure monitoring has emerged as a valuable tool in determining blood pressure (BP) in SLE patients in whom hypertension has been associated with damage accrual, stroke and cognitive dysfunction. Although prevalent, current guidelines neglect the specific management of hypertension in SLE patients in their recommendations. This review discusses the mechanisms that may lead to hypertension and the literature evaluating hypertension screening and management in SLE patients.


Asunto(s)
Hipertensión/complicaciones , Lupus Eritematoso Sistémico/etiología , Lupus Eritematoso Sistémico/patología , Humanos , Pronóstico , Factores de Riesgo
16.
BMJ Open ; 9(5): e029268, 2019 05 27.
Artículo en Inglés | MEDLINE | ID: mdl-31133597

RESUMEN

INTRODUCTION: 24-hour ambulatory blood pressure monitoring (ABPM) is the gold standard diagnostic method for hypertension, but has some shortcomings in clinical practice while clinical settings often lack sufficient devices to accommodate all patients with suspected hypertension. Home blood pressure monitoring (HBPM) and office blood pressure monitoring (OBPM) also have shortcomings, such as the white coat effect or a lack of accuracy. This study aims to study the validity of a new method of diagnosing hypertension consisting of monitoring blood pressure (BP) for 1 hour and comparing it with OBPM and HBPM and examining the sensitivity and specificity of this method compared with 24-hour ABPM. The patient experience will be examined in each method. METHODS AND ANALYSIS: A minimum sample of 214 patients requiring a diagnostic test for hypertension from three urban primary healthcare centres will be included. Participants will undergo 24-hour ABPM, 1-hour BP measurement (1-BPM), OBPM for three consecutive weeks and HBPM. Patients will follow a random sequence to first receive 24-hour ABPM or 1-hour ABPM. Daytime 24-hour ABPM records will be compared with the other monitoring methods using the correlation coefficient and Bland Altman plots. The kappa concordance index and the sensitivity and specificity of the methods will be calculated. The patient's experience will be studied, with selected indicators of efficiency and satisfaction calculated using parametric tests. ETHICS AND DISSEMINATION: The protocol has been authorised by the research ethics committee of the Hospital Clinic of Barcelona (Ref. HCB/2014/0615): protocol details and amendments will be recorded and reported to ClinicalTrials.com. The results will be disseminated in peer-reviewed literature, and to policy makers and healthcare partners. TRIAL REGISTRATION: NCT03147573; Pre-results.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial/métodos , Hipertensión/diagnóstico , Proyectos de Investigación , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
17.
Fam Pract ; 36(6): 693-698, 2019 11 18.
Artículo en Inglés | MEDLINE | ID: mdl-31044230

RESUMEN

BACKGROUND: Although both hospitalization and mortality due to heart failure (HF) have been widely studied, less is known about the impact of HF on disability and quality of life. AIM: To assess the degree of disability and quality of life in HF patients attended at family medicine centres. DESIGN AND SETTING: Cross-sectional study of a cohort of HF patients attended at family medicine centres. METHODS: Disability was assessed with the WHODAS 2 questionnaire, which provides a global and six domain scores that is understanding and communication, getting around, self-care, getting along with people, life activities and participation in society. Quality of life was assessed with the Minnesota Living with Heart Failure Questionnaire, which furnishes a global and two domain scores, physical and emotional. RESULTS: A breakdown of the results showed that 28% of patients had moderate disability and 16.7% had severe disability, with the most important areas affected being: life activities, 8.9% extreme disability and 30.3% severe disability; getting around, 34.6% severe disability and 2% extreme disability; and participation in society, 53.3% moderate-severe disability. Quality of life was mildly affected. New York Heart Association (NYHA) Functional Classification and sex were the major determinants of disability and quality of life. Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists were associated with better scores in the "getting around" and "life activity" domains. CONCLUSION: HF patients in primary care show an important degree of disability and an acceptable quality of life.


Asunto(s)
Evaluación de la Discapacidad , Personas con Discapacidad/estadística & datos numéricos , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/fisiopatología , Calidad de Vida , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Antagonistas de Receptores de Angiotensina/uso terapéutico , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Estudios Transversales , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Atención Primaria de Salud , Autocuidado/estadística & datos numéricos , España , Encuestas y Cuestionarios
18.
Rev. esp. salud pública ; 93: 0-0, 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-189462

RESUMEN

OBJETIVO: La vigilancia epidemiológica de la infección por el VIH permite monitorizar su incidencia así como eventuales cambios epidemiológicos, permitiendo planificar intervenciones específicas y monitorizar su impacto. El objetivo de este artículo fue describir los resultados de la monitorización y evaluación de la respuesta a la epidemia del VIH en Cataluña, a partir de los datos incluidos en el Sistema Integrado de Vigilancia Epidemiológica del Sida/VIH e Infecciones de transmisión sexual de Cataluña (SIVES). MÉTODOS: Se realizó un análisis descriptivo de los datos de las diferentes fuentes de información del SIVES. El periodo de tiempo se definió a partir de la disponibilidad de los datos de cada una de las fuentes de información incluidas en el análisis. La información se estructuró de acuerdo a la representación conceptual de la cascada de diagnóstico y tratamiento de VIH, tal y como se describe en las directrices de información estratégica consolidada de la Organización Mundial de la Salud para el VIH. RESULTADOS: Del total de 4.849 nuevos diagnósticos notificados (2012-2018), el 86% eran hombres. De estos, el grupo de transmisión informado más frecuente fueron los hombres que tiene sexo con hombres con un 65%. La tendencia del número de nuevos diagnósticos descendió en todos los grupos de transmisión. Se estima que en 2018 había 32.429 personas viviendo con el VIH en Cataluña, de las cuales el 89% estaban diagnosticadas. De estas, el 83% estaban en seguimiento en una unidad especializada, y el 78% de ellas estaban en tratamiento. El 73% de las personas en tratamiento tenían la carga viral suprimida. CONCLUSIONES: El SIVES, como sistema integrado de diferentes fuentes de información estratégica, permite monitorizar la epidemia del VIH en Cataluña y evaluar la respuesta a la misma, identificando poblaciones claves y determinantes para adquirir el VIH, así como las barreras a las que se enfrentan las personas que viven con VIH para lograr a supresión viral


BACKGROUND: Epidemiological surveillance of HIV infection allows monitoring its incidence as well as possible epidemiological changes, allowing specific interventions to be planned and their impact monitored. The objective of this article is to describe the results of the monitoring and evaluation of the response to the HIV epidemic in Catalonia, based on data included in the Integrated System of Epidemiological Surveillance of AIDS/HIV and Sexually Transmitted Infections of Catalonia (SIVES). METHODS: A descriptive analysis of the data from the different sources of information of the SIVES was performed. The time period was defined based on the availability of data from each of the sources of information included in the analysis. The information was structured according to the conceptual representation of the cascade of HIV care, as described in the World Health Organization consolidated strategic information guidelines for HIV. RESULTS: Of the total of 4,849 new diagnoses notified (2012-2018), 86% were men, of these; the most frequently reported transmission group was men having sex with men with 65%. The trend in the number of new diagnoses decreased in all transmission groups. It is estimated that in 2018 there were 32,429 people living with HIV in Catalonia, of which 89% were diagnosed, of these, 83% were under follow-up in a specialized unit and 78% of them were under treatment. 73% of people in treatment had suppressed the viral load. CONCLUSIONS: SIVES as an integrated system of different sources of strategic information allows monitoring the HIV epidemic in Catalonia and evaluating the response to it, identifying key populations and determinants to acquire HIV, as well as the barriers to which people living with HIV they face to achieve viral suppression


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Infecciones por VIH/epidemiología , Continuidad de la Atención al Paciente , Diagnóstico Precoz , Epidemias , Infecciones por VIH/diagnóstico , Infecciones por VIH/terapia , Incidencia , Vigilancia en Salud Pública , España/epidemiología
19.
Genesis ; 56(6-7): e23215, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-30134068

RESUMEN

The neural crest-derived ensheathing glial cells of the olfactory nerve (OECs) are unique in spanning both the peripheral and central nervous systems: they ensheathe bundles of axons projecting from olfactory receptor neurons in the nasal epithelium to their targets in the olfactory bulb. OECs are clinically relevant as a promising autologous cell transplantation therapy for promoting central nervous system repair. They are also important for fertility, being required for the migration of embryonic gonadotropin-releasing hormone (GnRH) neurons from the olfactory placode along terminal nerve axons to the medial forebrain, which they enter caudal to the olfactory bulbs. Like Schwann cell precursors, OEC precursors associated with the developing olfactory nerve express the glial marker myelin protein zero and the key peripheral glial transcription factor Sox10. The transition from Schwann cell precursors to immature Schwann cells is accelerated by canonical Notch signaling via the Rbpj transcription factor. Here, we aimed to test the role of Notch/Rbpj signaling in developing OECs by blocking the pathway in both chicken and mouse. Our results suggest that Notch/Rbpj signaling prevents the cranial neural crest cells that colonize the olfactory nerve from differentiating as neurons, and at later stages contributes to the guidance of GnRH neurons.


Asunto(s)
Proteína de Unión a la Señal Recombinante J de las Inmunoglobulinas/fisiología , Cresta Neural/metabolismo , Receptores Notch/fisiología , Animales , Diferenciación Celular/fisiología , Movimiento Celular/fisiología , Embrión de Pollo , Hormona Liberadora de Gonadotropina , Ratones , Cresta Neural/embriología , Neurogénesis/fisiología , Neuroglía/fisiología , Neuronas/metabolismo , Bulbo Olfatorio/fisiología , Transducción de Señal/fisiología
20.
J Neurosci ; 37(37): 9086-9099, 2017 09 13.
Artículo en Inglés | MEDLINE | ID: mdl-28904214

RESUMEN

There is consensus that, distal to peripheral nerve injury, myelin and Remak cells reorganize to form cellular columns, Bungner's bands, which are indispensable for regeneration. However, knowledge of the structure of these regeneration tracks has not advanced for decades and the structure of the cells that form them, denervated or repair Schwann cells, remains obscure. Furthermore, the origin of these cells from myelin and Remak cells and their ability to give rise to myelin cells after regeneration has not been demonstrated directly, although these conversions are believed to be central to nerve repair. Using genetic lineage-tracing and scanning-block face electron microscopy, we show that injury of sciatic nerves from mice of either sex triggers extensive and unexpected Schwann cell elongation and branching to form long, parallel processes. Repair cells are 2- to 3-fold longer than myelin and Remak cells and 7- to 10-fold longer than immature Schwann cells. Remarkably, when repair cells transit back to myelinating cells, they shorten ∼7-fold to generate the typically short internodes of regenerated nerves. The present experiments define novel morphological transitions in injured nerves and show that repair Schwann cells have a cell-type-specific structure that differentiates them from other cells in the Schwann cell lineage. They also provide the first direct evidence using genetic lineage tracing for two basic assumptions in Schwann cell biology: that myelin and Remak cells generate the elongated cells that build Bungner bands in injured nerves and that such cells can transform to myelin cells after regeneration.SIGNIFICANCE STATEMENT After injury to peripheral nerves, the myelin and Remak Schwann cells distal to the injury site reorganize and modify their properties to form cells that support the survival of injured neurons, promote axon growth, remove myelin-associated growth inhibitors, and guide regenerating axons to their targets. We show that the generation of these repair-supportive Schwann cells involves an extensive cellular elongation and branching, often to form long, parallel processes. This generates a distinctive repair cell morphology that is favorable for the formation of the regeneration tracks that are essential for nerve repair. Remyelination, conversely, involves a striking cell shortening to form the typical short myelin cells of regenerated nerves. We also provide evidence for direct lineage relationships between: (1) repair cells and myelin and Remak cells of uninjured nerves and (2) remyelinating cells in regenerated nerves.


Asunto(s)
Vaina de Mielina/metabolismo , Regeneración Nerviosa/fisiología , Proyección Neuronal , Traumatismos de los Nervios Periféricos/patología , Traumatismos de los Nervios Periféricos/fisiopatología , Células de Schwann/patología , Animales , Femenino , Masculino , Ratones , Ratones Transgénicos
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