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BACKGROUND: Molecular diagnosis in allergology helps to identify multiple allergenic molecules simultaneously. The use of purified and/or recombinant allergens increases the accuracy of individual sensitization profiles in allergic patients. OBJECTIVE: To assess the impact of molecular diagnosis through the ImmunoCAPTM ISAC 112 microarray on etiological diagnosis and specific immunotherapy (SIT) prescription. This was compared to the use of conventional diagnoses in pediatric, adolescent, and young adult patients with rhinitis or rhinoconjunctivitis and/or allergic asthma, sensitized to three or more pollen allergens of different botanical species. METHODS: A multicenter, prospective, observational study was conducted in patients aged 3-25 years who received care at the Allergology service of 14 hospitals in Catalonia from 2017 to 2020. Allergology diagnosis was established based on the patient's clinical assessment and the results of the skin prick test and specific immunoglobulin E assays. Subsequently, molecular diagnosis was conducted using ImmunoCAPTM ISAC® 112 to recombinant and/or purified allergen components. RESULTS: A total of 109 patients were included; 35 (32.1%) were pediatric patients and 74 (67.9%) were adolescents or young adults (mean age: 18 years), with 58.0% being females. A change of 51.0% was observed in SIT prescription following molecular etiological diagnosis by means of a multi-parameter microarray. CONCLUSIONS: Molecular diagnosis by means of multi-parameter tests increases the accuracy of etiological diagnosis and helps to define an accurate composition of SIT.
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Alérgenos , Desensibilización Inmunológica , Polen , Rinitis Alérgica Estacional , Humanos , Femenino , España , Adolescente , Masculino , Niño , Estudios Prospectivos , Polen/inmunología , Adulto Joven , Adulto , Preescolar , Alérgenos/inmunología , Alérgenos/administración & dosificación , Desensibilización Inmunológica/métodos , Rinitis Alérgica Estacional/diagnóstico , Rinitis Alérgica Estacional/inmunología , Rinitis Alérgica Estacional/terapia , Inmunoglobulina E/inmunología , Inmunoglobulina E/sangre , Pruebas Cutáneas , Técnicas de Diagnóstico MolecularRESUMEN
The intracellular developmental processes in plants, particularly concerning lignin polymer formation and biomass production are regulated by microRNAs (miRNAs). MiRNAs including miR397b are important for developing efficient and cost-effective biofuels. However, traditional methods of monitoring miRNA expression, like PCR, are time-consuming, require sample extraction, and lack spatial and temporal resolution, especially in real-world conditions. We present a novel approach using plasmonics nanosensing to monitor miRNA activity within living plant cells without sample extraction. Plasmonic biosensors using surface-enhanced Raman scattering (SERS) detection offer high sensitivity and precise molecular information. We used the Inverse Molecular Sentinel (iMS) biosensor on unique silver-coated gold nanorods (AuNR@Ag) with a high-aspect ratio to penetrate plant cell walls for detecting miR397b within intact living plant cells. MiR397b overexpression has shown promise in reducing lignin content. Thus, monitoring miR397b is essential for cost-effective biofuel generation. This study demonstrates the infiltration of nanorod iMS biosensors and detection of non-native miRNA 397b within plant cells for the first time. The investigation successfully demonstrates the localization of nanorod iMS biosensors through TEM and XRF-based elemental mapping for miRNA detection within plant cells of Nicotiana benthamiana. The study integrates shifted-excitation Raman difference spectroscopy (SERDS) to decrease background interference and enhance target signal extraction. In vivo SERDS testing confirms the dynamic detection of miR397b in Arabidopsis thaliana leaves after infiltration with iMS nanorods and miR397b target. This proof-of-concept study is an important stepping stone towards spatially resolved, intracellular miRNA mapping to monitor biomarkers and biological pathways for developing efficient renewable biofuel sources.
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Técnicas Biosensibles , Oro , MicroARNs , Nanotubos , Espectrometría Raman , Nanotubos/química , Técnicas Biosensibles/métodos , MicroARNs/genética , MicroARNs/análisis , Oro/química , Espectrometría Raman/métodos , Nicotiana/genética , Nicotiana/química , Plata/química , Biomarcadores , Lignina/químicaRESUMEN
The COVID-19 pandemic affected many aspects of everyday life including school, fitness regimens, and social interactions. The purpose of this study is to understand how COVID-19 restrictions affect the cardiovascular and mental health of Doctor of Physical Therapy (DPT) students as they progressed through the program. Data collection occurred in 16 DPT students (8F:8M, 24±3 years) over a total of 3 visits from 2020 to 2022, during high, moderate, and low COVID-19 restrictions. Outcome measures included VO2max, Venous Occlusion Plethysmography (VOP), %fat mass measured via DEXA, Perceived Stress Scale (PSS) and International Physical Activity Questionnaire (IPAQ). A RM-ANOVA with pairwise comparisons was utilized. Significance was set prior at an α level of 0.05. There was a significant increase (p<0.05) from visit 1 to 2 in VO2max, VOP baseline, BMI, and METs. There was a significant decrease (p<0.05) from visit 2 to 3 in VO2max. Finally, a significant increase in visit 3 was seen from visit 2 in VOP peak. Overall, there was no significant difference observed for PSS and %fat mass (p>0.05). Between high and moderate restrictions, there was an increase in VO2max, VOP baseline, and METs. However, between moderate and low restrictions, only VOP Peak increased. This could be attributed to gyms being closed and limiting the type of physical activity a person could do to exercises like running or walking. When restrictions were lifted, traveling to and from classes, traveling to gyms, and socializing all increased, limiting the time for physical activity.
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Water and several chemicals, including dyestuffs, surfactants, acids, and salts, are required during textile dyeing processes. Surfactants are harmful to the aquatic environment and induce several negative biological effects in exposed biota. In this context, the present study aimed to assess acute effects of five surfactants, comprising anionic and nonionic classes, and other auxiliary products used in fiber dyeing processes to aquatic organisms Vibrio fischeri (bacteria) and Daphnia similis (cladocerans). The toxicities of binary surfactant mixtures containing the anionic surfactant dodecylbenzene sulfonate + nonionic fatty alcohol ethoxylate and dodecylbenzene sulfonate + nonionic alkylene oxide were also evaluated. Nonionic surfactants were more toxic than anionic compounds for both organisms. Acute nonionic toxicity ranged from 1.3 mg/L (fatty alcohol ethoxylate surfactant) to 2.6 mg/L (ethoxylate surfactant) for V. fischeri and from 1.9 mg/L (alkylene oxide surfactant) to 12.5 mg/L (alkyl aryl ethoxylated and aromatic sulfonate surfactant) for D. similis, while the anionic dodecylbenzene sulfonate EC50s were determined as 66.2 mg/L and 19.7 mg/L, respectively. Both mixtures were very toxic for the exposed organisms: the EC50 average in the anionic + fatty alcohol ethoxylate mixture was of 1.0 mg/L ± 0.11 for V. fischeri and 4.09 mg/L ± 0.69 for D. similis. While the anionic + alkylene oxide mixture, EC50 of 3.34 mg/L for D. similis and 3.60 mg/L for V. fischeri. These toxicity data suggested that the concentration addition was the best model to explain the action that is more likely to occur for mixture for the dodecylbenzene sulfonate and alkylene oxide mixtures in both organisms. Our findings also suggest that textile wastewater surfactants may interact and produce different responses in aquatic organisms, such as synergism and antagonism. Ecotoxicological assays provide relevant information concerning hazardous pollutants, which may then be adequately treated and suitably managed to reduce toxic loads, associated to suitable management plans.
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Aliivibrio fischeri , Bencenosulfonatos , Daphnia , Tensoactivos , Aguas Residuales , Contaminantes Químicos del Agua , Tensoactivos/toxicidad , Contaminantes Químicos del Agua/toxicidad , Aguas Residuales/química , Aliivibrio fischeri/efectos de los fármacos , Animales , Daphnia/efectos de los fármacos , Ecotoxicología , TextilesRESUMEN
The holobiont concept (i.e., multiple living beings in close symbiosis with one another and functioning as a unit) is revolutionizing our understanding of biology, especially in marine systems. The earliest marine holobiont was likely a syntrophic partnership of at least two prokaryotic members. Since then, symbiosis has enabled marine organisms to conquer all ocean habitats through the formation of holobionts with a wide spectrum of complexities. However, most scientific inquiries have focused on isolated organisms and their adaptations to specific environments. In this review, we attempt to illustrate why a holobiont perspective-specifically, the study of how numerous organisms form a discrete ecological unit through symbiosis-will be a more impactful strategy to advance our understanding of the ecology and evolution of marine life. We argue that this approach is instrumental in addressing the threats to marine biodiversity posed by the current global environmental crisis.
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Biodiversidad , SimbiosisRESUMEN
Ascochyta blight, caused by Ascochyta fabae, poses a significant threat to faba bean and other legumes worldwide. Necrotic lesions on stems, leaves, and pods characterize the disease. Given the economic impact of this pathogen and the potential involvement of secondary metabolites in symptom development, a study was conducted to investigate the fungus's ability to produce bioactive metabolites that might contribute to its pathogenicity. For this investigation, the fungus was cultured in three substrates (Czapek-Dox, PDB, and rice). The produced metabolites were analyzed by NMR and LC-HRMS methods, resulting in the dereplication of seven metabolites, which varied with the cultural substrates. Ascochlorin, ascofuranol, and (R)-mevalonolactone were isolated from the Czapek-Dox extract; ascosalipyrone, benzoic acid, and tyrosol from the PDB extract; and ascosalitoxin and ascosalipyrone from the rice extract. The phytotoxicity of the pure metabolites was assessed at different concentrations on their primary hosts and related legumes. The fungal exudates displayed varying degrees of phytotoxicity, with the Czapek-Dox medium's exudate exhibiting the highest activity across almost all legumes tested. The species belonging to the genus Vicia spp. were the most susceptible, with faba bean being susceptible to all metabolites, at least at the highest concentration tested, as expected. In particular, ascosalitoxin and benzoic acid were the most phytotoxic in the tested condition and, as a consequence, expected to play an important role on necrosis's appearance.
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Fabaceae , Toxinas Biológicas , Vicia faba , Fabaceae/microbiología , Vicia faba/microbiología , Verduras , Productos Agrícolas , Ácido Benzoico , Extractos VegetalesRESUMEN
Liver allografts protect renal allografts from the same donor from some, but not all, preformed donor specific alloantibodies (DSA). However, the precise mechanisms of protection and the potential for more subtle alterations/injuries within the grafts resulting from DSA interactions require further study. Methods: We reevaluated allograft biopsies from simultaneous liver-kidney transplant recipients who had both allografts biopsied within 60 d of one another and within 30 d of DSA being positive in serum (positive: mean florescence intensity ≥5000). Routine histology, C4d staining, and specialized immunohistochemistry for Kupffer cells (KCs; CD163) and a C4d receptor immunoglobulin-like transcript-4 were carried out in 4 patients with 6 paired biopsies. Results: Overt antibody-mediated rejection was found in 3 of 4 renal and liver allografts. One patient had biopsy-confirmed renal and liver allograft antibody-mediated rejection despite serum clearance of DSA. All biopsies showed KC hypertrophy (minimal: 1; mild: 2; moderate: 1; severe: 2) and cytoplasmic C4d KC staining was easily detected in 2 biopsies from 2 patients; minimal and negative in 2 biopsies each. Implications of which are discussed. Control 1-y protocol liver allograft biopsies from DSA- recipients showed neither KC hypertrophy nor KC C4d staining (n = 6). Conclusions: Partial renal allograft protection by a liver allograft from the same donor may be partially mediated by phagocytosis/elimination of antibody and complement split products by KCs, as shown decades ago in controlled sensitized experimental animal experiments.
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Animals with complex nervous systems demand sleep for memory consolidation and synaptic remodeling. Here, we show that, although the Caenorhabditis elegans nervous system has a limited number of neurons, sleep is necessary for both processes. In addition, it is unclear if, in any system, sleep collaborates with experience to alter synapses between specific neurons and whether this ultimately affects behavior. C. elegans neurons have defined connections and well-described contributions to behavior. We show that spaced odor-training and post-training sleep induce long-term memory. Memory consolidation, but not acquisition, requires a pair of interneurons, the AIYs, which play a role in odor-seeking behavior. In worms that consolidate memory, both sleep and odor conditioning are required to diminish inhibitory synaptic connections between the AWC chemosensory neurons and the AIYs. Thus, we demonstrate in a living organism that sleep is required for events immediately after training that drive memory consolidation and alter synaptic structures.
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Caenorhabditis elegans , Odorantes , Animales , Caenorhabditis elegans/fisiología , Olfato , Sueño/fisiología , Sinapsis/fisiologíaRESUMEN
Nanoparticle-based platforms are gaining strong interest in plant biology and bioenergy research to monitor and control biological processes in whole plants. However, in vivo monitoring of biomolecules using nanoparticles inside plant cells remains challenging due to the impenetrability of the plant cell wall to nanoparticles beyond the exclusion limits (5-20 nm). To overcome this physical barrier, we have designed unique bimetallic silver-coated gold nanorods (AuNR@Ag) capable of entering plant cells, while conserving key plasmonic properties in the near-infrared (NIR). To demonstrate cellular internalization and tracking of the nanorods inside plant tissue, we used a comprehensive multimodal imaging approach that included transmission electron microscopy (TEM), confocal fluorescence microscopy, two-photon luminescence (TPL), X-ray fluorescence microscopy (XRF), and photoacoustics imaging (PAI). We successfully acquired SERS signals of nanorods in vivo inside plant cells of tobacco leaves. On the same leaf samples, we applied orthogonal imaging methods, TPL and PAI techniques for in vivo imaging of the nanorods. This study first demonstrates the intracellular internalization of AuNR@Ag inside whole plant systems for in vivo SERS analysis in tobacco cells. This work demonstrates the potential of this nanoplatform as a new nanotool for intracellular in vivo biosensing for plant biology.
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Nanopartículas del Metal , Nanopartículas , Nanotubos , Células Vegetales , Imagen Multimodal , Oro , Espectrometría Raman/métodosRESUMEN
A large body of literature has established the benefits of undergraduate research experiences via the traditional apprenticeship model. More recently, several studies have shown that many of these benefits can be recapitulated in course-based undergraduate research experiences (CUREs) that are more scalable and easier for students to participate in, compared to the apprenticeship-based research experiences. Many Biology curricula also incorporate more traditional laboratory courses, where students learn to use common laboratory techniques through guided exercises with known outcomes. Indeed, many programs across the nation provide such programs or courses for students early in their careers, with a view toward increasing student interest and engagement in Biology. While there is general consensus that all lab experiences have some benefits for students, very few studies have examined whether either research experiences or learning biological techniques in more traditional lab courses directly impacts student performance in lecture courses. Here, we show that prior familiarity with laboratory techniques does not improve student performance in a lecture course, even if these techniques are directly related to content being taught in the course. However, having prior research experience improves performance in the course, irrespective of whether the research experience included the use of course-related laboratory techniques.
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Curriculum , Aprendizaje , Humanos , Estudiantes , Evaluación Educacional , LaboratoriosRESUMEN
Physical fitness is one of the most important physical and mental health aspects for children with Autism Spectrum Disorder (ASD). This study aimed to test the effects of a long-term adapted judo program on the health-related physical fitness of children with ASD. The participants were recruited from various associations of families and schools for children with special needs. Twenty-one children were assigned to an experimental group and nineteen to a control group. The experimental group participated in a six-month adapted judo program consisting of 90 min of practice each week. Health-related physical fitness was measured using the indicators obtained from the ALPHA-fitness battery, the estimated VO2max and the waist/height ratio0.5. Changes within and between groups were analyzed using linear mixed models for repeated measures designs and test-retest reliability of tests requiring a maximum score using the Intraclass Correlation Coefficient (ICC). A judo program tailored for children with ASD can improve the cardio-metabolic health and cardiorespiratory fitness of its participants. The problems involved with administering physical aptitude tests that involve maximum effort or performance in children with ASD cast serious doubts on the reproducibility of their results.
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Trastorno del Espectro Autista , Artes Marciales , Humanos , Niño , Reproducibilidad de los Resultados , Aptitud Física , Ejercicio FísicoRESUMEN
Redistributing surplus food that would otherwise be discarded represents a viable strategy both for increasing food access and for addressing climate change. This study describes a public-private partnership that scaled such an effort in Los Angeles County. Public health worked with a technology-based company to introduce a mobile app that connected various traditional (e.g., food pantries) and non-traditional (e.g., businesses with surplus food, food rescue organizations, community-based organizations that work in low-income communities) organizations with a countywide surplus food redistribution process. In 11 months, 50 food businesses participated, a total of 43,900 pounds of food were recovered, and surplus food was delivered to 34 community sites, serving 28,400 meals. Lessons from the experience suggest that mobile app use was a key component of the redistribution effort, and that diverting food waste while increasing food access, with a priority towards obtaining food of high nutritional value, was both feasible and practical. It has previously been shown that reducing food loss and waste by at least 50% in the food service sector could help reduce energy use and greenhouse gas emissions.
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Servicios de Alimentación , Eliminación de Residuos , Humanos , Salud Pública , Tecnología , ComidasRESUMEN
Introduction: This study aimed to investigate the long-term effects of an adapted judo program on the motor skills and psychosocial abilities of children with Autism Spectrum Disorder (ASD). Methods: All participants had been diagnosed with ASD and were assessed twice, one time at the start of the intervention and again 6 months later, with the Test of Gross Motor Development (TGMD-3) and the Gilliam Autism Rating Scale-Third Edition (GARS-3). A one-way repeated measures MANOVA was carried out in order to evaluate these assessments, and a mediation analysis was done to determine the relationship between them. Results: The experimental group significantly improved (pâ<â0.05) from the pre-test to the post-test for several subtests of the TGMD-3 and the GARS-3. Conclusion: The study shows that participation in an adapted judo program clearly helps to improve the motor skills and psychosocial behaviors of children with ASD.
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This study describes barriers to using the MyPlate visual as a resource for communicating dietary recommendations to Asian American participants of a federally funded nutrition education program. To identify potential barriers to using MyPlate, an interdisciplinary team collected quantitative (n = 349) and qualitative (n = 40) data via a cross-sectional survey and a series of focus group interviews with convenience samples of Cambodian, Filipino, Japanese, Chinese, Vietnamese, and Korean adult participants of a nutrition education class in downtown Los Angeles. Findings showed that 13.2% of the participants ate meals only on a plate, 30.7% were accustomed to eating only refined grains like white rice, and 22.4% did not customarily make half their meals to consist of fruits and vegetables. Food customs, preference, and taste vary across these subgroups. The heterogeneity and complexity of dietary practices among Asian subgroups suggest a need to better tailor nutrition education resources for use in these populations.
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Asiático , Pobreza , Adulto , Estados Unidos , Humanos , Estudios Transversales , Educación en Salud , DietaRESUMEN
Previous research suggests a protective effect of vegetable consumption against chronic disease, but the quality of evidence underlying those findings remains uncertain. We applied a Bayesian meta-regression tool to estimate the mean risk function and quantify the quality of evidence for associations between vegetable consumption and ischemic heart disease (IHD), ischemic stroke, hemorrhagic stroke, type 2 diabetes and esophageal cancer. Increasing from no vegetable consumption to the theoretical minimum risk exposure level (306-372 g daily) was associated with a 23.2% decline (95% uncertainty interval, including between-study heterogeneity: 16.4-29.4) in ischemic stroke risk; a 22.9% (13.6-31.3) decline in IHD risk; a 15.9% (1.7-28.1) decline in hemorrhagic stroke risk; a 28.5% (-0.02-51.4) decline in esophageal cancer risk; and a 26.1% (-3.6-48.3) decline in type 2 diabetes risk. We found statistically significant protective effects of vegetable consumption for ischemic stroke (three stars), IHD (two stars), hemorrhagic stroke (two stars) and esophageal cancer (two stars). Including between-study heterogeneity, we did not detect a significant association with type 2 diabetes, corresponding to a one-star rating. Although current evidence supports increased efforts and policies to promote vegetable consumption, remaining uncertainties suggest the need for continued research.
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Diabetes Mellitus Tipo 2 , Neoplasias Esofágicas , Accidente Cerebrovascular Hemorrágico , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Teorema de Bayes , Diabetes Mellitus Tipo 2/epidemiología , Neoplasias Esofágicas/epidemiología , Neoplasias Esofágicas/prevención & control , Frutas , Humanos , Factores de Riesgo , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/prevención & control , VerdurasRESUMEN
Pharmaceuticals have increasingly received attention from the scientific community due to their growing intake, improved detection and potential ecological risks. Several pharmaceuticals, including antidepressants, anti-inflammatory and antidiabetic compounds and antibiotics, have been described as contaminants in different water matrices. In this context, the aim of the present study was to assess the acute and chronic effects of four classes of pharmaceuticals (acetylsalicylic acid, fluoxetine, metformin and ciprofloxacin) individually and in binary and quartenary mixture. Furthermore, the toxicity of binary mixtures containing the antidepressant fluoxetine was also evaluated. The results of the single acute and chronic toxicity assays indicate lower acetylsalicylic acid and higher fluoxetine toxicity towards Daphnia similis. Regarding the evaluated mixture toxicity, the nature of potential toxicological interactions was predicted by applying mathematical concentration addition and independent action models. The findings revealed both antagonistic and synergistic features, depending on the applied amounts and doses. Finally, the chronic assays performed with the quaternary mixture indicated the presence of a hormetic effect at low concentrations. In sum, the present study demonstrated that the effects of individual pharmaceuticals can underestimate the risk level of these contaminants in the environment.
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Metformina , Contaminantes Químicos del Agua , Animales , Daphnia , Fluoxetina/toxicidad , Contaminantes Químicos del Agua/toxicidad , Ciprofloxacina/toxicidad , Antibacterianos/farmacología , Agua/farmacología , Aspirina , Metformina/farmacología , Hipoglucemiantes , Preparaciones FarmacéuticasRESUMEN
BACKGROUND: Metabolic Syndrome (MetS) is a clinical diagnosis where patients exhibit three out of the five risk factors: hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, hyperglycemia, elevated blood pressure, or increased abdominal obesity. MetS arises due to dysregulated metabolic pathways that culminate with insulin resistance and put individuals at risk to develop various comorbidities with far-reaching medical consequences such as non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease. As it stands, the exact pathogenesis of MetS as well as the involvement of the gastrointestinal tract in MetS is not fully understood. Our study aimed to evaluate intestinal health in human subjects with MetS. METHODS: We examined MetS risk factors in individuals through body measurements and clinical and biochemical blood analysis. To evaluate intestinal health, gut inflammation was measured by fecal calprotectin, intestinal permeability through the lactulose-mannitol test, and utilized fecal metabolomics to examine alterations in the host-microbiota gut metabolism. RESULTS: No signs of intestinal inflammation or increased intestinal permeability were observed in the MetS group compared to our control group. However, we found a significant increase in 417 lipid features of the gut lipidome in our MetS cohort. An identified fecal lipid, diacyl-glycerophosphocholine, showed a strong correlation with several MetS risk factors. Although our MetS cohort showed no signs of intestinal inflammation, they presented with increased levels of serum TNFα that also correlated with increasing triglyceride and fecal diacyl-glycerophosphocholine levels and decreasing HDL cholesterol levels. CONCLUSION: Taken together, our main results show that MetS subjects showed major alterations in fecal lipid profiles suggesting alterations in the intestinal host-microbiota metabolism that may arise before concrete signs of gut inflammation or intestinal permeability become apparent. Lastly, we posit that fecal metabolomics could serve as a non-invasive, accurate screening method for both MetS and NAFLD.
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It is postulated that the inflammatory process resulting from SARS-CoV-2 infection is the main cause of smell and taste dysfunctions in patients. In view of this, photobiomodulation, due to its anti-inflammatory and antioxidant effects, may be a promising therapeutic modality to treat these disorders. In the present case report, we observed clinical improvement in the symptoms of anosmia and ageusia related to COVID-19 after treatment with photobiomodulation. Due to the inflammatory nature of COVID-19 and the anti-inflammatory effects, photobiomodulation antioxidants already proven in the literature make it a promising therapeutic modality, especially sequela COVID-related, including olfactory (anosmia) and taste (ageusia) dysfunction. In the present case report, the patient's olfactory and gustatory functions were re-established after 10 treatment sessions with photobiomodulation.
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Ageusia , COVID-19 , Terapia por Luz de Baja Intensidad , Trastornos del Olfato , Ageusia/etiología , Anosmia , COVID-19/complicaciones , COVID-19/radioterapia , Humanos , Trastornos del Olfato/complicaciones , SARS-CoV-2 , Olfato , Trastornos del Gusto/complicacionesRESUMEN
Coronavirus disease 2019 (COVID-19) infection in elderly patients is more aggressive and treatments have shown limited efficacy. Our objective is to describe the clinical course and to analyze the prognostic factors associated with a higher risk of mortality of a cohort of patients older than 80 years. In addition, we assess the efficacy of immunosuppressive treatments in this population. We analyzed the data from 163 patients older than 80 years admitted to our institution for COVID-19, during March and April 2020. A Lasso regression model and subsequent multivariate Cox regression were performed to select variables predictive of death. We evaluated the efficacy of immunomodulatory therapy in three cohorts using adjusted survival analysis. The mortality rate was 43%. The mean age was 85.2 years. The disease was considered severe in 76.1% of the cases. Lasso regression and multivariate Cox regression indicated that factors correlated with hospital mortality were: age (hazard ratio [HR] 1.12, 95% confidence interval [CI]: 1.03-1.22), alcohol consumption (HR 3.15, 95% CI: 1.27-7.84), CRP > 10 mg/dL (HR 2.67, 95% CI: 1.36-5.24), and oxygen support with Venturi Mask (HR 6.37, 95% CI: 2.18-18.62) or reservoir (HR 7.87, 95% CI: 3.37-18.38). Previous treatment with antiplatelets was the only protective factor (HR 0.47, 95% CI: 0.23-0.96). In the adjusted treatment efficacy analysis, we found benefit in the combined use of tocilizumab (TCZ) and corticosteroids (CS) (HR 0.09, 95% CI: 0.01-0.74) compared to standard treatment, with no benefit of CS alone (HR 0.95, 95% CI: 0.53-1.71). Hospitalized elderly patients suffer from a severe and often fatal form of COVID-19 disease. In this regard, several parameters might identify high-risk patients upon admission. Combined use of TCZ and CS could improve survival.
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Corticoesteroides/administración & dosificación , Anticuerpos Monoclonales Humanizados/administración & dosificación , Tratamiento Farmacológico de COVID-19 , COVID-19/mortalidad , Anciano de 80 o más Años , COVID-19/virología , Comorbilidad , Quimioterapia Combinada , Femenino , Mortalidad Hospitalaria , Hospitalización , Humanos , Masculino , Pronóstico , Estudios Retrospectivos , SARS-CoV-2/efectos de los fármacos , SARS-CoV-2/fisiología , España/epidemiología , Análisis de SupervivenciaRESUMEN
The public health lockdown prompted by the novel coronavirus (COVID-19) pandemic, which included school closures that may have potentially serious consequences for people with disabilities or special educational needs, disrupted an ongoing adapted judo training intervention in children with Autism Spectrum Disorder (ASD). The purpose of this study was to compare repetitive behaviours, social interaction, social communication, emotional responses, cognitive style and maladaptive speech scores across four time-points: baseline, after an eight-week control period, after an eight-week judo intervention and after an eight-week lockdown period due to COVID-19. The sample consisted of 11 children diagnosed with ASD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V), with an intelligence quotient (IQ) range between 60 and 70. Significant improvements were shown following the judo intervention period compared to the baseline and control periods. However, the same values significantly declined during the COVID-19 lockdown period resulting in values lower than those recorded at baseline, and following the control period and the judo intervention. The decline in psychosocial and behavioural scores are likely due to the stress caused by the sudden halt in activity and the increase in sedentary practices associated with the lockdown.