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1.
ACS Appl Mater Interfaces ; 16(35): 46374-46383, 2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39178309

RESUMEN

Fluorination is one of the most efficient and universal strategies to increase the hydrophobicity of materials and consequently their water stability. Zeolitic-imidazolate frameworks (ZIFs), which have limited stability in aqueous media and even lower stability when synthesized on a nanometric scale, can greatly benefit from the incorporation of fluorine atoms, not only to improve their stability but also to provide additional properties. Herein, we report the preparation of two different fluorinated ZIFs through a simple and scalable approach by using mixed ligands [2-methylimidazole, as a common ligand, and 4-(4-fluorophenyl)-1H-imidazole (monofluorinated linker) or 2-methyl-5-(trifluoromethyl)-1H-imidazole (trifluorinated linker) as a dopant], demonstrating the high versatility of the synthetic method developed to incorporate different fluorine-containing imidazole-based ligands. Second, we demonstrate for the first time that these nanoscale fluorinated ZIFs outperform the pristine ZIF-8 for water intrusion/extrusion, i.e., for storing mechanical energy via forced intrusion of nonwetting water due to the improved hydrophobicity and modified framework dynamics. Moreover, we also show that by varying the nature of the F-imidazole ligand, the performance of the resulting ZIFs, including the pressure thresholds and stored/dissipated energy, can be finely tuned, thus opening the path for the design of a library of fluorine-modified ZIFs with unique behavior.

2.
Nanomaterials (Basel) ; 14(3)2024 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-38334580

RESUMEN

This study evaluates the removal of several dyes with different charge properties, i.e., anionic (Acid Red 88), cationic (Basic Red 13), and neutral (Basic Red 5) using transition metal-doped TiO2 supported on a high-surface-area activated carbon. Experimental results confirm the successful deposition of TiO2 and the derivatives (Zr-, Cu-, and Ce-doped samples) on the surface of the activated carbon material and the development of extended heterojunctions with improved electronic properties. Incorporating a small percentage of dopants significantly improves the adsorption properties of the composites towards the three dyes evaluated, preferentially for sample AC/TiO2_Zr. Similarly, the photodegradation efficiency highly depends on the nature of the composite evaluated and the characteristics of the dye. Sample AC/TiO2_Zr demonstrates the best overall removal efficiency for Acid Red 88 and Basic Red 5-83% and 63%, respectively. This promising performance must simultaneously be attributed to a dual mechanism, i.e., adsorption and photodegradation. Notably, the AC/TiO2_Ce outperformed the other catalysts in eliminating Basic Red 13 (74%/6 h). A possible Acid Red 88 degradation mechanism using AC/TiO2_Zr was proposed. This study shows that the removal efficiency of AC/TiO2 composites strongly depends on both the material and pollutant.

3.
Clin Chem Lab Med ; 62(3): 493-505, 2024 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-37794778

RESUMEN

OBJECTIVES: Acylcarnitine and amino acid analyses of dried blood spot (DBS) samples using tandem mass spectrometry in newborn screening (NBS) programmes can generate false positive (FP) results. Therefore, implementation of second-tier tests (2TTs) using DBS samples has become increasingly important to avoid FPs. The most widely used 2TT metabolites include methylmalonic acid, 3-hydroxypropionic acid, methylcitric acid, and homocysteine. METHODS: We simultaneously measured 46 underivatised metabolites, including organic acids, acylglycine and acylcarnitine isomers, homocysteine, and orotic acid, in DBS samples using tandem mass spectrometry. To validate this method, we analysed samples from 147 healthy newborns, 160 patients with genetic disorders diagnosed via NBS, 20 patients with acquired vitamin B12 deficiency, 10 newborns receiving antibiotic treatment, and nine external quality control samples. RESULTS: The validation study revealed that 31 metabolites showed good analytical performance. Furthermore, this method detected key metabolites for all diseases associated with increased levels of the following acylcarnitines: C3, C4, C5, C4DC/C5OH, and C5DC. The sensitivity of this method to detect all diseases was 100 %, and the specificity was 74-99 %, except for glutaric aciduria type 1. This method can also be used to diagnose mitochondrial fatty acid ß-oxidation disorders (FAODs) and urea cycle defects (UCDs). CONCLUSIONS: We have described a 2TT panel of 31 metabolites in DBS samples based on an easy and rapid method without derivatisation. Its implementation allowed us to distinguish between different organic acidurias, some FAODs, and UCDs. This new strategy has increased the efficiency of our NBS programme by reducing FP and false negative results, second sample requests, and the time required for diagnosis.


Asunto(s)
Errores Innatos del Metabolismo de los Aminoácidos , Encefalopatías Metabólicas , Carnitina/análogos & derivados , Glutaril-CoA Deshidrogenasa/deficiencia , Tamizaje Neonatal , Espectrometría de Masas en Tándem , Humanos , Recién Nacido , Espectrometría de Masas en Tándem/métodos , Tamizaje Neonatal/métodos , España , Cromatografía Liquida/métodos , Homocisteína , Pruebas con Sangre Seca/métodos
4.
Angew Chem Int Ed Engl ; 63(6): e202315280, 2024 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-38088497

RESUMEN

We report the first experimental evidence for rapid formation of hydrogen clathrates under mild pressure and temperature conditions within the cavities of a zirconium-metalloporphyrin framework, specifically PCN-222. PCN-222 has been selected for its 1D mesoporous channels, high water-stability, and proper hydrophilic behavior. Firstly, we optimize a microwave (MW)-assisted method for the synthesis of nanosized PCN-222 particles with precise structure control (exceptional homogeneity in morphology and crystalline phase purity), taking advantage of MW in terms of rapid/homogeneous heating, time and energy savings, as well as potential scalability of the synthetic method. Second, we explore the relevance of the large mesoporous 1D open channels within the PCN-222 to promote the nucleation and growth of confined hydrogen clathrates. Experimental results show that PCN-222 drives the nucleation process at a lower pressure than the bulk system (1.35 kbar vs 2 kbar), with fast kinetics (minutes), using pure water, and with a nearly complete water-to-hydrate conversion. Unfortunately, PCN-222 cannot withstand these high pressures, which lead to a significant alteration of the mesoporous structure while the microporous network remains mainly unchanged.

5.
Nat Commun ; 13(1): 5953, 2022 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-36216832

RESUMEN

Clathrate hydrates are crystalline solids characterized by their ability to accommodate large quantities of guest molecules. Although CH4 and CO2 are the traditional guests found in natural systems, incorporating smaller molecules (e.g., H2) is challenging due to the need to apply higher pressures to stabilize the hydrogen-bonded network. Another critical limitation of hydrates is the slow nucleation and growth kinetics. Here, we show that specially designed activated carbon materials can surpass these obstacles by acting as nanoreactors promoting the nucleation and growth of H2 hydrates. The confinement effects in the inner cavities promote the massive growth of hydrogen hydrates at moderate temperatures, using pure water, with extremely fast kinetics and much lower pressures than the bulk system.

6.
Front Immunol ; 13: 816389, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35464418

RESUMEN

The rapid spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerging variants raises concerns about their capacity to evade immune protection provided by natural infection or vaccination. The receptor-binding domain (RBD) of the viral spike protein is the major target of neutralizing antibodies, and viral variants accumulate mutations in this region. In this study, we determined the antibody neutralization capacity against the RBD of SARS-CoV-2 variants Alpha (B.1.1.7), Gamma (P.1), Epsilon (B.1.427), Kappa (B.1.617.1), and Delta (B.1.617.2) in a cohort of healthcare workers naturally infected or receiving COVID-19 mRNA vaccines from Moderna or Pfizer-BioNTech. We show that the five RBD variants displayed an augmented binding to ACE2 compared to the original Wuhan strain. The most significant increase was observed in variants Epsilon and Delta, containing mutation L452R. Using a flow cytometry cell-based assay, we found that SARS-CoV-2-infected subjects presented low levels of RBD-specific neutralizing antibodies against all variants analyzed, except Alpha. However, the neutralizing activity incremented considerably after a subsequent mRNA-vaccine dose, to levels significantly higher than those in naïve individuals receiving two vaccine doses. Importantly, we observed partially impaired neutralizing responses against most variants in fully vaccinated individuals. Variants Gamma and Kappa encompassing RBD E484K/Q mutations presented the highest neutralizing resistance. Furthermore, a wide heterogeneity in the magnitude of RBD-specific neutralizing responses against all tested SARS-CoV-2 variants following both mRNA vaccines was detected. Altogether, our findings provide important knowledge regarding SARS-CoV-2 vaccine-induced immunity, and should be very useful to guide future vaccination regimens and personalized vaccine approaches.


Asunto(s)
COVID-19 , SARS-CoV-2 , Anticuerpos Neutralizantes , Anticuerpos Antivirales , COVID-19/prevención & control , Vacunas contra la COVID-19 , Humanos , ARN Mensajero/genética , SARS-CoV-2/genética , Glicoproteína de la Espiga del Coronavirus , Vacunación
7.
Nanomaterials (Basel) ; 10(6)2020 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-32545557

RESUMEN

In this work a natural zeolite was modified with silver following two different methods to derive Ag2O and Ag0 nanocomposites. The materials were fully characterized and the results showed that both materials were decorated with nanoparticles of size of 5-25 nm. The natural and modified zeolites were used for the removal of iodide from aqueous solutions of initial concentration of 30-1400 ppm. Natural zeolite showed no affinity for iodide while silver forms were very efficient reaching a capacity of up to 132 mg/g. Post-adsorption characterizations showed that AgI was formed on the surface of the modified zeolites and the amount of iodide removed was higher than expected based on the silver content. A combination of experimental data and characterizations indicate that the excess iodide is most probably related to negatively charged AgI colloids and Ag-I complexes forming in the solution as well as on the surface of the modified zeolites.

8.
Biosens Bioelectron ; 121: 54-61, 2018 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-30196048

RESUMEN

Detection of the hybridisation events is of great importance in many different biotechnology applications such as diagnosis, computing, molecular bioelectronics, and among others. However, one important drawback is the low current of some redox reporters that limits their application. This paper demonstrates the powerful features of molecular wires, in particular the case of S-[4-[2-[4-(2-Phenylethynyl)phenyl]ethynyl]phenyl] thiol molecule and the key role that play the nanometric design of the capture probe linkers to achieve an efficient couple of the DNA complementary ferrocene label with the molecular wire for an effective electron transfer in co-immobilised self-assembled monolayers (SAMs) for DNA hybridisation detection. In this article, the length of the linker capture probe was studied for electron transfer enhancement from the ferrocene-motifs of immobilised molecules towards the electrode surface to obtain higher kinetics in the presence of thiolated molecular wires. The use of the right couple of capture probe linker and molecular wire has found to be beneficial as it helps to amplify eightfold the signal obtained.


Asunto(s)
Técnicas Biosensibles/métodos , ADN/química , Electrodos , Hibridación de Ácido Nucleico , Compuestos de Sulfhidrilo/química
9.
BMJ Case Rep ; 20172017 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-29054935

RESUMEN

Appendectomy is the most commonly performed surgical procedure, affecting 1%-8% of the paediatric population, with a total 7% lifetime risk, most likely in adolescents and young adults.A case of familial aggregation was reported in our hospital in a family composed of nine siblings from which six of them (66.6%) had been treated of acute appendicitis, five of them in our centre.Many factors have been described as predisposing to appendicitis. Several studies have highlighted the influence of genes in the evolution of this disease and its severity, demonstrating a relative risk increase by three when family history is present.Family history of acute appendicitis is an important factor to be taken into consideration during the medical interview. Clinicians attempting to fine-tune their diagnostic accuracy when patients present with acute abdominal pain should inquire about family history of appendicitis.


Asunto(s)
Apendicitis/diagnóstico , Apendicitis/genética , Predisposición Genética a la Enfermedad , Anamnesis/normas , Adolescente , Adulto , Apendicectomía , Apendicitis/cirugía , Familia , Femenino , Humanos , Factores de Riesgo , Adulto Joven
10.
Arch. méd. Camaguey ; 17(3)20130500. gráf
Artículo en Español | CUMED | ID: cum-55803

RESUMEN

La inmunoterapia alergeno específica constituye el único tratamiento capaz de modificar el curso natural de las enfermedades alérgicas, tiene efecto multiorgánico y duradero a largo plazo después de suspender su administración y se han probado sus efectos preventivos, tanto en la prevención de nuevas sensibilizaciones como en la progresión de la rinitis al asma.Objetivo: evaluar la eficacia de una nueva pauta de inmunoterapia subcutánea con extractos alergénicos de ácaros en adultos asmáticos.Método: se realizó un ensayo clínico fase II, abierto, aleatorizado en 50 pacientes con diagnóstico de asma bronquial leve o moderada, sensibles a ácaros del polvo por prueba de Prick .La población objeto de estudio estuvo constituida por 200 pacientes con antecedentes patológicos de asma bronquial y edades entre 18 y 50 años, que acudieron a la consulta de Alergología del Hospital Universitario Manuel Ascunce Domenech, desde mayo de 2011 a mayo de 2012. A los mismos se les administró inmunoterapia subcutánea con extractos de ácaros (Dermatophagoides pteronyssinus, y Blomia tropicalis) a concentraciones de 20 UB/ml, 200 UB/ ml, 2 000 UB/ml y 20 000 UB/ml en el primer grupo, según el esquema propuesto por el BIOCEN, se alcanzó la dosis de mantenimiento en 13 semanas a intervalos semanales. El segundo grupo recibió pauta convencional de 16 semanas.Resultados: en la evaluación de la eficacia se comprobó una reducción de los síntomas clínicos y del consumo de medicación al final del tratamiento en ambos grupos pero de manera significativa en el grupo estudio (p=0,020). La reactividad cutánea a los ácaros disminuyó significativamente en el grupo estudio con respecto al grupo control.Conclusiones: se demuestró un alto grado de eficacia de esta pauta más acortada con extractos de ácaros, lo que garantiza una adhesión al tratamiento superior a la pauta de 16 semanas con frecuencia bisemanal (AU)


Allergen-specific immunotherapy is the only treatment capable of modifying the natural course of allergic diseases; it has multiple organ and long term effect after stopping its administration and its preventive effects have been tested, both in the prevention of new sensitizations and in the progression of rhinitis to asthma.Objective: to evaluate the effectiveness of a new subcutaneous immunotherapy schedule with mite extracts in asthmatic adults.Method: a phase II, open, randomized clinical trial was conducted in 50 patients with diagnosis of mild or moderate bronchial asthma, sensitive to dust mites by Prick test. The study population was constituted by 200 patients with a pathological history of bronchial asthma and aged between 18 and 50 years, who were treated in the Allergology consultation at the University Hospital Manuel Ascunce Domenech, from May 2011 to may 2012. They were given subcutaneous immunotherapy with mite extracts (Dermatophagoides pteronyssinus and Blomia tropicalis) at concentrations of 20 ml/UB 200 UB / UB/ml 2 000 and 20 000 ml/UB/ml in the first group, according to the schedule proposed by BIOCEN, it was reached the maintenance dose in 13 weeks at weekly intervals. The second group received conventional schedule of 16 weeks.Results: it was found a reduction of clinical symptoms as well as in medication consumption at the end of the treatment in both groups, but significantly in the study group (p=0,020). Skin reactivity to mites significantly decreased in the study group regarding the control group.Conclusions: a high degree of effectiveness of this new schedule with mites extracts was demonstrated, this guarantees a greater adhesion to treatment, which it is far superior to the previous 16-week schedule with a twice-weekly frequency (AU)


Asunto(s)
Humanos , Adulto , Desensibilización Inmunológica , Ácaros , Asma , Inyecciones Subcutáneas , Ensayos Clínicos Fase II como Asunto
11.
Arch. méd. Camaguey ; 17(3): 333-346, mayo-jun. 2013.
Artículo en Español | LILACS | ID: lil-679968

RESUMEN

Fundamento: la inmunoterapia alergeno específica constituye el único tratamiento capaz de modificar el curso natural de las enfermedades alérgicas, tiene efecto multiorgánico y duradero a largo plazo después de suspender su administración y se han probado sus efectos preventivos, tanto en la prevención de nuevas sensibilizaciones como en la progresión de la rinitis al asma. Objetivo: evaluar la eficacia de una nueva pauta de inmunoterapia subcutánea con extractos alergénicos de ácaros en adultos asmáticos. Método: se realizó un ensayo clínico fase II, abierto, aleatorizado en 50 pacientes con diagnóstico de asma bronquial leve o moderada, sensibles a ácaros del polvo por prueba de Prick .La población objeto de estudio estuvo constituida por 200 pacientes con antecedentes patológicos de asma bronquial y edades entre 18 y 50 años, que acudieron a la consulta de Alergología del Hospital Universitario Manuel Ascunce Domenech, desde mayo de 2011 a mayo de 2012. A los mismos se les administró inmunoterapia subcutánea con extractos de ácaros (Dermatophagoides pteronyssinus, y Blomia tropicalis) a concentraciones de 20 UB/ml, 200 UB/ ml, 2 000 UB/ml y 20 000 UB/ml en el primer grupo, según el esquema propuesto por el BIOCEN, se alcanzó la dosis de mantenimiento en 13 semanas a intervalos semanales. El segundo grupo recibió pauta convencional de 16 semanas. Resultados: en la evaluación de la eficacia se comprobó una reducción de los síntomas clínicos y del consumo de medicación al final del tratamiento en ambos grupos pero de manera significativa en el grupo estudio (p=0,020). La reactividad cutánea a los ácaros disminuyó significativamente en el grupo estudio con respecto al grupo control. Conclusiones: se demuestró un alto grado de eficacia de esta pauta más acortada con extractos de ácaros, lo que garantiza una adhesión al tratamiento superior a la pauta de 16 semanas con frecuencia bisemanal.


Background: allergen-specific immunotherapy is the only treatment capable of modifying the natural course of allergic diseases; it has multiple organ and long term effect after stopping its administration and its preventive effects have been tested, both in the prevention of new sensitizations and in the progression of rhinitis to asthma. Objective: to evaluate the effectiveness of a new subcutaneous immunotherapy schedule with mite extracts in asthmatic adults. Method: a phase II, open, randomized clinical trial was conducted in 50 patients with diagnosis of mild or moderate bronchial asthma, sensitive to dust mites by Prick test. The study population was constituted by 200 patients with a pathological history of bronchial asthma and aged between 18 and 50 years, who were treated in the Allergology consultation at the University Hospital Manuel Ascunce Domenech, from May 2011 to may 2012. They were given subcutaneous immunotherapy with mite extracts (Dermatophagoides pteronyssinus and Blomia tropicalis) at concentrations of 20 ml/UB 200 UB / UB/ml 2 000 and 20 000 ml/UB/ml in the first group, according to the schedule proposed by BIOCEN, it was reached the maintenance dose in 13 weeks at weekly intervals. The second group received conventional schedule of 16 weeks. Results: it was found a reduction of clinical symptoms as well as in medication consumption at the end of the treatment in both groups, but significantly in the study group (p=0,020). Skin reactivity to mites significantly decreased in the study group regarding the control group. Conclusions: a high degree of effectiveness of this new schedule with mites’ extracts was demonstrated, this guarantees a greater adhesion to treatment, which it is far superior to the previous 16-week schedule with a twice-weekly frequency.

12.
In. Pérez Cabarco, Nancy; Sarduy Ramos, Carlos; López Molina, Léster; Rodríguez Pérez, Judit; Armenteros Medina, Yaramis. Medicina transfusional. Consideraciones generales. La Habana, ECIMED, 2012. , tab.
Monografía en Español | CUMED | ID: cum-64211
13.
In. Pérez Cabarco, Nancy; Sarduy Ramos, Carlos; López Molina, Léster; Rodríguez Pérez, Judit; Armenteros Medina, Yaramis. Medicina transfusional. Consideraciones generales. La Habana, ECIMED, 2012. , ilus.
Monografía en Español | CUMED | ID: cum-64209
14.
In. Pérez Cabarco, Nancy; Sarduy Ramos, Carlos; López Molina, Léster; Rodríguez Pérez, Judit; Armenteros Medina, Yaramis. Medicina transfusional. Consideraciones generales. La Habana, ECIMED, 2012. , ilus.
Monografía en Español | CUMED | ID: cum-64208
16.
Gastroenterol Hepatol ; 34(9): 599-604, 2011 Nov.
Artículo en Español | MEDLINE | ID: mdl-22037093

RESUMEN

INTRODUCTION: Because of the current overload of emergency services, new units, such as day units, have had to be created. Liver cirrhosis (LC) is a chronic disease with frequent decompensations requiring medical attention. The aim of this study was to compare differences between emergency consultations in a hepatology day hospital (HDH) and in an emergency service (ES) among patients with LC. METHODS AND MATERIAL: We performed an observational prospective study. All patients with LC attending the HDH or ES from September 2007 to August 2008 were asked to complete a questionnaire. Demographic, clinical, and radiological variables were collected. RESULTS: There were 743 consultations, of which 62% involved the HDH. The mean age was 65±12 years, and the male/female ratio was 2:3. The most frequent diagnosis in the ES was hepatic encephalopathy (26.2% ES versus 6% HDH, p<0.001) followed by upper gastrointestinal hemorrhage (17.7% ES versus 0.6% HDH, p<0.001), while the most frequent diagnosis in the HDH was ascites (66.2% HDH versus 22.7% ES, p<0.001). The tests performed were as follows: blood analysis: 95% ES versus 60% HDH (p<0.01); radiology: 71% ES versus 11% HDH (p<0.01) and paracentesis: 51% ES versus 74% HDH (p<0.01). The mean length of stay in the ES was 21.3±121.5 hours compared with 3.3±2.4 hours in the HDH (p<0.001). A total of 53% of patients attended in the ES were hospitalized compared with 12% of those attended in the HDH (p<0.05). CONCLUSION: Patients with LC preferentially attend the HDH, where fewer tests are performed and the length of stay is shorter. The care provided in the HDH is appropriate and efficient.


Asunto(s)
Centros de Día/estadística & datos numéricos , Servicios Médicos de Urgencia/estadística & datos numéricos , Cirrosis Hepática , Anciano , Femenino , Gastroenterología , Hospitales Especializados , Humanos , Cirrosis Hepática/terapia , Masculino , Estudios Prospectivos
17.
Gastroenterol. hepatol. (Ed. impr.) ; 34(9): 599-604, Nov. 2011.
Artículo en Español | IBECS | ID: ibc-98649

RESUMEN

Introducción El colapso actual de los servicios de urgencias ha originado el desarrollo de otros ámbitos de atención como los hospitales de día. La cirrosis hepática (CH) es una enfermedad crónica que presenta descompensaciones que requieren atención. El objetivo es comparar las diferencias entre las visitas urgentes de los pacientes con CH al hospital de día de hepatología (HDH) o al servicio de urgencias (URG).Material y métodos Estudio prospectivo observacional, mediante la complementación de un cuestionario de los pacientes que acudieron al HDH y a URG entre 9/2007 y 8/2008. Se recogieron variables demográficas, clínicas y exploraciones complementarias realizadas. Resultados Hubo 743 consultas, 62% al HDH. La edad media fue de 65±12 años, ratio hombre/mujer 2,3. El diagnóstico más frecuente en URG fue la encefalopatía (26,2% URG versus 6% HDH, p<0,001) seguido de la hemorragia digestiva alta (17,7% URG versus 0,6% HDH, p<0,001). La ascitis fue el más frecuente en HDH (66,2% HDH versus 22,7% URG, p<0,001). Las exploraciones realizadas fueron, análisis: 95% URG versus 60% HDH (p<0,01); radiología: 71% URG versus 11% HDH (p<0,01), y paracentesis: 51% URG versus 74% HDH (p<0,01). El tiempo de estancia en URG fue de 21,3±121,5 h respecto a 3,3±2,4 h en HDH (p<0,001). Se hospitalizaron el 53% de los visitados en URG y el 12% de los visitados en HDH (p<0,05).Conclusión los pacientes acuden mayoritariamente al HDH, realizándose menos pruebas y presentando un tiempo de estancia menor. La atención continuada de pacientes con CH en el HDH es adecuada y eficiente (AU)


Introduction Because of the current overload of emergency services, new units, such as day units, have had to be created. Liver cirrhosis (LC) is a chronic disease with frequent decompensations requiring medical attention. The aim of this study was to compare differences between emergency consultations in a hepatology day hospital (HDH) and in an emergency service (ES) among patients with LC. Methods and material We performed an observational prospective study. All patients with LC attending the HDH or ES from September 2007 to August 2008 were asked to complete a questionnaire. Demographic, clinical, and radiological variables were collected. Results There were 743 consultations, of which 62% involved the HDH. The mean age was 65±12 years, and the male/female ratio was 2:3. The most frequent diagnosis in the ES was hepatic encephalopathy (26.2% ES versus 6% HDH, p<0.001) followed by upper gastrointestinal hemorrhage (17.7% ES versus 0.6% HDH, p<0.001), while the most frequent diagnosis in the HDH was ascites (66.2% HDH versus 22.7% ES, p<0.001). The tests performed were as follows: blood analysis: 95% ES versus 60% HDH (p<0.01); radiology: 71% ES versus 11% HDH (p<0.01) and paracentesis: 51% ES versus 74% HDH (p<0.01). The mean length of stay in the ES was 21.3±121.5hours compared with 3.3±2.4hours in the HDH (p<0.001). A total of 53% of patients attended in the ES were hospitalized compared with 12% of those attended in the HDH (p<0.05).Conclusion Patients with LC preferentially attend the HDH, where fewer tests are performed and the length of stay is shorter. The care provided in the HDH is appropriate and efficient (AU)


Asunto(s)
Humanos , Cirrosis Hepática/epidemiología , Servicios Médicos de Urgencia/estadística & datos numéricos , Atención Ambulatoria/estadística & datos numéricos , Distribución por Edad y Sexo , Estudios Prospectivos , Centros de Día , Tratamiento de Urgencia/estadística & datos numéricos
18.
Arch. méd. Camaguey ; 13(4)jul.-ago. 2009. tab
Artículo en Español | CUMED | ID: cum-43932

RESUMEN

Ausencia de antecedentes de este estudio en nuestra ciudad de Camagüey. Objetivo: evaluar la eficacia de la prueba de prick con extracto alergénico de polen de Cynodon dactylon en pacientes con asma y/o rinitis. Método: se realizó un ensayo clínico diagnóstico, aleatorizado, desde enero a septiembre de 2006, en ciento ocho adultos (cincuenta y cuatro diagnosticados de asma y/o rinitis y cincuenta y cuatro voluntarios sanos, entre dieciocho y sesenta años de edad), provenientes de la consulta de Alergia del Hospital Provincial Universitario “Manuel Ascunce Domenech”, a los que se les realizó, previo consentimiento informado, prueba de prick por duplicado, con extracto alergénico de polen de Cynodon dactylon a una concentración de 14.600 UBE/ml (producido por los laboratorios Bial. ARISTEGUI).Resultados: el 62,9% de los enfermos presentó sensibilización al extracto empleado, para una sensibilidad de la prueba del 62,9% (IC 95% 52,3-64,5%) y una especificidad del 96,2% (IC 95% 88,5-98,3); el valor predictivo positivo fue del 94.4% (IC 95% 93,4-98,6) y predictivo negativo del 72,2% (IC 95% 69,5-78,6%). El promedio del diámetro del habón encontrado fue de 3,12% (IC95% 2,97-3,15%). Conclusiones: más del 50% de los enfermos presentó sensibilización cutánea al polen de Cynodon dactylon, especie de gramínea ampliamente distribuida por toda la Isla. La prueba cutánea de prick con el extracto empleado se considera eficaz en el diagnóstico de las alergias ocasionadas por este alergeno (AU)


Absence of this study in Camagüey city. Objective: to evaluate the effectiveness of the prick test with allergenic extract of Cynodon dactylon pollen in patients with asthma and/or rhinitis. Method: a randomized, diagnostic clinical test, from January to September 2006, in one-hundred eight adults (54 diagnosed of asthma and/or rhinitis and 54 healthy volunteers, between 18 and 60 years of age), coming from the Allergy consultation of the Provincial University Hospital "Manuel Ascunce Domenech", to those were carried out, previous informed consent, a duplicate prick test, with allergenic extract of Cynodon dactylon pollen to a concentration of 14 600 UBE / ml (produced by Bial. ARISTEGUI laboratories). Results: the 62,9% of the sick people presented sensitization to the used extract, for a sensibility of the test of 62,9% and (IC 95% (IC 95% 69,5-78,6) 52,3-64,5) a specificity of 96,2%; (IC 95% 88,5-98,3) the positive predictive value was about 94,4% and (IC 95% 93,4-98,6) negative predictive of 72,2%. The average of the wheal diameter found was about 3,12 (IC 95% 2,97-3,15). Conclusions: more than 50% of the sick people presented cutaneous sensitization to the pollen of Cynodon dactylon, species of gramineous broadly distributed by the whole Island. The cutaneous test of prick with the used extract is considered effective in the diagnosis of allergies caused by this allergen (AU)


Asunto(s)
Humanos , Rinitis Alérgica Estacional , Cynodon dactylon , Pruebas Cutáneas
19.
Arch. méd. Camaguey ; 13(4)jul.-ago. 2009. tab
Artículo en Español | LILACS | ID: lil-577838

RESUMEN

Ausencia de antecedentes de este estudio en nuestra ciudad de Camagüey. Objetivo: evaluar la eficacia de la prueba de prick con extracto alergénico de polen de Cynodon dactylon en pacientes con asma y/o rinitis. Método: se realizó un ensayo clínico diagnóstico, aleatorizado, desde enero a septiembre de 2006, en ciento ocho adultos (cincuenta y cuatro diagnosticados de asma y/o rinitis y cincuenta y cuatro voluntarios sanos, entre dieciocho y sesenta años de edad), provenientes de la consulta de Alergia del Hospital Provincial Universitario “Manuel Ascunce Domenech”, a los que se les realizó, previo consentimiento informado, prueba de prick por duplicado, con extracto alergénico de polen de Cynodon dactylon a una concentración de 14.600 UBE/ml (producido por los laboratorios Bial. ARISTEGUI).Resultados: el 62,9% de los enfermos presentó sensibilización al extracto empleado, para una sensibilidad de la prueba del 62,9% (IC 95% 52,3-64,5%) y una especificidad del 96,2% (IC 95% 88,5-98,3); el valor predictivo positivo fue del 94.4% (IC 95% 93,4-98,6) y predictivo negativo del 72,2% (IC 95% 69,5-78,6%). El promedio del diámetro del habón encontrado fue de 3,12% (IC95% 2,97-3,15%). Conclusiones: más del 50% de los enfermos presentó sensibilización cutánea al polen de Cynodon dactylon, especie de gramínea ampliamente distribuida por toda la Isla. La prueba cutánea de prick con el extracto empleado se considera eficaz en el diagnóstico de las alergias ocasionadas por este alergeno.


Absence of this study in Camagüey city. Objective: to evaluate the effectiveness of the prick test with allergenic extract of Cynodon dactylon pollen in patients with asthma and/or rhinitis. Method: a randomized, diagnostic clinical test, from January to September 2006, in one-hundred eight adults (54 diagnosed of asthma and/or rhinitis and 54 healthy volunteers, between 18 and 60 years of age), coming from the Allergy consultation of the Provincial University Hospital "Manuel Ascunce Domenech", to those were carried out, previous informed consent, a duplicate prick test, with allergenic extract of Cynodon dactylon pollen to a concentration of 14 600 UBE / ml (produced by Bial. ARISTEGUI laboratories). Results: the 62,9% of the sick people presented sensitization to the used extract, for a sensibility of the test of 62,9% and (IC 95% (IC 95% 69,5-78,6) 52,3-64,5) a specificity of 96,2%; (IC 95% 88,5-98,3) the positive predictive value was about 94,4% and (IC 95% 93,4-98,6) negative predictive of 72,2%. The average of the wheal diameter found was about 3,12 (IC 95% 2,97-3,15). Conclusions: more than 50% of the sick people presented cutaneous sensitization to the pollen of Cynodon dactylon, species of gramineous broadly distributed by the whole Island. The cutaneous test of prick with the used extract is considered effective in the diagnosis of allergies caused by this allergen.


Asunto(s)
Humanos , Cynodon dactylon , Rinitis Alérgica Estacional , Pruebas Cutáneas
20.
Arch. méd. Camaguey ; 12(2)mar.-abr. 2008. tab
Artículo en Español | CUMED | ID: cum-36203

RESUMEN

Fundamento: La gravedad de las infecciones intrahospitalarias es cada vez más frecuente y difícil de tratar, constituye una importante causa de morbilidad y mortalidad. Objetivo: Caracterizar la infección intrahospitalaria en servicios clínicos. Método: Se realizó un estudio descriptivo transversal en los servicios clínicos de Nefrología, Unidad de Cuidados Intermedios, Unidad de Cuidados Intensivos, Cardiocentro y Medicina Interna del Hospital Provincial Docente Clínico Quirúrgico ®Manuel Ascunce Domenech¼ de Camagüey durante un período de tres años (enero de 2004 a diciembre de 2006). La muestra estuvo constituida por 751 pacientes ingresados en estos servicios y en cuyas historias clínicas existían datos inequívocos de infección intrahospitalaria desde el punto de vista clínico y de laboratorio microbiológico. Resultados: No se encontraron diferencias significativas en cuanto al sexo. Los procederes invasivos terapéuticos con el 94 por ciento fueron los principales factores de riesgo identificados, dentro de los cuales el empleo de sondaje vesical, catéter venoso central y ventilación mecánica artificial fueron los más importantes. El mayor número de pacientes le correspondió a Unidad de Cuidados Intermedios y al servicio de Medicina Interna en los que predominaron la infección por Enterobacterias y Estafilococo sp. Aunque no resultó significativo, se aisló en las salas de terapia el Acinetobacter sp. multirresistente. Los sitios más frecuentes de infección fueron el sistema respiratorio y urinario. Conclusiones: La mayoría de los pacientes egresaron vivos y un tercio tuvo una estadía de 23 días y más. El 12.2 por ciento de los pacientes fallecieron a causa de la sepsis nosocomial(AU)


Background: The gravity of intrahospital infections is more frequent and difficult to treat, constitutes an important cause of morbidity and mortality. Objective: To characterize the intrahospital infection at clinical services. Method: A cross-sectional descriptive study was carried out at Nephrology, Intermediate Care Unit, Intensive Care Unit, Cardiology Center and Internal Medicine clinical services of the Surgical Clinical Educational Provincial Hospital ®Manuel Ascunce Domenech¼ of Camagüey during a period of three years (January 2004 to December 2006). The sample was constituted by 751 patients admitted in these services and in whose medical histories unmistakable data of intrahospital infection existed since the clinical point of view and microbiological laboratory. Results: It were not found significant differences about sex. The therapeutic invasive procedures with the 94 percent were the main risk factors identified, within the employment of vesical catheterization, central venous catheter and artificial mechanical ventilation were the most important. The major number of patients corresponded to Intermediate Care Unit and to Internal Medicine service in which the infection by Enterobacteria and Staphylococci sp dominated. Although did not turn out to be significant, the Acinetobacter sp. multirresistant was isolated in the therapy rooms. The most frequent sites of infection were the urinary and respiratory system. Conclusions: The majority of patients discharged alive and a one third had a stopover of 23 days and more. The 12.2 percent of patients died because of nosocomial sepsis(AU)


Asunto(s)
Humanos , Infección Hospitalaria , Factores de Riesgo , Sepsis/mortalidad , Infecciones por Acinetobacter/terapia , Epidemiología Descriptiva
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