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INTRODUCTION: The aims of this study were to update our experience with biodegradable polydioxanone (PDO) airway stents in children, focusing on effectiveness and safety, and to analyze the factors involved in the different outcomes observed. MATERIALS AND METHODS: Retrospective study of patients managed with PDO stents from 2012 to 2023. Variables collected: demographics, comorbidities, indication, clinical baseline, stent size, location, complications, clinical outcome, and time of follow-up. Statistical analyses were performed to detect the eventual contribution of variables in the different outcomes observed. RESULTS: Fifty-four PDO stents were placed in 26 patients (median age, 4 months). All showed severe symptoms of central airway obstruction due to tracheomalacia in nine patients, bronchomalacia five, tracheobronchomalacia 10, and tracheal stenosis two. Stent placement was uneventful in every case: 29 stents in the trachea and 25 in the main bronchi. 53.8% of patients needed successive stenting, and all exhibited comorbidities. Complete clinical resolution was observed in eight cases (30.7%), partial improvement in 13 (50%), unchanged in 4 (15.3%), and worsened in one. Age had a significant positive impact on outcome (6 vs. 3 months; p = 0.024). Additionally, smaller stents were associated with a better outcome (20 vs. 26 mm; p = 0.044). Granulation tissue was the most frequent complication (34.6%). Five patients (19.2%) died due to severe comorbidities, follow-up was complete in survivors (median, 58 months). CONCLUSIONS: PDO stents are safe and effective when dealing with severe tracheobronchial obstruction. Stent-related granulation tissue continues to be a relevant matter of concern. This issue, together with increased degradation times, deserves further research.
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Immunoglobulin heavy chain variable ( IGHV ) region mutations, TP53 mutation, fluorescence in situ hybridization (FISH), and cytogenetic analysis are the most important prognostic biomarkers used in chronic lymphocytic leukemia (CLL) patients in our daily practice. In real-life environment, there are scarce studies that analyze the correlation of these factors with outcome, mainly referred to time to first treatment (TTFT) and overall survival (OS). This study aimed to typify IGHV mutation status, family usage, FISH aberrations, and complex karyotype (CK) and to analyze the prognostic impact in TTFT and OS in retrospective study of 375 CLL patients from a Spanish cohort. We found unmutated CLL (U-CLL) was associated with more aggressive disease, shorter TTFT (48 vs. 133 months, p < 0.0001), and shorter OS (112 vs. 246 months, p < 0.0001) than the mutated CLL. IGHV3 was the most frequently used IGHV family (46%), followed by IGHV1 (30%) and IGHV4 (16%). IGHV5-51 and IGHV1-69 subfamilies were associated with poor prognosis, while IGHV4 and IGHV2 showed the best outcomes. The prevalence of CK was 15% and was significantly associated with U-CLL. In the multivariable analysis, IGHV2 gene usage and del13q were associated with longer TTFT, while VH1-02, +12, del11q, del17p, and U-CLL with shorter TTFT. Moreover, VH1-69 usage, del11q, del17p, and U-CLL were significantly associated with shorter OS. A comprehensive analysis of genetic prognostic factors provides a more precise information on the outcome of CLL patients. In addition to FISH cytogenetic aberrations, IGHV and TP53 mutations, IGHV gene families, and CK information could help clinicians in the decision-making process.
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Telecommunications industries are rapidly deploying the fifth generation (5G) spectrum and there is public concern about the safety and health impacts of this type of Radio Frequency Radiation (RFR), in part because of the lack of comparable scientific evidence. In this study we have used a validated commercially available setting producing a uniform field to expose zebrafish embryos (ZFe) to unmodulated 700 and 3500 MHz frequencies. We have combined a battery of toxicity, developmental and behavioral assays to further explore potential RFR effects. Our neurobehavioral profiles include a tail coiling assay, a light/dark activity assay, two thigmotaxis anxiety assays (auditory and visual stimuli), and a startle response - habituation assay in response to auditory stimuli. ZFe were exposed for 1 and 4 h during the blastula period of development and endpoints evaluated up to 120 hours post fertilization (hpf). Our results show no effects on mortality, hatching or body length. However, we have demonstrated specific organ morphological effects, and behavioral effects in activity, anxiety-like behavior, and habituation that lasted in larvae exposed during the early embryonic period. A decrease in acetylcholinesterase activity was also observed and could explain some of the observed behavioral alterations. Interestingly, effects were more pronounced in ZFe exposed to the 700 MHz frequency, and especially for the 4 h exposure period. In addition, we have demonstrated that our exposure setup is robust, flexible with regard to frequency and power testing, and highly comparable. Future work will include exposure of ZFe to 5G modulated signals for different time periods to better understand the potential health effects of novel 5G RFR.
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Acetilcolinesterasa , Pez Cebra , Animales , Conducta Animal , Larva , Embrión no MamíferoRESUMEN
INTRODUCTION: During the Coronavirus (COVID-19) pandemic, healthcare providers have overcome difficult experiences such as workplace violence. Nurses are particularly vulnerable to workplace violence. The objective of this study was to characterize violence and aggression against nurses during the COVID-19 pandemic in Latin America. METHODS: An electronic cross-sectional survey was conducted in 19 Latin American countries to characterize the frequency and type of violent actions against front-line healthcare providers. RESULTS: Of the original 3544 respondents, 16% were nurses (n = 567). The mean age was 39.7 ± 9.0 years and 79.6% (n = 2821) were women. In total, 69.8% (n = 2474) worked in public hospitals and 81.1% (n = 2874) reported working regularly with COVID-19 patients. Overall, about 68.6% (n = 2431) of nurses experienced at least one episode of workplace aggression during the pandemic. Nurses experienced weekly aggressions more frequently than other healthcare providers (45.5% versus 38.1%, p < .007). Nurses showed a trend of lower reporting rates against the acts of aggression suffered (p = .076). In addition, nurses were more likely to experience negative cognitive symptoms after aggressive acts (33.4% versus 27.8%, p = .028). However, nurses reported considering changing their work tasks less frequently compared to other healthcare providers after an assault event (p = .005). CONCLUSION: Workplace violence has been a frequent problem for all healthcare providers during COVID-19 pandemic in Latin America. Nurses were a particularly vulnerable subgroup, with higher rates of aggressions and cognitive symptoms and lower rate of complaints than other healthcare providers who suffered from workplace violence. It is imperative to develop strategies to protect this vulnerable group from aggressions during their tasks.
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COVID-19 , Cardiología , Violencia Laboral , Humanos , Femenino , Adulto , Persona de Mediana Edad , Masculino , Agresión/psicología , América Latina/epidemiología , Pandemias , Estudios Transversales , COVID-19/epidemiología , Violencia Laboral/psicología , Lugar de Trabajo/psicología , Encuestas y CuestionariosRESUMEN
The densification of multiple wireless communication systems that coexist nowadays, as well as the 5G new generation cellular systems advent towards the millimeter wave (mmWave) frequency range, give rise to complex context-aware scenarios with high-node density heterogeneous networks. In this work, a radiofrequency electromagnetic field (RF-EMF) exposure assessment from an empirical and modeling approach for a large, complex indoor setting with high node density and traffic is presented. For that purpose, an intensive and comprehensive in-depth RF-EMF E-field characterization study is provided in a public library study case, considering dense personal mobile communications (5G FR2 @28 GHz) and wireless 802.11ay (@60 GHz) data access services on the mmWave frequency range. By means of an enhanced in-house deterministic 3D ray launching (3D-RL) simulation tool for RF-EMF exposure assessment, different complex heterogenous scenarios of high complexity are assessed in realistic operation conditions, considering different user distributions and densities. The use of directive antennas and MIMO beamforming techniques, as well as all the corresponding features in terms of radio wave propagation, such as the body shielding effect, dispersive material properties of obstacles, the impact of the distribution of scatterers and the associated electromagnetic propagation phenomena, are considered for simulation. Discussion regarding the contribution and impact of the coexistence of multiple heterogeneous networks and services is presented, verifying compliance with the current established international regulation limits with exposure levels far below the aforementioned limits. Finally, the proposed simulation technique is validated with a complete empirical campaign of measurements, showing good agreement. In consequence, the obtained datasets and simulation estimations, along with the proposed RF-EMF simulation tool, could be a reference approach for the design, deployment and exposure assessment of the current and future wireless communication technologies on the mmWave spectrum, where massive high-node density heterogeneous networks are expected.
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Campos Electromagnéticos , Exposición a Riesgos Ambientales , Comunicación , Ondas de Radio , Tecnología InalámbricaRESUMEN
Este estudo teve por objetivo analisar a influência dos fatores sociodemográficos na mortalidade materna no estado da Bahia e identificar seus fatores de risco, para que sejam implantadas melhorias na Atenção Primária à Saúde. Foi realizado um estudo quantitativo, transversal e descritivo com dados secundários, coletados no período de fevereiro a junho de 2020 por meio do Departamento de Informática do Sistema Único de Saúde (Datasus). A população do estudo foi composta por todas as mulheres de faixa etária entre 10 e 49 anos que morreram durante a gravidez, parto ou puerpério, no período de 2007 a 2017. Foram estudadas as variáveis qualitativas escolaridade, estado civil, cor/raça e a variável quantitativa idade. Na análise dos dados, foram usadas a razão de mortalidade materna para calcular a variável quantitativa e as taxas de distribuição percentual para calcular as variáveis qualitativas. De acordo com a análise deste estudo, foi possível perceber que os óbitos maternos foram mais prevalentes em mulheres entre 40 e 49 anos, solteiras, com quatro a 11 anos de escolaridade e pardas. Assim, pode-se concluir que, a fim de reduzir a mortalidade materna na Bahia, são necessárias ações governamentais mais amplas e articuladas, para que ocorram mudanças efetivas no atual modelo assistencial de atenção obstétrica.
This study aimed to analyze the influence of sociodemographic factors on maternal mortality in the state of Bahia and to identify its risk factors, for implementing improvements in Primary Health Care. A quantitative, cross-sectional, and descriptive study was carried out with secondary data collected from February to June 2020 by using the Department of Informatics of the Unified Health System (DATASUS). The study population comprises all women aged between 10 and 49 years, who died during pregnancy, labor, or puerperium in the period from 2007 to 2017. Qualitative variables of schooling, marital status, skin color/race and quantitative age variable were studied. In the data analysis, maternal mortality ratios were used to calculate the quantitative variable and the percentage distribution rates to calculate the qualitative variables. According to this study analysis, noticing that maternal deaths were more prevalent in women between 40 and 49 years old, single, with four to 11 years of schooling and mixed race was possible. Thus, it is possible to conclude that, to reduce maternal mortality in Bahia, broader and more articulated governmental actions are necessary for effective changes to occur in the current model of obstetric care.
Este estudio tuvo como objetivo analizar la influencia de los factores sociodemográficos en la mortalidad materna en el estado de Bahía (Brasil) e identificar sus factores de riesgo para que se implementen mejoras en la atención primaria de salud. Se realizó un estudio cuantitativo, transversal y descriptivo con datos secundarios recolectados del Departamento de Informática del Sistema Único de Salud (DATASUS) en el período de febrero a junio de 2020. La población del estudio se compuso de mujeres entre los 10 y los 49 años, que fallecieron durante el embarazo, parto o puerperio en el período de 2007 a 2017. Se estudiaron las variables cualitativas de educación, estado civil, color/raza y la variable cuantitativa edad. En el análisis de datos, se utilizó la razón de mortalidad materna para calcular la variable cuantitativa y las tasas de distribución porcentual para calcular las variables cualitativas. Del análisis se pudo notar que las muertes maternas fueron más prevalentes en mujeres entre 40 y 49 años, solteras, con cuatro a 11 años de educación y pardas. Se concluyó que la reducción de la mortalidad materna en Bahía requiere de acciones gubernamentales más amplias y articuladas para que se produzcan cambios efectivos en el actual modelo de atención de la atención obstétrica.
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Humanos , Femenino , Mortalidad Materna , Salud de la Mujer , Análisis de Vulnerabilidad , Factores SociodemográficosRESUMEN
The aim of this study was to model and evaluate the Specific Energy Absorption Rate (SAR) values in humans in proximity to fixed multi-antenna I-RFID readers of passive tags under various scenarios mimicking exposure when they are incorporated in Real-Time Location Systems (RTLS), or used to monitor Personal Protective Equipment (PPE). The sources of the electromagnetic field (EMF) in the modelled readers were rectangular microstrip antennas at a resonance frequency in free space of 866 MHz from the ultra-high frequency (UHF) RFID frequency range of 865-868 MHz. The obtained results of numerical modelling showed that the SAR values in the body 5 cm away from the UHF RFID readers need consideration with respect to exposure limits set by international guidelines to prevent adverse thermal effects of exposure to EMF: when the effective radiated power exceeds 5.5 W with respect to the general public/unrestricted environments exposure limits, and with respect to occupational/restricted environments exposure limits, when the effective radiated power exceeds 27.5 W.
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Equipo de Protección Personal , Dispositivo de Identificación por Radiofrecuencia , Campos Electromagnéticos , Humanos , Monitoreo FisiológicoRESUMEN
The aim of this study was to evaluate the absorption in a user's head of an electromagnetic field (EMF) emitted by the Wi-Fi and/or Bluetooth module of a wearable small Internet of Things (IoT) electronic device (emitting EMF of up to 100 mW), in order to test the hypothesis that EMF has an insignificant influence on humans, and to compare the levels of such EMF absorption in various scenarios when using this device. The modelled EMF source was a meandered inverted-F antenna (MIFA)-type antenna of the ESP32-WROOM-32 radio module used in wearable devices developed within the reported study. To quantify the EMF absorption, the specific energy absorption rate (SAR) values were calculated in a multi-layer ellipsoidal model of the human head (involving skin, fat, skull bones and brain layers). The obtained results show up to 10 times higher values of SAR from the MIFA located in the headband, in comparison to its location on the helmet. Only wearable IoT devices (similar in construction and way of use to the investigated device) emitting at below 3 mW equivalent isotropically radiated power (EIRP) from Wi-Fi/Bluetooth communications modules may be considered environmentally insignificant EMF sources.
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Campos Electromagnéticos , Dispositivos Electrónicos Vestibles , Cabeza , Humanos , Internet , Lugar de TrabajoRESUMEN
The COVID-19 respiratory manifestations go from mild symptoms similar to those of a common cold to severe pneumonia with respiratory distress syndrome, septic shock and multiorgan failure. The disease is caused by the SARS-CoV-2 virus, whose transmission mechanism most relevant to dentistry is through respiratory droplets and possibly also aerosols, as well as direct contact with mucous membranes of the nose, mouth or eye via contaminated hands or objects. The professionals of the dental health units have a high risk exposure since they work at short distances (less than 1 m from the head of the patient) in the oral cavity, where a maximal expression of possible cell receptors for the virus has been reported. Also, most procedures in the dental cabinet imply aerosol generation. Cross-infection is possible during dental care, not only with diagnosed COVID-19-positive patients but also with patients who remain undetected due to asymptomatic or presymptomatic disease. For all these reasons, dental care in the primary health setting has had to change in order to adapt to the pandemic. The changes affect both the appointment scheduling and the care itself and imply the establishment of general and specific barrier protections as well as measures related to ventilation, cleaning, disinfection and sterilization, reinforced with additional infection prevention and control measures. This article summarizes the available scientific evidence about this adaptation.
En el término COVID-19 se incluyen cuadros respiratorios que varían desde el resfriado común hasta cuadros de neumonía grave con síndrome de distrés respiratorio, shock séptico y fallo multiorgánico. Esta enfermedad está causada por el virus SARS-CoV-2, cuyo mecanismo de transmisión más importante en odontología es, fundamentalmente, respiratorio, mediante gotitas, probablemente aerosoles y, también, por contacto directo con mucosas (nasales, orales u oculares) a través de manos o fómites contaminados. Los profesionales de las Unidades de Salud Bucodental representan una categoría laboral con un riesgo de exposición muy alto, ya que trabajan a una distancia de trabajo reducida (menos de un metro de la cabeza del paciente) en la cavidad oral, donde se ha descrito la máxima expresión de los posibles receptores celulares de dicho virus. Además, la mayoría de los procedimientos odontológicos conllevan la generación de aerosoles. Durante la atención odontológica puede producirse infección cruzada, tanto con pacientes diagnosticados positivos por COVID-19 como con aquellos no detectados por encontrarse asintomáticos o en fase presintomática. Por estas razones, la actividad odontológica en Atención Primaria ha tenido que adaptarse a la pandemia. Dichos cambios afectan a la distribución de la agenda de citación, a la atención odontológica, e implican el establecimiento de medidas universales y específicas de protección de barrera y otras relativas a ventilación, limpieza, desinfección y esterilización, reforzadas con medidas adicionales de control de infecciones. Este artículo resume la evidencia científica disponible relativa a dicha adaptación.
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Infecciones por Coronavirus/prevención & control , Odontólogos , Control de Infecciones/métodos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Aerosoles , Betacoronavirus , COVID-19 , Infección Hospitalaria/prevención & control , Odontología/organización & administración , Humanos , Equipo de Protección Personal , Admisión y Programación de Personal , SARS-CoV-2 , España/epidemiologíaRESUMEN
BACKGROUND: COVID-19 is one of the biggest pandemics in human history, along with other disease pandemics, such as the H1N1 influenza A, bubonic plague, and smallpox pandemics. This study is a small contribution that tries to find contrasted formulas to alleviate global suffering and guarantee a more manageable future. OBJECTIVE: In this study, a statistical approach was proposed to study the correlation between the incidence of COVID-19 in Spain and search data provided by Google Trends. METHODS: We assessed the linear correlation between Google Trends search data and the data provided by the National Center of Epidemiology in Spain-which is dependent on the Instituto de Salud Carlos III-regarding the number of COVID-19 cases reported with a certain time lag. These data enabled the identification of anticipatory patterns. RESULTS: In response to the ongoing outbreak, our results demonstrate that by using our correlation test, the evolution of the COVID-19 pandemic can be predicted in Spain up to 11 days in advance. CONCLUSIONS: During the epidemic, Google Trends offers the possibility to preempt health care decisions in real time by tracking people's concerns through their search patterns. This can be of great help given the critical, if not dramatic need for complementary monitoring approaches that work on a population level and inform public health decisions in real time. This study of Google search patterns, which was motivated by the fears of individuals in the face of a pandemic, can be useful in anticipating the development of the pandemic.
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COVID-19/diagnóstico , COVID-19/epidemiología , Salud Pública/tendencias , Motor de Búsqueda/tendencias , Brotes de Enfermedades , Progresión de la Enfermedad , Humanos , Incidencia , Internet , Estudios Longitudinales , Modelos Estadísticos , Pandemias , Vigilancia en Salud Pública/métodos , España/epidemiologíaRESUMEN
Coronavirus Disease 2019, COVID-19, es una enfermedad respiratoria causada por un coronavirus, el SARS-CoV-2. La ruta de trasmisión es a través de gotas y salpicaduras procedentes del tracto aerodigestivo de personas infectadas, así como por el contacto con superficies contaminadas y la posterior deposición en la mucosa de los ojos, nariz o boca, siendo probable su transmisión por aerosoles. Por otra parte, el trabajo dental no permite mantener una distancia de 2 metros, ni el uso por parte del paciente de mascarilla. Por esta razón, dentro del esquema de Equipos de Protección Individual (EPI), la protección respiratoria es fundamental, junto con la ocular, y con ello la selección de la mascarilla y, sobre todo, el uso que se haga de ella. La razón del presente artículo es describir los diferentes tipos de mascarillas y el uso apropiado de cada una de ellas según el objetivo buscado. Para ello, se recomendarán las mascarillas higiénicas y las quirúrgicas en usuarios generales, con la función de disminuir la trasmisión viral por medio de la minoración de la contaminación ambiental cuando es alta la trasmisión comunitaria. Las máscaras de protección respiratoria estarán indica-das en trabajadores sanitarios y otros en contacto con pacientes potencialmente infecciosos, al menos cuando los procedimientos de trabajo impliquen un riesgo elevado para el profesional
COVID-19 is a respiratory illness caused by a new coronavirus, SARS-CoV-2. The virus spreads through droplets and spray from the respiratory tracts of infected persons, and through contact with contaminated surfaces followed by touching the eyes, nose or mouth. It is also likely that the virus can be spread through aerosols. However, dentistry does not allow for a distance of two metres to be maintained, and nor does it allow for the patient to wear a mask. As such, within the scope of Personal Protective Equipment (PPE), respiratory protection is of fundamental importance, along with eye protection and the correct usage of available masks. The purpose of this article is to describe different types of masks and the appropriate use of each one according to the required need. To this end, it is recommended that hygienic and surgical masks are used with a view to decreasing viral transmission through the reduction of environmental contamination whilst community transmission is high. Respiratory protection masks will be shown on health workers and others who are in contact with potentially infectious patients, when the work involved brings with it an increased level of risk for the worker
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Humanos , Máscaras/normas , Personal de Odontología/organización & administración , Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus , Pandemias/prevención & control , Máscaras/tendencias , Máscaras/clasificación , Servicio Odontológico Hospitalario/normas , Personal de Odontología/normas , Descontaminación/métodos , Descontaminación/normasRESUMEN
BACKGROUND: Different studies have suggested that web search data are useful in forecasting several phenomena from the field of economics to epidemiology or health issues. OBJECTIVE: This study aimed to (1) evaluate the correlation between suicide rates released by the Spanish National Statistics Institute (INE) and internet search trends in Spain reported by Google Trends (GT) for 57 suicide-related terms representing major known risks of suicide and an analysis of these results using a linear regression model and (2) study the differential association between male and female suicide rates published by the INE and internet searches of these 57 terms. METHODS: The study period was from 2004 to 2013. In this study, suicide data were collected from (1) Spain's INE and (2) local internet search data from GT, both from January 2004 to December 2013. We investigated and validated 57 suicide-related terms already tested in scientific studies before 2015 that would be the best predictors of new suicide cases. We then evaluated the nowcasting effects of a GT search through a cross-correlation analysis and by linear regression of the suicide incidence data with the GT data. RESULTS: Suicide rates in Spain in the study period were positively associated (r<-0.2) for the general population with the search volume for 7 terms and negatively for 1 from the 57 terms used in previous studies. Suicide rates for men were found to be significantly different than those of women. The search term, "allergy," demonstrated a lead effect for new suicide cases (r=0.513; P=.001). The next significant correlating terms for those 57 studied were "antidepressant," "alcohol abstinence," "relationship breakup" (r=0.295, P=.001; r=0.295, P=.001; and r=0.268, P=.002, respectively). Significantly different results were obtained for men and women. Search terms that correlate with suicide rates of women are consistent with previous studies, showing that the incidence of depression is higher in women than in men, and showing different gender searching patterns. CONCLUSIONS: A better understanding of internet search behavior of both men and women in relation to suicide and related topics may help design effective suicide prevention programs based on information provided by search robots and other big data sources.
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Conducta en la Búsqueda de Información , Motor de Búsqueda/tendencias , Medios de Comunicación Sociales/instrumentación , Suicidio/estadística & datos numéricos , Adulto , Correlación de Datos , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Medios de Comunicación Sociales/tendencias , España/epidemiologíaRESUMEN
The asymmetric synthesis of a compound with the cyclopentan[c]pyran core of iridoid natural products in four steps and 40% overall yield is reported. Our methodology includes a one-pot tandem domino reaction which provides a trisubstituted cyclopentane with five new completely determined stereocenters, which were determined through 2D homo and heteronuclear NMR and n.O.e. experiments on different compounds specially designed for this purpose, such as a dioxane obtained from a diol. Due to their pharmaceutical properties, including sedative, analgesic, anti-inflammatory, CNS depressor or anti-conceptive effects, this methodology to produce the abovementioned iridoid derivatives, is an interesting strategy in terms of new drug discovery as well as pharmaceutical development.
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Productos Biológicos/síntesis química , Ciclopentanos/síntesis química , Iridoides/síntesis química , Piranos/síntesis química , Benzaldehídos/química , Productos Biológicos/química , Espectroscopía de Resonancia Magnética con Carbono-13 , Ciclopentanos/química , Iridoides/química , Oxidación-Reducción , Espectroscopía de Protones por Resonancia Magnética , Piranos/química , EstereoisomerismoRESUMEN
The COVID-19 respiratory manifestations go from mild symptoms similar to those of a common cold to severe pneumonia with respiratory distress syndrome, septic shock and multiorgan failure. The disease is caused by the SARS-CoV-2 virus, whose transmission mechanism most relevant to dentistry is through respiratory droplets and possibly also aerosols, as well as direct contact with mucous membranes of the nose, mouth or eye via contaminated hands or objects. The professionals of the dental health units have a high risk exposure since they work at short distances (less than 1 m from the head of the patient) in the oral cavity, where a maximal expression of possible cell receptors for the virus has been reported. Also, most procedures in the dental cabinet imply aerosol generation. Cross-infection is possible during dental care, not only with diagnosed COVID-19-positive patients but also with patients who remain undetected due to asymptomatic or presymptomatic disease. For all these reasons, dental care in the primary health setting has had to change in order to adapt to the pandemic. The changes affect both the appointment scheduling and the care itself and imply the establishment of general and specific barrier protections as well as measures related to ventilation, cleaning, disinfection and sterilization, reinforced with additional infection prevention and control measures. This article summarizes the available scientific evidence about this adaptation
The COVID-19 respiratory manifestations go from mild symptoms similar to those of a common cold to severe pneumonia with respiratory distress syndrome, septic shock and multiorgan failure. The disease is caused by the SARS-CoV-2 virus, whose transmission mechanism most relevant to dentistry is through respiratory droplets and possibly also aerosols, as well as direct contact with mucous membranes of the nose, mouth or eye via contaminated hands or objects. The professionals of the dental health units have a high risk exposure since they work at short distances (less than 1 m from the head of the patient) in the oral cavity, where a maximal expression of possible cell receptors for the virus has been reported. Also, most procedures in the dental cabinet imply aerosol generation. Cross-infection is possible during dental care, not only with diagnosed COVID-19-positive patients but also with patients who remain undetected due to asymptomatic or presymptomatic disease. For all these reasons, dental care in the primary health setting has had to change in order to adapt to the pandemic. The changes affect both the appointment scheduling and the care itself and imply the establishment of general and specific barrier protections as well as measures related to ventilation, cleaning, disinfection and sterilization, reinforced with additional infection prevention and control measures. This article summarizes the available scientific evidence about this adaptation
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Humanos , Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control , Pandemias , Atención Primaria de Salud/normas , Atención Odontológica/normas , Equipos de Seguridad , EspañaRESUMEN
BACKGROUND: S100B protein is one of the most accurate biomarkers for diagnosis of neuroapoptosis and brain damage. The aim was to evaluate the lactate concentration and acid-base balance (pH, pCO2, pO2, HCO3c and BEb) in umbilical cord blood to predict high risk of neuroapoptosis and analyze the relationship between the levels of these biomarkers and umbilical cord blood S100B protein concentration at birth. METHODS: Apparently healthy newborns were included. S100B protein and blood gas test (lactate and acid-base balance) were determined in umbilical cord blood at birth. Newborns were classified into two groups: with and without high risk of neuroapoptosis. Newborns with high umbilical cord blood S100B protein concentration were considered newborns at high risk of neuroapoptosis. RESULTS: Sixty-one newborns were included, 12 had high risk of neuroapoptosis and 49 did not. S100B protein concentration correlate directly with pCO2 levels (Rho: 0.286, pâ¯=â¯.0321) and lactate concentration (Rho: 0.278, pâ¯=â¯.0315); and indirectly with pH (Rho: -0.332, pâ¯=â¯.01). The analysis of the ROC curves yielded significant curves for pH and pCO2 to predict high risk of neuroapoptosis, pH optimal cutoff value was 7.19 (sensitivity: 50%, specificity: 83.7%, AUC: 0.708); and pCO2 optimal cutoff value was 60â¯mmHg (sensitivity: 30%, specificity: 85.4%, AUC: 0.705). CONCLUSIONS: Respiratory acidosis is associated to high concentrations of S100B protein in umbilical cord blood at birth. Umbilical cord blood pH and pCO2 may be useful in differentiating newborns at high risk of neuroapoptosis. Umbilical cord blood gas test may be valuable as risk indicator for neuroapoptosis at birth.
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Acidosis Respiratoria/sangre , Acidosis Respiratoria/patología , Apoptosis , Encéfalo/patología , Sangre Fetal/química , Adolescente , Adulto , Biomarcadores/sangre , Análisis de los Gases de la Sangre , Dióxido de Carbono/sangre , Estudios Transversales , Femenino , Hipoxia Fetal/sangre , Humanos , Concentración de Iones de Hidrógeno , Recién Nacido , Ácido Láctico/sangre , Masculino , Neuronas/patología , Curva ROC , Subunidad beta de la Proteína de Unión al Calcio S100/sangre , Sensibilidad y Especificidad , Adulto JovenRESUMEN
OBJECTIVES: Staff in PICUs shows high burnout, posttraumatic stress disorder symptoms, and posttraumatic growth levels. However, their levels of satisfaction with life and how positive and negative posttrauma outcomes relate to each other and contribute to predict satisfaction with life remain unknown. Thus, we attempted to explore these aspects and to compare the findings with data from pediatric professionals working in noncritical units. DESIGN: This is an observational multicentric, cross-sectional study. SETTING: The PICU of nine hospitals in Spain, and other pediatric units in the same hospitals. SUBJECTS: Two hundred ninety-eight PICU workers (57 physicians, 177 nurses, and 64 nursing assistants) and 189 professionals working in noncritical pediatric units (53 physicians, 104 nurses, and 32 nursing assistants). INTERVENTION: Participants completed the Maslach Burnout Inventory, the Trauma Screening Questionnaire, the Posttraumatic Growth Inventory, and the Satisfaction With Life Scale. MEASUREMENTS AND MAIN RESULTS: Of PICU staff, 16.4% were very satisfied with their lives, 34.2% were satisfied, 34.6% showed average satisfaction with life, and 14.8% were below average. No differences were found between PICU and non-PICU workers. Women reported lower satisfaction with life than men, and physicians reported higher satisfaction with life than other professional groups. The correlation between posttraumatic stress disorder and posttraumatic growth was low, but significant and positive. According to the path analysis with latent variables, 20% of the variance satisfaction with life could be predicted from burnout, posttraumatic stress disorder symptoms, and posttraumatic growth. Higher distress was inversely associated to satisfaction with life, whereas posttraumatic growth contributed to higher satisfaction with life. CONCLUSIONS: Posttraumatic growth can moderate the negative effect of traumatic work-related experiences in satisfaction with life. PICU and non-PICU workers were equally satisfied with their lives. Positive and negative impact of work-related potentially traumatic events can coexist in the same person. Interventions aimed at reducing distress and fostering posttraumatic growth could impact in an improvement in pediatric health professionals' satisfaction with life.
Asunto(s)
Agotamiento Profesional/epidemiología , Personal de Salud/psicología , Satisfacción Personal , Crecimiento Psicológico Postraumático , Trastornos por Estrés Postraumático/epidemiología , Adulto , Factores de Edad , Estudios Transversales , Ambiente , Femenino , Humanos , Unidades de Cuidado Intensivo Pediátrico , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Factores Sexuales , Factores Socioeconómicos , España , Lugar de Trabajo/psicologíaRESUMEN
Addictive behaviors are not limited to drugs use, but also include certain daily behaviors that can cause gratification. Their progression to more severe pathological patterns entails grave consequences for the individual, including multiple psychopathological manifestations. The early detection of this type of behavior is of concern to primary health care. Therefore, in order to detect risk at early stages, reliable and valid tools for daily practice are essential. The MULTICAGE CAD-4 questionnaire is a screening tool for simultaneously detecting addictive behaviors. This study includes a new scale for the detection of smartphone abuse. The objective is to evaluate the adequacy of its psychometric properties. A sample of 2,074 subjects that were recruited from primary care centers ofMadrid(Spain) completed the MULTICAGE CAD-4 questionnaire. A confirmatory factor analysis, using unweighted least squares method, was performed. The test showed good internal consistency both at item and scale levels. The questionnaire structure was consistent with theoretical expectations. The MULTICAGE CAD-4, including the new smartphone scale, is a robust, reliable tool with a valid structure for assessing the presence of dysfunctional or potentially addictive behaviors, and especially useful in primary health care services
Los comportamientos adictivos no se limitan al uso de drogas, sino que también incluyen ciertos comportamientos diarios que pueden causar gratificación. Su progresión a patrones patológicos más severos conlleva graves consecuencias para el individuo, incluidas múltiples manifestaciones psicopatológicas. La detección temprana de este tipo de comportamiento es de interés para la atención primaria de salud. Por lo tanto, para detectar riesgos en etapas tempranas, las herramientas confiables y válidas para la práctica diaria son esenciales. El cuestionario MULTICAGE CAD-4 es una herramienta de detección para detectar simultáneamente conductas adictivas. Este estudio incluye una nueva escala para la detección del abuso de teléfonos inteligentes. El objetivo es evaluar la adecuación de sus propiedades psicométricas. Una muestra de 2.074 sujetos reclutados en centros de atención primaria de Madrid (España) completó el cuestionario MULTICAGE CAD-4. Se realizó un análisis factorial confirmatorio, utilizando el método de mínimos cuadrados no ponderados. La prueba mostró una buena consistencia interna tanto a nivel del ítem como de las escalas. La estructura del cuestionario fue consistente con las expectativas teóricas. El MULTICAGE CAD-4, incluida la nueva escala para teléfonos inteligentes, es una herramienta robusta y confiable con una estructura válida para evaluar la presencia de comportamientos disfuncionales o potencialmente adictivos, y especialmente útil en servicios de atención primaria de salud
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Anciano , Anciano de 80 o más Años , Persona de Mediana Edad , Conducta Adictiva/epidemiología , Conducta Adictiva/psicología , Psicometría/métodos , Teléfono Inteligente/tendencias , Atención Primaria de Salud , Encuestas y Cuestionarios , Análisis Factorial , Estudios Transversales , Análisis de Datos , Persona de Mediana EdadRESUMEN
The Moroccan locust, Dociostaurus maroccanus (Thunberg, 1815) (Orthoptera: Acrididae), is a polyphagous pest capable of inflicting large losses in agriculture under favorable environmental and climatic conditions. Currently, control of the pest relies solely on the application of conventional insecticides that have negative effects on the environment and human safety. In the search for a more rational, environmentally acceptable approach for locust control, we have previously reported that ( Z/ E)-phytal (1) is a male-produced candidate sex pheromone of this acridid. This molecule, with two stereogenic centers at C-7 and C-11, has four different diastereomers along with the Z/ E stereochemistry of the double bond at C-2. In this paper, we present for the first time the enantioselective synthesis of the four diastereomers of ( E)-phytal and their electrophysiological and behavioral activity on males and females. Our results demonstrate that the ( R, R)-phytal is the most active diastereomer in both assays, significantly attracting females in a double-choice Y olfactometer, and confirming the previous chromatographic assignment as component of the sex pheromone of the Moroccan locust.
Asunto(s)
Aldehídos/síntesis química , Aldehídos/farmacología , Diterpenos/síntesis química , Diterpenos/farmacología , Feromonas/síntesis química , Feromonas/farmacología , Aldehídos/química , Animales , Diterpenos/química , Femenino , Saltamontes/efectos de los fármacos , Saltamontes/fisiología , Masculino , Feromonas/química , Conducta Sexual Animal/efectos de los fármacos , EstereoisomerismoRESUMEN
The aim is to evaluate specific absorption rate (SAR) values from exposure near handheld ultra-high frequency radiofrequency identification readers (UHF RFID guns-small electronic devices, or even portable computers with relevant accessories-emitting up to several watts of electromagnetic field (EMF) to search for RFID sensors (tags) attached to marked objects), in order to test the hypothesis that they have an insignificant environmental influence. Simulations of SAR in adult male and female models in seven exposure scenarios (gun near the head, arm, chest, hip/thigh of the operator searching for tags, or near to the chest and arm of the scanned person or a bystander). The results showed EMF exposure compliant with SAR limits for general public exposure (ICNIRP/European Recommendation 1999/519/EC) at emissions up to 1 W (reading range 3.5-11 m, depending on tag sensitivity). In the worst-case scenario, guns with a reading range exceeding 5 m (>2 W emission) may cause an SAR exceeding the general public limits in the palm of the user and the torso of the user, a bystander, or a scanned person; occupational exposure limits may be exceeded when emission >5 W. Users of electronic medical implants and pregnant women should be treated as individuals at particular risk in close proximity to guns, even at emissions of 1 W. Only UHF RFID guns emitting below 1 W may be considered as environmentally insignificant EMF sources.
RESUMEN
OBJECTIVE: To examine psychometric properties of the Brazilian version of the Posttraumatic Growth Inventory (PTGI). METHOD: A total of 300 university students were evaluated though instruments that investigated trauma history, depression and posttraumatic symptoms, and personality traits through the Big Five model. Pearson's correlation was used to assess internal consistency, inter-item reliability and construct validity. Principal component analysis and confirmatory factor analysis were performed to investigate the factor structure of the PTGI. RESULTS: Results confirmed the original five-factor structure. The results showed good internal consistency for the total scale (α = 0.91) and its subscales, ranging from α = 0.85 to α = 0.70. Also, evidence of construct and convergent validity was observed through correlations with posttraumatic and depression symptoms and personality measures. CONCLUSIONS: These preliminary results suggest that the Brazilian PTGI is reliable and showed adequate evidence of validity.