Outcomes of viral coinfections in infants hospitalized for acute bronchiolitis.

BACKGROUND AND OBJECTIVE: The clinical relevance of the detection of multiple respiratory viruses in acute bronchiolitis (AB) has not been established. Our goal was to evaluate the effect of viral coinfections on the progression and severity of AB. METHODS: A retrospective observational study was conducted in a tertiary hospital in Spain from September 2012 to March 2020. Infants admitted for AB with at least one respiratory virus identified by molecular diagnostic techniques were included. A comparison was made between single-virus infections and viral coinfections. The evolution and severity of AB were determined based on the days of hospitalization and admission to the pediatric intensive care unit (PICU). RESULTS: Four hundred forty-five patients were included (58.4% male). The median weight was 5.2 kg (IQR 4.2-6.5), and the median age was 2.5 months (IQR 1.4-4.6). A total of 105 patients (23.6%) were admitted to the PICU. Respiratory syncytial virus (RSV) was the most frequent etiological agent (77.1%). A single virus was detected in 270 patients (60.7%), and viral coinfections were detected in 175 (39.3%), of which 126 (28.3%) had two viruses and 49 (11%) had three or more viruses. Hospital length of stay (LOS) increased in proportion to the number of viruses detected, with a median of 6 days (IQR 4-8) for single infections, 7 days (IQR 4-9) for coinfections with two viruses and 8 days (IQR 5-11) for coinfections with ≥ 3 viruses (p = 0.003). The adjusted Cox regression model showed that the detection of ≥ 3 viruses was an independent risk factor for a longer hospital LOS (HR 0.568, 95% CI 0.410-0.785). No significant association was observed between viral coinfections and the need for PICU admission (OR 1.151; 95% CI 0.737-1.797). CONCLUSIONS: Viral coinfections modified the natural history of AB, prolonging the hospital LOS in proportion to the number of viruses detected without increasing the need for admission to the PICU.

SIGNIFICANCE: What is KnownThe main etiological agent of acute bronchiolitis (AB) is respiratory syncytial virus (RSV); however, other viruses are frequently detected. All viruses may be the sole etiological cause or may occur in association, and a high prevalence of viral coinfection has been described.To date, there are conflicting results on the role of viral coinfections in the severity of bronchiolitis.What is NewViral coinfections influence the progression of AB. The simultaneous detection of 3 or more respiratory viruses is a risk factor for longer hospital stay.The presence of viral coinfections does not condition a greater need for admission to the PICU.

Cardiac Rehabilitation in Primary Care. Impact of an Intervention on Perceived Self-Efficacy.

Cardiac rehabilitation is cost-effective and should be considered a part of the care system provided to patients who have suffered a myocardial infarction or another heart disease. The main variable to study was the scoring, prior to and after the intervention in the General Scale of Self-Efficacy by Baessler & Schwarzer. A clinical community trial that was open controlled and randomised was used. All adult subjects of both sexes who had completed a cardiac rehabilitation program for 12 months at the reference hospital were selected and offered to participate. The psychometric variables registered were the Salamanca screening questionnaire, the Hamilton Anxiety Rating Scale, and the Beck Depression Inventory. Eighty-nine subjects accepted to participate in the study (93.89% response rate), with an average age of 63.01 years (SD 8.75). Once the study was concluded, the main outcome was a difference in means of 6.09 points in the General Scale of Self-Efficacy (p < 0.0053, 96% confidence interval-4.1950-10.29), showing that the group exposed to the intervention reached a higher score in the above-mentioned scale. However, there were no significant differences (t-student 0.1211; p = 0.943) after the estimation and contrast of population means for score differences between the groups regarding the Hamilton scale. Similarly, there were no significant differences between the groups regarding the means obtained in the variable score difference in the Beck Depression Inventory (t-student -0.1281; p = 0.8987). The results showed an increase in those scores related to general self-efficacy among the population that completed the intervention program, as compared to the control group.

Autoeficacia percibida, rasgos de personalidad y biotipos previos a programa de rehabilitación cardíaca en atención primaria de salud / Perceived self-efficacy, personality and bioethics before a heart rehabilitation programme in primary health care

Objetivos: Existe evidencia del beneficio de la rehabilitación cardíaca tras evento cardiovascular sobre el estado de ánimo y la autoeficacia percibida por el paciente para con el cuidado de su salud. Se quiere conocer la correlación entre variables relacionadas con el estado anímico, biotipo y autoeficacia de esta población. Diseño: Estudio descriptivo. Emplazamiento, participantes: Sobre toda la población de pacientes dados de alta en unidad de rehabilitación cardíaca hospitalaria a lo largo de 12 meses. Mediciones principales: Se determinan variables universales, psicométricas (escala general de autoeficacia, cuestionario de personalidad Salamanca, Hamilton ansiedad e índice de depresión de Beck) y antropométricas. Se realiza estadística descriptiva y correlaciones de Pearson entre la variable dependiente principal y variables asociadas. Resultados: Se incluyó a 88 pacientes, tasa de respuesta 92%. La edad media fue 53 años, con el 80,23% varones. De forma significativa, la autoeficacia correlacionó negativamente con la ansiedad (r= -0,4009) y la depresión (r= -0,4152), así como con el rasgo dependiente de la personalidad (r= -03175) e impulsivo (r= -0,4243). El biotipo endomorfo correlaciona de forma positiva con niveles más altos de ansiedad (r= 0,3304) y síntomas relacionados con depresión (r= 0,2563). No hay diferencias según edad y sexo con la autoeficacia percibida. Conclusiones: Existe correlación entre rasgos de personalidad, estado anímico y biotipo corporal con la autoeficacia percibida en la población a estudio (AU)

Objectives: There is a clear evidence of the benefit of cardiac rehabilitation after a cardiovascular event on patients' mood and perceived self-efficacy in terms of their own health care. Our aim is to define the correlation between mood-related variables, biotype and self-efficacy in this population. Design: Descriptive study. Background, participants: The entire population of patients discharged from the cardiac rehabilitation unit over 12 months. Main measurements: Universal anthropometric and psychometric (general self-efficacy scale, Salamanca personality traits questionnaire, Hamilton anxiety scale and Beck depression inventory) variables are determined. Descriptive statistics and association between variables (correlation) is determined. Results: This study involved 88 patients, response rate 92%. The average age was 53 years old, 80.23% were males. Descriptive statistics and Pearson correlations for the main dependent variable and associated variables is performed. Significant evidence is shown, self-efficacy is negatively correlated with anxiety (r=-0.4009) and depression (r=-0.4152), as well as dependent(r=-03 175) and impulsive (r=-0.4243) personality traits. Higher levels of anxiety positively correlate with endomorph biotype (r=0.3304), and depression-associated symptoms (r=0.2563). Age and gender do not correlate with self-perceived efficacy. Conclusions: Self-efficacy in the study population is correlated with personality traits, mood and body biotype (AU)

Perceived self-efficacy, personality and bioethics before a heart rehabilitation programme in primary health care. / Autoeficacia percibida, rasgos de personalidad y biotipos previos a programa de rehabilitación cardíaca en atención primaria de salud.

OBJECTIVES: There is a clear evidence of the benefit of cardiac rehabilitation after a cardiovascular event on patients' mood and perceived self-efficacy in terms of their own health care. Our aim is to define the correlation between mood-related variables, biotype and self-efficacy in this population. DESIGN: Descriptive study. BACKGROUND, PARTICIPANTS: The entire population of patients discharged from thecardiac rehabilitation unit over 12 months. MAIN MEASUREMENTS: Universal anthropometric and psychometric (general self-efficacy scale, Salamanca personality traits questionnaire, Hamilton anxiety scale and Beck depression inventory) variables are determined. Descriptive statistics and association between variables (correlation) is determined. RESULTS: This study involved 88 patients, response rate 92%. The average age was 53 years old, 80.23% were males. Descriptive statistics and Pearson correlations for the main dependent variable and associated variables is performed. Significant evidence is shown, self-efficacy is negatively correlated with anxiety (r=-0.4009) and depression (r=-0.4152), as well as dependent(r=-03 175) and impulsive (r=-0.4243) personality traits. Higher levels of anxiety positively correlate with endomorph biotype (r=0.3304), and depression-associated symptoms (r=0.2563). Age and gender do not correlate with self-perceived efficacy. CONCLUSIONS: Self-efficacy in the study population is correlated with personality traits, mood and body biotype.