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1.
J Dent Educ ; 2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38627911

RESUMEN

INTRODUCTION: Three-dimensional (3D)-printing technology can provide customizable simulations, but its effects on patient care quality have not been well studied. This study aimed to assess the impact of practicing with patient-specific 3D-printed teeth models on the quality of patients' dental preparations performed by students transitioning to clinical training. Accordingly, the quality of posterior crown preparations was evaluated by objectively analyzing digital scans and grades in two groups: the study group, which practiced beforehand with patient-specific 3D-printed teeth models, and the control group, which did not practice with these models. METHODS: All 78 fourth-year dental students who had just finished their fixed prosthodontics course at the simulation laboratory with training on phantom heads and without previous clinical experience in crown preparations were invited to participate in the study. Sixty-eight agreed to take part and were randomly divided into a study group that practiced crown preparations on 3D-printed models of their own patient's teeth and a control group that did not practice with 3D-printed models and started their clinical work straightforwardly after simulation training. Students completed validated perception questionnaires on self-confidence and clinical skills before and after the protocol, which were compared using a chi-squared test. Crown preparations performed on 3D-printed models and then on patients were digitally scanned and objectively graded by prepCheck software for critical parameters, such as undercuts, taper, and occlusion reduction. Non-parametric tests were used to compare preparations on 3D-printed models and on patients performed by the study group and those on patients made by the control group. RESULTS: Initially, both groups reported similar perceptions of self-confidence and clinical skills levels. The study group significantly improved both aspects after the protocol. Analysis of the scanned preparations demonstrated that the study group removed less tooth structure from actual patients than from the initial 3D-printed models. In contrast, the control group showed excess occlusal clearance in their patients compared to the study group. CONCLUSIONS: Practicing patient-specific 3D-printed teeth before performing procedures clinically appears to enhance preparation quality and minimize unnecessary tooth reduction in early clinical experiences.

2.
J Clin Med ; 13(5)2024 Feb 20.
Artículo en Inglés | MEDLINE | ID: mdl-38592057

RESUMEN

(1) Background: SeptiCyte RAPID is a molecular test for discriminating sepsis from non-infectious systemic inflammation, and for estimating sepsis probabilities. The objective of this study was the clinical validation of SeptiCyte RAPID, based on testing retrospectively banked and prospectively collected patient samples. (2) Methods: The cartridge-based SeptiCyte RAPID test accepts a PAXgene blood RNA sample and provides sample-to-answer processing in ~1 h. The test output (SeptiScore, range 0-15) falls into four interpretation bands, with higher scores indicating higher probabilities of sepsis. Retrospective (N = 356) and prospective (N = 63) samples were tested from adult patients in ICU who either had the systemic inflammatory response syndrome (SIRS), or were suspected of having/diagnosed with sepsis. Patients were clinically evaluated by a panel of three expert physicians blinded to the SeptiCyte test results. Results were interpreted under either the Sepsis-2 or Sepsis-3 framework. (3) Results: Under the Sepsis-2 framework, SeptiCyte RAPID performance for the combined retrospective and prospective cohorts had Areas Under the ROC Curve (AUCs) ranging from 0.82 to 0.85, a negative predictive value of 0.91 (sensitivity 0.94) for SeptiScore Band 1 (score range 0.1-5.0; lowest risk of sepsis), and a positive predictive value of 0.81 (specificity 0.90) for SeptiScore Band 4 (score range 7.4-15; highest risk of sepsis). Performance estimates for the prospective cohort ranged from AUC 0.86-0.95. For physician-adjudicated sepsis cases that were blood culture (+) or blood, urine culture (+)(+), 43/48 (90%) of SeptiCyte scores fell in Bands 3 or 4. In multivariable analysis with up to 14 additional clinical variables, SeptiScore was the most important variable for sepsis diagnosis. A comparable performance was obtained for the majority of patients reanalyzed under the Sepsis-3 definition, although a subgroup of 16 patients was identified that was called septic under Sepsis-2 but not under Sepsis-3. (4) Conclusions: This study validates SeptiCyte RAPID for estimating sepsis probability, under both the Sepsis-2 and Sepsis-3 frameworks, for hospitalized patients on their first day of ICU admission.

5.
Comput Biol Med ; 170: 107979, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38219645

RESUMEN

Diabetic Macular Edema (DME) is the most common sight-threatening complication of type 2 diabetes. Optical Coherence Tomography (OCT) is the most useful imaging technique to diagnose, follow up, and evaluate treatments for DME. However, OCT exam and devices are expensive and unavailable in all clinics in low- and middle-income countries. Our primary goal was therefore to develop an alternative method to OCT for DME diagnosis by introducing spectral information derived from spontaneous electroretinogram (ERG) signals as a single input or combined with fundus that is much more widespread. Baseline ERGs were recorded in 233 patients and transformed into scalograms and spectrograms via Wavelet and Fourier transforms, respectively. Using transfer learning, distinct Convolutional Neural Networks (CNN) were trained as classifiers for DME using OCT, scalogram, spectrogram, and eye fundus images. Input data were randomly split into training and test sets with a proportion of 80 %-20 %, respectively. The top performers for each input type were selected, OpticNet-71 for OCT, DenseNet-201 for eye fundus, and non-evoked ERG-derived scalograms, to generate a combined model by assigning different weights for each of the selected models. Model validation was performed using a dataset alien to the training phase of the models. None of the models powered by mock ERG-derived input performed well. In contrast, hybrid models showed better results, in particular, the model powered by eye fundus combined with mock ERG-derived information with a 91 % AUC and 86 % F1-score, and the model powered by OCT and mock ERG-derived scalogram images with a 93 % AUC and 89 % F1-score. These data show that the spontaneous ERG-derived input adds predictive value to the fundus- and OCT-based models to diagnose DME, except for the sensitivity of the OCT model which remains the same. The inclusion of mock ERG signals, which have recently been shown to take only 5 min to record in daylight conditions, therefore represents a potential improvement over existing OCT-based models, as well as a reliable and cost-effective alternative when combined with the fundus, especially in underserved areas, to predict DME.


Asunto(s)
Diabetes Mellitus Tipo 2 , Retinopatía Diabética , Edema Macular , Humanos , Edema Macular/diagnóstico por imagen , Retinopatía Diabética/diagnóstico por imagen , Diabetes Mellitus Tipo 2/complicaciones , Fondo de Ojo , Tomografía de Coherencia Óptica/métodos
6.
Occup Med (Lond) ; 74(1): 71-77, 2024 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-37995321

RESUMEN

BACKGROUND: Hospital-based occupational health (HBOH) is uniquely positioned to not only prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, but to care for healthcare workers (HCWs) sick with coronavirus disease 2019 (COVID-19). AIMS: The primary objective of this study is to describe a system where HBOH services were adapted to provide a monitoring programme whereby HCWs with SARS-CoV-2 received daily evaluations and treatment options in order to improve access to care, and to report the clinical outcomes and predictors of hospitalization in HCWs enrolled in the programme. A secondary objective is to compare clinical outcomes to data on national HCWs with COVID-19. METHODS: This retrospective cohort study used survey data collected on HCWs at a university health system with COVID-19 from 1 March 2020 through 1 December 2021. A firth regression model was used to examine the unadjusted and adjusted association between clinical factors and hospitalization. RESULTS: The study cohort included 4814 HCWs with COVID-19. Overall hospitalizations were 119 (2%), and there were six deaths (0.12%). Predictors of hospitalization include several co-morbidities and symptoms. A total of 1835 HCWs monitored before vaccine or monoclonal antibody availability were compared with data on U.S. HCWs in a similar time period. The monitored HCWs had a lower rate of co-morbidities (19% versus 44%, P < 0.001), a lower hospitalization rate (3% versus 8% P < 0.001) and case-fatality rate (0.11% versus 0.95% P < 0.001). CONCLUSIONS: This monitoring strategy for COVID-19 may be feasible for HBOH systems to implement and improve access to care, but more data are needed to determine if it improves outcomes.


Asunto(s)
COVID-19 , Salud Laboral , Humanos , COVID-19/epidemiología , SARS-CoV-2 , Estudios Retrospectivos , Personal de Salud
8.
JACC CardioOncol ; 5(5): 641-652, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37969655

RESUMEN

Background: Cancer treatment increases cardiovascular disease risk, but physical activity (PA) may prevent cardiovascular disease. Objectives: This study examined whether greater PA was associated with better submaximal exercise capacity and cardiac function during cancer therapy. Methods: Participants included 223 women with stage I to III breast cancer (BC) before and 3 months after undergoing treatment and 126 control participants. Leisure-time PA (LTPA) was reported using the Godin-Shephard LTPA questionnaire. Cardiac function was assessed by cardiac magnetic resonance. Submaximal exercise capacity was determined by 6-minute walk distance. Results: BC participants reported similar baseline LTPA scores (24.7; 95% CI: 21.7-28.0) as control participants (29.4; 95% CI: 25.0-34.2). The BC group declined to 16.9 (95% CI: 14.4-19.6) at 3 months relative to 30.8 (95% CI: 26.2-35.8) in control participants. Among BC participants, more LTPA was related to better exercise capacity (ß ± SE: 7.1 ± 1.6; 95% CI: 4.0-10.1) and left ventricular (LV) circumferential strain (-0.16 ± 0.07; 95% CI: -0.29 to -0.02). Increased LTPA over the 3 months was associated with decreased likelihood of treatment-induced cardiac dysfunction according to LV circumferential strain classifications (OR: 0.98; 95% CI: 0.97-0.998). BC participants reporting insufficient LTPA according to PA guidelines exhibited deteriorations in exercise capacity (adjusted mean difference ± SE: -29 ± 10 m; P = 0.029), LV end-systolic volume (5.8 ± 1.3 mL; P < 0.001), LV ejection fraction (-3.2% ± 0.8%; P = 0.002), and LV circumferential strain (2.5% ± 0.5%; P < 0.001), but BC participants meeting LTPA guidelines did not exhibit these adverse changes. Conclusions: PA declined during BC therapy; however, PA participation was associated with attenuated declines in exercise capacity and cardiac function that are often observed in this population. (Understanding and Predicting Breast Cancer Events After Treatment [WF97415 UPBEAT]; NCT02791581).

9.
Eur J Paediatr Dent ; 24(3): 218-223, 2023 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-37668455

RESUMEN

AIM: To explore the relationship between parents' education levels, children obesity, children oral health and oral-related sleep disorders. BACKGROUND: Prevention of oral diseases in children is important for their long-term health. Parents play a crucial role in the health and wellness of their children. As such, it is important for parents to be well-informed about the importance of their children's oral health, as well as the steps they can take to ensure that their children receive the best possible care. METHODS: Observational cross-sectional study. At the time of enrollment data regarding parents' employment status and parents' education level were collected. We also collected BMI and anamnestic data regarding the presence or not of oral-related sleep disorders in the last 3 months: snoring, chronic mouth breathing, sleep bruxism. Oral health was also evaluated for each subject through the DMFT (decayed, missing and filled teeth) index. CONCLUSION: Parents' education levels influence several health outcomes, including oral health and the risk of obesity. In turn, obesity can represent a risk factor for oral-related sleep disturbances. Parents play a crucial role in the health and wellness of their children. As such, it is important for parents to be knowledgeable about the importance of their children's health, as well as the steps they can take to ensure that their children receive the best possible care.


Asunto(s)
Salud Bucal , Trastornos del Sueño-Vigilia , Niño , Humanos , Estudios Transversales , Escolaridad , Obesidad , Padres , Sueño
10.
Cancer Med ; 12(19): 20094-20105, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37768040

RESUMEN

PURPOSE: Adjuvant endocrine therapy (AET) often causes debilitating endocrine symptoms that compromise quality of life (QOL) in women diagnosed with hormone receptor positive breast cancer (BC). We examined whether greater levels of physical activity (PA) or prolonged sitting were associated with reduced side effects or worse side effects of AET, respectively. METHODS: We used parallel process latent growth curve models to examine longitudinal patterns in PA and sitting behaviors, and their association with endocrine symptoms and QOL over 3 years of follow-up in 554 female BC survivors undergoing AET. RESULTS: At baseline, women were a mean age of 59 years, mostly white (72%), with overweight/obesity (67%), and approximately 50% were within 1 year of diagnosis. Unconditional models showed significant increases in PA (p < 0.01) over time but no change in sitting. Endocrine symptoms, general and BC-specific QOL all significantly worsened over time (p < 0.01). Parallel process models showed no cross-sectional or longitudinal associations between PA and endocrine symptoms. Higher levels of baseline PA were associated with higher baseline QOL scores (p = 0.01) but changes in PA were not associated with changes in QOL. Conversely, more sitting at baseline was associated with worse endocrine symptoms, general and BC specific QOL (ps <0.01). At baseline, having better QOL scores was associated with increases in sitting (ps <0.01), while having worse endocrine symptoms was associated with a slower rate of increase in sitting (p < 0.01). Increases in sitting time were also associated with a slower rate of increase in endocrine symptoms (p = 0.017). Model fit statistics (x2, CFI, TLI, SRMR) were acceptable. CONCLUSION: Both PA and sitting behaviors are important for the management of symptoms and in maintaining QOL in BC survivors. Women with already high symptom burden do not increase sitting time further but having better general and BC specific QOL to begin with means a greater decline over time.


Asunto(s)
Neoplasias de la Mama , Supervivientes de Cáncer , Femenino , Humanos , Persona de Mediana Edad , Neoplasias de la Mama/tratamiento farmacológico , Calidad de Vida , Sobrevivientes , Ejercicio Físico
11.
Dalton Trans ; 52(34): 11965-11980, 2023 Aug 29.
Artículo en Inglés | MEDLINE | ID: mdl-37577968

RESUMEN

First-principles calculations based on density-functional theory have been used to investigate the effect of biaxial strain and oxygen vacancy on the electronic, photocatalytic, and electrocatalytic properties of PbTiO3 oxide. Our results show that PbTiO3 has a high exciton binding energy and a band gap that can be easily moderated with different strain regimes. From a reactivity viewpoint, the highly exothermic adsorption of hydrogen atoms in both pristine and strained PbTiO3 structures does not make it a potential electrocatalyst for the hydrogen evolution reaction. Fortunately, the presence of oxygen vacancies on the PbTiO3 surface induces moderate adsorption energies, making the reduced PbTiO3 suitable for hydrogen evolution reaction processes.

12.
J Neuroendocrinol ; 35(7): e13308, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37285180

RESUMEN

Environmental enrichment is a widely used experimental manipulation that physically, cognitively and socially stimulates individuals. It has a great variety of long-term effects at neuroanatomical, neurochemical, and behavioral level; however, the influence of parental environmental enrichment during gestation and pregestation on the development of the offspring and on the mother's behavior has been poorly explored. This article presents a review of the literature from the year 2000 about the effects of maternal and paternal environmental enrichment on the behavioral, endocrine, and neural systems of offspring and parents. Relevant research terms were searched for on the biomedical databases, PubMed, Medline, ScienceDirect, and Google Scholar. The data suggest that paternal/maternal environmental enrichment can profoundly affect the developmental trajectories of offspring through putative epigenetic mechanisms. Environmental enrichment presents as a promising therapeutic tool for human health interventions, especially to counteract the deleterious effects of impoverished and adverse growing conditions.


Asunto(s)
Conducta Animal , Epigénesis Genética , Animales , Humanos , Padres
13.
O.F.I.L ; 33(2)Abril-Junio 2023. tab, graf
Artículo en Español | IBECS | ID: ibc-223829

RESUMEN

Objetivos: Analizar la introducción de medicamentos biosimilares anti-TNF en primera línea para pacientes con artritis reumatoide (AR). Métodos: Estudio unicéntrico, retrospectivo y observacional en un hospital de tercer nivel. Se incluyeron pacientes con diagnóstico de AR tratados por primera vez con un fármaco biológico (biosimilar u original), entre febrero 2017-febrero 2021. Las variables de resultado recogidas fueron: porcentaje de pacientes que iniciaban tratamiento cada año con cada fármaco biológico y porcentaje de variación anual de utilización de fármacos anti-TNF que tenían biosimilar respecto al resto de alternativas. Resultados: 178 pacientes con diagnóstico de AR fueron tratados por primera vez con un fármaco biológico. Durante los dos primeros años de introducción de biosimilares, el porcentaje de pacientes con AR tratados en primera línea con adalimumab, infliximab y etanercept fue 23,9%, mientras que los dos últimos años aumentaron las prescripciones con estos fármacos, a pesar de la aparición de nuevos originales, de forma que durante el último año de estudio cubrían un 44,6% de las prescripciones. El uso de estos tres fármacos anti-TNF biosimilares en pacientes con AR ha supuesto un ahorro de 213.530 €. Conclusiones: En nuestro centro el uso de biosimilares anti-TNF se ha consolidado en los dos últimos años, a pesar de la incorporación de nuevos originales en el tratamiento de la AR. Considerando las diferentes políticas de introducción de biosimilares existentes, sería interesante que se realizarán estudios similares en otras regiones de nuestro país para poder establecer que política de uso de biosimilares puede ser más aceptada. (AU)


Objectives: To analyze the introduction of first-line anti-TNF biosimilar drugs for patients with rheumatoid arthritis (RA). Methods: Single-center, retrospective, observational study in a tertiary hospital. Patients with a diagnosis of RA treated for the first time with a biologic drug (biosimilar or original) between February 2017-February 2021 were included. The outcome variables collected were: percentage of patients initiating treatment each year with each biologic drug and percentage of annual variation in the use of anti-TNF drugs that had a biosimilar with respect to the other alternatives. Results: 178 patients diagnosed with RA were treated for the first time with a biologic drug. During the first two years of the introduction of biosimilars, the percentage of RA patients treated first line with adalimumab, infliximab and etanercept was 23.9%, while in the last two years prescriptions with these drugs increased, despite the appearance of new originals, so that during the last year of the study they covered 44.6% of prescriptions. The use of these three biosimilar anti-TNF drugs in patients with RA has resulted in savings of 213,530 €. Conclusions: In our center, the use of anti-TNF biosimilars has been consolidated in the last two years, despite the incorporation of new originals in the treatment of RA. Considering the different existing biosimilar introduction policies, it would be interesting to carry out similar studies in other regions of our country in order to establish which biosimilar use policy may be more accepted. (AU)


Asunto(s)
Humanos , Biosimilares Farmacéuticos , Necrosis , ADN de Neoplasias , Artritis Reumatoide , Adalimumab , Infliximab , Etanercept
14.
Morphologie ; 107(358): 100598, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37149420

RESUMEN

The ABFO study on third molar development is a benchmark in the scientific literature of dental age estimation. In its 30th anniversary, the study has been reproduced in the present external validation. Standardized comparative outcomes were obtained and discussed across studies. The sample consisted of 1.087 panoramic radiographs of Brazilian females (n=542, 49.87%) and males (n=545, 50.13%) between 14 and 22.9 years. All available third molars were classified into developmental stages following Mincer's adaptation of Demirjian's system (8 sequential stages, from A to H). The mean chronological age of individuals within each stage was assessed. The probability of an individual being ≥ 18 years was calculated for each third molar, sex and stage. Maxillary and mandibular third molars showed a similar development with an agreement between stages of about 90%. In general, males developed 0.5 years (6 months) earlier than females. The probability of being an adult increased considerably when at least one third molar is in stage G. Maxillary third molars had higher coefficients of determination (right: 0.704; left: 0.702), showing that statistical models with these teeth could explain better the age estimation outcomes. The reproducibility of the ABFO study on third molar development led to reference tables and probability measures for the studied Brazilian population.


Asunto(s)
Determinación de la Edad por los Dientes , Masculino , Adulto , Femenino , Humanos , Brasil , Reproducibilidad de los Resultados , Odontología Forense , Tercer Molar/diagnóstico por imagen , Reproducción
15.
ESMO Open ; 8(3): 101198, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37119788

RESUMEN

BACKGROUND: Metastatic colorectal cancer (mCRC) patients tend to have modest benefits from molecularly driven therapeutics. Patient-derived tumor organoids (PDTOs) represent an unmatched model to elucidate tumor resistance to therapy, due to their high capacity to resemble tumor characteristics. MATERIALS AND METHODS: We used viable tumor tissue from two cohorts of patients with mCRC, naïve or refractory to treatment, respectively, for generating PDTOs. The derived models were subjected to a 6-day drug screening assay (DSA) with a comprehensive pipeline of chemotherapy and targeted drugs against almost all the actionable mCRC molecular drivers. For the second cohort DSA data were matched with those from PDTO genotyping. RESULTS: A total of 40 PDTOs included in the two cohorts were derived from mCRC primary tumors or metastases. The first cohort included 31 PDTOs derived from patients treated in front line. For this cohort, DSA results were matched with patient responses. Moreover, RAS/BRAF mutational status was matched with DSA cetuximab response. Ten out of 12 (83.3%) RAS wild-type PDTOs responded to cetuximab, while all the mutant PDTOs, 8 out of 8 (100%), were resistant. For the second cohort (chemorefractory patients), we used part of tumor tissue for genotyping. Four out of nine DSA/genotyping data resulted applicable in the clinic. Two RAS-mutant mCRC patients have been treated with FOLFOX-bevacizumab and mitomycin-capecitabine in third line, respectively, based on DSA results, obtaining disease control. One patient was treated with nivolumab-second mitochondrial-derived activator of caspases mimetic (phase I trial) due to high tumor mutational burden at genotyping, experiencing stable disease. In one case, the presence of BRCA2 mutation correlated with DSA sensitivity to olaparib; however, the patient could not receive the therapy. CONCLUSIONS: Using CRC as a model, we have designed and validated a clinically applicable methodology to potentially inform clinical decisions with functional data. Undoubtedly, further larger analyses are needed to improve methodology success rates and propose suitable treatment strategies for mCRC patients.


Asunto(s)
Neoplasias del Colon , Neoplasias Colorrectales , Humanos , Cetuximab/efectos adversos , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/patología , Mutación
16.
Sci Rep ; 13(1): 4279, 2023 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-36922543

RESUMEN

Bacterial phytopathogens living on the surface or within plant tissues may experience oxidative stress because of the triggered plant defense responses. Although it has been suggested that polyamines can defend bacteria from this stress, the mechanism behind this action is not entirely understood. In this study, we investigated the effects of oxidative stress on the polyamine homeostasis of the plant pathogen Pseudomonas syringae and the functions of these compounds in bacterial stress tolerance. We demonstrated that bacteria respond to H2O2 by increasing the external levels of the polyamine putrescine while maintaining the inner concentrations of this compound as well as the analogue amine spermidine. In line with this, adding exogenous putrescine to media increased bacterial tolerance to H2O2. Deletion of arginine decarboxylase (speA) and ornithine decarboxylate (speC), prevented the synthesis of putrescine and augmented susceptibility to H2O2, whereas targeting spermidine synthesis alone through deletion of spermidine synthase (speE) increased the level of extracellular putrescine and enhanced H2O2 tolerance. Further research demonstrated that the increased tolerance of the ΔspeE mutant correlated with higher expression of H2O2-degrading catalases and enhanced outer cell membrane stability. Thus, this work demonstrates previously unrecognized connections between bacterial defense mechanisms against oxidative stress and the polyamine metabolism.


Asunto(s)
Poliaminas , Espermidina , Poliaminas/metabolismo , Espermidina/metabolismo , Putrescina/metabolismo , Pseudomonas syringae/metabolismo , Peróxido de Hidrógeno/metabolismo , Estrés Oxidativo , Ornitina Descarboxilasa/genética , Ornitina Descarboxilasa/metabolismo
17.
Health SA ; 28: 2180, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36873786

RESUMEN

Background: Student nurses provide nursing care to patients during clinical allocation, and their competence may affect the quality of care given to the patients. Good knowledge and positive attitudes enhance early detection for prevention and management of pressure ulcers. Aim: To determine undergraduate nursing students' knowledge, attitude and practices (KAP) towards prevention and management of pressure ulcers. Setting: A nursing education institution in Windhoek, Namibia. Methods: A quantitative, cross-sectional research design was used to conveniently sample (n = 50) student nurses and collect data using a self-administered questionnaire. Data were analysed using the statistical software programme (SPSS) version 27. Descriptive frequencies were applied, and Fishers exact test was performed. A statistical value of p < 0.05 was considered significant. Results: Fifty (n = 50) student nurses consented to participate in the study. Student nurses reported good levels of knowledge (n = 35; 70%), attitude (n = 39; 78%), practices (n = 47; 94%). There was no statistically significant association between demographic variables and the level of knowledge, attitudes and practices, p > 0.05. Conclusion: Student nurses have good knowledge, positive attitudes and practices on prevention and management of pressure ulcers. By the implications, the study concludes that the nursing students will competently manage the pressure ulcers occurring in the clinical setting. An observational study is recommended to assess practices in the clinical setting. Contribution: The findings of this study will help to close the gap in the implementation of standard operating procedures for the prevention and management of pressure ulcers.

18.
J Vis Exp ; (192)2023 02 17.
Artículo en Inglés | MEDLINE | ID: mdl-36876955

RESUMEN

Acute respiratory distress syndrome (ARDS) causes acute lung injury, characterized by rapid alveolar damage and severe hypoxemia. This, in turn, leads to high morbidity and mortality. Currently, there are no pre-clinical models that recapitulate the complexity of human ARDS. However, infectious models of pneumonia (PNA) can replicate the main pathophysiological features of ARDS. Here, we describe a model of PNA induced by the intratracheal instillation of live Streptococcus pneumoniae and Klebsiella pneumoniae in C57BL6 mice. In order to evaluate and characterize the model, after inducing injury, we carried out serial measurements of body weight and bronchoalveolar lavage (BAL) for measuring markers of lung injury. Additionally, we harvested lungs for cell count and differentials, BAL protein quantification, cytospin, bacterial colony-forming unit counts, and histology. Lastly, high dimensional flow cytometry was performed. We propose this model as a tool to understand the immune landscape during the early and late resolution phases of lung injury.


Asunto(s)
Lesión Pulmonar Aguda , Neumonía , Animales , Ratones , Humanos , Ratones Endogámicos C57BL , Streptococcus pneumoniae , Dimercaprol , Modelos Teóricos
19.
Eur J Appl Physiol ; 123(5): 975-988, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36607416

RESUMEN

BACKGROUND: Elevated low-density lipoprotein (LDL) and triglyceride concentrations are associated with future cardiovascular risk in young adults. Conversely, chronic physical activity is generally accepted to reduce CVD risk. Atherosclerosis is a major underlying cause of CVD, and atherogenesis is mediated by peripheral monocytes and monocyte-derived macrophages. The study aimed to determine if an individual's physical activity level impacts the phenotype of monocytes and monocyte-derived macrophages when stimulated with LDL and fatty acid ex vivo. METHODS: Peripheral blood mononuclear cells (PBMCs) were obtained from healthy, young adults of differing physical activity levels before and after a single bout of moderate intensity exercise (25 min at 60% of VO2peak). PBMCs were stimulated with LDL and palmitate ex vivo prior to differentiation into macrophages. Monocyte subset percentages and monocyte-derived macrophage expression of phenotypic (CD86, CD206) and functional (CCR2, ERK 1/2) markers were evaluated by flow cytometry. RESULTS: Compared to baseline, ex vivo LDL and palmitate stimulation decreased (p = 0.038) non-classical monocyte percentage from 24.7 ± 3.2 to 21.5 ± 2.6% in all participants. When ex vivo lipid stimulation was preceded by acute exercise, non-classical monocyte percentage was similar to baseline levels (p = 0.670, 25.8 ± 2.15%). Macrophage CD86/CD206 was increased from 1.30 ± 0.14 to 1.68 ± 0.19 when preceded by acute exercise in all participants. No differences were observed between participants of differing physical activity levels. CONCLUSIONS: Findings suggest that acute exercise modulates monocyte phenotype after LDL and palmitate stimulation in a protective manner, however, chronic physical activity does not alter monocyte/macrophage responses to any experimental condition in this population.


Asunto(s)
Enfermedades Cardiovasculares , Monocitos , Humanos , Monocitos/metabolismo , Leucocitos Mononucleares , Macrófagos/metabolismo , Ejercicio Físico/fisiología , Lipoproteínas LDL/farmacología
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