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Gene ; 806: 145922, 2022 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-34454032


Gastric cancer (GC)-derived cell lines were generally used in basic cancer research and drug screening. However, it is always concerned about the difference between cultured cells and primary tumor by oncologists. To address this question, we compared differentially expressed genes (DEGs) in primary cancers, healthy tissues, and cell lines both in vitro and in silico. Seven reported genes with decreased expression in GCs by DNA methylation were analyzed in our cohort studies and experimentally validation. Selected datasets from TCGA (The Cancer Genome Atlas), CCLE (The Broad Institute Cancer Cell Line Encyclopedia), and GTEx (The Genotype-Tissue Expression project) were used to represent GCs, GC-derived cell lines, and healthy tissues respectively in the in silico analysis. Thirty gastric tissues together with six cell lines were used for validations. Unexpectedly, we experimentally found that reported cancer-related downregulated genes were only found in cancer cell lines but not in biopsies. The unchanged gene expressions in primary GCs were generally consistent with our cohort study, using information from cancerous (TCGA) and healthy tissues (GETx). Substantial differences were also found between DEGs of cancer tissues (TGCA)/ healthy tissues (GTEx) pair and cell lines (CCLE)/ healthy tissues (GTEx) pair, which confirmed the significant differences between primary cancer and cancer cell lines. Moreover, elevated expression of YWHAQ (14-3-3 δ) and THBS1 were observed in the GC biopsies, which might be potential biomarkers for GC diagnosis, considering the increased YWHAQ and THBS1 associated with poor survival rates in gastric cancer patients. In sum, it is suggested that cautions should be taken when using GC cell lines to study genes that show great differences between cell lines and tissues.

Proteínas 14-3-3/genética , Regulación Neoplásica de la Expresión Génica , Proteínas de Neoplasias/genética , Neoplasias Gástricas/genética , Trombospondinas/genética , Proteínas 14-3-3/metabolismo , Anciano , Atlas como Asunto , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/metabolismo , Línea Celular Tumoral , Metilación de ADN , Conjuntos de Datos como Asunto , Epigénesis Genética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Biológicos , Proteínas de Neoplasias/metabolismo , Cultivo Primario de Células , Pronóstico , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Análisis de Supervivencia , Trombospondinas/metabolismo , Células Tumorales Cultivadas
Gene ; 806: 145935, 2022 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-34478821


Soluble molecules of programmed death ligand 1 (sPD-L1) are known to modulate T-cell depletion, an important mechanism of hepatitis B virus (HBV) persistence and liver disease progression. In addition, PD-L1 polymorphisms in the 3'-UTR can influence PD-L1 expression and have been associated with cancer risk, although not definitively. The purpose of this study was to investigate the association of PD-L1 polymorphisms and circulating levels of sPD-L1 in HBV infection and live disease progression. In this study, five hundred fifty-one HBV infected patients of the three clinically well-defined subgroups chronic hepatitis B (CHB, n = 186), liver cirrhosis (LC, n = 142) and hepatocellular carcinoma (HCC, n = 223) and 240 healthy individuals (HC) were enrolled. PD-L1 polymorphisms (rs2297136 and rs4143815) were genotyped by in-house validated ARMS assays. Logistic regression models were applied in order to determine the association of PD-L1 polymorphisms with HBV infection as well as with progression of related liver diseases. Plasma sPD-L1 levels were quantified by ELISA assays. The PD-L1 rs2297136 AA genotype was associated with HBV infection susceptibility (HBV vs. HC: OR = 1.6; 95%CI = 1.1-2.3; p = 0.0087) and disease progression (LC vs. CHB: OR = 1.8; 95%CI = 1.1-2.9; p = 0.018). Whereas, the rs2297136 GG genotype was a protective factor for HCC development. Plasma sPD-L1 levels were significantly high in HBV patients (p < 0.0001) and higher in the LC followed by CHB and HCC groups. High sPD-L1 levels correlated with increased liver enzymes and with advanced liver disease progression (Child-pugh C > B > A, p < 0.0001) and BCLC classification (BCLC D > C > B > A, p = 0.031). We could, for the first time, conclude that PD-L1 rs2297136 polymorphism and plasma sPD-L1 protein levels associate with HBV infection and HBV-related liver disease progression.

Antígeno B7-H1/genética , Carcinoma Hepatocelular/genética , Virus de la Hepatitis B/patogenicidad , Hepatitis B Crónica/genética , Cirrosis Hepática/genética , Neoplasias Hepáticas/genética , Polimorfismo Genético , Regiones no Traducidas 3' , Adulto , Anciano , Antígeno B7-H1/sangre , Biomarcadores/sangre , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/etiología , Carcinoma Hepatocelular/virología , Estudios de Casos y Controles , Progresión de la Enfermedad , Femenino , Expresión Génica , Predisposición Genética a la Enfermedad , Virus de la Hepatitis B/crecimiento & desarrollo , Hepatitis B Crónica/complicaciones , Hepatitis B Crónica/diagnóstico , Hepatitis B Crónica/virología , Humanos , Hígado/metabolismo , Hígado/patología , Hígado/virología , Cirrosis Hepática/diagnóstico , Cirrosis Hepática/etiología , Cirrosis Hepática/virología , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/etiología , Neoplasias Hepáticas/virología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas
Braz. j. oral sci ; 20: e211060, jan.-dez. 2021. ilus
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1254621


Aim: To evaluate the efficacy of ultrasonic bath and traditional brushing in the hygiene of complete dentures of dependent residents in long-term care institutions (LTCIs). Methods: A randomized cross-over clinical study was conducted in 17 maxillary complete denture wearers living in LTCIs. Cleaning protocols were brushing or ultrasonic bath, both applied with neutral liquid soap. Biofilm biomass were estimated by MTT reduction assay and specific microbial load (CFU) of Streptococcus spp., Staphylococcus spp. and Candida spp. were quantified by selective and differential culture media. Results: Ultrasound method showed higher percentage reduction of biofilm biomass and specific microbial loads of Streptococcus spp. compared to brushing (p<0.01). Reduction of microbial loads of the other microorganisms were not different between cleaning methods (p>0.05). Conclusions: The ultrasonic bath proved to be a feasible alternative method for the mechanical cleaning of complete dentures in LTCIs

Anciano , Higiene , Dentaduras , Biopelículas , Servicios de Salud para Ancianos
Rev. enferm. UERJ ; 29: e56924, jan.-dez. 2021.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1224444


Objetivo: descrever a incidência de complicações em feridas operatórias de mastectomia e identificar fatores associados. Método: estudo retrospectivo desenvolvido em uma coorte hospitalar de 545 mulheres mastectomizadas por câncer de mama no ano 2018 em um centro de assistência de alta complexidade em oncologia da cidade do Rio de Janeiro, Brasil, após aprovação por Comitê de Ética em Pesquisa. Os dados foram coletados a partir dos prontuários, permitindo cálculos da taxa de incidência e da razão da taxa de incidência para cada complicação. Resultados: a complicação que apresentou maior taxa de incidência foi o sangramento (57,14/100 mastectomias-dia), tendo como fatores associados a raça/cor da pele não branca (Razão da Taxa de Incidência: 3,11) e a diabetes mellitus (Razão da Taxa de Incidência: 0,48). Conclusão: os fatores associados ao sangramento da ferida operatória apontam para a necessidade de novas práticas no cuidado ao pós-operatório de mulheres mastectomizadas.

Objective: to describe the incidence of complications in mastectomy surgical wounds and to identify associated factors. Method: this retrospective study was conducted in a hospital cohort of 545 women mastectomized for breast cancer in 2018 at a high-complexity cancer care center Rio de Janeiro City, Brazil, after approval by the research ethics committee. Data were collected from medical records, allowing incidence rate and incidence rate ratio to be calculated for each complication. Results: the complication with the highest incidence rate was bleeding (57.14/100 mastectomies-day), associated factors being non-white race/skin color (incidence rate ratio 3.11) and diabetes mellitus (incidence rate ratio 0.48). Conclusion: the factors associated with bleeding from the surgical wound point to the need for new practices in post-operative care for women with mastectomies.

Objetivo: describir la incidencia de complicaciones en heridas quirúrgicas de mastectomía e identificar factores asociados. Método: estudio retrospectivo desarrollado en una cohorte hospitalaria de 545 mujeres mastectomizadas por cáncer de mama en 2018 en un centro de atención de alta complejidad en oncología de la ciudad de Río de Janeiro, Brasil, previa aprobación del Comité de Ética en Investigación. Los datos se obtuvieron de las historias clínicas, lo que permitió calcular la tasa de incidencia y el cociente de la tasa de incidencia para cada complicación. Resultados: la complicación que presentó mayor tasa de incidencia fue el sangrado (57,14 / 100 mastectomías-día), con factores asociados a la raza / color de piel no blanca (índice de tasa de incidencia: 3,11) y diabetes mellitus (índice de tasa de incidencia: 0,48). Conclusión: los factores asociados al sangrado de la herida quirúrgica apuntan a la necesidad de nuevas prácticas en el cuidado al postoperatorio de las mujeres con mastectomía.

Humanos , Femenino , Persona de Mediana Edad , Anciano , Neoplasias de la Mama , Factores de Riesgo , Herida Quirúrgica , Herida Quirúrgica/complicaciones , Mastectomía/efectos adversos , Periodo Posoperatorio , Brasil , Neoplasias de la Mama/terapia , Estudios de Cohortes , Mastectomía , Neoplasias
Rev. enferm. UERJ ; 29: e53642, jan.-dez. 2021.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1224513


Objetivo: descrever os cuidados domiciliares prestados por parteiras tradicionais durante a assistência ao parto. Método: estudo qualitativo conduzido por meio do método da História Oral Temática, realizado com 16 parteiras em nove municípios do Cariri cearense. A coleta de dados ocorreu entre julho e dezembro de 2015 por meio de entrevista semiestruturada, os relatos foram transcritos, textualizados e transcriados. Resultados: as parteiras prestavam cuidados familiares, assistência ao parto vaginal, cuidados com o recém-nascido e no puerpério imediato. Usavam chás e orações como adjuvantes do seu ofício. Conclusão: o cuidado das parteiras na assistência ao parto centralizava-se nas necessidades da mulher e da família, sendo, em alguns casos, extensivo à casa. As parteiras conheciam os sinais e sintomas do trabalho de parto e agiam nas possíveis intercorrências.

Objective: to describe home care provided by traditional midwives during childbirth care. Method: this qualitative study, using the Thematic Oral History method, was conducted with 16 midwives from nine municipalities in Cariri, Ceará. Data were collected from July to December 2015 through semi-structured interviews, the reports were transcribed, textualized and transcreated. Results: midwives provided family care, vaginal delivery care, newborn care and immediate postpartum care. They used teas and prayers as an adjuncts to their craft. Conclusion: childbirth care by midwives centered on the women's and families' needs and, in some cases, extended to the home. Midwives knew the signs and symptoms of labor and acted on possible complications.

Objetivo: describir los cuidados domiciliarios brindados por parteras tradicionales durante la atención al parto. Método: estudio cualitativo conducido mediante el método de Historia Oral Temática, realizado con 16 parteras en nueve municipios de Cariri en Ceará. La recolección de datos se realizó entre julio y diciembre de 2015 a través de entrevistas semiestructuradas; los relatos fueron transcritos, textualizados y transcreados. Resultados: las parteras brindaron atención familiar, asistencia en el parto vaginal, cuidados al recién nacido y en el puerperio inmediato. Usaban tés y oraciones como complemento de su oficio. Conclusión: el cuidado de las parteras en la atención al parto se centraba en las necesidades de la mujer y de la familia, extendiéndose, en algunos casos, al hogar. Las parteras conocían los signos y síntomas del trabajo de parto y actuaban sobre las posibles complicaciones.

Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Trabajo de Parto , Atención Perinatal , Parto Domiciliario , Partería , Enfermería Obstétrica , Parto , Periodo Posparto , Atención Domiciliaria de Salud
Rev. enferm. UERJ ; 29: e57581, jan.-dez. 2021.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1224578


Objetivo: descrever as características sociodemográficas e de saúde de mulheres e homens com 75 anos ou mais de idade, no baseline e follow-up de quatro anos e verificar para mulheres e homens as mudanças nas condições de saúde. Métodos: estudo longitudinal com 109 idosos de 75 anos ou mais de idade de um município no Triângulo Mineiro. A coleta dos dados, realizada em dois momentos (2014-2018), ocorreu no domicílio com a aplicação de instrumentos validados no Brasil. Procederam-se às análises descritiva e teste t pareado (p<0,05). Os projetos foram aprovados pelo Comitê de Ética e Pesquisa com Seres Humanos. Resultados: verificaram-se, em ambos os sexos, aumento do número de morbidades e diminuição do escore total das atividades instrumentais da vida diária. Entre as mulheres observou-se, ainda, aumento do número de quedas e do escore de fragilidade. Conclusão: ao longo do seguimento houve piora nas condições de saúde dos idosos, sendo mais expressiva entre as mulheres.

Objective: to describe the sociodemographic and health characteristics of women and men aged 75 or over, at baseline and after four years of follow-up, and to ascertain changes in their health status. Methods: in this longitudinal study of 109 elderly people aged 75 or over from a city in the Triângulo Mineiro, data were collected at two points (2014 and 2018), at home, by applying instruments validated for use in Brazil. Descriptive analysis and paired t-tests were performed (p < 0.05). The projects were approved by the human research ethics committee. Results: in both genders, the number of morbidities increased and the total score for instrumental activities of daily living decreased. Among women, the number of falls and frailty score also increased. Conclusion: the older people's health status worsened over the course of follow-up, more so among the women.

Objetivo: describir las características sociodemográficas y de salud de mujeres y hombres de 75 años o más, en la base de referencia y el seguimiento durante cuatro años, y verificar los cambios en las condiciones de salud de mujeres y hombres. Métodos: estudio longitudinal con 109 personas mayores, de 75 años o más, de un municipio del Triângulo Mineiro. La recolección de datos, realizada en dos momentos (2014-2018), se realizó en sus domicilios aplicando instrumentos validados en Brasil. Se realizaron análisis descriptivos y prueba t pareada (p <0.05). Los proyectos fueron aprobados por el Comité de Ética en Investigación con Humanos. Resultados: en ambos os sexos, hubo un aumento en el número de morbilidades y una disminución en la puntuación total de las actividades instrumentales de la vida diaria. Entre las mujeres, se observó asimismo un aumento en el número de caídas y la puntuación de fragilidad. Conclusión: a lo largo del seguimiento, las condiciones de salud de las personas mayores empeoraron, más expresivamente entre las mujeres.

Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Anciano de 80 o más Años , Anciano , Envejecimiento , Estado de Salud , Enfermería Geriátrica , Estudios Longitudinales , Determinantes Sociales de la Salud
Infectio ; 25(4): 262-269, oct.-dic. 2021. tab, graf
Artículo en Inglés | LILACS, COLNAL | ID: biblio-1286720


Abstract Objective: To analyse the clinic characteristics, risk factors and evolution of the first cohort of hospitalised patients with confirmed infection by COVID-19 in 5 Colombian institutions. Materials and methods: Is a retrospective observational study of consecutive hospitalized patients with a diagnosis of COVID-19 confirmed from March 01 to May 30, 2020 in Colombia. Results: A total of 44 patients were included. The median age was 62 years. 43.2% had a history of smoking, while 69.8% were overweight or obese. 88.6% had at least one comorbidity and 52.3% had three or more comorbidities. Hypertension and dyslipidaemia were the most frequent comorbidities (40.9% and 34.1%, respectively). The 30-day mortality rate was 47.7% with a median of 11 days. The composite outcome occurred in the 36.4%. The biomarkers associated with mor tality risk included troponin higher than 14 ng/L (RR: 5.25; 95% CI 1.37-20.1, p = 0.004) and D-dimer higher than 1000 ng/ml (RR: 3.0; 95% CI 1.4-6.3, p = 0.008). Conclusions: The clinical course of SARS-CoV-2 infection in hospitalized Colombian was characterised by a more advanced stage of the infection.

Resumen Objetivo: Analizar las características, clínicas, factores de riesgo, y la evolución de pacientes hospitalizados con infección confirmada por COVID-19 en 5 Institu ciones de Colombia. Material y método: Es un estudio observacional retrospectivo de pacientes consecutivos hospitalizados con diagnóstico de COVID-19 confirmado entre 01 de Febrero de 2020 y 30 de Mayo de 2020 en Colombia. Resultados: Un total de 44 pacientes fueron incluidos. La mediana de edad fue de 62 años y la mayoría del sexo masculino. El 43.2% tenían historia de tabaquismo, mientras que el 69.8% tenían sobrepeso u obesidad. El 88.6% tenían al menos una comorbilidad y el 52.3% tenían tres o más comorbilidades. La hipertensión arterial fue la comorbilidad más frecuente (40.9%), seguido de la dislipidemia (34.1%). La tasa de letalidad a 30 días fue de 47.7% y ocurrió con una mediana de 11 días. El 36.4% presentó el desenlace compuesto. Los biomarcadores asociados con el riesgo de muerte fue troponina > 14 ng/mL (RR:5.25, IC95% 1.37-20.1, p=0.004) y dímero D mayor a 1000 mg/dL (RR: 3.0, IC95% 1.4-6.3, p=0.008). Conclusiones: El curso clínico de la infección por SARS-CoV-2 en colombianos hospitalizados fue un estadio más avanzado de la infección.

Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Biomarcadores , COVID-19 , Pacientes , Tabaquismo , Comorbilidad , Riesgo , Factores de Riesgo , Mortalidad , Colombia , Sobrepeso , Cursos , Infecciones , Obesidad
Infectio ; 25(4): 256-261, oct.-dic. 2021. tab, graf
Artículo en Español | LILACS, COLNAL | ID: biblio-1286719


Resumen Objetivo: Determinar los factores de riesgo en adultos con COVID-19 en población rural andina durante 2020. Métodos: En este estudio de cohorte retrospectivo multicéntrico, incluimos a 184 pacientes adultos (≥18 años) con pruebas serológicas y moleculares para CO VID-19 de tres hospitales de la sierra peruana (Ancash y Apurímac) incluidos con sospecha clínica entre abril y junio. Se utilizó análisis descriptivos y regresión logística univariable para explorar los factores de riesgo asociados a los pacientes con COVID-19. Resultados: Del total de pacientes, 14 (7.6%) tuvieron SARS-CoV-2. En los pacientes infectados 12 (85.7%) fueron varones con promedio de edad de 47.3±21 años. Las comorbilidades estuvieron presentes en cerca de la tercera parte de pacientes, siendo la hipertensión y diabetes las más frecuentes (ambas 14.3%), y la sinto matología más frecuentes fueron fiebre y cefalea (57.2%). La regresión univariable mostró mayores probabilidades de infección con SARS-CoV-2 en la población rural andina asociada con la edad avanzada (OR: 1.1 IC95% 0.7-1.8; p=0,019), comorbilidades previas (OR: 1.7, IC95% 0.32-9.39; p=0,006), y sintomatología previa (OR: 49.8, IC95% 5.6-436.9; p=0,0011). Conclusiones: Los posibles factores de riesgo como la edad avanzada, las comorbilidades y sintomatología previas están relacionados con el desarrollo de CO VID-19 en población rural andina de Perú.

Abstract Objective: To determine the risk factors in adults with COVID-19 in the rural Andean population during 2020. Methods: This multicenter retrospective cohort study included 184 adult patients (≥18 years) with COVID-19's serological and molecular tests from three Hospitals in the Peruvian mountains (Ancash and Apurímac) included with clinical suspicion between April and June. Descriptive analysis and univariate logistic regression were used to explore the risk factors associated with patients with COVID-19. Results: Of total of patients, 14 (7.6%) had a SARS-CoV-2. In infected patients 12 (85.7%) were men with an average age of 47.3±21 years. Comorbidities were present in about a third of patients, with hypertension and diabetes being the most frequent (both 14.3%), and the most frequent symptoms were fever and hea dache (57.2%). Univariate regression showed higher probabilities of infection with SARS-CoV-2 in the rural Andean population associated with advanced age (OR: 1.1 95% CI 0.7 - 1.8; p = 0.019), previous comorbidities (OR: 1.7, 95%CI 0.32 - 9.39; p = 0.006), and previous symptoms (OR: 49.8, 95%CI 5.6 - 436.9; p = 0.0011). Conclusions: Possible risk factors such as advanced age, comorbidities and previous symptoms are related to the development of COVID-19 in the rural Andean population of Peru.

Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , COVID-19 , Perú , Población Rural , Factores de Riesgo , Estudios de Cohortes , SARS-CoV-2 , Cefalea , Hospitales , Hipertensión , Infecciones
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 25-31, set.-dez. 2021. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1284114


Os pilares personalizados são usados em reabilitações protéticas sobre implantes quando há exigências de angulação, perfil de emergência e margem gengival, em que os pilares convencionais não conseguem reabilitar de forma correta os conceitos de forma, função e estética. Através de um relato de caso clínico, onde houve a reabilitação dos elementos 21 e 22, com o uso de implante e próteses, usando o pilar personalizado em zircônia sobre o implante do 22, confeccionado com a tecnologia CAD/CAM. Esse sistema de pilares personalizados oferecem o desenho mais próximo do ideal e o ajuste mais perfeito em relação ao implante e ao tecido gengival, além de considerar as vantagens e desvantagen em relação aos pilares convencionais pré-fabricados nas questões de tempo de tratamento, custos e resultado estético e biológico. Concluimos que a reabilitação com pilares personalizados CAD/CAM confere uma excelente alternativa reabilitadora, devolvendo função e estética aos pacientes, desde que haja conhecimento adequado por parte dos profissionais envolvidos(AU)

Custom abutments are used in prosthetic rehabilitation on implants when angulation, emergence profile and gingival margin are used, where abutments are not recovered in a correct way to rehabilitate the concepts of shape, functions and aesthetics. Through a clinical case, where the elements 21 and 22 were rehabilitated, with the use of implants and practices, using the personalized abutments in zirconia, made with CAD / CAM technology. This customized system and abutments offers the closest ideal design and the most perfect fit in relation to the implant and gingival tissue, in addition to considering advantages and disadvantages in relation to the prefabricated applied abutments in terms of treatment time, costs and results aesthetic and biological. Conclude that a rehabilitation with customized CAD / CAM abutments provides an excellent rehabilitation alternative, returning function and aesthetics to patients, as long as there is adequate knowledge for part of the professionals involved(AU)

Humanos , Femenino , Anciano , Implantes Dentales , Diseño Asistido por Computadora , Materiales Biocompatibles , Prótesis Dental de Soporte Implantado , Estética Dental
Estima (Online) ; 19(1): e0421, jan.-dez. 2021.
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1178058


Objetivos:identificar na literatura científica o conhecimento produzido sobre lesões por fricção em idosos. Métodos: trata-se de uma revisão integrativa de literatura (2014-2019), realizada a partir de busca nas bases de dados/plataformas National Library of Medicine, Biomedical Answers e Biblioteca Virtual em Saúde, com descritores e os operadores booleanos "and" e "or". Resultados: a partir da busca bibliográfica, seleção e análise, oito artigos compuseram a amostra. Para lesão por fricção em idosos emergiram quatro pilares do cuidado: manutenção da homeostase orgânica e tissular com foco na nutrição e hidratação apropriada; evitar traumas na pele senil, proporcionando um ambiente seguro com dispositivos adequados; e a sistematização da assistência e educação em saúde do cuidado com a pele do idoso. Conclusão: como mecanismos de prevenção, encontram-se a realização da prevenção primária por meio de um plano de cuidados singular e as atividades de educação em saúde, focadas nos fatores de risco e nas vulnerabilidades, minimizando danos e complicações

Heridas y Lesiones , Anciano , Fricción , Enfermería Geriátrica
Adv Rheumatol ; 61(1): 55, 2021 09 03.
Artículo en Inglés | MEDLINE | ID: mdl-34479631


BACKGROUND: Anti-rheumatic drugs can increase the predisposition to infection, and patients may be unaware of continuing their treatment during the COVID-19 pandemic. OBJECTIVE: This study aimed to assess whether patients maintain their treatment for rheumatic conditions during the pandemic period and determine the factors responsible for discontinuation. METHODS: Patients were randomly selected from the prospectively collected database of our tertiary referral center. The patients were interviewed by telephone through a standardized closed-ended questionnaire, which is targeting the continuity of the treatment plan and the considerations related to the individual choice. The patients were asked whether they hesitated to visit the hospital for follow-up or intravenous drug administration. RESULTS: A total of 278 patients completed the questionnaire. While 62 of the patients (22.3%) had reduced or interrupted the treatment, only 11 patients (3.9%) stopped the treatment completely. A significant difference was observed between the duration of illness and the discontinuation of treatment. (p = 0.023) There was a significant difference in disease activity between the group that stopped treatment and continued treatment. (p = 0.001) There was no statistically significant difference in other demographic characteristics. One hundred thirty-five patients (48.6%) made the treatment decision by themselves, and 80% continued the treatment. Reasons for stopping the treatment were anxiety (48.4%), not being able to go to the hospital for intravenous treatment (45.1%), and not being able to find the drug (6.5%). CONCLUSION: Since patients with long-term illnesses were found to be significantly more likely to stop their treatment, this group of patients should be monitored.

Antirreumáticos/uso terapéutico , Actitud Frente a la Salud , COVID-19/epidemiología , Pandemias , Enfermedades Reumáticas/tratamiento farmacológico , Privación de Tratamiento/estadística & datos numéricos , Adulto , Anciano , Antirreumáticos/provisión & distribución , Ansiedad , Continuidad de la Atención al Paciente , Bases de Datos Factuales , Toma de Decisiones , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Reumáticas/psicología , Encuestas y Cuestionarios/estadística & datos numéricos , Centros de Atención Terciaria , Adulto Joven
Front Public Health ; 9: 614935, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34485207


Background: Aging is associated with an increase in adverse health outcomes for older people. Short screening instruments that easily and quickly identify those at highest risk can enable decision-makers to anticipate future needs, allocate scarce resources and act to minimize risk. The Risk Instrument for Screening in the Community (RISC) is a brief (2-5 min) Likert scale that scores one-year risk of institutionalization, hospitalization and death from low (1/5) to severe (5/5). Objectives: To externally validate the RISC, scored by general practitioners (GP's), in primary care in Northern Portugal. Methods: The RISC was translated and culturally adapted to Portuguese. A cohort of 457 older adults (aged ≥65) under active follow-up with their GP's were screened. Outcomes at one-year were recorded. Accuracy was determined from the area under the curve (AUC) of receiver operating curve analysis. Results: The mean age of participants was 75.2 years; 57% were female. The proportion identified as being at maximum risk (RISC scores of 3-5/5) of institutionalization, hospitalization and death, were 14.9, 52.4 and 38.4%, respectively. At follow-up 2% (10/431) were institutionalized, 18.6% (84/451) were hospitalized and 3% (14/456) died. Those who were institutionalized (p = 0.021), hospitalized (p = 0.012) or dead (p < 0.001) at one-year were significantly older. Those living alone were more likely to be institutionalized (p = 0.007). The RISC showed fair accuracy in predicting hospitalization (AUC of 0.62 [95% CI: 0.55-0.69]) and good accuracy for Institutionalization (AUC of 0.79 [95% CI: 0.62-0.96]) and death (AUC of 0.77 [95% CI: 0.65-0.88]). Conclusions: The Portuguese version of the RISC accurately predicted institutionalization and death at one-year but like most short screens was less able to predict hospitalization. Given its brevity, the RISC is useful for quickly identifying and stratifying those at increased risk in primary care.

Evaluación Geriátrica , Institucionalización , Anciano , Femenino , Hospitalización , Humanos , Portugal , Atención Primaria de Salud
Pak J Biol Sci ; 24(6): 663-671, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34486342


<b>Background and Objective:</b> Coronavirus disease 2019 (COVID-19), also known as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), became a global health issue that influenced the lives of billions of people all over the world. The goal of this study was to investigate the clinical findings and routine laboratory evaluations of COVID-19 patients in both average- and high-altitude settings in Saudi Arabia. <b>Materials and Methods:</b> A comparative study to explore the clinical characteristics and Laboratory tests results of COVID-19 patients at both high and average altitudes in Saudi Arabia has been conducted. The study included a total number of 103 patients (53 patients comprising the high-altitude group living in Taif, Saudi Arabia and 50 patients comprising the average-altitude group living in Al Ahsa, Saudi Arabia) were included in the study. Patients were diagnosed with SARS-CoV-2-positive by PCR test. Clinical characteristics, laboratory test results and symptoms of adult patients were collected and expressed as mean and standard deviation. Statistical analysis was done using SPSS software to compare between both groups and significance was considered when the p-value is less than 0.05. <b>Results:</b> Approximately 55.3% of the total cases were male with a mean age of 40.16±12.47 years. There were highly statistically significant differences between the groups in age, heart rate (p<0.001). There were also statistically significant differences between the groups in temperature, SpO<sub>2</sub>, fever, myalgia, shortness of breath and loss of smell and taste. <b>Conclusion:</b> The current study provides an understanding of the clinical and laboratory investigations of COVID-19 patients in two regions (high altitude and average altitude) in Saudi Arabia.

Altitud , Prueba de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , Evaluación de Síntomas , Adolescente , Adulto , Anciano , COVID-19/complicaciones , COVID-19/fisiopatología , COVID-19/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Arabia Saudita , Adulto Joven
Health Qual Life Outcomes ; 19(1): 214, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488787


BACKGROUND: The Needs Assessment Tool: Progressive Disease-Heart Failure (NAT: PD-HF) is a tool created to assess the needs of people living with heart failure and their informal caregivers to assist delivering care in a more comprehensive way that addresses actual needs that are unmet, and to improve quality of life. In this study, we aimed to (1) Translate the tool into German and culturally adapt it. (2) Assess internal consistency, inter-rater reliability, and test-retest reliability of the German NAT: PD-HF. (3) Evaluate whether and how patients and health care personnel understand the tool and its utility. (4) Assess the tool's face validity, applicability, relevance, and acceptability among health care personnel. METHODS: Single-center validation study. The tool was translated from English into German using a forward-backward translation. To assess internal consistency, we used Cronbach´s alpha. To assess inter-rater reliability and test-retest reliability, we used Cohen´s kappa, and to assess validity we used face validity. RESULTS: The translated tool showed good internal consistency. Raters were in substantial agreement on a majority of the questions, and agreement was almost perfect for all the questions in the test-retest analysis. Face validity was rated high by health care personnel. CONCLUSION: The German NAT: PD-HF is a reliable, valid, and internally consistent tool that is well accepted by both patients and health care personnel. However, it is important to keep in mind that effective use of the tool requires training of health care personnel.

Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/terapia , Evaluación de Necesidades/normas , Calidad de Vida/psicología , Encuestas y Cuestionarios/normas , Anciano , Progresión de la Enfermedad , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Cuidados Paliativos , Atención Dirigida al Paciente , Reproducibilidad de los Resultados , Volumen Sistólico , Traducción
Health Qual Life Outcomes ; 19(1): 213, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488798


BACKGROUND: Although physical activity (PA) and sedentary time in cancer survivors (CSs) were associated with health-related quality of life (HRQOL), it was not clear whether their associations were similar among CSs with different number of comorbid chronic diseases (CCDs). This study aimed to investigate the associations between PA, sedentary time and HRQOL in CSs with different number of CCDs. METHODS: A cross-sectional study was conducted among 1546 CSs between June and September 2018 in Shanghai, China. Data were collected with a self-reported questionnaire including sociodemographic characteristics, CCDs, PA, sedentary time and HRQOL. International Physical Activity Questionnaire and Cancer Quality of Life Questionnaire-Core30 were respectively used to measure PA and HRQOL of CSs. Associations of PA and sedentary time with HRQOL among CSs with different number of CCDs were evaluated by using logistic regression, adjusted for confounding factors. RESULTS: About seventy-five percent CSs had at least one CCD. Approximately three fifths CSs had high PA level and < 4 h/day sedentary time. Moderate PA level and high PA level were shown to be associated with better HRQOL among all participants. In CSs with ≤ 2 CCDs, high PA level was significantly associated with higher scores of physical function and lower scores of nausea and vomiting, appetite loss. However, there was a positive association between high PA level and constipation score among CSs with ≥ 3 CCDs. CSs with shorter sedentary time had better HRQOL in those with CCDs. CONCLUSIONS: High PA level and long sedentary time have significant association with worse HRQOL of CSs with ≥ 3 CCDs, while high PA level is positively associated with HRQOL in CSs with ≤ 2 CCDs. Our findings may support further studies of the causal association between PA, sedentary times and HRQOL to provide targeted proposal to improve the HRQOL of CSs according to their number of CCDs.

Supervivientes de Cáncer/psicología , Ejercicio Físico/fisiología , Neoplasias/mortalidad , Calidad de Vida/psicología , Conducta Sedentaria , Adulto , Anciano , Anciano de 80 o más Años , China/epidemiología , Estudios Transversales , Ejercicio Físico/psicología , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/terapia , Encuestas y Cuestionarios , Terapéutica
BMJ Open ; 11(9): e047054, 2021 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-34489273


OBJECTIVE: To explore predictors of district nursing care utilisation for community-living (older) people in the Netherlands using claims data. To cope with growing demands in district nursing care, knowledge about the current utilisation of district nursing care is important. SETTING: District nursing care as a part of primary care. PARTICIPANTS: In this nationwide study, claims data were used from the Dutch risk adjustment system and national information system of health insurers. Samples were drawn of 5500 pairs of community-living people using district nursing care (cases) and people not using district nursing care (controls) for two groups: all ages and aged 75+ years (total N=22 000). OUTCOME MEASURES: The outcome was district nursing care utilisation and the 114 potential predictors included predisposing factors (eg, age), enabling factors (eg, socioeconomic status) and need factors (various healthcare costs). The random forest algorithm was used to predict district nursing care utilisation. The performance of the models and importance of predictors were calculated. RESULTS: For the population of people aged 75+ years, most important predictors were older age, and high costs for general practitioner consultations, aid devices, pharmaceutical care, ambulance transportation and occupational therapy. For the total population, older age, and high costs for pharmaceutical care and aid devices were the most important predictors. CONCLUSIONS: People in need of district nursing care are older, visit the general practitioner more often, and use more and/or expensive medications and aid devices. Therefore, close collaboration between the district nurse, general practitioner and the community pharmacist is important. Additional analyses including data regarding health status are recommended. Further research is needed to provide an evidence base for district nursing care to optimise the care for those with high care needs, and guide practice and policymakers' decision-making.

Costos de la Atención en Salud , Atención Primaria de Salud , Anciano , Estado de Salud , Humanos , Países Bajos , Derivación y Consulta
BMJ Open ; 11(9): e052207, 2021 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-34489294


OBJECTIVES: To explore the prevalence, awareness, treatment and control rate of hypertension and analyse the potential social environment factors among Ngawa Tibetans in China. DESIGN: This was a cross-sectional observational study. SETTING: The investigation based on a multistage stratified cluster sampling was conducted in the Ngawa area, Sichuan Province, Southwest China. Tibetan residents were selected by random sampling method from one city and six counties in Ngawa. METHODS: Basic demographical information, physical activity and blood pressure were collected. In addition, the participants completed the questionnaire. A multivariate logistic regression analysis was used to examine the association between the prevalence, awareness, treatment and control rate of hypertension and the potential risk factors. PARTICIPANTS: The sample comprised 2228 Ngawa Tibetan residents (age 18-80 years) from September 2018 to June 2019. RESULTS: The prevalence rate of hypertension was 24.6%. The control rate was 6.2%, while the awareness rate (32.3%) and treatment rate (21.7%) of hypertension had been significantly improved. CONCLUSION: The prevalence of hypertension among Ngawa Tibetans was high. The awareness and treatment were improved in recent years. But the control rate was low. The government needs to strengthen the basic medical care and health education for Ngawa Tibetans.

Hipertensión , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , China/epidemiología , Estudios Transversales , Humanos , Hipertensión/epidemiología , Persona de Mediana Edad , Prevalencia , Tibet , Adulto Joven
Front Immunol ; 12: 681516, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34489933


Coronavirus disease 2019 (COVID-19) broke out and then became a global epidemic at the end of 2019. With the increasing number of deaths, early identification of disease severity and interpretation of pathogenesis are very important. Aiming to identify biomarkers for disease severity and progression of COVID-19, 75 COVID-19 patients, 34 healthy controls and 23 patients with pandemic influenza A(H1N1) were recruited in this study. Using liquid chip technology, 48 cytokines and chemokines were examined, among which 33 were significantly elevated in COVID-19 patients compared with healthy controls. HGF and IL-1ß were strongly associated with APACHE II score in the first week after disease onset. IP-10, HGF and IL-10 were correlated positively with virus titers. Cytokines were significantly correlated with creatinine, troponin I, international normalized ratio and procalcitonin within two weeks after disease onset. Univariate analyses were carried out, and 6 cytokines including G-CSF, HGF, IL-10, IL-18, M-CSF and SCGF-ß were found to be associated with the severity of COVID-19. 11 kinds of cytokines could predict the severity of COVID-19, among which IP-10 and M-CSF were excellent predictors for disease severity. In conclusion, the levels of cytokines in COVID-19 were significantly correlated with the severity of the disease in the early stage, and serum cytokines could be used as warning indicators of the severity and progression of COVID-19. Early stratification of disease and intervention to reduce hypercytokinaemia may improve the prognosis of COVID-19 patients.

COVID-19/inmunología , Citocinas/genética , Citocinas/inmunología , SARS-CoV-2/inmunología , Índice de Severidad de la Enfermedad , Transcriptoma/inmunología , Adulto , Anciano , Biomarcadores/sangre , Quimiocinas/sangre , Quimiocinas/genética , Quimiocinas/inmunología , Citocinas/sangre , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Gripe Humana/sangre , Gripe Humana/inmunología , Masculino , Persona de Mediana Edad
Front Immunol ; 12: 723585, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34489974


Objectives: Our objective was to determine the antibody and cytokine profiles in different COVID-19 patients. Methods: COVID-19 patients with different clinical classifications were enrolled in this study. The level of IgG antibodies, IgA, IgM, IgE, and IgG subclasses targeting N and S proteins were tested using ELISA. Neutralizing antibody titers were determined by using a toxin neutralization assay (TNA) with live SARS-CoV-2. The concentrations of 8 cytokines, including IL-2, IL-4, IL-6, IL-10, CCL2, CXCL10, IFN-γ, and TNF-α, were measured using the Protein Sample Ella-Simple ELISA system. The differences in antibodies and cytokines between severe and moderate patients were compared by t-tests or Mann-Whitney tests. Results: A total of 79 COVID-19 patients, including 49 moderate patients and 30 severe patients, were enrolled. Compared with those in moderate patients, neutralizing antibody and IgG-S antibody titers in severe patients were significantly higher. The concentration of IgG-N antibody was significantly higher than that of IgG-S antibody in COVID-19 patients. There was a significant difference in the distribution of IgG subclass antibodies between moderate patients and severe patients. The positive ratio of anti-S protein IgG3 is significantly more than anti-N protein IgG3, while the anti-S protein IgG4 positive rate is significantly less than the anti-N protein IgG4 positive rate. IL-2 was lower in COVID-19 patients than in healthy individuals, while IL-4, IL-6, CCL2, IFN-γ, and TNF-α were higher in COVID-19 patients than in healthy individuals. IL-6 was significantly higher in severe patients than in moderate patients. The antibody level of anti-S protein was positively correlated with the titer of neutralizing antibody, but there was no relationship between cytokines and neutralizing antibody. Conclusions: Our findings show the severe COVID-19 patients' antibody levels were stronger than those of moderate patients, and a cytokine storm is associated with COVID-19 severity. There was a difference in immunoglobulin type between anti-S protein antibodies and anti-N protein antibodies in COVID-19 patients. And clarified the value of the profile in critical prevention.

Anticuerpos Antivirales/sangre , COVID-19/inmunología , Citocinas/sangre , SARS-CoV-2/inmunología , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Neutralizantes/sangre , COVID-19/clasificación , Proteínas de la Nucleocápside de Coronavirus/inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina E/sangre , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Glicoproteína de la Espiga del Coronavirus/inmunología
J Korean Med Sci ; 36(35): e248, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34490756


BACKGROUND: Prediction of mortality in patients with coronavirus disease 2019 (COVID-19) is a key to improving the clinical outcomes, considering that the COVID-19 pandemic has led to the collapse of healthcare systems in many regions worldwide. This study aimed to identify the factors associated with COVID-19 mortality and to develop a nomogram for predicting mortality using clinical parameters and underlying diseases. METHODS: This study was performed in 5,626 patients with confirmed COVID-19 between February 1 and April 30, 2020 in South Korea. A Cox proportional hazards model and logistic regression model were used to construct a nomogram for predicting 30-day and 60-day survival probabilities and overall mortality, respectively in the train set. Calibration and discrimination were performed to validate the nomograms in the test set. RESULTS: Age ≥ 70 years, male, presence of fever and dyspnea at the time of COVID-19 diagnosis, and diabetes mellitus, cancer, or dementia as underling diseases were significantly related to 30-day and 60-day survival and mortality in COVID-19 patients. The nomogram showed good calibration for survival probabilities and mortality. In the train set, the areas under the curve (AUCs) for 30-day and 60-day survival was 0.914 and 0.954, respectively; the AUC for mortality of 0.959. In the test set, AUCs for 30-day and 60-day survival was 0.876 and 0.660, respectively, and that for mortality was 0.926. The online calculators can be found at CONCLUSION: The prediction model could accurately predict COVID-19-related mortality; thus, it would be helpful for identifying the risk of mortality and establishing medical policies during the pandemic to improve the clinical outcomes.

COVID-19/mortalidad , Nomogramas , SARS-CoV-2 , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Modelos Logísticos , Masculino , Persona de Mediana Edad , Probabilidad , Modelos de Riesgos Proporcionales , Índice de Severidad de la Enfermedad , Adulto Joven