Hospitalization Causes and Epidemiological Characteristics Among Patients With End-Stage Renal Disease: A Six-Year Retrospective Study.

BACKGROUND: Chronic kidney disease (CKD) leads to a high rate of complications requiring hospital admission for advanced management. Therefore, this study aims to analyze the main causes of hospitalization following the initiation of renal replacement therapy (RRT). MATERIALS AND METHODS: This observational and descriptive study utilized a non-probabilistic quota sampling method, reviewing a total of 423 medical records from General Regional Hospital 1 of the Mexican Social Security Institute in Querétaro. The study evaluated the frequency and causality of hospitalizations during a retrospective period from 2018 to 2023. RESULTS: There were 1,162 hospitalization events involving 423 patients; 71.63% of patients started RRT with peritoneal dialysis, while 26% began with hemodialysis. The leading cause of hospitalization was electrolyte imbalance (397; 34.17%), followed by peritonitis associated with peritoneal dialysis (351; 30.21%), change to hemodialysis (270; 23.24%), Tenckhoff catheter dysfunction (209; 17.99%), and fluid overload (205; 17.64%). The group with the highest number of events was renal-related complications, followed by infectious causes. CONCLUSIONS: Hospitalizations in end-stage CKD patients often arise from the complex renal pathophysiology and complications related to acute and decompensated renal function. This condition refers to the kidneys' failure to maintain essential physiological functions despite ongoing treatment, leading to issues such as electrolyte imbalances, fluid overload, and uremic syndrome. To reduce morbidity and mortality, measures such as enhanced training in ambulatory dialysis, improved catheter care, and early infection detection are crucial. A comprehensive approach that addresses both acute issues and preventive strategies is essential for improving clinical outcomes and quality of life for these patients.

Is Match Playing Time a Potential Tool for Managing Load in Women's Handball?

ABSTRACT: García-Sánchez, C, Navarro, RM, Nieto-Acevedo, R, and de la Rubia, A. Is match playing time a potential tool for managing load in women's handball? J Strength Cond Res XX(X): 000-000, 2024-The aim of this study was to explore the external load experienced by female handball players according to the time played in official matches (≥40, <40, and ≤20 minutes) and in relation to playing positions (backs, pivots, and wings). Twenty-two female players from the Spanish second Division were monitored across 13 matches. Total distance covered, high-speed running distance (HSR), accelerations, decelerations, and PlayerLoad were collected in absolute and relative values using a local positioning system (WIMU PRO, Realtrack Systems SL, Almería, Spain). One-way ANOVA with partial eta-squared and Cohen's d were used to determine the differences between playing time groups and between playing positions. This study revealed that players with more match playing time had a higher absolute values in all external load variables (p < 0.001; very large effects), except in HSR where only wings showed higher values according to the time played (p < 0.001; very large effects). However, these differences between playing time groups disappear when the external load values were normalized according to the effective playing time (p > 0.05). In relation to playing positions, wings covered more HSR/minutes than the other playing positions regardless of the playing time (p < 0.05; large effects). In addition, backs performed more ACC/minutes than wings in the high playing time group and more than pivots in the low playing time group (p < 0.05, moderate effects). In addition, backs performed more DEC/minutes than wings in the low playing time group (p < 0.05, moderate effects). Therefore, handball coaches should consider the playing time as an effective tool to optimize the weekly load distribution.

Sex-related differences in the load-velocity and load-power relationships of the decline bench press exercise.

The purpose of this study was to analyse the load-velocity and load-power relationships of the decline bench press exercise (DBPE) and to compare sex-related differences. Twelve young healthy men and women performed a progressive loading test for the determination of 1RM strength and individual load-velocity and load-power relationship in the DBPE. A very close relationship between mean propulsive velocity (MPV) and %1RM was observed (R2 = 0.94). This relationship improved when plotting data separately by sex (R2 = 0.96-97). Individual load-velocity profiles gave an R2 = 0.99 ± 0.01. The relationship between mean propulsive power (MPP) and %1RM was R2 = 0.23. When separating data by sex, R2 = 0.64-73 were obtained. Individual load-power profiles gave an R2 of 0.93 ± 0.07. Significant sex-related differences were found for MPV, with males having faster velocities than females from 30% to 40% 1RM (p = 0.01) and for MPP, with males having greater MPP (W) than females from 30% to 95% 1RM (p < 0.001). The results of this study show that a strong correlation exists between relative load and MPV/MPP in the DBPE, allowing the possibility of using one to predict the other with great precision, especially when a sex-specific equation is used.

Can Caffeine Change the Game? Effects of Acute Caffeine Intake on Specific Performance in Intermittent Sports During Competition: A Systematic Review and Meta-Analysis.

BACKGROUND: The benefits of oral caffeine intake to enhance several aspects of physical performance, such as aerobic endurance, strength, power, and muscle endurance performance, are well supported. However, how the physical performance benefits of caffeine supplementation are translated into better specific actions in intermittent sports during real or simulated competition has been the topic of fewer investigations, and their results need to be appropriately reviewed and meta-analyzed. OBJECTIVE: The aim of the study was to investigate the effects of acute caffeine intake on specific actions in intermittent sports involving decision making and high-intensity efforts (eg, team, racket, and combat sports) during real or simulated competitions. METHODS: All studies included had blinded and crossover experimental designs, and we conducted a risk-of-bias analysis. In total, we included 24 studies. A meta-analysis was performed using the random-effects model to calculate the standardized mean difference (SMD) estimated by Hedges g and 95% CIs. RESULTS: Caffeine ingestion increased high-intensity sport-specific actions during competition, such as the number of sprints (SMD: 0.48; 95% CI, 0.23-0.74), body impacts (SMD: 0.28; 95% CI, 0.08-0.49), accelerations (SMD: 0.35; 95% CI, 0.06-0.63), decelerations (SMD: 0.63; 95% CI, 0.12-1.14), and high-intensity offensive efforts (SMD: 0.36; 95% CI, 0.11-0.61). Additionally, caffeine ingestion induced a higher positive or success rate of actions during real or simulated competition (SMD: 0.44; 95% CI, 0.19-0.69). CONCLUSION: The current meta-analysis provides evidence of caffeine supplementation in increasing high-intensity efforts and the success rate of sport-specific actions during real or simulated competition.

Home-Court Advantage is Greater for Teams Competing at Higher Playing Levels: An Exploratory Analysis of Spanish Male Basketball Leagues.

This study aimed to (i) compare the extent of home-court advantage (HA) and home win percentage (HW) between Spanish basketball leagues across different playing levels (i.e., leagues) and (ii) analyze the influence of team ability on HA and HW within each playing level. We gathered data for game locations and results from open online sources for all games in the First Division (ACB), Second Division (LEB Gold), and Third Division (LEB Silver) Spanish male basketball leagues between 2010-2023. The dataset included 12 seasons, 635 teams (215 First Division, 203, Second Division, and 217 Third Division), and 19,539 games (7075 First Division, 6344 Second Division, and 5520 Third Division). We calculated HA [(total home wins/total wins) * 100] and HW [(total home wins/total home games) * 100] for each team across each season. We performed Kruskal Wallis tests, calculated partial eta squared (ηp2), and performed Mann-Whitney U tests with rank biserial correlation (rb) effect sizes and Dwass-Steel-Critchlow-Fligner pairwise comparisons to compare HA and HW between leagues and between team abilities (low, medium, and/or high) within each league. There was a significant effect for HA between leagues (p = .01) with post hoc comparisons revealing a higher HA for the First Division than for the Third Division (p = .01), but HW was not significantly different between leagues. In turn, variations in HA and HW between team abilities were consistent across playing levels, with HW significantly increasing in a progressive manner with higher team abilities (p < .001) and with HA significantly lower among high-level teams compared to lower-ability team clusters (p < .01). These findings emphasize the importance of considering playing level and team ability and interpreting HA and HW together to contextualize an apparent home advantage in Spanish basketball.

Examining the Role of Fan Support on Home Advantage and Home Win Percentage in Professional Women's Basketball.

Our main aim in this study was to analyze any differences in Win Percentages at Home (HW) that might represent a Home-Court Advantage (HA) in women's professional basketball. A secondary objective was to analyze how team ability might modify the HA effect by comparing any interaction effect between HW and team ability in games played with and without fans. We collected data from first Spanish female basketball divisions, using a linear mixed model (LMM) for repeated measures to identify differences between time periods (games with fans vs. games without fans) for HA and HW. When comparing games with and without fans, we found no significant HA and HW differences (p = .283 and p = .872, respectively). In fact, interestingly, we observed higher win values when fans were absent. Additionally, during the COVID-19 shut down stage, HA increased; but it returned to pre-pandemic levels afterward, with no significant differences between these periods (p = .482). Similarly, while HW seemed to increase during the COVID-19 shut down period and continued improving in the post-pandemic phase, there were actually no statistically significant differences (p = .772). Higher HA and HW were evident without fans during the pandemic compared to the pre-pandemic period when fans were present in women's professional basketball. During the post-pandemic period, HA decreased upon fans' return, while HW continued increasing. We discuss possible bases for these unexpected findings.

Sex Differences in the Load-Velocity Profiles of Three Different Row Exercises.

This study examined the force-velocity profile differences between men and women in three variations of row exercises. Twenty-eight participants (14 men and 14 women) underwent maximum dynamic strength assessments in the free prone bench row (PBR), bent-over barbell row (BBOR), and Smith machine bent-over row (SMBOR) in a randomized order. Subjects performed a progressive loading test from 30 to 100% of 1-RM (repetition maximum), and the mean propulsive velocity was measured in all attempts. Linear regression analyses were conducted to establish the relationships between the different measures of bar velocity and % 1-RM. The ANOVAs applied to the mean velocity achieved in each % 1-RM tested revealed significantly higher velocity values for loads < 65% 1-RM in SMBOR compared to BBOR (p < 0.05) and higher velocities for loads < 90% 1-RM in SMBOR compared to PBR (p < 0.05) for both sexes. Furthermore, men provided significantly higher velocity values than women (PBR 55-100% 1-RM; BBOR and SMBOR < 85% 1-RM; p < 0.05) and significant differences were found between exercises and sex for 30-40% 1-RM. These results confirm that men have higher velocities at different relative loads (i.e., % 1-RM) compared to women during upper-body rowing exercises.

Integrating Transcriptional, Metabolic, and Physiological Responses to Drought Stress in Ilex paraguariensis Roots.

The appearance of water stress episodes triggers leaf abscission and decreases Ilex paraguariensis yield. To explore the mechanisms that allow it to overcome dehydration, we investigated how the root gene expression varied between water-stressed and non-stressed plants and how the modulation of gene expression was linked to metabolite composition and physiological status. After water deprivation, 5160 differentially expressed transcripts were obtained through RNA-seq. The functional enrichment of induced transcripts revealed significant transcriptional remodelling of stress-related perception, signalling, transcription, and metabolism. Simultaneously, the induction of the enzyme 9-cis-expoxycarotenoid dioxygenase (NCED) transcripts reflected the central role of the hormone abscisic acid in this response. Consequently, the total content of amino acids and soluble sugars increased, and that of starch decreased. Likewise, osmotic adjustment and radical growth were significantly promoted to preserve cell membranes and water uptake. This study provides a valuable resource for future research to understand the molecular adaptation of I. paraguariensis plants under drought conditions and facilitates the exploration of drought-tolerant candidate genes.

A Systematic Review and Meta-Analysis of the Differences in Mean Propulsive Velocity between Men and Women in Different Exercises.

The purpose of this paper was to conduct a systematic review and meta-analysis of studies examining the differences in the mean propulsive velocities between men and women in the different exercises studied (squat, bench press, inclined bench press and military press). Quality Assessment and Validity Tool for Correlational Studies was used to assess the methodological quality of the included studies. Six studies of good and excellent methodological quality were included. Our meta-analysis compared men and women at the three most significant loads of the force-velocity profile (30, 70 and 90% of 1RM). A total of six studies were included in the systematic review, with a total sample of 249 participants (136 men and 113 women). The results of the main meta-analysis indicated that the mean propulsive velocity is lower in women than men in 30% of 1RM (ES = 1.30 ± 0.30; CI: 0.99-1.60; p < 0.001) and 70% of 1RM (ES = 0.92 ± 0.29; CI: 0.63, 1.21; p < 0.001). In contrast, for the 90% of the 1RM (ES = 0.27 ± 0.27; CI: 0.00, 0.55), we did not find significant differences (p = 0.05). Our results support the notion that prescription of the training load through the same velocity could cause women to receive different stimuli than men.

The Lambda Variant in Argentina: Analyzing the Evolution and Spread of SARS-CoV-2 Lineage C.37.

The second wave of COVID-19 occurred in South America in early 2021 and was mainly driven by Gamma and Lambda variants. In this study, we aimed to describe the emergence and local genomic diversity of the SARS-CoV-2 Lambda variant in Argentina, from its initial entry into the country until its detection ceased. Molecular surveillance was conducted on 9356 samples from Argentina between October 2020 and April 2022, and sequencing, phylogenetic, and phylogeographic analyses were performed. Our findings revealed that the Lambda variant was first detected in Argentina in January 2021 and steadily increased in frequency until it peaked in April 2021, with continued detection throughout the year. Phylodynamic analyses showed that at least 18 introductions of the Lambda variant into the country occurred, with nine of them having evidence of onward local transmission. The spatial--temporal reconstruction showed that Argentine clades were associated with Lambda sequences from Latin America and suggested an initial diversification in the Metropolitan Area of Buenos Aires before spreading to other regions in Argentina. Genetic analyses of genome sequences allowed us to describe the mutational patterns of the Argentine Lambda sequences and detect the emergence of rare mutations in an immunocompromised patient. Our study highlights the importance of genomic surveillance in identifying the introduction and geographical distribution of the SARS-CoV-2 Lambda variant, as well as in monitoring the emergence of mutations that could be involved in the evolutionary leaps that characterize variants of concern.

Should We Use the Men Load-Velocity Profile for Women in Deadlift and Hip Thrust?

Injuries are common in team sports and can impact both team and individual performance. In particular, hamstring strain injuries are some of the most common injuries. Furthermore, hamstring injury ratios, in number of injuries and total absence days, have doubled in the last 21 seasons in professional soccer. Weakness in hip extensor strength has been identified as a risk factor in elite-level sprinters. In addition, strength imbalances of the hamstring muscle group seem to be a common cause of hamstring strain injuries. In this regard, velocity-based training has been proposed to analyze deficits in the force-velocity profile. Previous studies have shown differences between men and women, since there are biomechanical and neuromuscular differences in the lower limbs between sexes. Therefore, the aim of this study was to compare the load-velocity profile between males and females during two of the most important hip extension exercises: the hip thrust and the deadlift. Sixteen men and sixteen women were measured in an incremental loading test following standard procedures for the hip thrust and deadlift exercises. Pearson's correlation (r) was used to measure the strength of the correlation between movement velocity and load (%1RM). The differences in the load-velocity relationship between the men and the women were assessed using a 2 (sex) × 15 (load) repeated-measures ANOVA. The main findings revealed that: (I) the load-velocity relationship was always strong and linear in both exercises (R2 range: 0.88-0.94), (II) men showed higher velocities for light loads (30-50%1RM; effect size: 0.9-0.96) than women for the deadlift, but no significant differences were found for the hip thrust. Based on the results of this study, the load-velocity equations seem to be sex-specific. Therefore, we suggest that using sex-specific equations to analyze deficits in the force-velocity profile would be more effective to control intensity in the deadlift exercise.

Transcriptome Dynamics of Rooting Zone and Leaves during In Vitro Adventitious Root Formation in Eucalyptus nitens.

Wood properties and agronomic traits associated with fast growth and frost tolerance make Eucalyptus nitens a valuable forest alternative. However, the rapid age-related decline in the adventitious root (AR) formation (herein, meaning induction, initiation, and expression stages) limits its propagation. We analyzed transcriptomic profile variation in leaves and stem bases during AR induction of microcuttings to elucidate the molecular mechanisms involved in AR formation. In addition, we quantified expressions of candidate genes associated with recalcitrance. We delimited the ontogenic phases of root formation using histological techniques and Scarecrow and Short-Root expression quantification for RNA sequencing sample collection. We quantified the gene expressions associated with root meristem formation, auxin biosynthesis, perception, signaling, conjugation, and cytokinin signaling in shoots harvested from 2- to 36-month-old plants. After IBA treatment, 702 transcripts changed their expressions. Several were involved in hormone homeostasis and the signaling pathways that determine cell dedifferentiation, leading to root meristem formation. In part, the age-related decline in the rooting capacity is attributable to the increase in the ARR1 gene expression, which negatively affects auxin homeostasis. The analysis of the transcriptomic variation in the leaves and rooting zones provided profuse information: (1) To elucidate the auxin metabolism; (2) to understand the hormonal and signaling processes involved; (3) to collect data associated with their recalcitrance.

[Chronic care for patients with post-COVID-19 syndrome after discharge from an intensive care unitCuidados prolongados de pacientes com síndrome pós-COVID-19 após internação em unidade de terapia intensiva]. / Cuidados crónicos en pacientes con síndrome pos-COVID-19 tras el egreso de la unidad de cuidados intensivos.

Objective: To describe the clinical features of patients with post-COVID-19 syndrome who have recently been discharged from intensive care units (ICUs) included in a chronic care program in Colombia. Methods: Descriptive case series study of a cohort of patients with post-COVID-19 syndrome who entered the Remeo® chronic care program between July 2020 and May 2021. Clinical features, complications, and treatments are described. Results: Among patients in the program discharged from an ICU, 122 cases of post-COVID-19 syndrome were identified. These patients continued in the program. The mean age was 66.9 years (CI 64-68); 62.29% were men, 88.9% (109) had a tracheostomy, 72.8% (90) had a gastrostomy, and 99% required supplemental oxygen. In the first four months, 9,518 interventions were carried out, including physical therapy (x̄:20.7), occupational therapy (x̄:10.9), respiratory therapy (x̄:41.4), and psychology (x̄:4.8). Conclusions: The chronic care program was an option for patients with post-COVID-19 syndrome recently discharged from an ICU, with a view to minimizing ICU occupation rates and facilitating patients' return to their homes.

Objetivo: Descrever as características clínicas de pacientes com síndrome pós-COVID-19 após internação em unidade de terapia intensiva (UTI), acompanhados em um programa de cuidados prolongados na Colômbia. Métodos: Estudo descritivo de série de casos oriundos de uma coorte de pacientes com síndrome pós-COVID-19 admitidos no programa de cuidados prolongados Remeo® entre julho de 2020 e maio de 2021. Foram descritas as características clínicas desses pacientes, assim como complicações e tratamentos. Resultados: Foram identificados 122 casos de pacientes com síndrome pós-COVID-19 que foram acompanhados no programa após alta da UTI. A média de idade foi 66,9 anos (IC 64­68), 62,29% pertenciam ao sexo masculino, 88,9% (109) haviam sido submetidos a traqueostomia, 72,8% (90) a gastrostomia e 99% precisavam usar oxigênio suplementar. Ao todo, 9.518 intervenções foram realizadas nos 4 meses iniciais de acompanhamento no programa, incluindo fisioterapia (x̄ 20,7), terapia ocupacional (x̄ 10,9), terapia respiratória (x̄ 41,4) e atendimento psicológico (x̄ 4,8). Conclusões: O programa de cuidados prolongados ofereceu uma alternativa aos pacientes com síndrome pós-COVID-19 após internação em UTI e teve o objetivo de reduzir a ocupação das UTIs e facilitar a transição do paciente da UTI para casa.

Cuidados crónicos en pacientes con síndrome pos-COVID-19 tras el egreso de la unidad de cuidados intensivos

[RESUMEN]. Objetivo. Describir las características clínicas de pacientes con síndrome pos-COVID-19 recién egresados de unidades cuidado intensivo (UCI) incluidos en un programa de cuidados crónicos en Colombia. Métodos. Estudio descriptivo de serie de casos procedentes de una cohorte de pacientes con síndrome pos-COVID-19 que ingresaron al programa de cuidados crónicos Remeo® entre julio de 2020 y mayo de 2021. Se describen las características clínicas, las complicaciones y el tratamiento de estos pacientes. Resultados. Se identificaron 122 casos de síndrome pos-COVID-19 dados de alta de la UCI para continuar en el Programa. La media de la edad fue de 66,9 años (IC 64-68); 62,29% fueron hombres, 88,9% (109) tenían traqueostomía, 72,8% (90) gastrostomía, y 99% requerían oxígeno suplementario. Se llevaron a cabo 9 518 intervenciones en los primeros 4 meses, inclusive terapia física (x¯:20,7), terapia ocupacional (x¯:10,9), terapia respiratoria (x¯:41,4) y psicología (x¯:4,8). Conclusiones. El Programa de cuidados crónicos representó una alternativa para pacientes con síndrome pos-COVID-19 recién egresados de las UCI, dirigido a minimizar la ocupación de estas y facilitar el paso del paciente desde la UCI al domicilio.

[ABSTRACT]. Objective. To describe the clinical features of patients with post-COVID-19 syndrome who have recently been discharged from intensive care units (ICUs) included in a chronic care program in Colombia. Methods. Descriptive case series study of a cohort of patients with post-COVID-19 syndrome who entered the Remeo® chronic care program between July 2020 and May 2021. Clinical features, complications, and treatments are described. Results. Among patients in the program discharged from an ICU, 122 cases of post-COVID-19 syndrome were identified. These patients continued in the program. The mean age was 66.9 years (CI 64–68); 62.29% were men, 88.9% (109) had a tracheostomy, 72.8% (90) had a gastrostomy, and 99% required supplemental oxygen. In the first four months, 9,518 interventions were carried out, including physical therapy (x¯:20.7), occupational therapy (x¯:10.9), respiratory therapy (x¯:41.4), and psychology (x¯:4.8). Conclusions. The chronic care program was an option for patients with post-COVID-19 syndrome recently discharged from an ICU, with a view to minimizing ICU occupation rates and facilitating patients' return to their homes.

[RESUMO]. Objetivo. Descrever as características clínicas de pacientes com síndrome pós-COVID-19 após internação em unidade de terapia intensiva (UTI), acompanhados em um programa de cuidados prolongados na Colômbia. Métodos. Estudo descritivo de série de casos oriundos de uma coorte de pacientes com síndrome pós- COVID-19 admitidos no programa de cuidados prolongados Remeo® entre julho de 2020 e maio de 2021. Foram descritas as características clínicas desses pacientes, assim como complicações e tratamentos. Resultados. Foram identificados 122 casos de pacientes com síndrome pós-COVID-19 que foram acompanhados no programa após alta da UTI. A média de idade foi 66,9 anos (IC 64–68), 62,29% pertenciam ao sexo masculino, 88,9% (109) haviam sido submetidos a traqueostomia, 72,8% (90) a gastrostomia e 99% precisavam usar oxigênio suplementar. Ao todo, 9.518 intervenções foram realizadas nos 4 meses iniciais de acompanhamento no programa, incluindo fisioterapia (x¯ 20,7), terapia ocupacional (x¯ 10,9), terapia respiratória (x¯ 41,4) e atendimento psicológico (x¯ 4,8). Conclusões. O programa de cuidados prolongados ofereceu uma alternativa aos pacientes com síndrome pós-COVID-19 após internação em UTI e teve o objetivo de reduzir a ocupação das UTIs e facilitar a transição do paciente da UTI para casa.

Cuidados crónicos en pacientes con síndrome pos-COVID-19 tras el egreso de la unidad de cuidados intensivos / Chronic care for patients with post-COVID-19 syndrome after discharge from an intensive care unit / Cuidados prolongados de pacientes com síndrome pós-COVID-19 após internação em unidade de terapia intensiva

RESUMEN Objetivo. Describir las características clínicas de pacientes con síndrome pos-COVID-19 recién egresados de unidades cuidado intensivo (UCI) incluidos en un programa de cuidados crónicos en Colombia. Métodos. Estudio descriptivo de serie de casos procedentes de una cohorte de pacientes con síndrome pos-COVID-19 que ingresaron al programa de cuidados crónicos Remeo® entre julio de 2020 y mayo de 2021. Se describen las características clínicas, las complicaciones y el tratamiento de estos pacientes. Resultados. Se identificaron 122 casos de síndrome pos-COVID-19 dados de alta de la UCI para continuar en el Programa. La media de la edad fue de 66,9 años (IC 64-68); 62,29% fueron hombres, 88,9% (109) tenían traqueostomía, 72,8% (90) gastrostomía, y 99% requerían oxígeno suplementario. Se llevaron a cabo 9 518 intervenciones en los primeros 4 meses, inclusive terapia física (x̄:20,7), terapia ocupacional (x̄:10,9), terapia respiratoria (x̄:41,4) y psicología (x̄:4,8). Conclusiones. El Programa de cuidados crónicos representó una alternativa para pacientes con síndrome pos-COVID-19 recién egresados de las UCI, dirigido a minimizar la ocupación de estas y facilitar el paso del paciente desde la UCI al domicilio.

ABSTRACT Objective. To describe the clinical features of patients with post-COVID-19 syndrome who have recently been discharged from intensive care units (ICUs) included in a chronic care program in Colombia. Methods. Descriptive case series study of a cohort of patients with post-COVID-19 syndrome who entered the Remeo® chronic care program between July 2020 and May 2021. Clinical features, complications, and treatments are described. Results. Among patients in the program discharged from an ICU, 122 cases of post-COVID-19 syndrome were identified. These patients continued in the program. The mean age was 66.9 years (CI 64-68); 62.29% were men, 88.9% (109) had a tracheostomy, 72.8% (90) had a gastrostomy, and 99% required supplemental oxygen. In the first four months, 9,518 interventions were carried out, including physical therapy (x̄:20.7), occupational therapy (x̄:10.9), respiratory therapy (x̄:41.4), and psychology (x̄:4.8). Conclusions. The chronic care program was an option for patients with post-COVID-19 syndrome recently discharged from an ICU, with a view to minimizing ICU occupation rates and facilitating patients' return to their homes.

RESUMO Objetivo. Descrever as características clínicas de pacientes com síndrome pós-COVID-19 após internação em unidade de terapia intensiva (UTI), acompanhados em um programa de cuidados prolongados na Colômbia. Métodos. Estudo descritivo de série de casos oriundos de uma coorte de pacientes com síndrome pós-COVID-19 admitidos no programa de cuidados prolongados Remeo® entre julho de 2020 e maio de 2021. Foram descritas as características clínicas desses pacientes, assim como complicações e tratamentos. Resultados. Foram identificados 122 casos de pacientes com síndrome pós-COVID-19 que foram acompanhados no programa após alta da UTI. A média de idade foi 66,9 anos (IC 64-68), 62,29% pertenciam ao sexo masculino, 88,9% (109) haviam sido submetidos a traqueostomia, 72,8% (90) a gastrostomia e 99% precisavam usar oxigênio suplementar. Ao todo, 9.518 intervenções foram realizadas nos 4 meses iniciais de acompanhamento no programa, incluindo fisioterapia (x̄ 20,7), terapia ocupacional (x̄ 10,9), terapia respiratória (x̄ 41,4) e atendimento psicológico (x̄ 4,8). Conclusões. O programa de cuidados prolongados ofereceu uma alternativa aos pacientes com síndrome pós-COVID-19 após internação em UTI e teve o objetivo de reduzir a ocupação das UTIs e facilitar a transição do paciente da UTI para casa.

Cost-Effective Method to Perform SARS-CoV-2 Variant Surveillance: Detection of Alpha, Gamma, Lambda, Delta, Epsilon, and Zeta in Argentina.

SARS-CoV-2 variants with concerning characteristics have emerged since the end of 2020. Surveillance of SARS-CoV-2 variants was performed on a total of 4,851 samples from the capital city and 10 provinces of Argentina, during 51 epidemiological weeks (EWs) that covered the end of the first wave and the ongoing second wave of the COVID-19 pandemic in the country (EW 44/2020 to EW 41/2021). The surveillance strategy was mainly based on Sanger sequencing of a Spike coding region that allows the identification of signature mutations associated with variants. In addition, whole-genome sequences were obtained from 637 samples. The main variants found were Gamma and Lambda, and to a lesser extent, Alpha, Zeta, and Epsilon, and more recently, Delta. Whereas, Gamma dominated in different regions of the country, both Gamma and Lambda prevailed in the most populated area, the metropolitan region of Buenos Aires. The lineages that circulated on the first wave were replaced by emergent variants in a term of a few weeks. At the end of the ongoing second wave, Delta began to be detected, replacing Gamma and Lambda. This scenario is consistent with the Latin American variant landscape, so far characterized by a concurrent increase in Delta circulation and a stabilization in the number of cases. The cost-effective surveillance protocol presented here allowed for a rapid response in a resource-limited setting, added information on the expansion of Lambda in South America, and contributed to the implementation of public health measures to control the disease spread in Argentina.

The utilisation of tools to facilitate cross-border communication during international food safety events, 1995-2020: a realist synthesis.

Efficient communication and coordination are needed between countries to prevent, detect and respond to international food safety events. While communication tools, networks and systems exist, current evidence suggests that they are only useful within particular contexts and several only target specific geographic areas. There is a need to unpack and explore the mechanisms of how and in what context such communication tools and their components are effective at facilitating international communication and coordination to keep food safe and mitigate the burden of foodborne disease around the world.A realist synthesis was undertaken to understand how and why certain processes and structures of communication tools, used during international food safety events, influence their utility and effectiveness according to different contextual factors. The focus of this review was explanatory and aimed to develop and refine theory regarding how contextual factors trigger specific processes and mechanisms to produce outcomes. Using the realist context-mechanism-outcome configuration of theory development, a range of sources was used to develop an initial programme theory, including the authors' experience, a scoping review of published papers and grey literature and input from an expert reference committee. Literature was then systematically located and synthesised from several databases with input from the expert reference committee to refine the programme theory.The programme theory developed indicates that when a country has interests in food import or export, has the technical infrastructure to detect and respond to food safety events, and is governed in accordance with regional and/or global laws and regulations relating to food control and global health security, then specific mechanisms will facilitate various outcomes. Mechanisms include trust, experience, support, awareness, understanding, a sense of community, standardisation and intersectoral collaboration. The outcomes include using communication tools to relay information abroad and the prevention of foodborne diseases, among others.Components of such communication tools may be adapted according to different contextual factors to promote, support and improve their use. Improving international coordination and communication during international food safety events is in the interest of global health security and can mitigate the global burden of foodborne disease.

Differential DNA methylation and gene expression during development of reproductive and vegetative organs in Ilex species.

Differential epigenetic (DNA cytosine methylation) and gene expression patterns were investigated in reproductive and vegetative organs from Ilex paraguariensis and I. dumosa, at distinct developmental stages. We aimed at contributing towards elucidating major molecular changes underlying the sexual differentiation processes which, in these dioecious species, are completely unknown. Simultaneously, as a first step towards the development of an early sexing system, we searched for promising molecular markers. This was assessed through Methylation Sensitive Amplified Polymorphism (MSAP) and Amplified Fragment Length Polymorphism on cDNA (cDNA-AFLP) techniques, applying discriminant multivariate analyses, and bioinformatic characterization of differential fragments. A significant positive correlation was found between epigenetic and indirect 'genetic' information for both species, indicating influence of the genetic background on the epigenetic variation. Higher epigenetic than genetic diversities were estimated. Our outcomes showed up to 1.86 times more representation of mCG subepiloci than mCCG in all organs sampled. Along the maturing stages of floral buds, the frequency of mCG evidenced an incremental trend, whereas mCCG and unmethylated conditions showed opposite tendencies. Reproductive and vegetative samples tended to cluster apart based on epigenetic patterns; at gene expression level, organs exhibited clear-cut distinctive patterns, nonetheless profiles of young leaves and floral primordia resemble. Epigenetic and expression data allowed discrimination of I. dumosa´s samples according to the gender of the donor; more elusive patterns were observed for I. paraguariensis. In total, 102 differentially methylated and expressed fragments were characterized bioinformatically. Forty-three were annotated in various functional categories; four candidate markers were validated through qPCR, finding statistical differences among organs but not among sexes. The methylation condition of epilocus C13m33 appears as indicative of gender in both species. Thirty-three organ-specific and 34 gender-specific methylated markers were discriminated and deserve further research, particularly those expressed in leaves. Our study contributes concrete candidate markers with potential for practical application.

Molecular characterization of a novel cytorhabdovirus with a unique genomic organization infecting yerba mate (Ilex paraguariensis) in Argentina.

The genome of a novel rhabdovirus was detected in yerba mate (Ilex paraguariensis St. Hil.). The newly identified virus, tentatively named "yerba mate virus A" (YmVA), has a genome of 14,961 nucleotides. Notably, eight open reading frames were identified in the antigenomic orientation of the negative-sense, single-stranded viral RNA, including two novel accessory genes, in the order 3'-N-P-3-4-M-G-L-8-5'. Sequence comparisons of the encoded proteins as well as phylogenetic analysis suggest that YmVA is a new member of the genus Cytorhabdovirus, family Rhabdoviridae. YmVA's unique genomic organization and phylogenetic relationships indicate that this virus likely represents a distinct evolutionary lineage among the cytorhabdoviruses.

Trends of maxillofacial trauma: An update from the prospective register of a multicenter study in emergency services of Chile

Background: Determine the behavior of the maxillofacial trauma of adults treated in 3 tertiary care centers in the central zone of Chile. Material and Methods: descriptive, cross-sectional, multicenter study, based on the prospective records of maxillofacial trauma cases attended between May 2016 and April 2017 by dental and maxillofacial clinical teams of Adult Emergency Units of hospitals Dr. Sótero del Río (metropolitan region), Carlos Van Buren and Dr. Gustavo Fricke (region V). Age, sex, date of occurrence, type of trauma according to ICD-10, etiology, legal medical prognosis and associated injuries were recorded, stratifying by sex and age. Chi square and unpaired Wilcoxon tests were used to compare by groups. Results: 2.485 cases and 3.285 injuries were investigated. The male: female ratio was 1.7: 1 with age under 30 predominant, followed by older adults. Variability was observed in the yearly, weekly and daily presentation The highest frequencies were in January and September, weekends and at night. The main etiologies were violence (42.3%), falls (13.1%) and road traffic crashes (12.9%) with differences by age and sex (p <0.05). 31,9% of the injuries occurred in hard tissue, being fractures in nasal bones predominant (S02.2). Conclusions: the profile of the maxillofacial trauma in Chile seems to be mixed by age, affecting young people and the elderly. The male sex predominates; the main cause, which varies by age group, is violence. Their surveillance is possible from hospital emergency records

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