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1.
Support Care Cancer ; 32(7): 479, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38954025

RESUMO

PURPOSE: Continuous lenalidomide maintenance treatment after autologous stem cell transplantation delivers improvement in progression free and overall survival among newly diagnosed multiple myeloma patients and has been the standard of care in the UK since March 2021. However, there is scant information about its impact on patients' day-to-day lives. This service evaluation aimed to qualitatively assess patients receiving lenalidomide treatment at a cancer centre in London, in order that the service might better align with needs and expectations of patients. METHODS: We conducted 20 semi-structured interviews among myeloma patients who were on continuous lenalidomide maintenance treatment at a specialist cancer centre in London. Members of the clinical team identified potentially eligible participants to take part, and convenience sampling was used to select 10 male and 10 female patients, median age of 58 (range, 45-71). The median treatment duration was 11 months (range, 1-60 months). Participants were qualitatively interviewed following the same semi-structured interview guide, which was designed to explore patient experience and insights of lenalidomide. Reflexive thematic analysis was used for data analysis. RESULTS: Four overarching themes were as follows: (i) lenalidomide: understanding its role and rationale; (ii) reframing the loss of a treatment-free period to a return to normal life; (iii) the reality of being on lenalidomide: balancing hopes with hurdles; (iv) gratitude and grievances: exploring mixed perceptions of care and communication. Results will be used to enhance clinical services by tailoring communication to better meet patients' preferences when making treatment decisions. CONCLUSION: This study highlights that most patients feel gratitude for being offered continuous lenalidomide and perceive it as alleviating some fears concerning relapse. It reveals variations in side effects in different age groups; younger patients reported no/negligible side effects, whilst several older patients with comorbidities described significant symptom burden, occasionally leading to treatment discontinuation which caused distress at the perceived loss of prolonged remission. Future research should prioritise understanding the unique needs of younger patients living with multiple myeloma.


Assuntos
Lenalidomida , Mieloma Múltiplo , Pesquisa Qualitativa , Humanos , Mieloma Múltiplo/tratamento farmacológico , Mieloma Múltiplo/psicologia , Mieloma Múltiplo/terapia , Lenalidomida/uso terapêutico , Lenalidomida/administração & dosagem , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Londres , Quimioterapia de Manutenção/métodos , Entrevistas como Assunto , Qualidade de Vida , Transplante Autólogo/métodos , Antineoplásicos/uso terapêutico , Antineoplásicos/administração & dosagem
2.
Front Pharmacol ; 15: 1390705, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39050758

RESUMO

The SARS coronavirus 2 (SARS-CoV-2) epidemic remains globally active. The emergence of new variants of interest and variants of concern (VoCs), which are potentially more vaccine-resistant and less sensitive to existing treatments, is evident due to their high prevalence. The prospective spread of such variants and other coronaviruses with epidemic potential demands preparedness that can be met by developing fast-track workflows to find new candidates that target viral proteins with a clear in vitro and in vivo phenotype. Mpro (or 3CLpro) is directly involved in the viral replication cycle and the production and function of viral polyproteins, which makes it an ideal target. The biological relevance of Mpro is highly conserved among betacoronaviruses like HCoV-OC43 and SARS-CoV-2, which makes the identification of new chemical scaffolds targeting them a good starting point for designing broad-spectrum antivirals. We report an optimized methodology based on orthogonal cell-free assays to identify small molecules that inhibit the binding pockets of both SARS-CoV-2-Mpro and HCoV-OC43-Mpro; this blockade correlates with antiviral activities in HCoV-OC43 cellular models. By using such a fast-tracking approach against the Open Global Health Library (Merck KGaA), we have found evidence of the antiviral activity of compound OGHL98. In silico studies dissecting intermolecular interactions between OGHL98 and both proteases and comprising docking and molecular dynamics simulations (MDSs) concluded that the binding mode was primarily governed by conserved H-bonds with their C-terminal amino acids and that the rational design of OGHL98 has potential against VoCs proteases resistant to current therapeutics.

3.
Biomed Pharmacother ; 177: 117018, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38908208

RESUMO

Pancreatic cancer (PC) shows a high fatality rate that can only be faced with a combination of surgery and chemotherapy or palliative treatment in the case of advanced patients. Besides, PC tumors are enriched with subpopulations of cancer stem cells (CSCs) that are resistant to the existing chemotherapeutic agents, which raises an important need for the identification of new drugs. To fill this gap, we have tested the anti-tumoral activity of microbial extracts, which chemical diversity offers a broad spectrum of potential new bioactive compounds. Extracts derived from the fungus Onychocola sp. CF-107644 were assayed via high throughput screening followed by bioassay-guided fractionation and resulted in the identification and isolation of six benzophenone derivatives with antitumoral activity: onychocolones A-F (#1-6). The structures of the compounds were established by spectroscopic methods, including ESI-TOF MS, 1D and 2D NMR analyses and X-ray diffraction. Compounds #1-4 significantly inhibited the growth of the pancreas tumoral cell lines, with low-micromolar Median Effective Doses (ED50s). Compound #1 (onychocolone A) was prioritized for further profiling due to its pro-apoptotic effect, which was further validated on 3D spheroids and pancreatic CSCs. Protein expression assays showed that the effect was mechanistically linked to the inhibition of MEK onco-signaling pathway. The efficacy of onychocolone A was also demonstrated in vivo by the reduction of tumor growth in a pancreatic xenograft mouse model generated by CSCs. Altogether, the data support that onychocolone A is a promising new small molecule for hit-to-lead development of a new treatment for PC.


Assuntos
Antineoplásicos , Células-Tronco Neoplásicas , Neoplasias Pancreáticas , Transdução de Sinais , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/patologia , Animais , Humanos , Células-Tronco Neoplásicas/efeitos dos fármacos , Células-Tronco Neoplásicas/patologia , Células-Tronco Neoplásicas/metabolismo , Linhagem Celular Tumoral , Transdução de Sinais/efeitos dos fármacos , Camundongos , Antineoplásicos/farmacologia , Benzofenonas/farmacologia , Benzofenonas/química , Ensaios Antitumorais Modelo de Xenoenxerto , Ascomicetos/química , Camundongos Nus , Proliferação de Células/efeitos dos fármacos
4.
Data Brief ; 54: 110443, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38708298

RESUMO

In recent years, both in the world of research and consulting, the concept of innovation in the business model has been gaining a lot of interest. As a result, an incipient number of scientific and popular publications are being generated, which try to delimit and explain this term, as well as work methodologies for its application in the business world. The family business field can benefit from the application of this approach. But, at the same time, it can also serve as an object of study since its special idiosyncrasy will allow to deepen the analysis of successful business models. To illustrate innovation in business models, data from 112 family firms representative of the regional economy are presented. The companies are also associated with the Murcian Association of Family Businesses (Amefmur). The collaboration with this organization has made it possible to obtain very valuable and representative information thanks to the support provided. The collection of information was carried out through an electronic survey. These data could be especially useful for establishing business recommendations for this type of companies and for analyzing other possible interrelationships of the variables available in the database.

5.
BMC Genomics ; 25(1): 359, 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38605287

RESUMO

Inherited hearing impairment is a remarkably heterogeneous monogenic condition, involving hundreds of genes, most of them with very small (< 1%) epidemiological contributions. The exception is GJB2, the gene encoding connexin-26 and underlying DFNB1, which is the most frequent type of autosomal recessive non-syndromic hearing impairment (ARNSHI) in most populations (up to 40% of ARNSHI cases). DFNB1 is caused by different types of pathogenic variants in GJB2, but also by large deletions that keep the gene intact but remove an upstream regulatory element that is essential for its expression. Such large deletions, found in most populations, behave as complete loss-of-function variants, usually associated with a profound hearing impairment. By using CRISPR-Cas9 genetic edition, we have generated a murine model (Dfnb1em274) that reproduces the most frequent of those deletions, del(GJB6-D13S1830). Dfnb1em274 homozygous mice are viable, bypassing the embryonic lethality of the Gjb2 knockout, and present a phenotype of profound hearing loss (> 90 dB SPL) that correlates with specific structural abnormalities in the cochlea. We show that Gjb2 expression is nearly abolished and its protein product, Cx26, is nearly absent all throughout the cochlea, unlike previous conditional knockouts in which Gjb2 ablation was not obtained in all cell types. The Dfnb1em274 model recapitulates the clinical presentation of patients harbouring the del(GJB6-D13S1830) variant and thus it is a valuable tool to study the pathological mechanisms of DFNB1 and to assay therapies for this most frequent type of human ARNSHI.


Assuntos
Conexina 30 , Perda Auditiva , Animais , Camundongos , Conexina 26/genética , Conexina 30/genética , Modelos Animais de Doenças , Perda Auditiva/genética , Mutação , Fenótipo
6.
Microorganisms ; 12(3)2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-38543479

RESUMO

SARS-CoV-2 has spread throughout the world since 2019, changing in its genome and leading to the appearance of new variants. This gave it different evolutionary advantages, such as greater infectivity and/or a greater ability to avoid the immune response, which could lead to an increased severity of COVID-19 cases. There is no consistent information about the viral load that occurs in infection with the different SARS-CoV-2 variants, hence, in this study we quantify the viral load of more than 16,800 samples taken from the Mexican population with confirmed diagnosis of COVID-19 and we analyze the relation between different demographic and disease variables. We detected that the viral load caused by different variants differs only in the first two days after the onset of symptoms, being higher when infections are caused by the delta variant and lower when caused by omicron. Furthermore, the viral load appears to be higher in outpatients compared to hospitalized patients or in cases of death. On the other hand, no differences were found in the viral load produced in vaccinated and unvaccinated patients, nor did it differ between genders.

7.
Cell ; 187(7): 1762-1768.e9, 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38471501

RESUMO

Biological dinitrogen (N2) fixation is a key metabolic process exclusively performed by prokaryotes, some of which are symbiotic with eukaryotes. Species of the marine haptophyte algae Braarudosphaera bigelowii harbor the N2-fixing endosymbiotic cyanobacteria UCYN-A, which might be evolving organelle-like characteristics. We found that the size ratio between UCYN-A and their hosts is strikingly conserved across sublineages/species, which is consistent with the size relationships of organelles in this symbiosis and other species. Metabolic modeling showed that this size relationship maximizes the coordinated growth rate based on trade-offs between resource acquisition and exchange. Our findings show that the size relationships of N2-fixing endosymbionts and organelles in unicellular eukaryotes are constrained by predictable metabolic underpinnings and that UCYN-A is, in many regards, functioning like a hypothetical N2-fixing organelle (or nitroplast).


Assuntos
Cianobactérias , Haptófitas , Fixação de Nitrogênio , Cianobactérias/metabolismo , Haptófitas/citologia , Haptófitas/metabolismo , Haptófitas/microbiologia , Nitrogênio/metabolismo , Simbiose
8.
Int J Biol Macromol ; 264(Pt 1): 130458, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38423421

RESUMO

The PD-1/PD-L1 protein-protein interaction (PPI) controls an adaptive immune resistance mechanism exerted by tumor cells to evade immune responses. The large-molecule nature of current commercial monoclonal antibodies against this PPI hampers their effectiveness by limiting tumor penetration and inducing severe immune-related side effects. Synthetic small-molecule inhibitors may overcome such limitations and have demonstrated promising clinical translation, but their design is challenging. Microbial natural products (NPs) are a source of small molecules with vast chemical diversity that have proved anti-tumoral activities, but which immunotherapeutic properties as PD-1/PD-L1 inhibitors had remained uncharacterized so far. Here, we have developed the first cell-based PD-1/PD-L1 blockade reporter assay to screen NPs libraries. In this study, 6000 microbial extracts of maximum biosynthetic diversity were screened. A secondary metabolite called alpha-cyclopiazonic acid (α-CPA) of a bioactive fungal extract was confirmed as a new PD-1/PD-L1 inhibitor with low micromolar range in the cellular assay and in an additional cell-free competitive assay. Thermal denaturation experiments with PD-1 confirmed that the mechanism of inhibition is based on its stabilization upon binding to α-CPA. The identification of α-CPA as a novel PD-1 stabilizer proves the unprecedented resolution of this methodology at capturing specific PD-1/PD-L1 PPI inhibitors from chemically diverse NP libraries.


Assuntos
Antígeno B7-H1 , Neoplasias , Humanos , Antígeno B7-H1/metabolismo , Receptor de Morte Celular Programada 1/metabolismo , Anticorpos Monoclonais
9.
Sci Data ; 11(1): 154, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38302528

RESUMO

The Ocean microbiome has a crucial role in Earth's biogeochemical cycles. During the last decade, global cruises such as Tara Oceans and the Malaspina Expedition have expanded our understanding of the diversity and genetic repertoire of marine microbes. Nevertheless, there are still knowledge gaps regarding their diversity patterns throughout depth gradients ranging from the surface to the deep ocean. Here we present a dataset of 76 microbial metagenomes (MProfile) of the picoplankton size fraction (0.2-3.0 µm) collected in 11 vertical profiles covering contrasting ocean regions sampled during the Malaspina Expedition circumnavigation (7 depths, from surface to 4,000 m deep). The MProfile dataset produced 1.66 Tbp of raw DNA sequences from which we derived: 17.4 million genes clustered at 95% sequence similarity (M-GeneDB-VP), 2,672 metagenome-assembled genomes (MAGs) of Archaea and Bacteria (Malaspina-VP-MAGs), and over 100,000 viral genomic sequences. This dataset will be a valuable resource for exploring the functional and taxonomic connectivity between the photic and bathypelagic tropical and sub-tropical ocean, while increasing our general knowledge of the Ocean microbiome.


Assuntos
Metagenoma , Plâncton , Archaea/genética , Bactérias/genética , Oceanos e Mares , Plâncton/genética
10.
Microbiol Spectr ; 12(1): e0167923, 2024 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-38009959

RESUMO

IMPORTANCE: The COVID-19 pandemic has revealed the lack of effective treatments against betacoronaviruses and the urgent need for new broad-spectrum antivirals. Natural products are a valuable source of bioactive compounds with pharmaceutical potential that may lead to the discovery of new antiviral agents. Specifically, compared to conventional synthetic molecules, microbial natural extracts possess a unique and vast chemical diversity and are amenable to large-scale production. The implementation of a high-throughput screening platform using the betacoronavirus OC43 in a human cell line infection model has provided proof of concept of the approach and has allowed for the rapid and efficient evaluation of 1,280 microbial extracts. The identification of several active compounds validates the potential of the platform for the search for new compounds with antiviral capacity.


Assuntos
Produtos Biológicos , Coronavirus Humano OC43 , Humanos , Produtos Biológicos/farmacologia , Produtos Biológicos/metabolismo , Pandemias , Linhagem Celular , Antivirais/farmacologia
11.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1559943

RESUMO

Introducción: La artritis reumatoide resulta una enfermedad autoinmune, inflamatoria, crónica y progresiva, que afecta al aparato locomotor. Puede provocar deformidad, dolor y disminución de la función del pie. Su tratamiento puede ser conservador o quirúrgico. Objetivo: Demostrar la eficacia de la artrodesis de la primera articulación metatarsofalángica con la panresección metatarsal en el tratamiento quirúrgico del pie reumático. Presentación del caso: Se presentaron diez casos de pacientes con factor reumatoideo positivo, intervenidos mediante artrodesis de la primera articulación metatarsofalángica y panresección metatarsal. Se valoró el seguimiento posquirúrgico inmediato y al año de evolución. Tras la intervención se consiguió una media de satisfacción de la escala Likert de 9,3 y una media de la escala visual analógica de dolor de 2,0. Asimismo, disminuyeron considerablemente los ángulos hallux abductus valgus e intermetatarsal I-II. Conclusiones: La combinación de artrodesis de la primera articulación metatarsofalángica con la panresección metatarsal se aplica en este tipo de pacientes, ya que favorece la funcionabilidad del pie y aminora significativamente la sintomatología dolorosa.


Introduction: Rheumatoid arthritis is an autoimmune, inflammatory, chronic and progressive disease that affects the locomotor system. It can cause deformity, pain, and decreased function of the foot. The treatment can be conservative or surgical. Objective: To demonstrate the efficacy of arthrodesis of the first metatarsophalangeal joint with metatarsal panresection in the surgical treatment of the rheumatoid foot. Methods: Ten cases of patients with positive rheumatoid factor who underwent arthrodesis of the first metatarsophalangeal joint and metatarsal panresection were reported. Immediate post-surgical follow-up and one year of evolution were assessed. Results: After the intervention, a mean Likert scale satisfaction of 9.3 was achieved and a visual analogue pain scale mean of 2.0. Likewise, the hallux abductus valgus and intermetatarsal I-II angles decreased considerably. Conclusions: The combination of arthrodesis of the first metatarsophalangeal joint with metatarsal panresection is used in this type of patients, since it favors the functionality of the foot and significantly reduces painful symptoms.

12.
Rev Esp Salud Publica ; 972023 Nov 16.
Artigo em Espanhol | MEDLINE | ID: mdl-37970884

RESUMO

OBJECTIVE: The healthcare approach to rehabilitation has undergone important changes due to the COVID-19 pandemic. The objective of the study was to assess the role of a home respiratory telerehabilitation program based on exercises and education in patients admitted to COVID-19. METHODS: An observational cohort study of COVID-19 patients admitted to General Hospital La Mancha Centro from March to June 2020 was carried out, who were assessed and treated by the rehabilitation, physiotherapy and occupational therapy service. After hospital discharge, the functional capacity, quality of life, mental health and happiness of the patients were assessed by telephone consultation at two, fifteen and thirty days. A descriptive analysis was carried out and for follow-up the McNemar test was used for qualitative variables and Student's t or Wilcoxon paired samples test for quantitative variables. RESULTS: Thirty patients were included in the study. The mean age was 60.9 years, with 50% male and 50% female. 80% of the patients were admitted to the ICU, with a mean of thirty four days. 73.3% of the patients developed ICU-acquired weakness. There are statistically significant changes in functional capacity (Barthel from 57.5 to 90), quality of life (EQ-VAS from 60 to 70), mental health (MHI-5 from 23 to 27) and happiness (Lyubomirsky from 4 to 4.5) of patients at thirty days after discharge. CONCLUSIONS: Patients admitted for COVID-19 and included in the home respiratory rehabilitation program through telerehabilitation significantly improve their functional capacity, quality of life, mental health, and happiness during follow-up.


OBJECTIVE: El abordaje asistencial de la rehabilitación ha sufrido cambios importantes con motivo de la pandemia de la COVID-19. El objetivo del estudio fue valorar el papel de un programa de telerehabilitación respiratoria domiciliaria basada en ejercicios y educación en pacientes ingresados con COVID-19. METHODS: Se realizó un estudio observacional de una cohorte de pacientes con COVID-19 ingresados en el Hospital General La Mancha Centro desde marzo a junio de 2020, que fueron valorados y tratados por el servicio de rehabilitación, fisioterapia y terapia ocupacional. Tras el alta hospitalaria, se valoró mediante consulta telefónica a los dos, quince y treinta días, la capacidad funcional, la calidad de vida, la salud mental y la felicidad de los pacientes. Se realizó un análisis descriptivo y para el seguimiento se utilizó los test de McNemar para variables cualitativas y t de student o Wilcoxon de muestras apareados para las cuantitativas. RESULTS: Treinta pacientes fueron incluidos en el estudio. La edad media fue de 60,9 años, siendo un 50% hombres y un 50% mujeres. El 80% de los pacientes ingresaron en UCI, con una media de treinta y cuatro días. El 73,3% de los pacientes desarrollaron debilidad adquirida en UCI. Existen cambios estadísticamente significativos sobre capacidad funcional (Barthel de 57,5 a 90), calidad de vida (EVA de 60 a 70), salud mental (MHI5 de 23 a 27) y felicidad (Lyubomirsky de 4 a 4,5) de los pacientes a los treinta días tras el alta hospitalaria. CONCLUSIONS: Los pacientes ingresados por COVID-19 e incluidos en el programa de rehabilitación respiratoria domiciliaria mediante telerehabilitación mejoran de forma significativa su capacidad funcional, calidad de vida, salud mental y felicidad durante su seguimiento.


Assuntos
COVID-19 , Qualidade de Vida , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Pandemias , Encaminhamento e Consulta , Telefone , Espanha/epidemiologia , Estudos Retrospectivos , Complicações Pós-Operatórias/epidemiologia
13.
Biomedicines ; 11(11)2023 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-38001944

RESUMO

Non-syndromic hearing impairment (NSHI) is a very heterogeneous genetic condition, involving over 130 genes. Mutations in GJB2, encoding connexin-26, are a major cause of NSHI (the DFNB1 type), but few other genes have significant epidemiological contributions. Mutations in the STRC gene result in the DFNB16 type of autosomal recessive NSHI, a common cause of moderate hearing loss. STRC is located in a tandem duplicated region that includes the STRCP1 pseudogene, and so it is prone to rearrangements causing structural variations. Firstly, we screened a cohort of 122 Spanish familial cases of non-DFNB1 NSHI with at least two affected siblings and unaffected parents, and with different degrees of hearing loss (mild to profound). Secondly, we screened a cohort of 64 Spanish sporadic non-DFNB1 cases, and a cohort of 35 Argentinean non-DFNB1 cases, all of them with moderate hearing loss. Amplification of marker D15S784, massively parallel DNA sequencing, multiplex ligation-dependent probe amplification and long-range gene-specific PCR followed by Sanger sequencing were used to search and confirm single-nucleotide variants (SNVs) and deletions involving STRC. Causative variants were found in 13 Spanish familial cases (10.7%), 5 Spanish simplex cases (7.8%) and 2 Argentinean cases (5.7%). In all, 34 deleted alleles and 6 SNVs, 5 of which are novel. All affected subjects had moderate hearing impairment. Our results further support this strong genotype-phenotype correlation and highlight the significant contribution of STRC mutations to moderate NSHI in the Spanish population.

14.
Rev. esp. salud pública ; 97: e202311097, Nov. 2023. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-228334

RESUMO

Fundamentos: El abordaje asistencial de la rehabilitación ha sufrido cambios importantes con motivo de la pandemia de la COVID-19. El objetivo del estudio fue valorar el papel de un programa de telerehabilitación respiratoria domiciliaria basada en ejercicios y educación en pacientes ingresados con COVID-19. Métodos: Se realizó un estudio observacional de una cohorte de pacientes con COVID-19 ingresados en el Hospital General La Mancha Centro desde marzo a junio de 2020, que fueron valorados y tratados por el servicio de rehabilitación, fisioterapia y terapia ocupacional. Tras el alta hospitalaria, se valoró mediante consulta telefónica a los dos, quince y treinta días, la capacidad funcional, la calidad de vida, la salud mental y la felicidad de los pacientes. Se realizó un análisis descriptivo y para el seguimiento se utilizó los test de McNemar para variables cualitativas y t de student o Wilcoxon de muestras apareados para las cuantitativas. Resultados: Treinta pacientes fueron incluidos en el estudio. La edad media fue de 60,9 años, siendo un 50% hombres y un 50% mujeres. El 80% de los pacientes ingresaron en UCI, con una media de treinta y cuatro días. El 73,3% de los pacientes desarrollaron debilidad adquirida en UCI. Existen cambios estadísticamente significativos sobre capacidad funcional (Barthel de 57,5 a 90), calidad de vida (EVA de 60 a 70), salud mental (MHI5 de 23 a 27) y felicidad (Lyubomirsky de 4 a 4,5) de los pacientes a los treinta días tras el alta hospitalaria. Conclusiones: Los pacientes ingresados por COVID-19 e incluidos en el programa de rehabilitación respiratoria domiciliaria mediante telerehabilitación mejoran de forma significativa su capacidad funcional, calidad de vida, salud mental y felicidad durante su seguimiento.(AU)


Background: The healthcare approach to rehabilitation has undergone important changes due to the COVID-19 pandemic. The objective of the study was to assess the role of a home respiratory telerehabilitation program based on exercises and education in patients admitted to COVID-19. Methods: An observational cohort study of COVID-19 patients admitted to General Hospital La Mancha Centro from March to June 2020 was carried out, who were assessed and treated by the rehabilitation, physiotherapy and occupational therapy service. After hospital discharge, the functional capacity, quality of life, mental health and happiness of the patients were assessed by telephone consultation at two, fifteen and thirty days. A descriptive analysis was carried out and for follow-up the McNemar test was used for qualitative variables and Student’s t or Wilcoxon paired samples test for quantitative variables.Results: Thirty patients were included in the study. The mean age was 60.9 years, with 50% male and 50% female. 80% of the patients were admitted to the ICU, with a mean of thirty four days. 73.3% of the patients developed ICU-acquired weakness. There are statistically significant changes in functional capacity (Barthel from 57.5 to 90), quality of life (EQ-VAS from 60 to 70), mental health (MHI-5 from 23 to 27) and happiness (Lyubomirsky from 4 to 4.5) of patients at thirty days after discharge. Conclusions: Patients admitted for COVID-19 and included in the home respiratory rehabilitation program through telerehabilitation significantly improve their functional capacity, quality of life, mental health, and happiness during follow-up.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Telerreabilitação/métodos , /reabilitação , Terapia Ocupacional , Serviços de Reabilitação , Modalidades de Fisioterapia , Qualidade de Vida , Saúde Pública , Espanha/epidemiologia , /epidemiologia , Estudos de Coortes , Inquéritos e Questionários , Saúde Mental , Felicidade
15.
Biomedicines ; 11(10)2023 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-37893235

RESUMO

This was a retrospective, multicenter study that aimed to report the characteristics of type 3 Gaucher disease (GD3) patients in Spain, including the genotype, phenotype, therapeutic options, and treatment responses. A total of 19 patients with GD3 from 10 Spanish hospitals were enrolled in the study (14 men, 5 women). The median age at disease onset and diagnosis was 1 and 1.2 years, respectively, and the mean age at follow-up completion was 12.37 years (range: 1-25 years). Most patients exhibited splenomegaly (18/19) and hepatomegaly (17/19) at the time of diagnosis. The most frequent neurological abnormalities at onset were psychomotor retardation (14/19) and extrinsic muscle disorders (11/19), including oculomotor apraxia, supranuclear palsy, and strabismus. The L444P (c.1448T>C) allele was predominant, with the L444P (c.1448T>C) homozygous genotype mainly associated with visceral manifestations like hepatosplenomegaly, anemia, and thrombocytopenia. All patients received enzyme replacement therapy (ERT); other treatments included miglustat and the chaperone (ambroxol). Visceral manifestations, including hepatosplenomegaly and hematological and bone manifestations, were mostly controlled with ERT, except for kyphosis. The data from this study may help to increase the evidence base on this rare disease and contribute to improving the clinical management of GD3 patients.

16.
Acta Derm Venereol ; 103: adv9604, 2023 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-37721356

RESUMO

The pathogenesis of frontal fibrosing alopecia has been linked to specific genetic variants. CYP1B1 codes for a component of the cytochrome p450 machinery that is involved in the metabolism of xenobiotic oestrogens. The study of the prevalence of polymorphisms in this gene may help to understand their role in the development of frontal fibrosing alopecia. The aim of this study is to describe the frequency of genetic variations in the alleles HLA-B*07:02 and CYP1B1 in patients with frontal fibrosing alopecia. A cross-sectional study was designed to evaluate blood samples from patients with frontal fibrosing alopecia who attended the Dermatology Department at University Hospital Ramón y Cajal (Madrid, Spain), in search of the polymorphisms rs9258883 and rs1800440 in the alleles HLA-B*07:02 and CYP1B1, respectively. A total of 223 patients were included in the study. Among the 83.8% of patients who carried the rs9258883 polymorphism in HLA-B*07:02, 58.7% were heterozygous for this variant and it was not present in 14.8% of the cases. The majority of patients with frontal fibrosing alopecia lacked the protective rs1800440 polymorphism in CYP1B1 (75.2%). This suggests a relevant role of this variant in development of frontal fibrosing alopecia. The genetic approach to this condition might influence patient prognosis and therapy options.


Assuntos
Alopecia , Citocromo P-450 CYP1B1 , Antígenos HLA-B , Humanos , Alopecia/diagnóstico , Alopecia/genética , Estudos Transversais , Citocromo P-450 CYP1B1/genética , Genótipo , Heterozigoto , Antígenos HLA-B/genética
17.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1559929

RESUMO

Introducción: Los sesamoideos del hallux son huesos constantes de pequeño tamaño y lentiformes. Se localizan en la región plantar de la cabeza del primer metatarsiano dentro de la cápsula de la primera articulación metatarsofalángica. El diagnóstico diferencial de metatarsalgia sobre el primer radio del pie, sin antecedente traumático, incluye patologías referidas a los sesamoideos y otras. Entre las primeras se encuentran principalmente la sesamoiditis, las fracturas de estrés y la necrosis avascular de los sesamoideos. Objetivo: Presentar un caso de sesamoiditis y su evolución después del tratamiento quirúrgico. Presentación del caso: Mujer de 25 años con un cuadro de fractura por estrés del sesamoideo peroneal. Tras infiltración seriada con corticoesteroides, desencadenó una necrosis séptica del sesamoideo. Se determinó realizar una sesamoidectomía por abordaje plantar. Conclusiones: La sesamoidectomía resulta una opción quirúrgica en procesos degenerativos de los sesamoideos, cuando los tratamientos conservadores son insuficientes. El abordaje plantar se considera adecuado para la extirpación del sesamoideo peroneal. Esta técnica requiere un adecuado seguimiento posoperatorio para optimizar la cicatrización plantar.


Introduction: The hallux sesamoid are constant bones of small size and lentiform. They are located in the plantar region of the first metatarsal head within the capsule of the first metatarsophalangeal joint. The differential diagnosis of metatarsalgia over the first radius of the foot, without traumatic history, includes pathologies related to the sesamoids and others. Among the former are mainly sesamoiditis, stress fractures and avascular necrosis of the sesamoids. Objective: To report a case of sesamoiditis and its evolution after surgical treatment. Case report: This the case of a 25-year-old woman with a stress fracture of the fibular sesamoid. After serial infiltration with corticosteroids, it triggered a septic sesamoid necrosis, it was decided to perform a sesamoidectomy by plantar approach. Conclusions: Sesamoidectomy is a surgical option in degenerative processes of the sesamoids, when conservative treatments are insufficient. The plantar approach is considered adequate for removal of the fibular sesamoid. This technique requires adequate postoperative follow-up to optimize plantar healing.

18.
Rev. esp. quimioter ; 36(3): 302-309, jun. 2023. tab, graf
Artigo em Inglês | IBECS | ID: ibc-220761

RESUMO

Objectives: To determine susceptibility to the novel β-lactam/β-lactamase inhibitor combination imipenem/relebactam in clinical isolates recovered from intra-abdominal (IAI), urinary (UTI), respiratory (RTI) and bloodstream (BSI) infections in the SMART (Study for Monitoring Antimicrobial Resistance Trends) study in SPAIN during 2016 – 2020.Methods: Broth microdilution MICs for imipenem/relebactam and comparators were determined by a central laboratory against isolates of Enterobacterales and Pseudomonas aeruginosa. MICs were interpreted using EUCAST-2021 breakpoints.Results: In total, 5,210 Enterobacterales and 1,418 P. aeruginosa clinical isolates were analyzed. Imipenem/relebactam inhibited 98.8% of Enterobacterales. Distinguishing by source of infection susceptibility was 99.1% in BSI, 99.2% in IAI, 97.9% in RTI, and 99.2% in UTI. Of intensive care unit isolates (ICU) 97.4% were susceptible and of non-ICU isolates 99.2% were susceptible. In Enterobacterales, activity against Class A, Class B and Class D carbapenemases was 96.2%, 15.4% and 73.2%, respectively. In P. aeruginosa, imipenem/relebactam was active in 92.2% of isolates. By source of infection it was 94.8% in BSI, 92.9% in IAI, 91.7% in RTI, and 93.1% in UTI. An 88.7% of ICU isolates and 93.6% of non-ICU isolates were susceptible to imipenem/relebactam. Imipenem/relebactam remained active against P. aeruginosa ceftazidime-resistant (76.3%), cefepime-resistant (73.6%), imipenem-resistant (71.5%) and piperacillin-resistant (78.7%) isolates. Of all multidrug-resistant or difficult-to-treat resistance P. aeruginosa isolates, 75.1% and 46.2%, respectively, were susceptible to imipenem/relebactam. (AU)


Objetivos: Determinar la sensibilidad a la nueva combinación de β-lactámico e inhibidor de β-lactamasas imipenem/relebactam en aislados clínicos procedentes de infecciones intraabdominales (IIA), urinarias (ITU), respiratorias (ITR) y bacteriemias del estudio SMART (Study for Monitoring Antimicrobial Resistance Trends) en ESPAÑA durante 2016 - 2020. Métodos. Se determinó la CMI mediante microdilución en caldo de imipenem/relebactam y antibióticos comparadores frente a aislados de Enterobacterales y Pseudomonas aeruginosa. Las CMI se analizaron empleando los puntos de corte EUCAST-2021. Resultados: En total, se incluyeron 5.210 aislados de Enterobacterales y 1.418 aislados de P. aeruginosa. Imipenem/ relebactam fue activo frente al 98,8% de los Enterobacterales. Distinguiendo por foco de infección, la sensibilidad fue del 99,1% en bacteriemia, del 99,2% en IIA, del 97,9% en ITR y del 99,2% en ITU. El 97,4% de los aislados procedentes de unidades de cuidados intensivos (UCI) fueron sensibles, y el 99,2% de los aislados no procedentes de UCI. En Enterobacterales, la sensibilidad frente a carbapenemasas de clase A, clase B y clase D fue del 96,2%, 15,4% y 73,2%, respectivamente. En P. aeruginosa,imipenem/relebactam fue activo en el 92,2% de los aislados. Distinguiendo por foco de infección, la sensibilidad frente a P. aeruginosa fue del 94,8% en bacteriemia, 92,9% en IIA, 91,7% en ITR y 93,1% en ITU. El 88,7% de los aislados de la UCI y el 93,6% de los aislados no procedentes de UCI fueron sensibles a imipenem/relebactam. Imipenem/relebactam fue activo frente a aislados de P. aeruginosa resistentes a ceftazidima (76,3%), cefepima (73,6%), imipenem (71,5%) y piperacilina/tazobactam (78,7%). Frente a los aislados de P. aeruginosa clasificados como MDR o DTR, el 75,1% y el 46,2%, respectivamente, fueron sensibles a imipenem/relebactam. (AU)


Assuntos
Humanos , Imipenem , Pseudomonas aeruginosa , Espanha , Resistência a Múltiplos Medicamentos , beta-Lactamas , Penicilinase
19.
Data Brief ; 48: 109152, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37128588

RESUMO

The data comes from an empirical study conducted to determine the intention to use mobile devices as a means of payment. The data collection was conducted on a total of 463 students at a university, with 425 valid cases. These students were chosen because of their greater affinity with mobile devices, making them digital natives. The questionnaire was developed using scales recognized in the literature on aspects such as intention to use, learning costs or perceived functional value. The reliability and validity of all constructs showed that the questionnaire was proper for measurement. Data analysis was applied l to examine the validity of scales. But, what makes this data really interesting and singular is the collection of data in 2013 (265 respondents) and 2016 (160 respondents). This allows cross-sectional and longitudinal analyses to check the evolution of respondents' perceptions of mobile payments. Results imply that the data is suitable for conducting replication studies.

20.
Front Microbiol ; 14: 1130695, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37138636

RESUMO

The multiple symbiotic partnerships between closely related species of the haptophyte algae Braarudosphaera bigelowii and the nitrogen-fixing cyanobacteria Candidatus Atelocyanobacterium thalassa (UCYN-A) contribute importantly to the nitrogen and carbon cycles in vast areas of the ocean. The diversity of the eukaryotic 18S rDNA phylogenetic gene marker has helped to identify some of these symbiotic haptophyte species, yet we still lack a genetic marker to assess its diversity at a finer scale. One of such genes is the ammonium transporter (amt) gene, which encodes the protein that might be involved in the uptake of ammonium from UCYN-A in these symbiotic haptophytes. Here, we designed three specific PCR primer sets targeting the amt gene of the haptophyte species (A1-Host) symbiotic with the open ocean UCYN-A1 sublineage, and tested them in samples collected from open ocean and near-shore environments. Regardless of the primer pair used at Station ALOHA, which is where UCYN-A1 is the pre-dominant UCYN-A sublineage, the most abundant amt amplicon sequence variant (ASV) was taxonomically classified as A1-Host. In addition, two out of the three PCR primer sets revealed the existence of closely-related divergent haptophyte amt ASVs (>95% nucleotide identity). These divergent amt ASVs had higher relative abundances than the haptophyte typically associated with UCYN-A1 in the Bering Sea, or co-occurred with the previously identified A1-Host in the Coral Sea, suggesting the presence of new diversity of closely-related A1-Hosts in polar and temperate waters. Therefore, our study reveals an overlooked diversity of haptophytes species with distinct biogeographic distributions partnering with UCYN-A, and provides new primers that will help to gain new knowledge of the UCYN-A/haptophyte symbiosis.

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