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1.
Lancet Reg Health Am ; 31: 100705, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38445021

RESUMO

Background: Reducing maternal mortality ratio (MMR) remains a paramount goal for low- and middle-income countries (LMICs), especially after COVID-19's devastating impact on maternal health indicators. We describe our experience implementing the Hospital Padrino Strategy (HPS), a collaborative model between a high-complexity hospital (Fundación Valle del Lili) and 43 medium- and low-complexity hospitals in one Colombian department (an administrative and territorial division) from 2021 to 2022, to sustain the trend towards reducing MMR. The study aimed to assess the effects of implementing HPS on both hospital performance and maternal health indicators in Valle del Cauca department (VCD). Methods: A mixed-methods study was conducted, comprising two phases. In the first phase, we investigated a cohort of hospitals through prospective follow-up to assess the outcomes of HPS implementation on hospital performance and maternal health indicators in VCD. In the second phase, qualitative data were collected through focus groups with 131 health workers from 33 hospitals to explore the implications of the HPS implementation on healthcare personnel. All data were obtained from records within the HPS implementation and from the Health Secretary of VCD. Findings: Evidence shows that in the context of HPS, 51 workshops involved 980 healthcare workers, covering the entire territory. Substantial improvements were observed in hospital conditions and healthcare personnel's technical competencies when providing obstetric care. Seven hundred eighty-five pregnant women with obstetric or perinatal emergencies received care through telehealth systems, with a progressive increase in technology adoption. Nine percent required Intensive Care Unit (ICU) admission, and none died. The MMR decreased from 78.8 in 2021 to 12.0 cases per 100,000 live births by 2022. Improvements in indicators and conducted training sessions instilled confidence and empowerment among the healthcare teams in the sponsored hospitals, as evidenced in focus groups derived from a sample of 131 healthcare workers from 33 hospitals. Interpretation: Implementing the Hospital Padrino Strategy led to a significant MMR reduction, and consolidated a model of social healthcare innovation replicable in LMICs. Funding: The Hospital Padrino Strategy was funded by the Fundación Valle del Lili and the Health Secretary of Valle del Cauca. Furthermore, this study received funding from a general grant for research from Tecnoquimicas S.A.

2.
Allergol Immunopathol (Madr) ; 51(6): 89-96, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37937501

RESUMO

BACKGROUND: Leukocyte adhesion deficiency type 1 (LAD-1) is an inborn error of immunity characterized by a defect in leukocyte trafficking. METHODS: Patients with clinical suspicion of LAD-1 were referred to our institution. Complete blood count and flow cytometric analysis, to identify the expression of CD18, CD11b, and the lymphocyte population phenotyping, were performed, and statistical analysis was completed. RESULTS: We report clinical manifestations and immunological findings of six Mexican patients diagnosed with LAD-1. The diagnosis was based on typical clinical presentation, combined with laboratory demonstration of leukocytosis, and significant reduction or near absence of CD18 and its associated molecules CD11a, CD11b, and CD11c on leukocytes. We found atypical manifestations, not described in other countries, such as early-onset autoimmunity or infections caused by certain microorganisms. CONCLUSIONS: Patients with LAD-1 may present with atypical manifestations, making flow cytometry an indispensable tool to confirm the diagnosis. We present the first report of LAD-1 patients in a Latin American country.


Assuntos
Antígenos CD18 , Síndrome da Aderência Leucocítica Deficitária , Humanos , Antígenos CD18/metabolismo , México , Síndrome da Aderência Leucocítica Deficitária/diagnóstico , Leucócitos
3.
Rev. enferm. Inst. Mex. Seguro Soc ; 31(4): 100-105, 09-oct-2023. tab
Artigo em Espanhol | BDENF - Enfermagem, LILACS | ID: biblio-1518861

RESUMO

Introduction: T he COVID-19 p andemic caused by t he SARS-CoV-2 coronavirus h as shaken the world since the beginning of 2020, causing a huge number of patient deaths. Objective: To evaluate the main symptoms of patients hospitalized for SARS CoV-2 in th e H.G.Z No.1 of the IMSS in Nayarit. Methodology: It is a retrospective, observational and cross-sectional study, with information collected from the clinical records of patients admitted through the respiratory triage area with a diagnosis of SARS Cov-2, confirmed with PCR. Results: 433 patients were included, of these 267 male patients (62%) and 166 female patients (38%), with an average age of 62 years. Within the main symptomatology is dyspnea (96%), fever (78%), attack to the general state (78%), cough (76%) and headache (67%). In addition, 102 (23.6%) patients required advanced airway management, of whom 89 died (87%). Of the total number of patients, 208 (48%) died and 225 (54%) showed improvement. Conclusions: The main symptoms of patients hospitalized for SARS CoV-2 are dyspnea, fever, general condition attack, cough and headache.


Introducción: la pandemia de COVID-19 provocada por el coronavirus SARS-CoV-2 ha sacudido al mundo desde el comienzo del año 2020, provocando un número ingente de fallecimientos de pacientes. Objetivo: evaluar la principal sintomatología de los pacientes hospitalizados por SARS-CoV-2 en el Hospital General de Zona No.1 del IMSS. Metodología: estudio retrospectivo, observacional y transversal, con información recabada de los expedientes clínicos de pacientes que ingresaron por área de triage respiratorio con diagnóstico de SARS-CoV-2 confirmado mediante prueba PCR. Resultados: se incluyeron 433 pacientes, de estos 267 pacientes de sexo masculinos (62%) y 166 pacientes del femenino (38%), con una edad promedio de 62 años. Dentro de la principal sintomatología se encuentra la disnea (96%), fiebre (78%), ataque al estado general (78%), tos (76%) y cefalea (67%). Además, 102 (23.6%) pacientes necesitaron manejo avanzado de la vía aérea, de los cuales 89 fallecieron (87%). Del total de pacientes, 208 (48%) fallecieron y 225 (54%) mostraron mejoría. Conclusiones: los principales síntomas de pacientes hospitalizados por SARS CoV-2 son disnea, fiebre, ataque del estado general, tos y cefalea.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , COVID-19/complicações , COVID-19/patologia , México
5.
Pediatr Allergy Immunol Pulmonol ; 36(3): 119-121, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37466470

RESUMO

The etiology of Kawasaki disease (KD) and its precise genetic basics remain unknown. Genetic variants affecting immunity have been found in some patients. The occurrence of KD in siblings is rare, but KD pedigrees with multiple affected members have been described in Japan and North America. Cases in twins have been documented. We report 2 pairs of trizygotic triplets who developed KD associated with SARS-CoV2 infection from 2 different families. Our cases show that KD is multifactorial in origin, and both infectious etiology (particularly SARS-CoV2 as in our cases) and genetic factors are relevant in the disease.


Assuntos
COVID-19 , Doenças Transmissíveis , Síndrome de Linfonodos Mucocutâneos , Humanos , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Síndrome de Linfonodos Mucocutâneos/genética , COVID-19/complicações , RNA Viral , SARS-CoV-2/genética , Doenças Transmissíveis/complicações
6.
Rev. mex. trastor. aliment ; 13(1): 1-16, ene.-jun. 2023. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1530214

RESUMO

Resumen Se reconoce la participación de la oxitocina en el control de la alimentación, pero su mecanismo de acción no se ha establecido totalmente. Por tanto, el objetivo de esta investigación fue evaluar el efecto del acceso intermitente a una solución de sacarosa, sobre la expresión de las neuronas del núcleo paraventricular (PVN) y del núcleo supraótico (SON) que producen oxitocina (Oxt), y caracterizar la microestructura de la conducta de beber en ratas saciadas. Se tuvieron tres grupos de ratas macho Wistar saciadas, y en la primera hora al inicio del periodo de luz, el grupo Control tuvo agua, el grupo Restringido 5g de una solución de sacarosa al 20% y el grupo Ad libitum acceso libre a la solución de sacarosa. Los sujetos incrementaron el consumo de la solución de sacarosa a pesar de estar saciados; debido a la interrupción del estado de saciedad y la demora de la satisfacción. La actividad de las neuronas de Oxt se incrementó en ambos núcleos, en el grupo Restringido la mayor expresión se observó en el SON y en el grupo Ad libitum en el PVN. No se encontró correlación entre la cantidad de bebida ingerida y la actividad de las neuronas Oxt.


Abstract The role of oxytocin in feeding control is recognized, but its mechanism of action has not been fully established. Therefore, the aim of this research was to evaluate the effect of intermittent access to a sucrose solution on the expression of paraventricular nucleus (PVN) and supraotic nucleus (SON) neurons that produce oxytocin (Oxt), and to characterize the microstructure of drinking behavior in satiated rats. Three groups of male Wistar rats satiated were used, and in the first hour at the beginning of the light period, a Control group had water, a Restricted group 5g of a 20% sucrose solution and Ad libitum group with free access to sucrose solution. The experimental subjects increased the consumption of the sucrose solution despite being satiated, due to the interruption of the state of satiety and the delay of the satiation process. Oxt neurons increased their activity in both nuclei, in the Restricted group the highest expression was observed in the SON and in the Ad libitum group in the PVN. No correlation was found between the amount of drink ingested and the activity of Oxt neurons.

7.
Cardiol Young ; 33(5): 800-802, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36052505

RESUMO

Multisystemic inflammatory syndrome in children is an inflammatory condition with multiorgan dysfunction that manifest late in the course of Severe acute respiratory syndrome coronavirus 2 infection. We present a 12-year-old boy with a history of fever, vomiting, diarrhoea, and abdominal pain. He developed shock with ventricular dysfunction and pericardial effusion. He was diagnosed with multisystemic inflammatory syndrome in children and treatment with intravenous immunoglobulins, corticosteroids, and tocilizumab proved to be ineffective. Eventually, the patient responded to cyclosporin-A treatment. Multisystemic inflammatory syndrome in children has been treated with immunoglobulins and glucocorticoids and in refractory cases biologics and cyclosporin-A have been used. Intravenous and oral cyclosporin-A seems to be a safe and effective alternative treatment for refractory multisystemic inflammatory syndrome in children patients.


Assuntos
COVID-19 , Ciclosporina , Masculino , Humanos , Criança , Dor Abdominal , Administração Intravenosa , Diarreia , Síndrome
8.
Allergol. immunopatol ; 51(6): 89-96, 2023. ilus, graf, tab
Artigo em Inglês | IBECS | ID: ibc-227312

RESUMO

Background: Leukocyte adhesion deficiency type 1 (LAD-1) is an inborn error of immunity characterized by a defect in leukocyte trafficking. Methods: Patients with clinical suspicion of LAD-1 were referred to our institution. Complete blood count and flow cytometric analysis, to identify the expression of CD18, CD11b, and the lymphocyte population phenotyping, were performed, and statistical analysis was completed. Results: We report clinical manifestations and immunological findings of six Mexican patients diagnosed with LAD-1. The diagnosis was based on typical clinical presentation, combined with laboratory demonstration of leukocytosis, and significant reduction or near absence of CD18 and its associated molecules CD11a, CD11b, and CD11c on leukocytes. We found atypical manifestations, not described in other countries, such as early-onset autoimmunity or infections caused by certain microorganisms. Conclusions: Patients with LAD-1 may present with atypical manifestations, making flow cytometry an indispensable tool to confirm the diagnosis. We present the first report of LAD-1 patients in a Latin American country (AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Antígenos CD18/metabolismo , Síndrome da Aderência Leucocítica Deficitária/diagnóstico , Leucócitos/imunologia , Biomarcadores , México
9.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1520093

RESUMO

Introducción: Evidencias indican que la arteria esplénica presenta un patrón común al tener en cuenta: origen, trayecto y terminación; sin embargo, en ocasiones pueden aparecer variantes anatómicas de importancia elemental para las especialidades quirúrgicas. Objetivo: Describir el patrón común y las variantes anatómicas del sistema arterial esplénico en el hombre adulto. Métodos: Se realizó un estudio descriptivo, transversal con un universo conformado por todos los bloques anatómicos existentes en el departamento, cuya muestra no probabilística a criterio de los autores quedó constituida por 25 bloques anatómicos. La información fue recogida en un formulario contentivo de las variables objeto de estudio. Se caracterizó el patrón común y las variantes anatómicas de la arteria esplénica considerando el origen, trayecto, ramas colaterales y ramas terminales. Se determinó la longitud y el diámetro externo en el origen y terminación de la arteria esplénica. Las piezas anatómicas fueron adquiridas mediante convenio cumpliendo los aspectos éticos establecidos. Para la recolección de la información se confeccionó un formulario contentivo de las variables que fueron objeto de estudio y los resultados procesados en Excel mediante el software estadístico SPSS 25.0. Resultados: En la mayoría de las piezas anatómicas predominó el patrón común de la arteria esplénica correspondiente al 88 % y solo se observaron variantes de la norma en tres bloques representando el 12 %. Prevaleció el trayecto sinuoso en 22 piezas, mientras que en dos se observó el serpenteado y en una pieza el rectilíneo. La longitud máxima encontrada de la arteria esplénica fue de 205 mm mientras que la longitud mínima de 102 mm. Conclusiones: Se observó el patrón común según origen, trayecto y terminación de la arteria esplénica sobre las variantes anatómicas.


Introduction: Evidence indicates that the splenic artery presents a common pattern taking into account: origin, route and termination, however, sometimes anatomical variants of elementary importance for surgical specialties may appear. Objective: To describe the common pattern and the anatomical variants of the splenic arterial system in the adult man. Methods: A cross-sectional descriptive study with a universe made up of all the anatomical blocks existing in the department was carried out, whose noon-probabilistic sample at the authors discretion was made up of 25 anatomical blocks. The information was collected in a form containing the variables under study. The common pattern and the anatomical variants of the splenic artery were characterized considering the origin, route, collateral branches and terminal branches. The length and external diameter at the origin and termination of the splenic artery were determined. The anatomical pieces were acquired by agreement complying with the established ethical aspects. For the collection of information, a form containing the variables under study and the results processed in Excel using the statistical software SPSS 25.0 was prepared. Results: In most of the anatomical pieces, the common pattern of the splenic artery prevailed, corresponding to 88% and only variants of the norm were observed in 3 blocks, representing 12 %. The winding path predominated in 22 pieces, while in 2 pieces presented a serpentine path was observed and in 1 piece rectilinear one. The maximum length found of the splenic artery was 205 mm while the minimum length was 102 mm. Conclusions : The common pattern prevailed according to origin, route and termination of the splenic artery prevailed over the anatomical variants.

10.
F1000Res ; 12: 747, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38571570

RESUMO

Background: The paper describes lead ion adsorption on variable charge oxidic calcined substrates with chemically modified surfaces. Amphoteric oxides of iron, aluminum, titanium, and manganese, change their surface electric charge after acid or alkaline treatment, letting cationic or anionic adsorption reactions from aqueous solutions. This property allows using them as adsorbing substrate for heavy metals retention in water treatment systems. Methods: Substrate was prepared by extruding cylindrical strips from a saturate paste of the oxidic lithological material-OLM; dries it up and thermally treated by calcination. The study was performed by triplicated trial, on batch mode, using 2 grams samples of treated with NaOH 0.1N and non-treated substrate. Lead analysis was performed by AAS-GF. Freundlich and Langmuir models were used to fit results. Comparing differential behavior between treated and non-treated substrates showed the variable charge nature of the OLM. Results: Results show L-type isotherms for the adsorption of Pb(II) ions on the activated substrate, suggesting good affinity between Pb(II) ions and OLM's surface. Average value of adsorption capacity ( K) for activated substrate (1791.73±13.06), is around four times greater than the non-activated substrate (491.54±31.97), during the adsorption reaction, 0.35 and 0.26 mmolH + of proton are produced on the activated and non-activated substrate respectively using a 1 mM Pb(II) solution and 72.2 and 15.6 mmolH + using a 10 mM Pb(II) solution. This acidification agrees with the theoretic model of transitional metals chemisorption on amphoteric oxides, present in lithological material used for the preparation of adsorbent substrates, confirming the information given by the L-type isotherms. Conclusions: Results suggest that these variable charge oxidic adsorbent substrate show great potential as an alternative technique for water treatment at small and medium scale using granular filtration system. The easiness and low price make them suitable to apply in rural media where no treating water systems is available.


Assuntos
Chumbo , Óxidos , Adsorção , Concentração de Íons de Hidrogênio , Óxidos/química , Íons
12.
Chem Sci ; 13(33): 9706-9712, 2022 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-36091908

RESUMO

Substitutional N-doping of single-walled carbon nanotubes is a common strategy to enhance their electrocatalytic properties in the oxygen-reduction reaction (ORR). Here, we explore the encapsulation of SWNTs within N-rich macrocycles as an alternative strategy to display electroactive sites on the surface of SWNTs. We design and synthesize four types of mechanically interlocked derivatives of SWNTs (MINTs) by combining two types of macrocycles and two types of SWNT samples. Comprehensive electrochemical characterization of these MINTs and their reference SWNTs allows us to establish structure-activity relationships. First, we show that all MINT samples are superior electrocatalysts compared to pristine SWNTs, which serves as general validation of our strategy. Secondly, we show that macrocycles displaying both N atoms and carbonyl groups perform better than those with N atoms only. Finally, we demonstrate that a tighter fit between macrocycles and SWNTs results in enhanced catalytic activity and stability, most likely due to a more effective charge-transfer between the SWNTs and the macrocycles. These results, focusing on the ORR as a testbed, show the possibility of understanding electrocatalytic performance of SWNTs at the molecular level and thus enable the design of more active and more stable catalysts in the future.

13.
Angew Chem Int Ed Engl ; 61(35): e202208189, 2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-35789180

RESUMO

Mechanically interlocked derivatives of carbon nanotubes (MINTs) are interesting nanotube products since they show high stability without altering the carbon nanotube structure. So far, MINTs have been synthesized using ring-closing metathesis, disulfide exchange reaction, H-bonding or direct threading with macrocycles. Here, we describe the encapsulation of single-walled carbon nanotubes within a palladium-based metallosquare. The formation of MINTs was confirmed by a variety of techniques, including high-resolution transmission electron microscopy. We find the making of these MINTs is remarkably sensitive to structural variations of the metallo-assemblies. When a metallosquare with a cavity of appropriate shape and size is used, the formation of the MINT proceeds successfully by both templated clipping and direct threading. Our studies also show indications on how supramolecular coordination complexes can help expand the potential applications of MINTs.

15.
Diabetes Metab Syndr Obes ; 15: 1771-1784, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35711690

RESUMO

Purpose: Differences in metformin effect on glycemic control in type 2 Diabetes (T2D) have been associated with diet, obesity, years since T2D diagnosis and genetic factors, such as the Met408Val (rs628031) SLC22A1/OCT1 gene polymorphism. This study aimed to analyze the effect of metformin and diet on glycemic control and its association with the Met408Val polymorphism in patients with T2D from western Mexico. Patients and Methods: A total of 240 T2D adult patients were enrolled in this cross-sectional study. Anti-hyperglycemic therapy, dietary intake, body composition and glycemic profile were recorded and the determination of genotypes of SLC22A1/OCT1 gene (rs628031) was performed using an allelic discrimination assay. Results: The type of metformin therapy was 47% monotherapy, 45% dual therapy (metformin+glibenclamide or metformin+insulin) and 8% triple therapy (metformin+glibenclamide+insulin). Individuals with metformin monotherapy had a higher glycemic control frequency (%HbA1c <7.0) compared with the dual and triple treatment schemes (77% vs 35% and 15%, respectively; p<0.001). Interestingly, a high potassium intake was documented in the three anti-hyperglycemic therapies and a lower intake of micronutrients, including calcium, magnesium, and zinc. An interaction was found between calcium intake and carriers of the risk allele A (408Val) with %HbA1c (P interaction=0.028), and potassium intake with the TyG index (P interaction=0.027). In addition, there was a positive correlation between calcium intake and %HbA1c (r=0.682; p=0.010), and potassium intake vs TyG index (r=0.593; p=0.033) in risk allele A (408Val) carriers with metformin monotherapy. Genotype frequencies were GG homozygotes (76.6%), GA heterozygotes (21.5%) and AA homozygotes (1.9%). The allele frequency was 87.4% for the ancestral allele G and 12.6% for the risk allele A. Conclusion: These findings suggest a differing effect of metformin on glycemic control regarding calcium and potassium intake and the Met408Val SLC22A1/OCT1 gene polymorphism in T2D patients.

16.
BMC Health Serv Res ; 22(1): 665, 2022 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-35581581

RESUMO

BACKGROUND: The COVID-19 pandemic has changed the organisational and management strategies of healthcare institutions such as primary care centres. Organisational culture as well as leadership style are key issues for the success of these institutions. Due to the multidimensional nature of identity processes, it is necessary to explore the changes experienced by health professionals from these perspectives. This study explores health professionals' organisational and management strategies in primary care settings during the COVID-19 pandemic. DESIGN: Qualitative, exploratory study based on the analysis of participants' accounts within a hermeneutic phenomenologicaly approach. METHODS: Research was conducted in primary care settings in two neighbouring Spanish healthcare regions. The sample included participants with different demographics (gender, age), professional roles (practice managers, general practitioners, paediatricians), employment status (permanent, temporary, zero-hours), and years of experience (under or over ten years' experience). Data were collected between July and December 2020 through focus groups and in-depth, semi-structured individual interviews. RESULTS: A total of 53 primary care workers participated in the study, of which 38 were individually interviewed and 15 participated in three focus groups. Of these, 78.4% were healthcare professionals, 49% were female nurses, and 70.5% had more than 10 years of work experience in primary care. Two main themes emerged: "liquid" healthcare and "the best healthcare system in the world". During the first wave of the COVID-19 pandemic, new, more fluid organisational and management models were implemented in primary care settings, which have remained in place since. Primary care workers' perceived a lack of appreciation and inclusion in decision-making that risked their alienation and disengagement. CONCLUSION: Primary care workers' professional identity became gradually blurred due to shifting perceptions of their professional roles in a context of increasing improvisation and flexible working practices. This affected their professional performance. TRIAL REGISTRATION: The study was approved by the Clinical Research Ethical Committee of the Talavera de la Reina Integrated Management Area (CEIm del AGI de Talavera de la Reina in Spain, Hospital Nuestra Señora del Prado, ref: 23/2020).


Assuntos
COVID-19 , Clínicos Gerais , COVID-19/epidemiologia , Atenção à Saúde , Feminino , Humanos , Masculino , Pandemias , Atenção Primária à Saúde , Pesquisa Qualitativa
17.
BMC Prim Care ; 23(1): 64, 2022 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-35361146

RESUMO

BACKGROUND: Pandemics and epidemics have represented public health emergencies with severe consequences at a global level. Primary care teams have played a crucial role in disease surveillance and monitoring during the COVID-19 pandemic through early detection, contact tracing, and isolation of positive cases. The objective of this study was to explore the impact of the COVID-19 pandemic on primary care teams regarding their internal dynamics and their professional performance. METHODS: Qualitative study carried out between July and December 2020 in two large central and southern Spanish regions (Castilla la Mancha and Madrid). Semi-structured interviews and focus groups were conducted with primary care workers. Data was analysed using thematic content analysis. Participants were accessed using purposive sampling. RESULTS: A total of 53 primary care workers participated in the study, of which 38 were individually interviewed, and 15 participated in three focus groups.The analysis of their experiences revealed two main themes regarding the impact of the COVID-19 pandemic on primary care teams: 1) The need to reorganise traditional roles: Primary care settings closed their doors to the public and their workers restructured their roles to ensure the delivery of essential services; 2) The need to implement a new primary care delivery model: Each primary care team had to self-organise, making sure their reference population was cared for and developing resource optimisation strategies. CONCLUSIONS: Primary care teams have quickly adapted their roles and internal dynamics to respond to the demands generated by COVID-19. In the new delivery model, some positive aspects could be highlighted - such as increased communication between professionals and the use of telemedicine for some cases. However, it is important to address the negative impact that the COVID-19 crisis has had on of the main functions of primary care. These measures are necessary to promote well-being in primary care teams, and to provide quality care that addresses the complex and individual needs of each person and reduces inequalities in healthcare delivery.


Assuntos
COVID-19 , COVID-19/epidemiologia , Grupos Focais , Humanos , Pandemias , Atenção Primária à Saúde , Pesquisa Qualitativa
18.
Cardiol Young ; 32(3): 506-507, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34278987

RESUMO

Multisystem inflammatory syndrome in children is a new entity in association with SARS-CoV2. Clinical features of Kawasaki disease were noted from the first reported cases of MIS-C. Before the COVID-19 pandemic, Kawasaki disease shock syndrome was considered to be a distinct and unique form of KD. We present a representative case that prove the current difficulty in clearly distinguishing MIS-C from pre-COVID-19-KDSS and emphasie the overlap of the diagnostic criteria.


Assuntos
COVID-19 , Síndrome de Linfonodos Mucocutâneos , Choque , COVID-19/complicações , Criança , Humanos , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Pandemias , RNA Viral , SARS-CoV-2 , Choque/etiologia , Síndrome de Resposta Inflamatória Sistêmica
19.
Healthcare (Basel) ; 9(12)2021 Dec 13.
Artigo em Inglês | MEDLINE | ID: mdl-34946447

RESUMO

BACKGROUND: The literature review shows that most studies on the psychological impact of COVID-19 on healthcare professionals have focused on hospital staff, with few specifically addressing the primary care workforce. This study aims to explore primary care workers' verbal accounts of the emotions they experienced. METHODS: This is a qualitative study carried out between July and December 2020 in Spain. Semi-structured interviews and focus groups were conducted with primary care workers. Data were analysed through thematic content analysis. Participants were selected using purposive sampling. RESULTS: A total of 53 primary care workers participated in the study, of whom 38 were individually interviewed, and 15 participated in three focus groups. Our analysis revealed themes in two categories: (1) from infection to affection; and (2) affected, but not patients-a discourse based on the acceptance of their experience as part of their work in primary care, creating an ideological construct or "shield" based on emotional self-management. CONCLUSIONS: Self-reflection on the emotional impact of COVID-19 is scarce. Examples of emotional affections include an obsessive focus on hygiene, the inability to establish clear boundaries between the personal and the professional spheres, and experiencing-and having to self-manage-emotional strain.

20.
J Am Chem Soc ; 143(50): 21286-21293, 2021 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-34825564

RESUMO

Atomic-scale reproducibility and tunability endorse magnetic molecules as candidates for spin qubits and spintronics. A major challenge is to implant those molecular spins into circuit geometries that may allow one, two, or a few spins to be addressed in a controlled way. Here, the formation of mechanically bonded, magnetic porphyrin dimeric rings around carbon nanotubes (mMINTs) is presented. The mechanical bond places the porphyrin magnetic cores in close contact with the carbon nanotube without disturbing their structures. A combination of spectroscopic techniques shows that the magnetic geometry of the dimers is preserved upon formation of the macrocycle and the mMINT. Moreover, the metallic core selection determines the spin location in the mMINT. The suitability of mMINTs as qubits is explored by measuring their quantum coherence times (Tm). Formation of the dimeric ring preserves the Tm found in the monomer, which remains in the µs scale for mMINTs. The carbon nanotube is used as vessel to place the molecules in complex circuits. This strategy can be extended to other families of magnetic molecules. The size and composition of the macrocycle can be tailored to modulate magnetic interactions between the cores and to introduce magnetic asymmetries (heterometallic dimers) for more complex molecule-based qubits.

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