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1.
ACS Photonics ; 11(2): 626-633, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38405395

RESUMO

Optical trapping is a well-established, decades old technology with applications in several fields of research. The most common scenario deals with particles that tend to be centered on the brightest part of the optical trap. Consequently, the optical forces keep the particle away from the dark zones of the beam. However, this is not the case when a focused doughnut-shaped beam generates on-axis trapping. In this system, the particle is centered on the intensity minima of the laser beam and the bright annular part lies on the periphery of the particle. Researchers have shown great interest in this phenomenon due to its advantage of reducing light interaction with trapped particles and the intriguing increase in the trapping strength. This work presents experimental and theoretical results that extend the analysis of on-axis trapping with light vortex beams. Specifically, in our experiments, we trap micron-sized spherical silica (SiO2) particles in water and we measure, through the power spectrum density method, the trap stiffness constant κ generated by vortex beams with different topological charge orders. The optical forces are calculated from the exact solutions of the electromagnetic fields provided by the generalized Lorentz-Mie theory. We show a remarkable agreement between the theoretical prediction and the experimental measurements of κ. Moreover, our numerical model gives us information about the electromagnetic fields inside the particle, offering valuable insights into the influence of the electromagnetic fields present in the vortex beam trapping scenario.

4.
Artigo em Inglês | IBECS | ID: ibc-226410

RESUMO

Schistosomiasis is a highly prevalent disease, especially in immigrant populations, and is associated with significant morbidity and diagnostic delays outside endemic areas. For these reasons, the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Tropical Medicine and International Health (SEMTSI) have developed a joint consensus document to serve as a guide for the screening, diagnosis and treatment of this disease outside endemic areas. A panel of experts from both societies identified the main questions to be answered and developed recommendations based on the scientific evidence available at the time. The document was reviewed by the members from both societies for final approval (AU)


La esquistosomiasis es una enfermedad de elevada prevalencia, especialmente en población inmigrante, asociada a importante morbilidad y retraso diagnóstico fuera de zona endémica. Por estas razones, la Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC) y la Sociedad Española de Medicina Tropical y Salud Internacional (SEMTSI) han elaborado un documento conjunto de consenso que sirva de guía para el cribado, diagnóstico y tratamiento de esta patología en zonas no endémicas. Un panel de expertos de ambas sociedades identificó las principales preguntas a responder y elaboró las recomendaciones siguiendo la evidencia científica disponible en el momento. El documento fue revisado por los miembros de ambas sociedades para su aprobación final (AU)


Assuntos
Humanos , Esquistossomose/diagnóstico , Esquistossomose/tratamento farmacológico , Sociedades Médicas , Espanha , Consenso
5.
Eur J Pediatr ; 182(10): 4633-4645, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37555973

RESUMO

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide, seriously endangering human health. Although SARS-CoV-2 had a lower impact on paediatric population, children with COVID-19 have been reported as suffering from gastrointestinal (GI) symptoms at a higher rate than adults. The aim of this work was to evaluate faeces as a source of potential biomarkers of severity in the paediatric population, with an emphasis on intestinal microbiota and faecal immune mediators, trying to identify possible dysbiosis and immune intestinal dysfunction associated with the risk of hospitalization. This study involved 19 patients with COVID-19 under 24 months of age hospitalized during the pandemic at 6 different hospitals in Spain, and it included a comparable age-matched healthy control group (n = 18). Patients and controls were stratified according to their age in two groups: newborns or young infants (from 0 to 3 months old) and toddlers (infants from 6 to 24 months old). To characterize microbial intestinal communities, sequencing with Illumina technology of total 16S rDNA amplicons and internal transcribed spacer (ITS) amplicons of bifidobacteria were used. Faecal calprotectin (FC) and a range of human cytokines, chemokines, and growth factors were measured in faecal samples using ELISA and a multiplex system. Significant reduction in the abundance of sequences belonging to the phylum Actinobacteria was found in those infants with COVID-19, as well as in the Bifidobacteriaceae family. A different pattern of bifidobacteria was observed in patients, mainly represented by lower percentages of Bifidobacterium breve, as compared with controls. In the group of hospitalized young infants, FC was almost absent compared to age-matched healthy controls. A lower prevalence in faecal excretion of immune factors in these infected patients was also observed. CONCLUSION:  Hospitalized infants with COVID-19 were depleted in some gut bacteria, such as bifidobacteria, in particular Bifidobacterium breve, which is crucial for the proper establishment of a functional intestinal microbiota, and important for the development of a competent immune system. Our results point to a possible immature immune system at intestine level in young infants infected by SARS-CoV2 requiring hospitalization. WHAT IS KNOWN: • Although SARS-CoV-2 had a lower impact on paediatric population, children with COVID-19 have been reported as suffering from gastrointestinal symptoms at a higher rate than adults. • Changes in microbial composition have been described in COVID-19 adult patients, although studies in children are limited. WHAT IS NEW: • The first evidence that hospitalized infants with COVID-19 during the pandemic had a depletion in bifidobacteria, particularly in Bifidobacterium breve, beneficial gut bacteria in infancy that are crucial for the proper establishment of a competent immune system. • In young infants (under 3 months of age) hospitalized with SARS-CoV2 infection, the aberrant bifidobacterial profile appears to overlap with a poor intestinal immune development as seen by calprotectin and the trend of immunological factors excreted in faeces.


Assuntos
Bifidobacterium , COVID-19 , Adulto , Lactente , Recém-Nascido , Humanos , Pré-Escolar , Bifidobacterium/genética , Disbiose , RNA Viral , SARS-CoV-2 , Fezes/microbiologia , Complexo Antígeno L1 Leucocitário
6.
PLoS Negl Trop Dis ; 17(7): e0011330, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37440480

RESUMO

BACKGROUND: Trypanosoma cruzi causes Chagas disease (CD), a potentially fatal disease characterized by cardiac disorders and digestive, neurological or mixed alterations. T. cruzi is transmitted to humans by the bite of triatomine vectors; both the parasite and disease are endemic in Latin America and the United States. In the last decades, population migration has changed the classic epidemiology of T. cruzi, contributing to its global spread to traditionally non-endemic countries. Screening is recommended for Latin American populations residing in non-endemic countries. METHODS: The present study analyzes the epidemiological characteristics of 2,820 Latin American individuals who attended the International Health Service (IHS) of the Hospital Clinic de Barcelona between 2002 and 2019. The initial assessment of organ damage among positive cases of T. cruzi infection was analyzed, including the results of electrocardiogram (ECG), echocardiogram, barium enema and esophagogram. RESULTS: Among all the screened individuals attending the clinic, 2,441 (86.6%) were born in Bolivia and 1,993 (70.7%) were female. Of individuals, 1,517 (81.5%) reported previous exposure to the vector, which is a strong risk factor associated with T. cruzi infection; 1,382 individuals were positive for T. cruzi infection. The first evaluation of individuals with confirmed T. cruzi infection, showed 148 (17.1%) individuals with Chagasic cardiomyopathy, the main diagnostic method being an ECG and the right bundle branch block (RBBB) for the most frequent disorder; 16 (10.8%) individuals had a normal ECG and were diagnosed of Chagasic cardiomyopathy by echocardiogram. CONCLUSIONS: We still observe many Latin American individuals who were at risk of T. cruzi infection in highly endemic areas in their countries of origin, and who have not been previously tested for T. cruzi infection. In fact, even in Spain, a country with one of the highest proportion of diagnosis of Latin American populations, T. cruzi infection remains underdiagnosed. The screening of Latin American populations presenting with a similar profile as reported here should be promoted. ECG is considered necessary to assess Chagasic cardiomyopathy in positive individuals, but echocardiograms should also be considered as a diagnostic approach given that it can detect cardiac abnormalities when the ECG is normal.


Assuntos
Doença de Chagas , Migrantes , Trypanosoma cruzi , Humanos , Feminino , Masculino , América Latina/epidemiologia , Doença de Chagas/diagnóstico , Coração
7.
J Psychiatr Res ; 164: 389-401, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37418886

RESUMO

People with mental disorders, such as psychosis or autism spectrum disorder (ASD), often present impairments in social cognition (SC), which may cause significant difficulties in real-world functioning. SC deficits are seen also in unaffected relatives, indicating a genetic substratum. The present review evaluated the evidence on the association between SC and the polygenic risk score (PRS), a single metric of the molecular genetic risk to develop a specific disorder. In July 2022, we conducted systematic searches in Scopus and PubMed following the PRISMA-ScR guidelines. We selected original articles written in English reporting results on the association between PRSs for any mental disorder and domains of SC either in people with mental disorders or controls. The search yielded 244 papers, of which 13 were selected for inclusion. Studies tested mainly PRSs for schizophrenia, ASD, and attention-deficit hyperactivity disorder. Emotion recognition was the most investigated domain of SC. Overall, evidence revealed that currently available PRSs for mental disorders do not explain variation in SC performances. To enhance the understanding of mechanisms underlying SC in mental disorders, future research should focus on the development of transdiagnostic PRSs, study their interaction with environmental risk factors, and standardize outcome measurement.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtornos Psicóticos , Humanos , Cognição Social , Transtorno do Espectro Autista/genética , Transtorno do Espectro Autista/psicologia , Transtornos Psicóticos/genética , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Fatores de Risco
8.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 41(6): 329-334, Jun-Jul. 2023. mapas, tab
Artigo em Espanhol | IBECS | ID: ibc-221427

RESUMO

Introducción: La generalización del tratamiento con dexametasona u otros inmunosupresores en pacientes con infección por SARS-CoV-2 puede aumentar el riesgo de aparición de formas graves de estrongiloidiosis. Se realizó una encuesta a nivel nacional para conocer mejor de la situación diagnóstica y terapéutica de la estrongiloidiosis en España en pacientes coinfectados por SARS-CoV-2. Materiales y métodos: Se diseñó una encuesta que fue enviada a todos los miembros de SEIMC durante los meses de febrero y marzo de 2021. Las respuestas se exportaron para su procesamiento informático al programa Microsoft Excel 2017 y se procesaron estadísticamente con el software libre PSPP. Resultados: Se recibieron 189 respuestas, de las cuales se seleccionaron 121 (64%) para su procesamiento posterior. En 84 centros (69,5%) no existía ningún protocolo de cribado específico de estrongiloidiosis. Cuarenta y dos centros (34,7%) disponían de técnicas serológicas en sus laboratorios y en el resto se enviaban a un laboratorio de referencia. Solo 22 centros (18%) realizaron cribado de estrongiloidiosis en pacientes infectados por SARS-CoV-2. Se diagnosticaron 227 casos de estrongiloidiosis en pacientes con infección por el SARS-CoV-2. En cuatro casos los pacientes desarrollaron un síndrome de hiperinfestación masiva que condujo al fallecimiento de uno. Conclusión: La COVID-19 ha puesto de manifiesto la necesidad de unificar protocolos de cribado y tratamiento de patologías importadas como la estrongiloidiosis. Es necesario realizar un esfuerzo de difusión del conocimiento para que esta patología potencialmente mortal sea tratada adecuadamente en los pacientes con mayor riesgo de complicaciones, como son aquellos con COVID-19.(AU)


Introduction: The generalization of treatment with dexamethasone or other immunosuppressants in patients with SARS-CoV-2 infection may increase the risk of occurrence of severe forms of strongyloidiasis. A nationwide survey was conducted to better understand the diagnostic and therapeutic situation of strongyloidiasis in SARS-CoV-2 co-infected patients in Spain. Materials and methods: A survey was designed and sent to all SEIMC members during February and March 2021. Responses were exported for computer processing to Microsoft Excel 2017 and statistically processed with the free software PSPP. Results: 189 responses were received, of which 121 (64%) were selected for further processing. Eighty-four centers (69.5%) had no specific strongyloidiasis screening protocol. Forty-two centers (34.7%) had serological techniques available in their laboratories and the rest were sent to a reference laboratory. Only 22 centers (18%) screened for strongyloidiasis in SARS-CoV-2 infected patients. A total of 227 cases of strongyloidiasis were diagnosed in patients with SARS-CoV-2 infection. In four cases patients developed a massive hyperinfestation syndrome leading to the death of one patient. Conclusion: COVID-19 has highlighted the need to unify screening and treatment protocols for imported pathologies such as strongyloidiasis. Efforts to disseminate knowledge are needed to ensure that this potentially fatal disease is adequately treated in patients with the highest risk of complications, such as those with COVID-19.(AU)


Assuntos
Humanos , Pandemias , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Infecções por Coronavirus/epidemiologia , Estrongiloidíase/diagnóstico , Estrongiloidíase/tratamento farmacológico , Strongyloides stercoralis , Espanha , Inquéritos e Questionários , Dexametasona , Programas de Rastreamento , Microbiologia , Técnicas Microbiológicas , Técnicas de Laboratório Clínico
9.
Acta méd. peru ; 40(3)jul. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1527631

RESUMO

Establecer la capacidad discriminativa del puntaje de riesgo finlandés para disglucemia en usuarios de una unidad de medicina familiar localizada en zona conurbana del Estado de Guerrero, México. Material y métodos: Realizamos un estudio transversal de marzo a diciembre del 2021 en una Unidad de Medicina Familiar. Previo consentimiento informado aplicamos a 200 personas de 20 a 60 años, el puntaje de riesgo finlandés para detección de disglucemia, obtuvimos medidas somatométricas y cifras de glucosa plasmática en ayuno. Estimamos sensibilidad, especificidad, valor predictivo positivo y negativo, razón de verosimilitud positiva y negativa, y calculamos el área bajo la curva (AUC) para estimar la capacidad discriminativa del puntaje de riesgo, donde la prueba de referencia fue la glucosa en ayuno. Realizamos análisis bivariado para identificar factores asociados a disglucemia, obteniendo Odds Ratio (OR), e intervalos de confianza del 95 % (IC95%). La ocurrencia de disglucemia fue de 26.5 % (53/200). El AUC de la curva ROC del puntaje finlandés para disglucemia fue de 0.65 (IC95% 0.57-0.74). Los factores asociados a diabetes fueron ≥40 años (OR 2.1; IC95% 1.1-3.9), índice de masa corporal ≥25 Kg/m2 (OR 2.8; IC95% 1.2-6.7) y padecer hipertensión arterial (OR 2.2; IC95% 1.1-4.4). El FINDRISC demostró por AUC ser una mala herramienta para detectar personas en riesgo de padecer disglucemia, en población adscrita a unidad médica conurbana.


To establish the discriminative capacity of the Finnish risk score for dysglycemia in users of a family medicine unit located in the suburbs of the State of Guerrero, Mexico. We conducted a cross-sectional study from March to December 2021 in a Family Medicine Unit. With prior informed consent, we applied the Finnish risk score for the detection of dysglycemia to 200 people between the ages of 20 and 60, we obtained somatometric measurements and fasting plasma glucose figures. We estimated sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, and calculated the area under the curve (AUC) to estimate the discriminative ability of the risk score, where the reference test was fasting glucose. We performed bivariate analysis to identify factors associated with dysglycemia, obtaining Odds Ratio (OR) and 95% confidence intervals (95%CI). Result: The occurrence of dysglycemia was 26.5% (53/200). The AUC of the ROC curve of the Finnish score for dysglycemia was 0.65 (95%CI 0.57-0.74). The factors associated with diabetes were ≥40 years (OR 2.1; 95%CI 1.1-3.9), body mass index ≥25 Kg/m2 (OR 2.8; 95%CI 1.2-6.7) and suffering from arterial hypertension (OR 2.2; 95%CI 1.1 -4.4). The FINDRISC was shown by AUC to be a poor tool for detecting people at risk of suffering from dysglycemia, in a population attached to a suburban medical unit

10.
Enferm Infecc Microbiol Clin (Engl Ed) ; 41(8): 505-512, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37230838

RESUMO

Schistosomiasis is a highly prevalent disease, especially in immigrant populations, and is associated with significant morbidity and diagnostic delays outside endemic areas. For these reasons, the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Society of Tropical Medicine and International Health (SEMTSI) have developed a joint consensus document to serve as a guide for the screening, diagnosis and treatment of this disease outside endemic areas. A panel of experts from both societies identified the main questions to be answered and developed recommendations based on the scientific evidence available at the time. The document was reviewed by the members from both societies for final approval.

11.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 41(5): 269-277, May. 2023. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-219854

RESUMO

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are a public health problem, worsened by frequent reinfections, whose incidence rate is not known in Spain. The objective of this study is to estimate in patients diagnosed with NG, CT or mixed infection (NG and CT): (1) the incidence of reinfections by the same microorganism, (2) the total incidence of Sexually Transmitted Infections (STI), both by the same microorganism and by infections other than the initial one, and (3) to identify predictors of reinfection. Methods: Observational prospective case series involving 986 patients with CT and/or NG at specialized STI clinics in Biscay (Spain) between 2016 and 2019. Results: The six month cumulative incidence of reinfection by the same microorganism was 17.24% (CI95%: 14.9–19.7) and 24.65% (CI95%: 21.9–27.4) for any STI (reinfection or other). Being an immigrant (OR=1.8; CI95%: 1.3–2.6), men who have sex with men (OR=1.8; CI95%: 1.3–2.6), number of sexual partners (OR=4.3; CI95%: 2.7–6.8 for more than 5 partners), having a new partner (OR=1.7; CI95%: 1.08–2.6), not always using a condom (OR=1.4; CI95%: 1.02–1.9) and consumption of alcohol prior to sex (OR=3.8; CI95%: 1.5–9.5) were associated with reinfection by any STI. Conclusion: These characteristics allow doctors to identify patients in whom to prioritize short-term rescreening for repeated infections with any STIs after initial treatment for NG or CT.(AU)


Introducción: Las infecciones por Chlamydia trachomatis (CT) y Neisseria gonorrhoeae (NG) son un problema de salud pública, agravado por frecuentes reinfecciones, cuya incidencia desconocemos en España. Objetivos: Estimar en pacientes diagnosticados de NG, CT o infección mixta (NG y CT): 1) la incidencia de reinfecciones por el mismo germen, 2) la incidencia total de infecciones de transmisión sexual (ITS), tanto por el mismo germen, como por infecciones diferentes a la inicial y 3) identificar características que predicen la reinfección. Métodos: Estudio observacional prospectivo de una serie de casos: 986 pacientes diagnosticados de CT y/o NG en las consultas de ITS de Bizkaia (España) entre septiembre de 2016 a enero de 2019. Resultados: En 6 meses de seguimiento promedio la incidencia de reinfección por el mismo germen fue del 17,24% (IC95%: 14,9-19,7) y la de cualquier ITS (reinfección u otra) del 24,65% (IC95%: 21,9-27,4). Los factores asociados con la reinfección por cualquier ITS fueron: ser inmigrante (OR=1,8; IC95%: 1,3-2,6), hombre que tiene sexo con hombres (OR=1,8; IC95%: 1,3-2,6), número de parejas sexuales (OR=4,3; IC95%: 2,7-6,8 para más de 5 parejas), tener una pareja nueva (OR=1,7; IC95%: 1,08-2,6), no utilizar siempre preservativo (OR=1,4; IC95%: 1,02-1,9) y consumo de alcohol en relación al sexo (OR=3,8; IC95%: 1,5-9,5). Conclusión. Estas características sirven para identificar pacientes de alto riesgo en los que priorizar el rescreening de ITS tras una infección, que debe ser completo, incluyendo otras infecciones diferentes a la inicial.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Gonorreia/prevenção & controle , Chlamydia trachomatis , Incidência , Tratamento Farmacológico , Infecções Sexualmente Transmissíveis , Neisseria gonorrhoeae , Estudos Prospectivos , Doenças Transmissíveis
12.
Cir Cir ; 91(1): 28-33, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36787613

RESUMO

BACKGROUND: Management of breast cancer is increased by late diagnoses. OBJECTIVE: To analyse direct costs of breast cancer in early and advanced stage in a third level medical facility at Mexican Social Security Institute. METHOD: Observational study, direct costs of care in breast cancer in initial and advanced clinical stages are compared. Variables analysed were laboratory and diagnostic imaging studies, drugs, as well as hospitalization costs. The evaluated period included from the first care to the completion of the treatment. Costs were determined according to the table of Unit Costs by Level of Medical Care for the year 2019 of the Mexican Social Security Institute. Student's t test was used to determinate differences between groups, as well as descriptive statistics. RESULTS: The advanced stage compared to the initial stage, causes a greater number of laboratory-cabinet studies, surgeries, day/bed and interconsultations. The average cost of breast cancer care per patient is $99,280.36 (US$5,230.78) and $148,023.60 (US$7,789.92) for the initial and advanced stages, respectively (p = 0.024). CONCLUSIONS: Cost of medical attention in the initial stage is lower than that of the advanced stage.


ANTECEDENTES: Los diagnósticos tardíos elevan los costes de atención del cáncer de mama. OBJETIVO: Analizar los costes directos de la atención del cáncer de mama en etapa temprana y avanzada en el tercer nivel de atención en el Instituto Mexicano del Seguro Social (IMSS). MÉTODO: Estudio observacional que compara los costes directos de atención en cáncer de mama en estadios clínicos inicial y avanzado. Los datos analizados fueron estudios de laboratorio, gabinete, tratamiento y hospitalización. El tiempo evaluado incluyó desde la primera atención hasta la finalización del primer tratamiento. Se determinaron los costes de acuerdo con la tabla de Costes Unitarios por Nivel de Atención Médica para el año 2019 del IMSS. Se utilizó la prueba t de Student para diferencias entre grupos, así como estadística descriptiva. RESULTADOS: El estadio avanzado, comparado con el estadio inicial, ocasiona un número mayor de estudios de laboratorio-gabinete, cirugías, día/cama e interconsultas. El coste promedio de la atención del cáncer de mama por paciente es $99,280,36 (US$5,230.78) y $148,023.60 (US$7,789.92) para los estadios inicial y avanzado, respectivamente (p = 0.024). CONCLUSIONES: El coste de la atención médica del estadio inicial es menor que el del estadio avanzado.


Assuntos
Neoplasias da Mama , Humanos , Feminino , México , Estudos Retrospectivos
13.
Enferm Infecc Microbiol Clin (Engl Ed) ; 41(5): 269-277, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36610838

RESUMO

BACKGROUND: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are a public health problem, worsened by frequent reinfections, whose incidence rate is not known in Spain. The objective of this study is to estimate in patients diagnosed with NG, CT or mixed infection (NG and CT): (1) the incidence of reinfections by the same microorganism, (2) the total incidence of Sexually Transmitted Infections (STI), both by the same microorganism and by infections other than the initial one, and (3) to identify predictors of reinfection. METHODS: Observational prospective case series involving 986 patients with CT and/or NG at specialized STI clinics in Biscay (Spain) between 2016 and 2019. RESULTS: The six month cumulative incidence of reinfection by the same microorganism was 17.24% (CI95%: 14.9-19.7) and 24.65% (CI95%: 21.9-27.4) for any STI (reinfection or other). Being an immigrant (OR=1.8; CI95%: 1.3-2.6), men who have sex with men (OR=1.8; CI95%: 1.3-2.6), number of sexual partners (OR=4.3; CI95%: 2.7-6.8 for more than 5 partners), having a new partner (OR=1.7; CI95%: 1.08-2.6), not always using a condom (OR=1.4; CI95%: 1.02-1.9) and consumption of alcohol prior to sex (OR=3.8; CI95%: 1.5-9.5) were associated with reinfection by any STI. CONCLUSION: These characteristics allow doctors to identify patients in whom to prioritize short-term rescreening for repeated infections with any STIs after initial treatment for NG or CT.


Assuntos
Infecções por Chlamydia , Gonorreia , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Masculino , Humanos , Gonorreia/epidemiologia , Gonorreia/prevenção & controle , Chlamydia trachomatis , Incidência , Reinfecção , Homossexualidade Masculina , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/tratamento farmacológico , Infecções por Chlamydia/epidemiologia , Infecções Sexualmente Transmissíveis/epidemiologia
14.
Enferm Infecc Microbiol Clin ; 41(6): 329-334, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-34931102

RESUMO

Introduction: The generalization of treatment with dexamethasone or other immunosuppressants in patients with SARS-CoV-2 infection may increase the risk of occurrence of severe forms of strongyloidiasis. A nationwide survey was conducted to better understand the diagnostic and therapeutic situation of strongyloidiasis in SARS-CoV-2 co-infected patients in Spain. Materials and methods: A survey was designed and sent to all SEIMC members during February and March 2021. Responses were exported for computer processing to Microsoft Excel 2017 and statistically processed with the free software PSPP. Results: 189 responses were received, of which 121 (64%) were selected for further processing. Eighty-four centers (69.5%) had no specific strongyloidiasis screening protocol. Forty-two centers (34.7%) had serological techniques available in their laboratories and the rest were sent to a reference laboratory. Only 22 centers (18%) screened for strongyloidiasis in SARS-CoV-2 infected patients. A total of 227 cases of strongyloidiasis were diagnosed in patients with SARS-CoV-2 infection. In four cases patients developed a massive hyperinfestation syndrome leading to the death of one patient. Conclusion: COVID-19 has highlighted the need to unify screening and treatment protocols for imported pathologies such as strongyloidiasis. Efforts to disseminate knowledge are needed to ensure that this potentially fatal disease is adequately treated in patients with the highest risk of complications, such as those with COVID-19.

15.
Artigo em Inglês | MEDLINE | ID: mdl-35970704

RESUMO

INTRODUCTION: The generalization of treatment with dexamethasone or other immunosuppressants in patients with SARS-CoV-2 infection may increase the risk of occurrence of severe forms of strongyloidiasis. A nationwide survey was conducted to better understand the diagnostic and therapeutic situation of strongyloidiasis in SARS-CoV-2 co-infected patients in Spain. MATERIALS AND METHODS: A survey was designed and sent to all SEIMC members during February and March 2021. Responses were exported for computer processing to Microsoft Excel 2017 and statistically processed with the free software PSPP. RESULTS: 189 responses were received, of which 121 (64%) were selected for further processing. Eighty-four centers (69.5%) had no specific strongyloidiasis screening protocol. Forty-two centers (34.7%) had serological techniques available in their laboratories and the rest were sent to a reference laboratory. Only 22 centers (18%) screened for strongyloidiasis in SARS-CoV-2 infected patients. A total of 227 cases of strongyloidiasis were diagnosed in patients with SARS-CoV-2 infection. In four cases patients developed a massive hyperinfestation syndrome leading to the death of one patient. CONCLUSION: COVID-19 has highlighted the need to unify screening and treatment protocols for imported pathologies such as strongyloidiosis. Efforts to disseminate knowledge are needed to ensure that this potentially fatal disease is adequately treated in patients with the highest risk of complications, such as those with COVID-19.


Assuntos
COVID-19 , Strongyloides stercoralis , Estrongiloidíase , Animais , Humanos , Estrongiloidíase/diagnóstico , Estrongiloidíase/tratamento farmacológico , Estrongiloidíase/epidemiologia , SARS-CoV-2 , Espanha/epidemiologia , Pandemias , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/complicações , Teste para COVID-19
16.
Artigo em Inglês | MEDLINE | ID: mdl-36497895

RESUMO

During the COVID-19 pandemic, medical students were burdened with high levels of stress, anxiety, and depression. The objective of the present study was to investigate predictors of positive mental health among medical students during the COVID-19 pandemic. We conducted an online survey from September 2021 to March 2022. We applied the snowball recruitment technique involving medical students from the University of Catania, Italy. We administered, anonymously, a questionnaire about demographic characteristics, the Depression Anxiety Stress Scale (DASS-21), the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A), and the short form of the Mental Health Continuum (MHC-SF). Participants showed moderate anxiety, depression, and stress levels, and more than half had positive mental health status overall. This finding was inversely related to age, depression severity, cyclothymic, and depressive temperaments. Our results showed that medical students with depressive and cyclothymic temperaments were more at risk of worsening mental health status during the pandemic. Our findings may allow for further developments about the impact of personological characteristics on students' mental health to enable more efficient support for the most vulnerable.


Assuntos
COVID-19 , Estudantes de Medicina , Humanos , Psicometria , Pandemias , Saúde Mental , COVID-19/epidemiologia , Temperamento , Ansiedade/epidemiologia , Ansiedade/psicologia , Inquéritos e Questionários , Depressão/epidemiologia , Depressão/psicologia , Inventário de Personalidade
17.
Clin Ther ; 44(12): e39-e58, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36411116

RESUMO

PURPOSE: This systematic review assesses currently available clinical information on which cannabinoids and what range of doses have been used to achieve positive effects in a diversity of medical context. METHODS: The data were collected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol guidelines. Inclusion criteria were articles that assessed administration of any cannabinoid to any clinical population, reported in the ClinicalTrials.gov or PubMed databases, that involved a comparison with other treatment or placebo and a result measurement to assess the effectiveness or ineffectiveness of the cannabinoid. Exclusion criteria were review or letter; articles not in the English language; not full-text articles; not a clinical trial, case report, case series, open-label trial, or pilot study; administration in animals, in vitro, or in healthy participants; cannabinoids administered in combination with other cannabinoids (except for cannabidiol [CBD] or tetrahydrocannabinol [THC]) or as whole cannabis extracts; no stated concentration; inhalation or smoke as a route of administration; and no results described. The articles were assessed by the risk of bias. FINDING: In total, 1668 articles were recovered, of which 55 studies met the inclusion criteria for 21 diseases. Positive effects were reported in clinical studies: 52% with THC (range, 0.01-0.5 mg/kg/d [0.62-31 mg/d]), 74% with CBD (range, 1-50 mg/kg/d [62-3100 mg/d]), 64% with THC-CBD (mean, 1:1.3 mg/kg/d [ratio, 1:1]), and 100% with tetrahydrocannabivarin (THCV) (0.2 mg/kg/d). IMPLICATIONS: THC, CBD, and THCV can regulate activity in several pathologies. New studies of cannabinoids are highly encouraged because each patient is unique and requires a unique cannabinoid medication.


Assuntos
Canabidiol , Canabinoides , Cannabis , Animais , Humanos , Dronabinol , Projetos Piloto
18.
Front Public Health ; 10: 652271, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36203664

RESUMO

This study explores the perceptions and motivation for weight loss among participants who completed a free community-based weight loss program in a predominantly Hispanic and low-income region along the US-Mexico border using a Self-Determination Theory (SDT) perspective. This manuscript is timely as qualitative research on the effect of motivation as a factor in behavioral interventions to reduce overweight or obesity is currently lacking. Individual semi-structured interviews were conducted with 20 participants (80%, n = 16 female) who completed a community weight-loss intervention to assess motivation for weight loss and participating, and the role of social support and self-efficacy in weight loss. Directed content analysis was used with SDT guiding the questions and subsequent theme analysis. The findings communicate perspectives of participants relevant to 8 prominent themes. The regulation types and constructs related to SDT included: non-regulation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic regulation as well as competence and relatedness. Participants mentioned external sources of motivation, such as wanting to improve their physical appearance, and motivation due to financial incentives. Fewer participants reported intrinsic motivators, which the literature suggests are more likely to create lasting change and improved health behaviors. Understanding the motivation for behavior change and completion of weight loss programs is essential to help participants reach their goals effectively and sustain weight loss. A greater emphasis during weight loss programs on the motives for individuals to lose weight may help improve outcomes in weight-loss interventions. Additionally, increasing strategies targeted at enhancing intrinsic motivation for weight loss may be beneficial.


Assuntos
Programas de Redução de Peso , Feminino , Humanos , México , Motivação , Autonomia Pessoal , Redução de Peso
19.
Arch Prev Riesgos Labor ; 25(3): 271-284, 2022 07 15.
Artigo em Espanhol | MEDLINE | ID: mdl-36265109

RESUMO

OBJECTIVE: To describe the sociodemographic characteristics and determine the factors associated with psychological manifestations of depression, anxiety, and stress in healthcare workers in the context of COVID-19 pandemic in health facilities in Peru during the month of May 2020. METHODS: An analytical cross-sectional study was conducted out in healthcare workers of hospital establishments in Peru. To evaluate the outcome of interest, we administered a structured questionnaire that asked about type of healthcare personnel; sociodemographic characteristics; Generalized Anxiety Disorder scale (GAD-7); Patient Health Questionnaire scale (PHQ-9); and the Revised Stressor Impact scale (IES-R). We used generalized linear Poisson models, with a logarithmic link function and robust variance. RESULTS: Out of 258 respondents, 254 completed the survey; 61.8% were women; the most common work area was emergency department or hospitalization (inpatient) services (62.2%). The median PHQ-9 score was 4 points (IQR: 2-7); for the GAD-7, it was 6 points (IQR: 4-8), and for the IES-R, 16 points (IQR: 8-24). The multivariate analysis showed that being a physician was associated with less anxiety (PR: 0.77; 95% CI: 0.62-0.94), whereas living alone was associated with a greater risk of depression (PR: 1.46; 95% CI: 1.11-1.92). CONCLUSIONS: Healthcare personnel are at risk of manifesting psychological alterations, mainly associated with the female gender, non-medical personnel and living alone.


OBJETIVO: Describir las características sociodemográficas y determinar los factores asociados a manifestaciones psicológicas de depresión, ansiedad y estrés en trabajadores sanitarios en el contexto de la pandemia por COVID-19 en los establecimientos de salud del Perú durante mayo de 2020. Métodos: Se realizó un estudio transversal en trabajadores sanitarios de establecimientos hospitalarios del Perú. Se elaboró un cuestionario estructurado que incluía las características sociodemográficas, la profesión, área y lugar de trabajo, y cuestionarios validados para trastorno de ansiedad generalizada (GAD-7), Salud del paciente (PHQ-9) y la Escala de impacto del estresor revisada (IES-R). Para el análisis se utilizó modelos lineales generalizados de Poisson, función de enlace logarítmico y varianzas robustas. Se calculó el rango intercuartílico (RIC) y la razón de prevalencia ajustada (RPa) y su intervalo de confianza del 95% (IC95%). RESULTADOS: De un total de 258 encuestados, 254 (98%) completaron al cuestionario, siendo el 61,8% mujeres y el área de trabajo más común emergencia u hospitalización (62,2%). La puntuación mediana del PHQ-9 fue 4 (RIC:2-7), del GAD-7 fue 6 (RIC:4-8) y para el IES-R fue 16 (RIC:8-24). El análisis multivariado mostró que ser médico se asocia con una menor prevalencia de ansiedad (RPa: 0,77; IC 95%: 0,62-0,94), mientras que vivir solo se asoció con una mayor prevalencia de depresión (RPa: 1,46; IC 95%: 1,11-1,92). Conclusión: El personal sanitario manifestó alteraciones psicológicas, asociado principalmente al personal no médico y vivir solo.


Assuntos
COVID-19 , Humanos , Feminino , Masculino , COVID-19/epidemiologia , Pandemias , Peru/epidemiologia , SARS-CoV-2 , Depressão/epidemiologia , Depressão/psicologia , Estudos Transversais , Ansiedade/epidemiologia , Ansiedade/psicologia , Instalações de Saúde , Atenção à Saúde
20.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 40(7): 359-366, Ago - Sep 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-207358

RESUMO

Introducción: Las infecciones por Chlamydia trachomatis (CT) son un problema de salud pública por su alta incidencia y consecuencias sobre la salud reproductiva. Nuestro objetivo es describir las características sociodemográficas, conductuales y clínicas de los pacientes con infección por CT para adaptar las intervenciones preventivas a los grupos con mayor riesgo. Métodos: Serie de casos prospectiva de todos los pacientes diagnosticados de CT entre septiembre del 2016 a enero del 2019 en las consultas de referencia para infecciones de transmisión sexual (ITS) de Osakidetza en Bizkaia.Resultados: Aceptaron participar 847 pacientes (88,2%): 41% mujeres, 33,8% varones heterosexuales y 25% hombres que tenían sexo con hombres (HSH); 33% eran inmigrantes y 26% menores de 25 años (33% entre las mujeres). Un 20% utilizaba siempre preservativo. Un 36% había tenido ITS anteriormente y 28% tenía otra ITS simultánea. El 55% de las infecciones fueron asintomáticas (70% entre las mujeres). El recto fue la localización más frecuente entre los HSH (69,5%), seguida de la uretra (31,4%) y la faringe (14,5%). En las mujeres, la infección afectó principalmente el cérvix (86,5% de los casos), seguido del recto (17,6%) y la faringe (13,8%). Se estudió a los contactos del 58% de los pacientes. La tasa de reinfección a las cuatro semanas fue del 17% entre aquellos con criterios para realizar un test de cura.Conclusión: Estos resultados justifican la implantación de cribados oportunistas en mujeres menores de 25 años e inmigrantes jóvenes de ambos sexos, con toma de muestras genitales y extra-genitales, y el establecimiento de guías apropiadas para la notificación de contactos.(AU)


Background: Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. Methods: Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain). Results: 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. Conclusion: Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.(AU)


Assuntos
Humanos , Masculino , Feminino , Chlamydia trachomatis , Infecções Sexualmente Transmissíveis , Epidemiologia , Saúde Reprodutiva , Minorias Sexuais e de Gênero , Mulheres , Estudos Prospectivos , Microbiologia , Doenças Transmissíveis
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