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1.
Healthcare (Basel) ; 12(7)2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38610148

RESUMO

This study examined the effect of outdoor-fitness-equipment-based resistance training on the health parameters of middle-aged and older adults, as well as analyzing the effect of age on the results found. A total of 149 volunteers were randomly assigned to the training (TG) and control (CG) groups. The TG performed two weekly sessions of resistance training for 8 weeks using outdoor fitness equipment, while the CG continued with their regular daily activities. Body composition was measured using DXA, and the maximal isometric voluntary contraction in knee extension, elbow flexion, and hand grip were assessed, along with the 4 m walk test, the Timed Up and Go Test, and the Short Form 36 Health Survey Questionnaire. The TG showed a significant increase in the lean mass index (p = 0.002) and maximal isometric voluntary contraction in both legs (p < 0.001) and arms (p < 0.001), as well as in physical functioning (p < 0.001) and the role physical dimension (p = 0.006) of the Short Form 36 Health Survey Questionnaire, compared to the CG, which showed a decrease in all these variables. In addition, the TG showed a greater decrease in fat mass (p < 0.001), fat mass index (p = 0.003), and the Timed Up and Go Test (p < 0.001) than the CG. Age conditioned the evolution of most of the variables analyzed (p < 0.05). In conclusion, resistance training with outdoor fitness equipment may be useful for improving the health of middle-aged and older adults, although age is a factor that could influence the adaptations found.

2.
Int J Mol Sci ; 25(7)2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38612532

RESUMO

Cherry stems, prized in traditional medicine for their potent antioxidant and anti-inflammatory properties, derive their efficacy from abundant polyphenols and anthocyanins. This makes them an ideal option for addressing skin aging and diseases. This study aimed to assess the antioxidant and anti-inflammatory effects of cherry stem extract for potential skincare use. To this end, the extract was first comprehensively characterized by HPLC-ESI-qTOF-MS. The extract's total phenolic content (TPC), antioxidant capacity, radical scavenging efficiency, and its ability to inhibit enzymes related to skin aging were determined. A total of 146 compounds were annotated in the cherry stem extract. The extract effectively fought against NO· and HOCl radicals with IC50 values of 2.32 and 5.4 mg/L. Additionally, it inhibited HYALase, collagenase, and XOD enzymes with IC50 values of 7.39, 111.92, and 10 mg/L, respectively. Based on the promising results that were obtained, the extract was subsequently gently integrated into a cosmetic gel at different concentrations and subjected to further stability evaluations. The accelerated stability was assessed through temperature ramping, heating-cooling cycles, and centrifugation, while the long-term stability was evaluated by storing the formulations under light and dark conditions for three months. The gel formulation enriched with cherry stem extract exhibited good stability and compatibility for topical application. Cherry stem extract may be a valuable ingredient for creating beneficial skincare cosmeceuticals.


Assuntos
Antocianinas , Cosméticos , Antioxidantes/farmacologia , Anti-Inflamatórios/farmacologia , Extratos Vegetais/farmacologia
3.
J Enzyme Inhib Med Chem ; 39(1): 2330907, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38651823

RESUMO

Antimicrobial resistance (AMR) is a pressing global issue exacerbated by the abuse of antibiotics and the formation of bacterial biofilms, which cause up to 80% of human bacterial infections. This study presents a computational strategy to address AMR by developing three novel quantitative structure-activity relationship (QSAR) models based on molecular topology to identify potential anti-biofilm and antibacterial agents. The models aim to determine the chemo-topological pattern of Gram (+) antibacterial, Gram (-) antibacterial, and biofilm formation inhibition activity. The models were applied to the virtual screening of a commercial chemical database, resulting in the selection of 58 compounds. Subsequent in vitro assays showed that three of these compounds exhibited the most promising antibacterial activity, with potential applications in enhancing food and medical device safety.


Assuntos
Antibacterianos , Biofilmes , Desenho de Fármacos , Testes de Sensibilidade Microbiana , Relação Quantitativa Estrutura-Atividade , Biofilmes/efeitos dos fármacos , Antibacterianos/farmacologia , Antibacterianos/química , Antibacterianos/síntese química , Estrutura Molecular , Humanos , Contaminação de Alimentos/prevenção & controle , Relação Dose-Resposta a Droga
4.
Int Ophthalmol ; 44(1): 145, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38498219

RESUMO

PURPOSE: To compare the visual, refractive, and topographic outcomes of a high irradiance accelerated corneal crosslinking (ACXL) protocol after a 12-month follow-up between pediatric and adult patients with progressive keratoconus (KC). METHODS: Retrospective, comparative, cohort study. Patients with KC were divided into two groups: pediatric (≤ 18 years) and adult (> 18 years). All of them were managed with epi-OFF ACXL (30 mW/cm2, 8 min, pulsed 1:1 on and off = 7.2 J/cm2). Visual, refractive, and topographic values were measured preoperatively and at 1, 3, 6, and 12 months postoperative. KC progression, defined as a Kmax increase of ≥ 1D during follow-up, was recorded. RESULTS: Eighty-nine eyes (53 patients) were included for analysis; 45 (50.6%) eyes were from pediatric patients and 44 (49.4%) from adults. At one-year follow-up, pediatric patients experienced significantly higher rates of progression (22.2% vs. 4.5%, p = .014). Contrariwise, female gender (Beta = - 3.62, p = .018), a baseline uncorrected visual acuity of Snellen ≥ 20/60 (Beta = - 5.96, p = .007), and being ≥ 15 years at ACXL treatment (Beta = - 0.31, p = .021) were associated with non-progressive disease. A significant improvement in best-corrected visual acuity, Kmin, Km, and Kmax was recorded in both groups. Overall, 86.5% of eyes from both groups showed Kmax stabilization or improvement. CONCLUSIONS: Despite the similarity in visual, refractive, and topographic outcomes in both groups, younger age was associated with KC progression after ACXL at one year of follow-up.


Assuntos
Ceratocone , Fotoquimioterapia , Adulto , Humanos , Feminino , Criança , Ceratocone/diagnóstico , Ceratocone/tratamento farmacológico , Fármacos Fotossensibilizantes/uso terapêutico , Fotoquimioterapia/métodos , Crosslinking Corneano , Estudos Retrospectivos , Estudos de Coortes , Riboflavina/uso terapêutico , Raios Ultravioleta , Topografia da Córnea/métodos , Seguimentos , Reagentes de Ligações Cruzadas/uso terapêutico , Colágeno/uso terapêutico
6.
Ophthalmology ; 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38452874

RESUMO

PURPOSE: Analyze the influence of risk factors at presentation in the long-term immunosuppressive therapy (IMT) outcomes of ocular mucous membrane pemphigoid (OMMP). DESIGN: Retrospective multicenter study. PARTICIPANTS: Patients with OMMP seen at the Duke Eye Center, Tecnologico de Monterrey, and Hospital Clinic of Barcelona from 1990 to 2022. METHODS: Data at presentation on demographics, direct immunofluorescence, ocular findings, sites of extraocular manifestations (EOMs), and previous treatments in patients with a clinical or laboratory diagnosis of OMMP, were analyzed with multivariable analysis and Kaplan-Meier plots to identify factors associated with adverse outcomes. MAIN OUTCOME MEASURES: (1) Inflammatory control (no conjunctival inflammation in both eyes at 3 months on IMT); (2) relapse (new-onset inflammation after absolute control in either eye); (3) progression (≥ 1 cicatrizing stage progression in either eye); and (4) vision loss (≥ 2 Snellen lines). RESULTS: A total of 117 patients (234 eyes), 61% (71/117) of whom were women, with a mean age of 66.6 (SD: 12.4) years (range: 37-97 years) and median follow-up of 34 months (interquartile range: 16-66 months; range: 3-265 months), were enrolled. Inflammatory control was achieved in 57% of patients (67/117), with high-risk EOM (HR-EOM), including esophageal, nasopharyngeal, and/or genital involvement (adjusted odds ratio [aOR]: 12.51; 95% confidence interval [CI]: 2.61-59.99; P = 0.002) and corneal scarring (aOR: 3.06; 95% CI, 1.15-8.14; P = 0.025), as significant risk factors for persistent inflammation. Disease relapse, progression, and vision loss occurred in 20% of patients (23/117), 12% of patients (14/117), and 27% of patients (32/117), respectively. Baseline corneal scarring was a risk factor for relapse (adjusted hazard ratio: 4.14; 95% CI: 1.61-10.62; P = 0.003), progression (aOR: 11.46; 95% CI: 1.78-73.75; P = 0.010), and vision loss (aOR: 3.51; 95% CI: 1.35-9.10; P = 0.010). HR-EOM was associated with stage progression (aOR, 34.57; 95% CI, 6.57-181.89; P<0.001) and vision loss (aOR, 8.42; 95% CI, 2.50-28.42; P = 0.001). No significant differences were found between IMT regimes and relapse (P = 0.169). CONCLUSIONS: Ocular mucous membrane pemphigoid presenting with HR-EOMs and corneal scarring has an increased risk of stage progression and vision loss. Corneal scarring and severe inflammation at baseline were associated with an increased risk of relapse. A disease progression staging system incorporating both the HR-EOMs and corneal involvement is required to predict the visual outcome of OMMP better. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

8.
Med Educ ; 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38449293
9.
Front Neurol ; 15: 1336627, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38469592

RESUMO

Objective: Patients with superior canal dehiscence syndrome (SCDS) can present with a plethora of auditory and/or vestibular symptoms associated with a bony defect of the superior semicircular canal. While surgical repair is a reasonable option for patients with significant localizing symptoms, the degree of clinical improvement will vary among patients and poses challenges in outcome prediction. This study aims to assess the relationship between preoperative and postoperative symptoms and identify predictors of symptom persistence following repair. Study design: Retrospective chart review. Setting: Tertiary neurotology single-institution care center. Main outcome measures: The primary outcome was to determine the proportion of resolved and persistent primary (most bothersome) and non-primary audiologic and vestibular symptoms following SCD repair. Secondary outcomes included comparison of patient, operative and radiologic characteristics between patients with resolved vs. persistent symptoms. Standardized patient questionnaires including 11 auditory and 8 vestibular symptoms were administered to patients at their preoperative and follow-up visits. Patient pre- vs. postoperative survey results, demographic and clinical characteristics, operative characteristics, audiometric data and cervical vestibular evoked myogenic potential (cVEMP) thresholds were compared via univariate χ2 and multivariate binary logistic regression analyses between those patients reporting full postoperative resolution of symptoms and persistence of one or more symptoms. Radiologic computed tomography (CT) measurements of superior canal dehiscence (SCD) defect size, location, and laterality were also compared between these two groups. Results: Of 126 patients (132 ears) included in our study, 119 patients (90.2%) reported postoperative resolution (n = 82, 62.1%) or improvement (n = 37, 28.0%) of primary (most bothersome) symptoms, while 13 patients (9.8%) reported persistence of primary symptoms. The median (interquartile range) and range between surgery and questionnaire completion were 9 (4-28), 1-124 months, respectively. Analyzing all symptoms (primary and non-primary) 69 (52.3%) and 68 (51.1%) patients reported complete postoperative auditory and vestibular symptom resolution, respectively. The most likely persistent symptoms included imbalance (33/65/67, 50.8%), positional dizziness (7/20, 35.0%) and oscillopsia (44/15, 26.7%). Factors associated with persistent auditory symptoms included history of seizures (0% vs. 7.6%, p = 0.023), auditory chief complaint (50.0% vs. 70.5%), higher PTA (mean 19.6 vs. 25.1 dB, p = 0.043) and higher cervical vestibular evoked myogenic potential (cVEMP) thresholds at 1000 Hz (mean 66.5 vs. 71.4, p = 0.033). A migraine diagnosis (14.0% vs. 41.9% p < 0.010), bilateral radiologic SCD (17.5% vs. 38.1%, p = 0.034) and revision cases (0.0% vs. 14.0%, p = 0.002) were associated with persistent vestibular symptoms. Neither SCD defect size nor location were significantly associated with symptom persistence (P > 0.05). Conclusions: Surgical repair for SCDS offers meaningful reduction in the majority of auditory and vestibular symptoms. However, the persistence of certain, mostly non-primary, symptoms and the identification of potential associated factors including migraines, PTA thresholds, cVEMP threshold, bilateral SCD, and revision cases emphasize the importance of individualized patient counseling and management strategies.

10.
Psicosom. psiquiatr ; (28): 18-28, Ene-Mar, 2024. tab
Artigo em Espanhol | IBECS | ID: ibc-231741

RESUMO

Introducción: Existe evidencia sobre una asociación directa entre la Violencia Machista/Violencia de Género (VdG) y el suicidio, e incluso se señala que la VdG es el principal factor precipitante para que una mujer realice una tentativa suicida. Además, se ha demostrado que las mujeres con enfermedades mentales crónicas sufren especialmente más violencia que la población en general. Sin embargo, existen relativamente pocos datos sobre la capacidad de detección de VdG de los servicios de urgencias. En Catalunya, el Programa Código Riesgo de Suicidio (CRS) atendió a 12.596 persones con episodios de conducta suicida y ha demostrado su eficacia en nuestro hospital. Objetivo principal: Cuantificar el grado de detección de la VdG de nuestros registros sanitarios en mujeres visitadas en el servicio urgencias de nuestro hospital por ideación y/o tentativa suicida y que han sido incluidas en el Programa CRS. Hipótesis principal: La detección actual de VdG en las mujeres es <10%. Metodología: Estudio descriptivo retrospectivo basado en registros electrónicos sanitarios. Se identificaron todas las mujeres que habían estado en seguimiento telefónico en los últimos 12 meses por haber acudido al servicio de urgencias de nuestro Hospital por ideación y/o intento suicida. El período de análisis incluyó del 1 de enero al 31 de diciembre de 2020. Se realizó una revisión completa de todos los informes de alta de estas mujeres visitadas en urgencias y de los registros clínicos de todos los profesionales (médicos, psiquiatrías, enfermeras...) disponibles en la historia clínica informatizada. Se realizó un análisis descriptivo simple de los datos. Resultados: Durante el período de estudio, se detectaron cuatro casos de violencia machista/VdG (1,92%) y dos casos de violencia familiar entre las 208 mujeres que se visitaron por ideación y/o intento autolítico...(AU)


Introduction: There is evidence of a direct association between interpersonal partner/sexist/gender violence (IPV) and suicide, and it is even pointed out that IPV is the main precipitating factor for a woman to make a suicide attempt. In addition, it has been shown that women with chronic mental illness suffer especially more violence than the general population. However, there is relatively little data on the IPV detection capacity of emergency departments. In Catalonia, the Suicide Risk Code Program (CRS) treated 12,596 people with episodes of suicidal behaviour and has demonstrated its effectiveness in our hospital. Main objective: To quantify the degree of detection of IPV in our health records in women visited in the emergency department of our hospital for suicidal ideation and/or attempt and who have been included in the CRS Program.Main hypothesis: Current detection of IPV in women is <10%. Methodology: Retrospective descriptive study based on electronic health records. All the women who had been in telephone follow-up in the last 12 months for having gone to the emergency department of our hospital for suicidal ideation and/or attempt were identified. The analysis period included from January 1 to December 31, 2020. A complete review of all the discharge reports of the women visited in the emergency room and of all the clinical records of all the professionals (doctors, psychiatrists, nurses...) available in the computerized medical record was carried out. A simple descriptive analysis of the data was performed. Results: During the study period, four cases of IPV (1.92%) and two cases of family violence were detected among the 208 women who were visited for suicidal ideation and/or attempt. All the women who were detected with IPV were recommended to visit the Women’s Care Center, but it is unknown if they were actually referred to other professionals or if they actually attended...(AU)


Assuntos
Humanos , Masculino , Feminino , Violência de Gênero , Androcentrismo , Suicídio , Violência por Parceiro Íntimo , Tentativa de Suicídio , Serviços Médicos de Emergência , Psiquiatria , Saúde Mental , Estudos Retrospectivos , Epidemiologia Descritiva
11.
J Surg Res ; 296: 704-710, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38364698

RESUMO

INTRODUCTION: Intraoperative cryoablation of intercostal thoracic nerves is gaining popularity as a technique that decreases postoperative pain in thoracic surgery. Our study evaluates the efficacy and safety of cryoablation in pain management of pediatric cancer patients undergoing thoracotomy. METHODS: We reviewed cancer patients undergoing thoracotomies for pulmonary metastasis resection at our children's hospital from 2017 to 2023. Patients who received cryoablation were compared to those who did not. Our primary outcomes were self-reported postoperative pain scores (from 0 to 10) and opioid consumption, measured as oral morphine equivalent per kilogram. RESULTS: Thirty eight procedures were performed in 17 patients, of which 11 (64.7%) were males. Cryoablation was used in 14 (32.4%) procedures, while it was not in 24 (67.6%). Median age (17 y in both groups, P = 0.84) and length of surgery (300 cryoablation versus 282 no cryoablation, P = 0.65) were similar between the groups. Patients treated with cryoablation had a shorter hospital stay compared to those who did not (3.0 versus 4.5 d, respectively, P = 0.04) and received a lower total dose of opioids (2.2 oral morphine equivalent per kilogram versus 14.4, P = 0.004). No significant difference was noted in daily pain scores between the two groups (3.8 cryoablation versus 3.9 no cryoablation, P = 0.93). There was no difference in rates of readmissions between the cryoablation and no-cryoablation groups (14.3% versus 8.3%, P = 0.55). CONCLUSIONS: Our study suggests that cryoablation of the thoracic nerves during a thoracotomy is associated with reduced opiate consumption and shorter hospital stay. Cryoablation appears to be a promising technique for pain management in this patient population.


Assuntos
Criocirurgia , Neoplasias Pulmonares , Metastasectomia , Masculino , Criança , Humanos , Feminino , Analgésicos Opioides/uso terapêutico , Criocirurgia/efeitos adversos , Tempo de Internação , Estudos Retrospectivos , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico , Morfina/uso terapêutico , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/tratamento farmacológico
12.
Int Ophthalmol ; 44(1): 60, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38345707

RESUMO

PURPOSE: To analyze higher-order aberrations (HOAs) and their visual impact in a pediatric blepharokeratoconjunctivitis (PBKC) cohort compared with healthy controls. METHODS: Prospective case-control study of pediatric patients (≤ 16 years old). Subjects underwent wavefront aberrometry analysis to compare HOAs and their impact on visual quality. RESULTS: A total of 150 eyes from 76 patients were included in the analysis. The PBKC group consisted of 50 eyes and the control group of 100 healthy eyes. Mean age was 10.39 ± 3.81 years for the PBKC group and 10.80 ± 3.61 years for the controls. Mean corrected-distance visual acuity (CDVA) was 0.24 ± 0.21 logMAR in the PBKC group and 0.07 ± 0.1 in the controls (P < 0.001). Mean astigmatism was 1.6 ± 1.98D in the PBKC group vs. 0.67 ± 0.76D in the control group (P = 0.01). Mean RMS of HOAs was 1.05 ± 1.7mm in the PBKC group and 0.41 ± 0.18mm in the controls (P < 0.001). The mean modulation transfer function (MTF) in the PBKC group was significantly lower (16.37 ± 16.32) than controls (30.3 ± 23.57) (P < 0.001). Corneal leukomas, stromal vascularization, peripheral nummular subepithelial scars, and pannus formation are associated with increased HOAs. CONCLUSIONS: There was a significant increase in total HOAs of eyes with PBKC compared to healthy controls. Corneal opacity, vascularization, and scarring are associated with increased HOAs. The PBKC eye aberration profile: coma, secondary astigmatism, quadrafoil, and pentafoil, were associated with decreased CDVA and visual quality (PSF and MTF).


Assuntos
Astigmatismo , Opacidade da Córnea , Aberrações de Frente de Onda da Córnea , Humanos , Criança , Adolescente , Estudos de Casos e Controles , Acuidade Visual , Córnea , Refração Ocular
13.
Int J Colorectal Dis ; 39(1): 29, 2024 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-38386177

RESUMO

PURPOSE: Our study investigates ethnic disparities in pediatric appendicitis, focusing on the impact of Hispanic ethnicity on presentation, complications, and postoperative outcomes. METHODS: We conducted a retrospective analysis of pediatric patients undergoing appendectomy for acute appendicitis from 2015 to 2020 using the National Surgical Quality Improvement Program-Pediatric database. We compared 30-day postoperative complications, postoperative length of stay, and postoperative interventions between Hispanic and non-Hispanic White patients. RESULTS: 65,976 patients were included, of which 23,462 (35.56%) were Hispanic and 42,514 (64.44%) non-Hispanic White. Hispanic children were more likely to present to the hospital with complicated appendicitis (31.75% vs. 25.15%, P < 0.0001) and sepsis (25.22% vs. 19.02%, P < 0.0001) compared to non-Hispanic White. Hispanics had higher rates of serious complications (4.06% vs. 3.55%, P = 0.001) but not overall complications (5.37% vs. 5.09%, P = 0.12). However, after multivariate analysis, Hispanic ethnicity was not associated with an increased rate of serious postoperative complications (OR 0.93, CI 0.85-1.01, P = 0.088); it was associated with less overall complications (OR 0.88, CI 0.81-0.96, P = 0.003) but a longer postoperative length of stay (OR 1.09, CI 1.04-1.14, P < 0.0001). CONCLUSION: Hispanic children are more likely to present with complicated appendicitis, contributing to increased postoperative complications. Notably, upon adjustment for the impact of complicated appendicitis, our findings suggest potentially favorable outcomes for Hispanic ethnicity. This emphasizes the need to understand delays in presentation to improve outcomes in the Hispanic population.


Assuntos
Apendicite , Disparidades em Assistência à Saúde , Hispânico ou Latino , Criança , Humanos , Apendicite/cirurgia , Etnicidade , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos
15.
Int Ophthalmol ; 44(1): 4, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38315255

RESUMO

PURPOSE: Actinic conjunctivitis (AC), along with cheilitis (AChe), is part of the clinical spectrum of actinic prurigo (AP), a rare photo dermatosis that affects high-risk populations. We analyzed the clinical manifestations and onset of actinic conjunctivitis (AC), and its relationship with prurigo (AP) in a susceptible population. METHODS: This prospective observational cohort study was performed on Indigenous populations from the highlands of Chiapas, Mexico. Thorough dermatological and ophthalmological examinations were performed in patients attending a primary health care center. The clinical features, labor and environmental factors, onset timing, and clinical staging of AC and AP were analyzed. RESULTS: Of the 2913 patients studied, 54 patients (108 eyes) (1.8%) had AC, and 14 patients (25.9%) had AP. The mean age at diagnosis was 36.18 ± 18.52 years (6-70 years). The mean residential altitude was 1884 ± 434.2 m above sea level. Mean self-reported sun exposure was 5.14 ± 3.1 h a day (0.5-12 h). A total of 90.7% reported exposure to biomass fuels during cooking, and 50% to farm animals. AC was the sole manifestation in 70% of the cases. All patients had nasal and temporal photo-exposed conjunctiva. Among the eyes, 12.9% were classified as stage-1, 64.8% as stage-2, and 22.2% stage-3. A total of 83.3% of the patients had hyperpigmented lesions, and 35.1% had evaporative dry eye disease. CONCLUSIONS: AC may be the initial or sole manifestation of AP. Most AC cases (87%) were initially observed at the advanced stages of the disease. Although solar exposure was not associated with late AC stages, a positive association was found with farm animal exposure. Evaporative dry eye associated with meibomian gland dysfunction has not been previously reported in patients with AC.


Assuntos
Conjuntivite , Transtornos de Fotossensibilidade , Prurigo , Dermatopatias Genéticas , Animais , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , México/epidemiologia , Prurigo/complicações , Prurigo/epidemiologia , Prurigo/patologia , Estudos Prospectivos , Povos Indígenas
16.
Artigo em Inglês | MEDLINE | ID: mdl-38327257

RESUMO

OBJECTIVE: Characterizing access to sudden sensorineural hearing loss (SSNHL) care at private practice otolaryngology clinics of varying ownership models. STUDY DESIGN: Cross-sectional prospective review. SETTING: Private practice otolaryngology clinics. METHODS: We employed a Secret Shopper study design with private equity (PE) owned and non-PE-owned clinics within 15 miles of one another. Using a standardized script, researchers randomly called 50% of each clinic type between October 2021 and January 2022 requesting an appointment on behalf of a family member enrolled in either Medicaid or private insurance (PI) experiencing SSNHL. Access to timely care was assessed between clinic ownership and insurance type. RESULTS: Seventy-eight total PE-owned otolaryngology clinics were identified across the United States. Only 40 non-PE clinics could be matched to the PE clinics; 39 PE and 28 non-PE clinics were called as Medicaid patients; 39 PE and 25 non-PE clinics were called as PI patients; 48.7% of PE and 28.6% of non-PE clinics accepted Medicaid. The mean wait time to new appointment ranged between 9.55 and 13.21 days for all insurance and ownership types but did not vary significantly (P > .480). Telehealth was significantly more likely to be offered for new Medicaid patients at non-PE clinics compared to PE clinics (31.8% vs 0.0%, P = .001). The mean cost for an appointment was significantly greater at PE clinics than at non-PE clinics ($291.18 vs $203.75, P = .004). CONCLUSIONS: Patients seeking SSNHL care at PE-owned otolaryngology clinics are likely to face long wait times prior to obtaining an initial appointment and reduced telehealth options.

17.
Artigo em Inglês | MEDLINE | ID: mdl-38329219

RESUMO

OBJECTIVE: To elucidate the differences in auditory performance between auditory brainstem implant (ABI) patients with tumor or nontumor etiologies. DATA SOURCES: PubMed, Embase, and Web of Science Core Collection from 1990 to 2021. REVIEW METHODS: We included published studies with 5 or more pediatric or adult ABI users. Auditory outcomes and side effects were analyzed with weighted means for closed-set, open-set speech, and categories of auditory performance (CAP) scores. Overall performance was compared using an Adult Pediatric Ranked Order Speech Perception (APROSPER) scale created for this study. RESULTS: Thirty-six studies were included and underwent full-text review. Data were extracted for 662 tumor and 267 nontumor patients. 83% were postlingually deafened and 17% were prelingually deafened. Studies that included tumor ABI patients had a weighted mean speech recognition of 39.2% (range: 19.6%-83.3%) for closed-set words, 23.4% (range: 17.2%-37.5%) for open-set words, 21.5% (range: 2.7%-48.4%) for open-set sentences, and 3.1 (range: 1.0-3.2) for CAP scores. Studies including nontumor ABI patients had a weighted mean speech recognition of 79.8% (range: 31.7%-84.4%) for closed-set words, 53.0% (range: 14.6%-72.5%) for open-set sentences, and 2.30 (range: 2.0-4.7) for CAP scores. Mean APROSPER results indicate better auditory performance among nontumor versus tumor patients (3.5 vs 3.0, P = .04). Differences in most common side effects were also observed between tumor and nontumor ABI patients. CONCLUSION: Auditory performance is similar for tumor and nontumor patients for standardized auditory test scores. However, the APROSPER scale demonstrates better ABI performance for nontumor compared to tumor patients.

18.
PLoS One ; 19(2): e0297901, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38416704

RESUMO

Throughout the early stages of the COVID-19 pandemic in Mexico (August-December 2020), we closely followed a cohort of n = 100 healthcare workers. These workers were initially seronegative for Immunoglobulin G (IgG) antibodies against SARS-CoV-2, the virus that causes COVID-19, and maintained close contact with patients afflicted by the disease. We explored the database of demographic, physiological and laboratory parameters of the cohort recorded at baseline to identify potential risk factors for infection with SARS-CoV-2 at a follow-up evaluation six months later. Given that susceptibility to infection may be a systemic rather than a local property, we hypothesized that a multivariate statistical analysis, such as MANOVA, may be an appropriate statistical approach. Our results indicate that susceptibility to infection with SARS-CoV-2 is modulated by sex. For men, different physiological states appear to exist that predispose to or protect against infection, whereas for women, we did not find evidence for divergent physiological states. Intriguingly, male participants who remained uninfected throughout the six-month observation period, had values for mean arterial pressure and waist-to-hip ratio that exceeded the normative reference range. We hypothesize that certain risk factors that worsen the outcome of COVID-19 disease, such as being overweight or having high blood pressure, may instead offer some protection against infection with SARS-CoV-2.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Masculino , Feminino , COVID-19/epidemiologia , Pandemias/prevenção & controle , Fatores de Risco , Imunoglobulina G , Pessoal de Saúde , Anticorpos Antivirais
20.
World J Pediatr Surg ; 7(1): e000700, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38298825

RESUMO

Introduction: As fire pits grow in popularity, so do the associated burn injuries. Our study examines pediatric fire pit burns characteristics to raise awareness and promote safety precautions. Methods: We conducted a retrospective review of pediatric patients (≤21 years) with firepit burns at a tertiary care hospital from 2016 to 2021. Results: Eighty-four patients were identified, of whom 70.2% were male, with a median age of 62 months. The median percent total body surface area burned was 2% (interquartile range (IQR)=1-4). Thirty-five (41.7%) patients were admitted and 7 (8.3%) underwent grafting. Neck and trunk burns had the highest grafting rates (66% and 33%, respectively). The hands (41.7%) and the lower extremities (27.4%) were the most frequently burned body areas. The leading causes of burns were ashes/hot coals (34.5%), flames (31.0%), and direct contact (25.0%), often resulting from falling into the fire (59.5%) or running or playing in activities near it (26.2%). Thirty-five (41.7%) were admitted for inpatient management, while 49 (58.3%) were treated as outpatient. Eleven (13.2%) underwent at least one reconstructive surgery, 7 (8.4%) had at least one rehabilitation visit, and 65 (77.4%) had follow-up clinic visits. The median length of stay was 2 days (IQR=1.0-3.5). The peak months for burns were from August through October (n=40, 46.0%), with an increase observed from 10 cases in 2016 to 20 cases in 2020. Conclusions: Given the significant proportion of firepit burns resulting from unsafe fire behaviors, it is crucial that caretakers are aware of proper firepit safety precautions. Level of evidence: III.

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