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1.
Eur Geriatr Med ; 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38587614

RESUMO

PURPOSE: Falls are a major and growing health care problem in older adults. A patient portal has the potential to provide older adults with fall-prevention advice to reduce fall-risk. However, to date, the needs and preferences regarding a patient portal in older people who have experienced falls have not been explored. This study assesses content preferences, potential barriers and facilitators with regard to using a patient portal, as perceived by older people who have experienced falls, and explores regional differences between European participants. METHODS: We conducted a survey of older adults attending an outpatient clinic due to a fall or fall-related injury, to explore their content preferences, perceived barriers, and facilitators with respect to a fall-prevention patient portal. Older adults (N = 121, 69.4% female, mean age: 77.9) were recruited from seven European countries. RESULTS: Almost two-thirds of respondents indicated they would use a fall-prevention patient portal. The portal would preferably include information on Fall-Risk-Increasing Drugs (FRIDs), and ways to manage other related/relevant medical conditions. Facilitators included a user-friendly portal, with easily accessible information and physician recommendations to use the portal. The most-commonly-selected barriers were privacy issues and usage fees. A family member's recommendation to use the portal was seemingly more important for Southern and Eastern European participants compared to the other regions. CONCLUSION: The majority of older people with lived falls experience expressed an interest in a fall-prevention patient portal providing personalized treatment advice to prevent further falls. The results will be used to inform the development of a fall-prevention patient portal. The fall-prevention patient portal is intended to be used in addition to a consultation with a physician. Future research is needed to explore how to prevent falls in older patients who are not interested in a fall-prevention patient portal.

2.
Animal ; 18(3): 101090, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38377814

RESUMO

Due to the lack of a recording system for individual consumption of group-housed rabbits, published studies about feeding behaviour are based on information recorded at the group- and not at the individual level and periods covering only a few days or, in some cases, only part of a day. Such information could be used to inform rabbit management systems but cannot be used for genetic selection. We aimed to generate and use information from a novel automated feeder for group-housed rabbits to identify new phenotypes for individual animals that could be incorporated into breeding programs to improve feed efficiency and social behaviour under different feeding regimens. At 39 d of age, rabbits from 15 batches were placed in cages and fed ad libitum to become used to the electronic feeder. From 42 to 58-59 d, one group of 1 086 rabbits was fed ad libitum (AL), while another group of 1 134 rabbits was fed on a restricted feeding schedule (R) by limiting the feeding time to the period between 1800 and 0600 h of the following day. We implemented a reliable multivariate method to remove anomalous feeding behaviour records. We then defined novel traits for feeding behaviour that apply to both types of feeding regimes, and for social behaviour that indicates an animal's rank within the cage hierarchy. We based these traits on feeder records and a biologically sound definition of a meal. Finally, we estimated the phenotypic correlations of those traits with growth and feed efficiency traits. Our findings demonstrate that variables about resource distribution among cage mates and an animal's priority for feed access were found to be good indicators of an animal's dominant or subordinate status within the cage. Based on results obtained in R animals (results were similar in AL animals), the most efficient animals were those that ate less frequently (phenotypic correlation with feed conversion ratio, rho = 0.6), and consumed smaller amounts per meal (rho = 0.7), spent less time at the feeder (rho = 0.4), and appeared to be subordinate, as they did not have priority access to the feeder (rho = -0.3), and had the smallest share of resources (range of rho = 0.2-0.6). We conclude that quantifying feeding and social behaviour traits can enhance the understanding of the mechanisms through which individuals exert their effects on the performance of their cage mates.


Assuntos
Comportamento Alimentar , Comportamento Social , Coelhos , Animais , Fenótipo , Seleção Genética , Ração Animal/análise
3.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 50(1): [e102088], ene.- feb. 2024. tab, mapas
Artigo em Espanhol | IBECS | ID: ibc-229438

RESUMO

Introducción La lucha contra la infección por VIH sigue siendo un objetivo primordial del Sistema Nacional de Salud español. Los servicios de urgencias son un punto crítico a la hora disminuir las oportunidades de diagnóstico perdidas, donde se estima que se producen una de cada 3 oportunidades perdidas. El objetivo es examinar la distribución geográfica de los nuevos diagnósticos de VIH en el área de un hospital del centro de Madrid. Métodos Estudio descriptivo, observacional y retrospectivo que evalúa la distribución geográfica de los nuevos diagnósticos de VIH en el área asistencial de un hospital universitario de tercer nivel en la Comunidad de Madrid. Resultados Se analizaron 387 personas con un nuevo diagnóstico de infección por VIH entre los años 2018-2020, siendo en su mayoría personas jóvenes con una media de edad de 36±9 años. El 86% fueron hombres gais, bisexuales y otros hombres que tiene sexo con hombres y el 48,6% población inmigrante. El 15,3% se presentó con CD4+<200céls/mm3 y el 9,5% con una enfermedad definitoria de sida. El 32,7% y el 5,1% tenían un ARN-VIH-1>100.000 copias/mL y >500.000 copias/mL respectivamente, presentando, hasta un 13,7% de los sujetos mutaciones de resistencia al diagnóstico. En la distribución geográfica por las Áreas de Salud, el 51,4% de las personas procedían de 4 centros de salud y en 9 centros de salud se incluían más del 70% de los nuevos diagnosticados. Conclusión Conocer mejor la distribución geográfica de los nuevos diagnósticos de VIH por Áreas Sanitarias nos permite identificar las zonas de mayor riesgo de transmisión, para así poder dirigir y efectuar medidas de prevención, diagnóstico y tratamiento precoz (AU)


Introduction Countering HIV infection remains a primary objective of the Spanish National Health System. Emergency services play a crucial role in reducing missed diagnostic opportunities, with estimates suggesting that one in 3 such opportunities occur here. The aim of the study is to examine the geographical dispersion of newly diagnosed HIV cases, within a downtown Madrid hospital. Methods This is an observational, descriptive, retrospective study evaluating the geographical distribution of new HIV diagnoses in the care area of a tertiary University Hospital in the Community of Madrid. Results Three hundred and eighty-seven individuals with a new diagnosis of HIV infection between 2018 and 2020 were analysed, the majority being young people with an average age of 36±9 years. 86% were gay, bisexual and other men who have sex with men and 48.6% were immigrants. 15.3% presented with CD4+<200cells/mm3 and 9.5% with an AIDS-defining illness. 32.7% and 5.1% had an RNA-HIV-1>100,000copies/mL and >500,000copies/mL, respectively, with up to 13.7% of subjects presenting resistance mutations at diagnosis. Geographically, 51.4% of individuals came from 4 Health Centres and more than 70% of the new diagnoses were included in nine Health Centres. Conclusion Better understanding the geographical distribution of new HIV diagnoses by health areas allows us to identify areas of higher transmission risk, thereby directing and implementing prevention, early diagnosis, and treatment measures (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Atenção Terciária à Saúde , Infecções por HIV/epidemiologia , Infecções por HIV/diagnóstico , Estudos Retrospectivos , Espanha/epidemiologia
4.
AIDS Behav ; 28(2): 636-644, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38236321

RESUMO

Pain and heavy alcohol consumption are prevalent among people living with HIV/AIDS (PLWH), each contributing to impaired functioning and diminished quality of life. Each of these conditions may have negative effects on the HIV care continuum, but less is known about their combined influences. The current study examined how heavy drinking and pain were associated with HIV viral suppression and CD4 cell count among participants receiving antiretroviral therapy (ART). The study sample consisted of 220 PLWH with past 12-month substance dependence or ever injection drug use enrolled in a large HIV cohort study. Logistic regression analyses showed an interaction between pain level (no/mild pain vs moderate/severe) and heavy drinking on viral suppression such that heavy drinking was a significant predictor of poorer viral suppression only for those who experienced moderate/severe pain. We also examined whether ART adherence differentially mediated the association between heavy drinking and HIV viral suppression by level of pain. Although there was a significant indirect effect of heavy drinking on viral suppression among those with moderate/severe pain, moderated mediational analyses did not indicate that the indirect effect of heavy drinking on viral suppression through ART adherence differed significantly by level of pain. Pain level did not significantly moderate the association between heavy drinking and CD4 cell count. We conclude that heavy drinking may be particularly likely to be associated with poorer HIV viral suppression among PLWH with moderate or severe pain. Providers should routinely address comorbid heavy drinking and pain to improve HIV outcomes.


Assuntos
Infecções por HIV , Humanos , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Estudos de Coortes , Qualidade de Vida , Consumo de Bebidas Alcoólicas/epidemiologia , Dor , Adesão à Medicação
5.
Arch. Soc. Esp. Oftalmol ; 99(1): 9-15, enero 2024. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-229547

RESUMO

Objetivo: Traducir y validar al castellano el cuestionario V-FUCHS en una población de pacientes que padecen distrofia endotelial de Fuchs (DEF).MétodosEl V-FUCHS consta de 15 preguntas, que valoran aspectos visuales de la calidad de vida en los pacientes con DEF, las cuales se pueden agrupar en 7 que valoran el factor «dificultad visual» y 8 que valoran el factor «deslumbramiento». Para la traducción y adaptación se siguieron las normas estandarizadas, destacando, una traducción, una retro-traducción y una aplicación en pacientes con DEF.ResultadosEn una primera fase se llegó al consenso de la traducción al castellano del V-FUCHS. Posteriormente, se incluyeron 25 pacientes para realizar la fase pre-test con el objetivo de valorar la aplicabilidad y la viabilidad del test. La puntuación de las mismas obtuvo un valor mínimo de −0,88 y un valor máximo de +2,44, según la escala probabilística de Rasch. El valor medio obtenido de las preguntas que conforman el factor dificultad visual fue de 0,61 (±0,71) y la media del factor deslumbramiento (Glare) fue de 0,41 (±0,51).ConclusiónLa validación del cuestionario V-FUCHS, tras su traducción y adaptación al castellano, demostró ser una herramienta útil para la valoración de la calidad visual de los pacientes con DEF. Los pacientes con un estado más avanzado de la enfermedad presentaron una mayor severidad en el resultado de la prueba. Asimismo, el factor deslumbramiento se correlaciona mejor con el aumento paquimétrico que con la agudeza visual del paciente. (AU)


Purpose: To translate and validate the V-FUCHS questionnaire into Spanish in a population of patients with Fuchs endothelial dystrophy (DEF).MethodsThe V-FUCHS consists of 15 short, easily understandable questions that assess visual aspects of quality of life in patients with DEF, which can be gathered into a group of seven that assess the “Visual Difficulty” factor and another group of eight that assess the “Glare Factor”. For the translation and cultural adaptation, the standardized norms for this process were followed, among other phases, a translation, a back-translation and an application in patients with DEF.ResultsIn the first phase, consensus was reached on the Spanish translation of the V-FUCHS. Subsequently, 25 patients were included to carry out the pre-test phase with the aim of assessing the applicability and feasibility of the test. The score obtained a minimum value of −0.88 and a maximum value of +2.44, according to the Rasch probabilistic scale. The mean value obtained from the Visual Difficulty factor was 0.61 (±0.71), while the mean for the Glare factor was 0.41 (±0.51).ConclusionThe validation of the V-FUCHS questionnaire, after its translation and adaptation into Spanish, proved to be a useful tool for assessing the visual quality of patients with DEF. Patients with a more advanced stage of the disease presented a greater severity in the test result. Likewise, the Glare factor (Glare) correlates better with the pachymetric increase than with the visual acuity of the patient. (AU)


Assuntos
Humanos , Córnea , Distrofia Endotelial de Fuchs , Nível de Saúde , Qualidade de Vida , Inquéritos e Questionários
6.
Arch Soc Esp Oftalmol (Engl Ed) ; 99(1): 9-15, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37944642

RESUMO

PURPOSE: To translate and validate the V-FUCHS questionnaire into Spanish in a population of patients with Fuchs endothelial dystrophy (DEF). METHODS: The V-FUCHS consists of 15 short, easily understandable questions that assess visual aspects of quality of life in patients with DEF, which can be gathered into a group of seven that assess the "Visual Difficulty" factor and another group of eight that assess the "Glare Factor". For the translation and cultural adaptation, the standardized norms for this process were followed, among other phases, a translation, a back-translation and an application in patients with DEF. RESULTS: In the first phase, consensus was reached on the Spanish translation of the V-FUCHS. Subsequently, 25 patients were included to carry out the pre-test phase with the aim of assessing the applicability and feasibility of the test. The score obtained a minimum value of -0.88 and a maximum value of +2.44, according to the Rasch probabilistic scale. The mean value obtained from the Visual Difficulty factor was 0.61 (±0.71), while the mean for the Glare Factor was 0.41 (±0.51). CONCLUSION: The validation of the V-FUCHS questionnaire, after its translation and adaptation into Spanish, proved to be a useful tool for assessing the visual quality of patients with DEF. Patients with a more advanced stage of the disease presented a greater severity in the test result. Likewise, the Glare Factor (Glare) correlates better with the pachymetric increase than with the visual acuity of the patient.


Assuntos
Distrofia Endotelial de Fuchs , Qualidade de Vida , Humanos , Córnea , Nível de Saúde , Inquéritos e Questionários , Idioma
7.
Theriogenology ; 215: 50-57, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38006855

RESUMO

The aim of this work was to assess the antioxidant status and the developmental competence of oocytes recovered by ovum pick-up (OPU) in Italian Mediterranean buffaloes supplemented with green tea extracts (GTE) for 90 days. Buffalo cows (n = 16) were randomly assigned to a control group receiving no supplement and a treatment group, receiving GTE starting 90 days before OPU, carried out for five consecutive sessions. Blood samples were collected before the start of supplementation with GTE (T0) and at day 45 (T1) and day 90 (T2) of supplementation, to measure ferric reducing activity (FRAP), total antioxidant capacity (TAC), superoxide dismutase (SOD) and catalase (CAT). The antioxidant status of follicles was measured as TAC on the follicular fluid collected from the dominant follicle just prior OPU, coinciding with T2, and at the end of five repeated OPU sessions (T3). Another objective was to assess in vitro the protective effects of green tea extracts on hepatic cells exposed to methanol insult. Different concentrations of GTE (0.5 µM and 1 µM) were tested on cultured hepatic cells and viability, morphology and SOD activity were assessed at 24, 48 and 72 h. Supplementation with GTE increased (P < 0.05) the number of total follicles (8.7 ± 0.5 vs 6.9 ± 0.5), the number and the percentage of Grade A + B cumulus-oocyte complexes (COCs) compared with the control (3.7 ± 0.4 vs 2.3 ± 0.3 and 57.5 ± 4.2 vs 40.4 ± 4.9 %, respectively). Oocyte developmental competence was improved in the GTE group as indicated by the higher (P < 0.05) percentages of Grade 1,2 blastocysts (44.8 vs 29.1 %). In the GTE group, plasma TAC was higher both at T1 and T2, while FRAP increased only at T2, with no differences in SOD and CAT. The TAC of follicular fluid was higher (P < 0.05) in the GTE compared to the control both at T2 and at T3 The in vitro experiment showed that co-treatment with methanol and 1 µM GTE increased (p < 0.01) cell viability at 24 h (P < 0.01), 48 h (P < 0.05) and 72 h (P < 0.01) compared with the methanol treatment co-treatment with 1 µM GTE prevented the decrease in SOD activity observed with methanol at 24 and 48 h of culture. In conclusion, the results of in vivo and in vitro experiments suggest that supplementation with GTE increases buffalo oocyte developmental competence, by improving oxidative status and liver function.


Assuntos
Antioxidantes , Bison , Feminino , Bovinos , Animais , Antioxidantes/farmacologia , Búfalos , Metanol , Oócitos , Suplementos Nutricionais , Ferro , Chá , Superóxido Dismutase , Itália
8.
Semergen ; 50(1): 102088, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-37827046

RESUMO

INTRODUCTION: Countering HIV infection remains a primary objective of the Spanish National Health System. Emergency services play a crucial role in reducing missed diagnostic opportunities, with estimates suggesting that one in 3 such opportunities occur here. The aim of the study is to examine the geographical dispersion of newly diagnosed HIV cases, within a downtown Madrid hospital. METHODS: This is an observational, descriptive, retrospective study evaluating the geographical distribution of new HIV diagnoses in the care area of a tertiary University Hospital in the Community of Madrid. RESULTS: Three hundred and eighty-seven individuals with a new diagnosis of HIV infection between 2018 and 2020 were analysed, the majority being young people with an average age of 36±9 years. 86% were gay, bisexual and other men who have sex with men and 48.6% were immigrants. 15.3% presented with CD4+<200cells/mm3 and 9.5% with an AIDS-defining illness. 32.7% and 5.1% had an RNA-HIV-1>100,000copies/mL and >500,000copies/mL, respectively, with up to 13.7% of subjects presenting resistance mutations at diagnosis. Geographically, 51.4% of individuals came from 4 Health Centres and more than 70% of the new diagnoses were included in nine Health Centres. CONCLUSION: Better understanding the geographical distribution of new HIV diagnoses by health areas allows us to identify areas of higher transmission risk, thereby directing and implementing prevention, early diagnosis, and treatment measures.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Masculino , Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Estudos Retrospectivos , Centros de Atenção Terciária , Atenção à Saúde , Demografia
9.
Rev Neurol ; 77(10): 229-239, 2023 11 16.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37962534

RESUMO

INTRODUCTION: Headache is a frequent symptom at the acute phase of coronavirus disease 2019 (COVID-19) and also one of the most frequent adverse effects following vaccination. In both cases, headache pathophysiology seems linked to the host immune response and could have similarities. We aimed to compare the clinical phenotype and the frequency and associated onset symptoms in patients with COVID-19 related-headache and COVID-19 vaccine related-headache. SUBJECTS AND METHODS: A case-control study was conducted. Patients with confirmed COVID-19 infection and COVID-19-vaccine recipients who experienced new-onset headache were included. A standardised questionnaire was administered, including demographic variables, prior history of headaches, associated symptoms and headache-related variables. Both groups were matched for age, sex, and prior history of headache. A multivariate regression analysis was performed. RESULTS: A total of 238 patients fulfilled eligibility criteria (143 patients with COVID-19 related-headache and 95 subjects experiencing COVID-19 vaccine related-headache). Patients with COVID-19 related-headache exhibited a higher frequency of arthralgia, diarrhoea, dyspnoea, chest pain, expectoration, anosmia, myalgia, odynophagia, rhinorrhoea, cough, and dysgeusia. Further, patients with COVID-19 related-headache had a more prolonged daily duration of headache and described the headache as the worst headache ever experienced. Patients with COVID-19 vaccine-related headache, experienced more frequently pain in the parietal region, phonophobia, and worsening of the headache by head movements or eye movements. CONCLUSION: Headache caused by SARS-CoV-2 infection and COVID-19 vaccination related-headache have more similarities than differences, supporting a shared pathophysiology, and the activation of the innate immune response. The main differences were related to associated symptoms.


TITLE: Diferencias y similitudes entre la cefalea relacionada con la COVID-19 y la cefalea relacionada con la vacuna de la COVID-19. Un estudio de casos y controles.Introducción. La cefalea es un síntoma frecuente en la fase aguda de la enfermedad por coronavirus 2019 (COVID-19) y también uno de los efectos adversos más comunes tras la vacunación. En ambos casos, la fisiopatología de la cefalea parece estar relacionada con la respuesta inmunitaria del huésped y podría presentar similitudes. Nuestro objetivo fue comparar el fenotipo clínico y la frecuencia de los síntomas asociados y los síntomas de inicio en pacientes con cefalea relacionada con la COVID-19 y cefalea relacionada con la vacuna de la COVID-19. Sujetos y métodos. Se realizó un estudio de casos y controles. Se incluyó a pacientes con infección confirmada por COVID-19 y receptores de la vacuna de la COVID-19 que experimentaron un nuevo inicio de cefalea. Se administró un cuestionario estandarizado que incluyó variables demográficas, antecedentes previos de cefaleas, síntomas asociados y variables relacionadas con la cefalea. Ambos grupos se emparejaron por edad, sexo y antecedentes previos de cefaleas. Se realizó un análisis de regresión multivariante. Resultados. Un total de 238 pacientes cumplieron con los criterios de elegibilidad (143 pacientes con cefalea relacionada con la COVID-19 y 95 sujetos con cefalea relacionada con la vacuna de la COVID-19). Los pacientes con cefalea relacionada con la COVID-19 presentaron una mayor frecuencia de artralgia, diarrea, disnea, dolor torácico, expectoración, anosmia, mialgia, odinofagia, rinorrea, tos y disgeusia. Además, los pacientes con cefalea relacionada con la COVID-19 experimentaron una duración diaria más prolongada de la cefalea y describieron la cefalea como la peor que habían experimentado. Los pacientes con cefalea relacionada con la vacuna de la COVID-19 experimentaron con más frecuencia dolor en la región parietal, fonofobia y empeoramiento de la cefalea por movimientos de la cabeza o de los ojos. Conclusión. La cefalea causada por la infección por el SARS-CoV-2 y la cefalea relacionada con la vacunación de la COVID-19 presentan más similitudes que diferencias, lo que respalda una fisiopatología compartida y la activación de la respuesta inmunitaria innata. Las principales diferencias estuvieron relacionadas con los síntomas asociados.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Vacinas contra COVID-19/efeitos adversos , COVID-19/complicações , Estudos de Casos e Controles , SARS-CoV-2 , Cefaleia/induzido quimicamente , Cefaleia/epidemiologia , Dor no Peito
10.
Sci Rep ; 13(1): 20606, 2023 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-37996442

RESUMO

The care-kill response determines whether a sick individual will be treated or eliminated from an insect society, but little is known about the physiological underpinnings of this process. We exploited the stepwise infection dynamics of an entomopathogenic fungus in a termite to explore how care-kill transitions occur, and identify the chemical cues behind these shifts. We found collective responses towards pathogen-injected individuals to vary according to severity and timing of pathogen challenge, with elimination, via cannibalism, occurring sooner in response to a severe active infection. However, injection with inactivated fungal blastospores also resulted in increased albeit delayed cannibalism, even though it did not universally cause host death. This indicates that the decision to eliminate an individual is triggered before pathogen viability or terminal disease status has been established. We then compared the surface chemistry of differently challenged individuals, finding increased amounts of long-chained methyl-branched alkanes with similar branching patterns in individuals injected with both dead and viable fungal blastospores, with the latter showing the largest increase. This coincided with the highest amounts of observed cannibalism as well as signs of severe moribundity. Our study provides new mechanistic insight into the emergent collective behaviors involved in the disease defense of a termite society.


Assuntos
Isópteros , Humanos , Animais , Isópteros/fisiologia , Canibalismo
12.
BMC Prim Care ; 24(1): 220, 2023 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-37880601

RESUMO

BACKGROUND: Social Prescribing is a Primary Health Care service that provides people with non-clinical care alternatives that may have an impact on their health. Social Prescribing can be more or less formal and structured. Social Prescribing Schemes are formal Social Prescribing of health assets by Primary Health Care teams in coordination and follow-up of patients with providers. The emerging evidence suggests that this service can improve people's health and well-being, create value and provide sustainability for the healthcare system. However, some evaluations note that the current evidence regarding social prescribing is insufficient and needs further investigation. The EvaLRA project aims to elaborate an evaluation model of Social Prescribing Schemes in Primary Health Care based on a set of structure, process, and outcomes indicators. METHODS: In the region of Aragon, the Community Health Care Strategy aims to promote the development of social prescription schemes in Primary Health Care teams. This study is divided into two stages. Stage 1: identification of primary health care teams that implement social prescribing schemes and establish a first set of indicators to evaluate social prescribing using qualitative consensus techniques with experts. Stage 2 evaluation of the relevance, feasibility and sensitivity of selected indicators after 6 and 12 months in primary health care teams. The results will provide a set of indicators considering structure, process and outcomes for social prescribing schemes. DISCUSSION: Current evaluations of the application of social prescribing schemes use different criteria and indicators. A set of agreed indicators and its piloting in primary health care teams will provide a tool to evaluate the implementation of social prescription schemes. In addition, the scorecard created could be of interest to other health systems in order to assess the service and improve its information system, deployment and safety.


Assuntos
Prescrições , Atenção Primária à Saúde , Humanos , Espanha , Serviços de Saúde Comunitária , Pesquisa Qualitativa
13.
Mar Pollut Bull ; 196: 115638, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37839132

RESUMO

We studied the depuration mechanisms of metals (Cd, Cu, Pb, Zn, Mn, Ni, Cr, Fe) in Neohelice granulata, from sites with different human impacts (PC, a more impacted site and VM, a less impacted one). Our objectives included assessing metal concentrations (essential and non-essential) before and after depuration treatment, evaluating biochemical biomarkers (non-enzymatic and enzymatic) pre and post-treatment, and determining the role of metal-rich granules (MRG) in depuration. We observed variability in metals and biomarkers post-depuration, with no significant differences observed in PC, while Cd and Mn increased and Ni, Cu, and Fe decreased in VM. Integrated biomarkers' response indicated the prevailing antioxidant capacity in depurated organisms. Lipid peroxidation changes were insignificant, except in depurated-VM where values increased. MRG showed a significant decrease only for Mn and Fe, suggesting they were not the primary depuration structure. We concluded that depuration might depend on the species, gender and contamination history.


Assuntos
Braquiúros , Metais Pesados , Poluentes Químicos da Água , Animais , Humanos , Metais Pesados/análise , Braquiúros/química , Cádmio , Bioacumulação , Poluentes Químicos da Água/análise , Monitoramento Ambiental , Biomarcadores
14.
Curr Opin Microbiol ; 75: 102368, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37677865

RESUMO

Infections that involve interkingdom microbial communities, such as those between bacteria and yeast pathogens, are difficult to treat, associated with worse patient outcomes, and may be a source of antimicrobial resistance. In this review, we address co-occurrence and co-infections of Candida albicans and Pseudomonas aeruginosa, two pathogens that occupy multiple infection niches in the human body, especially in immunocompromised patients. The interaction between the pathogen species influences microbe-host interactions, the effectiveness of antimicrobials and even infection outcomes, and may thus require adapted treatment strategies. However, the molecular details of bacteria-fungal interactions both inside and outside the infection sites, are insufficiently characterised. We argue that comprehensively understanding the P. aeruginosa-C. albicans interaction network through integrated systems biology approaches will capture the highly dynamic and complex nature of these polymicrobial infections and lead to a more comprehensive understanding of clinical observations such as reshaped immune defences and low antimicrobial treatment efficacy.


Assuntos
Anti-Infecciosos , Coinfecção , Humanos , Candida albicans , Pseudomonas aeruginosa/genética , Interações entre Hospedeiro e Microrganismos
15.
Arch. Soc. Esp. Oftalmol ; 98(9): 507-520, sept. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-224812

RESUMO

La cirugía de cristalino transparente (RLE) permite corregir las ametropías y la presbicia mediante el reemplazo del cristalino por una lente intraocular (LIO), ya sea monofocal, multifocal (MIOL) o de profundidad de foco extendida (EDOF). El desprendimiento de retina (DR) es uno de los eventos adversos más graves tras la RLE. El objetivo de este estudio fue revisar la evidencia y los resultados clínicos relacionados con el riesgo de DR después de la RLE. Se realizó una búsqueda utilizando PubMed y un procedimiento de bola de nieve para identificar estudios originales y series de casos. Según la bibliografía, los pacientes < 60 años con longitudes axiales > 23 mm tienen el mayor riesgo de DR. Solo nueve artículos reportaron la agudeza visual (AV) tras el DR en RLE, y solo 25% de los ojos mostraron una AV > 20/40. Teniendo en cuenta que la disminución de la AV tras el DR se puede dar con todos los tipos de LIO independientemente de su diseño óptico, la actitud más acertada al realizar una RLE sería una cuidadosa selección del paciente, evitando aquellos ojos con factores de riesgo para DR (AU)


Refractive lens exchange (RLE) allows to correct ametropias and presbyopia by replacing the crystalline lens with a monofocal, extended depth of focus or multifocal intraocular lens (IOL). Retinal detachment (RD) is one of the most serious adverse events after RLE. This study aimed to review the evidence related to the risk of RD after RLE and its clinical outcomes. A search using PubMed and a snowball search approach was conducted to identify articles and case reports. According to the literature, patients <60 years old with axial lengths >23 mm have the higher postoperative risk of RD. Only nine articles reported visual acuity (VA) after RD in RLE, and only 25% of eyes had a VA>20/40. Considering that the decrease in VA might be uniform for all types of IOLs after RD, surgeons should focus on preventing the RD by means of selecting the appropriate patient, rather than choosing on a particular IOL optical design (AU)


Assuntos
Humanos , Implante de Lente Intraocular/efeitos adversos , Descolamento Retiniano/etiologia , Lentes Intraoculares Multifocais , Acuidade Visual
16.
Brain Behav Immun Health ; 30: 100643, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37304334

RESUMO

Background: Depression is associated with a reduced sensitivity to rewards and low reward-related brain function in cortico-striatal circuitry. A separate literature documents elevated peripheral inflammation in depression. Recently, integrated reward-inflammation models of depression have been proposed. These models draw on work indicating that peripheral inflammatory proteins access the brain, where they lower reward responsiveness. This blunted reward responsiveness is proposed to initiate unhealthy behaviors (substance use, poor diet), as well as sleep disruption and stress generation, which further heighten inflammation. Over time, dysregulation in reward responsiveness and immune signaling may synergize in a positive feedback loop, whereby dysregulation in each system exacerbates dysregulation in the other. Project RISE (Reward and Immune Systems in Emotion) provides a first systematic test of reward-immune dysregulation as a synergistic and dynamic vulnerability for first onset of major depressive disorder and increases in depressive symptoms during adolescence. Methods: This NIMH-funded R01 study is a 3-year prospective, longitudinal investigation of approximately 300 community adolescents from the broader Philadelphia area, United States of America. Eligible participants must be 13-16 years old, fluent in English, and without a prior major depressive disorder. They are being selected along the entire dimension of self-reported reward responsiveness, with oversampling at the low tail of the dimension in order to increase the likelihood of major depression onsets. At Time 1 (T1), T3, and T5, each a year apart, participants complete blood draws to quantify biomarkers of low-grade inflammation, self-report and behavioral measures of reward responsiveness, and fMRI scans of reward neural activity and functional connectivity. At T1-T5 (with T2 and T4 six months between the yearly sessions), participants also complete diagnostic interviews and measures of depressive symptoms, reward-relevant life events, and behaviors that increase inflammation. Adversity history is assessed at T1 only. Discussion: This study is an innovative integration of research on multi-organ systems involved in reward and inflammatory signaling in understanding first onset of major depression in adolescence. It has the potential to facilitate novel neuroimmune and behavioral interventions to treat, and ideally prevent, depression.

17.
Arch Soc Esp Oftalmol (Engl Ed) ; 98(9): 507-520, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37364678

RESUMO

Refractive lens exchange (RLE) allows to correct ametropias and presbyopia by replacing the crystalline lens with an extended depth of focus or multifocal intraocular lens (IOL). Retinal detachment (RD) is one of the most serious adverse events after RLE. This study aimed to review the evidence related to the risk of RD after RLE and clinical outcomes. A search using PubMed and a snowball search approach was conducted to identify articles and case reports. According to the literature, the risks of RD should be considered in patients <60 years old with axial lengths >23 mm. Only nine articles reported visual acuity (VA) after RD in RLE, and only 25% of eyes had a VA > 20/40. Considering that the decrease in VA might be uniform for all types of IOLs after RD, surgeons should focus on selecting the patient to prevent RD rather than on a particular IOL optical design based on the potential risk of DR.


Assuntos
Lentes Intraoculares , Lentes Intraoculares Multifocais , Descolamento Retiniano , Humanos , Pessoa de Meia-Idade , Lentes Intraoculares/efeitos adversos , Descolamento Retiniano/etiologia , Implante de Lente Intraocular/efeitos adversos , Acuidade Visual
18.
Psychiatr Clin North Am ; 46(2): 391-401, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37149352

RESUMO

Increased awareness of the growing disease burden of treatment resistant depression (TRD), in combination with technological advances in MRI, affords the unique opportunity to research biomarkers that characterize TRD. We provide a narrative review of MRI studies investigating brain features associated with treatment-resistance and treatment outcome in those with TRD. Despite heterogeneity in methods and outcomes, relatively consistent findings include reduced gray matter volume in cortical regions and reduced white matter structural integrity in those with TRD. Alterations in resting state functional connectivity of the default mode network were also found. Larger studies with prospective designs are warranted.


Assuntos
Transtorno Depressivo Resistente a Tratamento , Humanos , Transtorno Depressivo Resistente a Tratamento/diagnóstico por imagem , Transtorno Depressivo Resistente a Tratamento/tratamento farmacológico , Depressão , Mapeamento Encefálico , Encéfalo , Imageamento por Ressonância Magnética
19.
AIDS Care ; 35(8): 1100-1106, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37182222

RESUMO

Gundo-So is a community-based programme developed by and for women living with HIV (WLHIV) in Mali through the ARCAD-Santé-PLUS association. It provides support, co-constructed with WLHIV, to develop strategies on whether or not to disclose their status. The aim of the ANRS-12373 research is to evaluate the impact of this programme in the short and medium term. As part of this research, semi-structured interviews were conducted with participants (14). These interviews were analysed thematically. Three themes are presented here: positive feedback from the programme, which enabled them to be listened to and supported them both psychologically and financially. The impact of the programme on the participants' social network is also described, in terms of the links made with peers met during the programme. Finally, a new perspective on issues such as disease management, which improved through the contribution of knowledge, and also through the development of psychosocial resources. The programme enabled participants to acquire psychosocial skills, the ability to effectively self-manage their condition, and strategies on whether or not to disclose their HIV status. Participants' empowerment and social support in relation to the disease were developed through the programme, particularly through the links created with other women living with HIV.


Assuntos
Infecções por HIV , Humanos , Feminino , Infecções por HIV/terapia , Infecções por HIV/psicologia , Mali , Apoio Social , Empoderamento
20.
Neurosci Biobehav Rev ; 150: 105162, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37028579

RESUMO

Elevated inflammation is a risk factor for many psychiatric (e.g., depression) and somatic conditions (e.g., rheumatoid arthritis). Inflammation is influenced by psychosocial processes such as emotion regulation. Characterization of which emotion regulation characteristics impact inflammation could help refine psychosocial interventions aimed at normalizing health-harming inflammatory activity for individuals with psychiatric and somatic illnesses. To investigate this issue, we systematically reviewed the literature on associations between a variety of emotion regulation traits and inflammation. Out of 2816 articles identified, 38 were included in the final review. 28 (74%) found that (a) poor emotion regulation is associated with higher inflammation and/or (b) strong emotion regulation skills are associated with lower inflammation. Consistency of results differed as a function of the emotion regulation construct investigated and methodological characteristics. Results were most consistent for studies testing positive coping/social support seeking or broadly defined emotion regulation/dysregulation. Methodologically, studies testing reactivity to a stressor, adopting a vulnerability-stress framework, or using longitudinal data were most consistent. Implications for integrated, transdiagnostic psychoimmunological theories are discussed, as well as recommendations for clinical research.


Assuntos
Regulação Emocional , Emoções , Humanos , Emoções/fisiologia , Inflamação , Fatores de Risco , Fenótipo
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