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1.
Front Genet ; 15: 1278201, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38645486

RESUMO

The high prevalence of obesity in Mexico starting from the early stages of life is concerning and represents a major public health problem. Genetic association studies have reported that single nucleotide variants (SNVs) in SIRT1, an NAD+-dependent deacetylase that plays an important role in the regulation of metabolic cellular functions, are associated with multiple metabolic disorders and the risk of obesity. In the present study, we analyzed the effect that the SNVs rs1467568 and rs7895833 of the SIRT1 gene may have on cardiometabolic risk factors in a young adult population from Mexico. A cross-sectional study was carried out with young adults between the ages of 18 and 25 who had a body mass index (BMI) greater than 18.5 kg/m2. This study included 1122 young adults who were classified into the normal weight (n = 731), overweight group (n = 277), and obesity group (n = 114) according to BMI of whom 405 and 404 volunteers were genotyped for rs1467568 and rs7895833 respectively using TaqMan probes through allelic discrimination assays. We found that the male sex carrying the G allele of rs7895833 had slightly lower BMI levels (p = 0.009). Furthermore, subjects carrying rs1467568 (G allele) showed a 34% lower probability of presenting with hyperbetalipoproteinemia where female carrying rs1467568 had lower levels of total cholesterol (p = 0.030), triglycerides (p = 0.026) and LDL cholesterol (p = 0.013). In conclusion, these findings suggest that the presence of both SNVs could have a non-risk effect against dyslipidemia in the Mexican population.

2.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38246346

RESUMO

PURPOSE: The aim of this study is to assess the time to return to work (TRW) in patients undergoing trapezial resection using the Mini TightRope® system at our center and to investigate factors that might delay return to work following this surgery. MATERIAL AND METHODS: A retrospective study was conducted on patients who underwent Trapezial resection and suspensionplasty using the Mini TightRope® system between 2015 and 2016, with a minimum one-year follow-up. Telephone interviews were conducted along with a review of medical records and radiology reports, as well as temporary work disability documents, collecting epidemiological and occupational data. Groups were compared based on age, gender, dominant hand, biomechanical occupational requirements of the patients, and whether they had experienced prior temporary work disability. RESULTS: A total of 36 patients (29 women and 7 men) with an average age of 55.7 years were included. The median time to return to work was 126 days. Self-employed workers re-entered the workforce 72 days earlier on average; workers who had experienced prior temporary work disability had a greater total temporary work disability duration and took 91 days longer to return to work compared to those who had not. CONCLUSIONS: Patients employed by others and those who had experienced prior temporary work disability before the surgery had longer temporary work disability periods. In our study, no differences were observed based on gender, dominant hand, or biomechanical work demands of the intervened patients.

4.
Fisioterapia (Madr., Ed. impr.) ; 45(4): 188-197, jul.- ago. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-222303

RESUMO

Introducción El método Kabat sostiene que el sincronismo normal se produce de distal a proximal, lo cual requiere evidencia electromiográfica. Objetivo Describir el sincronismo muscular de patrones motores de miembros superiores descritos por Kabat, en posiciones sedente y supina, a partir de la medición de la latencia al inicio del pico de la máxima activación electromiográfica (IPMA-EMG) de músculos seleccionados. Material y métodos Se realizó un estudio analítico comparativo. Se evaluó a 20 hombres y 20 mujeres entre 19 y 26 años. Cada participante realizó 3repeticiones activas sin resistencia externa de cada uno de los patrones de movimiento (flexor y extensor) de las 2diagonales. Se registró la latencia del IPMA-EMG para cada uno de los 8músculos evaluados en los 4patrones de movimiento, tanto en supino como en sedente. Estos se promediaron y se ordenaron de menor a mayor para obtener la secuencia de contracciones musculares en cada patrón de movimiento. Se compararon las secuencias obtenidas para cada patrón en sedente y supino y se valoró la existencia de correlaciones entre ellas. Resultados Se observó correlación significativa en las secuencias del IPMA-EMG entre posiciones supina y sedente, en todos los patrones de movimiento (p<0,05), excepto en el patrón extensor de la primera diagonal (p=0,139). No hubo diferencias estadísticamente significativas entre posiciones en ninguno de los patrones (p>0,05). Conclusiones Aunque con variaciones en la IPMA-EMG, se halló, en general, un sincronismo muscular de proximal a distal, más evidenciado en la posición sedente y en los patrones flexores (AU)


Introduction The Kabat method argues that normal synchronism occurs from distal to proximal, which requires electromyographic evidence. Objective To describe the muscular timing of motor patterns of the upper limbs described by Kabat, in seated and supine positions, from the measurement of the latency at the beginning of the peak of the maximum electromyographic activation (BPM-EMG-A) of selected muscles. Material and methods A comparative analytical study was carried out. Twenty men and 20 women between 19 and 26 years old were evaluated. Each participant performed 3active repetitions without external resistance of each of the movement patterns (flexor and extensor) of the 2diagonals. BPM-EMG-A latency was recorded for each of the 8muscles tested in the 4movement patterns, both supine and seated. These were averaged and ordered from lowest to highest to obtain the sequence of muscle contractions in each movement pattern. The sequences obtained for each pattern in seated and supine were compared and the existence of correlations between them was assessed. Results Significant correlation was observed in the BPM-EMG-A sequences between supine and seated positions, in all movement patterns (P<0.05), except in the extensor pattern of the first diagonal (P=0.139). There were no statistically significant differences between positions in any of the patterns (P>0.05). Conclusion Although with variations in BPM-EMG-A, muscle timing was generally found from proximal to distal, more evident in the sitting position and in flexor patterns (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Técnicas de Exercício e de Movimento/métodos , Contração Muscular/fisiologia , Propriocepção/fisiologia , Braço/fisiologia , Eletromiografia
5.
Ultrasound Obstet Gynecol ; 62(6): 882-890, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37448172

RESUMO

OBJECTIVES: There is a paucity of literature providing evidence-based guidelines for the management of large placental chorioangioma (≥ 4 cm in diameter). The objectives of this study were to compare outcomes between patients managed expectantly and those undergoing in-utero intervention and to describe the different in-utero techniques used for cessation of blood flow to the tumor and the associated outcome. METHODS: This was a retrospective cohort study of 34 patients referred for the management of large placental chorioangioma in a single center between January 2011 and December 2022, who were managed expectantly or underwent in-utero intervention. In-utero intervention was performed when the fetus developed any signs of impending compromise, including high combined cardiac output (CCO), worsening polyhydramnios or abnormal fetal Doppler velocimetry findings. Interventions included radiofrequency ablation (RFA), interstitial laser ablation (ILA) and single-port or two-port fetoscopic laser photocoagulation (FLP). Treatment selection was dependent on the proximity of the tumor to the umbilical cord insertion (UCI) and placental location. The two-port technique was performed in patients with a chorioangioma with large feeding vessels (≥ 3 mm) located in the posterior placenta, in which one port was used for occlusion using bipolar forceps and the other port was used for laser photocoagulation of the feeding vessels downstream. The single-port technique was used for chorioangioma with small feeding vessels (< 3 mm) located in the posterior placenta. ILA or RFA was performed in cases with an anterior placenta. Supportive treatments, including amnioreduction and intrauterine transfusion (IUT), were performed for worsening polyhydramnios and suspected fetal anemia based on middle cerebral artery Doppler flow studies, respectively. Comparative statistical analysis between cases undergoing expectant management vs in-utero intervention was performed. Descriptive details were provided for patients who underwent in-utero intervention. RESULTS: Thirty-four cases of large chorioangioma were evaluated, of which 25 (73.5%) were managed expectantly and nine (26.5%) underwent intervention. The frequency of polyhydramnios was significantly higher in the intervention group compared with the expectant-management group (66.7% vs 8.0%, P < 0.001). The live-birth rate among expectantly managed cases with large chorioangioma was significantly higher compared with that in cases that underwent in-utero intervention (96.0% vs 62.5%, P = 0.01). In the intervention group, preoperative CCO was elevated in all cases with available information and preoperative hydrops was present in 33.3% (3/9) of cases. One patient experienced fetal demise following IUT prior to planned FLP. Among the remaining eight patients, four underwent two-port FLP, two underwent single-port FLP, one underwent ILA and one underwent both ILA and RFA. All three cases in which hydrops was present at the time of intervention resulted in fetal demise. CONCLUSIONS: In-utero interventions aimed at cessation of blood flow in the feeding vessels are a therapeutic option for the management of cases with large chorioangioma. The two-port percutaneous technique appears to improve the efficiency of FLP when a large chorioangioma with large feeding vessels is located in the posterior placenta. We propose that in-utero interventions for large chorioangioma should be initiated prior to the development of fetal hydrops. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Hemangioma , Doenças Placentárias , Poli-Hidrâmnios , Gravidez , Humanos , Feminino , Placenta/cirurgia , Placenta/patologia , Poli-Hidrâmnios/etiologia , Poli-Hidrâmnios/patologia , Estudos Retrospectivos , Doenças Placentárias/diagnóstico por imagem , Doenças Placentárias/cirurgia , Morte Fetal , Lasers , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Edema
6.
Braz J Biol ; 84: e271624, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37311126

RESUMO

Among the different handling techniques in aquaculture, the use of anesthetics has had a growing interest focused on guaranteeing animal welfare, and reducing possible stress situations during general handling. The aim of this study was to present the use of eugenol and lidocaine with non-invasive anesthesia procedures in Dormitator latifrons, in which the different stages of anesthesia (induction and recovery) were determined. One hundred and twenty healthy fish of average weight of 73.59 ± 13.53 g and standard length of 17 ± 1.36 cm were used. The experimental fish were subjected to fasting for 24 h prior to the tests. Five fish were subjected to eugenol (25, 50, 100, and 200 µL/L), and lidocaine (100, 200, 300, and 400 mg/L), in triplicate. The time to reach deep and recovery anesthesia were recorded and the data analyzed using ANOVA (α= 0.05). Organisms exposed to anesthetics evidenced early episodes of fast, short-distance swimming (initial hyperactivity) for short periods of time. Survival was 100% with both compounds and concentrations. Fish exposed to a eugenol concentration of 200 µL/L had longer anesthesia times and took longer time to recover (P<0.05). The most effective concentrations for eugenol and lidocaine were of 200 µL/L and 400 µL/L in juvenile fish, promoting rapid inductions, without compromising the conditions for the recovery of the fish. This work provides practical information for handling and transportation D. latiforns with the least possible stress and ensuring animal welfare.


Assuntos
Anestésicos , Perciformes , Animais , Lidocaína/farmacologia , Óleo de Cravo/farmacologia , Eugenol/farmacologia , Anestésicos/farmacologia , Peixes , Sono
7.
Actas urol. esp ; 47(3): 127-139, abr. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-218402

RESUMO

Contexto y objetivo El cáncer de próstata (CP) es la neoplasia maligna con mayor incidencia a nivel mundial después del cáncer de pulmón. El objetivo de este estudio es revisar la literatura para conocer qué métodos permiten mejorar la eficacia de la estrategia actual de diagnóstico precoz del CP clínicamente significativo (csCP), basada en la realización de la resonancia magnética (RM) y biopsias dirigidas cuando se detectan lesiones sospechosas, además de la biopsia sistemática. Adquisición de la evidencia Se realizó una revisión sistemática de la literatura en PubMed, Web of Science y Cochrane según los criterios Preferred reporting items for systematic reviews and meta-analyses (PRISMA), utilizando los términos de búsqueda: RM multiparamétrica, RM biparamétrica, densidad de antígeno prostático específico (PSA), prostate cancer antigen 3 (PCA3), Prostate Health Index (PHI), 4 K score, cáncer de próstata, diagnóstico precoz. Se identificaron 297 referencias y, a través de los criterios de selección Participants, Interventions, Comparisons and Outcomes (PICO), se seleccionaron 21 publicaciones para sintetizar la evidencia. Síntesis de la evidencia Con la consolidación de la RM como prueba de elección el diagnóstico del CP, la densidad de PSA (DPSA) es una herramienta de gran importancia incluyéndose en nomogramas predictores, sin coste añadido. La PSAD y los biomarcadores, en asociación con la RM, ofrecen un poder diagnóstico elevado con un área bajo la curva (ABC) por encima del 0,7. Únicamente, el modelo SHTLM3 integra biomarcadores en la elaboración de un nomograma. Los modelos predictores ofrecen una eficacia constante en las diferentes series, con un ABC superior a 0,8 en asociación con la RM. Conclusiones La eficacia de la RM, para diagnosticar el csCP, se puede mejorar con diferentes parámetros con el objetivo de generar modelos predictivos que apoyen la toma de decisiones (AU)


Background and Objective Prostate cancer (PC) is the malignant neoplasm with the highest incidence after lung cancer worldwide. The objective of this study is to review the literature on the methods that improve the efficacy of the current strategy for the early diagnosis of clinically significant PC (csPC), based on the performance of magnetic resonance imaging (RM) and targeted biopsies when suspicious lesions are detected, in addition to systematic biopsy. Evidence acquisition A systematic literature review was performed in PubMed, Web of Science and Cochrane according to the PRISMA criteria (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), using the search terms: multiparametric magnetic resonance imaging, biparametric magnetic resonance imaging, biomarkers in prostate cancer, prostate cancer y early diagnosis. A total of 297 references were identified and, using the PICO selection criteria, 21 publications were finally selected to synthesize the evidence. Evidence synthesis With the consolidation of MRI as the test of choice for the diagnosis of prostate cancer, the role of PSA density (PSAD) becomes relevant as a predictive tool included in prediction nomograms, without added cost. PSAD and diagnostic markers, combined with MRI, offer a high diagnostic power with an area under curve (AUC) above 0,7. Only the SHTLM3 model integrates markers in the creation of a nomogram. Prediction models also offer consistent efficacy with an AUC greater than 0,8 when associating MRI. Conclusions The efficacy of MRI in clinically significant prostate cancer detection can be improved with different parameters in order to generate predictive models that support decision making (AU)


Assuntos
Humanos , Masculino , Imageamento por Ressonância Magnética , Neoplasias da Próstata/diagnóstico por imagem , Detecção Precoce de Câncer , Sensibilidade e Especificidade
8.
Actas Urol Esp (Engl Ed) ; 47(3): 127-139, 2023 04.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36462603

RESUMO

BACKGROUND AND OBJECTIVE: Prostate cancer (PC) is the malignant neoplasm with the highest incidence after lung cancer worldwide. The objective of this study is to review the literature on the methods that improve the efficacy of the current strategy for the early diagnosis of clinically significant PC (csPC), based on the performance of magnetic resonance imaging (RM) and targeted biopsies when suspicious lesions are detected, in addition to systematic biopsy. EVIDENCE ACQUISITION: A systematic literature review was performed in PubMed, Web of Science and Cochrane according to the PRISMA criteria (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), using the search terms: multiparametric magnetic resonance imaging, biparametric magnetic resonance imaging, biomarkers in prostate cancer, prostate cancer y early diagnosis. A total of 297 references were identified and, using the PICO selection criteria, 21 publications were finally selected to synthesize the evidence. EVIDENCE SYNTHESIS: With the consolidation of MRI as the test of choice for the diagnosis of prostate cancer, the role of PSA density (PSAD) becomes relevant as a predictive tool included in prediction nomograms, without added cost. PSAD and diagnostic markers, combined with MRI, offer a high diagnostic power with an area under curve (AUC) above 0.7. Only the SHTLM3 model integrates markers in the creation of a nomogram. Prediction models also offer consistent efficacy with an AUC greater than 0.8 when associating MRI. CONCLUSIONS: The efficacy of MRI in clinically significant prostate cancer detection can be improved with different parameters in order to generate predictive models that support decision making.


Assuntos
Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética , Neoplasias da Próstata , Humanos , Masculino , Detecção Precoce de Câncer , Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia
9.
Heliyon ; 8(12): e12483, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36568659

RESUMO

Objective: To analyse the COVID-19-related lockdown impact on University workers, to identify groups based on this information, and to study the factors associated with each group. Study design: Cross-sectional study. Methods: A survey was conducted 3.5 weeks after COVID-19-related lockdown in University workers in Spain. Sociodemographic variables, housing, work, health conditions, levels of anxiety, stress and depression (DASS-21), and social support (MSPSS) were collected. A cluster analysis was performed to identify groups depending on the impact of the lockdown. Differences between groups were tested using Chi-square and Mann-Whitney-U tests, and associated factors with binary logistic regression. Results: We identified two groups of workers. "G1: Consequences in the daily life routine" was mainly composed of men, Research and Teaching Personnel (RTP) with more stable professional categories, higher income level, and bigger houses than people in G2. Participants in "G2: Concerns for the current and future well-being" presented worse intensity of pain than before the lockdown, more anxiety, depression, stress and less social support than people in G1. ASP (Administration and Services Personnel) had more risk of belonging to G2 than RTP (OR = 5.863). A higher number of people living at home decreased the risk of being in G2 (OR = 0.439). People with lower pain intensity had less risk of being in G2 (OR = 0.014), and this risk decreased as friends support increased (OR = 0.833). Conclusions: In G1, the consequences were immediately reflected in the stress resulting from changes in their daily work routine. In G2, the concerns were related to their professional future, with worse mental health, greater intensity of pain and less social support.

10.
Nat Metab ; 4(12): 1732-1745, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36443520

RESUMO

High maternal weight is associated with detrimental outcomes in offspring, including increased susceptibility to neurological disorders such as anxiety, depression and communicative disorders. Despite widespread acknowledgement of sex biases in the development of these disorders, few studies have investigated potential sex-biased mechanisms underlying disorder susceptibility. Here, we show that a maternal high-fat diet causes endotoxin accumulation in fetal tissue, and subsequent perinatal inflammation contributes to sex-specific behavioural outcomes in offspring. In male offspring exposed to a maternal high-fat diet, increased macrophage Toll-like receptor 4 signalling results in excess microglial phagocytosis of serotonin (5-HT) neurons in the developing dorsal raphe nucleus, decreasing 5-HT bioavailability in the fetal and adult brains. Bulk sequencing from a large cohort of matched first-trimester human samples reveals sex-specific transcriptome-wide changes in placental and brain tissue in response to maternal triglyceride accumulation (a proxy for dietary fat content). Further, fetal brain 5-HT levels decrease as placental triglycerides increase in male mice and male human samples. These findings uncover a microglia-dependent mechanism through which maternal diet can impact offspring susceptibility for neuropsychiatric disorder development in a sex-specific manner.


Assuntos
Placenta , Serotonina , Gravidez , Masculino , Feminino , Camundongos , Animais , Humanos , Encéfalo , Dieta Hiperlipídica/efeitos adversos , Gorduras na Dieta
11.
Arch. esp. urol. (Ed. impr.) ; 75(6): 507-516, Aug. 28, 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-209630

RESUMO

Objective: Incorporate the immune function as determined by the absolute lymphocyte count (ALC) into the CAPRA-S risk stratification score to determine if predictive values could be improved. Materials and Methods: The clinical pathological findings in the surgical specimen and total PSA were used to define the three CAPRA-S risk groups. One month after surgery and at each follow up total PSA and the ALC were determined, until biochemical failure (BF) or the end of the study period. A cut off value of <1,000 lymphocytes/mm3 was used to define lymphocytopenia (LCP). Each CAPRA-S group was sub-divided based on the presence or absence of LCP. Kaplan-Meier biochemical failure free survival (BFFS) curves and restricted mean biochemical failure free survival times were calculated for each group. Results: 404 patients participated of whom 103 (25.5%) underwent BF. 270 men were CAPRA-S low risk (LR), 89 intermediate risk (IR) and 45 high risk (HR), of whom LCP was found in 22 (8%) of low risk, 24 (27%) of intermediate risk and 17 (38%) of high risk men. LCP was significantly associated with a higher PSA, higher Gleason and CAPRA-S scores and BF. HRs were 1.76 for IR, 2.49 for HR and 1.29 for LCP. Five-year BFFS for men without LCP, LR 93.5%, IR 61% and HR 36%, for those with LCP, LR 55%, IR 25% and HR 6%. All patients with LCP and IR or HR scores relapsed within 6 years. 10 year BFFS for men without LCP were 71% LR, 43% IR and 23% HR, LR with LCP 16%. Men with BF had increasing LCP approximately 18 months before BF. Conclusions: The incorporation of the ALC taken one month after surgery with the CAPRA-S improves risk stratification; decreases in the ALC suggest that BF is occuring. These results need to be confirmed with larger studies (AU)


Objetivo: Establecer el riesgo de recidiva bioquímica(RBQ) basado en la puntuación CAPRA-S (riesgo bajo(RB) , riesgo intermedio (RI) y riesgo alto (RA) y recuentoabsoluto de linfocitos (RAL) ≤1000 por mm3(definidiacomo linfocitipenia LCP).Material y Métodos: Entre 2005 y 2020, se realizaun estudio observacional prospectivo de sujetos con cáncerpróstatico tratado con cirugia. Se registran los hallazgos delespécimen quirúrgico y el PSA para definir la CAPRA-S.Un mes pos-cirugía y durante el seguimiento el PSA y RALfueron determinados hasta la RBQ o final del estudio. Seconstruye un modelo de supervivencia flexible paramétrico(FP) para predecir la RBQ a 5 años utilizando la puntuaciónCAPRA-S y la LCP. Se evalúan mediante regresión localponderada mediciones repetidas de los RAL y el tiempo aRBQ o fin del estudio.Resultados: De los 404 participantes observaron 103(25,5%) RBQ. Puntajes de la CAPRA-S: 270 RB, 89 RI y45 RA. La LCP estaba asociada con niveles elevados delPSA, puntuación Gleason, márgenes comprometidos, extensión extracapsular, invasión de vesículas seminales ynodos linfáticos. El modelo FP incorporo en forma independiente y significativa ( coeficiente con valor P<0,01) laLCP ( 1,29), RA (2,49), RI (1,76) y RB (1); mostrando unaC de Harrell de 0,81 con adecuada validez. la media restringida en años (MR) para ocurrencia de RBQ, como lasupervivencia predicha (SP) a 5 años fueron: sin LCP RA(MR: 3,63; SP 42,1%) RI (MR 4,3; SP 63,1%) RB (MR4,83; SP 91,7%) con LCP RA (MR 2,1; SP 4,34%) RI (MR3,14; SP 18,9%) y RB (MR 4,42; SP 73,1%). Los sujetoscon RBQ tuvieron LCP 18 meses previo a la RBQ. LCP más CAPRA-S predicen la RB en sujetos tratado con cirugia (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Estudos Prospectivos , Seguimentos , Medição de Risco , Recidiva Local de Neoplasia , Prostatectomia , Antígeno Prostático Específico/sangue
12.
J Healthc Qual Res ; 37(5): 335-342, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35780057

RESUMO

INTRODUCTION AND OBJECTIVES: The outbreak of COVID-19 has overwhelmed healthcare systems all over the world. The aim of this article is to describe the process of transforming the Vall d'Hebron University Hospital, the second largest hospital in Spain, into a COVID-19 centre coordinating response to the pandemic in its reference area. MATERIALS AND METHODS: The study draws on the experience of the authors in transforming the hospital into a comprehensive resource in response to the COVID-19 pandemic. The strategy is based on four central strategies: early planning, coordination of all healthcare agents in its reference area, definition of clear leadership roles, and the organisation of care based on multidisciplinary teams with minimal recruitment of new staff. RESULTS: The transformation strategy enabled the hospital to cope with the surge in patients without exceeding its capacity. During the response phases, which amounted to a period of 57 days, 3106 patients consulted the ER and 2054 were admitted, 346 of whom were treated at the ICU. To accommodate the number of adult COVID-19 patients, adult ICU availability was progressive increased by 371%, and ordinary beds increased by 240. A total of 671 staff members went on sick leave after testing positive for COVID-19. CONCLUSION: The transformation experience of the hospital provides insight into how effectively adapt the structures and functioning of large hospitals. The relevance of territorial coordination during the pandemic is stressed as an effective strategy that contributed coping the pandemic.


Assuntos
COVID-19 , Adulto , COVID-19/epidemiologia , Hospitais Universitários , Humanos , Pandemias , SARS-CoV-2 , Espanha/epidemiologia
13.
Cureus ; 14(6): e26349, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35903572

RESUMO

Post-traumatic hydrocephalus is common after traumatic brain injury (TBI), particularly following decompressive craniectomy. Cerebrospinal fluid (CSF) removal by lumbar drain (LD) aids in the workup of post-traumatic hydrocephalus and serves as a bridge to definitive CSF diversion. Hemorrhagic complications following LD are rare but can include intracranial hemorrhage. We present a case of fatal brainstem hemorrhage following LD in a patient three months after craniectomy. A 32-year-old male presented with severe TBI and an acute subdural hematoma. He underwent emergent decompressive craniectomy and hematoma evacuation. The next day, he required ventriculostomy for elevated intracranial pressure (ICP), which was able to be successfully removed. Three months after the injury, the patient's neurological exam declined, and computed tomography (CT) findings were consistent with communicating hydrocephalus. An LD was placed with 15 mL of CSF and drained every two hours. Five days after LD placement, the CSF became blood-tinged, and a repeat head CT demonstrated an acute brainstem hemorrhage. The patient ultimately expired. Given the prevalence of post-traumatic hydrocephalus and the frequent use of CSF diversion in the management of this condition, it is important for neurosurgeons to remain cognizant of the potential risk for catastrophic brainstem hemorrhage following LD in decompressive craniectomy patients.

14.
Data Brief ; 43: 108410, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35811652

RESUMO

This document contains additional information for the production of activated carbons (AC) and carbon foams (CF) from agroindustrial wastes, orange peel (OP) and sugarcane bagasse (SCB). In particular, a set of data is presented for the characterization of carbonaceous structures (AC and CF) and their application in the removal of metallic ions contained in polluted waters. The adsorbent materials were obtained combining chemical and physical activation processes. Data presented here included characterization of AC and CF using dynamic light scattering (DLS), BET (Brunauer, Emmet and Teller) surface area analysis, Barrett-Joyner-Halenda (BJH) method to assess pore size distribution and zeta potential (ζ) to evaluate electrokinetic potential of carbonaceous structures. In addition, energy dispersive spectroscopy (SEM/EDS) to identify heavy metals on the surface of carbonaceous materials is shown and complementary adsorption capacity data for metal ion removal are presented in the paper. The data can be used as a reference to promote reuse of agroindustrial wastes and provide added value; particularly for the synthesis of carbonaceous structures applied to the water purification.

15.
J Prev Alzheimers Dis ; 9(2): 297-305, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35543003

RESUMO

BACKGROUND: Preclinical Alzheimer's disease (AD) provides an opportunity for the study and implementation of interventions and strategies aimed at delaying, mitigating, and preventing AD. While this preclinical state is an ideal target, it is difficult to identify efficiently and cost-effectively. Recent findings have suggested that cognitive-motor dual task paradigms may provide additional inference. OBJECTIVES: Investigate the relationship between dual task performance and amyloidosis, suggestive of preclinical Alzheimer's disease and whether dual task performance provides additional information beyond a cognitive composite, to help in the identification of amyloidosis. DESIGN: Cross-sectional. SETTING: Outpatient specialty brain health clinical research institution in the United States. PARTICIPANTS: 52 cognitively healthy adults. MEASUREMENTS: The data included demographics, amyloid standardized uptake value ratio obtained via florbetapir-PET, neuropsychological testing, apolipoprotien E genotype, and dual task performance measures. Data were analyzed via hierarchal multiple linear regression or logistic regression, controlling for age, education, and apolipoprotien E genotype. Receiver operating characteristic curves were plotted, and sensitivity and specificity calculated via 2x2 contingency tables. RESULTS: There was a moderate relationship (rs>.30) between motor and cognitive dual task effects and amyloid standardized uptake value ratio (ps<.042). A strong relationship (r=.58) was found between combined dual task effect, a measure of automaticity derived from dual task performance, and amyloid standardized uptake value ratio (p<.001). Additionally, combined dual task effect showed promise in its unique contributions to amyloid standardized uptake value ratio, accounting for 7.8% of amyloid standardized uptake value ratio variance beyond cognitive composite scores (p=.018). Additionally, when incorporated into the cognitive composite, combined dual task effect resulted in improved diagnostic accuracy for determining elevated amyloid standardized uptake value ratio, and increased the sensitivity and specificity of the cognitive composite. CONCLUSSION: Dual task performance using the combined dual task effect, a measure of automaticity, was a moderate predictor of cerebral amyloidosis, which suggests that it has utility in the screening and diagnosis of individuals for preclinical AD. Additionally, when combined with the cognitive composite, the combined dual task effect improves diagnostic accuracy. Further research is warranted.


Assuntos
Doença de Alzheimer , Amiloidose , Adulto , Doença de Alzheimer/diagnóstico por imagem , Amiloide , Peptídeos beta-Amiloides , Amiloidose/diagnóstico por imagem , Estudos Transversais , Humanos , Tomografia por Emissão de Pósitrons , Análise e Desempenho de Tarefas
16.
Data Brief ; 42: 108256, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35599820

RESUMO

This document presents the supporting information for the evaluation of the role of Ni amount during the in situ synthesis of vulcan supported PdNi nanostructures using an organometallic approach for hydrogen evolution reaction in alkaline medium [1]. The data here presented included analysis of deconvolution during structural characterization, chemical composition and transmission electron microscopy. The information also contains complement data of cyclic voltammograms during activation in alkaline media. Supplement data of electrochemical impedance spectroscopy measurements at two different overpotentials (-100 and -300 mV) and temperatures on the onset potential for hydrogen evolution reaction (HER) are also showed in this paper. The files can be used as a reference to determinate the effect of adding different in situ amount of Ni to Pd/C catalysts in presence of 2 equivalents of hexadecylamine (HDA) in order to improve the electrochemical performance on HER using an adjusted organometallic method. The data provided in this article have not been previously published and are available to enable critical or extended analyses.

17.
Epidemiol Psychiatr Sci ; 31: e28, 2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35485802

RESUMO

AIMS: Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. METHODS: 8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. RESULTS: 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. CONCLUSIONS: Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565.


Assuntos
COVID-19 , Transtorno Depressivo Maior , COVID-19/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Pessoal de Saúde , Humanos , Estudos Longitudinais , Pandemias
18.
Actas urol. esp ; 46(3): 159-166, abril 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-203567

RESUMO

Introducción La incontinencia urinaria después de la prostatectomía radical es un efecto adverso con gran impacto en la calidad de vida. Actualmente no disponemos de medidas estandarizadas para su evaluación. La reconstrucción posterior del rabdoesfínter (RPR) puede mejorar la incontinencia urinaria precoz. Nuestro objetivo fue analizar diferentes definiciones y factores pronósticos de continencia urinaria precoz después de prostatectomía radical robótica (PRR).Materiales y métodos Realizamos un ensayo clínico aleatorizado (NCT03302169) incluyendo 152 pacientes con cáncer de próstata localizado sometidos a PRR y aleatorizados en anastomosis uretrovesical simple (grupo control) y RPR previa a la anastomosis (grupo RPR). La continencia urinaria se evaluó mediante cuestionarios específicos (EPIC-26 y ICIQ-SF), y la utilización de compresas (0-1 compresa y 0 compresas) a los 7, 15, 30, 90, 180 y 365 días tras la retirada de la sonda vesical. Se analizaron factores predictores para recuperación de continencia urinaria precoz.Resultados Se incluyeron 72 pacientes en el grupo control y 80 en el grupo RPR. Las características basales fueron similares entre grupos excepto el índice de masa corporal, mayor en el grupo RPR. La definición «0 compresas» fue la única que demostró beneficio de la RPR a los 30 días, con continencia del 33,8% en el grupo RPR y 18,1% en el grupo control, p=0,022, y a los 90 días, 58,8% y 43,1%, respectivamente, p=0,038. Los cuestionarios no mostraron diferencias entre grupos. La RPR fue el único factor predictor de continencia urinaria precoz.Conclusiones La RPR mejora las tasas de continencia urinaria precoz, pero la definición de continencia es determinante. El único factor predictor de continencia urinaria precoz fue la RPR (AU)


Introduction Urinary incontinence after radical prostatectomy (RP) is an adverse event with high impact on patient's quality of life. Nowadays there is no standardized method for urinary continence measurement. Posterior rhabdosphincter reconstruction (PRR) is a surgical step that can improve early urinary continence after RP. Our objective was to analyse different continence definitions and predictors of urinary continence recovery after robot-assisted RP (RARP).Materials and methods We conducted a double-blind, randomised controlled trial (NCT03302169) including 152 consecutive patients with localized prostate cancer subjected to RARP. Patients were randomised to single urethrovesical anastomosis (control arm) or PRR before urethrovesical anastomosis (PRR arm). Urinary continence was measured with the EPIC-26 and ICIQ-SF validated questionnaires, and pad use (0-1 pads and no pads), at 7, 15, 30, 90, 180 and 365 days after catheter removal. Prognostic factors for early urinary continence recovery were analysed.Results 72 patients were included in the control arm and 80 in the PRR arm. Baseline characteristics were similar between arms, except body mass index, which was higher in PRR arm. “No pad” was the only definition assessing the benefit of PRR at 30 days, 33.8% in PRR arm and 18.1% in control arm, p=0.022; and at 90 days, 58.8 and 43.1% respectively, p=0.038. Questionnaires did not detect differences in terms of continence recovery. PRR was the only predictor for early continence recovery, p=0.03.Conclusions PRR increased early urinary continence recovery after RARP. Continence definition was critical to assess benefit. The only predictive factor for early continence recovery was PRR (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Prostatectomia/métodos , Procedimentos Cirúrgicos Robóticos , Neoplasias da Próstata/cirurgia , Incontinência Urinária/reabilitação , Prognóstico , Qualidade de Vida , Estudos Prospectivos , Método Duplo-Cego , Inquéritos e Questionários
19.
Sci Total Environ ; 831: 154883, 2022 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-35358521

RESUMO

The high levels of heavy metals contained in residual water and the pollution generated by a large amount of unexploited agro-industrial waste are a serious problem for the environment and mankind. Therefore, in the present work, with the aim of treating and reducing the pollution caused by heavy metal ions (Pb, Cd, Zn and Cu), activated carbons (ACs) were synthesized from sugarcane bagasse (SCB) and orange peel (OP) by means of physical - chemical activation method in an acid medium (H3PO4, 85 wt%) followed by an activation at high temperature (500 and 700 °C). Thereafter, these materials were used to produce carbon foams (CF) by the replica method and to evaluate their adsorbent capacity for the removal of heavy metals from synthetic water. XRD, FTIR, DLS, BET, Zeta Potential (ζ), SEM-EDS and AAS were used to investigate their structures, surface area, pore size, morphology, and adsorption capacity. The results show that as-prepared CF have a second level mesoporous structure and AC present a micro-mesoporous structure with a pore diameter between 3 and 4 nm. The experimental adsorption capacities of heavy metals showed that the CF from OP present a better elimination of heavy metals compared to the AC; exhibiting a removal capacity of 95.2 ± 3.96% (Pb) and 94.7 ± 4.88% (Cu) at pH = 5. The adsorption values showed that the optimal parameters to reach a high metal removal are pH values above 5. In the best of cases, the minimum remaining concentration of lead and copper were 2.4 and 2.6 mg L-1, respectively. The experimental data for carbon adsorbents are in accordance with the Langmuir and BET isotherms, with R2 = 0.99 and the maximum homogenous biosorption capacity for lead and copper was Qmax = 968.72 and 754.14 mg g-1, respectively. This study showed that agro-industrial wastes can be effectively retrieved to produce adsorbents materials for wastewater treatment applications.


Assuntos
Citrus sinensis , Metais Pesados , Saccharum , Poluentes Químicos da Água , Adsorção , Biomassa , Celulose , Cobre , Concentração de Íons de Hidrogênio , Resíduos Industriais , Íons , Cinética , Chumbo , Metais Pesados/análise , Água/química , Poluentes Químicos da Água/análise
20.
Actas Urol Esp (Engl Ed) ; 46(3): 159-166, 2022 04.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35272967

RESUMO

INTRODUCTION: Urinary incontinence after radical prostatectomy (RP) is an adverse event with high impact on patient's quality of life. Nowadays there is no standardized method for urinary continence measurement. Posterior rhabdosphincter reconstruction (PRR) is a surgical step that can improve early urinary continence after RP. Our objective was to analyse different continence definitions and predictors of urinary continence recovery after robot-assisted RP (RARP). MATERIAL AND METHODS: We conducted a double-blind, randomised controlled trial (NCT03302169) including 152 consecutive patients with localized prostate cancer subjected to RARP. Patients were randomised to single urethrovesical anastomosis (control arm) or PRR before urethrovesical anastomosis (PRR arm). Urinary continence was measured with the EPIC-26 and ICIQ-SF validated questionnaires, and pad use (0-1 pads and no pads), at 7, 15, 30, 90, 180 and 365 days after catheter removal. Prognostic factors for early urinary continence recovery were analysed. RESULTS: 72 patients were included in the control arm and 80 in the PRR arm. Baseline characteristics were similar between arms, except body mass index, which was higher in PRR arm. "No pad" was the only definition assessing the benefit of PRR at 30 days, 33.8% in PRR arm and 18.1% in control arm, p = 0.022; and at 90 days, 58.8 and 43.1% respectively, p = 0.038. Questionnaires did not detect differences in terms of continence recovery. PRR was the only predictor for early continence recovery, p = 0.03. CONCLUSIONS: PRR increased early urinary continence recovery after RARP. Continence definition was critical to assess benefit. The only predictive factor for early continence recovery was PRR.


Assuntos
Robótica , Humanos , Masculino , Prognóstico , Próstata/cirurgia , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Qualidade de Vida
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