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2.
BMC Med ; 19(1): 309, 2021 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-34809617

RESUMO

BACKGROUND: Surveillance tools to estimate viral transmission dynamics in young populations are essential to guide recommendations for school opening and management during viral epidemics. Ideally, sensitive techniques are required to detect low viral load exposures among asymptomatic children. We aimed to estimate SARS-CoV-2 infection rates in children and adult populations in a school-like environment during the initial COVID-19 pandemic waves using an antibody-based field-deployable and non-invasive approach. METHODS: Saliva antibody conversion defined as ≥ 4-fold increase in IgM, IgA, and/or IgG levels to five SARS-CoV-2 antigens including spike and nucleocapsid constructs was evaluated in 1509 children and 396 adults by high-throughput Luminex assays in samples collected weekly in 22 summer schools and 2 pre-schools in 27 venues in Barcelona, Spain, from June 29th to July 31st, 2020. RESULTS: Saliva antibody conversion between two visits over a 5-week period was 3.22% (49/1518) or 2.36% if accounting for potentially cross-reactive antibodies, six times higher than the cumulative infection rate (0.53%) assessed by weekly saliva RT-PCR screening. IgG conversion was higher in adults (2.94%, 11/374) than children (1.31%, 15/1144) (p=0.035), IgG and IgA levels moderately increased with age, and antibodies were higher in females. Most antibody converters increased both IgG and IgA antibodies but some augmented either IgG or IgA, with a faster decay over time for IgA than IgG. Nucleocapsid rather than spike was the main antigen target. Anti-spike antibodies were significantly higher in individuals not reporting symptoms than symptomatic individuals, suggesting a protective role against COVID-19. CONCLUSION: Saliva antibody profiling including three isotypes and multiplexing antigens is a useful and user-friendlier tool for screening pediatric populations to detect low viral load exposures among children, particularly while they are not vaccinated and vulnerable to highly contagious variants, and to recommend public health policies during pandemics.

3.
Mar Drugs ; 19(10)2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34677451

RESUMO

The interest in seaweeds for cosmetic, cosmeceutics, and nutricosmetics is increasing based on the demand for natural ingredients. Seaweeds offer advantages in relation to their renewable character, wide distribution, and the richness and versatility of their valuable bioactive compounds, which can be used as ingredients, as additives, and as active agents in the formulation of skin care products. Bioactive compounds, such as polyphenols, polysaccharides, proteins, peptides, amino acids, lipids, vitamins, and minerals, are responsible for the biological properties associated with seaweeds. Seaweed fractions can also offer technical features, such as thickening, gelling, emulsifying, texturizing, or moistening to develop cohesive matrices. Furthermore, the possibility of valorizing industrial waste streams and algal blooms makes them an attractive, low cost, raw and renewable material. This review presents an updated summary of the activities of different seaweed compounds and fractions based on scientific and patent literature.

4.
Proc Natl Acad Sci U S A ; 118(40)2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34580197

RESUMO

Ca2+ is the most ubiquitous second messenger in neurons whose spatial and temporal elevations are tightly controlled to initiate and orchestrate diverse intracellular signaling cascades. Numerous neuropathologies result from mutations or alterations in Ca2+ handling proteins; thus, elucidating molecular pathways that shape Ca2+ signaling is imperative. Here, we report that loss-of-function, knockout, or neurodegenerative disease-causing mutations in the lysosomal cholesterol transporter, Niemann-Pick Type C1 (NPC1), initiate a damaging signaling cascade that alters the expression and nanoscale distribution of IP3R type 1 (IP3R1) in endoplasmic reticulum membranes. These alterations detrimentally increase Gq-protein coupled receptor-stimulated Ca2+ release and spontaneous IP3R1 Ca2+ activity, leading to mitochondrial Ca2+ cytotoxicity. Mechanistically, we find that SREBP-dependent increases in Presenilin 1 (PS1) underlie functional and expressional changes in IP3R1. Accordingly, expression of PS1 mutants recapitulate, while PS1 knockout abrogates Ca2+ phenotypes. These data present a signaling axis that links the NPC1 lysosomal cholesterol transporter to the damaging redistribution and activity of IP3R1 that precipitates cell death in NPC1 disease and suggests that NPC1 is a nanostructural disease.

5.
Dis Esophagus ; 2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34378016

RESUMO

BACKGROUND: Indocyanine green (ICG) fluorescence imaging is an emerging technology that might help decreasing anastomotic leakage (AL) rates. The aim of this study was to determine the usefulness of ICG fluorescence imaging for the prevention of AL after minimally invasive esophagectomy with intrathoracic anastomosis. METHODS: A systematic literature review of the MEDLINE and Cochrane databases was performed to identify all articles on totally minimally invasive Ivor Lewis esophagectomy. Studies were then divided into two groups based on the use or not of ICG for perfusion assessment. Primary outcome was anastomotic leak. Secondary outcomes included operative time, ICG-related adverse reactions, and mortality rate. A meta-analysis was conducted to estimate the overall weighted proportion and its 95% confidence interval (CI) for main outcomes. RESULTS: A total of 3,171 patients were included for analysis: 381 (12%) with intraoperative ICG fluorescence imaging and 2,790 (88%) without ICG. Mean patients' age and proportion of males were similar between groups. Mean operative time was also similar between both groups (ICG: 354.8 vs. No-ICG: 354.1 minutes, P = 0.52). Mean ICG dose was 12 mg (5-21 mg). No ICG-related adverse reactions were reported. AL rate was 9% (95% CI, 5-17%) and 9% (95% CI, 7-12%) in the ICG and No-ICG groups, respectively. The risk of AL was similar between groups (odds ratio 0.85, 95% CI 0.53-1.28, P = 0.45). Mortality was 3% (95% CI, 1-9%) in patients with ICG and 2% (95% CI, 2-3%) in those without ICG. Median length of hospital stay was also similar between groups (ICG: 13.6 vs. No-ICG: 11.2 days, P = 0.29). CONCLUSION: The use of ICG fluorescence imaging for perfusion assessment does not seem to reduce AL rates in patients undergoing minimally invasive esophagectomy with intrathoracic anastomosis.

6.
Artigo em Inglês | MEDLINE | ID: mdl-34444048

RESUMO

BACKGROUND: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists' work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. MATERIAL AND METHODS: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. RESULTS: Here, 517 dental hygienists were surveyed, of which 86.2% followed the official recommendations to avoid contagion and 63.8% agreed with the gradual return to work by limiting the use of aerosols. Private dental hygienists identified more with returning to work without restrictions (14.5%) versus those working for the public service (1.2%) (p < 0.005). CONCLUSIONS: Dental hygienists' return to work has involved different strategies, aimed at controlling infection and guaranteeing the safety of patients and the rest of the dental team. The availability of personal protective equipment, the adaptation of clinical infrastructure, and patient care management have differed between professionals working in the private and public sectors.


Assuntos
COVID-19 , Assistência Odontológica , Higienistas Dentários , Pandemias , Atitude do Pessoal de Saúde , Estudos Transversais , Atenção à Saúde , Humanos , Espanha , Inquéritos e Questionários
7.
Surgery ; 170(6): 1692-1701, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34389164

RESUMO

BACKGROUND: Evidence comparing conventional minimally invasive esophagectomy (CMIE) via laparoscopy and thoracoscopy with robot-assisted minimally invasive esophagectomy (RAMIE) is scarce. The aim of this meta-analysis was to compare surgical outcomes after CMIE and RAMIE with an intrathoracic anastomosis. METHODS: A systematic literature search was performed to identify original articles analyzing outcomes after CMIE and RAMIE. Main surgical outcomes included operative time, intraoperative blood loss, anastomotic leak rates, pneumonia, overall morbidity, length of stay (LOS), and 30-day mortality. Oncologic outcomes included lymph node yield and R0 resections rates. A meta-analysis of proportions and linear regression models were used to assess the effect of each procedure on the different outcomes. RESULTS: A total of 6,249 patients were included for analysis; 5,275 (84%) underwent CMIE and 974 (16%) RAMIE. Robotic esophagectomy had longer operative time and less intraoperative blood loss. Anastomotic leakage rates were similar with both approaches. Patients undergoing RAMIE had significantly lower rates of postoperative pneumonia (OR 0.46, 95% CI 0.35-0.61, P < .0001) and overall morbidity (OR 0.67, 95% CI 0.58-0.79, P < .0001). Median LOS was similar in both procedures (RAMIE: 12.1 versus CMIE: 11.9 days, P = .64). Similar mortality rates were found after RAMIE and CMIE (OR 0.69, 95% CI 0.34-1.38, P = .29). Lymph node yield was similar in both procedures, but RAMIE was associated with higher rates of R0 resection (OR 2.84, 95% CI 1.53-5.26, P < .001). CONCLUSION: Patients undergoing robotic esophagectomy have less intraoperative blood loss, lower rates of postoperative pneumonia, reduced overall morbidity, and higher rates of R0 resections, as compared with those undergoing a laparoscopic-thoracoscopic esophageal resection.

8.
Ecancermedicalscience ; 15: 1235, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34221118

RESUMO

Background: The authors report on an extremely rare case of skeletal muscle metastasis from primary lung cancer that involved the radial nerve and humerus, which was 'over-treated' with wide tumour resection and frozen autograft reconstruction upon misdiagnosis of sarcoma by intraoperative frozen section, amid pressure of expediting hospital care in a low-resource setting during the coronavirus disease (COVID-19) pandemic. Case presentation: A 61-year-old male living outside Metro Manila presented with painful mass in his left distal arm during the enhanced community quarantine, and requested admission upon testing negative for COVID-19. Imaging studies suggested a diagnosis of soft tissue sarcoma involving the radial nerve and humerus, and intending to prevent nosocomial severe acute respiratory syndrome coronavirus 2infection of patient, treatment was expedited by foregoing biopsy and opting for intraoperative frozen section prior to resection. Frozen section findings suggested malignancy intraoperatively, and surgical team proceeded with wide tumour resection and frozen autograft reconstruction of the humerus using plates and screws. However, permanent sections revealed metastatic carcinoma from primary non-small cell lung cancer, with positron emission tomography (PET) scan confirming lung mass in the right apical lobe. Conclusion: The report concludes that establishment of a definite tumour diagnosis by final histopathological analysis is indispensable, even when planning for emergent surgery in the time of the COVID-19 pandemic.

9.
Open Forum Infect Dis ; 8(7): ofab299, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34258322

RESUMO

Immune response after a single dose of BNT162b2 vaccine was markedly increased in subjects with previous severe acute respiratory syndrome coronavirus 2 infection, reaching similar immunoglobulin titers to those elicited by the full 2 doses in naive cases, and increased modestly after the second dose. These data may inform the priority of the boosting dose.

10.
Antioxidants (Basel) ; 10(6)2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34208721

RESUMO

Wheat bran (WB) is a byproduct from the milling industry that contains bioactive compounds beneficial to human health. The aim of this work was on the one hand, increasing extractability of antioxidant and anti-inflammatory compounds (specifically ferulic acid, FA), through enzymatic hydrolysis combined with hydrothermal treatment (HT) and high hydrostatic pressure (HHP). On the other hand, enhancing the stability of final ingredient applying spray-drying (SPD) and microencapsulation (MEC). The use of HT increased FA, total phenolics (TP), and antioxidant capacity (AC) in WB hydrolysates, regardless the HT duration. However, the HT tested (30 min, HT30) produced a loss in anti-inflammatory activity (AIA). The combination of HT (15 min, HT15) with HHP increased AIA of the WB. SPD enhanced the TP yield in WB with no significant effect of inlet temperature (up to 140 °C) on phenolic profile mainly composed of trans-FA and smaller amounts of cis-FA and apigenin diglucosides. SPD caused a temperature-dependent increase in AC (160 °C > 140 °C > 130 °C). SPD inlet temperatures affected total solids yield (from 22 to 36%), with the highest values at 140 °C. The use of HHP in combination with HT resulted in >2-fold increase in total solids yield.

11.
Dermatol Online J ; 27(5)2021 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-34118824

RESUMO

Plica neuropathica (PN), also known as plica polonica, felting, matting or bird's nest hair, is an acquired hair condition in which hair becomes twisted, leading to the formation of a compact mass. Psychiatric disorders are an important etiologic factor for PN. We report a case of PN in a woman with severe reactive depression and present the trichoscopic findings.

12.
Artigo em Inglês | MEDLINE | ID: mdl-34085112

RESUMO

PURPOSE: Stump appendicitis (SA) is a rare long-term complication after laparoscopic appendectomy (LA) that can be associated with high morbidity due to delayed diagnosis. We aimed to determine the incidence, risk factors, diagnosis, and management of SA by reviewing our large cohort of LA and performing a systematic review of the literature. METHODS: We retrospectively reviewed data of all patients who developed SA after LA between 2006 and 2020. Demographics, peri-operative variables, and postoperative outcomes were analyzed. A systematic review of the PubMed/MEDLINE, Embase and GoogleScholar bibliographic databases was also performed to identify publications regarding SA following LA. RESULTS: A total of 2,019 patients underwent LA; 5 (0.25%) developed SA after a median of 292 days. The most common symptom at presentation was right lower quadrant pain. Four SA (80%) occurred in patients with a history of complicated appendicitis at index operation. All patients were diagnosed with computed tomography and underwent completion stump appendectomy by laparoscopy. No postoperative complications were recorded. A total of 55 studies with 76 cases of SA after LA were identified in the systematic review. Most SA (98.7%) underwent surgery: 52% by laparoscopic approach and 36% through an open approach. Stump appendectomy was performed in 94.4% cases and an extended resection in 5.6%. CONCLUSION: Although SA is a rare complication after LA, a high index of clinical suspicious and imaging studies are key for early diagnosis and treatment. A laparoscopic resection of the inflamed appendiceal stump is feasible, safe, and highly effective. A minority of patients with severe cecum compromise may need extended resections or conversion to open surgery.

13.
EMBO J ; 40(13): e105990, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34019311

RESUMO

Cholesterol and phosphoinositides (PI) are two critically important lipids that are found in cellular membranes and dysregulated in many disorders. Therefore, uncovering molecular pathways connecting these essential lipids may offer new therapeutic insights. We report that loss of function of lysosomal Niemann-Pick Type C1 (NPC1) cholesterol transporter, which leads to neurodegenerative NPC disease, initiates a signaling cascade that alters the cholesterol/phosphatidylinositol 4-phosphate (PtdIns4P) countertransport cycle between Golgi-endoplasmic reticulum (ER), as well as lysosome-ER membrane contact sites (MCS). Central to these disruptions is increased recruitment of phosphatidylinositol 4-kinases-PI4KIIα and PI4KIIIß-which boosts PtdIns4P metabolism at Golgi and lysosomal membranes. Aberrantly increased PtdIns4P levels elevate constitutive anterograde secretion from the Golgi complex, and mTORC1 recruitment to lysosomes. NPC1 disease mutations phenocopy the transporter loss of function and can be rescued by inhibition or knockdown of either key phosphoinositide enzymes or their recruiting partners. In summary, we show that the lysosomal NPC1 cholesterol transporter tunes the molecular content of Golgi and lysosome MCS to regulate intracellular trafficking and growth signaling in health and disease.


Assuntos
Membrana Celular/metabolismo , Complexo de Golgi/metabolismo , Lisossomos/metabolismo , Proteína C1 de Niemann-Pick/metabolismo , Fosfatos de Fosfatidilinositol/metabolismo , Animais , Transporte Biológico/fisiologia , Células CHO , Linhagem Celular , Colesterol/metabolismo , Cricetulus , Retículo Endoplasmático/metabolismo , Células HEK293 , Humanos , Membranas Intracelulares/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Masculino , Alvo Mecanístico do Complexo 1 de Rapamicina/metabolismo , Glicoproteínas de Membrana/metabolismo , Camundongos , Transdução de Sinais/fisiologia
14.
Clin Infect Dis ; 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33709138

RESUMO

BACKGROUND: Understanding the role of children in SARS-CoV-2 transmission is critical to guide decision-making for schools in the pandemic. We aimed to describe the transmission of SARS-CoV-2 among children and adult staff in summer schools. METHODS: During July 2020 we prospectively recruited children and adult staff attending summer schools in Barcelona who had SARS-CoV-2 infection. Primary SARS-CoV-2 infections were identified through: (1) surveillance program in 22 summer schools' of 1905 participants, involving weekly saliva sampling for SARS-CoV-2 RT-PCR during 2-5 weeks; (2)cases identified through the Catalonian Health Surveillance System of children diagnosed with SARS-CoV-2 infection by nasopharyngeal RT-PCR. All centres followed prevention protocols: bubble groups, hand washing, facemasks and conducting activities mostly outdoors. Contacts of a primary case within the same bubble were evaluated by nasopharyngeal RT-PCR. Secondary attack rates and effective reproduction number in summer schools(R*) were calculated. RESULTS: Among the over 2000 repeatedly screened participants, 30children and 9adults were identified as primary cases. A total of 253 close contacts of these primary cases were studied (median 9 (IQR 5-10) for each primary case), among which twelve new cases (4.7%) were positive for SARS-CoV-2. The R* was 0.3, whereas the contemporary rate in the general population from the same areas in Barcelona was 1.9. CONCLUSIONS: The transmission rate of SARS-CoV-2 infection among children attending school-like facilities under strict prevention measures was lower than that reported for the general population. This suggests that under preventive measures schools are unlikely amplifiers of SARS-CoV-2 transmission and supports current recommendations for school opening.

15.
Br J Pharmacol ; 178(7): 1507-1523, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33444462

RESUMO

BACKGROUND AND PURPOSE: The enzyme α/ß-hydrolase domain containing 6 (ABHD6), a new member of the endocannabinoid system, is a promising therapeutic target against neuronal-related diseases. However, how ABHD6 activity is regulated is not known. ABHD6 coexists in protein complexes with the brain-specific carnitine palmitoyltransferase 1C (CPT1C). CPT1C is involved in neuro-metabolic functions, depending on brain malonyl-CoA levels. Our aim was to study CPT1C-ABHD6 interaction and determine whether CPT1C is a key regulator of ABHD6 activity depending on nutritional status. EXPERIMENTAL APPROACH: Co-immunoprecipitation and FRET assays were used to explore ABHD6 interaction with CPT1C or modified malonyl-CoA-insensitive or C-terminal truncated CPT1C forms. Cannabinoid CB1 receptor-mediated signalling was investigated by determining cAMP levels. A novel highly sensitive fluorescent method was optimized to measure ABHD6 activity in non-neuronal and neuronal cells and in brain tissues from wild-type (WT) and CPT1C-KO mice. KEY RESULTS: CPT1C interacted with ABHD6 and negatively regulated its hydrolase activity, thereby regulating 2-AG downstream signalling. Accordingly, brain tissues of CPT1C-KO mice showed increased ABHD6 activity. CPT1C malonyl-CoA sensing was key to the regulatory role on ABHD6 activity and CB1 receptor signalling. Fasting, which attenuates brain malonyl-CoA, significantly increased ABHD6 activity in hypothalamus from WT, but not CPT1C-KO, mice. CONCLUSIONS AND IMPLICATIONS: Our finding that negative regulation of ABHD6 activity, particularly in the hypothalamus, is sensitive to nutritional status throws new light on the characterization and the importance of the proteins involved as potential targets against diseases affecting the CNS.


Assuntos
Carnitina O-Palmitoiltransferase , Monoacilglicerol Lipases/metabolismo , Estado Nutricional , Animais , Carnitina O-Palmitoiltransferase/genética , Hidrolases , Malonil Coenzima A , Camundongos
16.
Foods ; 10(1)2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33430507

RESUMO

Bran, a byproduct still mainly used for animal feed, is receiving increased attention as potential ingredient for a healthier diet. The aim of this study was to characterize and evaluate the nutritional and antioxidant properties of wheat and oat bran in order to promote their use as nutraceutical ingredients in flour and/or other products. The effects of grain (wheat vs. oat) and milling fraction (whole grain vs. bran) on the phenolic profile (free vs. bound phenolics), antioxidant and nutrient profiles, and glycemic index were evaluated. Differences in antioxidant capacity through different methodologies between grain and bran were observed, supporting a higher in vitro antioxidant capacity of the whole grain than that of the refined flours, which lack the bran fraction. The highest RACI (Relative Antioxidant Capacity Index) corresponded to wheat bran bound fraction, which showed the highest concentration of ferulic acid and correlation with antioxidant parameters tested. The in vitro glycemic index of the bran fractions was reduced, as compared with grain, with lower values found for wheat. The results support the important benefits of the polyphenols linked to fiber and the importance to develop methods to increase bioavailability of these compounds, which would promote WB use as nutraceutical ingredient.

18.
J Clin Exp Dent ; 12(12): e1183-e1188, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33282140

RESUMO

Background: In March 2020, the World Health Organization (WHO) declared the COVID-19 pandemic and, a few days later, the Spanish Government declared a State of Emergency and the population lockdown. This crisis situation crisis forced deep changes in health care. At dental care level, it became necessary for both public health services and private consultations to plan changes to enable them to face this healthcare challenge. Material and Methods: SESPO and the General Council of Dentists of Spain (CGDE) appointed a Working Group to prepare a protocol for dental clinics after the lockdown stage. Continuing with this teamwork task, a series of recommendations addressed to public health managers and the dental workforce were agreed, according to the COVID-19 protection protocols, with the evidence available at the time of their preparation. Results: The SESPO Working Group prepared a schedule with recommendations to be taken. The CGDE presented this document to the Ministry of Health, Consumption and Social Welfare, and SESPO emailed it to all the Health Councils of the autonomous regions. The document was also uploaded to the CGDE and SESPO websites and was emailed to all SESPO associated members. Conclusions: Keeping in mind the existing territorial variation, both at the organization level of dental public health services, and at the care level (especially in child preventive programs and care for pregnant women), this health crisis has highlighted the importance of teamwork. It is necessary to unify the standards for all dental health care units in the national territory in challenging times. Key words:COVID-19, Dental public health, dental care, dentistry, primary care, infection, SARS-CoV-2.

19.
Updates Surg ; 2020 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-33174113

RESUMO

Despite laparoscopy is considered an adequate tool for the diagnosis and management of postoperative surgical complications, its role after laparoscopic appendectomy (LA) remains uncertain. The aim of this study was to evaluate whether laparoscopy is useful for treating complications after laparoscopic appendectomy. A retrospective analysis of a prospectively collected database of patients undergoing LA, who needed a reoperation for postoperative complications during the period 2006-2020, was performed. Demographics, operative variables, and postoperative outcomes were analyzed. A total of 2019 LA were performed, and 41 patients (2%) underwent a RL for post appendectomy complications. Twenty-three patients (56%) were male. The mean age was 32 years old (16-92 years). The majority of patients (75%) had a complicated acute appendicitis in the first operation. The most common findings at RL were generalized peritonitis (36.4%) and intraabdominal abscesses (26.8%). Five patients (12.1%) developed stump appendicitis, all of them as a late complication. The procedures were completed laparoscopically in 85% and 6 patients (15%) required conversion to an open approach. Three patients (7.3%) required a percutaneous drainage and two patients (4.9%) needed an additional surgery (laparotomy) after RL, all of them presenting with generalized peritonitis at the RL. No mortality was registered. Re-laparoscopy is feasible, safe, and highly effective for the diagnosis and treatment of post appendectomy complications. RL should be encouraged to avoid more aggressive procedures.

20.
Artigo em Espanhol | MEDLINE | ID: mdl-33246641

RESUMO

BACKGROUND AND OBJECTIVE: We aimed to perform a cross-cultural adaptation of the Wisconsin Gait Scale (WGS) to Spanish and ensure its reliability, validity and sensitivity. MATERIAL AND METHOD: A cross-sectional descriptive study was conducted in patients with stroke between September 2017 and March 2019. We developed the Spanish version through the translation-back-translation method, and reached a consensus on the problematic items. The Spanish version of the WGS was applied in 25 post-stroke patients, assessed in the Hospital Movement Analysis Unit. All patients were evaluated by 2 independent evaluators, subsequently performing the instrumented gait analysis using the Elite System (BTS), SMART System. Interobserver confirmation (intraclass correlation coefficient), internal consistency (Cronbach's alpha), and validation were verified by checking their relationship with spatial and temporal parameters and sensitivity to change (Pearson's correlation). RESULTS: After the translation-back-translation, the committee found cultural equivalence in all but 2 items and reached a consensus on the final version. Interobserver reliability had an intraclass coefficient of 0.99 for the total score, and > 0.7 for each item; Cronbach's alpha was > 0.8; the validity between the WGS and the spatial and temporal parameters was significant (p < 0.05). Sensitivity to change was significant on comparison of the results of the scale at baseline and at 1 month (correlation coefficient 0.92). CONCLUSION: The Spanish version of the WGS is a culturally equivalent instrument to the original version, providing an objective means to document observational analysis of gait in post-stroke patients by rehabilitation teams.

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