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1.
Phys Ther Sport ; 52: 248-255, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34656829

RESUMO

OBJECTIVES: To compare trunk muscle endurance among females and males with and without patellofemoral pain (PFP), and to investigate the correlations between trunk muscle endurance and performance of the single leg hop test (SLHT) and forward step-down test (FSDT). DESIGN: Cross-sectional. SETTING: Laboratory-based study. PARTICIPANTS: 110 females and 38 males with PFP, 61 females and 31males without PFP. MAIN OUTCOME MEASURES: Anterior and lateral trunk muscle endurance were assessed with the prone and bilateral side-bridge tests, respectively. Performance during the SLHT and FSDT was also assessed. RESULTS: Lower anterior and lateral trunk muscle endurance were identified in females (p < .001; d = -0.74 to -0.86), but not in males (p ≥ .806; d = -0.04 to 0.05) with PFP as compared to sex-matched controls. Moderate to large, positive correlations between anterior and lateral trunk muscle endurance with performance in the SLHT and FSDT were identified in females (r = .27 to .50; p < .004) and males (r = 0.27 to 0.59; p < .031) with PFP and females without PFP (r = 0.26 to 0.40; p < .044). CONCLUSION: Our findings highlight that assessing trunk muscle endurance is advised in females with PFP. Trunk muscle endurance of individuals with PFP may have a role in the performance of hopping and stepping down tasks.

2.
Environ Pollut ; : 118382, 2021 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-34666097

RESUMO

Glyphosate-based herbicides (GBH) -the most widely used herbicides in agriculture worldwide-are frequently generalized by the name of "glyphosate". However, GBH encompass a variety of glyphosate salts as active ingredient and different adjuvants, which differ between products. These herbicides reach water bodies and produce diverse impacts over aquatic communities. Yet, the risk assessment assays required for the approval focus mostly on active ingredients. Herein, we compared the effect of five different GBH as well as of monoisopropylamine salt of glyphosate (GIPA) on aquatic microbial communities from natural shallow lakes that were mixed and allowed to evolve in an outdoor pond. We performed an 8-day long assay under indoor control conditions to evaluate the effects of exposure on the structure of nano-plus microphytoplankton (net phytoplankton, with sizes between 2 and 20 µm and >20 µm, respectively) and picoplankton (size ranging between 0.2 and 2 µm) communities through microscopy and flow cytometry, respectively. Significantly different effects were evident on the structure of microbial communities dependent on the GBH, even with herbicides sharing similar active ingredients. Each GBH evoked increases of different magnitude in bacterioplankton abundance. Furthermore, GIPA and a formulation decreased the abundance of a phycocyanin-rich (PC-rich) picocyanobacteria (Pcy) cytometric population and GIPA further altered Pcy composition. Also, two GBH increased net phytoplankton total abundance and, unlike the tested GBH, no apparent effect of GIPA was detected on this community structure. These results demonstrate that GBH effects on aquatic microbial communities should not be summarized as "glyphosate" effects considering that the formulations have effects beyond those exerted by the active ingredients alone. This work intends to alert on the lack of real knowledge regarding the consequences of the variety of GBH on natural aquatic ecosystems. Indeed, the wide use of the term "glyphosate effect" should be thoroughly rethought.

3.
Rev Esp Enferm Dig ; 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34470456

RESUMO

We introduce a 42-year-old male without previous medical history that presented hematochezia, tenesmus and weight loss for two months. An ulcerated lesion located in the pectineal line and extended through the entire circumference was identified through colonoscopy. Histologically, there was a lymphoplasmacytic infiltrate and histiocytes with atypical Hodgkin-like lymphoid cells and in the immunohistochemistry tested positive for EBV. Random biopsies of the colorectal mucosa were found normal. Thus, the patient was diagnosed with Epstein-Barr virus mucocutaneous ulcer (EBVMCU).

4.
Neurosci Lett ; 762: 136156, 2021 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-34358624

RESUMO

Pleiotrophin (PTN) and midkine (MK) are growth factors that modulate alcohol consumption and reward. Since both PTN and MK limit the rewarding effects of alcohol, pharmacological potentiation of the PTN and MK signaling pathways has been proposed for the treatment of alcohol use disorders (AUD). Although the use of this therapy in the prevention of alcohol relapse is important, the potential role of these cytokines in extinguishing alcohol-induced seeking behavior is a key question that remains unanswered. To fill this gap, we have now studied the extinction of the conditioned place preference (CPP) induced by different doses of alcohol in Ptn knockout (Ptn-/-) and Mk knockout (Mk-/-) mice. The data confirm a higher sensitivity of Ptn-/- mice to the conditioning effects of a low dose (1 g/kg) and a rewarding dose (2 g/kg) of alcohol, while Mk-/- mice are only more susceptible to the conditioning effects of the low dose of this drug. More importantly, the percentage of Mk-/- mice, not Ptn-/- mice, that efficiently extinguished alcohol-induced CPP was significantly higher than that of Wt mice. Taken together, the data presented here confirm that Ptn and Mk are genetic factors that determine the conditioning effects of alcohol in mice and that Mk is a novel factor that plays an important role in the extinction of alcohol-induced CPP.

5.
Rev Esp Salud Publica ; 952021 Jul 21.
Artigo em Espanhol | MEDLINE | ID: mdl-34267174

RESUMO

OBJECTIVE: The population-based Program for the Prevention of Colorectal Cancer (PPCRC) was implemented in 2005 in the Valencian Community, following the guidelines of the European Union. To achieve the desired effectiveness in these programs, it is necessary to achieve a series of requirements, assessable through the program indicators. The objective of this study was to analyze the evolution of the program indicators from 2006 to 2016. METHODS: The accumulated indicators for the period were calculated. The Poisson regression model was used to compare the indicators by age groups and sex, by type of screening, by type of fecal occult blood test (FOBT) and by year. RESULTS: The number of people invited to participate was 1,934,266. The participation rate was 44.4%, being 87.6% in the subsequent screening and 33.7% in the initial one, with men over 60 having the lowest participation figures. Except for the positive predictive value (PPV) for low risk adenomas, which was higher in a group of men aged 50 to 59 years of successive screening, the detection rates and PPV for the different types of lesions were higher in the initial screening, with immunological test and in the group of men over 60 years old. Throughout the period, there was a decrease in the test positivity rates and in the advanced adenomas and cancers detection rates. CONCLUSIONS: The PPCCR reaches levels of quality for which the effectiveness of the program is demonstrated. However, the insufficient participation of some population groups highlights the need to carry out studies to achieve the desired objectives in all population groups and thus result in greater effectiveness of the program.


Assuntos
Neoplasias Colorretais/prevenção & controle , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Espanha
6.
Sci Rep ; 11(1): 14679, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34282205

RESUMO

Escherichia coli dynamics in urban watersheds are affected by a complex balance among external inputs, niche modulation and genetic variability. To explore the ecological processes influencing E. coli spatial patterns, we analyzed its abundance and phylogenetic structure in water samples from a stream network with heterogeneous urban infrastructure and environmental conditions. Our results showed that environmental and infrastructure variables, such as macrophyte coverage, DIN and sewerage density, mostly explained E. coli abundance. Moreover, main generalist phylogroups A and B1 were found in high proportion, which, together with an observed negative relationship between E. coli abundance and phylogroup diversity, suggests that their dominance might be due to competitive exclusion. Lower frequency phylogroups were associated with sites of higher ecological disturbance, mainly involving simplified habitats, higher drainage infrastructure and septic tank density. In addition to the strong negative relationship between phylogroup diversity and dominance, the occurrence of these phylogroups would be associated with increased facilitated dispersal. Nutrients also contributed to explaining phylogroup distribution. Our study proposes the differential contribution of distinct ecological processes to the patterns of E. coli in an urban watershed, which is useful for the monitoring and management of fecal pollution.

7.
Cell Syst ; 12(8): 780-794.e7, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34139154

RESUMO

COVID-19 is highly variable in its clinical presentation, ranging from asymptomatic infection to severe organ damage and death. We characterized the time-dependent progression of the disease in 139 COVID-19 inpatients by measuring 86 accredited diagnostic parameters, such as blood cell counts and enzyme activities, as well as untargeted plasma proteomes at 687 sampling points. We report an initial spike in a systemic inflammatory response, which is gradually alleviated and followed by a protein signature indicative of tissue repair, metabolic reconstitution, and immunomodulation. We identify prognostic marker signatures for devising risk-adapted treatment strategies and use machine learning to classify therapeutic needs. We show that the machine learning models based on the proteome are transferable to an independent cohort. Our study presents a map linking routinely used clinical diagnostic parameters to plasma proteomes and their dynamics in an infectious disease.


Assuntos
Biomarcadores/análise , COVID-19/patologia , Progressão da Doença , Proteoma/fisiologia , Fatores Etários , Contagem de Células Sanguíneas , Gasometria , Ativação Enzimática , Humanos , Inflamação/patologia , Aprendizado de Máquina , Prognóstico , Proteômica , SARS-CoV-2/imunologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-34168057

RESUMO

OBJECTIVE: To understand COVID-19 characteristics in people with multiple sclerosis (MS) and identify high-risk individuals due to their immunocompromised state resulting from the use of disease-modifying treatments. METHODS: Retrospective and multicenter registry in patients with MS with suspected or confirmed COVID-19 diagnosis and available disease course (mild = ambulatory; severe = hospitalization; and critical = intensive care unit/death). Cases were analyzed for associations between MS characteristics and COVID-19 course and for identifying risk factors for a fatal outcome. RESULTS: Of the 326 patients analyzed, 120 were cases confirmed by real-time PCR, 34 by a serologic test, and 205 were suspected. Sixty-nine patients (21.3%) developed severe infection, 10 (3%) critical, and 7 (2.1%) died. Ambulatory patients were higher in relapsing MS forms, treated with injectables and oral first-line agents, whereas more severe cases were observed in patients on pulsed immunosuppressors and critical cases among patients with no therapy. Severe and critical infections were more likely to affect older males with comorbidities, with progressive MS forms, a longer disease course, and higher disability. Fifteen of 33 patients treated with rituximab were hospitalized. Four deceased patients have progressive MS, 5 were not receiving MS therapy, and 2 were treated (natalizumab and rituximab). Multivariate analysis showed age (OR 1.09, 95% CI, 1.04-1.17) as the only independent risk factor for a fatal outcome. CONCLUSIONS: This study has not demonstrated the presumed critical role of MS therapy in the course of COVID-19 but evidenced that people with MS with advanced age and disease, in progressive course, and those who are more disabled have a higher probability of severe and even fatal disease.


Assuntos
COVID-19/fisiopatologia , Hospedeiro Imunocomprometido , Imunossupressores/administração & dosagem , Esclerose Múltipla Crônica Progressiva/tratamento farmacológico , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Sistema de Registros , Índice de Gravidade de Doença , Adulto , Fatores Etários , COVID-19/epidemiologia , Comorbidade , Feminino , Humanos , Imunossupressores/efeitos adversos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla Crônica Progressiva/epidemiologia , Esclerose Múltipla Recidivante-Remitente/epidemiologia , Neurologia , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Sociedades Médicas , Espanha
9.
Acta colomb. psicol ; 24(1): 107-120, Jan.-June 2021. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1278127

RESUMO

Abstract The construct "parental psychological control" has been used to refer to those parental behaviors that interfere with the children's thoughts and feelings. Examples of this type of behaviors would be inducing guilt or shame as well as the withdrawal of affection. The objective of this study was to validate and adapt the Spanish version of the Psychological Control Scale-Youth Self-Report (PCS-YSR) and the Psychological Control-Disrespect Scale (PCDS) and to analyze if the parental psychological control is defined as one dimension or two dimensions through manipulative and disrespectful behaviors towards adolescents. Also, the unique contribution of parental psychological control in predicting adolescent's self-concept was examined. In two samples of undergraduate university students (the first, N = 367, mean age = 19.8, women=62.7%, men=37.3%, and the second, N= 312, mean age=19.7, women=73.9%, men=26.1%), exploratory and confirmatory factor analyses confirmed the hypothesized factor structure of the PCS-YSR and the PCDS, for both paternal and maternal ratings. Convergent validity was confirmed by consistent associations between both measures of parental psychological control and other measures of parental autonomy support and parental psychological control. The multi-group analysis confirmed that parental psychological control had a negative influence on self-concept. The results indicated that both scales are useful instruments for assessing parental psychological control.


Resumen El constructo "control psicológico parental" se ha utilizado para referirse a los comportamientos de los progenitores que interfieren con los pensamientos y sentimientos de los niños y niñas. Ejemplos de este tipo de comportamientos son la inducción de culpa o vergüenza, así como la retirada de afecto. Nuestro estudio tuvo como objetivo validar y adaptar la versión española de la Escala de Control Psicológico-Autoinforme Adolescente (PCS-YSR) y la Escala Control Psicológico-Falta de Respeto (PCDS), y analizar si el control psicológico parental se define como una dimensión o dos dimensiones a través de conductas manipuladoras e irrespetuosas hacia los adolescentes. Además, examinamos la contribución única del control psicológico parental en la predicción del autoconcepto del adolescente. En dos muestras de estudiantes universitarios de pregrado (la primera n = 367, edad media = 19.8, mujeres = 62.7%, hombres = 37.3%, y la segunda, n = 312, edad media = 19.7, mujeres = 73.9%, hombres = 26.1%), los análisis factoriales exploratorios y confirmatorios confirmaron la estructura factorial hipotética del PCS-YSR y del PCDS, tanto para las puntuaciones paterna como materna. La validez convergente fue confirmada por asociaciones consistentes entre ambas medidas de control psicológico parental y otras medidas de apoyo parental a la autonomía y control psicológico parental. El análisis multigrupo confirmó que el control psicológico de los progenitores influyó negativamente en el autoconcepto. Los resultados indicaron que ambas escalas son instrumentos útiles para evaluar el control psicológico parental.

10.
Mol Neurobiol ; 58(9): 4716-4726, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34169444

RESUMO

First-line therapy with interferon beta (IFN-ß), involved in gene expression modulation in immune response, is widely used for multiple sclerosis. However, 30-50% of patients do not respond optimally. Variants in CBLB, CTSS, GRIA3, OAS1 and TNFRSF10A genes have been proposed to contribute to the variation in the individual response. The purpose of this study was to evaluate the influence of gene polymorphisms on the IFN-ß response in relapsing-remitting multiple sclerosis (RRMS) patients. CBLB (rs12487066), GRIA3 (rs12557782), CTSS (rs1136774), OAS1 (rs10774671) and TNFRSF10A (rs20576) polymorphisms were analysed by Taqman in 137 RRMS patients. Response to IFN-ß and change in the Expanded Disability Status Scale (EDSS) after 24 months were evaluated using multivariable logistic regression analysis. Carriers of at least one copy of the C allele of CTSS-rs1136774 had a better response to IFN-ß (p = 0.0423; OR = 2.94; CI95% = 1.03, 8.40). Carriers of TT genotype of TNFRSF10A-rs20576 had a higher probability of maintaining their EDSS stable after 24 months of IFN-ß treatment (p = 0.0251; OR = 5.71; CI95% = 1.39, 31.75). No influence of CBLB (rs12487066), OAS1 (rs10774671) and GRIA3 (rs12557782) gene polymorphisms in the variation of the individual response to IFN-ß was shown. Our results suggest that the TNFRSF10A-rs20576 and CTSS-rs1136774 gene polymorphisms influence the response to IFN-ß after 24 months, while the CBLB (rs12487066), OAS1 (rs10774671) or GRIA3 (rs12557782) gene polymorphisms had no effect on the variation of the individual response to IFN-ß.

11.
Bone Marrow Transplant ; 56(10): 2555-2566, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34023859

RESUMO

Limited data are available on legionellosis after hematopoietic stem cell transplant (HSCT). The aim of this study was to report the cases of legionellosis and to identify predictors of legionellosis, legionellosis-associated death, and non-relapse mortality (NRM). All cases of post-HSCT legionellosis from the EBMT registry were included and matched with controls in a 3:1 ratio for the analyses of risk factors. In the years 1995-2016, 80 cases from 52 centers in 14 countries were identified (mainly from France, Italy, and Spain). Median time from HSCT to legionellosis was 203 days (range, 0-4099); 19 (23.8%) patients developed early legionellosis (within-day +30 post-HSCT). Patients were mainly male (70%), after allogeneic HSCT (70%), with acute leukemia (27.5%), lymphoma (23.8%), or multiple myeloma (21.3%), and the median age of 46.6 (range, 7.2-68.2). Predictors of legionellosis were allogeneic HSCT (OR = 2.27, 95%CI:1.08-4.80, p = 0.03) and recent other infection (OR = 2.96, 95%CI:1.34-6.52, p = 0.007). Twenty-seven (33.8%) patients died due to legionellosis (44% after early legionellosis), NRM was 50%. Predictors of NRM were female sex (HR = 2.19, 95%CI:1.13-4.23, p = 0.02), early legionellosis (HR = 2.24, 95%CI:1.13-4.46, p = 0.02), and south-eastern geographical region (HR = 2.16, 95%CI:1.05-4.44, p = 0.036). In conclusion, legionellosis is a rare complication after HSCT, mainly allogeneic, occurring frequently within 30 days after HSCT and associated with high mortality.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Legionelose , Leucemia Mieloide Aguda , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Legionelose/etiologia , Masculino , Recidiva , Estudos Retrospectivos , Fatores de Risco
12.
J Clin Med ; 10(6)2021 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-33807085

RESUMO

INTRODUCTION: Perioperative transfusions are associated with complications of free flaps. The purpose of the present study was to find out whether there is a significant relationship between the risk of developing complications in vascular anastomoses and the history of transfusions. METHODS: We studied 372 patients retrospectively with microsurgical reconstruction between 2009 and 2017 with regards to the number of red blood cell concentrates transfused. Complications were analyzed relative to flap loss and complications in microvascular anastomoses. RESULTS: 130 patients (34.9%) received blood transfusions. Some 55% of them were transfused between the day of the intervention and the first postoperative day. Ninety-six patients were reoperated on (25.7%). Of those, thirty-six patients (37.5%) corresponded to anastomosis failure. The percentage of patients transfused among those who required reoperation was 55.2%. The percentage of patients transfused among those who were reoperated on within the first 72 h due to an alteration in the anastomosis was 60.6%, while it was 25.6% (Chi square P = 0.0001) for the rest of the patients. CONCLUSIONS: Although there is a strong association between transfusion and vascular anastomosis failure, it is not possible to establish the causation between the two.

13.
Clin Nutr ; 40(4): 1510-1518, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33743286

RESUMO

BACKGROUND AND AIMS: Previous studies, mainly focused on quantity rather than variety, have shown beneficial associations between the amount of fruit and vegetable consumed, diet quality and healthy lifestyle. The aim is to evaluate the association between fruit and vegetable consumption, diet quality and lifestyle in an elderly Mediterranean population, considering both variety and the combination of quantity and variety (QV). METHODS: A cross-sectional analysis of 6647 participants (51.6% of males) was conducted in the framework of the PREDIMED-Plus study. A variety score was created as the sum of vegetables and/or fruits consumed at least once per month using food frequency questionnaires. Dietary Reference Intakes (EAR and IA values) were used to estimate the prevalence of inadequate intake of dietary fiber and micronutrients. Logistic regression models were performed to examine the association between fruit and vegetable consumption and not meeting the DRIs, by tertiles of fruit and vegetable variety and QV categories. RESULTS: Participants with higher fruit and vegetable variety score reported a significant higher intake of fiber, vitamins, minerals and flavonoids and were significantly more likely to be physically active and non-smoker. Besides, higher variety in fruit and vegetable consumption was associated with lower prevalence of having an inadequate intake of fiber [(0.13 (0.11-0.16)], two or more [(0.17 (0.14-0.21)], three or more [(0.15 (0.13-0.18)] and four or more [(0.11 (0.10-0.14)] micronutrients in our participants. Higher quantity and variety in fruit and vegetable consumption was associated with lower prevalence of having an inadequate intake of fiber [(0.05 (0.04-0.06)], two or more [(0.08 (0.06-0.10)], three or more [(0.08 (0.06-0.09)] and four or more [(0.06 (0.05-0.07)] micronutrients. CONCLUSION: Greater variety in fruit and vegetable intake was associated with better nutrient adequacy, diet quality and healthier lifestyle in an elderly Mediterranean population.


Assuntos
Dieta Saudável/estatística & dados numéricos , Frutas , Estilo de Vida , Verduras , Idoso , Estudos Transversais , Dieta/efeitos adversos , Inquéritos sobre Dietas , Fibras na Dieta/análise , Comportamento Alimentar/fisiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Desnutrição/epidemiologia , Desnutrição/etiologia , Micronutrientes/análise , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Ensaios Clínicos Controlados Aleatórios como Assunto , Recomendações Nutricionais , Espanha/epidemiologia
14.
Sci Total Environ ; 772: 145045, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-33770879

RESUMO

Aerobic methane-oxidizing bacteria (MOB) play an important role in reducing methane emissions in nature. Most current researches focus on the natural habitats (e.g., lakes, reservoirs, wetlands, paddy fields, etc.). However, methanotrophs and the methane-oxidizing process remain essentially unclear in artificial habitat, such as the urban water cycle systems. Here, high-throughput sequencing and qPCR were used to analyze the community structure and abundance of MOB. Six different systems were selected from Yunyang City, Chongqing, China, including the raw water system (RW), the water supply pipe network system (SP), the wastewater pipe network system (WP), the hospital wastewater treatment system (HP), the municipal wastewater treatment plant system (WT) and the downstream river system (ST) of a wastewater treatment plant. Results clearly showed that the MOB community structure and network interaction patterns of the urban water cycle system were different from those of natural water bodies. Type I MOB was the dominant clade in HP. Methylocysis in Type II was the most abundant genus among the whole urban water cycle system, indicating that this genus had a high adaptability to the environment. Temperature, dissolved oxygen, pH and concentration significantly affected the MOB communities in the urban water cycle system. The network of MOB in WT was the most complicated, and there were competitive relationships among species in WP. The structure of the network in HP was unstable, and therefore, it was vulnerable to environmental disturbances. Methylocystis (Type II) and Methylomonas (Type I) were the most important keystone species in the entire urban water cycle system. Overall, these findings broaden the understanding of the distribution and interaction patterns of MOB communities in an urban water cycle system and provide valuable clues for ecosystem restoration and environmental management.


Assuntos
Ecossistema , Methylococcaceae , China , Metano , Oxirredução , Microbiologia do Solo , Ciclo Hidrológico
15.
J Allergy Clin Immunol ; 147(5): 1652-1661.e1, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33662370

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a highly variable condition. Validated tools to assist in the early detection of patients at high risk of mortality can help guide medical decisions. OBJECTIVE: We sought to validate externally, as well as in patients from the second pandemic wave in Europe, our previously developed mortality prediction model for hospitalized COVID-19 patients. METHODS: Three validation cohorts were generated: 2 external with 185 and 730 patients from the first wave and 1 internal with 119 patients from the second wave. The probability of death was calculated for all subjects using our prediction model, which includes peripheral blood oxygen saturation/fraction of inspired oxygen ratio, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, IL-6, and age. Discrimination and calibration were evaluated in the validation cohorts. The prediction model was updated by reestimating individual risk factor effects in the overall cohort (N = 1477). RESULTS: The mortality prediction model showed good performance in the external validation cohorts 1 and 2, and in the second wave validation cohort 3 (area under the receiver-operating characteristic curve, 0.94, 0.86, and 0.86, respectively), with excellent calibration (calibration slope, 0.86, 0.94, and 0.79; intercept, 0.05, 0.03, and 0.10, respectively). The updated model accurately predicted mortality in the overall cohort (area under the receiver-operating characteristic curve, 0.91), which included patients from both the first and second COVID-19 waves. The updated model was also useful to predict fatal outcome in patients without respiratory distress at the time of evaluation. CONCLUSIONS: This is the first COVID-19 mortality prediction model validated in patients from the first and second pandemic waves. The COR+12 online calculator is freely available to facilitate its implementation (https://utrero-rico.shinyapps.io/COR12_Score/).


Assuntos
COVID-19 , Interleucina-6/imunologia , Modelos Imunológicos , SARS-CoV-2/imunologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/imunologia , COVID-19/mortalidade , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco
16.
Sensors (Basel) ; 21(4)2021 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-33668544

RESUMO

Surgeons' procedural skills and intraoperative decision making are key elements of clinical practice. However, the objective assessment of these skills remains a challenge to this day. Surgical workflow analysis (SWA) is emerging as a powerful tool to solve this issue in surgical educational environments in real time. Typically, SWA makes use of video signals to automatically identify the surgical phase. We hypothesize that the analysis of surgeons' speech using natural language processing (NLP) can provide deeper insight into the surgical decision-making processes. As a preliminary step, this study proposes to use audio signals registered in the educational operating room (OR) to classify the phases of a laparoscopic cholecystectomy (LC). To do this, we firstly created a database with the transcriptions of audio recorded in surgical educational environments and their corresponding phase. Secondly, we compared the performance of four feature extraction techniques and four machine learning models to find the most appropriate model for phase recognition. The best resulting model was a support vector machine (SVM) coupled to a hidden-Markov model (HMM), trained with features obtained with Word2Vec (82.95% average accuracy). The analysis of this model's confusion matrix shows that some phrases are misplaced due to the similarity in the words used. The study of the model's temporal component suggests that further attention should be paid to accurately detect surgeons' normal conversation. This study proves that speech-based classification of LC phases can be effectively achieved. This lays the foundation for the use of audio signals for SWA, to create a framework of LC to be used in surgical training, especially for the training and assessment of procedural and decision-making skills (e.g., to assess residents' procedural knowledge and their ability to react to adverse situations).


Assuntos
Colecistectomia Laparoscópica , Competência Clínica , Cirurgia Geral , Reconhecimento Automatizado de Padrão , Cirurgia Geral/normas , Humanos , Salas Cirúrgicas , Fala
18.
J Gerontol A Biol Sci Med Sci ; 76(8): e127-e132, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-33711156

RESUMO

BACKGROUND: The most susceptible population group to critical and fatal coronavirus disease 2019 (COVID-19) is older adults. In severe acute respiratory syndrome coronavirus 2 infection, the host immune response is thought to play a key role in the pathophysiological effects of lung damage. Therefore, corticosteroid therapy could modulate inflammation-mediated pulmonary injury and thereby reduce progression to severe respiratory failure and death. The aim of this study was to analyze the safety and clinical efficacy of corticosteroid therapy in older adults with severe COVID-19 pneumonia. METHOD: We reviewed the clinical records of confirmed COVID-19 patients aged 75 years or older admitted to our hospital over a 3-month period (March 1-May 31, 2020). A total of 143 patients were included in the study cohort. From 2 April, 2020, in accordance with World Health Organization guidance on COVID-19, our hospital protocol added corticosteroid for COVID-19 treatment. We compared in-hospital mortality among patients with critical COVID-19 who received corticosteroids therapy and those who did not. RESULTS: In total, 88 patients (61.5%) were treated with corticosteroids, and 55 patients (38.4%) were not. Both groups were similar in baseline characteristics. The median age was 85 years (interquartile range: 82-89), and 61.5% (88/143) were male. In-hospital mortality was lower in the corticosteroid group (68.2%) compared with patients in the noncorticosteroid group (81.8%). Treatment with corticosteroids was an independent survival factor (hazard ratio: 0.61; 95% CI: 0.41-0.93; p = .006). CONCLUSIONS: In critically ill older adults with COVID-19 pneumonia, the use of corticosteroid treatment resulted in lower mortality without severe adverse events.


Assuntos
Corticosteroides/uso terapêutico , COVID-19/tratamento farmacológico , Mortalidade Hospitalar/tendências , Hospitalização , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Insuficiência Respiratória/fisiopatologia , Estudos Retrospectivos , SARS-CoV-2
19.
Biomolecules ; 11(2)2021 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-33578998

RESUMO

Alzheimer's disease (AD) is the most common cause of dementia. Epidemiological studies show the association between AD and type 2 diabetes (T2DM), although the mechanisms are not fully understood. Dietary habits and lifestyle, that are risk factors in both diseases, strongly modulate gut microbiota composition. Also, the brain-gut axis plays a relevant role in AD, diabetes and inflammation, through products of bacterial metabolism, like short-chain fatty acids. We provide a comprehensive review of current literature on the relation between dysbiosis, altered inflammatory cytokines profile and microglia in preclinical models of AD, T2DM and models that reproduce both diseases as commonly observed in the clinic. Increased proinflammatory cytokines, such as IL-1ß and TNF-α, are widely detected. Microbiome analysis shows alterations in Actinobacteria, Bacteroidetes or Firmicutes phyla, among others. Altered α- and ß-diversity is observed in mice depending on genotype, gender and age; therefore, alterations in bacteria taxa highly depend on the models and approaches. We also review the use of pre- and probiotic supplements, that by favoring a healthy microbiome ameliorate AD and T2DM pathologies. Whereas extensive studies have been carried out, further research would be necessary to fully understand the relation between diet, microbiome and inflammation in AD and T2DM.


Assuntos
Doença de Alzheimer/complicações , Complicações do Diabetes/metabolismo , Dieta , Microbiota , Actinobacteria/metabolismo , Doença de Alzheimer/metabolismo , Doença de Alzheimer/microbiologia , Animais , Bacteroidetes/metabolismo , Diabetes Mellitus/metabolismo , Diabetes Mellitus/microbiologia , Modelos Animais de Doenças , Firmicutes/metabolismo , Microbioma Gastrointestinal , Humanos , Inflamação , Estilo de Vida , Camundongos , Estado Pré-Diabético/metabolismo , Estado Pré-Diabético/microbiologia , Probióticos , Fatores de Risco
20.
Cient. dent. (Ed. impr.) ; 18(1): 35-41, feb. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-201769

RESUMO

El tratamiento de recesiones gingivales utilizando procedimientos de cirugía plástica periodontal es habitualmente requerido en la odontología moderna. El objetivo final de estos procedimientos es la cobertura completa de la raíz y los resultados estéticos agradables. La literatura muestra que el colgajo de avance coronal + injerto de tejido conectivo podría ser considerado como el "gold standard" para el tratamiento de recesiones gingivales unitarias. Sin embargo, en la arcada inferior podemos encontrarnos con limitaciones anatómicas que nos impidan realizar las técnicas convencionales de cirugía mucogingival. En este trabajo se presenta y describe el tratamiento de recesiones gingivales unitarias y múltiples que afectan a la zona anteroinferior, las cuales se trataron mediante la técnica de Edlan-Mejchar modificada. La utilización de la técnica de Edlan-Mejchar modificada muestra resultados positivos para tratar recesiones gingivales en el sector anteroinferior


Treatment of gingival recessions using periodontal plastic surgery procedures is routinely required in modern dentistry. The ultimate goal of these procedures is complete root coverage and pleasing aesthetic results. The literature shows that the coronal advancement flap + connective tissue graft could be considered as the "gold standard" for the treatment of single gingival recessions. However, in the lower arch we can find anatomical limitations that prevent us from performing conventional mucogingival surgery techniques. In this work we present and describe the treatment of single and multiple gingival recessions that affect the lower anterior zone, which were treated using the modified Edlan-Mejchar technique. The use of the modified Edlan-Mejchar technique shows positive results to treat gingival recessions in the mandibular anterior area


Assuntos
Humanos , Feminino , Adulto Jovem , Adulto , Retração Gengival/cirurgia , Gengivoplastia/métodos , Tecido Conjuntivo/transplante , Retalhos Cirúrgicos/cirurgia , Resultado do Tratamento , Estética Dentária
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