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1.
Nurse Educ Pract ; 40: 102629, 2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31568983

RESUMO

The ability to empathize with patients has a positive effect on health outcomes and quality of care. This study aimed to evaluate the psychometric characteristics of the Spanish version of the Jefferson Scale of Empathy-Health Profession Student version (JSE-HPS) in a sample of 422 nursing students and to compare their factorial structure with that of the original scale. In this study, the Cronbach α value was 0.828. These analyses showed that the scale has a factorial structure with three dimensions and all the items loaded adequately (>0.36) except for item 18 (0.266). The main factor, ̔Perspective taking̕ grouped 10 items; the second factor, ̔Compassionate care̕, grouped 6 items, and the third factor, ̔Standing in the patient's shoes̕, grouped 3 items; 42.2% of the variance was explained. The results of the confirmatory factor analysis suggest that the Spanish version of the JSE-HPS is a valid and reliable way to evaluate the empathic capacity of nursing students.

2.
Front Immunol ; 10: 1819, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31428100

RESUMO

Cow's milk protein allergy (CMPA) is the most common allergy in the first year of life. Non-IgE mediated CMPA is characterized by digestive symptoms and tolerance development before the age of three. Gut microbiota composition in early life has been associated with food allergy. The ingestion of different foods/nutrients may mark different shifts in the microbial colonization of the infant intestine as well as the consumption of probiotics. Aim: To analyze changes in microbiota composition and metabolic and cytokine profiles in fecal samples from infants with non-IgE mediated CMPA after successful milk challenges, tolerance acquisition, and increasing dairy introduction in their diet. Methods: Twelve children with CMPA, aged between 1 and 2 years old, were recruited for the study. Participants were initially consuming hypoallergenic hydrolyzed formulas (four of them supplemented with the probiotic Lactobacillus rhamnosus GG), before being exposed to a standardized oral challenge (SOC) with cow's milk. Fecal samples were collected before, 1 week, and 1 month after performing the SOC. Changes in gut microbiota were determined by high-throughput amplicon sequencing of the 16S rRNA gene. Levels of lactobacilli were also determined by quantitative PCR (qPCR). Microbial metabolites were analyzed by chromatographic methods and fecal cytokines related to the Th1/Th2 balance were determined by immunoassay. Results: Lactic acid bacteria significantly increased in infants who outgrew non-IgE CMPA, after the introduction of milk. Microbial metabolites derived from the fermentation of proteins, such as branched chain fatty acids, and p-cresol, diminished. After the SOC, some cytokines related to inflammation (TNF-α, IFN-γ) increased. Accompanying the introduction of an unrestricted diet, we found significant differences in fecal microbial composition, metabolites, and cytokines between infants who did not consume the probiotic L. rhamnosus GG and those that did. Conclusions: These findings indicate that the introduction of intact milk proteins is followed by modifications in the infant gut environment through changes in immune mediators, microbiota, and its metabolic end-products. Consumption of probiotics during CMPA may contribute to gut homeostasis by fine-tuning these profiles.

3.
Inorg Chem ; 58(12): 8188-8197, 2019 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-31124665

RESUMO

The pyridazine-pyridine triazole-based Rat ligand, Lpydzpy [4-(4-methylphenyl)-3-(3-pyridazinyl)-5-(2-pyridinyl)-1,2,4-triazole], is potentially ditopic. Nevertheless, Lpydzpy is shown herein to exclusively form mononuclear iron(II) complexes, [FeII(Lpydzpy)2(NCE)2]·solvent, in the presence of coordinating NCE anions (E = S or Se). Specifically, a new family of 10 mononuclear complexes, in which Lpydzpy binds in a monotopic bidentate manner, has been made: two solvent-free complexes, [FeII(Lpydzpy)2(NCS)2] (1) and [FeII(Lpydzpy)2(NCSe)2] (2); six solvatomorphs, 1·4CH3CN, 2·4CH3CN, 1·2.25CH3CN, 2·3CH3CN, 2·tetrahydrofuran, and 2·CHCl3; and a pair of desolvated polymorphs, 1' and 2'. Seven of them are spin crossover-active, the exceptions being 1, 2, and 2'. This is confirmed by single-crystal X-ray diffraction (XRD) for 1, 2, 1·4CH3CN, and 2·4CH3CN and is consistent with variable-temperature optical microscopy observations on single crystals of 1·4CH3CN and 2·4CH3CN and on samples of 1' and 2'. Powder XRD, thermogravimetric analysis, and solid-state magnetometry reveal that desolvated 1' and 2' are capable of absorbing and desorbing a range of volatile guests: CH3CN in both cases and also tetrahydrofuran and CHCl3 in the case of 2'.

4.
Radiographics ; 39(3): 651-667, 2019 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30951437

RESUMO

Fibrosing mediastinitis is a rare benign but potentially life-threatening process that occurs because of proliferation of fibrotic tissue in the mediastinum. The focal subtype is more common and typically is associated with an abnormal immunologic response to Histoplasma capsulatum infection. Affected patients are typically young at presentation, but a wide age range has been reported, without a predilection for either sex. The diffuse form may be idiopathic or associated with autoimmunity, usually affects middle-aged and/or elderly patients, and is more common in men. For both subtypes, patients present with signs and symptoms related to obstruction or compression of vital mediastinal structures. The most common presenting signs and symptoms are cough, dyspnea, recurrent pneumonia, hemoptysis, and pleuritic chest pain. Patients with the diffuse subtype may have additional extrathoracic symptoms depending on the other organ systems involved. Because symptom severity is variable, treatment should be individualized with therapies tailored to alleviate compression of the affected mediastinal structures. Characteristic imaging features of fibrosing mediastinitis include infiltrative mediastinal soft tissue (with or without calcification) with compression or obstruction of mediastinal vascular structures and/or the aerodigestive tract. When identified in the appropriate clinical setting, these characteristic features allow the radiologist to suggest the diagnosis of fibrosing mediastinitis. Careful assessment is crucial at initial and follow-up imaging for exclusion of underlying malignancy, assessment of disease progression, identification of complications, and evaluation of treatment response. Online supplemental material is available for this article. ©RSNA, 2019.

5.
Enferm. glob ; 18(54): 1-24, abr. 2019. tab, graf
Artigo em Espanhol | LILACS-Express | ID: ibc-ET1-2977

RESUMO

Objetivo: Determinar la prevalencia de ser víctima de bullying y analizar la influencia de factores personales y sociales sobre este fenómeno en una población de adolescentes. Metodología: Estudio descriptivo, transversal y multicéntrico, realizado entre alumnos de 15-18 años en cinco institutos de educación secundaria de Cuenca durante el curso académico 2015-1016. Las variables de estudio se recogieron mediante un cuestionario autoadministrado que incluyó: edad, sexo, diferentes subescalas del cuestionario KIDSCREEN-52 y la escala de resiliencia CD-RISC 10.Resultados: Se recogieron datos de 844 estudiantes (54% chicas), la edad media de la muestra fue de 16,36 años. La prevalencia de víctimas de bullying fue de 29,5%. El análisis multivariante para los factores personales, mostró que ser chica, ser más resiliente, tener mejor autopercepción y bienestar psicológico, protegen frente a ser víctimas. Mientras que el modelo de factores sociales indicó que tienen también un efecto protector los recursos económicos, las relaciones con los padres, amigos y entorno escolar. Conclusión: El bullying es un fenómeno complejo de elevada prevalencia y gran repercusión social. En nuestro trabajo, las características propias de los adolescentes tales como la capacidad de resistencia y el control emocional, así como las relacionadas con su red social de apoyo, son factores protectores frente al bullying. Las políticas de prevención deben ser multisectoriales y multidisciplinares implicando a la familia, entorno escolar y asistencial y red social. Las enfermeras de atención primaria y especialmente la enfermera escolar, podrían facilitar una mayor coordinación entre los distintos sectores y aunar esfuerzos para promover entornos seguros para nuestros jóvenes


Objective: To determine the prevalence of bullying victimization and to analyze personal and social factors influence over this phenomenon in an adolescent population.Methodology: A descriptive, cross-sectional and multicenter study was carried out in 15-18 years old pupils in five secondary schools of Cuenca during the 2015-16 school year. The variables were collected through a self-administered questionnaire and included age, gender, different subscales of the KIDSCREEN-52 questionnaire and the resilience scale CD-RISC 10.Results: Data were obtained from 844 students (of whom 54% were girls) whose average age was 16.36 years old. The prevalence of bullying victimization was 29,5%. The multivariate analysis for the personal factors showed that being girl, more resilient, having better self-perception and psychological well-being, protect from being victims. Whereas the social factors model indicated that financial resources, parents and peers' relations and school environment do also have a protective effect.Conclusion: Bullying is a complex phenomenon with high prevalence and great social impact. In our work, adolescents' specific characteristics such as resistance capacity and emotional control, as well as the ones related to their social support, are protective factors against bullying. Prevention polices should be multisectoral and multidisciplinary involving the family, school and health environment and social network. Primary care nurses and especially the school nurse could provide greater coordination among the different sectors and join efforts to promote safe environments for our young people

7.
Metas enferm ; 22(2): 21-26, mar. 2019. tab
Artigo em Espanhol | LILACS-Express | ID: ibc-ET2-2266

RESUMO

Objetivo: analizar la influencia de los diferentes estilos de escucha sobre la empatía en estudiantes de Enfermería. Método: estudio descriptivo transversal, en estudiantes de Enfermería que han realizado asignaturas de prácticas clínicas (n= 557). Variables de estudio: edad, sexo, empatía (Jefferson Scale of Empathy for Health Professions [JSE-HPS]) y estilos de escucha (The Listening Styles Profile [LSP-16]). Análisis estadístico: análisis bivariante mediante t de Student y coeficiente de correlación de Pearson; análisis multivariante mediante regresión lineal. Resultados: participaron 446 estudiantes (edad media: 22,8 años; 20,4% hombres). Puntuación media en empatía: 118,0 (DE: 12,2). Los valores medios de los estilos de escucha fueron: 12,5 (DE: 1,8) para persona; 9,1 (DE: 2,2) para contenido; 7,5 (DE: 2,7) para acción y 4,8 (DE: 2,8) para tiempo. El análisis multivariado mostró, ajustando por edad y sexo, que la capacidad empática aumenta a mayor puntuación en el estilo centrado de la Persona (ß= 0,243) y, de forma opuesta, disminuye a medida que aumenta el estilo centrado en Tiempo (ß= -0,271). Conclusión: el estilo de escucha orientado a Persona, que se centra en las necesidades y sentimientos del paciente, es el que predomina y aumenta la capacidad empática; mientras que el orientado al Tiempo es característico de los oyentes impacientes y tiene un efecto negativo sobre la empatía. A lo largo de la formación clínica, el alumnado tiene que ser consciente de la influencia de su estilo de escucha durante la interacción con el paciente


Objectives: to analyze the influence of different listening styles on empathy among Nursing students. Method: a descriptive and cross-sectional study among Nursing students who have completed subjects from practical to clinical (n= 557). Study variables; age, gender, empathy (Jefferson Scale of Empathy for Health Professions (JSE-HPS)) and listening styles (The Listening Styles Profile (LSP-16)). Statistical analysis: bivariate analysis through Student's t and Pearson Correlation Coefficient; multivariate analysis through linear regression. Results: in total, 446 students participated (mean age: 22.8 years; 20.4% were male). The mean score in empathy was 118.0 (SD: 12.2). The mean values for listening styles were: 12.5 (SD: 1.8) for People; 9.1 (SD: 2.2) for Contents; 7.5 (SD: 2.7) for Action and 4.8 (SD: 2.8) for Time. The multivariate analysis, adjusted by age and gender, showed that the empathic ability increases when there is a higher score in the People-oriented style (ß= 0.243); and, on the other hand, it is reduced when there is an increase in the Time-oriented style (ß= -0.271). Conclusion: the Person-oriented listening style, which focuses on the needs and feelings by the patient, is the prevailing one and it increases the empathic ability; while the Time-oriented style is characteristic in impatient listeners, and has a negative effect on empathy. During clinical training, students must be aware of the influence of their listening style during their interaction with patients

8.
Radiographics ; 39(2): 321-343, 2019 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30735469

RESUMO

Orthotopic heart transplant (OHT) is the treatment of choice for end-stage heart disease. As OHT use continues and postoperative survival increases, multimodality imaging evaluation of the transplanted heart will continue to increase. Although some of the imaging is performed and interpreted by cardiologists, a substantial proportion of images are read by radiologists. Because there is little to no consensus on a systematic approach to patients after OHT, radiologists must become familiar with common normal and abnormal posttreatment imaging features. Intrinsic transplant-related complications may be categorized on the basis of time elapsed since transplant into early (0-30 days), intermediate (1-12 months), and late (>12 months) stages. Although there can be some overlap between stages, it remains helpful to consider the time elapsed since surgery, because some complications are more common at certain stages. Recognition of differing OHT surgical techniques and their respective postoperative imaging features helps to avoid image misinterpretation. Expected early postoperative findings include small pneumothoraces, pleural effusions, pneumomediastinum, pneumopericardium, postoperative atelectasis, and an enlarged cardiac silhouette. Early postoperative complications also can include sternal dehiscence and various postoperative infections. The radiologist's role in the evaluation of allograft failure and rejection, endomyocardial biopsy complications, cardiac allograft vasculopathy, and posttransplant malignancy is highlighted. Because clinical manifestations of disease may be delayed in transplant recipients, radiologists often recognize postoperative complications on the basis of imaging and may be the first to suggest a specific diagnosis and thus positively affect patient outcomes. Online supplemental material is available for this article. ©RSNA, 2019.

9.
Chem Asian J ; 14(8): 1158-1166, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30550630

RESUMO

Five new mononuclear iron(II) tris-ligand complexes, and four solvatomorphs, have been made from the azine-substituted 1,2,4-triazole ligands (Lazine ): [FeII (Lpyridazine )3 ](BF4 )2 (1), [FeII (Lpyrazine )3 ](BF4 )2 (2), [FeII (Lpyridine )3 ](BF4 )2 (3), [FeII (L2pyrimidine )3 ](BF4 )2 (4), and [FeII (L4pyrimidine )3 ](BF4 )2 (5). Single-crystal XRD and solid-state magnetometry reveal that all of them are low-spin (LS) iron(II), except for solvatomorph 5⋅4 H2 O. Evans method NMR studies in CD2 Cl2 , (CD3 )2 CO and CD3 CN show that all are LS in these solvents, except 5 in CD2 Cl2 (consistent with L4pyrimidine imposing the weakest field). Cyclic voltammetry in CH3 CN vs. Ag/0.01 m AgNO3 reveals an, at best quasi-reversible, FeIII/II redox process, with Epa increasing from 0.69 to 0.99 V as the azine changes: pyridine< pyridazine<2-pyrimidine<4-pyrimidine< pyrazine. The observed Epa values correlate linearly with the DFT calculated HOMO energies for the LS complexes.

10.
Radiol Clin North Am ; 57(1): 213-231, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30454814

RESUMO

Various disease processes may affect the ascending thoracic aorta, aortic arch, and/or descending thoracic aorta, including aneurysms, dissections, intramural hematomas, penetrating atherosclerotic ulcers, and aortic transection/rupture. Many of those conditions require surgical intervention for repair. Multiple open and endovascular techniques are used for treatment of thoracic aortic pathology. It is imperative that the cardiothoracic radiologist have a thorough knowledge of the surgical techniques available, the expected postoperative imaging findings, and the complications that may occur to accurately diagnose life-threatening pathology when present, and avoid common pitfalls of misinterpreting normal postoperative findings as pathologic conditions.


Assuntos
Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Meios de Contraste , Humanos
11.
Sensors (Basel) ; 19(1)2018 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-30587826

RESUMO

The Internet of Things (IoT) contains sets of hundreds of thousands of network-enabled devices communicating with central controlling nodes or information collectors. The correct behaviour of these devices can be monitored by inspecting the traffic that they create. This passive monitoring methodology allows the detection of device failures or security breaches. However, the creation of hundreds of thousands of traffic time series in real time is not achievable without highly optimised algorithms. We herein compare three algorithms for time-series extraction from traffic captured in real time. We demonstrate how a single-core central processing unit (CPU) can extract more than three bidirectional traffic time series for each one of more than 20,000 IoT devices in real time using the algorithm DStries with recursive search. This proposal also enables the fast reconfiguration of the analysis computer when new IoT devices are added to the network.

12.
Nutrients ; 10(10)2018 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-30314304

RESUMO

Cow's milk protein allergy (CMPA) is the most common food allergy in infancy. Non-IgE mediated (NIM) forms are little studied and the responsible mechanisms of tolerance acquisition remain obscure. Our aim was to study the intestinal microbiota and related parameters in the fecal samples of infants with NIM-CMPA, to establish potential links between type of formula substitutes, microbiota, and desensitization. Seventeen infants between one and two years old, diagnosed with NIM-CMPA, were recruited. They were all on an exclusion diet for six months, consuming different therapeutic protein hydrolysates. After this period, stool samples were obtained and tolerance development was evaluated by oral challenges. A control group of 10 age-matched healthy infants on an unrestricted diet were included in the study. Microbiota composition, short-chain fatty acids, calprotectin, and transforming growth factor (TGF)-ß1 levels were determined in fecal samples from both groups. Infants with NIM-CMPA that consumed vegetable protein-based formulas presented microbiota colonization patterns different from those fed with an extensively hydrolyzed formula. Differences in microbiota composition and fecal parameters between NIM-CMPA and healthy infants were observed. Non-allergic infants showed a significantly higher proportion of Bacteroides compared to infants with NIM-CMPA. The type of protein hydrolysate was found to determine gut microbiota colonization and influence food allergy resolution in NIM-CMPA cases.

13.
Enferm. clín. (Ed. impr.) ; 28(5): 283-291, sept.-oct. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-177675

RESUMO

Objetivo: Analizar la influencia de la resiliencia sobre las distintas dimensiones de la calidad de vida relacionada con la salud en un grupo de adolescentes escolarizados en la ciudad de Cuenca. Método: Se realizó un estudio descriptivo, transversal, multicéntrico y polietápico en 5 institutos de Educación Secundaria durante el curso académico 2015-1016. Instrumentos: Cuestionario autoadministrado que incluía variables sociodemográficas y las escalas CD-RISC 10 para evaluar resiliencia y KIDSCREEN-52 para medir la calidad de vida relacionada con la salud. Resultados: Se recogieron datos de 844 estudiantes, de los cuales el 54% fueron chicas y la edad media de la muestra fue de 16,36±1,05 años. Se observaron valores superiores de resiliencia en los chicos. Con respecto a la calidad de vida relacionada con la salud, fue menor en las chicas (salvo en la dimensión de aceptación social) y en el grupo de mayor edad. La resiliencia se asoció significativamente con todas las dimensiones del KIDSCREEN-52 y resultó ser un predictor relevante, especialmente en las dimensiones relacionadas con la salud mental y en todas las que miden relaciones sociales. Conclusión: Nuestro estudio aporta evidencias sobre la sinergia calidad de vida relacionada con la salud-resiliencia en adolescentes. La resiliencia se asocia con niveles más elevados de calidad de vida en adolescentes y, al ser menor en chicas, puede ser uno de los factores explicativos de su peor calidad de vida relacionada con la salud


Objective: To analyze the influence of resilience on the different dimensions of health-related quality of life in a group of adolescents in Cuenca. Method: A descriptive, cross-sectional, multicentre and multistage study was carried out in 5 secondary schools during the 2015-2016 school year. Instruments: A self-administered questionnaire, which included sociodemographic characteristics and the CD-RISC 10 scale to assess resilience together with the KIDSCREEN-52 questionnaire to measure health-related quality of life. Results: Data were obtained from 844 students, of whom 54% were girls and the mean age was 16.36±1.05 years. Higher resilience scores were observed in boys. Health-related quality of life was lower in girls (except in the dimension of social acceptance) and in the oldest group. Resilience was significantly associated with all KIDSCREEN-52 dimensions and proved to be a relevant predictor, especially in the dimensions related with mental health and all those that measure social relationships. Conclusion: Our study provides evidence on the synergy between health-related quality of life and resilience in adolescents. Resilience is associated with higher levels of quality of life in adolescents and as the scores are lower in girls, it could be one of the explanatory factors for their poorer health-related quality of life


Assuntos
Humanos , Masculino , Feminino , Adolescente , Nível de Saúde , Qualidade de Vida , Resiliência Psicológica , Estudos Transversais , Autorrelato
14.
Aten. prim. (Barc., Ed. impr.) ; 50(8): 493-499, oct. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-179133

RESUMO

Objetivo: Analizar, en una población de adolescentes escolarizados, la relación entre síntomas psicosomáticos y calidad de vida relacionada con la salud (CVRS) diferenciando por sexo y grupo de edad. Diseño: Estudio transversal. Emplazamiento: Cinco Institutos de Educación Secundaria. Participantes: Ochocientos cuarenta y cuatro adolescentes de entre 15 y 18 años que cursaban 3.° y 4.° de Educación Secundaria Obligatoria y Bachillerato. Mediciones principales: CVRS mediante KIDSCREEN-52 y síntomas psicosomáticos con la escala de problemas psicosomáticos (PSP). Resultados: Las chicas y los adolescentes de 17-18 años presentaron síntomas psicosomáticos significativamente más altos, ambos grupos también puntuaron peor en todas las dimensiones de CVRS aunque solo alcanzaron significación las dimensiones relacionadas con bienestar físico, bienestar mental y estado de ánimo y estrés. Todos los síntomas psicosomáticos se asociaron de forma inversa con las 10 dimensiones del KIDSCREEN-52. Los modelos de regresión realizados mostraron que tristeza, dificultad de concentración y dificultad para dormir fueron los predictores de peor CVRS en ambos sexos y grupos de edad, y estas variables explicaron entre un 30 y un 41% de la varianza de la CVRS de los adolescentes. Conclusiones: Los síntomas psicosomáticos son más frecuentes en las chicas y en los adolescentes mayores, y predictores de peor CVRS. Es importante diferenciarlos de afecciones médicas para evitar intervenciones innecesarias. Como expresiones de malestar emocional deben ser evaluados y tratados de forma integral porque interfieren en la vida cotidiana y aumentan la vulnerabilidad propia de la adolescencia


Aim: To analyze, in a population of adolescents in school, the relationship between psychosomatic symptoms and the perception of health-related quality of life (HRQoL), differentiating by gender and age group. Design: Transversal study. Location: Five Secondary Schools. Participants: Eight hundred and forty four adolescents between the ages of 15 and 18 in secondary school. Main measurements: HRQoL using KIDSCREEN-52 and psychosomatic symptoms with the psychosomatic problems scale (PSP). Results: Girls and adolescents aged 17-18 years presented significantly higher psychosomatic symptoms, both groups also scored worse in all dimensions of HRQoL, although only the dimensions related to physical and mental wellness, mood and stress reached significance. All psychosomatic symptoms were inversely associated with the ten dimensions of KIDSCREEN-52. The regression models showed that sadness, concentrating difficulties and sleeping difficulties were the predictors of worse HRQoL in both sexes and age groups and these variables explained between 30 and 41% of the HRQoL variance of the adolescents. Conclusions: Psychosomatic symptoms are frequent especially in girls and in older adolescents and predictors of worse HRQoL. It is important to distinguish them from medical conditions to avoid unnecessary interventions. As expressions of emotional discomfort they must be evaluated and treated in an integral way because they interfere with daily life and increase the vulnerability proper of adolescence


Assuntos
Humanos , Masculino , Feminino , Adolescente , Transtornos Psicofisiológicos/psicologia , Qualidade de Vida/psicologia , Saúde do Adolescente , Estudos Transversais , Estudo Observacional , Inquéritos e Questionários
15.
Aliment Pharmacol Ther ; 48(7): 723-730, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30095176

RESUMO

BACKGROUND: Little is known about the impact of Epstein-Barr virus (EBV) infection on clinical outcomes in adults with inflammatory bowel disease (IBD). AIM: To evaluate seroprevalence, seroconversion rate and complications associated with EBV infection in an adult IBD cohort attending a tertiary care hospital in Spain between 2006 and 2016. METHODS: EBV serological status was determined. In seronegative patients, the seroconversion rate was evaluated. The complications associated with primary and latent EBV infection are described. RESULTS: One thousand four hundred and eighty-three patients over the age of 17 were included in the study (mean age at EBV serological status determination was 48.3). Overall seroprevalence of EBV was 97.4% (95% CI: 96.6%-98.2%). The seroconversion rate was 29.7% (95% CI: 16.2-45.9) after a mean of 47.5 months. There were no differences in seroconversion rates between patients 35 years or younger and patients older than 35 years. A 66-year-old man, on treatment with thiopurines, developed lymphoma and a hemophagocytic syndrome during a primary EBV infection. Overall, six patients (one with primary infection and five with prior EBV infection) developed lymphoma. In three of five patients with lymphoma and thiopurine use, EBV was associated to the development of lymphoma. CONCLUSIONS: There is a small percentage of adults with IBD at risk of primary EBV infection. The risks of seroconversion and its complications remain through adulthood. Our results suggest that, when considering the use of thiopurines in IBD, the information on EBV serological status should be taken into account at any age.

16.
Enferm Clin ; 28(5): 283-291, 2018 Sep - Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30037487

RESUMO

OBJECTIVE: To analyze the influence of resilience on the different dimensions of health-related quality of life in a group of adolescents in Cuenca. METHOD: A descriptive, cross-sectional, multicentre and multistage study was carried out in 5 secondary schools during the 2015-2016 school year. INSTRUMENTS: A self-administered questionnaire, which included sociodemographic characteristics and the CD-RISC 10 scale to assess resilience together with the KIDSCREEN-52 questionnaire to measure health-related quality of life. RESULTS: Data were obtained from 844 students, of whom 54% were girls and the mean age was 16.36±1.05 years. Higher resilience scores were observed in boys. Health-related quality of life was lower in girls (except in the dimension of social acceptance) and in the oldest group. Resilience was significantly associated with all KIDSCREEN-52 dimensions and proved to be a relevant predictor, especially in the dimensions related with mental health and all those that measure social relationships. CONCLUSION: Our study provides evidence on the synergy between health-related quality of life and resilience in adolescents. Resilience is associated with higher levels of quality of life in adolescents and as the scores are lower in girls, it could be one of the explanatory factors for their poorer health-related quality of life.

18.
Cardiovasc Diagn Ther ; 8(3): 362-371, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30057882

RESUMO

Complications following cardiothoracic surgery are responsible for prolonged hospital stay, increase cost in patient care and increased morbidity and mortality. Vascular complications in particular are significant contributors to poor patient outcome due to either hemorrhage or thrombosis and ischemia. Evaluation of vascular complications in the postoperative patient requires a rapid and reliable imaging approach. Vascular complications after cardiothoracic surgery include pulmonary artery thrombosis, pseudoaneurysm, pulmonary vein thrombosis, vascular fistulas, stenosis and infarction. Multidetector CT (MDCT), often the imaging modality of choice, offers a one-stop-shop capability to visualize the entire cardiothoracic vasculature, airways, lung parenchyma, mediastinum and chest wall with excellent temporal and spatial resolution.

19.
Case Rep Radiol ; 2018: 8574642, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29854536

RESUMO

Primary pulmonary lymphomas are rare with primary pulmonary non-Hodgkin lymphoma accounting for only 0.3% of primary lung neoplasms. Of these, the large majority are made up of marginal zone B-cell lymphoma and diffuse large B-cell lymphoma. We present a case of a very rare primary pulmonary anaplastic large cell lymphoma presenting as the luftsichel sign on chest radiograph. Pertinent imaging and pathology findings are discussed.

20.
Eur J Haematol ; 101(3): 332-339, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29846964

RESUMO

BACKGROUND: High-risk acute leukemia (AL) and myelodysplastic syndrome (MDS) remain a therapeutic challenge. Unmanipulated haploidentical-related donor transplantation based on a myeloablative conditioning regimen (HAPLO-MAC) and post-transplant cyclophosphamide (PT-Cy) as prophylaxis against graft vs host disease (GvHD) is now a promising rescue strategy that could become universally available. OBJECTIVE: To evaluate the results of HAPLO-MAC with PT-Cy in patients with AL and MDS reported to the Haploidentical Transplantation Subcommittee of the Spanish Group for Hematopoietic Transplantation (GETH). PATIENTS AND METHODS: We report our multicenter experience using an IV busulfan-based HAPLO-MAC regimen and PT-Cy for treatment of 65 adults with high-risk AL and MDS. RESULTS: Engraftment was recorded in 64 patients (98.5%), with a median time to neutrophil and platelet recovery of 16 and 27 days, respectively. The cumulative incidence of grade II-IV acute GvHD and chronic GvHD was 28.6% and 27.5%, respectively. After a median follow-up of 31 months for survivors, the cumulative incidence of non-relapse mortality and relapse at 2 years was 18.8% and 25%, respectively. Estimated 30-month event-free survival and overall survival were 56% and 54.5%, respectively. CONCLUSION: HAPLO-MAC comprising an IV busulfan-based conditioning regimen enabled long-term disease control with acceptable toxicity in high-risk AL and MDS.

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