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1.
Adv Exp Med Biol ; 1307: 331-355, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32034728

RESUMO

In type 1 diabetes mellitus (T1DM) pancreas beta-cells do not segregate insulin. This hormone is necessary to convert glucose into energy. Thus, people with diabetes are required to maintain blood glucose (BG) levels within a safe range using external control solutions. Insulin recommender systems (IRS's) provide the precise amount of insulin to the patient when needed, reducing the effects of the disease. The goal of this paper is to review and summarize all current proposals of IRS's and, with this purpose, 70 papers have been analysed. The analysis of the works was performed taking the following aspects into account: (i) technology of the recommendation process, (ii) control procedures, (iii) complementary processes, (iv) hardware, testing and assessment, (v) pricing and (vi) results. Those are our main conclusions after the review: There is a lack of published research works providing real experimentation together with simulation processes. Information about the IRS's features is also lacking in a remarkable percentage of the publications. Due to the variability in how experiments are performed and results are presented, research work comparisons become difficult. In summary, this topic requires standards to be able to perform comparison analysis of published papers and therefore, progress adequately.

2.
Invest. educ. enferm ; 38(3): [e03], Octubre 20 2020.
Artigo em Inglês | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1128915

RESUMO

The development of care research and its teaching in the Faculty of Nursing at Universidad de Antioquia cannot be understood outside the context in which it emerges and from the trajectory of its leading players. This is how this article will present a synthesis of the future of research, with its principal milestones and events in institutional history, in dialogue with the trajectories of four teaching nurses, protagonists of key moments in said history and living testimony of 70 years of institutional life. This panorama seeks to constitute a referent for strategic reflection, which inspires new generations to meet the research challenges and teach care research.


El desarrollo de la investigación del cuidado y de su enseñanza en la Facultad de Enfermería de la Universidad de Antioquia no puede ser entendido por fuera del contexto en que emerge y de la trayectoria de sus protagonistas. En este artículo se presentará una síntesis del devenir de la investigación, con sus principales hitos y acontecimientos en la historia institucional, en diálogo con las trayectorias de cuatro enfermeras docentes, protagonistas de momentos claves de dicha historia y testimonio vivo de 70 años de vida institucional. Este panorama pretende constituir un referente para la reflexión estratégica que inspire a las nuevas generaciones para responder a los retos de la investigación y la enseñanza de la investigación del cuidado


O desenvolvimento da pesquisa do cuidado e seu ensino na Faculdade de Enfermagem da Universidade de Antioquia não podem ser compreendidos fora do contexto em que se inserem e da trajetória de seus protagonistas. É assim que este artigo apresentará uma síntese da evolução da pesquisa, com seus principais marcos e acontecimentos na história institucional, em diálogo com as trajetórias de quatro enfermeiras professoras, protagonistas de momentos chaves de dita história e testemunho vivo de 70 anos de vida institucional. Este panorama pretende constituir um ponto de referência para a reflexão estratégica, que inspire as novas gerações a responder aos desafios da investigação e do ensino da investigação em cuidados.


Assuntos
Humanos , Apoio à Pesquisa como Assunto , Pesquisa em Enfermagem , Educação em Enfermagem , Fontes de Financiamento de Pesquisa , Cuidados de Enfermagem
3.
Artigo em Inglês | MEDLINE | ID: mdl-33048581

RESUMO

Background: The Patient Empowerment through Predictive Personalised Decision Support (PEPPER) system provides personalised bolus advice for people with Type 1 diabetes. The system incorporates an adaptive insulin recommender system (based on case-based reasoning, an artificial intelligence methodology), coupled with a safety system which includes predictive glucose alerts and alarms, predictive low-glucose suspend, personalised carbohydrate recommendations and dynamic bolus insulin constraint. We evaluated the safety and feasibility of the PEPPER system compared to a standard bolus calculator. Methods: This was an open-labelled multicentre randomized controlled cross-over study. Following 4-week run-in, participants were randomized to PEPPER/Control or Control/PEPPER in a 1:1 ratio for 12-weeks. Participants then crossed over after a wash-out period. The primary end-point was percentage time in range (TIR, 3.9mmol/L-10.0mmol/L (70-180mg/dL)). Secondary outcomes included glycaemic variability, quality of life, and outcomes on the safety system and insulin recommender. Results: 54 participants on multiple daily injections (MDI) or insulin pump completed the run-in period, making up the intention-to-treat analysis. Median (interquartile range) age was 41.5 (32.3-49.8) years, diabetes duration 21.0 (11.5-26.0) years and HbA1c 61.0 (58.0-66.1) mmol/mol. No significant difference was observed for percentage TIR between the PEPPER and Control groups (62.5 (52.1-67.8) % vs 58.4 (49.6-64.3) % respectively, p=0.27). For quality of life, participants reported higher perceived hypoglycaemia with the PEPPER system despite no objective difference in time spent in hypoglycaemia. Conclusions: The PEPPER system was safe but did not change glycaemic outcomes, compared to control. There is wide scope for integrating PEPPER into routine diabetes management for pump and MDI users. Further studies are required to confirm overall effectiveness.

4.
PLoS Pathog ; 16(10): e1008929, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33002063

RESUMO

The ability of Mycobacterium tuberculosis (Mtb) to persist inside host cells relies on metabolic adaptation, like the accumulation of lipid bodies (LBs) in the so-called foamy macrophages (FM), which are favorable to Mtb. The activation state of macrophages is tightly associated to different metabolic pathways, such as lipid metabolism, but whether differentiation towards FM differs between the macrophage activation profiles remains unclear. Here, we aimed to elucidate whether distinct macrophage activation states exposed to a tuberculosis-associated microenvironment or directly infected with Mtb can form FM. We showed that the triggering of signal transducer and activator of transcription 6 (STAT6) in interleukin (IL)-4-activated human macrophages (M(IL-4)) prevents FM formation induced by pleural effusion from patients with tuberculosis. In these cells, LBs are disrupted by lipolysis, and the released fatty acids enter the ß-oxidation (FAO) pathway fueling the generation of ATP in mitochondria. Accordingly, murine alveolar macrophages, which exhibit a predominant FAO metabolism, are less prone to become FM than bone marrow derived-macrophages. Interestingly, direct infection of M(IL-4) macrophages with Mtb results in the establishment of aerobic glycolytic pathway and FM formation, which could be prevented by FAO activation or inhibition of the hypoxia-inducible factor 1-alpha (HIF-1α)-induced glycolytic pathway. In conclusion, our results demonstrate that Mtb has a remarkable capacity to induce FM formation through the rewiring of metabolic pathways in human macrophages, including the STAT6-driven alternatively activated program. This study provides key insights into macrophage metabolism and pathogen subversion strategies.

5.
Sci Rep ; 10(1): 18631, 2020 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-33122803

RESUMO

Wild migratory waterfowl are considered one of the most important reservoirs and long-distance carriers of highly pathogenic avian influenza (HPAI). Our study aimed to explore the spatial and temporal characteristics of wild migratory waterfowl's wintering habitat in the Republic of Korea (ROK) and to evaluate the impact of these habitats on the risk of HPAI outbreaks in commercial poultry farms. The habitat use of 344 wild migratory waterfowl over four migration cycles was estimated based on tracking records. The association of habitat use with HPAI H5N8 outbreaks in poultry farms was evaluated using a multilevel logistic regression model. We found that a poultry farm within a wild waterfowl habitat had a 3-8 times higher risk of HPAI outbreak than poultry farms located outside of the habitat. The range of wild waterfowl habitats increased during autumn migration, and was associated with the epidemic peak of HPAI outbreaks on domestic poultry farms in the ROK. Our findings provide a better understanding of the dynamics of HPAI infection in the wildlife-domestic poultry interface and may help to establish early detection, and cost-effective preventive measures.

6.
Int J Cardiol ; 2020 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-32931857

RESUMO

Background Seemingly conflicting findings exist regarding the prognostic impact of totally occluded infarct-related arteries (oIRA) in non-ST elevation acute coronary syndromes (NSTE-ACS). Methods Retrospective analysis of prospective multicenter registry data comprising a single-center NSTE-ACS cohort, aimed at assessing the impact of occluded (TIMI flow 0/1) versus patent culprit vessels (pIRA, TIMI flow 2/3) on the composite endpoint of all-cause death and cardiogenic shock events at 30 days. Results Of 568 patients, 183 (32.5%) had oIRA. Male sex, refractory angina, ECG suggestive of multivessel or left main disease, and larger infarct sizes with inferior/posterolateral wall involvement, were identified as highly specific markers of oIRA. Successful culprit-lesion revascularization occurred more frequently in patent than in oIRA (90% vs. 96%; P = 0.013). Conversely, patients with oIRA more frequently achieved successful revascularization of concurrent non-IRAs including chronic total occlusions than did those with pIRA (28% vs. 3%; P = 0.0005). Multivariate analysis revealed neutral effects of oIRA on outcomes and identified incomplete revascularization as a powerful predictor of mortality. Moderation analysis revealed a significant interaction between completeness of revascularization and IRA patency, whereby among the incompletely revascularized patients, those with oIRA enjoyed a significant survival advantage over their counterparts with pIRA (11.8% vs. 28%, adjusted OR 0.34; 95% CI 0.10-0.73; Pinteraction = 0.012). Conclusions Approximately one third of NSTE-ACS patients in this cohort had oIRA. However, compared with pIRA, the occurrence of oIRA did not portend poor outcomes, likely resulting from the higher rate of incomplete revascularization and increased risk of subsequent mortality in patients with pIRA. These exploratory findings warrant further investigation.

7.
Medisan ; 24(4): 578-592, jul.-ago. 2020. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1125134

RESUMO

RESUMEN Introducción: El temblor es frecuente. Además de agravar el dolor, aumenta la demanda metabólica y el consumo de oxígeno; varios fármacos son utilizados para eliminarlo. Objetivo: Determinar la efectividad de la ketamina y el sulfato de magnesio en pacientes con temblor posanestesia subaracnoidea. Métodos: Se realizó una investigación cuasi-experimental de 394 pacientes, quienes se encontraban bajo anestesia espinal de forma electiva, atendidos en el Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde septiembre de 2016 hasta igual periodo de 2018. Se dividieron en 2 grupos aleatorios con 197 integrantes cada uno: A (ketamina 0,4 mg/kg) y B (sulfato de magnesio 50 mg/kg), a los cuales se le suministraron los medicamentos una vez iniciado el temblor. Resultados: En ambos grupos predominaron los pacientes de 45-64 años de edad. Hubo homogeneidad entre hombres y mujeres, sin significación estadística (p= 0,5378). La mayoría de los afectados se encontraban en el grupo de riesgo anestésico II (88,1 %). En los 2 grupos primó del grado III del temblor antes de la terapia, solo 3,5 % del grupo B a los 30 minutos mantuvo igual condición. En los primeros 10 minutos de suministrar el sulfato de magnesio despareció el temblor en la mayoría de los pacientes (74,5 %). Dicho fármaco resultó efectivo en 83,8 % de los afectados y en aquellos que recibieron ketamina fue de 42,1 %, ambos sin efectos secundarios. Conclusiones: La incidencia del temblor fue alta. La ketamina y el sulfato de magnesio fueron efectivos al permitir la desaparición del temblor en un corto periodo de tiempo, pero el segundo fármaco superó al primero en magnitud considerable.


ABSTRACT Introduction: The shaking is frequent. Besides increasing the pain, it increases the metabolic demand and the oxygen consumption; several drugs are used to eliminate it. Objective: To determine the effectiveness of ketamine and magnesium sulfate in patients with shaking after subarachnoid anesthesia. Methods: A quasi-experimental investigation of 394 patients who received spinal anesthesia in an elective way, assisted at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba, from September, 2016 to the same period in 2018. They were divided in 2 random groups with 197 members each one: A (ketamine 0.4 mg/kg) and B (magnesium sulfate 50 mg/kg), to whom the medications were given once shaking began. Results: In both groups the 45-64 years patients prevailed. There was homogeneity between men and women, without statistical significance (p = 0.5378). Most of those affected were in the group of anesthetic risk II (88.1 %). In the 2 groups the degree III of shaking before therapy prevailed, just 3.5 % in group B maintained the same condition at 30 minutes. In the first 10 minutes of giving the magnesium sulfate shaking disappeared in most of the patients (74.5 %). This drug was effective in 83.8 % of those affected and in those that received ketamine it was of 42.1 %, both without side effects. Conclusions: The incidence of shaking was high. The ketamine and magnesium sulfate were effective when allowing the disappearance of shaking in a short period of time, but the second drug overcame the first one in a considerable magnitude.

8.
Rev. cuba. anestesiol. reanim ; 19(2): e654, mayo.-ago. 2020. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1126366

RESUMO

RESUMEN Introducción: En diciembre del año 2019, una serie de casos de neumonía surgieron en Wuhan, Hubei, China; el 11 de marzo de 2020 se identifica el primer caso en Cuba. El SARS-CoV-2 se transmite rápidamente con consecuencias nefastas para la población y constituye actualmente una pandemia. Las técnicas avanzadas para manejo de vía aérea son propias de anestesiólogos e intensivistas, estas complejas y requieren de elementos y dispositivos que no se encuentran generalmente fuera del ámbito de quirófano. Objetivo: Describir la conducta anestesiológica ante pacientes anunciados para procedimientos quirúrgicos de urgencias o emergencia, con sospecha o confirmación de estar infectado por la COVID-19, durante el perioperatorio. Métodos: Se realizó una revisión de artículos referentes a conductas y estrategias a seguir en pacientes con sospecha/confirmación de la enfermedad COVID-19, tales como: preparación y limpieza del quirófano, consideraciones anestésicas, manejo de la vía aérea y las medidas y equipos de protección necesarias para el personal anestésico-quirúrgico. Desarrollo: La Organización Mundial de la Salud y organizaciones sanitarias recomiendan adoptar en todos estos enfermos de forma rutinaria, una serie de indicaciones descritas en el presente artículo. Conclusiones: Se requiere de entrenamiento y actualización continua por parte del personal médico y paramédico. Los especialistas involucrados en el manejo de la vía área deben disponer de algoritmos locales y del material necesario para garantizar una atención perioperatoria de calidad.


ABSTRACT Introduction: In December 2019, a series of pneumonia cases appeared in Wuhan, Hubei, China. On March 11, 2020, the first case in Cuba was identified. SARS-CoV-2 spreads rapidly, with fatal consequences for the population, and is currently a pandemic. The advanced techniques for the management of the airways are typical of anesthesiologists and intensivists. These are complex and require elements and devices not generally found outside the operating room. Objective: To describe the anesthesiological behavior in patients announced for emergency surgical procedures and with suspicion or confirmation of being affected by COVID-19, during the perioperative period. Methods: A review of articles referring to behaviors and strategies to follow in patients with suspicion/confirmation of COVID-19 disease was carried out; for example, preparation and cleaning of the operating room, anesthetic considerations, management of the airway, as well as the safety measures and the equipment necessary for the anesthetic-surgical personnel. Development: The World Health Organization and other health organizations recommend that a series of indications described in this article be adopted routinely in all these patients. Conclusions: Continuous training and updating is required by medical and paramedical personnel. The specialists involved in the management of the airways must have local algorithms and the materials necessary to guarantee quality perioperative care.

9.
Front Vet Sci ; 7: 385, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32766292

RESUMO

Cardiomyopathy syndrome (CMS) is a severe cardiac disease of Atlantic salmon caused by the piscine myocarditis virus (PMCV), which was first reported in Ireland in 2012. In this paper, we describe the use of data-driven network modeling as a framework to evaluate the transmission of PMCV in the Irish farmed Atlantic salmon population and the impact of different mitigation measures. Input data included live fish movement data from 2009 to 2017, population dynamics events and the spatial location of the farms. With these inputs, we fitted a network-based stochastic infection spread model. After assumed initial introduction of the agent in 2009, our results indicate that it took 5 years to reach a between-farm prevalence of 100% in late 2014, with older fish being most affected. Local spread accounted for only a small proportion of new infections, being more important for sustained infection in a given area. Spread via movement of subclinically infected fish was most important for explaining the observed countrywide spread of the agent. Of the targeted intervention strategies evaluated, the most effective were those that target those fish farms in Ireland that can be considered the most connected, based on the number of farm-to-farm linkages in a specific time period through outward fish movements. The application of these interventions in a proactive way (before the first reported outbreak of the disease in 2012), assuming an active testing of fish consignments to and from the top 8 ranked farms in terms of outward fish movement, would have yielded the most protection for the Irish salmon farming industry. Using this approach, the between-farm PMCV prevalence never exceeded 20% throughout the simulation time (as opposed to the simulated 100% when no interventions are applied). We argue that the Irish salmon farming industry would benefit from this approach in the future, as it would help in early detection and prevention of the spread of viral agents currently exotic to the country.

10.
Artigo em Inglês | MEDLINE | ID: mdl-32785035

RESUMO

It is necessary to determine which variables help prevent the presence of decline or deterioration during the aging process as a function of advancing age. This research analyses the relations between cognitive reserve (CR) and cognitive impairment in 300 individuals. It also aims to confirm the influence of different variables (gender, age, level of studies and institutionalization) in CR and in deterioration in a population of older adults. The results indicate that people with higher CR present less deterioration. Regarding the role of the sociodemographic variables in the level of deterioration and CR, there are no differences between men and women, but there are differences in the variables age, level of studies and institutionalization, in such a way that the older age the greater the cognitive deterioration, the higher the level of studies, the more RC and less deterioration and it was found that the non-institutionalized people present less deterioration and greater CR. It is affirmed that two people with similar clinical characteristics may present different levels of pathology, being the CR the explanation of this fact. The results obtained allow us to affirm that the measurement of CR is considered an essential variable for the diagnosis of neurodegenerative diseases.

11.
J Avian Med Surg ; 34(2): 164-171, 2020 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-32702956

RESUMO

The purpose of this study was to determine whether the thermal image temperatures of the tibiotarsal scaled region of the raptor leg and the plantar surface of ipsilateral foot while perching were correlated. The correlation between leg and foot temperature was sought to determine whether remote imaging of the legs can be used as a reliable predictor of foot temperature. The right and left tarsometatarsal region (Leg) and metatarsal pad (Foot) of 10 captive hawks, including 8 red-tailed hawks (Buteo jamaicensis), 1 Harris's hawk (Parabuteo unicinctus), and 1 Swainson's hawk (Buteo swainsoni) were imaged once daily over 3 consecutive days. To account for conditions of the metatarsal pad that might affect the thermal image, 3 groups were identified: Normal, Active when mild hyperemia was present, and Suspect when abrasions were noted. A significant correlation was evident when thermography readings of the tarsometatarsal region (R.Leg and L.Leg) of the unrestrained bird were compared with readings from the plantar surface of the ipsilateral metatarsal pad when restrained (R.Foot and L.Foot). The correlations for R.Leg versus R.Foot (r = 0.81) and L.Leg versus L.Foot (r = 0.74) suggest that temperatures of the tarsometatarsal region of perching hawks measured by infrared thermography may be useful to screen and monitor for the presence of thermal changes associated with inflammation of the metatarsal pad in captive hawk species.

12.
Sci Rep ; 10(1): 10553, 2020 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-32601329

RESUMO

The type of suture used to repair perineal injury may be associated with this healing process and subsequent sexual function. This study aims to assess whether the suture technique used (continuous or interrupted) has an impact on a woman's sexual function following childbirth. A single-blind randomised clinical trial was conducted with primiparous women who had experienced a perineal injury during childbirth. A computer-generated random number table was applied to allocate women to each group. Data were collected on sociodemographic variables, variables associated with childbirth, and outcomes during the 3 months after childbirth. Mean difference was used to assess the influence of the suture type on outcomes. Multivariate analyses were carried out to adjust for unbalanced variables after randomisation. Seventy women participated in the intervention group (continuous suture) and 64 women in the control group (interrupted suture). The women in the intervention group scored high for sexual desire, adjusted mean difference (aMD) = 1.8, 95% CI = 1.1-2.6 (p < 0.001); the same happened with arousal (aMD = 1.7, 95% CI = 0.8-2.5, p < 0.001). In the intervention group, orgasm was more easily reached, aMD = 0.8, 95% CI = 0.4-1.1 (p < 0.001). Women who received a continuous suture indicated they felt less discomfort (p < 0.001). Women who had a continuous suture reported better postpartum sexual function.Trial registration: ClinicalTrials.gov NCT03825211 posted 31/01/ 2019.

13.
Nanoscale ; 12(26): 14194-14203, 2020 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-32602873

RESUMO

Hot-injection has become the most widespread method used for the synthesis of perovskite quantum dots (QDs) with enormous interest for application in optoelectronic devices. However, there are some aspects of the chemistry involved in this synthesis that have not been completely investigated. In this work, we synthesized ultra-high stable CsPbI3 QDs for more than 15 months by controlling two main parameters: synthesis temperature and the concentration of capping ligands. By increasing the capping ligand concentration during the QD synthesis, we were able to grow CsPbI3 in a broad range of temperatures, improving the photophysical properties of QDs by increasing the synthesis temperature. We achieved the maximum photoluminescence quantum yield (PLQY) of 93% for a synthesis conducted at 185 °C, establishing an efficient surface passivation to decrease the density of non-radiative recombination sites. Under these optimized synthesis conditions, deep red LEDs with an External Quantum Efficiency (EQE) higher than 6% were achieved. The performance of these LEDs is higher than that of the reported CsPbI3 QD-LEDs containing standard capping agents, without additional elements or further element exchange. We show that it is possible to produce stable CsPbI3 QDs with high PLQY and red emission beyond the requirement of the Rec. 2020 standards for red color.

14.
Vet Ophthalmol ; 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32608141

RESUMO

PURPOSE: To explore the effects of chronic, uncontrolled glaucoma on pressure sensitivity in dogs before and after enucleation of the painful globe. METHODS: Client-owned dogs undergoing enucleation for chronic glaucoma with no other sources of pain were enrolled. Normal dogs of similar breeds and skull morphology were enrolled as controls. Craniofacial ratio (CFR) and relative palpebral fissure width (RPFW) were assessed in all patients. Serial mechanical quantitative sensory testing (QST) was performed the day before surgery, and 14, 30, 60, and 120 days after surgery. QST consisted of electronic Von Frey (eVF), and blunt algometry (BA) performed above and below the nonglaucomatous eye, the metacarpus, and metatarsus. Cochet-Bonnet esthesiometry (CB) was also performed on the remaining eye. RESULTS: Twelve dogs (6 per group) were included. Compared to baseline values, sensitivity tended to decrease over time (increased thresholds) in treatment dogs while it stayed constant or increased slightly in control dogs. The difference in change from baseline sensitivity between control and treatment groups was significant at day 120 using BA at supraorbital (P = .0153), infraorbital (P = .0209), and metacarpal sites (P = .007) and overall (P = .0470). This divergence was also significant using CB (P = .0470) on the opposite cornea. As patient CFR and RPFWV increased, both eVF (P = .005-.023) and BA (P = .004-.041) increased. CONCLUSIONS: Sensitivity to mechanical stimuli decreased both locally and at remote sites in dogs following enucleation for painful chronic glaucoma. Cranial conformation is associated with differences in sensitivity.

15.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(3): 137-146, mayo-jun. 2020. tab
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET5-938

RESUMO

INTRODUCCIÓN: La evaluación neuropsicológica es esencial para identificar los cambios cognitivos que ocurren durante el envejecimiento normal y patológico. Sin embargo, es necesario contar con baremos adaptados a las características del funcionamiento cognitivo de la población diana para reducir la posibilidad de falsos diagnósticos de alteración cognitiva. El objetivo de este trabajo es proporcionar baremos normativos basados en una muestra de personas mayores cognitivamente activas que participan en un programa universitario para personas mayores. MATERIALES Y MÉTODOS: Se analizaron datos de 87 participantes (70,9% mujeres) de 66,73 años de edad media, emparejados por edad y nivel educativo, a quienes se aplicó el test de Barcelona revisado-abreviado. Los datos normativos se calcularon mediante regresión lineal controlando la edad, el sexo y los años de escolaridad. Se analizó la utilidad de estos datos normativos en comparación con los baremos disponibles en el manual del test y obtenidos en la población general. RESULTADOS: La variable con mayor peso en la regresión fueron los años de escolaridad, seguida de la edad y el sexo. Los baremos obtenidos en la muestra de personas cognitivamente activas mostraron un número de puntuaciones bajas diferente al de los datos normativos de la población general. El número de puntuaciones bajas difirió en función de los años de escolaridad y del funcionamiento cognitivo general. CONCLUSIONES: Los datos normativos obtenidos con la población mayor cognitivamente activa podrían ayudar a identificar el funcionamiento cognitivo real de personas mayores cognitivamente activas con mayor precisión que utilizando los baremos establecidos con la población general


INTRODUCTION: Neuropsychological assessment is mandatory in order to identify cognitive changes that occur during either normal or pathological aging. However, normative data adapted to the characteristics of the population are needed in order to reduce the probability of false diagnoses of cognitive impairment. The aim of the present work was to compute normative data for cognitively active elderly people attending a University course for the elderly. MATERIALS AND METHODS: An analysis was performed on the data from 87 participants (70.9% women) with a mean age of 66.73 years who undertook the abbreviated- revised Barcelona test (test de Barcelona revisado-abreviado). Normative data were calculated using linear regressions controlling for age, gender, and years of education. Adjusted normative data were compared with normative data available from the test manual and obtained from the general population. RESULTS: Years of education and gender showed the highest weights in the regression model. Normative data for cognitively active older adults showed a different number of low scores compared to normative data from the general population. The number of low scores were related to years of education and general cognitive functioning. CONCLUSIONS: Normative data obtained from cognitively active older people could help identify more accurately the cognitive functioning of cognitively active older people than do normative data obtained from the general population

16.
Transbound Emerg Dis ; 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32559348

RESUMO

There are several routes of African swine fever (ASF) introduction into a country. Among the possible routes of entry, quarantine policies determine the possibility of introduction by legal import of live pigs and pig products. This study aimed at assessing the probability of ASF introduction through legal import of live pigs and pig products during the high risk period (HRP) using a quantitative stochastic approach during 2009-2018. The result indicates that the mean annual probability of ASF introduction by legal import of live pig was 1.58×10-7 (1.52~1.67×10-7 95% CI). The mean annual probability by legal import of pig products was 1.59×10-10 (1.55~1.64×10-10 95% CI), of which Poland assumed 87.9% of the mean annual risk. The current import quarantine policy of Korean government may be enough to block the release of the virus via legal import of live pigs and pig products, and it should be continually enforced. This result can help to elucidate source of infection and minimize the catastrophic consequences of the potential ASF reintroduction into South Korea by designing risk mitigation strategies such as risk-based selection of routes to be assessed and prevented and decreased exposure possibility by increased control of food waste and swill feeding practices.

17.
PLoS One ; 15(6): e0234489, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555649

RESUMO

RATIONALE/BACKGROUND: Though much smaller than the bovine industry, the porcine sector in Argentina involves a large number of farms and represents a significant economic sector. In recent years Argentina has implemented a national registry of swine movements amongst other measures, in an effort to control and eventually eradicate endemic Aujesky's disease. Such information can prove valuable in assessing the risk of transmission between farms for endemic diseases but also for other diseases at risk of emergence. METHODS: Shipment data from 2011 to 2016 were analyzed in an effort to define strategic locations and times at which control and surveillance efforts should be focused to provide cost-effective interventions. Social network analysis (SNA) was used to characterize the network as a whole and at the individual farm and market level to help identify important nodes. Spatio-temporal trends of pig movements were also analyzed. Finally, in an attempt to classify farms and markets in different groups based on their SNA metrics, we used factor analysis for mixed data (FAMD) and hierarchical clustering. RESULTS: The network involved approximate 136,000 shipments for a total of 6 million pigs. Over 350 markets and 17,800 production units participated in shipments with another 83,500 not participating. Temporal data of shipments and network metrics showed peaks in shipments in September and October. Most shipments where within provinces, with Buenos Aires, Cordoba and Santa Fe concentrating 61% of shipments. Network analysis showed that markets are involved in relatively few shipments but hold strategic positions with much higher betweenness compared to farms. Hierarchical clustering yielded four groups based on SNA metrics and node characteristics which can be broadly described as: 1. small and backyard farms; 2. industrial farms; 3. markets; and 4. a single outlying market with extreme centrality values. CONCLUSION: Characterizing the network structure and spatio-temporal characteristics of Argentine swine shipments provides valuable information that can guide targeted and more cost-effective surveillance and control programs. We located key nodes where efforts should be prioritized. Pig network characteristics and patterns can be used to create dynamic disease transmission models, which can both be used in assessing the impact of emerging diseases and guiding efforts to eradicate endemic ones.


Assuntos
Criação de Animais Domésticos/estatística & dados numéricos , Fazendas/estatística & dados numéricos , Pseudorraiva/prevenção & controle , Doenças dos Suínos/prevenção & controle , Transportes/estatística & dados numéricos , Animais , Argentina , Análise por Conglomerados , Pseudorraiva/epidemiologia , Fatores de Risco , Análise Espaço-Temporal , Suínos , Doenças dos Suínos/epidemiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-32516983

RESUMO

Super-refractory status epilepticus (SRSE) represents a neurological emergency that is characterized by a lack of response to the third line of antiepileptic treatment, including intravenous general anesthetics. It is a medical challenge with high morbidity and mortality. Electroconvulsive therapy (ECT) has been recommended as a nonpharmacologic option of treatment after other alternatives are unsuccessful. Its effect on the cessation of SRSE has been minimally investigated. The objective of this article is to analyze the effect of ECT on SRSE. For this purpose, a multidisciplinary team created a protocol based on clinical guidelines similar to those described previously by Ray et al. (2017). ECT was applied to six patients with SRSE after the failure of antiepileptic treatment and pharmacologic coma.The objective of each ECT session was to elicit a motor seizure for at least 20 s. SRSE was resolved in all patients after several days of treatment, including ECT as a therapy, without relevant adverse effects. Thus, ECT is an effective and feasible option in the treatment of SRSE, and its place in the algorithm in treatment should be studied due to the uncommon adverse effects and the noninvasive character of the therapy.


Assuntos
Eletroconvulsoterapia , Estado Epiléptico , Anticonvulsivantes , Criança , Humanos , Estudos Prospectivos
19.
Mem Inst Oswaldo Cruz ; 115: e190401, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32401897

RESUMO

Bacillus Calmette Guerin (BCG) vaccines comprise a family of related strains. Whole genome sequencing has allowed the better characterisation of the differences between many of the BCG vaccines. As sequencing technologies improve, updating of publicly available sequence data becomes common practice. We hereby announce the draft genome of four commonly used BCG vaccines in Brazil, Argentina and Venezuela.


Assuntos
Vacina BCG/genética , Mapeamento Cromossômico , Mycobacterium bovis/genética , Argentina , Sequência de Bases , Brasil , Humanos , Dados de Sequência Molecular , Polimorfismo de Nucleotídeo Único , Venezuela
20.
Behav Brain Res ; 390: 112624, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32428634

RESUMO

It has been reported that environmental stimuli can positively influence addictive responses and the pharmacological effects of drugs of abuse. In this work, we evaluated the ability of environmental enrichment (EE) to attenuate addictive behaviours in mice after repeated exposure to toluene. We also analysed the role of D1 receptors (D1R) in animals chronically exposed to toluene and in those housed under EE. Mice (Swiss Webster) were exposed to toluene (0, 2000 or 4000 ppm, 30 min a day), and addictive responses were examined in the behavioural sensitization model. The induction of sensitization was evaluated over 4 weeks, and its expression was assessed in animals repeatedly exposed to toluene (0 or 4000 ppm, 30 min a day/4 weeks) and then housed under EE conditions during 4 more weeks. D1R levels were measured under these two experimental conditions in the prefrontal cortex, nucleus accumbens, hippocampus and caudate. The results showed that D1R levels decreased during toluene-induced behavioural sensitization. An increase in D1R levels was found in animals housed in EE conditions, in addition to the attenuated expression of behavioural sensitization. These results indicate that environmental stimulation attenuates addictive behaviour induced by toluene and that dynamic changes in D1R are linked in this response.

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