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1.
Neurosurgery ; 2021 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-33548921

RESUMO

BACKGROUND: Progressive and/or unresectable pilocytic astrocytomas (PAs) carry a poor prognosis compared to typical PA. Early radiotherapy (RT) may have severe long-term neurocognitive side effects in this patient population. Intra-arterial (IA) chemotherapy is a viable alternative or addition to intravenous (IV) chemotherapy, which may be beneficial in avoidance of early RT. OBJECTIVE: To evaluate the safety and efficacy of IA chemotherapy in this subset of patients. METHODS: This is a retrospective review of medical records of PA patients who are treated with IA chemotherapy at Oregon Health & Science University from 1997 until 2019. Response to treatment was categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Progression free survival (PFS) and overall survival (OS) are also reported. RESULTS: Twelve patients were identified. All patients experienced progression prior to initiation of IA chemotherapy. The most common grade 3 or 4 toxicities related to chemotherapy were thrombocytopenia (66%), neutropenia (66%), leukopenia (50%), anemia (33%), and lymphopenia (16%). Responses achieved were CR in 1, PR in 3, SD in 7, and PD in 1. Median PFS and median OS were 16.5 and 83.5 mo, respectively. A total of 112 procedures (IA injections) were performed and 250 arteries were catheterized. There were 3 minor and no major complications attributable to procedures. CONCLUSION: This study demonstrates that IA chemotherapy can be safely used in patients with unresectable or progressive PA.

2.
Med Clin (Barc) ; 2021 Jan 28.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33518373

RESUMO

BACKGROUND AND OBJECTIVES: Atrial fibrillation (AF) detection in patients with embolic stroke of underdetermined source (ESUS) entails a change of medical treatment and a significant decrease in the incidence of new strokes. It is necessary to determine which patients would benefit more from prolonged electrocardiographic monitoring. Our aim was to find electrocardiographic and echocardiographic AF predictors in patients with ESUS. METHODS: We performed a cohort study that included 95 consecutive patients admitted to the hospital because of an ESUS. An electrocardiogram, each subject in the study underwent a 24-hour Holter-electrocardiogram (Holter-ECG) and an echocardiogram. A 2-year follow up was also conducted, with a 24-hour Holter-ECG every 3months for the first year, and every 6months during the second one. RESULTS: During the follow-up, AF was detected in 11 patients (11.6%), with a detection rate of 3.2% at 6months, 7.4% at 12months, and 11.6% at 18months as well as at 24months. The variables that were independently related to AF detection included moderate or severe left atrium dilation (P=.02), interatrial advanced block (P=.04) and more than 1000 premature atrial beats on 24-hour Holter-ECG (P=.01). CONCLUSIONS: Moderate or severe atrial dilation, interatrial advanced block, and the presence of more than 1000 premature atrial beats on 24-hour Holter-ECG behave as AF predictors in patients with ESUS.

3.
Ecol Lett ; 2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33501751

RESUMO

Vector-borne diseases (VBDs) are embedded within complex socio-ecological systems. While research has traditionally focused on the direct effects of VBDs on human morbidity and mortality, it is increasingly clear that their impacts are much more pervasive. VBDs are dynamically linked to feedbacks between environmental conditions, vector ecology, disease burden, and societal responses that drive transmission. As a result, VBDs have had profound influence on human history. Mechanisms include: (1) killing or debilitating large numbers of people, with demographic and population-level impacts; (2) differentially affecting populations based on prior history of disease exposure, immunity, and resistance; (3) being weaponised to promote or justify hierarchies of power, colonialism, racism, classism and sexism; (4) catalysing changes in ideas, institutions, infrastructure, technologies and social practices in efforts to control disease outbreaks; and (5) changing human relationships with the land and environment. We use historical and archaeological evidence interpreted through an ecological lens to illustrate how VBDs have shaped society and culture, focusing on case studies from four pertinent VBDs: plague, malaria, yellow fever and trypanosomiasis. By comparing across diseases, time periods and geographies, we highlight the enormous scope and variety of mechanisms by which VBDs have influenced human history.

4.
J Craniofac Surg ; 2021 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-33464778

RESUMO

INTRODUCTION: The incidence of facial bones fractures is 18 to 32 for each 100,000 inhabitants. The most affected population are young working people. Fractures are most commonly caused by assaults and motor vehicle accidents. Its cost of care reaches 1.06 billion dollars. Premodeling osteosynthesis plates with anatomical models can decrease surgical time, bleeding, and increase patient satisfaction. This study aims to evaluate the impact of premodeled osteosynthesis plates, using anatomical models in patients with facial fractures. MATERIAL AND METHODS: Patients with facial fractures treated by open reduction and internal fixation were included-Group A without premolding plates and Group B with premolding. The variables studied were: age, sex, etiology of the fractures, number of fractures, among other variables that reflect the quality of the results. RESULTS: A total of 17 osteosynthesis plates were included in 6 patients. The age was 22 to 47 years; all patients were male. The maximum surgery time was 129 to 300 minutes. The average time to start work was 4.8 weeks. When comparing the variables between the groups, we found no difference between the groups for bleeding P = 0.24, the start of work P = 0.19, the time of surgery P = 0.082, or for osteosynthesis time P = 0.15. There was only a significant difference in patient satisfaction, P = 0.04. CONCLUSIONS: The evidence collected shows that premodeling the plates only improves patients' satisfaction among facial fractures treated by open reduction and internal fixation.

5.
J Vasc Surg ; 73(1): 356, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33349393
7.
Analyst ; 145(22): 7252-7259, 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33164011

RESUMO

A nanocrystalline graphite-like amorphous carbon (graphite from the University of Idaho thermolyzed asphalt reaction, GUITAR) shares morphological features with classical graphites, including basal and edge planes (BP, EP). However, unlike graphites and other sp2-hybridized carbons, GUITAR has fast heterogenous electron transfer (HET) across its basal planes, and resistance to corrosion similar to sp3-C and boron-doped diamond electrodes. In this contribution, quinoid modified BP-GUITAR (q-GUITAR) is examined as a sensor for pH determination. This modification is performed by applying 2.0 V (vs. Ag/AgCl) for 150 seconds followed by 15 cyclic voltammetric scans from -0.7 to 1.0 V at 50 mV s-1 in 1.0 M H2SO4. The quinoid surface coverage of q-GUITAR is 1.35 × 10-9 mol cm-2, as measured by cyclic voltammetry. X-ray photoelectron spectroscopy analysis also confirms the high surface coverage. The quinoid surface concentration ranks highest in literature when compared with other basal plane graphitic materials. This yields a sensor that responds through a square wave voltammetric reduction peak shift of 63.3 mV per pH over a pH range from 0 to 11. The response on q-GUITAR is stable for >20 measurements and no surface re-activation is required between the measurements. The common interferents, Na+, K+ and dissolved oxygen, have no effect on the response of the q-GUITAR-based pH sensor.

8.
J Clin Gastroenterol ; 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33252555

RESUMO

OBJECTIVE: The authors investigated the incidence, risk factors, clinical characteristics, and outcomes of upper gastrointestinal bleeding (UGB) in patients with coronavirus disease 2019 (COVID-19), who were attending the emergency department (ED), before hospitalization. METHODS: We retrospectively reviewed all COVID-19 patients diagnosed with UGB in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We formed 2 control groups: COVID-19 patients without UGB (control group A) and non-COVID-19 patients with UGB (control group B). Fifty-three independent variables and 4 outcomes were compared between cases and controls. RESULTS: We identified 83 UGB in 74,814 patients with COVID-19 who were attending EDs (1.11%, 95% CI=0.88-1.38). This incidence was lower compared with non-COVID-19 patients [2474/1,388,879, 1.78%, 95% confidence interval (CI)=1.71-1.85; odds ratio (OR)=0.62; 95% CI=0.50-0.77]. Clinical characteristics associated with a higher risk of COVID-19 patients presenting with UGB were abdominal pain, vomiting, hematemesis, dyspnea, expectoration, melena, fever, cough, chest pain, and dysgeusia. Compared with non-COVID-19 patients with UGB, COVID-19 patients with UGB more frequently had fever, cough, expectoration, dyspnea, abdominal pain, diarrhea, interstitial lung infiltrates, and ground-glass lung opacities. They underwent fewer endoscopies in the ED (although diagnoses did not differ between cases and control group B) and less endoscopic treatment. After adjustment for age and sex, cases showed a higher in-hospital all-cause mortality than control group B (OR=2.05, 95% CI=1.09-3.86) but not control group A (OR=1.14, 95% CI=0.59-2.19) patients. CONCLUSIONS: The incidence of UGB in COVID-19 patients attending EDs was lower compared with non-COVID-19 patients. Digestive symptoms predominated over respiratory symptoms, and COVID-19 patients with UGB underwent fewer gastroscopies and endoscopic treatments than the general population with UGB. In-hospital mortality in COVID-19 patients with UGB was increased compared with non-COVID patients with UGB, but not compared with the remaining COVID-19 patients.

9.
Eur. j. anat ; 24(6): 523-526, nov. 2020. ilus
Artigo em Inglês | IBECS-Express | IBECS | ID: ibc-ET2-7787

RESUMO

The sesamoid bones are round or oval bones that are located within tendons, and most theories consider that sesamoid bones in humans develop in response to local mechanical stress on a joint. Although their function is not well understood, it is known that they act as a pulley modifying the angle of movement and their insertion. They are mostly inconsistent, which is why they tend to be supernumerary and are located in different parts of the body at the level of the extremities, with the patella being the largest, most constant and best known. The prevalence and distribution of sesamoids in the hand varies between different populations and sex. They are rarely reported since they are only considered anatomical variants, but clinically there are several pathologies related to the sesamoid bones in the hand such as: trauma, degenerative disorders, giant cell tumors, osteochondroma, avascular necrosis, tendon ruptures, genetic disorders and attention should be paid in patients with acromegaly where their length is increased. In this article, we report a total of 16 sesamoid bones, symmetrically distributed 8 ineach hand of a healthy individual treated in the Plastic Surgery Department of the "Dr. Rubén Leñero" Hospital in Mexico City. In the literature reviewed, we did not find a report with the presence of so many sesamoid bones in both hands, which motivated us to report it


No disponible

10.
J Agric Food Chem ; 68(41): 11512-11523, 2020 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-32924472

RESUMO

This study aimed to investigate the key compounds involved in the aroma of French Syrah wines from the northern Rhone valley from two vintages characterized by distinct climatic conditions. The volatile composition of the wines was assessed through the determination of 76 molecules. After identifying the best matrix and best model for aroma reconstitution studies, omission tests were conducted using the Pivot profile method. For both vintages, 35 molecules with odor activity values (OAVs) above 0.5 were identified. While remarkably high levels of 2-furfurylthiol (FFT) were reported in both wines, rotundone and 3-sulfanylhexanol (3SH) enabled the strongest discrimination between the two wines. Wine dearomatized using supercritical carbon dioxide (sCO2) was identified as the best matrix. The best models built using this matrix were composed of molecules with OAV > 5 and OAV > 10 highlighting that this dearomatization approach can be valuable to reconstitute the aroma of wine using a small number of molecules. For the cool vintage wine, the omission of rotundone and FFT had the greatest impact on the olfactive profile for nonanosmic and anosmic respondents to rotundone, respectively. 3SH, whose omission decreased the rating of the "fruity" attribute, was identified as the main contributor to the aroma of Syrah wine produced in the warm vintage.

11.
Biomolecules ; 10(7)2020 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-32708695

RESUMO

In northern Mexico, the distilled spirit sotol with a denomination of origin is made from species of Dasylirion. The configuration of the volatile metabolites produced during the spontaneous fermentation of Dasylirion sp. must is insufficiently understood. In this study, the aim was to investigate the composition of the microbial consortia, describe the variation of volatile metabolites, and relate such profiles with their particular flavor attributes during the fermentation of sotol (Dasylirion sp.) must. Ascomycota was the phylum of most strains identified with 75% of total abundance. The genus of fermenting yeasts constituted of 101 Pichia strains and 13 Saccharomyces strains. A total of 57 volatile metabolites were identified and grouped into ten classes. The first stage of fermentation was composed of diesel, green, fruity, and cheesy attributes due to butyl 2-methylpropanoate, octan-1-ol, ethyl octanoate, and butanal, respectively, followed by a variation to pungent and sweet descriptors due to 3-methylbutan-1-ol and butyl 2-methylpropanoate. The final stage was described by floral, ethereal-winey, and vinegar attributes related to ethyl ethanimidate, 2-methylpropan-1-ol, and 2-hydroxyacetic acid. Our results improve the knowledge of the variations of volatile metabolites during the fermentation of sotol must and their contribution to its distinctive flavor.

12.
Rev. esp. cardiol. (Ed. impr.) ; 73(7): 554-560, jul. 2020. tab, graf
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-ET1-6231

RESUMO

INTRODUCCIÓN Y OBJETIVOS: El bloqueo auriculoventricular (BAV) en presencia de fármacos bradicardizantes (FBZ) puede ser reversible, y está en controversia el implante de marcapasos. El objetivo es analizar la necesidad de tratamiento con marcapasos a medio plazo, tras la suspensión de los FBZ, e identificar factores predictores. MÉTODOS: Se estudió a una cohorte de pacientes que acudieron a urgencias con BAV de alto grado mientras tomaban FBZ. Se estudió la persistencia de BAV tras la interrupción del fármaco, la recurrencia en los pacientes con resolución del BAV y las variables predictoras asociadas con la necesidad de marcapasos a los 3 años de seguimiento. RESULTADOS: De 127 pacientes (edad, 79 [71-83] años), en 60 (47,2%) se resolvió el BAV; de estos, en 40 (66,6%) el BAV recurrió en los 24 meses de seguimiento medio; 107 pacientes (84,3%) tuvieron indicación de implante de marcapasos pese a suspenderse los FBZ. Las variables asociadas con la necesidad de marcapasos a los 3 años en el multivariable fueron: frecuencia cardiaca<35 lpm (OR=8,12; IC95%, 1,82-36,17); síntomas diferentes del síncope (OR=4,09; IC95%, 1,18-14,13) y QRS ancho (OR=5,65; IC95%, 1,77-18,04). El tratamiento con antiarrítmicos no se asoció con necesidad de marcapasos (OR=0,12; IC95%, 0,02-0,66). CONCLUSIONES: Más del 80% de los pacientes con BAV secundario a FBZ precisan implante de marcapasos a pesar de suspenderlos; los predictores son el QRS ancho, la frecuencia cardiaca <35 lpm y la presentación clínica distinta del síncope


INTRODUCTION AND OBJECTIVES: Atrioventricular block (AVB) in the presence of bradycardic drugs (BD) can be reversible, and pacemaker implantation is controversial. Our objective was to analyze the pacemaker implantation rate in the mid-term, after BD suspension, and to identify predictive factors. METHODS: We performed a cohort study that included patients attending the emergency department with high-grade AVB in the context of BD. We studied the persistence of AVB after BD discontinuation, recurrence in patients with AVB resolution, and the predictive variables associated with pacemaker requirement at 3 years. RESULTS: Of 127 patients included (age, 79 [71-83] years), BAV resolved in 60 (47.2%); among these patients, recurrence occurred during the 24-month median follow-up in 40 (66.6%). Pacemaker implantation was required in 107 patients (84.3%), despite BD discontinuation. On multivariable analysis, the variables associated with pacemaker need at 3 years were heart rate <35 bpm (OR, 8.12; 95%CI, 1.82-36.17), symptoms other than syncope (OR, 4.09; 95%CI, 1.18-14.13), and wide QRS (OR, 5.65; 95%CI, 1.77-18.04). Concomitant antiarrhythmic treatment was associated with AVB resolution (OR, 0.12; 95%CI, 0.02-0.66). CONCLUSIONS: More than 80% of patients with AVB secondary to BD require pacemaker implantation despite drug discontinuation. Predictive variables were wide QRS, heart rate <35 bpm, and clinical presentation other than syncope

14.
Sci Rep ; 10(1): 8139, 2020 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-32424127

RESUMO

The treatment of patients with bifascicular block (BFB) and syncope in the absence of structural heart disease (SHD) is not well defined. The objective of our study is to compare pacemaker empirical implantation with the use of electrophysiological studies (EPS). This is a prospective cohort study that included 77 patients with unexplained cardiogenic syncope and BFB without structural heart disease between 1997 and 2012. Two groups: 36 patients received empirical pacemakers (Group A) and 41 underwent EPS (Group B) to guide their treatment. The incidence of syncope recurrence and atrioventricular block was lower in group A. Mortality and complication rates were similar between both groups. Multivariate analysis demonstrated a higher number of events (combined endpoint) in group B. Our study shows that treatment according to EPS does not improve the results of a treatment strategy based on empirical pacemaker.

15.
Acta Neurochir (Wien) ; 162(7): 1619-1628, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32405669

RESUMO

BACKGROUND: Evaluation of changes in quality of life (QOL) in ICU patients several years after traumatic brain injury (TBI) is not well documented. METHODS: A prospective cohort study was conducted in all patients with TBI admitted between 2004 and 2008 to the ICU of Regional Hospital of Malaga (Spain). Functional status was evaluated by Glasgow Outcome Scale (GOS) and QOL by PAECC (Project for the Epidemiologic Analysis of Critical Care patients) questionnaire between 0 (normal QOL) to 29 points (worst QOL). RESULTS: A total of 531 patients. Median(Quartile1,Quartile 3) age: 35 (22, 56) years. After 3-4 years, 175 died (33%). Survivor QOL was deteriorated (median total PAECC score: 5 (0, 11) points) although 75.76% of patients who survived showed good functional situation (GOS normal or mild dysfunction). An improvement in QOL scores between 1 and 3-4 years was observed (median PAECC score differences between 3-4 years and 1 year: - 1(- 4, 0) points). QOL score improved during this interval of time: 62.6% of patients. Change in QOL was related by multivariate analysis to admission cranial-computed tomography scan (Marshall's classification), age, and Injury Severity Score (ISS), with the biggest improvement seen in younger patients and with more severe ISS. Basic physiological activities were maintained in the majority of patients. Subjective aspects and working activities improved between 1 and 3-4 years but with a high proportion still impaired in these items after 3-4 years. CONCLUSIONS: ICU patients with TBI after 1 year show improvement in QOL between 1 and 3-4 years, with the biggest improvement in QOL seen in younger patients and in those with more severe ISS.

16.
Int J Nurs Stud ; 108: 103613, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32473396

RESUMO

BACKGROUND: In acute coronary syndrome the time elapsed between the start of symptoms and the moment the patient receives treatment is an important determinant of survival and subsequent recovery. However, many patients do not receive treatment as quickly as recommended, mostly due to substantial prehospital delays such as waiting to seek medical attention after symptoms have started. OBJECTIVE: To conduct a systematic review with meta-analysis of the relationship between nine frequently investigated psychological and cognitive factors and prehospital delay. DESIGN: A protocol was preregistered in PROSPERO [CRD42018094198] and a systematic review was conducted following PRISMA guidelines. DATA SOURCES: The following databases were searched for quantitative articles published between 1997 and 2019: Medline (PubMed), Web of Science, Scopus, Psych Info, PAIS, and Open grey. REVIEW METHODS: Study risk of bias was assessed with the NIH Quality Assessment Tool for Observational, Cohort, and Cross-Sectional Studies. A best evidence synthesis was performed to summarize the findings of the included studies. RESULTS: Forty-eight articles, reporting on 57 studies from 23 countries met the inclusion criteria. Studies used very diverse definitions of prehospital delay and analytical practices, which precluded meta-analysis. The best evidence synthesis indicated that there was evidence that patients who attributed their symptoms to a cardiac event (n = 37), perceived symptoms as serious (n = 24), or felt anxiety in response to symptoms (n = 15) reported shorter prehospital delay, with effect sizes indicating important clinical differences (e.g., 1.5-2 h shorter prehospital delay). In contrast, there was limited evidence for a relationship between prehospital delay and knowledge of symptoms (n = 18), concern for troubling others (n = 18), fear (n = 17), or embarrassment in asking for help (n = 14). CONCLUSIONS: The current review shows that symptom attribution to cardiac events and some degree of perceived threat are fundamental to speed up help-seeking. In contrast, social concerns and barriers in seeking medical attention (embarrassment or concern for troubling others) may not be as important as initially thought. The current review also shows that the use of very diverse methodological practices strongly limits the integration of evidence into meaningful recommendations. We conclude that there is urgent need for common guidelines for prehospital delay study design and reporting.

17.
J Phys Chem B ; 124(21): 4338-4357, 2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32352290

RESUMO

The use of ionic liquids (ILs) as both catalysts and solvents in a wide range of chemical reactions has received considerable attention over the last few years due to their positive effects in enhancing reaction rates and selectivities. In this work, hybrid quantum mechanics/molecular mechanics (QM/MM) molecular dynamics simulations were carried out in conjunction with umbrella-sampling techniques to study the bimolecular nucleophilic substitution (SN2) fluorination reaction between propyl-mesylate and potassium fluoride using five ILs as solvents, specifically, 1-butyl-3-methylimidazolium mesylate ([C4mim][OMs]), 1-butyl-3-methylimidazolium tetrafluoroborate ([C4mim][BF4]), 1-butyl-3-methylimidazolium trifluoroacetate ([C4mim][CF3COO]), 1-butyl-3-methylimidazolium bromide ([C4mim][Br]), and 1-butyl-3-methylimidazolium chloride ([C4mim][Cl]) at 373.15 K. The QM region (reactive part) in all QM/MM systems was simulated using the Parametric Method 6 (PM6) semiempirical methods, and for the MM region (IL solvent), classical force fields (FF) were employed, with the FF developed within the group. The calculated activation free energy barriers (ΔG‡) for the SN2 reaction in the presence of [C4mim][OMs] and [C4mim][BF4] ILs were in agreement with the experimental values reported in the literature. On the other hand, only predicted values were obtained for the activation energies for the [C4mim][CF3COO], [C4mim][Br], and [C4mim][Cl] ILs. These activation energies indicated that the SN2 reaction would be more facile to proceed using the [C4mim][Cl] and [C4mim][OMs] ILs, in contrast with the use of [C4mim][Br] IL, which presented the highest activation energy. Energy-pair distributions, radial distribution functions, and noncovalent interactions (NCI) were also calculated to elucidate the molecular interactions between the reactive QM region and the solvents or reaction media. From these calculations, it was found that not only the reactivity can be enhanced by selecting a specific anion to increase the K-F separation but also the cation plays a relevant role, producing a synergetic effect by forming hydrogen bonds with the fluorine atom from KF and with the oxygen atoms within the mesylate leaving group. Three interactions are significant for the IL catalytic behavior, FQM-HX, KQM-anion, and OQM-HX interactions, where the FQM and KQM labels correspond to fluorine and potassium atoms from the KF salt, OQM corresponds to oxygen atoms within the mesylate leaving group (reactant), and HX refers to hydrogen atoms within the IL cation. The NCI analysis revealed that KQM-anion interactions are of weak type, indicating the importance of hydrogen bond interactions from the cation such as FQM-HX and OQM-HX for the catalytic behavior of ILs.

18.
Food Res Int ; 131: 108983, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32247465

RESUMO

Calcium supplements have increasingly been used at pre-harvest stages for improving fruit firmness, aiming at mitigating environmental stress. However, as recent studies demonstrated that calcium modifies the polyphenolic profile of grape berries, we hypothesize in this study that it also affects wine volatile profile. In a two-year study, grapevines cv. "Vinhão" were sprayed with 2% CaCl2 throughout the fruiting season, and musts were prepared at a laboratory scale. Musts from calcium-treated fruits contained higher calcium levels and less anthocyanins. Increased calcium content did not affect the course of fermentation induced with a S. cerevisiae starter inoculum, but impacted the course of spontaneous fermentations carried out by endogenous berry microflora. Several compounds associated to varietal and fermentative aromas were largely influenced by the calcium treatment. For instance, volatile phenols decreased, together with ß-damascenone, benzaldehyde and γ-nonalactone, while several acetates and alcohols increased. Principal component analysis showed that the volatile profile of control wines produced by spontaneous fermentation substantially differed between replicates, but calcium treatment lowered replicate variability. Volatile profiles were also influenced by the vintage and fermentation type. The shift in wine volatile profile upon calcium treatment may be relevant from an oenological perspective.

19.
Pain Pract ; 20(6): 639-646, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32255266

RESUMO

OBJECTIVES: To compare the efficacy and safety between leucocyte-rich platelet-rich plasma (LR-PRP) and corticosteroid in fluoroscopically guided caudal epidural injection for patients with complex chronic lumbar spinal pain. STUDY DESIGN: A prospective randomized controlled double-blinded study. METHODS: Fifty eligible patients with complex chronic degenerative spinal pain were randomly assigned with a 1:1 allocation ratio to receive caudal epidural injection of corticosteroid (triamcinolone acetonide, 60 mg) or LR-PRP (isolated from 60 mL autologous blood) under fluoroscopic guidance. Levels of low back pain, quality of life, and complications (or adverse effects) were evaluated at 1, 3, and 6 months after treatment. Pain levels and quality of life were assessed using the VAS and Short Form 36-Item Health Survey (SF-36), respectively. RESULTS: No significant difference was shown at baseline between the 2 groups. Compared with the pretreatment values, there were significant reductions in the VAS score in both groups. A significantly lower VAS score at 1-month follow-up was detected in patients who received corticosteroid injection. However, the scores were lower in the LR-PRP group at 3- and 6-month follow-up. SF-36 responses at 6 months showed significant improvement in all domains in the LR-PRP group. There were no complications or adverse effects related to treatment at 6-month follow-up in either group. CONCLUSIONS: Both autologous LR-PRP and corticosteroid for caudal epidural injections under fluoroscopic guidance are equally safe and therapeutically effective in patients with complex chronic lumbar spinal pain. However, LR-PRP is superior to corticosteroid for a longer pain-relieving effect and improvement in quality of life.


Assuntos
Anti-Inflamatórios/uso terapêutico , Dor Lombar/terapia , Plasma Rico em Plaquetas , Doenças da Coluna Vertebral/terapia , Triancinolona Acetonida/uso terapêutico , Adulto , Dor Crônica/etiologia , Dor Crônica/terapia , Método Duplo-Cego , Feminino , Humanos , Injeções Epidurais , Dor Lombar/etiologia , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Projetos Piloto , Estudos Prospectivos , Qualidade de Vida , Doenças da Coluna Vertebral/complicações , Resultado do Tratamento
20.
PLoS One ; 15(1): e0228262, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32004332

RESUMO

Patients diagnosed with coronary heart disease should follow lifestyle recommendations that can reduce their cardiovascular risk (e.g., avoid smoking). However, some patients fail to follow these recommendations and engage in unhealthy behavior. With the aim to identify psychosocial factors that characterize patients at high risk of repeated cardiovascular events, we investigated the relationship between social support, mental health (coping, self-esteem, and perceived stress), and unhealthy behavior. We conducted a cross-sectional study of 419 patients recently diagnosed with coronary heart disease (myocardial infarction or angina) who participated in the National Health Survey in Spain (2018). Unhealthy behaviors were defined according to the European Guidelines on cardiovascular disease prevention. Only 1% of patients reported no unhealthy behaviors, with 11% reporting one, 40% two, 35% three, and 13% four or more unhealthy behaviors. In multiple regression controlling for demographic and traditional risk factors, mental health was the only significant psychosocial factor, doubling the odds of accumulated unhealthy behaviors, OR(high vs. low) = 2.03, 95% CI [1.14, 3.64]. Mental health was especially strongly related to unhealthy behavior among patients with obesity, OR(high vs. low) = 3.50, 95% CI [1.49, 8.45]. The relationship between mental health and unhealthy behaviors suggests that a large proportion of patients may not adhere to lifestyle recommendations not because they purposefully choose to do so, but because they lack coping skills to maintain the recommended healthy behaviors. Low mental well-being may be especially detrimental for behavior change of patients with obesity.


Assuntos
Cardiologistas , Doença das Coronárias/psicologia , Comportamentos Relacionados com a Saúde , Adulto , Idoso , Feminino , Humanos , Estilo de Vida , Masculino , Saúde Mental , Pessoa de Meia-Idade , Risco , Apoio Social
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