Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 63
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Artigo em Inglês | MEDLINE | ID: mdl-31883820

RESUMO

BACKGROUND: Acute rejection is one of the most important direct contributors to mortality after heart transplantation. Advances in the development of novel non-invasive approaches for the early identification of allograft rejection are necessary. We conducted a non-targeted proteome characterization focused on identifying multiple plasmatic protein differences to evaluate their diagnostic accuracy for rejection episodes. METHODS: We included consecutive plasma samples from transplant recipients undergoing routine endomyocardial biopsies. A liquid chromatography-tandem mass spectrometry analysis using isobaric tags (tandem mass tag 10-plex) was performed and concentrations of CD5L were validated using a specific sandwich enzyme-linked immunosorbent assay. RESULTS: A total of 17 altered proteins were identified as potential markers for detecting heart transplant rejection, most involved in inflammation and immunity. CD5L, an apoptosis inhibitor expressed by macrophages, showed the best results in the proteomic analysis (n = 30). We confirm this finding in a larger patient cohort (n = 218), obtaining a great diagnostic capacity for clinically relevant rejection (≥Grade 2R: area under the curve = 0.892, p < 0.0001) and preserving the accuracy at mild rejection (Grade 1R: area under the curve = 0.774, p < 0.0001). CD5L was a strong independent predictor, with an odds ratio of 14.74 (p < 0.0001), for the presence of rejection. CONCLUSIONS: Episodes of acute cardiac allograft rejection are related to significant changes in a key inhibitor of apoptosis in macrophages, CD5L. Because of its precision to detect acute cellular rejection, even at mild grade, we propose CD5L as a potential candidate to be included in the studies of molecule combination panel assays. This finding could contribute to improving the diagnostic and preventive methods for the surveillance of cardiac transplanted patients.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31768947

RESUMO

Transcriptomic signature of XPO1 was highly expressed and inversely related to left ventricular function in ischemic cardiomyopathy patients. We hypothesized that treatment with AAV9-shXPO1 attenuates left ventricular dysfunction and remodeling in a myocardial infarction rat model. We induced myocardial infarction by coronary ligation in Sprague-Dawley rats (n = 10), which received AAV9-shXPO1 (n = 5) or placebo AAV9-scramble (n = 5) treatment. Serial echocardiographic assessment was performed throughout the study. After myocardial infarction, AAV9-shXPO1-treated rats showed partial recovery of left ventricular fractional shortening (16.8 ± 2.8 vs 24.6 ± 4.1%, P < 0.05) and a maintained left ventricular dimension (6.17 ± 0.95 vs 4.70 ± 0.93 mm, P < 0.05), which was not observed in non-treated rats. Furthermore, lower levels of EXP-1 (P < 0.05) and lower collagen fibers and fibrosis in cardiac tissue were observed. However, no differences were found in the IL-6 or TNFR1 plasma levels of the myocardium of AAV9-shXPO1 rats. AAV9-shXPO1 administration attenuates cardiac dysfunction and remodeling in rats after myocardial infarction, producing the gene silencing of XPO1.

3.
Front Psychol ; 10: 2398, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31736820

RESUMO

Recent studies pointing to evaluation methods in natural environments suggest that their use in the analysis of metacognitive skills provides more precise information than the use of off-line evaluation methods. In this research, mixed methods are used over one academic year for the evaluation of the metacognitive skills that students of Secondary Education apply to solve physics problems. The objectives of this study are to analyze the use of metacognitive skills in natural environments and to study behavioral patterns of student learning through a longitudinal study. A total of 509 recordings of think-aloud protocols are analyzed through the categorization of the responses (liquefying) and the protocol of Van der Stel and Veenman for the analysis of the quality of metacognitive skills. Fewer conceptual errors and less uncertainty over vocabulary were noted during the academic year. Nevertheless, a degree of ambiguity persisted in the understanding of physics concepts. The metacognitive skills of Orientation and Planning were used more than any others. The technique of graph analysis is also applied, to establish the patterns of behavior of each student throughout the academic year. Different patterns were found, the analysis of which helped to identify academically challenged and at-risk students. The use of mixed observation techniques and graph analysis facilitated information on the pace of learning of each student. Future studies will be directed at proposals for the automation of these evaluation techniques in natural learning environments.

4.
Materials (Basel) ; 12(19)2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31569702

RESUMO

OBJECTIVES: The aim of this research was to determine the osseointegration of two presentations of biphasic calcium phosphate (BCP) biomaterial-one untreated and another submitted to biofunctionalization with a TGF-ß1 inhibitor peptide, P144, on dental alveolus. Materials and Methods: A synthetic bone graft was used, namely, (i) Maxresorb® (Botiss Klockner) (n = 12), and (ii) Maxresorb® (Botiss Klockner) biofunctionalized with P144 peptide (n = 12). Both bone grafts were implanted in the two hemimandibles of six beagle dogs in the same surgical time, immediately after tooth extraction. Two dogs were sacrificed 2, 4, and 8 weeks post implant insertion, respectively. The samples were submitted to histomorphometrical and histological analyses. For each sample, we quantified the new bone growth and the new bone formed around the biomaterial's granules. After optical microscopic histological evaluation, selected samples were studied using backscattered scanning electron microscopy (BS-SEM). Results: The biofunctionalization of the biomaterial's granules maintains a stable membranous bone formation throughout the experiment timeline, benefitting from the constant presence of vascular structures in the alveolar space, in a more active manner that in the control samples. Better results in the experimental groups were proven both by quantitative and qualitative analysis. Conclusions: Synthetic bone graft biofunctionalization results in slightly better quantitative parameters of the implant's osseointegration. The qualitative histological and ultramicroscopic analysis shows that biofunctionalization may shorten the healing period of dental biomaterials.

5.
Sci Rep ; 9(1): 13880, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31554869

RESUMO

Accumulating evidence has confirmed that the expression of sarcoplasmic reticulum calcium ATPase 2a (SERCA2a) is downregulated in heart failure and cardiac allograft rejection. Although many SERCA2a-related genes and proteins involved in the regulation of myocardial Ca2+ fluxes have been explored, its related metabolites remain poorly studied. Our main objective was to identify circulating SERCA2a-related metabolites altered in cardiac allograft rejection and to determine whether these could serve as non-invasive biomarkers. Sixty plasma samples from adult heart transplant were included in a metabolomic analysis. Sphingosine-1 phosphate (S1P), metabolite closely related with SERCA, were increased in patients with cardiac rejection (p < 0.0001). S1P discriminated between patients with and without rejection: normal grafts vs. all rejecting grafts (AUC = 0.911, p < 0.0001), normal grafts vs. Grade 1 R (AUC = 0.819, p < 0.01), Grade 2 R (AUC = 0.911, p < 0.0001), Grade 3 R (AUC = 0.996, p < 0.0001). In addition, we found changes in key enzymes and receptors of S1P pathway analysed on explanted hearts from heart failure patients. This preliminary study reveals that circulating S1P determination could be a novel approach to detect cardiac rejection, showing a robust capability for detection that improves gradually with the severity of rejection. These alterations could be relevant to better understand the involvement of calcium regulation on the pathophysiology of rejection.

6.
Am J Med Genet A ; 179(10): 1913-1981, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31468724

RESUMO

Dental anomalies occur frequently in a number of genetic disorders and act as major signs in diagnosing these disorders. We present definitions of the most common dental signs and propose a classification usable as a diagnostic tool by dentists, clinical geneticists, and other health care providers. The definitions are part of the series Elements of Morphology and have been established after careful discussions within an international group of experienced dentists and geneticists. The classification system was elaborated in the French collaborative network "TÊTECOU" and the affiliated O-Rares reference/competence centers. The classification includes isolated and syndromic disorders with oral and dental anomalies, to which causative genes and main extraoral signs and symptoms are added. A systematic literature analysis yielded 408 entities of which a causal gene has been identified in 79%. We classified dental disorders in eight groups: dental agenesis, supernumerary teeth, dental size and/or shape, enamel, dentin, dental eruption, periodontal and gingival, and tumor-like anomalies. We aim the classification to act as a shared reference for clinical and epidemiological studies. We welcome critical evaluations of the definitions and classification and will regularly update the classification for newly recognized conditions.

7.
Hematol Oncol Stem Cell Ther ; 12(4): 194-203, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31319058

RESUMO

OBJECTIVE/BACKGROUND: Patients with follicular lymphoma (FL) with early therapy failure (ETF) within 2 years of frontline therapy have poor overall survival (OS). We recently reported the results of autologous stem cell transplantation (ASCT) in patients from the Grupo Español de Linfomas y Trasplantes de Médula Ósea (GELTAMO) registry treated with rituximab prior to ASCT and with ETF after first-line immunochemotherapy, leading to 81% 5-year OS since ASCT. We explored whether ASCT is also an effective option in the pre-rituximab era-that is, in patients treated in induction and rescued only with chemotherapy. METHODS: ETF was defined as relapse/progression within 2 years of starting first-line therapy. We identified two groups: the ETF cohort (n = 87) and the non-ETF cohort (n = 47 patients receiving ASCT but not experiencing ETF following first-line therapy). RESULTS: There was a significant difference in 5-year progression-free survival between the ETF and non-ETF cohorts (43% vs. 57%, respectively; p = .048). Nevertheless, in patients with ETF with an interval from first relapse after primary treatment to ASCT of <1 year, no differences were observed in 5-year progression-free survival (48% vs. 66%, respectively; p = .44) or in 5-year OS (69% vs. 77%, p = .4). Patients in the ETF cohort transplanted in complete remission showed a plateau in the OS curves, at 56%, beyond 13.7 years of follow-up. CONCLUSION: ASCT may be a curative option for ETF in patients who respond to rescue chemotherapy, without the need for immunotherapy or other therapies, and should be considered as an early consolidation, especially in patients with difficult access to rituximab.

8.
Psicothema (Oviedo) ; 31(2): 170-178, mayo 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-185223

RESUMO

Background: Learning is increasingly frequent in B-Learning spaces. It is therefore necessary to study the characteristics that guarantee deeper and more successful learning in these learning environments. Method: We work with sample of 233 university students using the Moodle 3.1 platform in the third year of their degrees in Health Sciences. The effectiveness of four types of B-Learning on Learning Results (LR), behaviors on the platform, and student satisfaction are all studied. Prior knowledge is also used as a covariable. Results: It was found that the B-Learning environment in which the students obtained better general Outcomes Learning Results (LR) and a higher degree of satisfaction was the one that included the use of infographics and virtual laboratories based on Self-Regulated Learning (SRL). Conclusions: The design of B-Learning environments together with the use of SRL, is a factor that enhances effective learning and increases student satisfaction, especially if they include infographics and virtual laboratories. In addition, the use of these resources implements better overall LR on a larger number of students. Likewise, it promotes more homogeneous groups in the general LO. Future investigations will be aimed at verifying these results in other knowledge branches


Antecedentes: es cada vez más frecuente que el aprendizaje se realice en espacios B-Learning. Por ello, es preciso estudiar cuáles son las características que garantizan en estos entornos aprendizajes más profundos y exitosos. Método: se trabajó en la plataforma Moodle 3.1 con una muestra 233 estudiantes universitarios de tercero de grado en la rama de Ciencias de la Salud. Se estudió la efectividad de cuatro tipos de B-Learning sobre los Resultados de Aprendizaje (RA), las conductas de aprendizaje y la satisfacción de los estudiantes. Asimismo, se utilizó como covariable los conocimientos previos. Resultados: se halló que el entorno B-Learning en el que los estudiantes obtuvieron mejores RA generales y mayor grado de satisfacción fue el que incluía el uso de infografías y de laboratorios virtuales basados en aprendizaje autorregulado (SRL). Conclusiones: el diseño de entornos B-Learning, junto con la utilización de SRL, es un factor que potencia aprendizajes eficaces e incrementa la satisfacción de los estudiantes, especialmente si incluyen infografías y laboratorios virtuales. Además, el uso de estos recursos implementa mejores RA generales en un mayor número de estudiantes. Futuras investigaciones irán dirigidas a comprobar estos resultados en otras ramas de conocimiento


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Educação a Distância , Aprendizagem , Ensino
9.
An. pediatr. (2003. Ed. impr.) ; 90(5): 301-309, mayo 2019. tab, graf
Artigo em Espanhol | IBECS-Express | ID: ibc-ET2-3886

RESUMO

Introducción: La Atención Temprana (AT), como servicio pediátrico, obliga a cuantificar resultados de intervención y calidad de servicio ofrecido. La disposición de instrumentos de medida válidos y fiables permitirá a los profesionales evaluar la calidad de estos servicios. Objetivo principal: Revisar la literatura científica, analizar la calidad metodológica de las herramientas utilizadas en AT para la medición de la calidad de servicio. Métodos: Se realizó una búsqueda en diferentes bases de datos: Medline (a través de Pubmed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC y Scielo. La calidad metodológica de los estudios identificados se evaluó a través de la escala Consensus-based Standards for the Selection of Health Measurement (COSMIN) Resultados: Se seleccionaron 13 artículos que cumplieron los criterios de inclusión, de los cuales 10 obtuvieron una puntuación «buena» o «razonable» según la escala COSMIN. Conclusiones: Pese a su importancia, aún no existe consenso entre los autores sobre la medición de la calidad de servicio en AT. Habitualmente, es la familia de los niños atendidos en AT la población sobre la que se realizan los estudios, aunque la perspectiva de los profesionales toma auge y completa la información


Introduction: Early Intervention (EI), as a paediatric service, has the duty of quantifying the results and the quality of its services provided. The accessibility of valid and reliable tools allows professionals to evaluate the quality of these services. Main objective: The aim of this study is to review the scientific literature on tools used to measure the methodological and service quality in EI. Methods: A search was made in different databases: Medline (from PubMed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC and Scielo. The methodological quality of the studies was tested using the COSMIN scale. Results: A total of 13 manuscripts met the criteria to be included in this review. Ten of them received a "Good" or "reasonable" score based on the COSMIN scale. Conclusions: Despite its importance, there is no consensus among authors on the measurement of service quality in EI. It is often the family of the children attended in EI that are considered the target to study, although the opinion of professionals carries more weight and completes the information

10.
Psicothema ; 31(2): 170-178, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31013242

RESUMO

BACKGROUND: Learning is increasingly frequent in B-Learning spaces. It is therefore necessary to study the characteristics that guarantee deeper and more successful learning in these learning environments. METHOD: We work with sample of 233 university students using the Moodle 3.1 platform in the third year of their degrees in Health Sciences. The effectiveness of four types of B-Learning on Learning Results (LR), behaviors on the platform, and student satisfaction are all studied. Prior knowledge is also used as a covariable. RESULTS: It was found that the B-Learning environment in which the students obtained better general Outcomes Learning Results (LR) and a higher degree of satisfaction was the one that included the use of infographics and virtual laboratories based on Self-Regulated Learning (SRL). CONCLUSIONS: The design of B-Learning environments together with the use of SRL, is a factor that enhances effective learning and increases student satisfaction, especially if they include infographics and virtual laboratories. In addition, the use of these resources implements better overall LR on a larger number of students. Likewise, it promotes more homogeneous groups in the general LO. Future investigations will be aimed at verifying these results in other knowledge branches.


Assuntos
Educação a Distância , Aprendizagem , Ensino , Feminino , Humanos , Masculino , Adulto Jovem
11.
Clin Orthop Relat Res ; 477(4): 741-755, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30810538

RESUMO

BACKGROUND: Surgical reconstruction of large bone defects with structural bone allografts can restore bone stock but is associated with complications such as nonunion, fracture, and infection. Vascularized reconstructive techniques may provide an alternative in the repair of critical bone defects; however, no studies specifically addressing the role of vascularized periosteal flaps in stimulating bone allograft revascularization and osseointegration have been reported. QUESTIONS/PURPOSES: (1) Does a vascularized periosteal flap increase the likelihood of union at the allograft-host junction in a critical-size defect femoral model in rats? (2) Does a vascularized periosteal flap promote revascularization of a critical-size defect structural bone allograft in a rat model? (3) What type of ossification occurs in connection with a vascularized periosteal flap? METHODS: Sixty-four rats were assigned to two equal groups. In both the control and experimental groups, a 5-cm critical size femoral defect was created in the left femur and then reconstructed with a cryopreserved structural bone allograft and intramedullary nail. In the experimental group, a vascularized periosteal flap from the medial femoral condyle, with a pedicle based on the descending genicular vessels, was associated with the allograft. The 32 rats of each group were divided into subgroups of 4-week (eight rats), 6-week (eight rats), and 10-week (16 rats) followup. At the end of their assigned followup periods, the animals were euthanized and their femurs were harvested for semiquantitative and quantitative analysis using micro-CT (all followup groups), quantitative biomechanical evaluation (eight rats from each 10-week followup group), qualitative confocal microscopic, backscattered electron microscopic, and histology analysis (4-week and 6-week groups and eight rats from each 10-week followup group). When making their analyses, all the examiners were blinded to the treatment groups from which the samples came. RESULTS: There was an improvement in allograft-host bone union in the 10-week experimental group (odds ratio [OR], 19.29 [3.63-184.50], p < 0.05). In contrast to control specimens, greater bone neoformation in the allograft segment was observed in the experimental group (OR [4-week] 63.3 [39.6-87.0], p < 0.05; OR [6-week] 43.4 [20.5-66.3], p < 0.05; OR [10-week] 62.9 [40.1-85.7], p < 0.05). In our biomechanical testing, control samples were not evaluable as a result of premature breakage during the embedding and assembly processes. Therefore, experimental samples were compared with untreated contralateral femurs. No difference in torsion resistance pattern was observed between both groups. Both backscattered electron microscopy and histology showed newly formed bone tissue and osteoclast lacunae, indicating a regulated process of bone regeneration of the initial allograft in evaluated samples from the experimental group. They also showed intramembranous ossification produced by the vascularized periosteal flap in evaluated samples from the experimental group, whereas samples from the control group showed an attempted endochondral ossification in the allograft-host bone junctions. CONCLUSIONS: A vascularized periosteal flap promotes and accelerates allograft-host bone union and revascularization of cryopreserved structural bone allografts through intramembranous ossification in a preclinical rat model. CLINICAL RELEVANCE: If large-animal models substantiate the findings made here, this approach might be used in allograft reconstructions for critical defects using fibular or tibial periosteal flaps as previously described.


Assuntos
Transplante Ósseo/métodos , Fraturas do Fêmur/cirurgia , Fêmur/irrigação sanguínea , Fêmur/cirurgia , Neovascularização Fisiológica , Osseointegração , Periósteo/irrigação sanguínea , Periósteo/cirurgia , Retalhos Cirúrgicos/irrigação sanguínea , Aloenxertos , Animais , Modelos Animais de Doenças , Fraturas do Fêmur/diagnóstico por imagem , Fraturas do Fêmur/fisiopatologia , Fêmur/diagnóstico por imagem , Fêmur/fisiopatologia , Consolidação da Fratura , Masculino , Ratos Sprague-Dawley , Fatores de Tempo
12.
ACS Appl Mater Interfaces ; 11(9): 8818-8830, 2019 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-30740968

RESUMO

Bone apatite consists of carbonated calcium-deficient hydroxyapatite (CDHA) nanocrystals. Biomimetic routes allow fabricating synthetic bone grafts that mimic biological apatite. In this work, we explored the role of two distinctive features of biomimetic apatites, namely, nanocrystal morphology (plate vs needle-like crystals) and carbonate content, on the bone regeneration potential of CDHA scaffolds in an in vivo canine model. Both ectopic bone formation and scaffold degradation were drastically affected by the nanocrystal morphology after intramuscular implantation. Fine-CDHA foams with needle-like nanocrystals, comparable in size to bone mineral, showed a markedly higher osteoinductive potential and a superior degradation than chemically identical coarse-CDHA foams with larger plate-shaped crystals. These findings correlated well with the superior bone-healing capacity showed by the fine-CDHA scaffolds when implanted intraosseously. Moreover, carbonate doping of CDHA, which resulted in small plate-shaped nanocrystals, accelerated both the intrinsic osteoinduction and the bone healing capacity, and significantly increased the cell-mediated resorption. These results suggest that tuning the chemical composition and the nanostructural features may allow the material to enter the physiological bone remodeling cycle, promoting a tight synchronization between scaffold degradation and bone formation.


Assuntos
Materiais Biomiméticos/química , Substitutos Ósseos/química , Nanopartículas/química , Animais , Materiais Biomiméticos/farmacologia , Regeneração Óssea , Substitutos Ósseos/farmacologia , Osso e Ossos/diagnóstico por imagem , Adesão Celular/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Células Cultivadas , Cães , Durapatita/química , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Osteoblastos/citologia , Osteoblastos/metabolismo , Osteocalcina/metabolismo , Osteogênese/efeitos dos fármacos , Ratos , Tecidos Suporte/química , Microtomografia por Raio-X
13.
Front Psychol ; 10: 88, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30809162

RESUMO

Learning management systems (LMSs) that incorporate hypermedia Smart Tutoring Systems and personalized student feedback can increase self-regulated learning (SRL), motivation, and effective learning. These systems are studied with the following aims: (1) to verify whether the use of LMS with hypermedia Smart Tutoring Systems improves student learning outcomes; (2) to verify whether the learning outcomes will be grouped into performance clusters (Satisfactory, Good, and Excellent); and (3) to verify whether those clusters will group together the different learning outcomes assessed in four different evaluation procedures. Use of the LMS with hypermedia Smart Tutoring Systems was studied among students of Health Sciences, all of whom had similar test results in the use of metacognitive skills. It explained 38% of the variance in student learning outcomes in the evaluation procedures. Likewise, three clusters that grouped the learning outcomes in relation to the variable 'Use of an LMS with hypermedia Smart Tutoring Systems vs. No use' explained 60.4% of the variance. Each cluster grouped the learning outcomes in the different evaluation procedures. In conclusion, LMS with hypermedia Smart Tutoring Systems in Moodle increased the effectiveness of student learning outcomes, above all in the individual quiz-type tests. It also facilitated personalized learning and respect for the individual pace of student-learning. Hence, modules for the analysis of supervised, unsupervised and multivariate learning should be incorporated into the Moodle platform to provide teaching tools that will undoubtedly contribute to improvements in student learning outcomes. HIGHLIGHTS -Learning management systems (LMS) that incorporate hypermedia Smart Tutoring Systems and personalized student feedback can increase self-regulated learning (SRL).-Learning management systems with hypermedia Smart Tutoring Systems increased the effectiveness of student learning outcome.-The use of an LMS with hypermedia Smart Tutoring Systems vs. No use' explained 60.4% of the variance in student learning outcome.

14.
An Pediatr (Barc) ; 90(5): 301-309, 2019 May.
Artigo em Espanhol | MEDLINE | ID: mdl-29887369

RESUMO

INTRODUCTION: Early Intervention (EI), as a paediatric service, has the duty of quantifying the results and the quality of its services provided. The accessibility of valid and reliable tools allows professionals to evaluate the quality of these services. MAIN OBJECTIVE: The aim of this study is to review the scientific literature on tools used to measure the methodological and service quality in EI. METHODS: A search was made in different databases: Medline (from PubMed), Web of Science, PsycINFO, Cochrane, Scopus, ERIC and Scielo. The methodological quality of the studies was tested using the COSMIN scale. RESULTS: A total of 13 manuscripts met the criteria to be included in this review. Ten of them received a "good" or "reasonable" score based on the COSMIN scale. CONCLUSIONS: Despite its importance, there is no consensus among authors on the measurement of service quality in EI. It is often the family of the children attended in EI that are considered the target to study, although the opinion of professionals carries more weight and completes the information.


Assuntos
Deficiências do Desenvolvimento/terapia , Qualidade da Assistência à Saúde , Criança , Humanos , Pediatria/organização & administração , Pediatria/normas
15.
Clin Rehabil ; 33(4): 724-736, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30563369

RESUMO

OBJECTIVE:: The aim of this study is to examine the psychometric properties of the Spanish version of the Oxford Cognitive Screen in a subacute stroke population. PARTICIPANTS AND SETTING:: Fifty-seven subacute stroke outpatients and 54 healthy individuals were recruited in Alicante province, Spain. MAIN MEASURE:: The Oxford Cognitive Screen. OTHER MEASURES:: The Montreal Cognitive Assessment, the Barcelona test, and the Barthel Index. DESIGN:: A validation study was conducted to analyze the inter-rater, intra-rater, test-retest, and internal consistency of the Spanish version of the Oxford Cognitive Screen. Concurrent validity was assessed using the Montreal Cognitive Assessment and the Barcelona test, and divergent validity using the Barthel index. Discriminant indices such as the sensitivity, specificity, predictive values, and optimal cut-offs were also estimated. RESULTS:: The subtests of the Spanish version of the Oxford Cognitive Screen showed excellent estimates for the inter-reliability (intraclass correlation coefficient (ICC) = 0.790 to 1.000; rs = 0.693 to 1.000), and acceptable-good for intra-reliability (ICC = 0.181 to 0.990) and test-retest reliability ( rs = 0.173 to 0.971). Internal consistency was also excellent (standardized Cronbach's α = 0.907). Spearman correlations for the concurrent validity were low-strong ( rs = -0.193 to 0.95) and low-moderate ( rs = -0.091 to 0.443) for divergent validity. The optimal cut-offs estimated for the subtests of the Spanish version of the Oxford Cognitive Screen showed good-high specificity (66.7%-100%) and positive predictive value (67.9%-100%), and low-good sensitivity (14.8%-83.3%) and moderate-good negative predictive value (53.5%-76.6%). Discriminant power as measured by the area under the curve indicated acceptable-good values (0.397 to 0.894). CONCLUSION:: Our findings support that the Spanish version of the Oxford Cognitive Screen is a reliable and valid tool for screening cognitive impairments in subacute stroke patients.


Assuntos
Disfunção Cognitiva/diagnóstico , Testes Neuropsicológicos , Acidente Vascular Cerebral/complicações , Idoso , Estudos de Casos e Controles , Disfunção Cognitiva/etiologia , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Espanha , Traduções
16.
Pancreas ; 47(10): 1304-1311, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30286014

RESUMO

OBJECTIVES: The aim of this study was to comparatively analyze the effects of different concentrations of cigarette smoke condensate (CSC, a standardized tobacco extract) and ethanol on intracellular enzyme activation, cell necrosis, alteration of cytosolic calcium concentration ([Ca]c), and amylase secretion in pancreatic acinar cells. METHODS: The effects of CSC (1 µg/mL to 0.4 mg/mL) and ethanol (10-100 mM) on intracellular enzyme activity, cell necrosis, and [Ca]c were measured by fluorescence assays in isolated pancreatic acinar cells. Amylase secretion was evaluated by spectrophotometry. Supramaximal concentrations of cholecystokinin (10-100 nM) were used as positive control. RESULTS: Neither CSC nor ethanol induced trypsin or elastase activation. Both CSC (0.1-0.4 mg/mL) and ethanol (10-75 mM) significantly increased [Ca]c. Amylase secretion was increased only in CSC-treated cells (0.3 and 0.4 mg/mL). After 60 minutes, CSC (0.3 and 0.4 mg/mL) significantly increased acinar cell necrosis at a similar percentage to that induced by cholecystokinin. Ethanol did not induce any significant cell necrosis. CONCLUSIONS: Cigarette smoke condensate induces acinar cell injury and increases [Ca]c and amylase secretion, independently of intracellular enzyme activation, suggesting that tobacco could induce several main early events of pancreatitis in pancreatic acinar cells. However, ethanol only induces increases [Ca]c, having no effect on cell injury, amylase secretion, or intracellular enzyme activation.


Assuntos
Células Acinares/efeitos dos fármacos , Etanol/farmacologia , Nitrosaminas/farmacologia , Pâncreas/citologia , Células Acinares/metabolismo , Amilases/metabolismo , Animais , Cálcio/metabolismo , Carcinógenos/farmacologia , Células Cultivadas , Relação Dose-Resposta a Droga , Masculino , Camundongos , Necrose , Pancreatite/fisiopatologia , Cultura Primária de Células , Tabaco/química
17.
Salud ment ; 41(5): 237-243, Sep.-Oct. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-979129

RESUMO

Abstract Background Around 30% of pregnancies conclude in a gestational loss. Most women who suffer a gestational loss become pregnant again. However, mothers who have experienced this situation live the new pregnancy with fear and anxiety. Objective To perform an update of the main works done in the study of post-traumatic stress and related symptoms during pregnancy after a gestational loss. Method The Medline database was consulted. Articles published from 2007 to date were selected. Key words related to the topic of study were used. Results The studies reviewed showed five entities that deserve attention during a pregnancy achieved after a gestational loss: post-traumatic stress, depression, anxiety, relationship, and relationship with the future child. There is a relationship between the presence of post-traumatic stress and the risk of developing depression and anxiety. Discussion and conclusion Women who experience perinatal loss, regardless of the type of loss and the gestational age in which it occurs, are at risk of continuing grief, symptoms of depression, anxiety, and post-traumatic stress in later pregnancy. The gestational age and the time elapsed between the perinatal loss and the next pregnancy seem to be the most influential factors in the development of post-traumatic stress sindrome, and symptoms of dysfunctional grief, anxiety, and depression.


Resumen Antecedentes Alrededor de un 30% de los embarazos concluyen en una pérdida gestacional; de este porcentaje, la mayoría de las mujeres vuelve a quedar embarazada. Sin embargo quienes han experimentado esta situación viven con miedo y ansiedad su nuevo embarazo. Objetivo Realizar una actualización de los principales trabajos realizados en cuanto al estudio del estrés postraumático y los síntomas relacionados con el embarazo posterior a una pérdida gestacional. Método Se consultó la base de datos Medline y se seleccionaron artículos publicados desde 2007 hasta la fecha. Se emplearon palabras clave relacionadas con el tema de estudio. Resultados Los estudios revisados mostraron cinco entidades que merecen atención durante un embarazo experimentado tras una pérdida gestacional: estrés postraumático, depresión, ansiedad, relación de pareja y vínculo con el futuro infante. Se encontró que existe una relación entre la presencia de estrés postraumático y el riesgo de desarrollar depresión y ansiedad. Discusión y conclusión Las mujeres que experimentan pérdida perinatal, independientemente del tipo de pérdida y de la edad gestacional en la que se produce, corren el riesgo de continuar el duelo, los síntomas de depresión, la ansiedad y el estrés postraumático durante el embarazo posterior. La edad gestacional y el tiempo transcurrido entre la pérdida perinatal y el siguiente embarazo parecen ser los factores más influyentes en el desarrollo del síndrome de estrés postraumático, así como de síntomas de duelo disfuncional, ansiedad y depresión.

18.
Acta Biomater ; 79: 135-147, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30195084

RESUMO

There is an urgent need of synthetic bone grafts with enhanced osteogenic capacity. This can be achieved by combining biomaterials with exogenous growth factors, which however can have numerous undesired side effects, but also by tuning the intrinsic biomaterial properties. In a previous study, we showed the synergistic effect of nanostructure and pore architecture of biomimetic calcium deficient hydroxyapatite (CDHA) scaffolds in enhancing osteoinduction, i.e. fostering the differentiation of mesenchymal stem cells to bone forming cells. This was demonstrated by assessing bone formation after implanting the scaffolds intramuscularly. The present study goes one step forward, since it analyzes the effect of the geometrical features of the same CDHA scaffolds, obtained either by 3D-printing or by foaming, on the osteogenic potential and resorption behaviour in a bony environment. After 6 and 12 weeks of intraosseous implantation, both bone formation and material degradation had been drastically affected by the macropore architecture of the scaffolds. Whereas nanostructured CDHA was shown to be highly osteoconductive both in the robocast and foamed scaffolds, a superior osteogenic capacity was observed in the foamed scaffolds, which was associated with their higher intrinsic osteoinductive potential. Moreover, they showed a significantly higher cell-mediated degradation than the robocast constructs, with a simultaneous and progressive replacement of the scaffold by new bone. In conclusion, these results demonstrate that the control of macropore architecture is a crucial parameter in the design of synthetic bone grafts, which allows fostering both material degradation and new bone formation. Statement of Significance 3D-printing technologies open new perspectives for the design of patient-specific bone grafts, since they allow customizing the external shape together with the internal architecture of implants. In this respect, it is important to design the appropriate pore geometry to maximize the bone healing capacity of these implants. The present study analyses the effect of pore architecture of nanostructured hydroxyapatite scaffolds, obtained either by 3D-printing or foaming, on the osteogenic potential and scaffold resorption in an in vivo model. While nanostructured hydroxyapatite showed excellent osteoconductive properties irrespective of pore geometry, we demonstrated that the spherical, concave macropores of foamed scaffolds significantly promoted both material resorption and bone regeneration compared to the 3D-printed scaffolds with orthogonal-patterned struts and therefore prismatic, convex macropores.


Assuntos
Fosfatos de Cálcio/química , Nanoestruturas/química , Osteogênese , Impressão Tridimensional , Tecidos Suporte/química , Animais , Cães , Durapatita/química , Imagem Tridimensional , Nanoestruturas/ultraestrutura , Porosidade , Microtomografia por Raio-X
20.
Medicine (Baltimore) ; 97(19): e0701, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29742725

RESUMO

The aim of this study was to determine the association, if any, between foot posture and dental malocclusions in the anteroposterior plane, in children.The study population consisted of 189 children (95 boys and 94 girls) aged 6 to 9 years. In every case, previous informed consent was requested and obtained from the parent/guardian and the study was approved by the Ethics Committee of the University of Málaga (CEUMA 26/2015H).This observational, descriptive, cross-sectional analysis is based on a study population (STROBE). Qualified personnel conducted a podiatric and dental examination of each child, recording the Clarke angle and the foot posture index (FPI) as an outcomes measure in the feet, and also dental malocclusions, according to Angle classification.A significant correlation was observed for the FPI scores (for right foot) as well as the Clarke angle (for right foot), in relation to dental malocclusions as determined by Angle classification (P < .001). Of all the supinated feet analyzed, 38.46% were Class II according to Angle classification, and none were Class III. Of the pronated feet, 48.57% were Class III, 42.85% were Class I, and 8.57% were Class II.The Clarke angle decreases with the progression from Class I to III, whereas the FPI increases with that from Class I to III. These findings suggest there is a relation between the Clarke angle and FPI, on the one hand, and dental malocclusion on the other.


Assuntos
Pé/fisiologia , Má Oclusão/epidemiologia , Postura/fisiologia , Criança , Estudos Transversais , Feminino , Pé Chato/epidemiologia , Humanos , Masculino , Má Oclusão de Angle Classe I/epidemiologia , Má Oclusão de Angle Classe II/epidemiologia , Má Oclusão de Angle Classe III/epidemiologia , Espanha/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA