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1.
Int J Biometeorol ; 68(6): 1043-1060, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38453789

RESUMO

In 2022, Mexico registered an increase in dengue cases compared to the previous year. On the other hand, the amount of precipitation reported annually was slightly less than the previous year. Similarly, the minimum-mean-maximum temperatures recorded annually were below the previous year. In the literature, it is possible to find studies focused on the spread of dengue only for some specific regions of Mexico. However, given the increase in the number of cases during 2022 in regions not considered by previously published works, this study covers cases reported in all states of the country. On the other hand, determining a relationship between the dynamics of dengue cases and climatic factors through a computational model can provide relevant information on the transmission of the virus. A multiple-learning computational approach was developed to simulate the number of the different risks of dengue cases according to the classification reported per epidemiological week by considering climatic factors in Mexico. For the development of the model, the data were obtained from the reports published in the Epidemiological Panorama of Dengue in Mexico and in the National Meteorological Service. The classification of non-severe dengue, dengue with warning signs, and severe dengue were modeled in parallel through an artificial neural network model. Five variables were considered to train the model: the monthly average of the minimum, mean, and maximum temperatures, the precipitation, and the number of the epidemiological week. The selection of variables in this work is focused on the spread of the different risks of dengue once the mosquito begins transmitting the virus. Therefore, temperature and precipitation were chosen as climatic factors due to the close relationship between the density of adult mosquitoes and the incidence of the disease. The Levenberg-Marquardt algorithm was applied to fit the coefficients during the learning process. In the results, the ANN model simulated the classification of the different risks of dengue with the following precisions (R2): 0.9684, 0.9721, and 0.8001 for non-severe dengue, with alarm signs and severe, respectively. Applying a correlation matrix and a sensitivity analysis of the ANN model coefficients, both the average minimum temperature and precipitation were relevant to predict the number of dengue cases. Finally, the information discovered in this work can support the decision-making of the Ministry of Health to avoid a syndemic between the increase in dengue cases and other seasonal diseases.


Assuntos
Dengue , Redes Neurais de Computação , México/epidemiologia , Dengue/epidemiologia , Humanos , Tempo (Meteorologia) , Risco , Temperatura
2.
Pediatr Surg Int ; 39(1): 191, 2023 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-37140693

RESUMO

PURPOSE: Preoperative evaluation of Image Defined Risk Factors (IDRFs) in neuroblastoma (NB) is crucial for determining suitability for upfront resection or tumor biopsy. IDRFs do not all carry the same weighting in predicting tumor complexity and surgical risk. In this study we aimed to assess and categorize a surgical complexity (Surgical Complexity Index, SCI) in NB resection. METHODS: A panel of 15 surgeons was involved in an electronic Delphi consensus survey to identify and score a set of shared items predictive and/or indicative of surgical complexity, including the number of preoperative IDRFs. A shared agreement included the achievement of at least 75% consensus focused on a single or two close risk categories. RESULTS: After 3 Delphi rounds, agreement was established on 25/27 items (92.6%). A severity score was established for each item ranging from 0 to 3 with an overall SCI range varying from a minimum score of zero to a maximum score of 29 points for any given patient. CONCLUSIONS: A consensus on a SCI to stratify the risks related to neuroblastoma tumor resection was established by the panel experts. This index will now be deployed to critically assign a better severity score to IDRFs involved in NB surgery.


Assuntos
Neuroblastoma , Humanos , Neuroblastoma/cirurgia , Neuroblastoma/patologia , Fatores de Risco , Cuidados Pré-Operatórios , Biópsia
3.
J Environ Manage ; 345: 118699, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37536137

RESUMO

An amount of works has reported the effect of wastewater matrix composition on pollutants removal by different AOPs. The biggest challenge is that each wastewater source has a challenging composition (organic and inorganic compounds, pollutants, etc.) and not only the concentration of all these species but also the interaction between them may affect the effectiveness of the studied process. This work has been carried out to evaluate the photo-degradation kinetics of six different pesticides (flutriafol, imidacloprid, myclobutanil, pirimicarb, thiamethoxam and triadimenol) by solar photo-Fenton (SPF) process at acidic pH. First, oxidant concentration (H2O2) was optimized with an actual WWTP effluent. Then, the process was validated with two different secondary and tertiary WWTP effluents, in which main intermediate transformation by-products were identified. Finally, the effect of the inorganic water matrix components (bicarbonate, chloride, sulphate, nitrate and phosphate) was evaluated by a multivariate analysis. Once H2O2 has been optimized at 30 mg L-1, the photo-degradation efficiency of pesticides in real wastewater samples was compared. DOC content of both secondary and tertiary WWTP effluents was dropped by 67%. The identification of the main intermediate transformation by-products (such as 1H-1,2,4-triazole, desmethyl-formamido pirimicarb, thiamethoxam urea, chloronicotinic acid and imidacloprid urea) was reviewed. Following, the multivariate analysis on pesticides photo-degradation, generally, predicted four significant effects in common for the studied pesticides: a positive effect (interaction bicarbonate/nitrate) and three negative ones (chloride, phosphate and the interaction chloride/sulphate); among others. In addition, optimum values of inorganic ion concentrations, to obtain an optimum desirability on studied pesticides removal by SPF at acidic pH, were also evaluated.


Assuntos
Poluentes Ambientais , Praguicidas , Poluentes Químicos da Água , Águas Residuárias , Praguicidas/análise , Peróxido de Hidrogênio/química , Ferro/química , Tiametoxam/análise , Bicarbonatos/análise , Cloretos/análise , Nitratos/análise , Poluentes Ambientais/análise , Poluentes Químicos da Água/química , Oxirredução
4.
J Environ Manage ; 329: 117062, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36549052

RESUMO

Soil contamination by pesticides is a growing environmental problem. Even though nowadays numerous soil remediation technologies are available, most of them have not been tested at field scale. This study attempts to demonstrate the efficiency of solarization-ozonation techniques for the removal of twelve pesticides at full scale. Initial solarization and ozonation trials were conducted in plots located in a greenhouse using freshly and aged contaminated soils under controlled pilot conditions. The combination of solarization and ozonation treatment was efficient for all the studied pesticides both in freshly and in aged contaminated soils, being the lower degradation values found for the second type. This low removal suggests that the increase of pesticides' adsorption on soil resulting from ageing decreases their availability. Once the essays were carried out at pilot scale, the solarization-ozonation applicability was evaluated in a commercial farm soil. This trial was carried out in a greenhouse whose soil had previously been contaminated with some of the pesticides studied. A significant degradation (53.8%) was observed after 40 days of treatment. Pesticides' main metabolites were identified during the different remediation experiments. In addition, the cost of the combined solarization and ozonation technology was evaluated. Finally, our results suggest that this combination of techniques could be considered a promising technology to degrade pesticides in soil.


Assuntos
Recuperação e Remediação Ambiental , Ozônio , Praguicidas , Poluentes do Solo , Praguicidas/análise , Solo , Fazendas , Poluição Ambiental , Poluentes do Solo/análise
5.
Mol Phylogenet Evol ; 171: 107467, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35351636

RESUMO

The exceptional hidden diversity included in the squat lobster genus Phylladiorhynchus and its wide bathymetric and geographic range make it an interesting group to thoroughly study its evolutionary history. Here we have analyzed the entire currently known species diversity of Phylladiorhynchus using an integrative approach that includes morphological and molecular characters. The aim was to establish whether depth range (bathymetry) has played a role in their morphological and molecular evolution and in their diversification pathways. Phylogenetic analyses recovered the genus as monophyletic and as the sister group of Coralliogalathea, conforming with current systematic hypotheses, although their placement in a monophyletic Galatheidae is doubted. All the analyzed species represent well-supported lineages, structured in ten clades, correlated in most part with the morphological phylogeny. The reconstruction of ancestral habitat showed that the most recent common ancestor of Phylladiorhynchus most likely lived in shallow water environments. The divergence time estimation analyses dated the origin of the genus back to the Upper Jurassic, preceding the origin of all the other galatheoid lineages. Morphological analyses suggested that species from deeper waters exhibit greater morphological divergences and lower genetic divergences in comparison to species from shallower waters. In Phylladiorhynchus, the colonization of deeper waters has taken place independently multiple times since the Lower-Cretaceous. Our reconstruction of ancestral habitat suggests that shallow water ancestors might show an acceleration in the molecular rate of evolution and a slowdown in the rates of morphological evolution in comparison to deep sea lineages. However, although lineages from shallow and deep sea habitats show slight differences in diversification trends, bathymetry does not significantly affect the diversification rate in Phylladiorhynchus according to our diversification analyses.


Assuntos
Anomuros , Decápodes , Animais , Decápodes/genética , Evolução Molecular , Filogenia , Água
6.
J Environ Manage ; 310: 114781, 2022 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-35219209

RESUMO

This study aimed to investigate the effectiveness of ozonation and solarization techniques for the removal of different types of pesticides from soil during the summer season. The effect of two experimental parameters (temperature and ozone application mode) on the pesticide degradation was evaluated. The results showed that solarization (S), solarization with surface ozonation (SOS), and solarization with deep ozonation (SOD) enhanced pesticide degradation rates in comparison with the control (untreated soil, C). The triazole, anilinopyrimidine, strobilurin and neonicotinoid pesticides showed similar behaviour under S and SOS conditions. The highest decrease was found in SOD, indicating the significant effect of temperature and ozone application mode on the efficiency of the ozonation treatment. Thus, a higher soil temperature and a longer accumulated time at high temperature in treatments S, SOS and SOD were observed due to solarization process. In addition, the removal efficiency was enhanced with exposure time. Finally, the main 15 transformation products were identified during SOD treatment. The results suggest that solarization combined with ozonation techniques allows decontamination of soil containing pesticide residues.


Assuntos
Ozônio , Praguicidas , Neonicotinoides , Ozônio/química , Praguicidas/química , Solo , Estrobilurinas , Triazóis
7.
Clin Radiol ; 75(2): 100-107, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31515052

RESUMO

AIM: To analyse changes in post-neoadjuvant follow-up magnetic resonance imaging (MRI) staging accuracy for malignant adenopathies in rectal cancer, by comparing size criteria with morphological criteria using high-resolution T2-weighted sequences, as well as variations when adding diffusion-weighted imaging. METHODS AND MATERIALS: The present study was a cross-sectional study of a database including 46 1.5-T MRI examinations (2011-2016) from patients with biopsy-proven rectal cancer and chemoradiotherapy treatment before surgery. All cases were reviewed by three radiologists individually, who were blinded to any clinical information. The radiologists were experienced in rectal cancer (3-6 years) and evaluated the presence of malignant nodes in each patient. Malignancy was determined using morphological, size (5 mm), and diffusion criteria separately, as well as morphology plus diffusion. Each case was assessed four times: (1) evaluation of morphological criteria; (2) size criteria; (3) evaluation only using diffusion (b-values 50, 400, and 800); and (4) diffusion plus morphological criteria. Histological staging of surgical specimens was the reference standard. Statistical analysis included accuracy (area under the receiver operating characteristic [ROC] curve [AUC]), sensitivity, specificity, and positive/negative predictive values (PPV/NPV) for each radiologist, and group agreement (Fleiss' kappa). RESULTS: Mean values using morphological criteria were: AUC 0.78, sensitivity 77.7%, specificity 73.8%, PPV 66.1%, NPV 85.2%. Using size criterion: AUC 0.75, sensitivity 62.9%, specificity 83.2%, PPV 74.1%, NPV 80%. Added diffusion yielded no improvement, and yielded worse results by itself. CONCLUSIONS: Although morphological criteria showed better results in accuracy, sensitivity, and NPV, size criterion yielded the best specificity and PPV. Adding diffusion did not demonstrate a clear advantage over the criteria by themselves. Thus, mixed size-morphology criteria could have the greatest diagnostic value for follow-up N-staging.


Assuntos
Neoplasias Retais/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia , Estudos Transversais , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Metástase Linfática/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Neoplasias Retais/patologia , Neoplasias Retais/terapia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
8.
J Environ Manage ; 266: 110565, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32314743

RESUMO

In Mediterranean countries, reuse of reclaimed water is essential for crop irrigation. The occurrence of pesticides in agro-wastewater may represent a risk for human health and environment owing to their release in soil and translocation to plants. The novelty of this work relies on the reuse of reclaimed agro-wastewater polluted with thirteen pesticides for lettuce irrigation. Removing of pesticide residues in agro-wastewater was carried out using natural sunlight and TiO2/Na2S2O8 in a pilot facility located in Murcia (SE of Spain). The studied pesticides were azoxystrobin, boscalid, chlorpropham, flutolanil, flutriafol, isoxaben, methoxyfenozide, myclobutanil, napropamide, prochloraz, propamocarb, propyzamide and triadimenol, which are commonly used in southeast Spain to treat lettuces grown. Different heterogeneous and homogeneous processes were studied and compared. Previously, the optimization of the process for the selection of the best catalytic system was performed at lab-scale. TiO2+ S2O82- was selected due to the greater effectiveness, achieving almost complete disappearance after about 400 kJ m-2 of cumulative UVA exposure. No significant differences were observed in quality parameters of lettuce grown using treated and non-treated agro-wastewater.


Assuntos
Praguicidas , Águas Residuárias , Irrigação Agrícola , Lactuca , Espanha , Luz Solar
9.
Scand J Rheumatol ; 46(4): 273-280, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27701937

RESUMO

OBJECTIVES: To define the relative role of cognitive impairment, depression, disease activity, and disease damage in the decreased health-related quality of life (HRQoL) frequently observed in systemic lupus erythematosus (SLE) patients. METHOD: We studied 101 Chilean female SLE patients and applied the 12-item Medical Outcomes Study (MOS) Short Form Health Survey version 2 (SF-12v2) to assess HRQoL and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive function. Analysis of covariance (ANCOVA) models included demographic and disease-related factors and cognitive function tests of sustained attention, memory, and executive function. RESULTS: All measures of HRQoL were lower in the 101 female SLE patients compared to the women from the Chilean general population. HRQoL was associated with the following factors: (i) depression symptoms, which were detrimental to all components of the physical and mental HRQoL scores; (ii) executive dysfunction (spatial planning), which was associated with lower scores on role limitations due to physical health problems and emotional problems, and general health perceptions; (iii) higher activity and organ damage were deleterious to role physical, bodily pain, and physical summary scores; and (iv) higher damage also impacted physical function. Impairments in sustained attention and memory did not decrease the HRQoL. CONCLUSIONS: Our results highlight the relevance of executive dysfunction to poor physical and mental health components of HRQoL in SLE together with depression, while disease activity and disease damage are associated with lower HRQoL physical components. The need for cognitive function evaluation and rehabilitation in SLE is indicated.


Assuntos
Disfunção Cognitiva/psicologia , Depressão/psicologia , Nível de Saúde , Lúpus Eritematoso Sistêmico/psicologia , Qualidade de Vida/psicologia , Mulheres/psicologia , Adulto , Atenção , Estudos de Casos e Controles , Chile , Função Executiva , Feminino , Humanos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Índice de Gravidade de Doença , Inquéritos e Questionários
10.
Lupus ; 24(6): 558-68, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25318968

RESUMO

OBJECTIVE: Autoantibodies against N-methyl-D-aspartate receptor (anti-NMDAR) and ribosomal-P (anti-P) antigens are potential pathogenic factors in the frequently observed diffuse brain dysfunctions in patients with systemic lupus erythematosus (SLE). Although studies have been conducted in this area, the role of anti-NMDAR antibodies in SLE cognitive dysfunction remains elusive. Moreover, the specific contribution of anti-P antibodies has not been reported yet. The present study attempts to clarify the contribution of anti-NMDAR and anti-P antibodies to cognitive dysfunction in SLE. METHODS: The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess a wide range of cognitive function areas in 133 Chilean women with SLE. ANCOVA models included autoantibodies, patient and disease features. RESULTS: Cognitive deficit was found in 20%. Higher SLEDAI-2K scores were associated with impairment in spatial memory and learning abilities, whereas both anti-NMDAR and anti-P antibodies contributed to deficits in attention and spatial planning abilities, which reflect fronto-parietal cortex dysfunctions. CONCLUSIONS: These results reveal an association of active disease together with specific circulating autoantibodies, such as anti-NMDAR and anti-P, with cognitive dysfunction in SLE patients.


Assuntos
Autoanticorpos/imunologia , Transtornos Cognitivos/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/psicologia , Receptores de N-Metil-D-Aspartato/imunologia , Proteínas Ribossômicas/imunologia , Adulto , Autoanticorpos/sangue , Transtornos Cognitivos/sangue , Transtornos Cognitivos/psicologia , Feminino , Humanos , Lúpus Eritematoso Sistêmico/sangue , Testes Neuropsicológicos , Receptores de N-Metil-D-Aspartato/antagonistas & inibidores , Proteínas Ribossômicas/antagonistas & inibidores
11.
Ann Oncol ; 25(6): 1122-7, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24669015

RESUMO

BACKGROUND: Everolimus synergistically enhances taxane-induced cytotoxicity in breast cancer cells in vitro and in vivo in addition to demonstrating a direct antiproliferative activity. We aim to determine pharmacodynamics changes and response of adding everolimus to standard neoadjuvant chemotherapy in triple-negative breast cancer (TNBC). PATIENTS AND METHODS: Phase II study in patients with primary TNBC randomized to T-FEC (paclitaxel 80 mg/m(2) i.v. weekly for 12 weeks, followed by 5-fluorouracil 500 mg/m(2), epirubicin 100 mg/m(2), and cyclophosphamide 500 mg/m(2) every 3 weeks for four cycles) versus TR-FEC (paclitaxel 80 mg/m(2) i.v. and everolimus 30 mg PO weekly for 12 weeks, followed by FEC). Tumor samples were collected to assess molecular changes in the PI3K/AKT/mTOR pathway, at baseline, 48 h, 12 weeks, and at surgery by reverse phase protein arrays (RPPA). Clinical end points included 12-week clinical response rate (12-week RR), pathological complete response (pCR), and toxicity. RESULTS: Sixty-two patients were registered, and 50 were randomized, 27 received T-FEC, and 23 received TR-FEC. Median age was 48 (range 31-75). There was downregulation of the mTOR pathway at 48 h in the TR-FEC arm. Twelve-week RR by ultrasound were 29.6% versus 47.8%, (P = 0.075), and pCR were 25.9% versus 30.4% (P = 0.76) for T-FEC and TR-FEC, respectively. mTOR downregulation at 48 h did not correlate with 12-week RR in the TR-FEC group (P = 0.58). Main NCI grade 3/4 toxicities included anemia, neutropenia, rash/desquamation, and vomiting in both arms. There was one case of grade 3 pneumonitis in the TR-FEC arm. No grade 3/4 stomatitis occurred. CONCLUSION: The addition of everolimus to paclitaxel was well tolerated. Everolimus downregulated mTOR signaling but downregulation of mTOR at 48 h did not correlate with 12-week RR in the TR-FEC group. CLINICAL TRIAL NUMBER: NCT00499603.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Terapia Neoadjuvante/métodos , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Ciclofosfamida/administração & dosagem , Ciclofosfamida/efeitos adversos , Epirubicina/administração & dosagem , Epirubicina/efeitos adversos , Everolimo , Feminino , Fluoruracila/administração & dosagem , Fluoruracila/efeitos adversos , Humanos , Pessoa de Meia-Idade , Paclitaxel/administração & dosagem , Paclitaxel/efeitos adversos , Transdução de Sinais/efeitos dos fármacos , Sirolimo/administração & dosagem , Sirolimo/efeitos adversos , Sirolimo/análogos & derivados , Serina-Treonina Quinases TOR/efeitos dos fármacos , Serina-Treonina Quinases TOR/metabolismo
12.
Lupus ; 23(10): 1042-53, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24879658

RESUMO

OBJECTIVE: Our aim was to assess the contribution of depression to cognitive impairment in patients with systemic lupus erythematosus (SLE). METHODS: Clinical features, education, age, and Hospital Anxiety and Depression Scale (HADS) were evaluated in 82 patients with SLE and 22 healthy controls, all Chilean women. The Cambridge Neuropsychological Test Automated Battery (CANTAB eclipseTM) assessing attention, spatial memory, and learning and executive function domains was applied. Cognitive deficit definition: a cut-off for definite impairment was defined as a score below -2 standard deviations in at least one outcome measure in two or more domains. ANCOVA with stepwise selection evaluated influences of health status (SLE or control), age, education, and HADS depression and anxiety scores on cognitive outcomes. To avoid overfitting, a shrinkage method was performed. Also, adjusted p-values for multiple comparisons were obtained. RESULTS: Cognitive deficit affected 16 (20%) patients, and no controls (p=0.039). Median HADS depression score in SLE patients was 6 (range 0-19) and in controls was 0 (0-19), p<0.001). ANCOVA and shrinkage models showed that worse cognitive performance in sustained attention and spatial working memory tests was explained by the presence of SLE but not depression, whereas depression only affected a measure of executive function (I/ED Stages completed). CONCLUSION: Depression has a limited role in cognitive impairment in SLE. Impairments in sustained attention and spatial working memory are distinctly influenced by yet-unknown disease-intrinsic factors.


Assuntos
Transtornos Cognitivos/psicologia , Cognição , Depressão/psicologia , Lúpus Eritematoso Sistêmico/psicologia , Memória de Curto Prazo , Testes Neuropsicológicos , Memória Espacial , Adolescente , Adulto , Atenção , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Chile , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Estudos Transversais , Depressão/diagnóstico , Depressão/etiologia , Função Executiva , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Pessoa de Meia-Idade , Análise Multivariada , Fatores de Risco , Adulto Jovem
13.
Rehabilitacion (Madr) ; 57(2): 100736, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-35545483

RESUMO

INTRODUCTION: The COVID-19 pandemic situation has brought a considerable growth on the amount of patients requiring ICU admissions and long-term hospitalization. The present study is aimed at determining whether Rehabilitation Services has been able to reach a sufficient adaptation level, regarding the exponential increase on the demand of Rehab-related services from intensive care patients and inpatients. MATERIAL AND METHODS: Through this cross-sectional research, an online survey was implemented in various Rehabilitation Departments across Spain from December the 22nd, 2020 to February the 12th, 2021. SORECAR (The Spanish Cardiopulmonary Rehabilitation Society) was the responsible entity for the design of the survey (ICU Rehabilitation Services Identification). Descriptive statistical analysis was conducted using SPSS. OBJECTIVE: To address the specific needs and changes arising from the new COVID-19 pandemic situation within Spanish Rehabilitation Departments. RESULTS: 38 hospitals from 18 cities (From a total of 49) participated in the study. The ICUs weekly demand scored 7.84 ± 6,8 Medical Consultation (MC) on average (range: 2-45). The hospitalization average was displayed as 9, 63 ± 6,2 MC/week (range: 2-55). The total worktime dedicated by physicians was 10.38 h/week, from which physiotherapists stood with 25.95 h/week. Only 7 hospitals (16.7%) counted with occupational therapists (OT) (average dedication of 5 h/week). Each Rehab-session lasted 30 min on average. 59.1% (n = 23) of the included hospitals had already implemented a specific post-covid follow-up rehab-consultation, whereas 9.1% (n = 4) of them were planning on implementing it. 64.3% (n = 24) of the surveyed centers implemented specific protocols for COVID-19 patients, while another 7.1% (n = 3) were in development progress. 48.5% (n = 18) of the surveyed centers did not owe its own specific training program within its ICUs and respiratory rehab-areas for the internal medical residents. CONCLUSIONS: The pandemic situation has resulted in a substantial increase on the workload in the Spanish Rehabilitation Services. Most of the hospitals included in the present study had already implemented outpatient follow-up consultations. Rehabilitation in critical patients is an exponentially recurrent topic for this medical specialty that needs to be furtherly addressed in the nearby future.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias , SARS-CoV-2 , Espanha/epidemiologia , Estudos Transversais
14.
Addict Behav ; 143: 107683, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36963236

RESUMO

The Iowa Gambling Task (IGT) is one of the most widely used paradigms for assessing decision-making. An impairment in this process may be linked to several psychopathological disorders, such as obsessive-compulsive disorder (OCD), substance abuse disorder (SUD) or attention-deficit/hyperactivity disorder (ADHD), which could make it a good candidate for being consider a transdiagnostic domain. Resting-state functional connectivity (rsFC) has been proposed as a promising biomarker of decision-making. In this study, we aimed to identify idiosyncratic decision-making profiles among healthy people and impulsive-compulsive spectrum patients during the IGT, and to investigate the role of frontoparietal network (FPN) rsFC as a possible biomarker of different decision-making patterns. Using functional near-infrared spectroscopy (fNIRS), rsFC of 114 adults (34 controls; 25 OCD; 41 SUD; 14 ADHD) was obtained. Then, they completed the IGT. Hybrid clustering methods based on individual deck choices yielded three decision-makers subgroups. Cluster 1 (n = 27) showed a long-term advantageous strategy. Cluster 2 (n = 25) presented a maladaptive decision-making strategy. Cluster 3 (n = 62) did not develop a preference for any deck during the task. Interestingly, the proportion of participants in each cluster was not different between diagnostic groups. A Bayesian general linear model showed no credible differences in the IGT performance between diagnostic groups nor credible evidence to support the role of FPN rsFC as a biomarker of decision-making under the IGT context. This study highlights the importance of exploring in depth the behavioral and neurophysiological variables that may drive decision-making in clinical and healthy populations.


Assuntos
Jogo de Azar , Transtornos Relacionados ao Uso de Substâncias , Adulto , Humanos , Tomada de Decisões/fisiologia , Teorema de Bayes , Testes Neuropsicológicos , Biomarcadores
15.
Int J Tuberc Lung Dis ; 26(1): 44-49, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34969428

RESUMO

BACKGROUND: Adherence to TB treatment and therefore treatment success could be improved using digital adherence technology.OBJECTIVE: To evaluate the effectiveness of a medication event reminder monitor system (MERM) on treatment success and treatment adherence in patients with drug-susceptible pulmonary TB in Perú.METHODS: This was an experimental, randomised, open-label, controlled study conducted among patients in the second phase of TB treatment. The intervention group received their medications through MERM with the support of a treatment monitor, whereas the control group used the usual strategy. Participants were followed until they completed the 54 doses of the second phase of treatment.RESULTS: The study included 53 patients in each group; four in the intervention group withdrew from the study. Treatment success was significantly more frequent in the MERM group (RR 1.15, 95% CI 1.02-1.30; P = 0.0322). There was no significant difference in the adherence outcomes; however, the percentage of patients who missed at least one dose and patients with more than 10% of total doses missed were lower in the intervention group.CONCLUSION: The use of MERM in the second phase of treatment showed a significant improvement in the treatment success rate in patients with drug-susceptible pulmonary TB.


Assuntos
Antituberculosos , Tuberculose Pulmonar , Antituberculosos/uso terapêutico , Monitoramento de Medicamentos , Humanos , Adesão à Medicação , Cooperação e Adesão ao Tratamento , Tuberculose Pulmonar/tratamento farmacológico
16.
Environ Pollut ; 292(Pt A): 118367, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34655696

RESUMO

Scientific literature is full of works studying the removal of different pollutants from water through different Advanced Oxidation Processes (AOPs). Many of them only suggest it is reused for agricultural purposes or for small crops in pots. This study is based on the reuse of reclaimed agricultural wastewater contaminated with four insecticides (chlorantraniliprole, imidacloprid, pirimicarb and thiamethoxam) for growing lettuce in field conditions. First, solar photocatalysis with TiO2/Na2S2O8 was used on a pilot plant in a sunny area (Murcia, SE of Spain) as an environmentally friendly technology to remove insecticide residues and their main reaction intermediates from contaminated water. The necessary fluence (H, kJ m-2) to accomplish 90% removal (H90) ranged from 0.12 to 1212 kJ m-2 for pirimicarb and chlorantraniliprole, respectively. Only six (derived from imidacloprid, pirimicarb and thiametoxam) of 18 transformation intermediate products studied were detected in reclaimed water during the photoperiod (2000 kJ m-2 of accumulated UVA radiation) although all of them were totally photodegraded after a fluence of 1250 kJ m-2. Secondly, reclaimed agro-wastewater was used to irrigate two lettuce crops grown under greenhouse conditions and under agricultural field conditions. In no cases, insecticide residues nor their TIPs were noticed above their respective LOQs (limits of quantification) in soil and lettuce samples (between 0.03 and 0.04 µg kg-1 for pirimicarb and 2.49 and 2.23 µg kg-1 for thiamethoxam, respectively) when they were irrigated with reclaimed water, while residues of the four insecticides and some of their intermediates were found in soil and lettuce by the end of cultivation when they were irrigated with non-reclaimed contaminated water. According to the results, this technology can be applied in a sustainable way, mainly in areas with water scarcity and high solar radiation, contributing to water utilisation in drought areas and the use of renewable energy.


Assuntos
Inseticidas , Resíduos de Praguicidas , Irrigação Agrícola , Lactuca , Tecnologia , Águas Residuárias
17.
Allergol Immunopathol (Madr) ; 39(1): 3-9, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-20685025

RESUMO

OBJECTIVES: We characterised the T helper cytokine profiles on the surface of nasal mucosa of children with acute bronchiolitis caused by Respiratory Syncytial Virus, Parainfluenza Virus, Influenza Virus, Adenovirus, or without any viral identification, in order to examine whether these viral types modified cytokine responses. As an additional objective we sought to determine if T helper polarisation was associated with other demographic and environmental factors. METHODS: A prospective study of children with acute bronchiolitis was performed. Patients were recruited from the emergency department of a central hospital in Lisbon, Portugal. Demographical, epidemiological and clinical data were gathered from a questionnaire. Nasal swabs were collected for viral studies (immunofluorescence) and T cell cytokine responses (detection of expression of interleukins 4, 13, 12 and interferon-γ by real-time polymerase chain reaction assays). RESULTS: Respiratory Syncytial Virus elicited lower levels of interleukin 4, when compared with samples without virus identification. A similar tendency to Th1 polarisation was found in older children, in those who attended day-care centres, and in breastfed individuals. Exposure to tobacco smoke was associated with a Th2 bias in this population. CONCLUSIONS: These findings show that Respiratory Syncytial Virus infection contributes to Th1 polarisation in immune response of respiratory mucosa, an effect that is similar to other environmental factors. Further studies are needed to assess immune response to other infectious causes of acute bronchiolitis.


Assuntos
Bronquiolite Viral/imunologia , Citocinas/genética , Mucosa Nasal/imunologia , Células Th1/imunologia , Células Th2/imunologia , Doença Aguda , Bronquiolite Viral/epidemiologia , Bronquiolite Viral/virologia , Citocinas/imunologia , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Expressão Gênica/imunologia , Humanos , Lactente , Interferon gama/genética , Interferon gama/imunologia , Interleucina-12/genética , Interleucina-12/imunologia , Interleucina-13/genética , Interleucina-13/imunologia , Interleucina-4/genética , Interleucina-4/imunologia , Masculino , Mucosa Nasal/virologia , Portugal/epidemiologia , Estudos Prospectivos , Infecções por Vírus Respiratório Sincicial/imunologia , Vírus Sincicial Respiratório Humano/imunologia , Vírus Sincicial Respiratório Humano/isolamento & purificação , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Fatores de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários , Células Th1/virologia , Células Th2/virologia
18.
Physiol Behav ; 233: 113356, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33577871

RESUMO

RATIONALE: Compulsive behaviour, present in different psychiatric disorders such as obsessive-compulsive disorder, schizophrenia and drug abuse, is associated with altered levels of serotonin (5-hydroxytryptamine, 5-HT). The gut microbiota regulates tryptophan (TRP) metabolism and may affect global 5-H synthesis in the enteric and central nervous systems, suggesting a possible involvement of gut microbiota in compulsive spectrum disorders. OBJECTIVES: The present study investigated whether chronic TRP depletion by diet alters the faecal bacterial community profiles of compulsive versus non-compulsive rats in schedule-induced polydipsia (SIP). Peripheral plasma 5-HT and brain-derived neurotrophic factor (BDNF) levels were evaluated. METHODS: Wistar rats were selected as High Drinkers (HD) or Low Drinkers (LD) according to their SIP behaviour and were fed for 14 days with either a TRP-free diet (T-) or a TRP-supplemented diet (T+). The faecal bacterial community structure was investigated with 16S rRNA gene-targeted denaturing gradient gel electrophoresis (DGGE) fingerprinting analysis. RESULTS: Compulsive HD rats showed a lower bacterial diversity than LD rats, irrespectively of the diet. The TRP-depleted HD rats, the only group increasing compulsive licking in SIP, showed a reduction of bacterial evenness and a highly functionally organized community compared with the other groups, indicating that this bacterial community is more fragile to external changes due to the dominance of a low number of species. The chronic TRP depletion by diet effectively reduced peripheral plasma 5-HT levels in both HD and LD rats, while plasma BDNF levels were not altered. CONCLUSIONS: These results highlight the possible implication of reduced microbial diversity in compulsive behaviour and the involvement of the serotonergic system in modulating the gut brain-axis in compulsive spectrum disorders.


Assuntos
Polidipsia , Triptofano , Animais , Dieta , RNA Ribossômico 16S/genética , Ratos , Ratos Wistar
19.
Sci Rep ; 11(1): 5000, 2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33654160

RESUMO

The global demand for products manufactured with carbon fibers (CFs) has increased in recent years; however, the waste generated at the end of the product lifetime has also increased. In this research, the impact of the addition of carbon nanotubes (CNTs) on the interlaminated resistance of recycled carbon fibers (RCFs) was studied. In this work, a recycling process of the composite material was applied via thermolysis to obtain the CFs, followed by the growth of CNTs on their surface using the Poptube technique. The recycling temperature were 500 °C and 700 °C; and ferrocene and polypyrrole were used to grow CNTs on CFs surface. CNTs were verified by Raman spectroscopy and scanning electron microscopy (SEM). Finally, to determine the interlaminar resistance, a double cantilever beam (DCB) test was performed. The results indicate that with Poptube technique, CNTs can be grown on RCFs using both impregnations. Thermolysis recycling process at 500 °C allowed CFs without resin residues and without visible damage. The DCB tests showed a decrease in the fracture resistance in mode I loading of 34.9% for the polypyrrole samples and 29.3% for the ferrocene samples compared with the virgin carbon fibers (VCFs) samples with a resistance of 1052.5 J/m2.

20.
Toxicol In Vitro ; 70: 105041, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33127435

RESUMO

Transforming growth factor-beta 1 (TGF-ß1) is a cytokine with marked pro-fibrotic action on cardiac fibroblasts (CF). TGF-ß1 induces CF-to-cardiac myofibroblast (CMF) differentiation, defined by an increase in α-smooth muscle cells (α-SMA), collagen secretion and it has a cytoprotective effect against stimuli that induce apoptosis. In the Endoplasmic Reticulum (ER) lumen, misfolded protein accumulation triggers ER stress and induces apoptosis, and this process plays a critical role in cell death mediated by Ischemia/Reperfusion (I/R) injury and by ER stress inducers, such as Tunicamycin (Tn). Here, we studied the regulation of CHOP, a proapoptotic ER-stress-related transcription factor in CF under simulated I/R (sI/R) or exposed to Tn. Even though TGF-ß1 has been shown to participate in ER stress, its regulatory effect on CF apoptosis and ER stress-induced by sI/R or TN has not been evaluated yet. CF from neonatal rats were exposed to sI/R, and cell death was evaluated by cell count and apoptosis by flow cytometry. ER stress was assessed by western blot against CHOP. Our results evidenced that sI/R (8/24) h or Tn triggers CF apoptosis and an increase in CHOP protein levels. TGF-ß1 pre-treatment partially prevented apoptosis induced by sI/R or Tn. Furthermore, TGF-ß1 pre-treatment completely prevented CHOP increase by sI/R or Tn. Additionally, we found a decrease in α-SMA expression induced by sI/R and in collagen secretion induced by Tn, which were not prevented by TGF-ß1 treatment. In conclusion, TGF-ß1 partially protects CF apoptosis induced by sI/R or Tn, through a mechanism that would involve ER stress.


Assuntos
Apoptose/efeitos dos fármacos , Fibroblastos/efeitos dos fármacos , Fator de Transcrição CHOP/metabolismo , Fator de Crescimento Transformador beta1/farmacologia , Actinas/metabolismo , Animais , Animais Recém-Nascidos , Sobrevivência Celular/efeitos dos fármacos , Colágeno/metabolismo , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Fibroblastos/metabolismo , Traumatismo por Reperfusão Miocárdica/metabolismo , Miocárdio/citologia , Ratos Sprague-Dawley , Tunicamicina/farmacologia
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