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1.
Arch Orthop Trauma Surg ; 144(5): 2085-2091, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38653835

RESUMO

OBJECTIVE: To present the functional results obtained and the possible surgical difficulties after the surgical treatment of Dupuytren's disease (DD) recurrence in patients previously treated with Clostridium histolyticum (CCH) collagenase. MATERIALS AND METHODS: In this prospective study, 178 patients with DD were treated with CCH from 2011 to 2018; During long-term postoperative follow-up, 34 patients (19.1%) had recurrence of DD. In all patients injected in the IFP the disease recurred; In patients injected in the MCP, recurrence was highest in grade III and IV of the Tubiana classification, with involvement of the 5th finger and the two-finger Y-chord. Fourteen patients (7,8%) required surgery by partial selective fasciectomy due to recurrence of cord DD infiltration. The clinical and functional results of the patients, the difficulty of the surgical technique and the anatomopathological analysis of the infiltrated cords were evaluated in comparison with those of cords and patients who had had no previous CCH treatment. RESULTS: In all patients, cord rupture was achieved after injection, reducing joint contracture. In 14 patients, we observed during the follow-up the existence of DD recurrence that required surgical treatment by selective partial fasciectomy. There were no major difficulties in surgery and good clinical and functional results at 6 months of follow-up. The anatomopathological study of the resected tissue did not present histological alterations with respect to the samples obtained from patients initially treated by selective partial fasciectomy. CONCLUSIONS: Selective fasciectomy after CCH injection does not lead to important operative difficulties, as long as the CCH injection is performed according to the recommendations. There were no histological changes in the tissue after CCH injection. LEVEL OF EVIDENCE: III.


Assuntos
Contratura de Dupuytren , Colagenase Microbiana , Recidiva , Humanos , Contratura de Dupuytren/cirurgia , Contratura de Dupuytren/tratamento farmacológico , Colagenase Microbiana/uso terapêutico , Colagenase Microbiana/administração & dosagem , Estudos Prospectivos , Masculino , Idoso , Pessoa de Meia-Idade , Feminino , Injeções Intralesionais , Fasciotomia/métodos
2.
Nanotechnology ; 34(32)2023 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-37163999

RESUMO

The microwave detection capability of GaN-based asymmetric planar nanodiodes (so-called Self-Switching Diode, SSD, due to its non-linearity) has been characterized in a wide temperature range, from 70 K up to 300 K. At low temperature, microwave measurements reveal an enhancement of the responsivity at frequencies below 1 GHz, which, together with a pronounced hysteresis in the DC curves, indicate a significant influence of the surface states. This leads to a significant variability and non-repeatability which needs to be reduced since it degrades the accuracy of the detection. For this sake, the RF characterization was repeated after applying a positive/negative voltage able to fill/empty the surface states in order to have a well-established preconditioned state. As a consequence of the positive pre-soak bias, a significant enhancement of the measured responsivity, with a × 10 increase at low temperature. The RF detection measurements after such preconditioning contains a time dependence induced by the slow discharge mechanism of the traps, so that the improved responsivity remains even after 100s of seconds. On the other hand, a negative voltage pre-soak benefits the discharge process, thus suppressing the low frequency dispersion and the important variability of the detection without the pre-conditioning step. We also show that the relation between the voltage and current responsivities in each case allows to explain the impact of the surface charges in terms of the device impedance.

3.
HIV Med ; 22(5): 379-386, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33369104

RESUMO

OBJECTIVES: Spain is close to HCV microelimination, so rates of recently acquired HCV infection (RAHC) should decrease. Nowadays, men who have sex with men (MSM) carry the highest risk of HCV acquisition. Our aim was to estimate the incidence of and the factors associated with RAHC, together with reinfection rates, among patients sexually infected by HIV. METHODS: Primary RAHC infection was diagnosed when anti-HCV antibody seroconversion was documented. In anti-HCV positive patients, initially without HCV viraemia, a diagnosis of reinfection was established if plasma HCV RNA was detected. RESULTS: All 350 patients tested negative for anti-HCV at baseline and had at least one follow-up visit. Among them, there were 16 RAHC cases from 2016 to 2019. RAHC incidence rates [IR (95% confidence interval, CI)] per 100 person-years were 3.77 (0.5-12.9) in 2016, 1.85 (0.6-4.3) in 2017, 1.49 (0.4-3.8) in 2018 and 1.98 (0.6-4.5) in 2019. Only previous sexually transmitted infections [incidence rate ratio (IRR) = 18.23, 95% CI: 1.93-172.1; P = 0.011], male sex (IRR = 8.33, 95% CI: 1.38-54.15; P = 0.026) and sharing chem-sex drugs (IRR: 4.93, 95% CI: 1.17-20.76; P = 0.030), were independently associated with RAHC. Four out of 42 (9.5%) patients became reinfected. CONCLUSIONS: The incidence of RAHC among HIV-infected patients showed a decrease after 2016, although a lower but steady incidence of residual cases still remains. HCV reinfections showed a similar pattern. New infections were associated with sharing chem-sex drugs among MSM.


Assuntos
Infecções por HIV , Hepatite C , Minorias Sexuais e de Gênero , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Hepacivirus , Hepatite C/complicações , Hepatite C/epidemiologia , Homossexualidade Masculina , Humanos , Incidência , Masculino , Espanha/epidemiologia
4.
Transfus Apher Sci ; 60(3): 103130, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33840626

RESUMO

Plerixafor (PLX) appears to effectively enhance hematopoietic stem-cell mobilization prior to autologous hematopoietic stem cell transplantation (auto-HCT). However, the quality of engraftment following auto-HCT has been little explored. Here, engraftment following auto-HCT was assessed in patients mobilized with PLX through a retrospective, multicenter study of 285 consecutive patients. Information on early and 100-day post-transplant engraftment was gathered from the 245 patients that underwent auto-HCT. The median number of PLX days to reach the stem cell collection goal (≥2 × 106 CD34+ cells/kg) was 1 (range 1-4) and the median PLX administration time before apheresis was 11 h (range 1-18). The median number of apheresis sessions to achieve the collection goal was 2 (range 1-5) and the mean number of CD34+ cells collected was 2.95 × 106/kg (range 0-30.5). PLX administration was safe, with only 2 mild and transient gastrointestinal adverse events reported. The median time to achieve an absolute neutrophil count (ANC) >500/µL was 11 days (range 3-31) and the median time to platelet recovery >20 × 103/µL was 13 days (range 5-69). At 100 days after auto-HCT, the platelet count was 137 × 109/L (range 7-340), the ANC was 2.3 × 109/L (range 0.1-13.0), and the hemoglobin concentration was 123 g/L (range 79-165). PLX use allowed auto-HCT to be performed in a high percentage of poorly mobilized patients, resulting in optimal medium-term engraftment in the majority of patients in whom mobilization failed, in this case mainly due to suboptimal peripheral blood CD34+ cell concentration on day +4 or low CD34+ cell yield on apheresis.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Benzilaminas/uso terapêutico , Ciclamos/uso terapêutico , Mobilização de Células-Tronco Hematopoéticas/métodos , Transplante de Células-Tronco Hematopoéticas/métodos , Transplante Autólogo/métodos , Adolescente , Adulto , Idoso , Fármacos Anti-HIV/farmacologia , Benzilaminas/farmacologia , Criança , Pré-Escolar , Ciclamos/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
5.
Nanotechnology ; 31(40): 405204, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-32544891

RESUMO

The zero-bias microwave detection capability of self-switching diodes (SSDs) based on AlGaN/GaN is analyzed in a wide temperature range, from 10 K to 300 K. The measured responsivity shows an anomalous enhancement at low temperature, while the detected voltage exhibits a roll-off in frequency, which can be attributed to the presence of surface and bulk traps. To gain a deep insight into this behavior, a systematic DC and AC characterization of the diodes has been carried out in the mentioned temperature range. DC results confirm the existence of traps and AC measurements allow us to identify their properties. In particular, impedance studies enable to distinguish two types of traps: at the lateral surfaces of the channel, with a wide spread of relaxation times, and in the bulk.

6.
Acta Psychiatr Scand ; 140(6): 541-551, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31566713

RESUMO

AIMS: To study the temporal dynamics of depression symptom episodes in old-age and the related influence of risk factors. METHODS: Data from 41 362 old adults (54.61% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health - Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18-year period. A multi-state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition. RESULTS: Almost 85% of participants showed no depression, but prevalence became lower over time (B = -0.25, P < 0.001). New episode point prevalence was over 5.30% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86% of episode status transitions, with increasing rate over time (B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence (OR = 17.76) and persistence (OR = 5.93). CONCLUSIONS: The course of depression tends to become chronic and unremitting in old-age. This study may help to plan interventions to tackle symptom escalation and risk factor influence.


Assuntos
Envelhecimento/fisiologia , Depressão/fisiopatologia , Progressão da Doença , Solidão , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de Risco
8.
Acta Psychiatr Scand ; 138(2): 145-154, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29726004

RESUMO

OBJECTIVE: The current investigation aimed at studying the sociodemographic, clinical, and neuropsychological variables related to functional outcome in a sample of euthymic patients with bipolar disorder(BD) presenting moderate-severe levels of functional impairment. METHODS: Two-hundred and thirty-nine participants with BD disorders and with Functioning Assessment Short Test(FAST) scores equal or above 18 were administered a clinical and diagnostic interview, and the administration of mood measure scales and a comprehensive neuropsychological battery. Analyses involved preliminary Pearson bivariate correlations to identify sociodemographic and clinical variables associated with the FAST total score. Regarding neuropsychological variables, a principal component analysis (PCA) was performed to group the variables in orthogonal factors. Finally, a hierarchical multiple regression was run. RESULTS: The best fitting model for the variables associated with functioning was a linear combination of gender, age, estimated IQ, Hamilton Depression Rating Scale (HAM-D), number of previous manic episodes, Factor 1 and Factor 2 extracted from the PCA. The model, including all these previous variables, explained up to 29.4% of the observed variance. CONCLUSIONS: Male gender, older age, lower premorbid IQ, subdepressive symptoms, higher number of manic episodes, and lower performance in verbal memory, working memory, verbal fluency, and processing speed were associated with lower functioning in patients with BD.


Assuntos
Transtorno Bipolar/psicologia , Transtorno Ciclotímico/psicologia , Transtornos Neurocognitivos/psicologia , Adulto , Transtorno Bipolar/classificação , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Memória de Curto Prazo/fisiologia , Pessoa de Meia-Idade , Testes Neuropsicológicos/estatística & dados numéricos , Espanha/epidemiologia , Distúrbios da Fala/psicologia
9.
HIV Med ; 18(8): 546-554, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28116842

RESUMO

OBJECTIVES: Fatty liver disease (FLD) is frequently observed in HIV-infected patients. Obesity and type 2 diabetes mellitus (T2DM) are strongly associated with FLD. Because genetic variants within the fat mass and obesity-associated (FTO) gene have been associated with both pathologies, our aim was to evaluate the association of single nucleotide polymorphisms (SNPs) within the FTO, previously related to obesity or T2DM, with FLD in HIV-infected patients. METHODS: FLD was defined as a value of the controlled attenuation parameter (CAP) ≥ 238 dB/m, obtained by transient elastography. Four SNPs within FTO intron 1 (rs11642841, rs8050136, rs9939609 and rs9940128) were genotyped in 421 individuals using a custom Golden Gate protocol. The results were replicated in a validation sample consisting of a further 206 HIV-infected patients. Multivariate logistic regression analyses were conducted in the entire population. RESULTS: Three SNPs (rs8050136, rs9939609 and rs9940128) were associated with FLD, with rs9940128 showing the strongest association. This polymorphism also showed an association with FLD in the validation sample. In total, rs9940128 was genotyped in 627 HIV-infected patients, including 267 (42.6%) FLD-diagnosed individuals. The frequency of FLD among rs9940128 AA carriers was 55.7% (63 of 113 individuals) and that in patients without this genotype was 39.7% (204 of 514 individuals) [P = 0.009; adjusted odds ratio 1.88; 95% confidence interval (CI) 1.17-3.01]. CONCLUSIONS: Variations within FTO may be predictors of FLD in HIV-infected patients independently of metabolic factors.


Assuntos
Dioxigenase FTO Dependente de alfa-Cetoglutarato/genética , Fígado Gorduroso/genética , Predisposição Genética para Doença , Infecções por HIV/complicações , Obesidade/complicações , Polimorfismo de Nucleotídeo Único , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Técnicas de Imagem por Elasticidade , Fígado Gorduroso/patologia , Feminino , Técnicas de Genotipagem , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
Psychol Med ; 47(3): 414-425, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27780478

RESUMO

BACKGROUND: There is growing recognition of the importance of both functioning and quality of life (QoL) outcomes in the treatment of depressive disorders, but the meta-analytic evidence is scarce. The objective of this meta-analysis of randomized controlled trials (RCTs) was to determine the absolute and relative effects of psychotherapy, pharmacotherapy and their combination on functioning and QoL in patients with depression. METHOD: One hundred and fifty-three outcome trials involving 29 879 participants with depressive disorders were identified through database searches in Pubmed, PsycINFO and the Cochrane Central Register of Controlled Trials. RESULTS: Compared to control conditions, psychotherapy and pharmacotherapy yielded small to moderate effect sizes for functioning and QoL, ranging from g = 0.31 to g = 0.43. When compared directly, initial analysis yielded no evidence that one of them was superior. After adjusting for publication bias, psychotherapy was more efficacious than pharmacotherapy (g = 0.21) for QoL. The combination of psychotherapy and medication performed significantly better for both outcomes compared to each treatment alone yielding small effect sizes (g = 0.32 to g = 0.39). Both interventions improved depression symptom severity more than functioning and QoL. CONCLUSION: Despite the small number of comparative trials for some of the analyses, this study reveals that combined treatment is superior, but psychotherapy and pharmacotherapy alone are also efficacious for improving functioning and QoL. The overall relatively modest effects suggest that future tailoring of therapies could be warranted to better meet the needs of individuals with functioning and QoL problems.


Assuntos
Antidepressivos/farmacologia , Transtorno Depressivo/terapia , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Psicoterapia/estatística & dados numéricos , Qualidade de Vida , Terapia Combinada , Transtorno Depressivo/tratamento farmacológico , Humanos
11.
Ann Rheum Dis ; 75(2): 348-55, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25433020

RESUMO

OBJECTIVE: To score systemic activity at diagnosis and correlate baseline activity with survival in a large cohort of patients with primary Sjögren syndrome (SS). PATIENTS AND METHODS: We include 1045 consecutive patients who fulfilled the 2002 classification criteria for primary SS. The clinical and immunological characteristics and level of activity (EULAR-SS Disease Activity Index (ESSDAI) scores) were assessed at diagnosis as predictors of death using Cox proportional hazards regression analysis adjusted for age at diagnosis. The risk of death was calculated at diagnosis according to four different predictive models. RESULTS: After a mean follow-up of 117 months, 115 (11%) patients died. The adjusted standardised mortality ratio for the total cohort was 4.66 (95% CI 3.85 to 5.60), and survival rates at 5, 10, 20 and 30 years were 96%, 90%, 81% and 60%, respectively. The main baseline factors associated with overall mortality in the multivariate analysis were male gender, cryoglobulins and low C4 levels. Baseline activity in the constitutional, pulmonary and biological domains was associated with a higher risk of death. High activity in at least one ESSDAI domain (HR 2.14), a baseline ESSDAI score ≥14 (HR 1.85) and more than one laboratory predictive marker (lymphopenia, anti-La, monoclonal gammopathy, low C3, low C4 and/or cryoglobulins) (HR 2.82) were associated with overall mortality; these HRs increased threefold to 10-fold when the analysis was restricted to mortality associated with systemic disease. CONCLUSIONS: Patients with primary SS, who present at diagnosis with high systemic activity (ESSDAI ≥14) and/or predictive immunological markers (especially those with more than one), are at higher risk of death.


Assuntos
Índice de Gravidade de Doença , Síndrome de Sjogren/mortalidade , Adolescente , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antinucleares/sangue , Biomarcadores/sangue , Complemento C3/análise , Complemento C4/análise , Crioglobulinas/análise , Europa (Continente) , Feminino , Humanos , Linfopenia/sangue , Masculino , Pessoa de Meia-Idade , Paraproteinemias/sangue , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Síndrome de Sjogren/sangue , Fatores de Tempo
12.
Nat Mater ; 14(2): 187-92, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25384166

RESUMO

Thermal dissipation at the active region of electronic devices is a fundamental process of considerable importance. Inadequate heat dissipation can lead to prohibitively large temperature rises that degrade performance, and intensive efforts are under way to mitigate this self-heating. At room temperature, thermal resistance is due to scattering, often by defects and interfaces in the active region, that impedes the transport of phonons. Here, we demonstrate that heat dissipation in widely used cryogenic electronic devices instead occurs by phonon black-body radiation with the complete absence of scattering, leading to large self-heating at cryogenic temperatures and setting a key limit on the noise floor. Our result has important implications for the many fields that require ultralow-noise electronic devices.

13.
Br J Psychiatry ; 208(1): 87-93, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26541692

RESUMO

BACKGROUND: Few randomised clinical trials have examined the efficacy of an intervention aimed at improving psychosocial functioning in bipolar disorder. AIMS: To examine changes in psychosocial functioning in a group that has been enrolled in a functional remediation programme 1 year after baseline. METHOD: This was a multicentre, randomised, rater-masked clinical trial comparing three patient groups: functional remediation, psychoeducation and treatment as usual over 1-year follow-up. The primary outcome was change in psychosocial functioning measured by means of the Functioning Assessment Short Test (FAST). Group×time effects for overall psychosocial functioning were examined using repeated-measures ANOVA (trial registration NCT01370668). RESULTS: There was a significant group×time interaction for overall psychosocial functioning, favouring patients in the functional remediation group (F = 3.071, d.f. = 2, P = 0.049). CONCLUSIONS: Improvement in psychosocial functioning is maintained after 1-year follow-up in patients with bipolar disorder receiving functional remediation.


Assuntos
Transtorno Bipolar/terapia , Adulto , Transtorno Bipolar/tratamento farmacológico , Terapia Cognitivo-Comportamental , Função Executiva , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Método Simples-Cego , Espanha , Resultado do Tratamento
14.
Psychol Med ; 46(2): 291-301, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26387583

RESUMO

BACKGROUND: Functional remediation is a novel intervention with demonstrated efficacy at improving functional outcome in euthymic bipolar patients. However, in a previous trial no significant changes in neurocognitive measures were detected. The objective of the present analysis was to test the efficacy of this therapy in the enhancement of neuropsychological functions in a subgroup of neurocognitively impaired bipolar patients. METHOD: A total of 188 out of 239 DSM-IV euthymic bipolar patients performing below two standard deviations from the mean of normative data in any neurocognitive test were included in this subanalysis. Repeated-measures analyses of variance were conducted to assess the impact of the treatment arms [functional remediation, psychoeducation, or treatment as usual (TAU)] on participants' neurocognitive and functional outcomes in the subgroup of neurocognitively impaired patients. RESULTS: Patients receiving functional remediation (n = 56) showed an improvement on delayed free recall when compared with the TAU (n = 63) and psychoeducation (n = 69) groups as shown by the group × time interaction at 6-month follow-up [F 2,158 = 3.37, degrees of freedom (df) = 2, p = 0.037]. However, Tukey post-hoc analyses revealed that functional remediation was only superior when compared with TAU (p = 0.04), but not with psychoeducation (p = 0.10). Finally, the patients in the functional remediation group also benefited from the treatment in terms of functional outcome (F 2,158 = 4.26, df = 2, p = 0.016). CONCLUSIONS: Functional remediation is effective at improving verbal memory and psychosocial functioning in a sample of neurocognitively impaired bipolar patients at 6-month follow-up. Neurocognitive enhancement may be one of the active ingredients of this novel intervention, and, specifically, verbal memory appears to be the most sensitive function that improves with functional remediation.


Assuntos
Transtorno Bipolar/reabilitação , Transtornos Cognitivos/reabilitação , Rememoração Mental , Reabilitação Psiquiátrica/métodos , Aprendizagem Verbal , Adulto , Transtorno Bipolar/psicologia , Transtornos Cognitivos/psicologia , Feminino , Humanos , Masculino , Memória , Pessoa de Meia-Idade , Testes Neuropsicológicos , Educação de Pacientes como Assunto
15.
Acta Psychiatr Scand ; 133(5): 386-98, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26719018

RESUMO

OBJECTIVE: Cognitive reserve (CR) is a concept that was postulated as a protective factor for some clinical symptoms after the observation that there is not a direct relationship between the degree of brain damage and its clinical manifestation. This study aimed to explore the association between CR and the main outcomes in bipolar disorder (BD): cognitive functions, psychosocial functioning and perceived quality of life. METHOD: A sample of 224 euthymic bipolar patients was assessed with a neuropsychological battery, the Functioning Assessment Short Test and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). CR was calculated through three proxies: estimated premorbid Intelligent Quotient, educational level and occupational attainment. Relationships between CR and cognitive functions, psychosocial functioning and quality of life were assessed by multiple linear regression models. RESULTS: Higher CR was associated with better cognitive functioning (P < 0.001 in processing speed, working memory, verbal and visual memory, and executive function; P = 0.026 in attention) and better psychosocial functioning (P = 0.008). For quality of life, CR was positively associated with the physical component of the SF-36 (P = 0.016) but negatively associated with the mental component (P = 0.004). CONCLUSION: The results suggest that CR may play an important role in the course and prognosis of bipolar patients and it should be considered in both clinical and research settings related to BD.


Assuntos
Transtorno Bipolar/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Reserva Cognitiva/fisiologia , Função Executiva/fisiologia , Qualidade de Vida , Habilidades Sociais , Adulto , Transtorno Bipolar/complicações , Disfunção Cognitiva/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
Nanotechnology ; 26(48): 485202, 2015 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-26553008

RESUMO

This paper presents a comprehensive study of the behavior of surface charges in ballistic deflection transistors, at room temperature, where the in-plane geometry associating two drains with two gates in push-pull modes allows the control of electron path. Monte Carlo simulations were performed and compared with experimental data by using different models for accounting for surface charge effects. The simple model which assumes a constant and uniform value of the surface charge provides good results at equilibrium, but it is not able to correctly reproduce the BDT's complex behavior when biased. We have confirmed that for a correct description of the device operation it is necessary to use a model allowing the surface charge to adapt itself locally to the carrier concentration in its surroundings.

17.
Arch Virol ; 159(12): 3345-51, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25161034

RESUMO

The aim of this study was to analyze the impact of core variations on sustained virological response (SVR) to pegylated interferon plus ribavirin (PEG-IFN/RBV) and its association with predictive factors of response in Caucasian patients infected with genotype 1 hepatitis C virus (HCV-1). Full-length core sequences were analyzed in 100 Caucasian HCV-1-infected patients who received therapy with PEG-IFN/RBV. The associations between variations in the core protein and SVR, as well as with predictors of SVR, were analyzed. Variations at core 62, 70 and 110 were selected as candidates. There were almost no variations at these positions among patients harboring HCV-1a. However, they were identified in 10 (30.3 %), 21 (63.6 %) and 13 (39.4 %) subjects with HCV-1b, respectively. Among the HCV-1b patients, 39.1 % individuals carrying core R62 and 70 % subjects with core R62G showed SVR (p = 0.141), and 66.7 % of HCV-1b patients harboring core R70 and 38.1 % with core R70Q achieved SVR (p = 0.157), whereas the rate of SVR was 70 % for individuals with core T110 and 15.4 % for those with core T110N (p = 0.004). No statistical interaction between core variations and IL28B genotype was observed. Patients with R70 showed higher median (interquartile range) baseline plasma levels of low-density-lipoprotein cholesterol (LDL-C) than those with R70Q (96 [86-118] mg/dL vs. 76 [54-88] mg/dL, p = 0.014). We concluded that a substitution at core 110 is associated with a lower rate of SVR in Caucasian HCV-1b-infected patients receiving PEG-IFN/RBV. Furthermore, the variation at the core 70 position is related to plasma levels of LDL-C in these patients.


Assuntos
Substituição de Aminoácidos , Aminoácidos/genética , Antivirais/uso terapêutico , Hepacivirus/efeitos dos fármacos , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/virologia , Proteínas do Core Viral/genética , Quimioterapia Combinada , Hepacivirus/genética , Humanos , Interferon-alfa/uso terapêutico , Ribavirina/uso terapêutico , Resultado do Tratamento , População Branca
18.
Acta Psychiatr Scand ; 127(6): 482-93, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22943634

RESUMO

OBJECTIVE: To analyze, in a general population sample, clustering of delusional and hallucinatory experiences in relation to environmental exposures and clinical parameters. METHOD: General population-based household surveys of randomly selected adults between 18 and 65 years of age were carried out. SETTING: 52 countries participating in the World Health Organization's World Health Survey were included. PARTICIPANTS: 225 842 subjects (55.6% women), from nationally representative samples, with an individual response rate of 98.5% within households participated. RESULTS: Compared with isolated delusions and hallucinations, co-occurrence of the two phenomena was associated with poorer outcome including worse general health and functioning status (OR = 0.93; 95% CI: 0.92-0.93), greater severity of symptoms (OR = 2.5 95% CI: 2.0-3.0), higher probability of lifetime diagnosis of psychotic disorder (OR = 12.9; 95% CI: 11.5-14.4), lifetime treatment for psychotic disorder (OR = 19.7; 95% CI: 17.3-22.5), and depression during the last 12 months (OR = 11.6; 95% CI: 10.9-12.4). Co-occurrence was also associated with adversity and hearing problems (OR = 2.0; 95% CI: 1.8-2.3). CONCLUSION: The results suggest that the co-occurrence of hallucinations and delusions in populations is not random but instead can be seen, compared with either phenomenon in isolation, as the result of more etiologic loading leading to a more severe clinical state.


Assuntos
Delusões/epidemiologia , Alucinações/epidemiologia , Transtornos Psicóticos/epidemiologia , Adolescente , Adulto , Idoso , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Feminino , Alucinações/psicologia , Nível de Saúde , Inquéritos Epidemiológicos , Transtornos da Audição/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Desemprego/estatística & dados numéricos , Violência/estatística & dados numéricos , Organização Mundial da Saúde , Adulto Jovem
19.
Enferm Intensiva ; 24(2): 89-94, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23337423

RESUMO

OBJECTIVE: To present and analyze a clinical case that addresses the care plan for a patient with permanent ventricular assist in an intensive care unit (ICU). CLINICAL CASE PRESENTATION: A 65-year-old man admitted to an ICU in a tertiary teaching hospital in September 2011 after receiving an implant of a permanent ventricular assist device (Heartmate II). DISCUSSION AND IMPLICATIONS FOR PRACTICE: The case analysis has been structured into 3 categories identified in the review of the literature: prevention of risks and complications, management of the device and health education. CONCLUSION: This study shows the importance of establishing a protocolized care plan for the patients who are carriers of permanent ventricular assist in the ICU. This would avoid postoperative complications, reduce costs and hospitalization time.


Assuntos
Cuidados Críticos , Coração Auxiliar , Idoso , Transplante de Coração , Humanos , Unidades de Terapia Intensiva , Masculino
20.
Epidemiol Psychiatr Sci ; 32: e55, 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37655398

RESUMO

AIMS: To assess whether there is a change in the prevalence of depression and suicidal ideation after the strict lockdown measures due to the first wave of the COVID-19 pandemic in Spain, and to assess which are the factors associated with the incidence of a depressive episode or suicidal ideation during the lockdown. METHODS: Data from a longitudinal adult population-based cohort from Madrid and Barcelona were analysed (n = 1103). Face-to-face home-based (pre-pandemic) and telephone interviews were performed. Depression and suicidal ideation were assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Population prevalence estimates and multivariable logistic regressions were computed. RESULTS: Prevalence rates of depression changed significantly from before to after the COVID-19 outbreak (from 3.06% to 12.00%; p = 0.01) and per sex and age groups. Individuals reporting COVID-19 concerns (odds ratio [OR] = 3.11; 95% confidence interval [CI] = 1.45-6.69) and those feeling loneliness (OR = 1.99; 95% CI = 1.52-2.61) during the lockdown were at increased risk of developing depression during the confinement. Resilience showed a protective effect against the risk of depression (OR = 0.57; 95% CI = 0.39-0.83), while individuals perceiving social support during the confinement were at lower risk of developing suicidal thoughts (OR = 0.21; 95% CI = 0.09-0.46). Greater disability during the lockdown was also associated with the risk of suicidal ideation (OR = 2.77; 95% CI = 1.53-5.03). CONCLUSIONS: Continuous reinforcement of mental health preventive and intervening measures is of global importance, particularly among vulnerable groups who are experiencing the most distress. Future research should strive to evaluate the long-term effects of the COVID-19 crisis on mental health.


Assuntos
COVID-19 , Ideação Suicida , Adulto , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Longitudinais , Pandemias , Espanha/epidemiologia , Depressão/epidemiologia , Controle de Doenças Transmissíveis
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