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1.
J Hand Ther ; 36(4): 860-876, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37604769

RESUMEN

BACKGROUND: It is an updated systematic review with meta-analysis that compared supervised exercise therapy (SET) vs non-supervised exercise therapy (NSET) programs for patients with distal radius fracture. PURPOSE: The purpose of this systematic review is to appraise the current literature to determine if SET program is more effective than a NSET program for pain relief, improvement of range of movement, function and grip strength, both in the short or medium term for patients following distal radius fractures. STUDY DESIGN: Systematic review. METHODS: The following electronic databases were searched: Medline/Pubmed, PEDro, Cinahl, Embase, CENTRAL, and Lilacs. PICOT strategy was used for trial selection. The searches were conducted on August 22, 2021, and May 26, 2022. Two researchers performed an independent search for papers from the references of the chosen trials. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used for assessing the quality of evidence. RESULTS: The search strategy identified 2786 potentially eligible studies and 15 studies met our inclusion criteria. The results did not show that the SET program was more effective than the NSET program for all outcomes, in both terms for patients after distal radius fractures. GRADE showed that all analyses presented very low-quality evidence. CONCLUSIONS: Even the results showing there was no difference between the two programs analyzed, the available evidence for randomized controlled trials was insufficient to support these results.


Asunto(s)
Fracturas de la Muñeca , Humanos , Terapia por Ejercicio/métodos , Fuerza de la Mano
2.
Lancet ; 398(10296): 223-237, 2021 07 17.
Artículo en Inglés | MEDLINE | ID: mdl-34274064

RESUMEN

BACKGROUND: COVID-19 is a multisystem disease and patients who survive might have in-hospital complications. These complications are likely to have important short-term and long-term consequences for patients, health-care utilisation, health-care system preparedness, and society amidst the ongoing COVID-19 pandemic. Our aim was to characterise the extent and effect of COVID-19 complications, particularly in those who survive, using the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK. METHODS: We did a prospective, multicentre cohort study in 302 UK health-care facilities. Adult patients aged 19 years or older, with confirmed or highly suspected SARS-CoV-2 infection leading to COVID-19 were included in the study. The primary outcome of this study was the incidence of in-hospital complications, defined as organ-specific diagnoses occurring alone or in addition to any hallmarks of COVID-19 illness. We used multilevel logistic regression and survival models to explore associations between these outcomes and in-hospital complications, age, and pre-existing comorbidities. FINDINGS: Between Jan 17 and Aug 4, 2020, 80 388 patients were included in the study. Of the patients admitted to hospital for management of COVID-19, 49·7% (36 367 of 73 197) had at least one complication. The mean age of our cohort was 71·1 years (SD 18·7), with 56·0% (41 025 of 73 197) being male and 81·0% (59 289 of 73 197) having at least one comorbidity. Males and those aged older than 60 years were most likely to have a complication (aged ≥60 years: 54·5% [16 579 of 30 416] in males and 48·2% [11 707 of 24 288] in females; aged <60 years: 48·8% [5179 of 10 609] in males and 36·6% [2814 of 7689] in females). Renal (24·3%, 17 752 of 73 197), complex respiratory (18·4%, 13 486 of 73 197), and systemic (16·3%, 11 895 of 73 197) complications were the most frequent. Cardiovascular (12·3%, 8973 of 73 197), neurological (4·3%, 3115 of 73 197), and gastrointestinal or liver (0·8%, 7901 of 73 197) complications were also reported. INTERPRETATION: Complications and worse functional outcomes in patients admitted to hospital with COVID-19 are high, even in young, previously healthy individuals. Acute complications are associated with reduced ability to self-care at discharge, with neurological complications being associated with the worst functional outcomes. COVID-19 complications are likely to cause a substantial strain on health and social care in the coming years. These data will help in the design and provision of services aimed at the post-hospitalisation care of patients with COVID-19. FUNDING: National Institute for Health Research and the UK Medical Research Council.


Asunto(s)
COVID-19/complicaciones , Protocolos Clínicos/normas , Comorbilidad , Mortalidad Hospitalaria , Hospitalización , Factores de Edad , Anciano , COVID-19/epidemiología , Enfermedades Cardiovasculares , Femenino , Hospitales , Humanos , Masculino , Enfermedades del Sistema Nervioso , Estudios Prospectivos , Enfermedades Respiratorias , SARS-CoV-2 , Reino Unido/epidemiología , Organización Mundial de la Salud
3.
Trop Med Int Health ; 27(12): 1044-1052, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36261920

RESUMEN

OBJECTIVE: Ova and parasite (O&P) examination is recommended for the laboratory diagnosis of agents causing parasitic infections; however, this exam requires scientific and technological improvements to enhance its diagnostic validity. Dissolved air flotation (DAF) is an efficient technical principle separating suspended solids in a liquid medium. We aimed to develop and validate a new procedure for intestinal parasite detection with DAF. METHODS: In this study, we collected samples from 500 volunteers, screened them by direct examination, and transferred the material to tubes using the Three Faecal Test (TF-Test) for triplicate DAF tests. We evaluated physical-chemical parameters and DAF prototype components through quantifying parasites recovered from floated and non-floated regions of the flotation column. The DAF operation protocol was validated with the gold standard results. RESULTS: The 10% saturated volume proportion and cationic surfactant showed regularity and high parasite recovery (80%). Modifications of the needle device did not influence parasite recovery (p > 0.05). Sensitivity, specificity, accuracy and kappa agreement obtained with the DAF protocol were 91%, 100%, 93% and substantial (k = 0.64), respectively. CONCLUSION: The DAF principle could be used to process faecal samples in routine laboratory exams, enabling intestinal parasite detection.


Asunto(s)
Parasitosis Intestinales , Parásitos , Animales , Humanos , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/parasitología , Heces/parasitología , Técnicas de Laboratorio Clínico
4.
Trop Med Int Health ; 24(11): 1320-1329, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31505102

RESUMEN

OBJECTIVES: Human enteroparasites are considered a serious public health problem in underdeveloped countries located in world regions with tropical, subtropical and equatorial climates. These parasites are commonly diagnosed by the Parasitological Examination of Faeces (PEF), performed by conventional techniques and/or commercial kits that result in tests with low-to-moderate sensitivity, due to the use of destructive chemical solvents to parasite structures, and to present excess adipose substance and digestive residues in their microscopic slides. In order to improve the efficacy of these tests/examinations, this study aimed to investigate a new alternative for the PEF, with the use of Aqueous Biphasic System (ABS). METHODS: For this, four ABSs containing poly (ethylene glycol), PEG (PEG-4000 and PEG-6000), dipotassium phosphate and sodium citrate at different concentrations in the biphasic systems were evaluated with faecal samples containing eggs of Ascaris lumbricoides. RESULTS: The ABS consisting of PEG-4000 and dipotassium phosphate, at concentrations of 55% w/w and 20% w/w, respectively, achieved 100% satisfactory results compared to the conventional TF-Test technique in terms of preservation and concentration of A. lumbricoides eggs, with adequate separation of digestive residues, without using a centrifuge or chemical solvents that may cause harm to the parasites. CONCLUSIONS: This study presents ABS as a new low-cost technical principle for the detection of parasite eggs in PEF. The new technique is simple, fast, non-toxic, not harmful to the parasite and does not require a centrifuge.


UTILISATION DU SYSTÈME BIPHASIQUE AQUEUX COMME ALTERNATIVE À LA CONCENTRATION DES ŒUFS D'ASCARIS LUMBRICOIDES, AVEC SÉPARATION NON TOXIQUE DES RÉSIDUS FÉCAUX ET DES GRAISSES: OBJECTIFS: Les entéroparasites humains sont considérés comme un sérieux problème de santé publique dans les pays sous-développés situés dans des régions du monde aux climats tropicaux, subtropicaux et équatoriaux. L'examen parasitologique des matières fécales (EPMF) permet généralement de diagnostiquer ces parasites, à l'aide de techniques classiques et/ou de kits commerciaux, conduisant à des tests de sensibilité faible à modérée, dus à l'utilisation de solvants chimiques destructeurs pour les structures du parasite et résultant en excès de substances adipeuses et de résidus digestifs dans leurs lames microscopiques. Afin d'améliorer l'efficacité de ces tests/examens, cette étude visait à étudier une nouvelle alternative à l'EPMF, avec l'utilisation du Système Biphasique Aqueux (SBA). MÉTHODES: Pour cela, quatre SBA contenant du poly (éthylène glycol), du PEG (PEG-4000 et PEG-6000), du phosphate dipotassique et du citrate de sodium à différentes concentrations ont été évalués avec des échantillons de matières fécales contenant des œufs d'Ascaris lumbricoides. RÉSULTATS: Le SBA constitué de PEG-4000 et de phosphate dipotassique, à des concentrations respectives de 55% poids/poids et 20% poids/poids, a obtenu des résultats satisfaisants à 100% par rapport à la technique conventionnelle du TF-Test, en termes de préservation et de concentration des œufs de A. lumbricoides, avec une séparation adéquate des résidus digestifs, sans utiliser de centrifugeuse ni de solvants chimiques pouvant détruire les parasites. CONCLUSIONS: Cette étude présente le SBA comme un nouveau principe technique peu coûteux pour la détection des œufs de parasites dans l'EPMF. La nouvelle technique est simple, rapide, non toxique, n'endommage pas le parasite et ne nécessite pas de centrifugeuse.


Asunto(s)
Ascaris lumbricoides , Técnicas y Procedimientos Diagnósticos , Heces/parasitología , Animales , Recuento de Huevos de Parásitos , Fosfatos/química , Polietilenglicoles/química , Compuestos de Potasio/química , Sensibilidad y Especificidad , Citrato de Sodio/química
5.
Trop Med Int Health ; 24(5): 586-595, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30739367

RESUMEN

OBJECTIVES: Laboratory diagnosis of Schistosoma mansoni eggs is routinely performed by conventional quantitative techniques through the parasitological examination of human faeces. However, the diagnostic sensitivity of this type of exam varies from low to moderate. We aimed to develop a new parasitological technique called TF-Test Quantified (TFT-Quant), for the quantitative detection of S. mansoni eggs in human faeces. METHODS: Four study stages were performed using 43 mice infected by S. mansoni cercariae. These experiments allowed the definition of an operational protocol for TFT-Quant and a comparison of this new technique to the conventional Helm-Teste technique. RESULTS: The results show a good diagnostic efficacy of TFT-Quant, which reached 100% in sensitivity and specificity, indicating an 'Almost Perfect' Kappa (k) agreement. CONCLUSIONS: This new technique provided a quantitative gain in the detection of S. mansoni eggs, largely free of faecal debris. The next stage of this study is the field validation of the TFT-Quant technique with the use of human faecal samples from an endemic region for mansonic schistosomiasis in Brazil (Microregion Jequitinhonha, State of Minas Gerais). In parallel to this validation, computational algorithms will be developed to allow the automated quantitative diagnosis of S. mansoni eggs.


OBJECTIFS: Le diagnostic en laboratoire des œufs de Schistosoma mansoni est systématiquement effectué à l'aide de techniques quantitatives conventionnelles faisant appel à l'examen parasitologique de selles humaines. Cependant, la sensibilité diagnostique de ce type d'examen varie de faible à modérée. Nous avons voulu développer une nouvelle technique parasitologique appelée TF-Test Quantified (TFT-Quant), pour la détection quantitative des œufs de S. mansoni dans les selles humaines. MÉTHODES: Quatre étapes de l'étude ont été réalisées sur 43 souris infectées par des cercaires de S. mansoni. Ces expériences ont permis de définir un protocole opérationnel pour TFT-Quant et de comparer cette nouvelle technique à la technique classique Helm-Teste. RÉSULTATS: Les résultats montrent une bonne efficacité diagnostique de TFT-Quant, dont la sensibilité et la spécificité ont atteint 100%, ce qui indique une concordance kappa (k) «presque parfaite¼. CONCLUSIONS: Cette nouvelle technique a permis un gain quantitatif dans la détection des œufs de S. mansoni, largement exempts de débris fécaux. La prochaine étape de cette étude est la validation sur le terrain de la technique TFT-Quant avec l'utilisation d'échantillons de selles humaines provenant d'une région endémique pour la schistosomiase mansonique au Brésil (Microregion Jequitinhonha, dans l'Etat de Minas Gerais). Parallèlement à cette validation, des algorithmes informatiques de calcul seront développés pour permettre le diagnostic quantitatif automatisé des œufs de S. mansoni.


Asunto(s)
Pruebas Diagnósticas de Rutina/métodos , Heces/parasitología , Recuento de Huevos de Parásitos , Schistosoma mansoni , Esquistosomiasis mansoni/diagnóstico , Animales , Antígenos Helmínticos , Brasil , Técnicas de Laboratorio Clínico , Pruebas Diagnósticas de Rutina/normas , Femenino , Humanos , Ratones , Reproducibilidad de los Resultados , Esquistosomiasis mansoni/parasitología , Sensibilidad y Especificidad
6.
Cancer Control ; 26(1): 1073274819876598, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31538497

RESUMEN

Several statistical-based approaches have been developed to support medical personnel in early breast cancer detection. This article presents a method for feature selection aimed at classifying cases into categories based on patients' breast tissue measures and protein microarray. The effectiveness of this feature selection strategy was evaluated against the commonly used Wisconsin Breast Cancer Database-WBCD (with several patients and fewer features) and a new protein microarray data set (with several features and fewer patients). Features were ranked according to a feature importance index that combines parameters emerging from the unsupervised method of principal component analysis and the supervised method of Bhattacharyya distance. Observations of a training set were iteratively categorized into malignant and benign cases through 3 classification techniques: k-Nearest Neighbor, linear discriminant analysis, and probabilistic neural network. After each classification, the feature with the smallest importance index was removed, and a new categorization was carried out until there was only one feature left. The subset yielding maximum accuracy was used to classify observations in the testing set. Our method yielded average 99.17% accurate classifications in the testing set while retaining average 4.61 out of 9 features in the WBCD, which is comparable to the best results reported by the literature on that data set, with the advantage of relying on simple and widely available multivariate techniques. When applied to the microarray data, the method yielded average accuracy of 98.30% while retaining average 2.17% of the original features. Our results can aid health-care professionals during early diagnosis of breast cancer.


Asunto(s)
Neoplasias de la Mama/clasificación , Técnicas de Apoyo para la Decisión , Detección Precoz del Cáncer/métodos , Femenino , Humanos
7.
J Contemp Dent Pract ; 18(4): 330-336, 2017 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-28349914

RESUMEN

INTRODUCTION: Endodontic therapy is a specialized procedure more demanded by patients within public oral health care in the country. Then, single-visit endodontic therapy may offer advantages to the health care services, to the professionals, and to the patients by reducing access barriers. MATERIALS AND METHODS: A meta-analysis was done and the variables evaluated were periapical repair, microbiological control, and postobturation pain in randomized clinical trials (RCTs) involving endodontic treatment of nonvital teeth at single- or multiple visits. RESULTS: About 17 RCTs were included. There were no differences found in periapical repair or microbiological control in single- and multiple-visit therapy. Single-visit endodontic therapy resulted in 21% less postobturation pain (relative risks = 0.79; 95%, confidence interval: 0.66-0.94). CONCLUSION: There was less postobturation pain in the single-visit endodontic therapy group. In the public dental care, this analysis favors the adoption of this one therapy because it will be possible to increase the patient access and the supply of this therapy. CLINICAL SIGNIFICANCE: It is possible to get a better cost-effectiveness for the patients and the health care service. This is very important because the reduction of the cost to the patient allows it to become a complete treatment. The health service, in turn, is able to be better used, with a greater supply of this service.


Asunto(s)
Endodoncia/métodos , Diente no Vital/cirugía , Análisis Costo-Beneficio , Endodoncia/economía , Humanos , Resultado del Tratamiento
8.
Med Mycol ; 53(1): 51-9, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25550387

RESUMEN

In order to understand how fungal pathogens can survive inside the host, we must analyze how they evade the fungicidal mechanisms mounted by the host's immune system, such as generation of toxic reactive oxygen species. Studies have shown that infections caused by Sporothrix brasiliensis can be more aggressive than those due to Sporothrix schenckii. Therefore, we propose to analyze and compare the ability of these two pathogenic species to counteract oxidative stress, which, as noted, can be relevant in the host response to infection. We have shown that S. brasiliensis is more resistant to different oxidants, such as H2O2 and menadione, when compared with S. schenckii. Furthermore, our results suggest that the molecular mechanisms by which Sporothrix spp. AP-1 like transcription factors are regulated probably differs from the one seen in other fungal pathogens. Interestingly, comparison between sequences of SbHog1 and SsHog1 stress activated protein kinases suggest that S. brasiliensis Hog1 display mutations that could account for the differences seen in stress sensitivities of these two species. In summary, this is the first study to our knowledge to investigate oxidative stress responses of Sporothrix spp. and provided a model that can be employed in vivo to address how these fungal pathogens can surmount the oxidative stress generated by the host.


Asunto(s)
Proteínas Quinasas Activadas por Mitógenos/genética , Peróxidos/toxicidad , Transducción de Señal , Sporothrix/efectos de los fármacos , Sporothrix/fisiología , Estrés Fisiológico , Factor de Transcripción AP-1/genética , Biología Computacional , Regulación Fúngica de la Expresión Génica , Proteínas Quinasas Activadas por Mitógenos/metabolismo , Mutación Missense , Estrés Oxidativo , Sporothrix/genética , Factor de Transcripción AP-1/metabolismo
9.
Trop Anim Health Prod ; 47(8): 1465-71, 2015 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26224599

RESUMEN

The objective of this study was to evaluate the reproductive and productive performance of Santa Inês ewes bred at different times of the year in humid tropical climate. One hundred and forty-eight Santa Inês ewes were grouped according to the time of the year of their breeding season (i.e., mating period) (dry/wet, wet, wet/dry, and dry season). The service type was natural mating and the ewes and rams were kept together every night for 45 days. Reproductive efficiency was assessed by service, pregnancy, lambing, prolificacy, twinning, pregnancy loss, weaning, and lamb mortality rates. Ewes were weighed at the beginning and at the end of the breeding season and before and after parturition, and sequential weighing of the lambs was performed (at birth, 15, 30, 60, and 90 days). Reproductive efficiency index (number of lambs weaned/total of served ewes) and productive efficiency (kg of weaned lamb/kg of served or lambed ewes) were calculated. All ewes expressed estrus early in the breeding season; however, a higher percentage (53.5 and 7.1 % at 30 and 45 days, respectively) of ewes returned to estrus during the wet/dry period. The lower rates (13.9 %) of return to estrus at 30 days were during the wet season (P < 0.05). There were no (P > 0.05) effects of breeding seasons on the remaining reproductive rates. Ewes that lambed during the wet/dry transition period weighted less, before (40.5 ± 2.5 kg) and after (38.6 ± 1.6 kg) parturition, than those of other groups (P < 0.05). Lamb weight at birth did not vary between groups, however, weight at weaning was higher (15.6 ± 2.1 kg) in lambs born during the wet season (P < 0.05). The reproductive efficiency index was lower (0.66) when the breeding season took place during the dry/wet period (P < 0.05). Productive rates were significantly higher (0.29 and 0.33 for kg of weaned lamb/kg of served and lambed ewes, respectively; P < 0.05) in ewes served in the dry season. The reproductive performance of Santa Inês ewes was not significantly influenced by the period of the year in which the breeding seasons took place, allowing for four breeding seasons a year in the Amazon region. Variations between periods in return to estrus rates, weight of ewes close to parturition and lamb weight at weaning indicate that climate changes can also affect reproductive rates.


Asunto(s)
Cruzamiento/estadística & datos numéricos , Reproducción , Oveja Doméstica/fisiología , Clima Tropical , Animales , Estro , Femenino , Masculino , Parto , Embarazo , Estaciones del Año , Ovinos , Destete
10.
J Synchrotron Radiat ; 21(Pt 1): 143-8, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24365929

RESUMEN

Xerogels of strontium chlorate and aluminium chlorate doped with europium (un-co-doped) and co-doped with rare earth ions (Ln = Gd, Dy, Er and Y) were prepared using the proteic sol-gel route. Synchrotron radiation was used to investigate the effect of different co-dopants on the Eu(3+) → Eu(2+) reduction process during the synthesis of the samples. Samples were excited at the Eu LIII-edge and the XANES regions were analyzed. The results suggest that some of the Eu ions can be stabilized in the divalent state and that it is difficult to completely reduce Eu(3+) to Eu(2+) during thermal treatment. The mechanisms of the Eu reduction processes are explained by a proposed model based on the incorporation of charge-compensation defects.

11.
Med Mycol ; 52(1): 19-28, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23768243

RESUMEN

Paracoccidioides lutzii, formerly known as 'Pb01-like' strains in the P. brasiliensis complex, is proposed as a new species based on phylogenetic and comparative genomics data, recombination analysis, and morphological characteristics. Conidia of P. lutzii are elongated, different from those of P. brasiliensis. P. lutzii occurs in the central and northern regions of Brazil. Studies comparing P. brasiliensis and P. lutzii may have significant clinical consequences for the diagnosis and treatment of paracoccidioidomycosis.


Asunto(s)
Paracoccidioides/clasificación , Paracoccidioides/aislamiento & purificación , Brasil , Análisis por Conglomerados , Proteínas Fúngicas/genética , Humanos , Microscopía , Datos de Secuencia Molecular , Paracoccidioides/citología , Paracoccidioides/genética , Paracoccidioidomicosis/microbiología , Filogenia , Análisis de Secuencia de ADN
12.
Future Microbiol ; 19(7): 607-619, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38530362

RESUMEN

Dye application for parasite highlighting in the Ova and Parasite exam is a common practice in parasitology diagnosis. Methods: A scoping review investigated how staining solutions interact with parasite structures. After screening 1334 papers, 35 met eligibility criteria. Results: Differentiating background from foreground in the fecal smear under light microscopy is the core of the research on this topic. Refractivity, unevenness of staining, size and temperature were explored to enhance staining protocols. Cryptosporidium spp. and Microsporidia were the main studied species. Conclusion: Studies on diagnostic efficacy outperform those that elucidate the physical-chemical interaction between dyes and parasites. An alternative approach involves technicians using computational tools to reduce subjectivity in fecal smear interpretation, deviating from conventional methods.


What is this article about? Coloring parasites during fecal exams has been widely used to find parasites in human feces. We searched for articles that could help us to answer the question: 'How do dyes give color to parasites?'. Then, we filtered the information from a total of 1334 articles to 35.What were the results? Cryptosporidium spp. and Microsporidia are microbes that can be seen only through a microscope. Researchers were interested in these two species in the last 40 years. Differentiating parasites from dirt on a glass slide is the main problem researchers are trying to solve. The way the light goes through parasites under a microscope, variation of staining, size and temperature of dyes have been explored to identify what gives better results in coloring protocols.What do the results of the study mean? Little is known about the chemical interaction between dyes and parasites. On the other hand, there are many studies on how good coloring methods are and comparing protocols. An alternative to the conventional approaches in staining parasites is the use of computational tools to reduce doubt in the exam interpretation by technicians.


Asunto(s)
Colorantes , Heces , Parasitología , Coloración y Etiquetado , Heces/parasitología , Coloración y Etiquetado/métodos , Humanos , Parasitología/métodos , Colorantes/química , Animales , Cryptosporidium/aislamiento & purificación , Microsporidios/aislamiento & purificación , Microscopía/métodos , Parásitos/aislamiento & purificación
13.
Rev Panam Salud Publica ; 34(6): 401-6, 2013 Dec.
Artículo en Portugués | MEDLINE | ID: mdl-24569968

RESUMEN

OBJECTIVE: To investigate the factors associated with inequality in the use of oral health services in the Brazilian Family Health Program (Estratégia Saúde da Família, ESF) as measured by dental extractions. METHODS: A population-based household survey was carried out in two municipalities with full coverage by the ESF in the state of Bahia, Brazil. Ten census tracts were randomly selected. Households were selected by systematic sampling. To assess the use of public services by the population, a prevalence of 50%, sampling error of 4%, and confidence interval of 95% were considered. Trained community health workers conducted key informant interviews on use of oral health services and collected demographic data for all household members aged 15 years or older. Dental extraction was the main outcome. The association between dental extraction and predictive variables was assessed using prevalence ratio, and multivar logistic regression analysis was performed using odds ratio (OR). RESULTS: Data from 2,539 people was collected. Of these, 682 (26.86%) had used primary oral health care services in the previous 12 months. Dental extraction was performed in 218 (31.96%) out of 682 primary care patients. Being assisted by social programs (OR = 1.43; IC95%: 1.02-2.01), being older than 35 years (OR = 1.59; IC95%: 1.12-2.27), and having lower education levels (OR = 1.81; IC95%: 1.27-2.56) were independently associated with the outcome. CONCLUSIONS: The present results suggest that historical inequalities of access to oral health services persist. Intersectoral actions may play an important role in improving oral health conditions.


Asunto(s)
Servicios de Salud Dental/estadística & datos numéricos , Disparidades en el Estado de Salud , Disparidades en Atención de Salud , Atención Primaria de Salud/estadística & datos numéricos , Extracción Dental/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adulto , Brasil , Niño , Servicios de Salud Dental/organización & administración , Escolaridad , Etnicidad/estadística & datos numéricos , Femenino , Encuestas de Atención de la Salud , Humanos , Renta , Masculino , Atención Primaria de Salud/organización & administración , Bienestar Social
14.
PLoS One ; 18(5): e0284374, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37224126

RESUMEN

BACKGROUND: Online anti-social behaviour is on the rise, reducing the perceived benefits of social media in society and causing a number of negative outcomes. This research focuses on the factors associated with young adults being perpetrators of anti-social behaviour when using social media. METHOD: Based on an online survey of university students in Canada (n = 359), we used PLS-SEM to create a model and test the associations between four factors (online disinhibition, motivations for cyber-aggression, self-esteem, and empathy) and the likelihood of being a perpetrator of online anti-social behaviour. RESULTS: The model shows positive associations between two appetitive motives for cyber-aggression (namely recreation and reward) and being a perpetrator. This finding indicates that young adults engage in online anti-social behaviour for fun and social approval. The model also shows a negative association between cognitive empathy and being a perpetrator, which indicates that perpetrators may be engaging in online anti-social behaviour because they do not understand how their targets feel.


Asunto(s)
Medios de Comunicación Sociales , Humanos , Adulto Joven , Agresión , Trastorno de Personalidad Antisocial , Canadá , Emociones
15.
Artículo en Inglés | MEDLINE | ID: mdl-36593771

RESUMEN

Background: In December 2020, the COVID-19 disease was confirmed in 1,665,775 patients and caused 45,784 deaths in Spain. At that time, health decision support systems were identified as crucial against the pandemic. Methods: This study applies Deep Learning techniques for mortality prediction of COVID-19 patients. Two datasets with clinical information were used. They included 2,307 and 3,870 COVID-19 infected patients admitted to two Spanish hospitals. Firstly, we built a sequence of temporal events gathering all the clinical information for each patient, comparing different data representation methods. Next, we used the sequences to train a Recurrent Neural Network (RNN) model with an attention mechanism exploring interpretability. We conducted an extensive hyperparameter search and cross-validation. Finally, we ensembled the resulting RNNs to enhance sensitivity. Results: We assessed the performance of our models by averaging the performance across all the days in the sequences. Additionally, we evaluated day-by-day predictions starting from both the hospital admission day and the outcome day. We compared our models with two strong baselines, Support Vector Classifier and Random Forest, and in all cases our models were superior. Furthermore, we implemented an ensemble model that substantially increased the system's sensitivity while producing more stable predictions. Conclusions: We have shown the feasibility of our approach to predicting the clinical outcome of patients. The result is an RNN-based model that can support decision-making in healthcare systems aiming at interpretability. The system is robust enough to deal with real-world data and can overcome the problems derived from the sparsity and heterogeneity of data.

16.
Drug Test Anal ; 15(3): 292-298, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-36346023

RESUMEN

Blood transfusion is performed by cheating athletes to rapidly increase oxygen delivery to exercise muscles and enhance their performance. This method is banned by the World Anti-doping Agency (WADA). Heterologous or allogenic blood transfusion happens when blood from a different person is transfused. The method used to detect this type of doping is based on flow cytometry, by identifying variations in blood group minor antigens present on the red blood cells' surface. Transfusion practices have regained interest since the introduction of human recombinant erythropoietin detection method. It has been reported that the number of occurrences of two athletes sharing an identical phenotype in the same sport was five times higher than the theoretical populational probability. The present work describes the prevalence of 10 erythrocytes surface antigens in a population of 261 athletes from all five continents. The matching phenotype per sport is also described.


Asunto(s)
Doping en los Deportes , Deportes , Humanos , Transfusión Sanguínea , Eritrocitos , Atletas
17.
Future Microbiol ; 18: 197-203, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36916423

RESUMEN

Aim: Ova and parasite examination by flotation requires hypertonic solutions, which can damage the egg and cyst membranes, leading to false negatives. The authors investigated the harmful effects of ZnSO4 and C12H22O11 solutions on the ova and parasite examination. Materials & methods: The authors processed samples using the Three Fecal Test technique. Aliquots were floated in different pH levels, temperatures and solution densities. Results: Densities above 1.12 g/ml led structures to collapse after 6-10 min. pH neutralization of the ZnSO4 solution did not prevent the parasites from changing. Conclusion: All structures were altered when standard methods were performed. To delay collapse, the parasite floating under 5 °C is highly desirable.


Fecal exams require solutions that can damage the intestinal parasite's shape. This is bad for diagnosis. The authors investigated the harmful effects of these solutions on fecal exams. The authors processed samples using a technique called the Three Fecal Test. Fecal samples were floated in different conditions, including neutral and acidic solutions, high and low temperatures and varying densities of chemical solutions. Densities above 1.12 g/ml altered the structures of parasites. Neutral solutions did not prevent the structures from changing. The structures of all parasites were altered when the usual techniques were performed. Thus, the techniques for diagnosing intestinal parasites in feces must be improved. Temperatures under 5 °C are the best for preventing the destruction of parasite membranes.


Asunto(s)
Parasitosis Intestinales , Parásitos , Animales , Humanos , Recuento de Huevos de Parásitos/métodos , Parasitosis Intestinales/diagnóstico , Parasitosis Intestinales/parasitología , Intestinos , Soluciones Hipertónicas , Heces
18.
Comput Biol Med ; 163: 107203, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37437360

RESUMEN

Diagnosing gastrointestinal parasites by microscopy slide examination often leads to human interpretation errors, which may occur due to fatigue, lack of training and infrastructure, presence of artifacts (e.g., various types of cells, algae, yeasts), and other reasons. We have investigated the stages in automating the process to cope with the interpretation errors. This work presents advances in two stages focused on gastrointestinal parasites of cats and dogs: a new parasitological processing technique, named TF-Test VetPet, and a microscopy image analysis pipeline based on deep learning methods. TF-Test VetPet improves image quality by reducing cluttering (i.e., eliminating artifacts), which favors automated image analysis. The proposed pipeline can identify three species of parasites in cats and five in dogs, distinguishing them from fecal impurities with an average accuracy of 98,6%. We also make available the two datasets with images of parasites of dogs and cats, which were obtained by processing fecal smears with temporary staining using TF-Test VetPet.


Asunto(s)
Enfermedades de los Gatos , Enfermedades de los Perros , Parasitosis Intestinales , Parásitos , Gatos , Animales , Perros , Humanos , Enfermedades de los Gatos/diagnóstico por imagen , Enfermedades de los Gatos/parasitología , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/parasitología , Parasitosis Intestinales/diagnóstico por imagen , Parasitosis Intestinales/veterinaria , Heces/parasitología
19.
Eur J Pain ; 27(5): 636-650, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36799447

RESUMEN

BACKGROUND: New-onset chronic pain has been acknowledged as part of the post-COVID-19 condition. However, available fine-grained data about its clinical phenotype, trajectories and main associated characteristics remain scarce. We described the distinct temporal evolutions of post-COVID-19 pain and their epidemiological and phenotypical features. METHODS: A prospective cross-sectional study enrolled post-COVID-19 condition patients (i.e. who had persisting COVID-19-related symptoms over 30 days since their first positive laboratory test), whose COVID-19 diagnosis had been supported by RT-PCR of oral/nasopharyngeal swab or serology. They underwent in-person evaluations with a structured interview, pain and quality-of-life-related questionnaires and thorough physical examination. Chronic pain (CP) and probable neuropathic pain (NP) were defined according to IASP criteria. RESULTS: The present study included 226 individuals, 177 (78.3%) of whom presented over 3 months since their first COVID-19 symptom. New-onset pain occurred in 170 (75.2%) participants and was chronic in 116 (68.2%). A chronic course was associated with COVID-19-related hospitalization, new-onset fatigue, lower cognitive performance, motor and thermal sensory deficits, mood and sleep impairments and overall lower quality-of-life levels. Probable NP occurred in only 7.6% new-onset pain patients, and was associated with pain chronification, new-onset fatigue, motor and thermal sensory deficits, mechanical allodynia and lower rates of SARS-CoV-2 vaccination. Previous CP was reported by 86 (38.1%) individuals and had aggravated after the infection in 66 (76.7%) of them, which was associated with orthostatic hypotension. CONCLUSIONS: Post-COVID pain phenomena follow different paths, which are associated with specific clinical and epidemiological features, and possibly distinct underlying mechanisms, prognostic and therapeutic implications. SIGNIFICANCE: COVID-19-related pain usually follows a chronic course and is non-neuropathic. Its possible courses and phenotypes are associated with distinct clinical and epidemiological features. This suggests differing underlying mechanisms, which may have significant prognostic and therapeutic implications.


Asunto(s)
COVID-19 , Dolor Crónico , Neuralgia , Humanos , COVID-19/complicaciones , SARS-CoV-2 , Estudios Transversales , Prueba de COVID-19 , Dolor Crónico/epidemiología , Dolor Crónico/etiología , Estudios Prospectivos , Vacunas contra la COVID-19 , Neuralgia/epidemiología , Neuralgia/etiología
20.
J Raman Spectrosc ; 53(7): 1342-1346, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35572166

RESUMEN

When performing computational modeling and machine learning experiments, it is imperative to follow a protocol that minimizes bias. In this communication, we share our concerns regarding the article "An efficient primary screening COVID-19 by serum Raman spectroscopy" published in this journal. We consider that the authors may have inadvertently biased their results by not guaranteeing complete independence of test samples from the training data. We corroborate our point by reproducing the experiment with the available data, showing that if full independence of the test set was ensured, the reported results should be lower. We ask the authors to provide more information regarding their article, as well as making available all code used to generate their results. Our experiments are available at https://doi.org/10.6084/m9.figshare.14124356.

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