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1.
Appl Opt ; 63(7): B49-B58, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38437255

RESUMO

Among modern optical microscopy techniques, digital lensless holographic microscopy (DLHM) is one of the simplest label-free coherent imaging approaches. However, the hardware simplicity provided by the lensless configuration is often offset by the demanding computational postprocessing required to match the retrieved sample information to the user's expectations. A promising avenue to simplify this stage is the integration of artificial intelligence and machine learning (ML) solutions into the DLHM workflow. The biggest challenge to do so is the preparation of an extensive and high-quality experimental dataset of curated DLHM recordings to train ML models. In this work, a diverse, open-access dataset of DLHM recordings is presented as support for future research, contributing to the data needs of the applied research community. The database comprises 11,760 experimental DLHM holograms of bio and non-bio samples with diversity on the main recording parameters of the DLHM architecture. The database is divided into two datasets of 10 independent imaged samples. The first group, named multi-wavelength dataset, includes 8160 holograms and was recorded using laser diodes emitting at 654 nm, 510 nm, and 405 nm; the second group, named single-wavelength dataset, is composed of 3600 recordings and was acquired using a 633 nm He-Ne laser. All the experimental parameters related to the dataset acquisition, preparation, and calibration are described in this paper. The advantages of this large dataset are validated by re-training an existing autofocusing model for DLHM and as the training set for a simpler architecture that achieves comparable performance, proving its feasibility for improving existing ML-based models and the development of new ones.

2.
Am J Med Genet B Neuropsychiatr Genet ; 195(3): e32966, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37921405

RESUMO

Valproate is among the most prescribed drugs for bipolar disorder; however, 87% of patients do not report full long-term treatment response (LTTR) to this medication. One of valproate's suggested mechanisms of action involves the brain-derived neurotrophic factor (BDNF), expressed in the brain areas regulating emotions, such as the prefrontal cortex. Nonetheless, data about the role of BDNF in LTTR and its implications in the structure of the dorsolateral prefrontal cortex (dlPFC) is scarce. We explore the association of BDNF variants and dorsolateral cortical thickness (CT) with LTTR to valproate in bipolar disorder type I (BDI). Twenty-eight BDI patients were genotyped for BDNF polymorphisms rs1519480, rs6265, and rs7124442, and T1-weighted 3D brain scans were acquired. LTTR to valproate was evaluated with Alda's scale. A logistic regression analysis was conducted to evaluate LTTR according to BDNF genotypes and CT. We evaluated CT differences by genotypes with analysis of covariance. LTTR was associated with BDNF rs1519480 and right dlPFC thickness. Insufficient responders with the CC genotype had thicker right dlPFC than TC and TT genotypes. Full responders reported thicker right dlPFC in TC and TT genotypes. In conclusion, different patterns of CT related to BDNF genotypes were identified, suggesting a potential biomarker of LTTR to valproate in our population.


Assuntos
Transtorno Bipolar , Humanos , Transtorno Bipolar/tratamento farmacológico , Transtorno Bipolar/genética , Ácido Valproico/farmacologia , Ácido Valproico/uso terapêutico , Fator Neurotrófico Derivado do Encéfalo/genética , Encéfalo , Genótipo
3.
J Pediatr Psychol ; 48(3): 216-227, 2023 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-36303445

RESUMO

BACKGROUND: Providing high-quality psychosocial care to parents and other primary caregivers of children with cancer (henceforth referred to as caregivers) is important, given the numerous challenges associated with a pediatric cancer diagnosis and the increased risk for negative psychosocial sequelae among caregivers. The Electronic Surviving Cancer Competently Intervention Program (eSCCIP) is a psychosocial eHealth intervention for caregivers, developed using an iterative, user-centered process. METHOD: eSCCIP was tested in a single-arm pilot trial at Nemours Children's Hospital, Delaware (NCT05333601). The primary outcomes were intervention acceptability and feasibility, assessed via enrollment and retention targets, and item-level acceptability ratings. Enrollment and retention targets of 45% were set based on previous work, and an item-level acceptability threshold of 80% was set. A secondary exploratory analysis was conducted examining acute distress, anxiety, symptoms of post-traumatic stress, and family functioning. RESULTS: 44 caregivers enrolled in the study and 31 completed. The intervention was rated favorably by completers, with over 80% of the sample selecting "mostly true" or "very true" for all items of the eSCCIP Evaluation Questionnaire, which was used to assess acceptability and feasibility. Enrollment and retention rates were 54% and 70%, respectively. Exploratory psychosocial outcomes showed statistically significant decreases from pre-intervention to post-intervention for overall symptoms of post-traumatic stress disorder (PTSD), cluster D symptoms of PTSD (negative mood and cognitions), and anxiety. Small-moderate effect sizes were observed for all psychosocial outcomes of interest. CONCLUSIONS: eSCCIP is an acceptable and feasible intervention for caregivers. Results are promising regarding reductions in symptoms of post-traumatic stress and anxiety.


Assuntos
Neoplasias , Transtornos de Estresse Pós-Traumáticos , Criança , Humanos , Ansiedade/terapia , Cuidadores/psicologia , Estudos de Viabilidade , Neoplasias/psicologia , Projetos Piloto , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/psicologia
4.
Appl Opt ; 62(10): D39-D47, 2023 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-37132768

RESUMO

The adaptation of an off-the-shelf Blu-ray optical pickup unit (OPU) into a highly versatile point source for digital lensless holographic microscopy (DLHM) is presented. DLHM performance is mostly determined by the optical properties of the point source of spherical waves used for free-space magnification of the sample's diffraction pattern; in particular, its wavelength and numerical aperture define the achievable resolution, and its distance to the recording medium sets the magnification. Through a set of straightforward modifications, a commercial Blu-ray OPU can be transformed into a DLHM point source with three selectable wavelengths, a numerical aperture of up to 0.85, and integrated micro-displacements in both axial and transversal directions. The functionality of the OPU-based point source is then experimentally validated in the observation of micrometer-sized calibrated samples and biological specimens of common interest, showing the feasibility of obtaining sub-micrometer resolution and offering a versatile option for the development of new cost-effective and portable microscopy devices.

5.
Diabetes Spectr ; 36(3): 245-252, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37583556

RESUMO

Objective: At the outset of the coronavirus disease 2019 (COVID-19) pandemic, health care systems rapidly implemented telehealth services to maintain continuity of type 1 diabetes care. Youth of color are more likely to have suboptimal glycemic control and may benefit most from efforts to ensure continuity of care. However, research examining the perspectives of families of youth of color regarding telehealth for pediatric type 1 diabetes care is limited. We gathered perspectives from youth of color, their caregivers, and health care providers (HCPs) on telehealth for type 1 diabetes care during COVID-19. Methods: Fifty participants (22 caregivers, 19 youth, and nine HCPs) completed semi-structured interviews conducted in English (n = 44) or Spanish (n = 6). Transcripts containing mentions of telehealth (n = 33) were included for qualitative analysis to extract themes pertaining to perceptions of type 1 diabetes care and telehealth use during COVID-19. Results: Themes related to perceptions, feasibility, and quality of telehealth diabetes care were obtained. Most families had positive perceptions of telehealth. Families and HCPs described logistical and technical challenges and noted the potential for disparities in telehealth access and use. Furthermore, caregivers and HCPs felt that the lack of in-person interaction and limited access to clinical data affected the quality of care. Conclusion: Families of youth of color with type 1 diabetes mostly had positive perceptions of telehealth but also identified issues with feasibility and quality of care. Our findings highlight a need for interventions promoting equal access to telehealth and quality care for all youth with type 1 diabetes to minimize disruptions in care.

6.
Sensors (Basel) ; 23(6)2023 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-36991910

RESUMO

Ocean color is the result of absorption and scattering, as light interacts with the water and the optically active constituents. The measurement of ocean color changes enables monitoring of these constituents (dissolved or particulate materials). The main objective of this research is to use digital images to estimate the light attenuation coefficient (Kd), the Secchi disk depth (ZSD), and the chlorophyll a (Chla) concentration and to optically classify plots of seawater using the criteria proposed by Jerlov and Forel using digital images captured at the ocean surface. The database used in this study was obtained from seven oceanographic cruises performed in oceanic and coastal areas. Three approaches were developed for each parameter: a general approach that can be applied under any optical condition, one for oceanic conditions, and another for coastal conditions. The results of the coastal approach showed higher correlations between the modeled and validation data, with rp values of 0.80 for Kd, 0.90 for ZSD, 0.85 for Chla, 0.73 for Jerlov, and 0.95 for Forel-Ule. The oceanic approach failed to detect significant changes in a digital photograph. The most precise results were obtained when images were captured at 45° (n = 22; Fr cal=11.02>Fr crit=5.99). Therefore, to ensure precise results, the angle of photography is key. This methodology can be used in citizen science programs to estimate ZSD, Kd, and the Jerlov scale.

7.
Pediatr Blood Cancer ; 69(1): e29352, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34532970

RESUMO

BACKGROUND: The Electronic Surviving Cancer Competently Intervention Program (eSCCIP), a psychosocial eHealth intervention for parents and caregivers of children with cancer (parents), was delivered in a community-based psychosocial oncology center. Primary endpoints were intervention acceptability, feasibility, and accessibility, with a secondary exploratory focus on psychosocial outcomes. PROCEDURE: Oncology therapists in a psychosocial oncology center were trained in eSCCIP delivery. Participants were eligible for participation if they were the primary caregiver of a child with cancer between the ages 0 and 17, could read and write in English, and had reliable internet access to complete eSCCIP. Surveys were administered electronically at baseline and post intervention to evaluate study endpoints. Effect sizes (Cohen's d) were computed for exploratory psychosocial outcomes. Nineteen parents completed the intervention. RESULTS: Parents rated eSCCIP as highly acceptable, feasible, and accessible. A large clinical effect was detected for acute distress (d = 0.79). Moderate clinical effects were reported for overall posttraumatic stress disorder (PTSD) symptoms (d = 0.37), negative mood/cognitions (d = 0.59), and symptoms of anxiety (d = 0.48). CONCLUSIONS: Results indicate that eSCCIP is an acceptable, feasible, and accessible psychosocial intervention for parents. Exploratory analyses suggest that participation in eSCCIP may contribute to decreases in acute distress, symptoms of anxiety, and symptoms of PTSD.


Assuntos
Cuidadores , Neoplasias , Pais , Intervenção Psicossocial , Telemedicina , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Neoplasias/terapia
8.
Health Qual Life Outcomes ; 19(1): 93, 2021 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-33731142

RESUMO

BACKGROUND: Worldwide, type 2 diabetes mellitus (T2DM) is one of the most prevalent chronic diseases and one of those producing greatest impact on patients' day-to-day quality of life. Our study aim is to validate the "Living with Chronic Illness Scale" for a Spanish-speaking T2DM population. METHODS: In this observational, international, cross-sectional study, 582 persons with T2DM were recruited in primary care and outpatient hospital consultations, in Spain and Colombia, during the period from May 2018 to June 2019. The properties analysed were feasibility/acceptability, internal consistency, reliability, precision and (structural) content-construct validity including confirmatory factor analysis. The COSMIN checklist was used to assess the methodological/psychometric quality of the instrument. RESULTS: The scale had an adequate internal consistency and test retest reliability (Cronbach's alpha = 0.90; intraclass correlation coefficient = 0.96, respectively). In addition, the instrument is precise (standard error of measurement = 3.34, with values < ½SD = 8.52) and correlates positively with social support (DUFSS) (rs = 0.56), quality of life (WHOQOL-BREF) (rs = 0.51-0.30) and ssatisfaction with life (SLS-6) (rs = 0.50-0.38). The original 26-items version of the scale did not support totally the confirmatory factor analysis. The COSMIN checklist is favourable for all the properties analysed, although weaknesses are detected for structural validity. CONCLUSIONS: The LW-CI-T2DM is a valid, reliable and accurate instrument for use in clinical practice to determine how a person's life is affected by the presence of diabetes. This instrument correlates well with the associated constructs of social support, quality of life and satisfaction. Additional research is needed to determine how well the questionnaire structure performs when robust factor analysis methods are applied.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Qualidade de Vida , Inquéritos e Questionários/normas , Adulto , Colômbia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Espanha
9.
Int J Mol Sci ; 22(24)2021 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-34948050

RESUMO

α-Synuclein (αSyn) species can be detected in synaptic boutons, where they play a crucial role in the pathogenesis of Parkinson's Disease (PD). However, the effects of intracellular αSyn species on synaptic transmission have not been thoroughly studied. Here, using patch-clamp recordings in hippocampal neurons, we report that αSyn oligomers (αSynO), intracellularly delivered through the patch electrode, produced a fast and potent effect on synaptic transmission, causing a substantial increase in the frequency, amplitude and transferred charge of spontaneous synaptic currents. We also found an increase in the frequency of miniature synaptic currents, suggesting an effect located at the presynaptic site of the synapsis. Furthermore, our in silico approximation using docking analysis and molecular dynamics simulations showed an interaction between a previously described small anti-amyloid beta (Aß) molecule, termed M30 (2-octahydroisoquinolin-2(1H)-ylethanamine), with a central hydrophobic region of αSyn. In line with this finding, our empirical data aimed to obtain oligomerization states with thioflavin T (ThT) and Western blot (WB) indicated that M30 interfered with αSyn aggregation and decreased the formation of higher-molecular-weight species. Furthermore, the effect of αSynO on synaptic physiology was also antagonized by M30, resulting in a decrease in the frequency, amplitude, and charge transferred of synaptic currents. Overall, the present results show an excitatory effect of intracellular αSyn low molecular-weight species, not previously described, that are able to affect synaptic transmission, and the potential of a small neuroactive molecule to interfere with the aggregation process and the synaptic effect of αSyn, suggesting that M30 could be a potential therapeutic strategy for synucleinopathies.


Assuntos
Isoquinolinas/farmacologia , Neurônios/citologia , alfa-Sinucleína/química , alfa-Sinucleína/metabolismo , Animais , Benzotiazóis/farmacologia , Células Cultivadas , Humanos , Interações Hidrofóbicas e Hidrofílicas , Camundongos , Simulação de Acoplamento Molecular , Simulação de Dinâmica Molecular , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Ligação Proteica , Domínios Proteicos , Ratos , Transmissão Sináptica
10.
Eur Eat Disord Rev ; 29(2): 204-215, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33252835

RESUMO

OBJECTIVE: This study provides a comprehensive assessment of own body representation and linguistic representation of bodies in general in women with typical and atypical anorexia nervosa (AN). METHODS: In a series of desktop experiments, participants rated a set of adjectives according to their match with a series of computer generated bodies varying in body mass index, and generated prototypic body shapes for the same set of adjectives. We analysed how body mass index of the bodies was associated with positive or negative valence of the adjectives in the different groups. Further, body image and own body perception were assessed. RESULTS: In a German-Italian sample comprising 39 women with AN, 20 women with atypical AN and 40 age matched control participants, we observed effects indicative of weight stigmatization, but no significant differences between the groups. Generally, positive adjectives were associated with lean bodies, whereas negative adjectives were associated with obese bodies. DISCUSSION: Our observations suggest that patients with both typical and atypical AN affectively and visually represent body descriptions not differently from healthy women. We conclude that overvaluation of low body weight and fear of weight gain cannot be explained by generally distorted perception or cognition, but require individual consideration.


Assuntos
Anorexia Nervosa , Imagem Corporal , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Linguística , Magreza
11.
J Pediatr Psychol ; 45(5): 530-539, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32196090

RESUMO

OBJECTIVE: Psychosocial intervention studies with parents often have difficulty with regard to participant recruitment, retention, and engagement. Prior to conducting a pilot test of the Electronic Surviving Cancer Competently Intervention Program (eSCCIP), a psychosocial eHealth intervention for parents of children with cancer, a qualitative study was designed to preemptively generate strategies to address potential difficulties in these domains. METHODS: Two focus groups and three semi-structured interviews were conducted with parents of children with cancer. Qualitative data were analyzed using the principles of thematic and content analysis. Themes were generated to describe results and inform the development of concrete recruitment, retention, and engagement strategies to be utilized in future intervention trials. RESULTS: Five themes emerged specific to recruitment, and three themes emerged related to retention and engagement. Parents highlighted a number of important potential recruitment, retention, and engagement strategies, including the importance of flexibility, ease of access and use, intervention timing, and pathways to follow-up care. Themes were linked to actionable recruitment, retention, and engagement strategies which can be utilized in future studies. CONCLUSION: Results from the current study will be utilized when designing future eSCCIP intervention trials and will also be of use to the broader field of psychosocial eHealth intervention research in pediatric psychology. This study also underscores the importance of working with parent stakeholders at all phases of study design and implementation.


Assuntos
Neoplasias , Seleção de Pacientes , Telemedicina , Criança , Feminino , Grupos Focais , Humanos , Masculino , Neoplasias/terapia , Pais , Pesquisa Qualitativa
12.
Rev Invest Clin ; 73(5)2020 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-33075042

RESUMO

BACKGROUND: The biology of some hematological diseases varies among different populations. No previous studies have evaluated the clinical behavior of mantle cell lymphoma (MCL) in México. OBJECTIVE AND METHODS: This is a retrospective review of MCL cases seen in Mexico from January 2003 to June 2020. A total of 12 cases were identified. RESULTS: There were nine males and three females; median age was 56 years. Eight patients had a high MCL international prognostic index score, one was intermediate, and three were low. Five patients had circulating malignant monoclonal cells. Initial treatment included rituximab, cyclophosphamide, daunorubicin, vincristine, and prednisone (R-CHOP) and CHOP. Subsequent treatment included hematopoietic stem cell transplantation in five patients; two were given maintenance therapy. Splenectomy was done in four patients. Median overall survival (OS) for all the patients has not been reached and exceeds 162 mos: OS at 162 mos was 56%. Achieving a complete remission (CR) after the first treatment was a significant prognostic factor, with a median OS exceeding 141 mos in patients achieving CR, and 16 mos among those not achieving CR (p = 0.0006). CONCLUSION: Some of MCL patients in Mexico have an indolent clinical course, particularly patients who achieve a CR to initial treatment and who undergo splenectomy.

13.
BMC Microbiol ; 16(1): 243, 2016 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-27756222

RESUMO

BACKGROUND: Biofilms are a highly structured consortia of microorganisms that adhere to a substrate and are encased within an extracellular matrix (ECM) that is produced by the organisms themselves. Aspergillus fumigatus is a biotechnological fungus that has a medical and phytopathogenic significance, and its biofilm occurs in both natural and artificial environments; therefore, studies on the stages observed in biofilm formation are of great significance due to the limited knowledge that exists on this specific topic and because there are multiple applications that are being carried out. RESULTS: Growth curves were obtained from the soil and clinical isolates of the A. fumigatus biofilm formation. The optimal conditions for both of the isolates were inocula of 1 × 106 conidia/mL, incubated at 28 °C during 24 h; these showed stages similar to those described in classic microbial growth: the lag, exponential, and stationary phases. However, the biofilms formed at 37 °C were uneven. The A. fumigatus biofilm was similar regardless of the isolation source, but differences were presented according to the incubation temperature. The biofilm stages included the following: 1) adhesion to the plate surface (4 h), cell co-aggregation and exopolymeric substance (EPS) production; 2) conidial germination into hyphae (8-12 h), development, hyphal elongation, and expansion with channel formation (16-20 h); and 3) biofilm maturation as follows: mycelia development, hyphal layering networks, and channels formation, and high structural arrangement of the mycelia that included hyphal anastomosis and an extensive production of ECM (24 h); the ECM covered, surrounded and strengthened the mycelial arrangements, particular at 37 °C. In the clinical isolate, irregular fungal structures, such as microhyphae that are short and slender hyphae, occurred; 4) In cell dispersion, the soil isolate exhibited higher conidia than the clinical isolate, which had the capacity to germinate and generate new mycelia growth (24 h). In addition, we present images on the biofilm's structural arrangement and chemical composition using fluorochromes to detect metabolic activity (FUNI) and mark molecules, such as chitin, DNA, mannose, glucose and proteins. CONCLUSIONS: To our knowledge, this is the first time that, in vitro, scanning electronic microscopy (SEM) images of the stages of A. fumigatus biofilm formation have been presented with a particular emphasis on the high hyphal organization and in diverse ECM to observe biofilm maturation.


Assuntos
Aspergillus fumigatus/citologia , Aspergillus fumigatus/fisiologia , Biofilmes/crescimento & desenvolvimento , Microscopia Eletrônica de Varredura/métodos , Aspergilose/microbiologia , Aspergillus fumigatus/crescimento & desenvolvimento , Aspergillus fumigatus/isolamento & purificação , Meios de Cultura , Matriz Extracelular/microbiologia , Matriz Extracelular/fisiologia , Proteínas Fúngicas/análise , Proteínas Fúngicas/genética , Germinação/fisiologia , Humanos , Hifas/citologia , Hifas/crescimento & desenvolvimento , México , Microbiologia do Solo , Esporos Fúngicos/citologia , Esporos Fúngicos/crescimento & desenvolvimento , Temperatura
14.
J Neurochem ; 132(6): 731-41, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25669123

RESUMO

It has been postulated that the accumulation of extracellular α-synuclein (α-syn) might alter the neuronal membrane by formation of 'pore-like structures' that will lead to alterations in ionic homeostasis. However, this has never been demonstrated to occur in brain neuronal plasma membranes. In this study, we show that α-syn oligomers rapidly associate with hippocampal membranes in a punctate fashion, resulting in increased membrane conductance (5 fold over control) and the influx of both calcium and a fluorescent glucose analogue. The enhancement in intracellular calcium (1.7 fold over control) caused a large increase in the frequency of synaptic transmission (2.5 fold over control), calcium transients (3 fold over control), and synaptic vesicle release. Both primary hippocampal and dissociated nigral neurons showed rapid increases in membrane conductance by α-syn oligomers. In addition, we show here that α-syn caused synaptotoxic failure associated with a decrease in SV2, a membrane protein of synaptic vesicles associated with neurotransmitter release. In conclusion, extracellular α-syn oligomers facilitate the perforation of the neuronal plasma membrane, thus explaining, in part, the synaptotoxicity observed in neurodegenerative diseases characterized by its extracellular accumulation. We propose that α-synuclein (α-syn) oligomers form pore-like structures in the plasma membrane of neurons from central nervous system (CNS). We believe that extracellular α-syn oligomers facilitate the formation of α-syn membrane pore-like structures, thus explaining, in part, the synaptotoxicity observed in neurodegenerative diseases characterized by its extracellular accumulation. We think that alterations in ionic homeostasis and synaptic vesicular depletion are key steps that lead to synaptotoxicity promoted by α -syn membrane pore-like structures.


Assuntos
Membrana Celular/metabolismo , Líquido Extracelular/metabolismo , Hipocampo/metabolismo , Neurônios/metabolismo , Transmissão Sináptica/fisiologia , alfa-Sinucleína/metabolismo , Animais , Encéfalo/citologia , Encéfalo/metabolismo , Células Cultivadas , Feminino , Hipocampo/citologia , Técnicas de Cultura de Órgãos , Gravidez , Ratos Sprague-Dawley
15.
Ocul Immunol Inflamm ; 32(3): 295-300, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36800519

RESUMO

PURPOSE: To describe chorioretinal findings in a patient with new-onset systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) after a stillbirth associated with preeclampsia. STUDY DESIGN: Case report. RESULTS: We report a patient with new-onset SLE and APS after pregnancy, who had a history of preeclampsia and intrauterine death that presented with bilateral visual loss after a seizure. Clinical findings of a unilateral vaso-occlusive retinopathy and choroidopathy associated with intraocular inflammation, serous retinal detachment, and vasculitis are presented, which responded well to immunosuppressive therapy. CONCLUSION: New-onset systemic lupus erythematosus (SLE) during or after pregnancy could occur, especially when complicated with preeclampsia, making it difficult to diagnose accurately. Pregnancy-induced hypertension retinopathy and choroidopathy, as well as chorioretinal manifestations of SLE and APS, can share similar ocular manifestations that can overlap and coexist in the same patient, and it is important to recognize them for an adequate management and follow-up.


Assuntos
Síndrome Antifosfolipídica , Lúpus Eritematoso Sistêmico , Pré-Eclâmpsia , Doenças Retinianas , Feminino , Gravidez , Humanos , Síndrome Antifosfolipídica/complicações , Síndrome Antifosfolipídica/diagnóstico , Natimorto , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Doenças Retinianas/diagnóstico
16.
PLOS Glob Public Health ; 4(2): e0002793, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38349901

RESUMO

Diabetes and poor glycemic control are significant predictors of severity and death in the COVID-19 disease. The perception of this risk in individuals with type 2 diabetes (T2D) could modify coping styles, leading to behaviors associated with better self-care and metabolic control. Theoretically, active coping is associated with better glycemic control in patients with T2D. Nonetheless, information during extreme risk like the COVID-19 pandemic is still limited. Our objective was to evaluate the association between coping styles and risk perception in the COVID-19 pandemic and the change in metabolic parameters. This is a prospective study that included individuals with T2D treated in a tertiary care center during the COVID-19 outbreak who returned to follow-up one year later. We assessed coping styles and risk perception with the Extreme Risk Coping Scale and the risk perception questionnaire. Clinical characteristics and metabolic parameters were registered in both visits. Groups were compared using Kruskal Wallis tests, and changes in metabolic parameters were assessed with Wilcoxon rank sum tests. Our sample included 177 participants at baseline, and 118 concluded the study. Passive coping was more frequent in women. Low-risk perception was associated with higher age, lower psychiatric comorbidities, and lower frequency of psychiatric treatment compared with other risk perception groups. Patients with active coping plus high-risk perception did not have a change in metabolic parameters at follow-up, whereas patients with other coping styles and lower risk perception had an increase in total cholesterol, LDL-cholesterol, and triglycerides. There were no differences by coping group or by risk perception in glycemic control.

17.
Chronic Illn ; : 17423953231192131, 2023 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-37537896

RESUMO

OBJECTIVE: To determine the effect of an anticipated care plan, structured around hospital discharge (PC-AH-US), regarding the caregiving load of people with NTCD residing in Colombia, 2019-2021. METHOD: This is a quasi-experimental study with pre- and post-intervention measurements. It includes 1170 participants who represented 585 chronic disease patient-caregiver pairs. We compared the PC-AH-US intervention, to the regular intervention. RESULTS: The PC-AH-US intervention group showed better results in all dimensions when compared to the regular intervention group: Awareness 8.7 (SD: 0.7) and 6.8 (SD: 1.7); Acknowledgement of their unique conditions 11.3 (SD: 1.0) and 9.4 (SD: 1.8); Capacity to fulfill care tasks 8.8 (SD: 0.7) and 7.5 (SD: 1.5); Wellbeing 11.4 (SD: 0.90) and 8.87 (SD: 2.3); Anticipation 5.88 (SD: 0.4) and 4.7 (SD: 1.1) and Support Network 11.4 (SD: 0.8) and 9.9 (SD: 2.5). CONCLUSION: The PC-AH-US intervention group showed a statistically significant decrease in the caregiving load for people with NTCD (p < 00). There were no significant institutional differences in readmissions or deaths. The PC-AH-US intervention backs institutional policies meant to care for people with NTCD.

18.
J Autism Dev Disord ; 53(11): 4308-4317, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36001195

RESUMO

Recognizing the multifaceted and chronic demands on families of children with Autism Spectrum Disorder (ASD) and challenges in providing care matched to need, we adapted the Psychosocial Assessment Tool (PAT), a brief caregiver-report screener of family psychosocial risk, for this population. Study methods included literature review, focus groups with providers, and feedback from caregivers. The PAT-ASD is consistent with the original PAT, with new items reflecting core behavioral manifestations of ASD and parent and family challenges associated with chronicity. The PAT-ASD was implemented in a four-month pilot and was completed online by 59% of families. Although further testing of its validity is necessary, the PAT-ASD is a promising means of assessing family psychosocial risk for families of children with ASD.


Assuntos
Transtorno do Espectro Autista , Criança , Humanos , Transtorno do Espectro Autista/diagnóstico , Cuidadores/psicologia , Pais/psicologia , Estresse Psicológico/psicologia
19.
Cureus ; 15(11): e48487, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38024061

RESUMO

BACKGROUND:  TikTok is a popular platform that can be used for medical insights. However, spreading inaccurate information about diagnosing or treating medical conditions can undermine the quality of patient care. Our assessment focused on the discourse surrounding knee osteoarthritis on TikTok, with two primary objectives: 1) identifying the creators behind osteoarthritis-related content, and 2) examining whether a connection exists between the reach of video content and the strength of recommendations provided. METHODS:  The top 100 TikTok videos were chosen based on likes on March 29, 2023. Posts were identified using the hashtag ("#Osteoarthritis"). Videos were classified by the following: number of likes, comments, shares, date of upload, uploader (medical professional, non-medical professional, or business), and video content (medical treatment, home remedy, personal story). Treatments were rated according to the American Academy of Orthopaedic Surgeons (AAOS) Evidence-Based Clinical Practice Guideline for Osteoarthritis using the strength of evidence criteria (1-4 stars). Descriptive and univariate analyses were performed. RESULTS:  Among the top videos, 67.7% were uploaded by medical professionals. Private companies, despite having the highest average likes (29,681.2) and shares (1,367.5) per video, had a limited average evidence strength of 2.13. Physician-created videos had the second-highest average number of likes (25,440.1) and shares (1,224.5) per video with a strength of evidence of 3.03. Non-medical professional videos had the lowest evidence support (0.89). Medical treatments, the most liked and shared content, had the lowest evidence strength (1). There was no statistically significant correlation between the number of likes (p=0.808), comments (p=0.647), or shares (p=0.439) to the strength of evidence regarding the intervention. DISCUSSION:  TikTok can be unreliable for knee osteoarthritis treatment information. It is common to find non-physicians sharing medical advice on the platform, with medical treatments demonstrating the weakest level of supporting evidence. Orthopaedic surgeons should advise their patients that TikTok treatment recommendations may not align with established guidelines.

20.
J Biomed Opt ; 28(10): 102910, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37799938

RESUMO

Significance: Optical coherence tomography (OCT) can be integrated into needle probes to provide real-time navigational guidance. However, unscanned implementations, which are the simplest to build, often struggle to discriminate the relevant tissues. Aim: We explore the use of polarization-sensitive (PS) methods as a means to enhance signal interpretability within unscanned coherence tomography probes. Approach: Broadband light from a laser centered at 1310 nm was sent through a fiber that was embedded into a needle. The polarization signal from OCT fringes was combined with Doppler-based tracking to create visualizations of the birefringence properties of the tissue. Experiments were performed in (i) well-understood structured tissues (salmon and shrimp) and (ii) ex vivo porcine spine. The porcine experiments were selected to illustrate an epidural guidance use case. Results: In the porcine spine, unscanned and Doppler-tracked PS OCT imaging data successfully identified the skin, subcutaneous tissue, ligament, and epidural spaces during needle insertion. Conclusions: PS imaging within a needle probe improves signal interpretability relative to structural OCT methods and may advance the clinical utility of unscanned OCT needle probes in a variety of applications.


Assuntos
Pele , Tomografia de Coerência Óptica , Animais , Suínos , Tomografia de Coerência Óptica/métodos , Pele/diagnóstico por imagem , Luz , Refração Ocular , Birrefringência
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