ABSTRACT
Objetivos La ablación con criobalón para el aislamiento de venas pulmonares es un procedimiento que ahorra tiempo y puede ahorrar recursos del laboratorio de electrofisiología. Este análisis modeló el impacto de la ablación con criobalón en el funcionamiento del laboratorio de electrofisiología utilizando datos de América Latina. Métodos Los datos de los centros de Argentina, México, Colombia y Chile del Cryo Global Registry se utilizaron como datos de entrada para un modelo de simulación de la eficiencia del laboratorio de electrofisiología. El modelo partió del supuesto de que se podían realizar dos (operaciones actuales del laboratorio de electrofisiología) o tres (incluidos los cambios operativos del laboratorio de electrofisiología) procedimientos de ablación con criobalón por día. Los criterios de valoración eran el porcentaje de días en los que se producían 1) horas extraordinarias y 2) tiempo restante para un procedimiento electrofisiológico adicional no relacionado con la ablación. Resultados Se incluyeron en el análisis los datos un total de 232 procedimientos de seis centros latinoamericanos. El tiempo medio de ocupación del laboratorio de electrofisiología para todos los procedimientos en Latinoamérica fue de 132 ± 62 minutos. En el escenario actual (dos procedimientos por día), el 7,4% de los días simulados resultaron en horas extras, y el 81,4% tuvo tiempo suficiente para un procedimiento de electrofisiología adicional. En el escenario de productividad mejorada (tres procedimientos por día), el 16,4% de los días utilizó horas extraordinarias, mientras que el 67,4% dispuso de tiempo suficiente para un procedimiento electrofisiológico extra sin ablación. Conclusiones Utilizando datos del mundo real específicos de América Latina, descubrimos que, aplicando cambios operativos, es factible realizar tres procedimientos de ablación al día, lo que deja tiempo para un procedimiento de electrofisiología adicional en más de la mitad de los días. Por lo tanto, el uso de la ablación con criobalón es una herramienta eficaz para mejorar la eficiencia de los laboratorios de electrofisiología en regiones con recursos limitados como América Latina.
Objective Cryoballoon ablation for pulmonary vein isolation is a time-efficient procedure that can alleviate stress on electrophysiology lab resources. This analysis modeled the impact of cryoballoon ablation on electrophysiology lab operation using data from Latin America. Methods Data from centers in Argentina, Mexico, Colombia, and Chile of the Cryo Global Registry were used as inputs for an electrophysiology lab efficiency simulation model. The model used the assumption that either two (today's electrophysiology lab operations) or three (including electrophysiology lab operational changes) cryoballoon ablation procedures could be performed per day. The endpoints were the percentage of days that resulted in 1) overtime and 2) time left for an extra non-ablation electrophysiology procedure. Results Data from a total of 232 procedures from six Latin American centers were included in the analysis. The average electrophysiology lab occupancy time for all procedures in Latin America was 132 ± 62 minutes. In the Current Scenario (two procedures per day), 7.4% of simulated days resulted in overtime, and 81.4% had enough time for an extra electrophysiology procedure. In the Enhanced Productivity Scenario (three procedures per day), 16.4% of days used overtime, while 67.4% allowed time for an extra non-ablation electrophysiology procedure. Conclusions Using real-world, Latin American-specific data, we found that with operational changes, three ablation procedures could feasibly be performed daily, leaving time for an extra electrophysiology procedure on more than half of days. Thus, use of cryoballoon ablation is an effective tool to enhance electrophysiology lab efficiency in resource-constrained regions such as Latin America.
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Introducción: el suicidio es responsable del 1,5% de las muertes mundiales, totalizando aproximadamente 800 000 muertes al año. Se estima que se convertirá en uno de los mayores contribuyentes a la carga mundial de morbilidad en las próximas 2 décadas. La formación clínica adecuada en el campo de la suicidología y la prevención de la conducta suicida resulta de especial relevancia en el contexto de la sala de internación de Psiquiatría. El presente estudio tiene como objetivo analizar los factores que contribuyen a la ideación y al comportamiento suicida en pacientes hospitalizados en la sala de internación de Psiquiatría de un hospital general universitario. Materiales y métodos: se realizó un estudio transversal de pacientes hospitalizados durante un año (octubre de 2018 a septiembre de 2019, n=254). Se examinaron las variables sociodemográficas, culturales y clínicas asociadas al suicidio. Resultados: el 39,4% de los pacientes que ingresaron en el período de estudio refería ideación suicida, el 13,4% un plan suicida y el 10,6% había presentado un intento de suicidio. Las mujeres tuvieron mayor chance de hospitalización debido a ideación suicida (OR=2,22, IC 95% [1,28-3,77]), plan suicida (OR=2,77, IC 95% [1,15-6,62]) e intento suicida (OR=3,12, IC 95% [1,13-8,47]). El 70% de los pacientes mayores de 65 años que tenían un plan suicida vivían solos, mientras que dicho porcentaje fue del 80% para quienes ingresaron luego de un intento de suicidio. Conclusiones: la mayor parte de los datos epidemiológicos en relación con la conducta suicida provienen de países desarrollados. Tratándose de un fenómeno de suma complejidad, creemos necesario incorporar al análisis aristas sociales, político-económicas, culturales y de género. La aplicación del método ideográfico podría brindar una herramienta útil para avanzar nuestro entendimiento en el campo de la suicidología, planteando un abordaje que se nutra de información tanto cuantitativa como cualitativa centrada en la persona, en un proceso iterativo que parta del individuo y luego busque elementos comunes contextualizados. (AU)
Introduction: Suicide is responsible for 1.5% of deaths worldwide, totaling approximately 800,000 deaths per year. Estimates suggest that it will become one of the leading contributors to the global burden of morbidity in the next two decades. Proper clinical training in the field of suicidology and the prevention of suicidal behavior is particularly relevant in the context of the psychiatric inpatient ward. This study aims to analyze the factors that contribute to suicidal ideation and behavior in patients hospitalized in the psychiatric inpatient ward of a general university hospital. Materials and Methods: We conducted a cross-sectional study of hospitalized patients over one year (October 2018 to September 2019, n=254). We examined sociodemographic, cultural, and clinical variables related to suicide. Results: Of the patients admitted during the study period, 39.4% reported suicidal ideation, 13.4% had a suicidal plan, and 10.6% had attempted suicide. Women had a higher chance of hospitalization due to suicidal ideation (OR=2.22, 95% CI [1.28-3.77]), suicidal plan (OR=2.77, 95% CI [1.15-6.62]), and suicide attempt (OR=3.12, 95% CI [1.13-8.47]). Seventy percent of patients over 65 years old with a suicidal plan lived alone, while this percentage was 80% for those admitted after a suicide attempt. Conclusions: Most epidemiological data on suicidal behavior come from developed countries. Considering the complexity of this phenomenon, we believe it is necessary to incorporate social, political-economic, cultural, and gender perspectives into the analysis. Application of the idiographic method could provide a useful tool to advance our understanding of suicidology by proposing an approach that draws on quantitative and qualitative information centered on the individual in an iterative process that starts with the individual and then seeks contextualized common elements. (AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Suicide/statistics & numerical data , Suicide, Attempted/statistics & numerical data , Self-Injurious Behavior/epidemiology , Suicidal Ideation , Suicide/psychology , Cross-Sectional Studies , Factor Analysis, Statistical , Age Factors , Cultural Factors , Sociodemographic Factors , Suicide Prevention/methods , HospitalizationABSTRACT
Introducción. Algunos estudios han señalado que la soledad podría estar relacionada con un aumento en el riesgo de mortalidad en pacientes con cáncer ya que puede debilitar la respuesta al tratamiento y del sistema inmunológico y promover comportamientos perjudiciales, lo que puede empeorar el pronóstico y aumentar la probabilidad de muerte en estos pacientes. El abordar la soledad en la salud pública es esencial para brindar apoyo social y mejorar los resultados en los pacientes con cáncer. Objetivo. Obtener un estimador de la asociación soledad no deseada - mortalidad en pacientes con cáncer. Materiales y métodos. Se le hizo el seguimiento durante dos años a una cohorte prospectiva de 400 pacientes (exposición=niveles de soledad; desenlace=tiempo hasta la muerte). Se incluyeron variables de control sociodemográficas y clínicas. Se utilizó un modelo de supervivencia paramétrico (log normal). Resultados. En la cohorte se encontró una mediana de supervivencia de 20,2 meses y una tasa de mortalidad de 3,2 muertes por 100 pacientes-mes (IC95%: 2,8 a 3,7). En el modelo de supervivencia se encontraron las siguientes razones de tiempo (RT): nivel moderado-nivel bajo: RT=0,55; IC95%: 0,39 a 0,77; nivel moderadamente alto-nivel bajo: RT=0,62; IC95%: 0.41 a 0.93; nivel alto-nivel bajo: RT=1,17; IC95%: 0,31 a 4,42. Conclusión. En comparación con los pacientes con niveles bajos de soledad, los pacientes con niveles moderados o moderadamente altos llegan más rápidamente a la muerte (RT estadísticamente significativas, habiendo ajustado por el efecto de las demás variables del modelo). Esto sugiere la utilidad de las intervenciones para mitigar la soledad y promover el apoyo social en los pacientes con cáncer.
Introduction. Some studies have indicated that loneliness may be associated with an increased risk of mortality in cancer patients, as it can weaken treatment response and the immune system, and promote harmful behaviors, worsening the prognosis and increasing the likelihood of death. Addressing loneliness in public health is essential to provide social support and improve outcomes in cancer patients. Objective. To obtain an estimator of the unwanted loneliness-mortality association. Materials and methods. We followed a prospective cohort of 400 patients for two years (exposure=loneliness levels; outcome=mortality; sociodemographic and clinical control variables were included). A parametric survival model (log normal) was used. Results. The cohort had a median survival of 20.2 months and a mortality rate of 3.2 deaths/100 patient-months (95% CI: 2.8 to 3.7). The survival model found the following time ratios (TR): moderate level/low level: TR=0.55; 95% CI: 0.39 to 0.77; moderately high level/ low level: TR=0.62; 95% CI: 0.41 to 0.93; high level/low level: TR=1.17; 95% CI: 0.31 to 4.42. Conclusion. Compared to patients with low levels of loneliness, patients with moderate or moderately high levels reach death more quickly (statistically significant TRs, adjusted for the effect of other variables in the model); this highlights the need for interventions to mitigate loneliness and promote social support in patients having cancer.
Subject(s)
Humans , Mortality , Loneliness , Neoplasms , Social Isolation , Public Health , Cohort StudiesABSTRACT
Objetivo: Estimar a prevalência da qualidade do sono e seus potenciais fatores associados em pessoas com diabetes mellitus durante o distanciamento social na pandemia da Coronavirus Disease 19. Métodos: Estudo de corte transversal, desenvolvido com 300 usuários acompanhados na Estratégia Saúde da Família de um município no Curimataú Paraibano, diagnosticados com diabetes mellitus tipo 1 ou 2. Os dados foram coletados no período de novembro de 2020 a fevereiro de 2021. Utilizou-se dois formulários, o primeiro com aspectos socioeconômicos, clínicos e hábitos comportamentais; o segundo, constou do Índice da Qualidade do Sono de Pittsburgh. Foram realizados os testes Qui-quadrado, Exato de Fisher, calculada a razão de prevalência, com os intervalos de confiança à 95%, e a Regressão de Poisson. Resultados: A prevalência em ter boa qualidade de sono foi 20% maior em homens, e 39% maior em pessoas sem comorbidades. Conclusão: Evidenciou-se que os dados socioeconômicos e clínicos apresentaram associação com o nível de qualidade do sono em pessoas com diabetes mellitus no período de distanciamento social na pandemia da Coronavirus Disease 19. (AU)
Objective: To estimate the prevalence of sleep quality and its potential associated factors in people with diabetes mellitus during social distancing in the Coronavirus Disease pandemic 19. Methods: Cross-sectional study, developed with 300 users monitored in the Family Health Strategy of a municipality in Curimataú Paraibano, diagnosed with type 1 or 2 diabetes mellitus. Data were collected from November 2020 to February 2021. Two were used. forms, the first with socioeconomic and clinical aspects and behavioral habits; the second was on the Pittsburgh Sleep Quality Index. The Chi-square test, Fisher's exact test, calculated the prevalence ratio, with confidence intervals at 95%, and Poisson Regression were performed. Results: The prevalence of having good sleep quality was 20% higher in men, and 39% higher in people without comorbidities. Conclusion: It was evident that socioeconomic and clinical data were associated with the level of sleep quality in people with diabetes mellitus in the period of social distancing in the Coronavirus Disease pandemic 19. (AU)
Objetivo: Estimar la prevalencia de la calidad del sueño y sus posibles factores asociados en personas con diabetes mellitus durante el distanciamiento social en la pandemia de la enfermedad por coronavirus 19. Métodos: Estudio transversal, desarrollado con 300 usuarios monitoreados en la Estrategia de Salud de la Familia de un municipio de Curimataú Paraibano, diagnosticados de diabetes mellitus tipo 1 o 2. Los datos fueron recolectados de noviembre de 2020 a febrero de 2021. Se utilizaron dos formularios, el primero con aspectos socioeconómicos, clínicos y hábitos de comportamiento; el segundo estaba en el índice de calidad del sueño de Pittsburgh. Se realizó la prueba de Chi-cuadrado, prueba exacta de Fisher, calculó la razón de prevalencia, con intervalos de confianza al 95%, y la Regresión de Poisson. Resultados: La prevalencia de tener una buena calidad del sueño fue un 20% mayor en los hombres y un 39% mayor en las personas sin comorbilidades. Conclusión: Se evidenció que los datos socioeconómicos y clínicos se asociaron con el nivel de calidad del sueño en personas con diabetes mellitus en el período de distanciamiento social en la pandemia de Enfermedad por Coronavirus 19. (AU)
Subject(s)
Diabetes Mellitus , Sleep , Social Isolation , Nursing , Coronavirus InfectionsABSTRACT
O objetivo do presente estudo foi analisar os impactos do período do lockdown ocorrido em 2020 na cidade de São Luís, no Maranhão, de acordo com as percepções de cinco categorias profissionais. Trata-se de um estudo observacional descritivo de caráter qualitativo, realizado por meio de entrevista semiestruturada aplicada aos profissionais selecionados sobre os impactos do lockdown no direito constitucional de ir e vir, na vida profissional e no sistema de saúde brasileiro. Foram entrevistados 130 profissionais, entre médicos, professores universitários, gestores de saúde, empresários e autônomos. Para a análise da pergunta aberta, foi utilizado o método do discurso do sujeito coletivo (DSC). Foram também aplicados Testes de qui-quadrado ou exato de Fisher, adotando-se p < 0,05 como hipótese de nulidade, para verificar a associação entre variáveis categóricas. A maioria dos entrevistados considerou como negativos os impactos do lockdown sobre o direito de ir e vir dos cidadãos (51,6%) e nas atividades de vida diária de suas respectivas profissões (67,7%). O Sistema Único de Saúde não conseguiu conter os avanços da doença, segundo opiniões da maioria (59,2%) dos entrevistados. Os resultados qualitativos mostraram que o lockdown foi desfavorável para 66 profissionais, seguido de 33 que o classificaram como favorável. Os participantes destacaram que o lockdown causou impactos negativos no direito de ir e vir e na vida profissional dos cidadãos, tendo sido considerada uma medida política equivocada e ineficiente na contenção da disseminação da covid-19.
Objective: to analyze the impacts of the lockdown period in the municipality of São Luís, Maranhão (2020), according to the perceptions of five professional categories. Methodology: this descriptive, qualitative, and observational study was carried out by a semi-structured interview applied to selected professionals about the impacts of the lockdown on their constitutional right to free movement, their professional life, and on the Brazilian health system. Results: Overall, 130 professionals were interviewed, including physicians, university professors, health managers, businesspeople, and self-employed people. To analyze the open question, the Collective Subject Discourse-DSC method was used. Chi-squared or Fisher's exact tests were also applied, adopting p < 0.05 as the null hypothesis, to attest to the association between categorical variables. Most interviewees considered the impacts of the lockdown on citizens' right to free movement (51.6%) and on the daily life activities of their respective professions (67.7%) as negative. The Brazilian Unified Health System was unable to contain the spread of the disease, according to the opinions of most (59.2%) interviewees. Qualitative results showed that the lockdown was unfavorable for 66 professionals, followed by 33 professionals who classified it as favorable. Conclusion: the lockdown negatively impacted the right to free movement and professional lives and was considered a mistaken and inefficient political measure to contain the spread of COVID-19.
El objetivo de este estudio fue analizar los impactos del período de confinamiento en 2020 en la ciudad de São Luís, Maranhão, según las percepciones de cinco categorías profesionales. Se trata de un estudio observacional descriptivo, de carácter cualitativo, realizado mediante una entrevista semiestructurada aplicada a profesionales seleccionados sobre los impactos del confinamiento en el derecho constitucional de ir y venir, en la vida profesional y en el sistema de salud brasileño. Se entrevistaron a 130 profesionales, entre médicos, profesores universitarios, gestores de salud, empresarios y autónomos. Para analizar la pregunta abierta se utilizó el método discurso del sujeto colectivo (DSC). También se aplicaron las pruebas de Chi-cuadrado o exacta de Fisher, adoptando p < 0,05 como hipótesis nula, para verificar la asociación entre variables categóricas. La mayoría de los entrevistados consideraron negativos los impactos del confinamiento en el derecho de ir y venir de los ciudadanos (51,6%) y en las actividades de la vida diaria de sus respectivas profesiones (67,7%). El Sistema Único de Salud (SUS) no pudo contener la propagación de la enfermedad, según la opinión de la mayoría (59,2%) de los entrevistados. Los resultados cualitativos mostraron que el confinamiento fue desfavorable para 66 profesionales, seguido de 33 profesionales que lo calificaron como favorable. Los participantes destacaron que el confinamiento provocó impactos negativos en el derecho a ir y venir y en la vida profesional, además, fue considerado una medida política equivocada e ineficaz para contener la propagación del covid-19.
Subject(s)
Social Isolation , Quarantine , Health's JudicializationABSTRACT
Introducción: La Pandemia COVID-19, ha tenido impactos negativos en la salud física y mental de las personas, así como las medidas adoptadas por los gobiernos, para prevenir el contagio masivo de la población como el confinamiento, el aislamiento social, el trabajo y educación virtual. Dentro de los afectados por estos cambios, se encontrarían los estudiantes universitarios del área de la salud, que además de estudiar en estas condiciones de pandemia, no han podido hacer sus prácticas de los servicios de salud. Esta situación de exposición al aislamiento, podría afectar la salud mental de los jóvenes estudiantes universitarios. Objetivo: determinar los niveles de depresión, ansiedad y estrés en estudiantes universitarios y su relación con variables sociodemográficas y las características del aislamiento social durante la Pandemia COVID-19. Métodos: Se realizó un estudio descriptivo, observacional, de corte transversal y cuantitativo, con una muestra de 818 estudiantes universitarios de facultades de ciencias de la salud, mediante el cuestionario autoadministrado DASS-21. Resultados: Los principales hallazgos fueron: una mayor prevalencia en niveles altos (severos y extremadamente severos) en la ansiedad, alcanzado casi a 4 de cada 10 de los evaluados; por otro lado, en depresión y el estrés, 2 de cada 10 de los evaluados, se encontraron en los niveles mencionados. En relación con las variables sociodemográficas, las relacionadas con el COVID-19 y aislamiento social, se hallaron diferencias estadísticamente significativas con el género (mujeres > varones), el haber tenido COVID-19 (Sí > No) y vivir con familiares como antes de la pandemia (Sí > No) obtuvieron en promedio mayores puntajes en depresión, ansiedad y estrés. Conclusión: Los estudiantes que presentaron mayor depresión, ansiedad y estrés con una diferencia significativa fueron de género femenino, con antecedentes de haber tenido Covid-19, menor contacto con familiares y haber cumplido con aislamiento social total.
Introduction: The COVID-19 Pandemic has had negative impacts on the physical and mental health of people, as well as the measures adopted by governments to prevent the massive contagion of the population, such as confinement, social isolation, virtual work, and virtual education. Among those affected by these changes would be university students in the health area who, in addition to studying in these pandemic conditions, have been unable to do their health service practices. This situation of exposure to isolation could affect the mental health of young university students. Objective: To determine the levels of depression, anxiety, and stress in university students, their relationship with sociodemographic variables, and the characteristics of social isolation during the COVID-19 Pandemic. Methods: A descriptive, observational, cross-sectional, and quantitative study was carried out with a sample of 818 university students from health sciences faculties using the DASS-21 self-administered questionnaire. Results: The main findings were a higher prevalence of high levels (severe and highly severe) in anxiety, reaching almost 4 out of 10 of those evaluated; On the other hand, in depression and stress, 2 out of 10 of those evaluated were found at the mentioned levels. Concerning the sociodemographic variables, those related to COVID-19 and social isolation, statistically significant differences were found with gender (women > men), having had COVID-19 (Yes > No), and living with relatives as before. On average, the pandemic (Yes > No) obtained higher scores in depression, anxiety, and stress. Conclusion: The students who presented greater depression, anxiety, and stress with a significant difference were female, with a history of having had Covid-19, less contact with family members, and having complied with total social isolation
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Introducción. El sobrepeso y la obesidad infantil constituyen un problema de salud pública. El inicio de la pandemia por COVID-19 pudo haber favorecido esta patología. El puntaje Z del índice de masa corporal (Z-IMC) es un indicador aceptado para su diagnóstico y seguimiento. Objetivo. Evaluar si la prevalencia de sobrepeso y obesidad, y el Z-IMC en niños de 2 a 5 años aumentó durante la pandemia. Población y métodos. Estudio de cohorte retrospectiva. Se incluyeron pacientes asistidos en efectores públicos de salud del Gobierno de la Ciudad Autónoma de Buenos Aires (GCABA), de 2 a 5 años de edad, con registro de peso y talla en dos consultas, antes y después de haber comenzado el aislamiento social preventivo y obligatorio (ASPO). Se registró estado nutricional (Z-IMC) y variación del Z-IMC entre ambas consultas. Resultados. Se evaluaron 3866 sujetos, edad promedio 3,4 ± 0,8 años; el 48,1 % fueron mujeres. El intervalo promedio entre consultas fue 14,3 ± 2,5 meses. La prevalencia de sobrepeso/obesidad aumentó del 12,6 % (IC95% 11,6-13,6) al 20,9 % (IC95% 19,6-22-2); p <0,001, al igual que el Z-IMC (0,4 ± 1,1 vs. 0,8 ± 1,3; p <0,001). Conclusión. La prevalencia de sobrepeso y obesidad, y el Z-IMC en niños de 2 a 5 años aumentó significativamente durante la pandemia.
Introduction. Childhood overweight and obesity are a public health problem. The onset of the COVID-19 pandemic may have contributed to this condition. The body mass index (BMI) Z-score has been accepted as an indicator for overweight and obesity diagnosis and follow-up. Objective. To assess whether the prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased during the pandemic. Population and methods. Retrospective, cohort study. Patients included were those seen at public health care facilities in the City of Buenos Aires (CABA), who were aged 2 to 5 years, had weight and height values recorded at 2 different visits, before and after the establishment of the preventive and mandatory social isolation policy. Patients' nutritional status (BMI Z-score) and the variation in this indicator between both visits were recorded. Results. A total of 3866 subjects were assessed; their average age was 3.4 ± 0.8 years; 48.1% were girls. The average interval between both visits was 14.3 ± 2.5 months. The prevalence of overweight/ obesity increased from 12.6% (95% CI: 11.613.6) to 20.9% (95% CI: 19.622.2), p < 0.001, and so did the BMI Z-score (0.4 ± 1.1 versus 0.8 ± 1.3, p < 0.001). Conclusion. The prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased significantly during the pandemic.
Subject(s)
Humans , Child, Preschool , Pediatric Obesity/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , Body Mass Index , Prevalence , Retrospective Studies , Cohort Studies , Overweight/epidemiology , Pandemics , SARS-CoV-2ABSTRACT
Resumen Esta revisión da cuenta de artículos que se refieren a la relación existente entre aislamiento social y funciones ejecutivas encargadas de la generación de recursos, para la adaptación de las personas a situaciones poco habituales. Se empleó una estrategia PICO para la definición de la pregunta de investigación y lineamientos básicos del modelo PRISMA, se revisó bases de datos en Scopus, Science Direct, Springer y Google académico. Se identificaron 7042 artículos que cumplían con los criterios de selección, reportándose finalmente 12 investigaciones. Se concluye que el aislamiento social se relaciona con un funcionamiento cognitivo general más deficiente, extendiéndose a otros dominios cognitivos como: orientación, memoria y atención. Además, se evidencia que el aislamiento actúa como un estresor crónico, observándose una disminución en la actividad cortical global y un aumento del cortisol.
Abstract This review reports articles aimed to analyze the relationship between social isolation and executive functions responsible for generating resources for adapting people to unusual situations. A PICO strategy was used to define the research question and essential guidelines of the PRISMA model, and databases in Scopus, Science Direct, Springer, and Google Scholar were reviewed. 7.042 articles that fulfilled the selection criteria were identified, finally reporting 12 investigations. It was concluded that social isolation is related to poorer general cognitive functioning, extending to other cognitive domains such as orientation, memory, and attention. It was also evidenced that isolation acts as a chronic stressor, showing decreased global cortical activity and increased cortisol.
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Objetivo: analisar as percepções de profissionais da atenção primária à saúde de Paranaguá/PR sobre as relações entre a pandemia de COVID-19 e casos de violência doméstica em seus territórios adscritos, identificando desafios na abordagem, impactos nas famílias e manejo dos casos. Metodologia: pesquisa qualitativa com entrevistas semiestruturadas e grupos focais com 36 profissionais de duas unidades básicas de saúde de Paranaguá, litoral paranaense. Resultados: profissionais da atenção primária à saúde foram unânimes em relatar o aumento no número de casos de violência doméstica naquelas comunidades, com impactos tanto para mulheres, quanto para crianças e adolescentes, sendo o fechamento das escolas um fator agravante. Como principais desafios, foram reportados: a desestruturação da atenção primária à saúde durante o auge da pandemia com deslocamento de profissionais e recursos; desinformação sobre fluxos de encaminhamento nos casos de violência doméstica na rede intersetorial; medo dos profissionais, tanto da pandemia, quanto de denunciar casos de violência doméstica; e rotatividade de profissionais. Conclusão: o período de isolamento social causado pela pandemia intensificou os casos de violência doméstica segundo as percepções de profissionais da atenção primária à saúde de Paranaguá. O desmonte da rede intersetorial prejudicou ainda mais o cuidado de pessoas em situação de vulnerabilidade e/ou violência. A ausência de diretrizes nacionais do governo federal deixou municípios e profissionais da atenção primária à saúde à própria sorte para lidar com o problema.
Objective: to analyze the perceptions of primary health care professionals in Paranaguá/PR about the relationship between the COVID-19 pandemic and cases of domestic violence in their assigned territories, identifying challenges in the approach, impacts on families and case management. Methodology: qualitative research was conducted using semi-structured interviews and focus groups with 36 professionals from two primary health care units in Paranaguá, on the Paraná coast. Results: primary health care professionals unanimously reported an increase in the number of domestic violence cases in those communities, affecting women, children, and adolescents, with the closure of schools identified as an aggravating factor. The main challenges highlighted were the disruption of primary health care services during the peak of the pandemic due to the reallocation of professionals and resources; misinformation about referral processes for domestic violence cases within the intersectoral network; fear among professionals regarding the pandemic and reporting domestic violence cases; and high staff turnover. Conclusion: the period of social isolation caused by the pandemic intensified domestic violence cases, according to the perceptions of primary health care professionals in Paranaguá. The dismantling of the intersectoral network further compromised the care of individuals in situations of vulnerability and/or violence. The absence of national guidelines from the federal government left municipalities and primary health care professionals on their own to deal with the issue.
Objetivo: analizar las percepciones de los profesionales de la atención primaria de salud de Paranaguá/PR sobre las relaciones entre la pandemia de COVID-19 y los casos de violencia doméstica en sus territorios asignados, identificando desafíos en el abordaje, impactos en las familias y gestión de casos. Metodología: investigación cualitativa con entrevistas semiestructuradas y grupos focales con 36 profesionales de dos unidades básicas de salud de Paranaguá, en la costa de Paraná. Resultados: los profesionales de la atención primaria de salud fueron unánimes al reportar el aumento del número de casos de violencia doméstica en esas comunidades, con afectaciones tanto a mujeres, niños y adolescentes, siendo el cierre de escuelas un agravante. Se informaron los principales desafíos: la interrupción de la atención primaria de salud durante el apogeo de la pandemia con el desplazamiento de profesionales y recursos; desinformación sobre los flujos de derivación de casos de violencia doméstica en la red intersectorial; miedo entre los profesionales, tanto a la pandemia como a denunciar casos de violencia doméstica; y rotación profesional. Conclusión: el período de aislamiento social provocado por la pandemia intensificó los casos de violencia doméstica según la percepción de los profesionales de la atención primaria de salud en Paranaguá. El desmantelamiento de la red intersectorial perjudicó aún más la atención a personas en situación de vulnerabilidad y/o violencia. La ausencia de directrices nacionales por parte del gobierno federal dejó a los municipios y a los profesionales de atención primaria de salud a su suerte a la hora de abordar el problema.
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Health LawABSTRACT
Objective: to identify factors associated to sedentary behavior and physical inactivity in individuals with stable chronic obstructive pulmonary disease (COPD) non-infected by SARS-CoV-2 during the COVID-19 pandemic, and to identify possible favorable conditions during social isolation in individuals who performed pulmonary rehabilitation in the pre-pandemic period. Method: time/day in sedentary activities and moderate/vigorous physical activities (SA and MVPA, respectively), history of previous rehabilitation, laboural activity, symptoms, insecurity and quality of life (Medical Outcomes Study 36-item Short-Form Health Survey [SF-36]) were assessed during strict social isolation due to the COVID-19 pandemic. Individuals were classified as sedentary if presenting time/day in SA >8.5 h/day and physically inactive if presenting time/day in MVPA <150 min/week. Result: The sample consisted of 33 individuals (69±7 years; 20 male). Regarding the SF-36, non-sedentary individuals presented better functional capacity than sedentary individuals (65 [38-73] vs. 33 [20-63] points; p=0.01) whereas physically active individuals presented better physical and social function than physically inactive individuals (100 [100-100] vs. 50 [25-100] points, p=0.049; and 100 [100-100] vs. 75 [69-100] points, p=0.022, respectively). Having a professional activity and working outside were associated with non-sedentary behavior (X2=5.93; p=0.025 and X2=7.03; p=0.009, respectively). Having undergone rehabilitation previously to the pandemic was associated with less insecurity to walk outside (X2=4.95; p=0.034) and better perception of symptoms' worsening (X2=5.46; p=0.033). Conclusion: non-sedentarism was associated with functional capacity and laboural activity; active lifestyle was associated with physical and social function; and previous rehabilitation was associated with better symptoms' recognition and less insecurity
Objetivo: identificar fatores associados ao comportamento sedentário e inatividade física em indivíduos com doença pulmonar obstrutiva crônica (DPOC) estável não-infectados pelo SARS-CoV-2 durante o isolamento social causado pela pandemia de COVID-19, e identificar eventuais condições favoráveis durante o isolamento social em indivíduos que realizaram reabilitação pulmonar pré-pandemia. Método: tempo/dia em atividades sedentárias e em atividades físicas moderadas/vigorosas (AS e AFMV, respectivamente), reabilitação prévia, atividade laboral, sintomas, insegurança e qualidade de vida (Medical Outcomes Study 36-item Short-Form Health Survey [SF-36]) foram avaliados durante a vigência de isolamento social devido à pandemia de COVID-19. Foram considerados sedentários aqueles que apresentassem tempo/dia em AS >8,5 h/dia e fisicamente inativos os que apresentassem tempo/dia em AFMV <150 min/semana. Resultado: a amostra consistiu em 33 indivíduos (69±7 anos; 20 homens). Pelo SF-36, indivíduos não-sedentários apresentaram melhor capacidade funcional do que sedentários (65 [38-73] vs. 33 [20-63] pontos; p=0,01) enquanto indivíduos fisicamente ativos apresentaram melhor função física e social do que os fisicamente inativos (100 [100-100] vs. 50 [25-100] pontos, p=0,049; e 100 [100-100] vs. 75 [69-100] pontos, p=0,022, respectivamente). Ter atividade profissional e trabalhar fora de casa associou-se com comportamento não-sedentário (X2=5,93; p=0,025 e X2=7,03; p=0,009, respectivamente). Ter participado de reabilitação pulmonar pré-pandemia associou-se com menos insegurança para caminhar em lugares públicos (X2=4,95; p=0,034) e melhor percepção de piora dos sintomas respiratórios (X2=5,46; p=0,033). Conclusão: não-sedentarismo associou-se com capacidade funcional e atividade laboral; ser fisicamente ativo associou-se com função física e social; e ter realizado reabilitação prévia com menos insegurança e melhor percepção dos sintomas
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Humans , Male , Female , Aged , Pulmonary Disease, Chronic Obstructive , Sedentary Behavior , Pandemics , Life Style , Perception , Quality of Life , Rehabilitation , Signs and Symptoms , Social Isolation , Time , World Health Organization , Behavior , Exercise , Disease , Health Surveys , Functional Status , SARS-CoV-2 , Men , MethodsABSTRACT
Objetivo: Revisar a literatura acerca das consequências do isolamento social decorrente da pandemia da COVID-19 sobre sinais e sintomas motores e não motores de idosos com doença de Parkinson (DP). Método: Trata-se de uma revisão integrativa com busca nas bases de dados: PUBMED, LILACS e SCOPUS com filtro para as publicações (novembro de 2019), sendo proporcional ao início do surto da COVID-19 (ano de 2020). Foram incluídos estudos em português, inglês ou espanhol, com a população idosa (≥60 anos) com DP, que avaliaram como exposição o isolamento social decorrente da pandemia e como desfecho os sintomas motores e/ou não motores da DP. Foram excluídos estudos que não responderam à pergunta norteadora e que não obedeceram aos critérios propostos. Para análise da qualidade metodológica e do nível de evidenciados artigos foram aplicados os instrumentos Critical Appraisal Skill Programme e Agency for Health care and Research and Quality. Para sumarização dos sinais e sintomas motores e não motores que pioraram durante o isolamento social, foi utilizado um critério de códigos inspirado em estudos anteriores. Resultados: A amostra final resultou em 8 artigos. Os pacientes idosos com DP enfrentaram piora dos sintomas motores, especialmente tremor e rigidez, e não motores, como ansiedade, depressão e fadiga. Conclusão: O isolamento social decorrente da pandemia da COVID-19 pode ter agravado os sintomas motores e não motores de idosos com doença de Parkinson. Portanto, é relevante a implementação de intervenções multidisciplinares, com um olhar e cuidado diferenciado da equipe de reabilitação a fim de prevenir agravos biopsicossociais.
Objective: To review the literature on the consequences of social isolation resulting from the COVID-19 pandemic on motor and non-motor signs and symptoms of elderly people with Parkinson's disease (PD). Method: This is an integrative review with a search in the following databases: PUBMED, LILACS and SCOPUS with filter for publications (November 2019), being proportional to the beginning of the COVID-19 outbreak (year 2020). Studies available in Portuguese, English or Spanish were included, with the elderly population (≥60 years) with PD, which assessed social isolation resulting from the pandemic as exposure and motor and/or non-motor symptoms of PD as an outcome. Studies that did not answer the guiding question and that did not comply with the proposed criteria were excluded. To analyze the methodological quality and the level of evidenced articles, the Critical Appraisal Skill Program and Agency for Health care and Research and Quality instruments were applied. To summarize the motor and non-motor signs and symptoms that worsened during social isolation, a coding criterion inspired by previous studies was used. Results: The final sample resulted in 8 articles. Elderly PD patients faced worsening motor symptoms, especially tremor and rigidity, and non-motor symptoms such as anxiety, depression, and fatigue. Conclusion: Social isolation resulting from the COVID-19 pandemic may have worsened the motor and non-motor symptoms of elderly people with Parkinson's disease. Therefore, it is important to implement multidisciplinary interventions, with a different perspective and care from the rehabilitation team in order to prevent biopsychosocial problems.
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ObjectiveTo provide technical support for the molecular surveillance of pathogenic bacteria strains carrying mobile colistin resistance-1 (mcr⁃1) gene isolate from inlet of wastewater treatment plants (WWTP). MethodsThe Enterobacteriaceae strains carrying mcr⁃1 resistance gene isolate from inlet of WWTP during April 1 to June 30, 2023 in Shanghai were cultured on blood-rich and SS culture medium and were identified using a mass spectrometry analyzer. The mcr⁃1 gene and copy number were detected by real-time fluorescence quantitative PCR. Drug susceptibility test was performed by microbroth dilution method. The copy numbers of Escherichia coli carrying mcr⁃1 gene isolated from wastewater and human fecel were statistically analyzed by SPSS 25.0. ResultsA total of 14 strains carrying the mcr⁃1 gene were isolated from 49 WWTP samples, and the positive isolation rate was 28.6%, including 12 non-diarrheal E. coli strains and 2 Klebsiella pneumoniae strains. The drug susceptibility results showed that all 14 strains were multi-drug resistant bacteria. They were all sensitive to imipenem and tigecycline, but were ampicillin- and cefazolin-resistant. There was no significant difference in the copy number between human-sourced diarrheal E. coli and wastewater-sourced non-diarrheal E. coli (t=0.647, P>0.05). ConclusionThe isolation and identification of strains carrying the mcr⁃1 gene from inlet of WWTP samples were firstly established in Shanghai. The multi-drug resistance among the isolated strains is severe. To effectively prevent and control the spread of colistin-resistant bacteria, more attention should be paid to the surveillance of mcr⁃1 gene.
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@#Objective To isolate,purify and identify exosomes secreted by mouse primary peritoneal macrophages.Methods Five male C57BL/6 mice were intraperitoneally injected with 3% mercaptoacetate broth respectively,and the primary peritoneal macrophages were obtained by lavage,and then the purity was analyzed by flow cytometry.The exosomes of mouse primary peritoneal macrophages were extracted by ExoQuick TC exosome kit,which were measured for the protein content with BCA kit,observed for the morphology by transmission electron microscopy,detected for the particle size and distribution with nanoparticle tracking analyzer,and determined for the expression of exosome-specific markers(CD9,CD63 and TSG101) by Western blot.Results About 5 × 10~6 peritoneal macrophages with the purity of(99.17±0.65)%were obtained from each mouse.Approximately 869 μg of exosomal protein was extracted from 5 mL of mouse primary peritoneal macrophage culture supernatant.The exosomes of mouse primary peritoneal macrophages were typical tea saucerlike vesicles with strong refraction under electron microscopy,and highly expressed the exosome-specific markers TSG101,CD63 and CD9.The particle size distribution was concentrated between 100 and 200 nm,with an average particle size of175.2 nm.Conclusion Intraperitoneal injection of mercaptoacetate broth can improve the yield of mouse primary peritoneal macrophages.ExoQuick TC.exosome kit can extract sufficient amount of exosomes with high purity from mouse primary peritoneal macrophages.
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@#In order to investigate the chemical constituents of glycosides in Piper sintenense Hatusima, column chromatographic techniques such as silica gel, ODS, MCI GEL CHP20P, Sephadex LH-20, and semi-preparative high performance liquid chromatography were used to afford nine glycosides from the n-butanol part of the 95% ethanol extract of Piper sintenense Hatusima. Based on the physicochemical properties and NMR data, the above compounds were identified as (2S)-2-hydroxy-1-(4-hydroxy-3-methoxyphenyl)-1-propanone-2-O-β-D-glucopyranoside (1), 2-phenylethyl β-D-glucopyranoside (2), benzyl α-L-arabinopyranosyl-(1''→6')-β-D-glucopyranoside (3), benzyl β-D-xylopyanosyl-(1''→6')-β-D-glucopyranoside (4), phenethyl β-D-apiofuranosyl-(1''→ 2')-β-D-glucopyranoside(5), salidroside (6), phenethanol β-D-xylopyanosyl-(1''→6')-β-D-glucopyranoside (7), (Z)-hexenyl-O-α-L-arabinopyranosyl-(1''→6')-O-β-D-glucopyranoside (8), (Z)-hexenyl-O-β-D-xylopyanosyl-(1''→6')-O-β-D-glucopyranoside (9). Compound 1 was identified as a new compound, and compounds 3-9 were isolated from the genus Piper for the first time.
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Objective:To investigate atrial fibrillation patients′illness perception during the blanking period after pulmonary vein isolation (PVI) and to analyze its influencing factors, so as to provide a reference for improving patients′cognition of the disease and speeding up the rehabilitation process.Methods:This study was a cross-sectional survey. Convenience sampling method was adopted to select 320 patients with atrial fibrillation who were reexamined in the outpatient department during the blanking period after PVI from Affiliated Hospital of Qingdao University from Auguest 2022 to May 2023 as the research subjects. The General Information Questionnaire, the Brief Illness Perception Questionnaire (BIPQ), and the Control Attitudes Scale-Revised (CAS-R) were used for on-site investigation.Results:Totally 320 patients were included in this study, including 177 males and 143 females, aged (61.64 ± 10.74) years old. The total score of BIPQ was (42.98 ± 10.49) points, the total score of CAS-R was (27.20 ± 5.65) points. The results of multiple linear regression analysis showed that age, resting heart rate, postoperative course, and perceived control were the influencing factors of illness perception ( F = 25.24, P<0.05). Conclusions:The illness perception of atrial fibrillation patients during the blanking period after PVI needs to be improved urgently. Medical staff should pay more attention to patients with old age, fast resting heart rate, short postoperative course, and low perceived control, and take effective measures to reduce negative illness perception and promote postoperative rehabilitation.
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BACKGROUND:Frog active peptides have rich activities,such as antibacterial and anti-tumor,and are expected to solve the problem of antibiotic resistance. OBJECTIVE:The active peptide QUB2984 was discovered in the skin secretions of Agalychnis callidryas.Its structure and properties were simulated by bioinformatics.The peptide was synthesized,purified,and identified and its biological functions were investigated. METHODS:Agalychnis callidryas skin secretions were collected by electrostimulation.The sequence of QUB2984 was obtained through constructing a cDNA library with isolated mRNA.BLAST was used for peptide sequence alignment.Besides that,Iterative Threading ASSEmbly Refinement(I-TASSER)and HeliQuest tools were used for protein secondary structure simulation.It was synthesized by solid-phase peptide synthesis,purified by reverse-phase high-performance liquid chromatography,and structurally confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.The purified peptide was used to evaluate its biological activity.Its antibacterial effect was evaluated by the minimum inhibitory concentration method.Its cytotoxic effect was detected by MTT assay.Its safety was investigated by a hemolysis test. RESULTS AND CONCLUSION:(1)Peptide QUB2984 had basically α-spiral structure,with a relatively intact hydrophobic surface,and a certain destructive ability to biofilm.The third amino acid position of QUB2984 was composed of W and had a G-X-G structure.(2)The minimum inhibitory concentration of QUB2984 against gram-positive Staphylococcus aureus was 2 μmol/L,the minimum inhibitory concentration against gram-negative Escherichia coli was 2 μmol/L,and the minimum inhibitory concentration against the fungus Candida albicans was 8 μmol/L.(3)The active peptide QUB2984 had obvious inhibitory effect on human non-small cell lung cancer cells NCI-H838 at 10-5 mol/L concentration,and the hemolytic effect on horse red cells at 64 μmol/L concentration was 50%.(4)The results showed that QUB2984 had anti-bacterial and anti-cancer activity,and it had a positive charge of +3,which was conducive to contact with bacteria or cells.
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Objective To isolate endophytic fungi from Angelica sinensis and evaluate the bioactivity of their secondary metabolites.Methods Angelica sinensis and rhizosphere soil were utilized as materials.The tissue homogenization method was employed with six diverse culture media to isolate endophytic fungi.The antibacterial activity of secondary metabolites was gauged using a 96-well plate assay,while UV spectrophotometry was used to evaluate the inhibitory activity of four enzymes.Results A total of 153 fungal strains were isolated and purified from Angelica sinensis roots,stems,leaves,and soil.The samples exhibited specific inhibitory activities against adenosine deaminase(ADA),β-lactamase,xanthine oxidase(XO),and tyrosinase(TYR),with rates of 45.83%,52.78%,51.39%and 55.56%,respectively.Furthermore,1.39%of the samples displayed wide-ranging inhibitory effects against four indicator bacteria.Strain 6B also showcased the lowest inhibitory concentration values of 62.5 and 7.81 μg/mL against Escherichia coli ATCC25922 and ATCC35218,respectively,signifying its potential research significance.Conclusion Angelica sinensis has abundant endophytic fungal resources and is a good source for discovering active compounds,demonstrating certain research value.
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AIM To study the neoflavonoids from Dalbergia cochinchinensis Pierre ex Laness and their anti-hypoxia/reoxygenation injury activities on H9c2 myocardial cells.METHODS The 70%ethanol extract from D.cochinchinensis was isolated and purified by silica gel,Sephadex LH-20 and reverse-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The CCK-8 method was used to detect their activities on H9c2 cells and protective effects on hypoxia-reoxygenation injury of H9c2 cells,and their structure-activity relationship was analyzed.RESULTS Twelve compounds were isolated and identified as latifolin(1),5-O-methyllatifolin(2),mimosifoliol(3),5-O-methydalbergiphenol(4),dalbergiphenol(5),cearoin(6),2,4-dihydroxy-5-methoxy-benzophenone(7),2-hydroxy-4,5-dimethoxybenzophenone(8),melannoin(9),2,2′,5-trihydroxy-4-methoxybenzophenone(10),dalbergin(11),4-methoxydalbergione(12).The dalbergiphenols and dalbergins had little toxicity to H9c2 cells,and dalbergiphenols had strong activity against hypoxia-reoxygenation injury of H9c2 cells.CONCLUSION Compound 8 is a new natural product.Compounds 4,9 are isolated from this plant for the first time.Dalbergiphenols may be the main neoflavonoids against hypoxia-reoxygenation injury of H9c2 cells.
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AIM To study the chemical constituents from Ganoderma angustisporum J.H.Xing,B.K.Cui&Y.C.Dai and their α-glucosidase inhibitory activities.METHODS The ethyl acetate extract from G.angustisporum was isolated and purified by silica gel,ODS,TLC and HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.pNPG method was used to evaluate their α-glucosidase inhibitory activities.RESULTS Seven compounds were isolated and identified as N-acetyl-L-phenylalanine ethyl ester(1),N-acetyl-L-phenylalanine methyl ester(2),4-hydroxy-17R-methylincisterol(3),6,8-di-O-methylaverufin(4),aversin(5),methyl 2-(4-hydroxyphenyl)aceate(6),5-toluene-1,3-diol(7).Compounds 1-2,4-7 showed inhibitory activities of α-glucosidase with IC50 values being(33.80±0.47),(45.45±7.95),(48.80±5.86),(39.48±2.82),(41.47±6.68),(55.38±10.12)μmol/L,and compound 1 showed good inhibitory activity.CONCLUSION Compound 1 is a new natural product.Compounds 2-7 are isolated from genus Ganoderma for the first time.Compounds 1-2,4-7 have α-glucosidase inhibitory activities.
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AIM To study the phenylethanoid glycosides from Verbenae Herba.METHODS The 80%ethanol extract from Verbenae Herba was isolated and purified by silica gel,Sephadex LH-20,TLC and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Nine compounds were isolated and identified as verbofficoside A(1),cistanoside D(2),epimeredinoside A(3),verbascoside(4),isoverbascoside(5),cistanoside C(6),cistanoside F(7),decaffeoylacteoside(8),jionoside C(9).CONCLUSION Compound 1 is a new compound.Compounds 3 and 6-9 are isolated from this plant for the first time.