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1.
Environ Impact Assess Rev ; 99: 107013, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36532697

ABSTRACT

COVID-19 lockdown measures have impacted the environment with both positive and negative effects. However, how human populations have perceived such changes in the natural environment and how they may have changed their daily habits have not been yet thoroughly evaluated. The objectives of this work were to investigate (1) the social perception of the environmental changes produced by the COVID-19 pandemic lockdown and the derived change in habits in relation to i) waste management, energy saving, and sustainable consumption, ii) mobility, iii) social inequalities, iv) generation of noise, v) utilization of natural spaces, and, vi) human population perception towards the future, and (2) the associations of these potential new habits with various socio-demographic variables. First, a SWOT analysis identified strengths (S), weaknesses (W), opportunities (O), and threats (T) generated by the pandemic lockdown measures. Second, a survey based on the aspects of the SWOT was administered among 2370 adults from 37 countries during the period from February to September 2021. We found that the short-term positive impacts on the natural environment were generally well recognized. In contrast, longer-term negative effects arise, but they were often not reported by the survey participants, such as greater production of plastic waste derived from health safety measures, and the increase in e-commerce use, which can displace small storefront businesses. We were able to capture a mismatch between perceptions and the reported data related to visits to natural areas, and generation of waste. We found that age and country of residence were major contributors in shaping the survey participants ´answers, which highlights the importance of government management strategies to address current and future environmental problems. Enhanced positive perceptions of the environment and ecosystems, combined with the understanding that livelihood sustainability, needs to be prioritized and would reinforce environmental protection policies to create greener cities. Moreover, new sustainable jobs in combination with more sustainable human habits represent an opportunity to reinforce environmental policy.

2.
Nanotechnology ; 33(33)2022 May 25.
Article in English | MEDLINE | ID: mdl-35508085

ABSTRACT

P-type and n-type metal oxide semiconductors are widely used in the manufacture of gas sensing materials, due to their excellent electronic, electrical and electrocatalytic properties. Hematite (α-Fe2O3) compound has been reported as a promising material for sensing broad types of gases, due to its affordability, good stability and semiconducting properties. In the present work, the efficient and easy-to-implement sol-gel method has been used to synthesizeα-Fe2O3nanoparticles (NPs). The TGA-DSC characterizations of the precursor gel provided information about the phase transformation temperature and the mass percentage of the hematite NPs. X-ray diffraction, transmission electron microscopy and x-ray photoelectron spectroscopy data analyses indicated the formation of two iron oxide phases (hematite and magnetite) when the NPs are subjected to thermal treatment at 400 °C. Meanwhile, only the hematite phase was determined for thermal annealing above 500 °C up to 800 °C. Besides, the crystallite size shows an increasing trend with the thermal annealing and no defined morphology. A clear reduction of surface defects, associated with oxygen vacancies was also evidenced when the annealing temperature was increased, resulting in changes on the electrical properties of hematite NPs. Resistive gas-sensing tests were carried out using hematite NPs + glycerin paste, to detect quaternary ammonium compounds. Room-temperature high sensitivity values (Sr âˆ¼ 4) have been obtained during the detection of ∼1 mM quaternary ammonium compounds vapor. The dependence of the sensitivity on the particle size, the mass ratio of NPs with respect to the organic ligand, changes in the dielectric properties, and the electrical conduction mechanism of gas sensing was discussed.

3.
J Healthc Qual Res ; 37(1): 34-43, 2022.
Article in Spanish | MEDLINE | ID: mdl-34417158

ABSTRACT

OBJECTIVE: Having a general practitioner in nursing homes during the pandemic by COVID-19 has allowed a multidisciplinary intervention to systematically review medication in institutionalized elderly patients; the objective of this study is to evaluate the impact of this intervention in reducing the number of drugs/patient. METHODS: A prospective multicenter study before-after of an intervention involving general practitioner and primare care pharmacists in 4 nursing homes of less than 50 residents. A review algorithm was used to identify Drug-Related Problems (DRPs) that were part of the primare care pharmacists recommendations. The degree of acceptance by the physician of these recommendations was measured. RESULTS: 121 patients reviewed with a mean age of 86.1 years (SD: 7.2); 87.6% were women. Of 98 patients analyzed, had an average of 9.4 (SD: 4.0) drugs/patient, was reduced by -1.6 [CI 95% -1.3 to -1.9] p<.001 after the intervention, the different was statistically significant. 409 DRPs were identified, an average of 4.2 per patient, who were part of a recommendation of which 316 (77.3%) were accepted. Most of the recommendations concerned deprescription or dose adjustment. Psycholeptics, antihypertensives and analgesics were the therapeutic groups most commonly involved in the detected DRPs. CONCLUSIONS: A statistically significant reduction in the mean number of drugs/patient following intervention has been observed. Many DRPs have been identified through the primare care pharmacists review, which have mostly been accepted by the physician.


Subject(s)
COVID-19 , Aged , Aged, 80 and over , Female , Humans , Nursing Homes , Pharmacists , Prospective Studies , SARS-CoV-2
4.
Biochim Biophys Acta Biomembr ; 1863(5): 183581, 2021 05 01.
Article in English | MEDLINE | ID: mdl-33556358

ABSTRACT

Hylaseptin-4 (HSP-4, GIGDILKNLAKAAGKAALHAVGESL-NH2) is an antimicrobial peptide originally isolated from Hypsiboas punctatus tree frog. The peptide has been chemically synthetized for structural investigations by CD and NMR spectroscopies. CD experiments reveal the high helical content of HSP-4 in biomimetic media. Interestingly, the aggregation process seems to occur at high peptide concentrations either in aqueous solution or in presence of biomimetic membranes, indicating an increase in the propensity of the peptide for adopting a helical conformation. High-resolution NMR structures determined in presence of DPC-d38 micelles show a highly ordered α-helix from amino acid residues I2 to S24 and a smooth bend near G14. A large separation between hydrophobic and hydrophilic residues occurs up to the A16 residue, from which a shift in the amphipathicity is noticed. Oriented solid-state NMR spectroscopy show a roughly parallel orientation of the helical structure along the POPC lipid bilayer surface, with an insertion of the hydrophobic N-terminus into the bilayer core. Moreover, a noticeable pH dependence of the aggregation process in both aqueous and in biomimetic membrane environments is attributed to a single histidine residue (H19). The protonation degree of the imidazole side-chain might help in modulating the peptide-peptide or peptide-lipid interactions. Finally, molecular dynamics simulations confirm the orientation and preferential helical conformation and in addition, show that HSP-4 tends to self-aggregate in order to stabilize its active conformation in aqueous or phospholipid bilayer environments.


Subject(s)
Antimicrobial Cationic Peptides/chemistry , Liposomes/chemistry , Amino Acid Sequence , Animals , Antimicrobial Cationic Peptides/chemical synthesis , Antimicrobial Cationic Peptides/metabolism , Antimicrobial Cationic Peptides/pharmacology , Anura/metabolism , Circular Dichroism , Escherichia coli/drug effects , Hydrogen-Ion Concentration , Liposomes/metabolism , Molecular Dynamics Simulation , Nuclear Magnetic Resonance, Biomolecular , Protein Binding , Protein Conformation, alpha-Helical , Staphylococcus aureus/drug effects
5.
Eat Weight Disord ; 25(3): 751-759, 2020 Jun.
Article in English | MEDLINE | ID: mdl-31077019

ABSTRACT

PURPOSE: The prevalence of childhood obesity continues to increase worldwide. The aims of this study were to (1) assess the psychological well-being and rates of teasing of Spanish children with obesity (OG) and compare them with their non-overweight peers (NG), and (2) analyze the mediating role of weight-related teasing on the relation between children's BMI z score and psychological well-being. METHODS: The cross-sectional study included 50 preadolescents with obesity, matched with non-overweight children according to age, sex, and socioeconomic status, who were assessed via self-report instruments measuring anxiety, depression, self-esteem, and teasing. RESULTS: The OG reported higher anxiety, depression, and teasing, and lower self-esteem. SEM revealed that children who scored worse on instruments assessing psychological well-being had higher BMI z scores. Weight-related teasing predicted poor psychological well-being scores and weight-related teasing mediated the relation between BMI and psychological well-being. CONCLUSIONS: The high rates of anxiety, depression, and weight-related teasing, as well as the low self-esteem, which was observed amongst the children with obesity, raise concerns about the quality of life of this population. Furthermore, the finding that weight-related teasing mediated the relationship between BMI and psychological well-being adds to a growing body of research, highlighting the harmful effects of weight-related stigma. Overall, these results highlight the importance of early intervention to assess for, and address, the presence of weight-related teasing and psychological well-being difficulties in preadolescents with obesity. LEVEL OF EVIDENCE: Level III, case-control study.


Subject(s)
Pediatric Obesity/psychology , Peer Group , Quality of Life/psychology , Self Concept , Anxiety/psychology , Body Mass Index , Case-Control Studies , Child , Cross-Sectional Studies , Depression/psychology , Female , Humans , Male , Spain
7.
Cytotherapy ; 19(10): 1176-1188, 2017 10.
Article in English | MEDLINE | ID: mdl-28801055

ABSTRACT

BACKGROUND: Obesity is associated with numerous cardiac complications, including arrhythmias, cardiac fibrosis, remodeling and heart failure. Here we evaluated the therapeutic potential of mesenchymal stromal cells (MSCs) and their conditioned medium (CM) to treat cardiac complications in a mouse model of high-fat diet (HFD)-induced obesity. METHODS: After obesity induction and HFD withdrawal, obese mice were treated with MSCs, CM or vehicle. Cardiac function was assessed using electrocardiography, echocardiography and treadmill test. Body weight and biochemical parameters were evaluated. Cardiac tissue was used for real time (RT)-polymerase chain reaction (PCR) and histopathologic analysis. RESULTS/DISCUSSION: Characterization of CM by protein array showed the presence of different cytokines and growth factors, including chemokines, osteopontin, cystatin C, Serpin E1 and Gas 6. HFD-fed mice presented cardiac arrhythmias, altered cardiac gene expression and fibrosis reflected in physical exercise incapacity associated with obesity and diabetes. Administration of MSCs or CM improved arrhythmias and exercise capacity. This functional improvement correlated with normalization of GATA4 gene expression in the hearts of MSC- or CM-treated mice. The gene expression of connexin 43, troponin I, adiponectin, transforming growth factor (TGF) ß, peroxisome proliferator activated receptor gamma (PPARγ), insulin-like growth factor 1 (IGF-1), matrix metalloproteinase-9 (MMP9) and tissue inhibitor of metalloproteinases 1 (TIMP1) were significantly reduced in MSCs, but not in CM-treated mice. Moreover, MSC or CM administration reduced the intensity of cardiac fibrosis. CONCLUSION: Our results suggest that MSCs and CM have a recovery effect on cardiac disturbances due to obesity and corroborate to the paracrine action of MSCs in heart disease models.


Subject(s)
Culture Media, Conditioned/pharmacology , Diet, High-Fat/adverse effects , Heart/physiopathology , Mesenchymal Stem Cell Transplantation/methods , Obesity/physiopathology , Animals , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/therapy , Cytokines/metabolism , Fibrosis/genetics , Fibrosis/pathology , GATA4 Transcription Factor/genetics , Gene Expression/drug effects , Heart/drug effects , Intercellular Signaling Peptides and Proteins/metabolism , Male , Mesenchymal Stem Cells/cytology , Mesenchymal Stem Cells/physiology , Mice, Inbred BALB C , Myocardium/pathology , Obesity/etiology
8.
Nat Prod Res ; 31(16): 1948-1953, 2017 Aug.
Article in English | MEDLINE | ID: mdl-27966397

ABSTRACT

Luehea species are found in almost all Central and South American countries. The present work describes the phytochemical study, isolation, and structural characterisation of friedelin, ß-friedelinol, lupeol, pseudotaraxasterol, ß-sitosterol, betulinic acid, taraxasterol, (-)-epicatechin, ß-sitosterol-3-O-ß-d-glucopyranoside, and (+)-epicatechin-(4ß→8)-epicatechin from stem barks of Luehea ochrophylla Mart. The structural identification of the isolated compounds was mainly performed by NMR analyses and comparison with the data from literature. These compounds were isolated for the first time in the genus Luehea, except ß-sitosterol glucopyranoside, (-)-epicatechin, and lupeol. Hexane extract (HE) and dichloromethane (DF) and ethyl acetate (AF) fractions exhibited antiparasitic activity against amastigote (intracellular) and trypomastigote culture forms of Trypanosoma cruzi. The ethanol extract (EE), DF, and ethanol fraction (EF) exhibited considerable antifungal activity against Candida albicans. Moreover, extracts and fractions exhibited significant percentage of capture free radicals of 2,2-diphenyl-picrylhydrazyl (DPPH) when compared to the standard of ascorbic acid.


Subject(s)
Anti-Infective Agents/pharmacology , Antioxidants/pharmacology , Antiparasitic Agents/pharmacology , Malvaceae/chemistry , Animals , Anti-Infective Agents/chemistry , Antioxidants/chemistry , Antiparasitic Agents/chemistry , Chlorocebus aethiops , Drug Evaluation, Preclinical/methods , Glucosides/isolation & purification , Glucosides/pharmacology , Inhibitory Concentration 50 , Magnetic Resonance Spectroscopy , Pentacyclic Triterpenes/isolation & purification , Pentacyclic Triterpenes/pharmacology , Plant Bark/chemistry , Plant Extracts/chemistry , Sitosterols/isolation & purification , Sitosterols/pharmacology , Sterols/isolation & purification , Sterols/pharmacology , Triterpenes/isolation & purification , Triterpenes/pharmacology , Vero Cells , Betulinic Acid
9.
Arch. Soc. Esp. Oftalmol ; 91(10): 501-504, oct. 2016. ilus
Article in Spanish | IBECS | ID: ibc-156181

ABSTRACT

OBJETIVO: Presentar los resultados del uso de un único segmento de autoinjerto limbar combinado con trasplante de membrana amniótica y epiteliectomías conjuntivales sectoriales secuenciales postoperatorias en 2 pacientes con insuficiencia límbica unilateral total. CONCLUSIONES: Un solo segmento de autoinjerto limbal junto con el trasplante de membrana amniótica puede ser suficiente para restaurar una superficie corneal estable, siendo en ocasiones necesario realizar en el postoperatorio epiteliectomías conjuntivales secuenciales en zonas remanentes de epitelio anómalo


OBJECTIVE: To present the results on the use of a single block limbal autograft, combined with amniotic membrane transplantation and sectoral sequential postoperative epitheliectomy of the conjunctiva in 2 patients with unilateral total limbal stem cell deficiency. CONCLUSIONS: A single block limbal autograft combined with amniotic membrane transplantation may be sufficient to restore a stable corneal surface, but sometimes sequential sectoral conjunctival epitheliectomy may be required to treat anomalous epithelial remnants


Subject(s)
Humans , Female , Adult , Transplantation, Autologous/instrumentation , Transplantation, Autologous/methods , Transplantation, Autologous , Conjunctiva/pathology , Conjunctiva/transplantation , Limbus Corneae/pathology , Limbus Corneae/surgery , Limbus Corneae , Corneal Neovascularization/surgery , Limbus Corneae/anatomy & histology , Fluorescein/administration & dosage , Fluorescein/analysis
10.
Rev. clín. esp. (Ed. impr.) ; 216(6): 301-307, ago.-sept. 2016. ilus
Article in Spanish | IBECS | ID: ibc-154668

ABSTRACT

Objetivo. La paradoja del tabaco es un fenómeno insuficientemente explicado en estudios previos. Este estudio analiza el papel pronóstico del tabaquismo previo o activo en pacientes con síndrome coronario agudo. Métodos. Obtuvimos los datos del registro ARIAM, entre 2001 y 2012. Se incluyó a 42.827 pacientes con síndrome coronario agudo (edad media 65±13 años, 26,4% mujeres). Se analizó la influencia del hábito tabáquico o de la condición de exfumador en la mortalidad mediante análisis multivariados. Resultados. Los fumadores eran más jóvenes, más frecuentemente hombres, tenían menos diabetes, hipertensión e historia previa de insuficiencia cardiaca, ictus, arritmia e insuficiencia renal, así como más frecuentemente elevación del ST e historia familiar. Los exfumadores presentaban más dislipidemia e historia de angina, infarto de miocardio, cardiopatía isquémica, vasculopatía periférica y broncopatía crónica. Fumadores y exfumadores desarrollaron menos frecuentemente shock cardiogénico (fumadores 4,2%, exfumadores 4,7% y no fumadores 6,9%, p<0,001). La mortalidad hospitalaria fue del 7,8% en los no fumadores, un 4,9% en los exfumadores y un 3,1% en los fumadores (p<0,001). En el análisis multivariado, el carácter fumador perdió su influencia en el pronóstico (-0,26%, p = 0,52 mediante cálculo de probabilidad inversa; y +0,26%, p=0,691 mediante análisis de propensión). Sin embargo, el carácter exfumador mostró una reducción significativa de la mortalidad en ambos test (-2,4% en el análisis de probabilidad inversa, p < 0,001, y -1,5% en el análisis de propensión, p = 0,005). Conclusiones. La paradoja del tabaco es un hallazgo que puede explicarse por otros factores pronósticos. El abandono del hábito tabáquico previo a un ingreso por síndrome coronario agudo se asocia a un mejor pronóstico (AU)


Objective. The tobacco paradox is a phenomenon insufficiently explained by previous studies. This study analyses the prognostic role of prior or active smoking in patients with acute coronary syndrome. Methods. We obtained data from the ARIAM registry, between 2001 and 2012. The study included 42,827 patients with acute coronary syndrome (mean age, 65±13 years; 26.4% women). The influence of smoking and that of being an ex-smoker on mortality was analysed using a multivariate analysis. Results. The smokers were younger, were more often men, had less diabetes, hypertension and prior history of heart failure, stroke, arrhythmia and renal failure and more frequently had ST-elevation and a family history of smoking. The ex-smokers had more dyslipidaemia and history of angina, myocardial infarction, ischemic heart disease, peripheral vasculopathy and chronic bronchial disease. Smokers and ex-smokers less frequently developed cardiogenic shock (smokers 4.2%, ex-smokers 4.7% and nonsmokers 6.9%, P<.001). Hospital mortality was 7.8% for the nonsmokers, 4.9% for the ex-smokers and 3.1% for the smokers (P<.001). In the multivariate analysis, the smoker factor lost its influence in the prognosis (-0.26%, p=.52 using an inverse probability calculation; and+0.26%, P=.691 using a propensity analysis). However, the exsmoker factor showed a significant reduction in mortality in both tests (-2.4% in the inverse probability analysis, P<.001; and -1.5% in the propensity analysis, P=.005). Conclusions. The tobacco paradox is a finding that could be explained by other prognostic factors. Smoking cessation prior to hospitalization for acute coronary syndrome is associated with a better prognosis (AU)


Subject(s)
Humans , Male , Female , Acute Coronary Syndrome/epidemiology , Acute Coronary Syndrome/prevention & control , Tobacco Use Cessation/methods , Tobacco Use Cessation/statistics & numerical data , Prognosis , Myocardial Infarction/epidemiology , Myocardial Infarction/prevention & control , Risk Factors , Heart Failure/epidemiology , Propensity Score , Helsinki Declaration , 28599 , Pulmonary Disease, Chronic Obstructive/complications , Renal Insufficiency/complications
11.
J Endocrinol Invest ; 39(12): 1401-1409, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27363699

ABSTRACT

PURPOSE: Pituitary macroadenomas (MACs) represent 10-30 % of Cushing's disease (CD) cases. The aim of this study was to report the clinical, laboratorial and imaging features and postsurgical outcomes of microadenoma (MIC) and MAC patients. METHODS: Retrospective study with 317 CD patients (median 32 years old, range 9-71 years) admitted between 1990 and 2014, 74 (23.3 %) of whom had MAC. RESULTS: Hirsutism, plethora facial, muscular weakness and muscular atrophy were more frequent in the MIC patients. Nephrolithiasis, osteopenia, hyperprolactinaemia and galactorrhoea were more prevalent in MAC patients. The morning serum cortisol (Fs), nocturnal salivary cortisol (NSC), nocturnal Fs (Fs 2400 h), low- and high-dose dexamethasone suppression test results and CRH and desmopressin test results were similar between the subgroups. MIC patients showed higher urinary cortisol at 24 h (UC), and MAC patients presented higher ACTH levels but lower Fs/ACTH, Fs 2400 h/ACTH, NSC/ACTH and UC/ACTH ratios. There were negative correlations of tumour size with Fs/ACTH, Fs 2400 h/ACTH, NSC/ACTH and UC/ACTH ratios. Overall, the postsurgical remission and recurrence rates were similar between MIC and MAC. However, patients in remission (MIC + MAC) showed smaller tumour diameters and a lower prevalence of invasion and extension on MRI. CONCLUSIONS: Despite exhibiting higher plasma ACTH levels, CD patients with MAC presented lower cortisol/ACTH ratios than did patients with MIC, with a negative correlation between tumour size and cortisol/ACTH ratios. The overall postsurgical remission and recurrence rates were similar between MIC and MAC patients, with those with larger and/or invasive tumours showing a lower remission rate.


Subject(s)
Adenoma/blood , Adrenocorticotropic Hormone/blood , Hydrocortisone/blood , Pituitary ACTH Hypersecretion/complications , Pituitary Neoplasms/blood , Adenoma/etiology , Adenoma/pathology , Adolescent , Adult , Aged , Child , Enzyme-Linked Immunosorbent Assay , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Recurrence, Local , Pituitary ACTH Hypersecretion/physiopathology , Pituitary Neoplasms/etiology , Pituitary Neoplasms/pathology , Retrospective Studies , Young Adult
12.
Vet Parasitol ; 224: 92-95, 2016 Jul 15.
Article in English | MEDLINE | ID: mdl-27270396

ABSTRACT

Toxoplasma gondii isolates from Brazil have a different phenotypic and genotypic pattern, with predominance of virulent isolates and recombinant genotypes, compared to the North Hemisphere. Considering that a new T. gondii genotype, non-pathogenic to mice, was previously identified from free-range chickens from the Fernando de Noronha Island, Brazil, this study aimed to identify genotypes of this parasite in tissue samples of feral cats (Felis catus) from this Brazilian Island. Anti-T. gondii IgG antibodies were detected in 18/31 (58%) feral cats. Two non-virulent T. gondii isolates were obtained by mouse bioassay. Genotyping was performed by PCR-RFLP using 10 genetic markers (SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, PK1, L358 and Apico) and an atypical strain of T. gondii (ToxoDB #146) was identified. This is the first report of this genotype in feral cats.


Subject(s)
Toxoplasma/genetics , Toxoplasma/pathogenicity , Toxoplasmosis, Animal/parasitology , Animals , Antibodies, Protozoan/blood , Brazil , Cats , DNA, Protozoan/genetics , Genetic Markers/genetics , Genotype , Islands , Mice , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Toxoplasma/isolation & purification , Virulence/genetics
13.
Arch Soc Esp Oftalmol ; 91(10): 501-4, 2016 Oct.
Article in English, Spanish | MEDLINE | ID: mdl-27156033

ABSTRACT

OBJECTIVE: To present the results on the use of a single block limbal autograft, combined with amniotic membrane transplantation and sectoral sequential postoperative epitheliectomy of the conjunctiva in 2 patients with unilateral total limbal stem cell deficiency. CONCLUSIONS: A single block limbal autograft combined with amniotic membrane transplantation may be sufficient to restore a stable corneal surface, but sometimes sequential sectoral conjunctival epitheliectomy may be required to treat anomalous epithelial remnants.


Subject(s)
Corneal Diseases/surgery , Corneal Transplantation/methods , Female , Humans , Limbus Corneae/surgery , Middle Aged , Transplantation, Autologous/methods , Young Adult
15.
Rev Clin Esp (Barc) ; 216(6): 301-7, 2016.
Article in English, Spanish | MEDLINE | ID: mdl-27118137

ABSTRACT

OBJECTIVE: The tobacco paradox is a phenomenon insufficiently explained by previous studies. This study analyses the prognostic role of prior or active smoking in patients with acute coronary syndrome. METHODS: We obtained data from the ARIAM registry, between 2001 and 2012. The study included 42,827 patients with acute coronary syndrome (mean age, 65±13 years; 26.4% women). The influence of smoking and that of being an ex-smoker on mortality was analysed using a multivariate analysis. RESULTS: The smokers were younger, were more often men, had less diabetes, hypertension and prior history of heart failure, stroke, arrhythmia and renal failure and more frequently had ST-elevation and a family history of smoking. The ex-smokers had more dyslipidaemia and history of angina, myocardial infarction, ischemic heart disease, peripheral vasculopathy and chronic bronchial disease. Smokers and ex-smokers less frequently developed cardiogenic shock (smokers 4.2%, ex-smokers 4.7% and nonsmokers 6.9%, P<.001). Hospital mortality was 7.8% for the nonsmokers, 4.9% for the ex-smokers and 3.1% for the smokers (P<.001). In the multivariate analysis, the smoker factor lost its influence in the prognosis (-0.26%, p=.52 using an inverse probability calculation; and+0.26%, P=.691 using a propensity analysis). However, the exsmoker factor showed a significant reduction in mortality in both tests (-2.4% in the inverse probability analysis, P<.001; and -1.5% in the propensity analysis, P=.005). CONCLUSIONS: The tobacco paradox is a finding that could be explained by other prognostic factors. Smoking cessation prior to hospitalization for acute coronary syndrome is associated with a better prognosis.

16.
Med. intensiva (Madr., Ed. impr.) ; 40(3): 163-168, abr. 2016. graf, tab
Article in Spanish | IBECS | ID: ibc-151562

ABSTRACT

OBJETIVO: No existe demasiada información sobre la evolución y estado neurológico a largo plazo de los pacientes en edad pediátrica que sobreviven a una parada cardiaca extrahospitalaria. Nuestro objetivo es describir la supervivencia y estado neurológico de estos pacientes a largo plazo. DISEÑO: Estudio observacional retrospectivo. Basado en el Registro Andaluz de Parada Cardiaca Extrahospitalaria. ÁMBITO: Atención Prehospitalaria. PACIENTES: Entre 0 y 15 años atendidos entre enero de 2008 y diciembre de 2012 por Parada Cardiaca Extrahospitalaria. Intervenciones: Seguimiento de pacientes. Variables: Se incluyen variables de la atención prehospitalaria, hospitalaria y del seguimiento al año y un seguimiento específico de los supervivientes en junio de 2014. RESULTADOS: Se incluyeron en el registro un total de 5069 pacientes de los que 125(2.5%) tenían 15 o menos años. La parada fue presenciada en el 52.8% de los casos y hubo reanimación previa en 65.6%. El ritmo inicial fue desfibrilable en 7 (5.2%) casos. Un 48.8% de los pacientes llegó al hospital aunque un 20% lo hizo en situación de reanimación en curso. De los 9 (7.2%) pacientes que sobrevivieron al alta hospitalaria, 5 de ellos lo hicieron con recuperación ad integrum y 4 con grave deterioro neurológico. Los 5 pacientes con recuperación completa mantuvieron su situación a largo plazo. Los 4 pacientes restantes, aunque con discreta mejoría, se mantuvieron en situación de discapacidad neurológica. CONCLUSIONES: La supervivencia de la parada cardiaca extrahospitalaria en edad pediátrica es baja. El pronóstico a largo plazo de los pacientes con buena recuperación neurológica desde el inicio se mantiene, aunque la mejoría en el resto es mínima


OBJECTIVE: Little is known about the evolution and long-term neurological status of pediatric patients who survive out-of-hospital cardiac arrest. Our aim is to describe long-term survival and neurological status. DESIGN: Retrospective observational study, based on the Andalusian Register of out-of-hospital Cardiac Arrest. SETTING: Pre-hospital Care. PATIENTS: The study included patients aged 0-15 years between January 2008 and December 2012. Interventions: Patients follow up. Variables: Prehospital and hospital care variables were analyzed and one-year follow-up was performed, along with a specific follow-up of survivors in June 2014. RESULTS: Of 5069 patients included in the register, 125 (2.5%) were aged less or equal15 years. Cardiac arrest was witnessed in 52.8% of cases and resuscitation was performed in 65.6%. The initial rhythm was shockable in 7 (5.2%) cases. Nearly half (48.8%) the patients reached the hospital alive, of whom 20% did so while receiving resuscitation maneuvers. Only 9 (7.2%) patients survived to hospital discharge; 5 showed ad integrum recovery and 4 showed significant neurological impairment. The 5 patients with complete recovery continued their long-term situation. The remaining 4 patients, although slight improvement, were maintained in situation of neurological disability. CONCLUSIONS: Survival after out-of-hospital cardiac arrest in pediatric patients was low. The long-term prognosis of survivors with good neurological recovery remains, although improvement in the rest was minimal


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Out-of-Hospital Cardiac Arrest/complications , Brain Damage, Chronic/epidemiology , Central Nervous System Diseases/epidemiology , Survival Analysis , Retrospective Studies
17.
Med Intensiva ; 40(3): 163-8, 2016 Apr.
Article in English, Spanish | MEDLINE | ID: mdl-26227868

ABSTRACT

OBJECTIVE: Little is known about the evolution and long-term neurological status of pediatric patients who survive out-of-hospital cardiac arrest. Our aim is to describe long-term survival and neurological status. DESIGN: Retrospective observational study, based on the Andalusian Register of out-of-hospital Cardiac Arrest. SETTING: Pre-hospital Care. PATIENTS: The study included patients aged 0-15 years between January 2008 and December 2012. INTERVENTIONS: Patients follow up. VARIABLES: Prehospital and hospital care variables were analyzed and one-year follow-up was performed, along with a specific follow-up of survivors in June 2014. RESULTS: Of 5069 patients included in the register, 125 (2.5%) were aged ≤15 years. Cardiac arrest was witnessed in 52.8% of cases and resuscitation was performed in 65.6%. The initial rhythm was shockable in 7 (5.2%) cases. Nearly half (48.8%) the patients reached the hospital alive, of whom 20% did so while receiving resuscitation maneuvers. Only 9 (7.2%) patients survived to hospital discharge; 5 showed ad integrum recovery and 4 showed significant neurological impairment. The 5 patients with complete recovery continued their long-term situation. The remaining 4 patients, although slight improvement, were maintained in situation of neurological disability. CONCLUSIONS: Survival after out-of-hospital cardiac arrest in pediatric patients was low. The long-term prognosis of survivors with good neurological recovery remains, although improvement in the rest was minimal.


Subject(s)
Nervous System Diseases/etiology , Out-of-Hospital Cardiac Arrest/mortality , Adolescent , Cardiopulmonary Resuscitation , Child , Child, Preschool , Emergency Medical Services , Female , Humans , Male , Out-of-Hospital Cardiac Arrest/complications , Prognosis , Retrospective Studies , Spain/epidemiology , Treatment Outcome
18.
Arq. bras. med. vet. zootec ; 66(5): 1585-1591, Sep-Oct/2014. graf
Article in Portuguese | LILACS | ID: lil-729747

ABSTRACT

O objetivo do presente trabalho foi utilizar métodos bacteriológicos e moleculares para a identificação do Mycobacterium bovis em lesões observadas em carcaças de bovinos durante a inspeção post mortem de rotina em matadouros-frigoríficos com serviço de inspeção oficial. Foram acompanhados o abate e a inspeção de 825.394 bovinos, sadios, ao exame ante mortem pelo serviço de inspeção oficial em 10 matadouros-frigoríficos do estado da Bahia, entre abril de 2009 e abril de 2012. Cento e oitenta bovinos apresentaram lesões sugestivas de tuberculose e outras linfadenites, as quais foram avaliadas quanto à presença de Mycobacterium bovis por exame bacteriológico e pela PCR multiplex. A maioria das lesões estava localizada em linfonodos do trato respiratório e 71% eram provenientes de bovinos machos com até 32 meses de idade. No isolamento bacteriano, 13,9% (25/180) das amostras apresentavam colônias pequenas, de superfície granular e de coloração creme-amareladas, em meio de cultura Stonebrink-Leslie, e o crescimento médio foi de 34 dias. Todos os esfregaços dos isolados evidenciaram BAAR, e, pela PCR multiplex, 56% (14/25) dos isolados foram identificados como M. bovis. A associação entre exame post mortem, bacteriológico e PCR multiplex permitiu a identificação do agente de forma rápida e em regiões com status sanitário de baixa prevalência, demonstrando ser importante para a detecção dos focos de tuberculose bovina e o auxílio nos programas de controle e erradicação da tuberculose...


The aim of the present study was to perform bacteriological and molecular methods for identification of Mycobacterium bovis in lesions derived from bovine carcasses detected during routine post-mortem examination in officially inspected slaughterhouses. We checked the slaughter and inspection of 825,394 bovines, health upon ante-mortem examination, by the official service in 10 slaughterhouses of Bahia state from April, 2009 to April 2012. Lesions suggestive of tuberculosis were collected from 180 bovines and further evaluated by bacteriology and multiplex PCR. The majority of lesions were located in the respiratory tract lymph nodes and 71% were from male bovines up to 32 months old. 13.9% of samples presented small, granular and creamy-yellowish colonies after being cultured in Stonebrink-Leslie with an average growth time of 34 days. All smears from the isolated samples were Acid Fast Bacilli (AFB) and among them 56% were identified by mPCR as M. bovis. Thus, the association between post-mortem examination, culture and multiplex PCR allowed the bacillus identification in a reduced time and in regions of low prevalence, pointing out its importance for bovine tuberculosis detection and as a supportive tool for the tuberculosis control and eradication program...


Subject(s)
Animals , Cattle , Bacteriology , Models, Molecular , Mycobacterium bovis , Sanitary Inspection , Abattoirs , Animal Culling , Food Inspection , Polymerase Chain Reaction , Tuberculosis, Bovine
19.
Int J Numer Method Biomed Eng ; 30(3): 430-45, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24574201

ABSTRACT

We analyse the effects of the air ambient temperature on the airflow across a Caucasian nasal cavity under different ambient temperatures using CFD simulations. A three-dimensional nasal model was constructed from high-resolution computed tomography images for a nasal cavity from a Caucasian male adult. An exhaustive parametric study was performed to analyse the laminar-compressible flow driven by two different pressure drops between the nostrils and the nasopharynx, which induced calm breathing flow rates ࣈ 5.7 L/min and ࣈ 11.3 L/min. The inlet air temperature covered the range - 10(o) C ⩽ To ⩽50(o) C. We observed that, keeping constant the wall temperature of the nasal cavity at 37(o) C, the ambient temperature affects mainly the airflow velocity into the valve region. Surprisingly, we found an excellent linear relationship between the ambient temperature and the air average temperature reached at different cross sections, independently of the pressure drop applied. Finally, we have also observed that the spatial evolution of the mean temperature data along the nasal cavity can be collapsed for all ambient temperatures analysed with the introduction of suitable dimensionless variables, and this evolution can be modelled with the help of hyperbolic functions, which are based on the heat exchanger theory.


Subject(s)
Air , Computer Simulation , Nasal Cavity/anatomy & histology , Nasal Cavity/physiology , Temperature , Humans , Male , Respiration , White People
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