Intervenciones para adultos con dependencia funcional y sus cuidadores durante la pandemia de COVID-19 / Interventions for functionally dependent adults and their caregivers during the COVID-19 pandemic

La pandemia de COVID-19 ha afectado a la población, perjudicando especialmente a los miembros de aquellos grupos sociales en situación de mayor vulnerabilidad. Estas poblaciones específicas, como aquellas con alguna dependencia funcional, podrían verse más afectadas por los efectos de la pandemia del COVID-19. Por lo tanto, el objetivo de este artículo fue describir las intervenciones para preservar la salud general, mantener la función y la independencia y prevenir la infección por COVID-19 para los adultos con dependencia funcional (ADF). Se realizó una búsqueda sistemática en bases de datos. Se revisaron los títulos y los resúmenes de cada publicación para determinar su relevancia. Dos revisores independientes accedieron a los artículos de texto completo para determinar su elegibilidad después de la selección inicial. Las búsquedas se realizaron en septiembre de 2021 y se actualizaron en enero y julio de 2022. La información encontrada se clasificó en 3 categorías: 1) ADF durante la pandemia de COVID-19; 2) ADF durante la pandemia de COVID-19 según una condición específica (condiciones neurológicas, discapacidades/deficiencias sensoriales y deterioro cognitivo), y 3) Adultos mayores con dependencia funcional. Los adultos con dependencia enfrentaron dificultades y barreras durante la pandemia por COVID-19. Las autoridades de cada país deben garantizar que los ADF tengan acceso a los servicios de rehabilitación en tiempos de crisis sanitaria. Además, es necesario aumentar la capacidad de los servicios de rehabilitación en tiempos de crisis como pandemias. De igual manera, se sugiere el fortalecimiento de estrategias como la telerehabilitación para evitar el deterioro o agravamiento de la funcionalidad de las personas dependientes. (AU)

The COVID-19 pandemic has affected the world population, especially people from social groups in a situation of greater vulnerability among people with some functional dependency. Therefore, the aim of this review was to describe interventions during the pandemic to preserve general health, maintain function and independence, and prevent COVID-19 infection for functionally dependent adults (FDA). A systematic search in databases was carried out. Titles and abstracts of each publication were reviewed for relevance. Full-text articles were accessed by two independent reviewers. The information found was classified into three categories: 1) FDA during the COVID-19 pandemic, 2) FDA during the COVID-19 pandemic according to a specific condition (neurological conditions, sensory disabilities/impairments, and cognitive impairment), and 3) Older adults with functional dependence. The FDAs have faced difficulties and barriers during the COVID-19 pandemic. Strengthening strategies such as telerehabilitation is suggested to avoid deterioration or aggravation of the functionality of dependent people. (AU)

[Interventions for functionally dependent adults and their caregivers during the COVID-19 pandemic]. / Intervenciones para adultos con dependencia funcional y sus cuidadores durante la pandemia de COVID-19.

The COVID-19 pandemic has affected the world population, especially people from social groups in a situation of greater vulnerability among people with some functional dependency. Therefore, the aim of this review was to describe interventions during the pandemic to preserve general health, maintain function and independence, and prevent COVID-19 infection for functionally dependent adults (FDA). A systematic search in databases was carried out. Titles and abstracts of each publication were reviewed for relevance. Full-text articles were accessed by two independent reviewers. The information found was classified into three categories: 1) FDA during the COVID-19 pandemic, 2) FDA during the COVID-19 pandemic according to a specific condition (neurological conditions, sensory disabilities/impairments, and cognitive impairment), and 3) Older adults with functional dependence. The FDAs have faced difficulties and barriers during the COVID-19 pandemic. Strengthening strategies such as telerehabilitation is suggested to avoid deterioration or aggravation of the functionality of dependent people.

Dodecagonal plasmonic quasicrystals for phage-based biosensing.

In this work, we fabricate and characterize a novel sensitive two-dimensional surface enhanced Raman spectroscopy (SERS) substrate made of plasmonic nanocavities in a photonic quasicrystal arrangement characterized by a 12-fold rotational symmetry. Our SERS device is capable of detecting chemisorbed bacteriophages at a femtomolar range. Most importantly, the paper presents for the first time a study on the procedure to functionalize the plasmonic quasicrystal with bacteriophages of the Podoviridae family. The immobilization of the phages on the plasmonic substrate has been studied and verified through SERS measurements. A new stable peak, visible in the SERS spectra at 1326 cm-1 at a greater than 60 times amplification, confirms the immobilization of the phages on the substrate. This functionalization approach can be used also for other types of phages or plasmonic sensors and hence, our achievements could allow the development of novel systems for the specific detection of different species of bacteria.

Engineered nanopatterned substrates for high-sensitive localized surface plasmon resonance: an assay on biomacromolecules.

In this paper, we report on novel iso-Y-shaped-nanopillar based photonic crystals (PCs) engineered for plasmonic lab-on-a-chip advanced diagnostics. The iso-Y shaped units are selected on the basis of their plasmonic properties, analyzed numerically and experimentally. We show that by accurately choosing the nanopillar shape, dimensions and their geometrical disposal it is possible to obtain efficient optical 2D structures for biomolecule detection by high-sensitive localized surface plasmonic resonance (LSPR). In particular, an assay is realized by using bovine serum albumin (BSA), a widely recognized model for biosystem studies. BSA was simply deposited on a self-assembled monolayer (SAM) of 4-mercaptobenzoic acid (4-MBA) previously grown-up on the plasmonic substrate. We demonstrate that the geometries considered allow the design of LSPR nano-assays working in the visible-NIR region based on both intensity interrogation and the resonance peak shift permitting the sensing of BSA with a limit of detection in the order of picomoles (LOD = 233 pM).

Structured beam diffraction.

We report on the observation of a modulated pattern induced by a single laser beam in a polymeric film. In spite of the simple geometrical configuration, the analysis of the far field diffraction pattern allows a sensitive retrieving of the wavelength of the recording beam and of its incidence angle, pointing out the high information content of the recorded spot. A theoretical model is presented which satisfactorily explains the observed behavior. It takes into account the interaction of structured light with structured matter with the same symmetries and spatial modulation frequencies close to each other. This result shows a feature of the interaction between structured light and structured matter which has not been explored yet.

Utilidad de la profilaxis para hemorragia digestiva. Estudio multicéntrico con 3438 casos / Utility of prophylaxis for digestive hemorrhage. Multicenter study with 3438 cases

Objetivos. Establecer la importancia de la profilaxis para prevenir la hemorragia digestiva en pacientes críticos, determinar los predictores del desarrollo de hemorragia digestiva en estos enfermos y cuantificar la neumonía intrahospitalaria. Materiales y métodos. Diseño prospectivo, observacional, longitudinal. Se estudiaron 3438 pacientes durante dos años. Luego de aplicar los criterios de exclusión y de eliminación, se evaluó a 3213 pacientes. La muestra fue consecutiva, se formaron dos grupos: con profilaxis (sucralfato o ranitidina) y sin profilaxis. Se registraron los siguientes datos: puntaje Apache II, disfunciones, diagnósticos de riesgo, hemorragia digestiva, neumonía intrahospitalaria, mortalidad. Resultados. Incidencia de hemorragia digestiva: 4,57%; con profilaxis frente a sin profilaxis: 4,64% y 4,50% (p = 0,91). Predictores de hemorragia digestiva en análisis multivariado: trauma grave (p = 0,0004), insuficiencia respiratoria (p = 0,0021), pancreatitis (p = 0,0202), insuficiencia renal aguda (p = 0,0220) y ayuno (p <0,0001). En pacientes con puntaje Apache II ≥15: trauma grave (p = 0,0228) y ayuno (p = 0,0000). Incidencia de neumonía intrahospitalaria 10,05%; con profilaxis y sin profilaxis: 11,47% y 8,68% (p = 0,001)(AU)

Objectives. Set the importance of prophylaxis for gastrointestinal bleeding in criticallly ill patients; determine predictors of gastrointestinal bleeding and quantify hospital-acquired pneumonia. Materials and methods. Prospective, observational and longitudinal design. A total of 3438 patients were studied during two years. After applying exclusion and elimination criteria, 3213 patients were left. It was a consecutive sample, and there were two groups; with prophylaxis (sucralfate or ranitidine) and without prophylaxis. Apache II, organ failures, risk diagnoses, digestive tract bleeding, hospital-acquired pneumonia and mortality were registered. Results. Gastrointestinal bleeding incidence: 4.57%, with vs. without prophylaxis: 4.64% vs. 4.50% (p = 0.91). Gastrointestinal bleeding predictors in the multivariate analysis: serious trauma: (p = 0.0004), respiratory failure (p = 0.0021), pancreatitis (p = 0.0202), acute renal failure (p = 0.0220) and fasting (p <0.0001). In Apache II ≥15 patients: serious trauma (p = 0.0228) and fasting (p = 0.0000). Incidence of hospital-acquired pneumonia: 10.05%, with vs. without prophylaxis: 11.47% vs. 8.68% (p = 0.001). Conclusions. Prophylaxis did not reduce gastrointestinal bleeding, it was associated with serious trauma, respiratory failure, pancreatitis, acute renal failure and fasting, and considering only patients with the worst Apache II score, it was associated with serious trauma and fasting. Acquired pneumonia was higher in the prophylaxis group.(AU)

Myocardial tissue Doppler assessment of diastolic function in the growth-restricted fetus.

OBJECTIVES: Myocardial tissue Doppler (MTD) is a technique for the measurement of myocardial velocities in systole and diastole. This study evaluates the use of MTD in the assessment of cardiac diastolic function in fetuses with intrauterine growth restriction (IUGR) with placental insufficiency and in appropriate-for-gestational age (AGA) fetuses with hypertensive mothers. METHODS: This study included 14 IUGR fetuses with placental insufficiency (Group 1), 13 AGA fetuses with hypertensive mothers (Group 2), and 29 AGA fetuses with healthy mothers (Group 3). Patients with other diseases were excluded. All fetuses had a gestational age of at least 25 weeks. MTD assessment was performed with the sample volume placed at the basal segment of the left ventricular side wall (LV), the interventricular septum (IVS) and the right ventricular free wall (RV). E'/A' ratios were calculated for each location. Mitral and tricuspid flows were assessed by conventional spectral pulsed Doppler. RESULTS: Significant differences were found between groups for E'/A' at the IVS (P < 0.001) and LV (P = 0.009), with a higher mean (+/- SD) value in Group 1 (IVS: 0.92 +/- 0.28; LV: 0.85 +/- 0.19) than in Groups 2 (IVS: 0.62 +/- 0.09; LV: 0.68 +/- 0.14) and 3 (IVS: 0.71 +/- 0.14; LV: 0.69 +/- 0.15). In the RV, there was no statistically significant difference in the E'/A' ratio (P = 0.2). No differences were observed for mitral and tricuspid flow velocities and ratios. CONCLUSIONS: Using MTD, the ratios between early and late diastolic myocardial velocities are higher in IUGR fetuses than in AGA fetuses at the IVS and the LV, regardless of the presence of maternal hypertension. MTD may be more sensitive than atrioventricular spectral Doppler for the detection of ventricular diastolic dysfunction in IUGR fetuses.

Nitroxide radical TEMPO reduces ozone-induced chemokine IL-8 production in lung epithelial cells.

Exposure to high levels of ozone (O(3)) damages respiratory tract epithelial cells. This research evaluated the ability of TEMPO (2,2,6,6-tetramethylpiperidine-N-oxyl), a stable nitroxide free radical, to decrease O(3)-mediated injury to a respiratory tract-derived cell line (A549 cells) by monitoring in this cell system the interleukine-8 (IL-8) production. TEMPO reduced O(3)-induced IL-8 production in A549 cells, as evidenced by PCR analysis, Western blot and ELISA assays. This behaviour is explainable on the basis of the reactivity between TEMPO with O(3) and/or O(3)-derived free radicals in biological systems. The study provides evidence that TEMPO reacts with O(3) and/or its cytotoxic products and may provide protections against O(3)-induced biotoxicities.

Esthesioneuroblastoma treated with external radiotherapy. Case report.

Esthesioneuroblastoma is a rare tumour arising from the olfactory epithelium of the nasal vault which frequently invades the cranial base and orbit. Esthesioneuroblastoma has a bimodal age distribution between 11 and 20 years and between 51 and 60 years. Esthesioneuroblastoma accounts for approximately 1-5% of intranasal cancers. The case is reported of a 79-year-old female patient with a Kadish stage C tumour with a one-year history of headache, nasal obstruction, anosmia, rhinorrhoea and epistaxis. Aim of this study is to analyse the natural history, treatment and prognosis of this tumour, based on a review of the literature.

[Multivariate analysis of prognostic factors and survival in patients with "glioblastoma multiforme"]. / Multivariate analysis of prognostic factors and survival inpatients with "glioblastoma multiforme".

PURPOSE: The aim of this study was to evaluate the survival of patients with "glioblastoma multiforme", to analyse the prognostic factors influencing the survival rate and to review recent results in the literature. MATERIALS AND METHODS: Seventy five patients underwent radiation treatment between May 1998 and April 2003. Among the factors under investigation we ascertained that sex, chemotherapy, conformal treatment, surgery, and the choice of the irradiation area (whole brain or only the involved field) did not influence the survival in a statistically significant manner. RESULTS: Whereas age and total dose were the 95% statistically significant variables. Hazard ratio of patients older than 58 years compared to younger patients was 1.69. The death risk was 69% in older than younger patients. A greater irradiation dose improved the survival with an increase of the median survival days. The total dose lower than 6000 cGy caused an increase of 81.8% in the death risk. The median survival from the diagnosis to the death was 14.7 months (446 days) and 1-, 2- and 3- year survival rate was 69.3%, 38.4%, and 14.7% respectively. CONCLUSIONS: The current medical literature and our experience attests that the use of temozolomide improves the survival of these patients.

Rapid mutagenesis and purification of phage RNA polymerases.

We have developed plasmid-based expression systems that encode modified forms of T7 RNA polymerase (RNAP) having 6-12 histidine residues fused to the amino terminus. The histidine-tagged RNAPs (His-T7 RNAPS) are indistinguishable from the wild-type (WT) enzyme in nearly all biochemical assays. Similar plasmids that encode His-tagged T3 and SP6 RNAPs have also been constructed. To facilitate site-directed mutagenesis of the RNAP gene, the size of the target plasmid was minimized by using T7 RNAP itself as a selectable marker. BL21 (DCAT4) cells (which carry a chromosomal copy of the chloramphenicol acetyltransferase cat gene under control of a T7 promoter) are resistant to chloramphenicol when functional T7 RNAP is expressed, thus allowing the selection and maintenance of the target plasmid in these cells. Mutagenesis is accomplished by denaturing the plasmid, annealing mutagenic DNA primers, and repairing the plasmid with T4 DNA polymerase. Two DNA primers are used: one corrects a defect in the bla gene, the other introduces the desired mutation into the RNAP gene; 30-85% of the ampicillin-resistant transformants carry the desired mutation in the RNAP gene. By using BL21 (DCAT4) cells as a recipient for transformation the functional integrity of the RNAP gene may conveniently be monitored by assessing the level of chloramphenicol resistance in vivo. Methods for rapid, simultaneous purification of multiple samples of modified (His-tagged) and conventional RNAPs are described. Together, these developments greatly enhance our ability to characterize this important class of enzymes.

Restoration of lipopolysaccharide-mediated B-cell response after expression of a cDNA encoding a GTP-binding protein.

Previous analysis of hybrid progeny derived from lipopolysaccharide (LPS) responder and nonresponder inbred mouse strains demonstrated that a single genetic locus controlled responsiveness to LPS. Using a differential functional screening approach, we report the isolation of a cDNA that has sequence homology to a GTP-binding protein. Expression of the cDNA in splenic B cells of C3H/HeJ nonresponder, endotoxin-resistant mice resulted in polyclonal B-cell activation in response to LPS stimulation. Thus a GTP-binding protein may be involved in LPS stimulation in B cells and perhaps other cell types.

RFLP-based genetic relationships of Einkorn wheats.

To study the relationships between different species of the Einkorn group, 55 different accessions ofTriticum monococcum,T. boeoticum,T. urartu,T. sinskajae,T. thaoudar andT. aegilopoides were analyzed. Fifteen anonymous probes and four clones corresponding to storage protein genes were used for detecting restriction fragment length polymorphisms (RFLPs). The DNA was restricted with the restriction enzymesAluI,HaeIII,RsaI andTaqI. The 25 probe/enzyme combinations employed yielded a total of 488 polymorphic fragments. Statistical analyses were performed using Jaccard's coefficient of similarity and principal coordinate analysis. Different values of similarity within the three main taxa,monococcum,boeoticum andurartu, were obtained; the grouping at the species level was quite well reflected by the RFLP analysis done here. The coincidence between RFLP data and the subspecies classification of theT. monococcum group was only partial. OneT. urartu accession is clearly different from all of the other 54 accessions. The need for an RFLP based revision of the Einkorn taxonomy is evident.

Reinserción social, capacidad funcional y supervivencia alejada al egreso de áreas críticas / Social reinsertion, functional capacity and survival far from leaving critical areas

Objetivos: 1) Establecer grado de supervivencia alejada (10 meses o más) al egreso de UTI; 2) Relacionar la mortalidad con los niveles de gravedad en la admisión (Score Mapuche) y el desarrollo de fracasos orgánicos (FO); 3) Relacionar las reinternaciones con el nivel de gravedad y la patología de base; 4) Evaluar la calidad de vida y el grado de reinserción laboral y social a través de parámetros objetivos y subjetivos; 5) Evaluar aspectos psíquicos y de relación médico-paciente referidos a la internación en UTI, según patología de base, y relacionarlos con secuelas psicofísicas posteriores y con reinternaciones; 6) Describir las características de la población fallecida al egreso de UTI. Material y métodos: Diseño prospectivo, observacional, transversal. Se incluyeron 105 pacientes asistidos en UTI y egresados vivos en 2 períodos: enero-septiembre 1991 y septiembre 1992-agosto 1993 (muestra azarizada), y pacientes nivel IV de la clasificación Mapuche y con 3 o más FO (en cualquier nivel), en iguales períodos, que egresaron vivos (muestra consecutiva). Se usaron como métodos estadísticos: media, porcentajes, desvío standar, chi cuadrado, T de Student y Test de Wilcoxon. Se registraron datos por revisión de Dbase y por encuesta personal o telefónica, referidos a supervivencia, y a las áreas psicológicas, afectiva, social, laboral, y a la capacidad funcional. Resultados y conclusiones: 1) Muestra con media de edad 60 años, 55 por ciento sexo M, el 67 por ciento internados menos de 6 días... 2) Sobrevivió el 79 por ciento,... 3) Mortalidad 21 por ciento... 4) Se reinternó el 16,8 por ciento... 5) El 31 por ciento presentó amnesia al egreso... 6) El 22 por ciento quienes trabajaban dejó de hacerlo; 7) El deterioro de las actividades cotidianas fue entre 13 y 61,4 por ciento; 8) El 14,4 por ciento presentó deterioro psíquico; 9) El 17 por ciento tuvo molestias en su internación, y el 50 por ciento de las mismas se debió a factores humanos del personal; 10) Se presentó miedo en el 24 por ciento... 11) Se halló relación entre deterioro psíquico y malas experiencias durante la internación... 12) El consumo de fármacos fue más alto al egreso; 13) Se observaron diferencias de mortalidad en pacientes de niveles I y II con menos de 3 FO; 14) El Mapuche mostró diferencias significativas entre fallecidos y sobrevivientes, no así los FO; 15) Hubo distinta mortalidad en ambos períodos, asociada a diferencias en el Mapuche (sin diferencias de edad y FO)

Reinserción social, capacidad funcional y supervivencia alejada al egreso de áreas críticas / Social reinsertion, functional capacity and survival far from leaving critical areas

Objetivos: 1) Establecer grado de supervivencia alejada (10 meses o más) al egreso de UTI; 2) Relacionar la mortalidad con los niveles de gravedad en la admisión (Score Mapuche) y el desarrollo de fracasos orgánicos (FO); 3) Relacionar las reinternaciones con el nivel de gravedad y la patología de base; 4) Evaluar la calidad de vida y el grado de reinserción laboral y social a través de parámetros objetivos y subjetivos; 5) Evaluar aspectos psíquicos y de relación médico-paciente referidos a la internación en UTI, según patología de base, y relacionarlos con secuelas psicofísicas posteriores y con reinternaciones; 6) Describir las características de la población fallecida al egreso de UTI. Material y métodos: Diseño prospectivo, observacional, transversal. Se incluyeron 105 pacientes asistidos en UTI y egresados vivos en 2 períodos: enero-septiembre 1991 y septiembre 1992-agosto 1993 (muestra azarizada), y pacientes nivel IV de la clasificación Mapuche y con 3 o más FO (en cualquier nivel), en iguales períodos, que egresaron vivos (muestra consecutiva). Se usaron como métodos estadísticos: media, porcentajes, desvío standar, chi cuadrado, T de Student y Test de Wilcoxon. Se registraron datos por revisión de Dbase y por encuesta personal o telefónica, referidos a supervivencia, y a las áreas psicológicas, afectiva, social, laboral, y a la capacidad funcional. Resultados y conclusiones: 1) Muestra con media de edad 60 años, 55 por ciento sexo M, el 67 por ciento internados menos de 6 días... 2) Sobrevivió el 79 por ciento,... 3) Mortalidad 21 por ciento... 4) Se reinternó el 16,8 por ciento... 5) El 31 por ciento presentó amnesia al egreso... 6) El 22 por ciento quienes trabajaban dejó de hacerlo; 7) El deterioro de las actividades cotidianas fue entre 13 y 61,4 por ciento; 8) El 14,4 por ciento presentó deterioro psíquico; 9) El 17 por ciento tuvo molestias en su internación, y el 50 por ciento de las mismas se debió a factores humanos del personal; 10) Se presentó miedo en el 24 por ciento... 11) Se halló relación entre deterioro psíquico y malas experiencias durante la internación... 12) El consumo de fármacos fue más alto al egreso; 13) Se observaron diferencias de mortalidad en pacientes de niveles I y II con menos de 3 FO; 14) El Mapuche mostró diferencias significativas entre fallecidos y sobrevivientes, no así los FO; 15) Hubo distinta mortalidad en ambos períodos, asociada a diferencias en el Mapuche (sin diferencias de edad y FO) (AU)