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1.
Environ Sci Pollut Res Int ; 31(20): 28870-28889, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38564130

ABSTRACT

Urbanization in watersheds leads to the introduction of sources of microplastics and other pollutants in water bodies. However, the effect of urbanization on microplastic pollution and the relationship between microplastics and water quality are not well understood. We assessed the distribution of microplastics in tributaries urbanized, non-urbanized and in the receiving lagoon body of Conceição Lagoon watershed. The results show that urbanization significantly affects water quality but does not differentiate tributaries in terms of microplastic concentrations. Microplastic concentrations were lower in the receiving lagoon body compared with the tributaries, highlighting their importance in microplastic pollution in the studied lagoon. Microplastic concentration was correlated with low N:P ratios in the lagoon and associated with high levels of total phosphorus, which indicate the discharge of effluents. The correlations between microplastic concentration, water temperature, and dissolved oxygen in the lagoon were based on the temporal variations of these variables. Precipitation and wind velocity had influence on microplastic distribution in the watershed. Our findings underscore the importance of evaluating water quality parameters and meteorological variables to comprehend the microplastic distribution at small watersheds.


Subject(s)
Environmental Monitoring , Microplastics , Urbanization , Water Pollutants, Chemical , Water Quality , Brazil , Microplastics/analysis , Water Pollutants, Chemical/analysis
2.
J Prosthet Dent ; 131(2): 251.e1-251.e7, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38368000

ABSTRACT

STATEMENT OF PROBLEM: Little is known about the effect of different composite resin cements on the bond strength of prefabricated and milled glass fiber post-and-cores. PURPOSE: The purpose of this in vitro study was to compare the push-out bond strengths of root dentin and standard, relined, or computer-aided design and computer-aided manufacturing (CAD-CAM) glass fiber post-and-cores luted with conventional, universal, or self-adhesive composite resin cement. MATERIAL AND METHODS: Post spaces were prepared in 90 premolars. Standard and relined prefabricated and CAD-CAM-milled glass fiber post-and-cores were luted with conventional (RelyX ARC; 3M ESPE), universal (RelyX Ultimate; 3M ESPE), and self-adhesive (RelyX U200; 3M ESPE) composite resin cement (n=10). All specimens were thermally aged (5000 cycles at 5°C and 55°C with a 20-second dwell time) and mechanical fatigue (1 000 000 cycles at 2 Hz, 50-N load). The specimens were sectioned perpendicularly to the root long axis into 1-mm-thick sections (apical, middle, and cervical root thirds), the push-out bond strength was determined, and the mode of failure recorded. Data were submitted to the Kruskal-Wallis test followed by the Bonferroni-Dunn multiple comparison test (α=.05). RESULTS: Push-out bond strength values did not differ (P>.05) among posts at the same root thirds. Standard posts showed higher bond strength than CAD-CAM at the apical third for data grouped by composite resin cements (P<.001). The cervical root thirds had higher bond strength than the apical thirds (P<.05). The cervical, middle, and apical root thirds showed decreasing bond strength values for each type of post for data grouped by composite resin cement (P<.001). Adhesive failures at the dentin-cement interface were predominant. CONCLUSIONS: The type of posts and cements did not affect the bond strength of glass fiber posts. The cervical root thirds had better bonding performance than the apical thirds.


Subject(s)
Dental Bonding , Post and Core Technique , Composite Resins/therapeutic use , Resin Cements/therapeutic use , Resin Cements/chemistry , Glass , Glass Ionomer Cements , Computer-Aided Design , Materials Testing , Dentin , Dental Pulp Cavity , Dental Stress Analysis
3.
BMC Oral Health ; 23(1): 394, 2023 06 15.
Article in English | MEDLINE | ID: mdl-37322456

ABSTRACT

BACKGROUND: This systematic review and network meta-analysis aimed to compare the clinical efficacy of bioactive and conventional restorative materials in controlling secondary caries (SC) and to provide a classification of these materials according to their effectiveness. METHODS: A search was performed in Pubmed, Web of Science, Embase, BBO, Lilacs, Cochrane Library, Scopus, IBECS and gray literature. Clinical trials were included, with no language or publication date limitations. Paired and network meta-analyses were performed with random-effects models, comparing treatments of interest and classifying them according to effectiveness in the permanent and deciduous dentition and at 1-year or 2/more years of follow-up. The risk of bias and certainty of evidence were evaluated. RESULTS: Sixty-two studies were included in the qualitative syntheses and 39 in the quantitative ones. In permanent teeth, resin composite (RC) (RR = 2.00; 95%CI = 1.10, 3.64) and amalgam (AAG) (RR = 1.79; 95%CI = 1.04, 3.09) showed a higher risk of SC than Glass Ionomer Cement (GIC). In the deciduous teeth, however, a higher risk of SC was observed with RC than with AAG (RR = 2.46; 95%CI = 1.42, 4.27) and in GIC when compared to Resin-Modified Glass Ionomer Cement (RMGIC = 1.79; 95%CI = 1.04, 3.09). Most randomized clinical trials studies showed low or moderate risk of bias. CONCLUSION: There is a difference between bioactive restorative materials for SC control, with GIC being more effective in the permanent teeth and the RMGIC in the deciduous teeth. Bioactive restorative materials can be adjuvants in the control of SC in patients at high risk for caries.


Subject(s)
Dental Caries Susceptibility , Dental Caries , Humans , Network Meta-Analysis , Dental Materials/therapeutic use , Dental Caries/prevention & control , Dental Caries/drug therapy , Composite Resins/therapeutic use , Treatment Outcome , Glass Ionomer Cements/therapeutic use , Dental Restoration, Permanent
4.
SAGE Open Med Case Rep ; 11: 2050313X231154064, 2023.
Article in English | MEDLINE | ID: mdl-36816823

ABSTRACT

During the coronavirus disease 2019 pandemic, Ecuador reported a collapse of the healthcare system, in which intensive care unit beds were lacking. Therefore, we sought to determine whether the use of threshold expiratory positive pressure with an adult non-rebreather oxygen mask plus prone positioning is useful for improving oxygenation. Twelve patients were included. Eight patients (66.7%) survived, while four patients (33.3%) died. Baseline arterial oxygen saturation (%) prior placement median (interquartile range) 85.5% (80%-89%) and arterial oxygen saturation (%) post placement of the device was median (interquartile range) (93%-96%) (P = 0.0001). Respiratory rate before placement was median (interquartile range) 38 (36-42) and post placement of the device was median (interquartile range) 24 (22-30) (P = 0.0005). The use of an adapted device might be useful for the management of acute hypoxemic respiratory failure due to severe acute respiratory syndrome coronavirus 2 pneumonia, particularly when mechanical ventilators and high-flow oxygen systems are unavailable.

5.
PeerJ ; 10: e14313, 2022.
Article in English | MEDLINE | ID: mdl-36389402

ABSTRACT

Biodiversity assessment is a mandatory task for sustainable and adaptive management for the next decade, and long-term ecological monitoring programs are a cornerstone for understanding changes in ecosystems. The Brazilian Long-Term Ecological Research Program (PELD) is an integrated effort model supported by public funds that finance ecological studies at 34 locations. By interviewing and compiling data from project coordinators, we assessed monitoring efforts, targeting biological groups and scientific production from nine PELD projects encompassing coastal lagoons to mesophotic reefs and oceanic islands. Reef environments and fish groups were the most often studied within the long-term projects. PELD projects covered priority areas for conservation but missed sensitive areas close to large cities, as well as underrepresenting ecosystems on the North and Northeast Brazilian coast. Long-term monitoring projects in marine and coastal environments in Brazil are recent (<5 years), not yet integrated as a network, but scientifically productive with considerable relevance for academic and human resources training. Scientific production increased exponentially with project age, despite interruption and shortage of funding during their history. From our diagnosis, we recommend some actions to fill in observed gaps, such as: enhancing projects' collaboration and integration; focusing on priority regions for new projects; broadening the scope of monitored variables; and, maintenance of funding for existing projects.


Subject(s)
Biodiversity , Ecosystem , Animals , Humans , Brazil , Oceans and Seas , Fishes
6.
Biol Bull ; 243(1): 14-27, 2022 08.
Article in English | MEDLINE | ID: mdl-36108041

ABSTRACT

AbstractInsular land crabs (Gecarcinidae) can transit between terrestrial and aquatic environments and inhabit vacant ecological niches that other species do not occupy in oceanic islands. During the reproductive period, these crabs migrate between residential and reproductive areas; this is a critical moment because individuals are more vulnerable to stressful conditions, especially species occupying anthropized islands. Currently, many insular crab species are considered threatened; yet few studies have evaluated the biology of this group, especially the size at which individuals reach sexual maturity. Here, we evaluate the size at the onset of morphological, physiological, and functional maturity for the insular land crab Johngarthia lagostoma in Trindade Island (Brazil) and assess the chronology of the events underlying those processes. Males and females exhibited the same order of occurrence of the different maturity processes, starting by being morphologically, physiologically, and, finally, functionally mature at similar sizes (about 56 mm carapace width). This value corresponds to at least half of the maximum size that J. lagostoma reaches in Trindade Island and is close to the average relative value registered to other Gecarcinidae species. Considering the current decline in the population of insular crabs, such estimates can be used in management programs, mainly for the definition and protection of breeding and recruitment areas. Specifically, our results can be used toward the conservation of J. lagostoma, which is currently classified as endangered in Brazil, especially in the isolated population of Trindade Island.


Subject(s)
Brachyura , Animals , Brachyura/physiology , Brazil , Ecosystem , Female , Humans , Male , Reproduction/physiology
9.
Clin Oral Investig ; 26(2): 1915-1925, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34505917

ABSTRACT

OBJECTIVES: To evaluate the effect of strontium-containing titanium- and/or magnesium-doped phosphate bioactive glass on the control of dental erosion. MATERIALS AND METHODS: Fifty fragments of human enamel were divided into five groups: negative control, 45S5 bioglass, strontium-containing Ti-doped phosphate bioactive glass (PBG-Ti), strontium-containing Mg-doped phosphate bioactive glass (PBG-Mg), and strontium-containing Ti- and Mg-doped phosphate bioactive glass (PBG-TiMg). The specimens underwent cycles of erosive challenge twice daily for 5 days with 1 mL of citric acid for 2 min followed by 1 mL of the suspension with bioactive substances for 3 min. After the cycles, profilometry, roughness and microhardness testing, and scanning electron microscopy (SEM) were performed. The following statistical tests were used: one-way ANOVA (profile, roughness, and surface microhardness (%VMS) data variation), Tukey's HSD (%VMS), Games-Howell test (profilometry), Student's t test (roughness), and Pearson's correlation between the variables. RESULTS: The lower loss of enamel surface and lower %VMS was observed in the PBG-Mg and PBG-TiMg groups, and only the PBG-Mg group showed similar roughness between baseline and eroded areas (p > 0.05). On SEM micrographs, PBG-Ti and PBG-Mg groups showed lower apparent demineralization. CONCLUSION: All bioactive materials protected the enamel against erosion. However, strontium-containing phosphate bioactive glasses showed lower enamel loss, and the presence of Mg in these bioactive glasses provided a greater protective effect. CLINICAL RELEVANCE: Experimental strontium-containing phosphate bioactive glasses are effective in controlling enamel erosion. The results obtained in this study will guide the development of new dental products.


Subject(s)
Magnesium Oxide , Tooth Erosion , Dental Enamel , Glass , Humans , Phosphates , Strontium , Titanium , Tooth Erosion/prevention & control
10.
Front Pediatr ; 9: 742916, 2021.
Article in English | MEDLINE | ID: mdl-34869100

ABSTRACT

Pediatric Intensive Care Units (PICUs) provide multidisciplinary care to critically ill children and their families. Grief is present throughout the trajectory of illness and can peak around the time of death or non-death losses. The objective of this study was to assess how PICUs around the world implement grief and bereavement care (GBC) as part of an integrated model of care. This is a multicenter cross-sectional, prospective survey study. Questionnaires with multiple-choice and open-ended questions focusing on unit infrastructure, personnel, policies, limited patient data, and practices related to GBC for families and health care professionals (HCPs) were completed by on-site researchers, who were HCPs on the direct care of patients. PICU fulfillment of GBC goals was evaluated using a custom scoring based on indicators developed by the Initiative for Pediatric Palliative Care (IPPC). We compared average total and individual items fulfillment scores according to the respective country's World Bank income. Patient characteristics and details of unit infrastructure were also evaluated as potential predictors of total GBC fulfillment scores. Statistical analysis included multilevel generalized linear models (GLM) with a Gaussian distribution adjusted by child age/gender and clustering by center, using high income countries (HICs) as the comparative reference. Additionally, we applied principals of content analysis to analyze and summarize open-ended answers to contextualize qualitative data. The study included 34 PICUs from 18 countries: high-income countries (HICs): 32.4%, upper middle-income countries (UMICs): 44.1%, low middle-income and low-income countries (LMI/LICs): 23.5%. All groups reported some compliance with GBC goals; no group reported perfect fulfillment. We found statistically significant differences in GBC fulfillment scores between HICs and UMICs (specifically, HCP grief support), and between HICs and LMICs (specifically, family grief support and HCP grief support). PICUs world-wide provide some GBC, independent of income, but barriers include lack of financial support, time, and training, overall unit culture, presence of a palliative care consultation service, and varying cultural perceptions of child death. Disparities in GBC for families and HCPs exist and were related to the native countries' income level. Identifying barriers to support families and HCPs, can lead to opportunities of improving GBC in PICUs world-wide.

11.
Crit Care Res Pract ; 2021: 7793657, 2021.
Article in English | MEDLINE | ID: mdl-34873453

ABSTRACT

INTRODUCTION: This study intends to determine the Apnea-Hypopnea Index in patients hospitalized with acute hypercapnic respiratory failure from chronic obstructive pulmonary disease exacerbation, who require noninvasive ventilation with average volume-assured pressure support (AVAPS), as well as describes the clinical characteristics of these patients. MATERIALS AND METHODS: We designed a single-center prospective study. The coexistence of Apnea-Hypopnea Index and clinical, gasometric, spirometric, respiratory polygraphy, and ventilatory characteristics were determined. The clinical characteristics found were categorized and compared according to the Apnea-Hypopnea Index (AHI) < 5, AHI 5-15, and AHI >15. A p value <0.05 was considered statistically significant. RESULTS: During the study period, a total of 100 patients were admitted to the ICU with a diagnosis of acute hypercapnic respiratory failure due to COPD exacerbation. 72 patients presented with acute respiratory failure and fulfilled criteria for ventilatory support. Within them, 24 received invasive mechanical ventilation and 48 NIV. After applying the inclusion criteria for this study, 30 patients were eligible. An AHI >5 was present in 24 of the 30 patients recruited (80%). Neck circumference (cm), Epworth scale, and Mallampati score evidenced significant differences when compared to the patient's AHI <5, AHI 5-15, and AHI >15 (p < 0.05). Furthermore, patients with an AHI >5 had longer hospital admissions, prolonged periods on mechanical ventilation, and a higher percentage of intubation rates. CONCLUSION: Apnea-Hypopnea Index and chronic obstructive pulmonary disease exacerbation are a frequent association found in patients with acute hypercapnic respiratory failure and COPD exacerbations that require NIV. This association could be a determining factor in the response to NIV, especially when AVAPS is used as a ventilatory strategy.

12.
Front Pediatr ; 9: 746489, 2021.
Article in English | MEDLINE | ID: mdl-34778135

ABSTRACT

The adequate assessment and management of pain remains a challenging task in the Pediatric Intensive Care Unit (PICU). Our goal is to describe how pain is assessed and managed in PICUs around the world and to examine how human and material resources impact achievement of this goal. An international multicenter cross-sectional observational study was designed with the participation of 34 PICUs located in urban, suburban, and rural areas of 18 countries. We evaluated how PICUs around the world assessed and managed pain according to the Initiative for Pediatric Palliative Care recommendations, and how human and material resources impacted achievement of this goal. Data was collected for this study from 2016 to 2018 using questionnaires completed by medical doctors and nurses. In this paper, we focus on the indicators related to how pain is managed and assessed. The average achievement of the goal of pain relief across all centers was 72.2% (SD: 21.1). We found a statistically significant trend of more effective pain management scores, routine assessment, proper documentation, and involvement of pain management experts by increasing country income. While there are efforts being made worldwide to improve the knowledge in pain assessment and management, there is a lack of resources to do so appropriately in low-middle-income countries. There is a mismatch between the existing guidelines and policies, which are mainly designed in high income countries, and the resources available in lower resourced environments.

13.
Cancers (Basel) ; 13(19)2021 Sep 26.
Article in English | MEDLINE | ID: mdl-34638300

ABSTRACT

We performed a retrospective analysis of angiosarcoma (AS) genomic biomarkers and their associations with the site of origin in a cohort of 143 cases. Primary sites were head and neck (31%), breast (22%), extremity (11%), viscera (20%), skin at other locations (8%), and unknown (9%). All cases had Next Generation Sequencing (NGS) data with a 592 gene panel, and 53 cases had Whole Exome Sequencing (WES) data, which we used to study the microenvironment phenotype. The immunotherapy (IO) response biomarkers Tumor Mutation Burden (TMB), Microsatellite Instability (MSI), and PD-L1 status were the most frequently encountered alteration, present in 36.4% of the cohort and 65% of head and neck AS (H/N-AS) (p < 0.0001). In H/N-AS, TMB-High was seen in 63.4% of cases (p < 0.0001) and PDL-1 positivity in 33% of cases. The most common genetic alterations were TP53 (29%), MYC amplification (23%), ARID1A (17%), POT1 (16%), and ATRX (13%). H/N-AS cases had predominantly mutations in TP53 (50.0%, p = 0.0004), POT1 (40.5%, p < 0.0001), and ARID1A (33.3%, p = 0.5875). In breast AS, leading alterations were MYC amplification (63.3%, p < 0.0001), HRAS (16.1%, p = 0.0377), and PIK3CA (16.1%, p = 0.2352). At other sites, conclusions are difficult to generate due to the small number of cases. A microenvironment with a high immune signature, previously associated with IO response, was evenly distributed in 13% of the cases at different primary sites. Our findings can facilitate the design and optimization of therapeutic strategies for AS.

15.
SAGE Open Med Case Rep ; 9: 2050313X211045232, 2021.
Article in English | MEDLINE | ID: mdl-34540229

ABSTRACT

During March and April 2020, Ecuador was the country with the highest death toll in Latin America due to the coronavirus disease 2019 pandemic. Simultaneously, research was being developed and published globally, and to a certain extent, guided therapeutic approaches in real time, mostly in under-resourced settings. We present the case of a 59-year-old male physician residing in Guayaquil, who presented with severe coronavirus disease 2019, in which mechanical ventilation, prone position, and pulmonary protective ventilatory strategy were used. We discuss the clinical management of the first reported case in the literature of a physician in Ecuador who survived severe acute respiratory syndrome coronavirus 2 infection, as well as the topic of self-medication within health professionals, the management approach that was emerging at the moment in scientific publications and guiding treatment, the role of responsible research and its worldwide impact, and the emotional burdens of the care team who had to make very difficult decisions in extremely adverse circumstances.

16.
Sci Rep ; 11(1): 15714, 2021 08 03.
Article in English | MEDLINE | ID: mdl-34344925

ABSTRACT

Ocean plankton comprise organisms from viruses to fish larvae that are fundamental to ecosystem functioning and the provision of marine services such as fisheries and CO2 sequestration. The latter services are partly governed by variations in plankton community composition and the expression of traits such as body size at community-level. While community assembly has been thoroughly studied for the smaller end of the plankton size spectrum, the larger end comprises ectotherms that are often studied at the species, or group-level, rather than as communities. The body size of marine ectotherms decreases with temperature, but controls on community-level traits remain elusive, hindering the predictability of marine services provision. Here, we leverage Tara Oceans datasets to determine how zooplankton community composition and size structure varies with latitude, temperature and productivity-related covariates in the global surface ocean. Zooplankton abundance and median size decreased towards warmer and less productive environments, as a result of changes in copepod composition. However, some clades displayed the opposite relationships, which may be ascribed to alternative feeding strategies. Given that climate models predict increasingly warmed and stratified oceans, our findings suggest that zooplankton communities will shift towards smaller organisms which might weaken their contribution to the biological carbon pump.

17.
Breast J ; 27(10): 768-775, 2021 10.
Article in English | MEDLINE | ID: mdl-34453383

ABSTRACT

BACKGROUND: Studies suggest that surgical breast augmentation with implants is a risk factor for breast desmoid tumors. The statistical strength of this correlation is unknown, as evidence is limited to anecdotal reports. METHODS: Patients with breast desmoid tumors and a history of breast implants seen at a single center between 2000 and 2021 were identified via radiology, breast, and sarcoma databases. The standardized incidence ratio (SIR) was calculated to assess the correlation between breast desmoid tumors and breast implants. The cases were pooled with published cases for analyses. Progression-free survival curves and hazard ratios were estimated using the Kaplan-Meier method and Cox proportional-hazards modeling. RESULTS: Fourteen patients from one institution and 66 cases in the literature were identified. All patients were female, and the mean age was 38 years old (range 20-66). 63 patients (82%) underwent resection, 9 (12%) received chemotherapy, 3 (4%) received sorafenib, 11 (14%) received hormonal therapy, and 3 (4%) underwent active surveillance. After resection, the 2-year recurrence-free survival rate was 77% (95% CI 65%-89%). The recurrence risk was lower for resection with no residual tumor (R0) compared to microscopic (R1) or macroscopic (R2) residual tumor (HR: 0.15; 95% CI 0.02-0.8; p < 0.05). The SIR was 482 (95% CI 259-775) to 823 (95% CI 442-1322), suggesting a 482-823 times higher risk of developing a breast desmoid tumor after breast augmentation than the general population. CONCLUSION: We present a nonrandom association between breast implants and desmoid tumors. Whether the tumors arise from the surgical trauma or the implant's biomaterial is unknown. When surgery is indicated, negative margins reduce the risk of recurrence.


Subject(s)
Breast Implants , Breast Neoplasms , Fibromatosis, Aggressive , Adult , Aged , Breast Neoplasms/epidemiology , Breast Neoplasms/etiology , Breast Neoplasms/surgery , Female , Fibromatosis, Aggressive/epidemiology , Fibromatosis, Aggressive/surgery , Humans , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Retrospective Studies , Young Adult
18.
Am J Case Rep ; 22: e930136, 2021 Jul 13.
Article in English | MEDLINE | ID: mdl-34253705

ABSTRACT

BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia has well-defined characteristics. We present a case of cavitary pneumonia due to MRSA in a patient who had undergone a recent outpatient gastroscopic procedure. CASE REPORT A 32-year-old man presented at the Emergency Department with tonic-clonic seizures of 2 min durations. He had a history of seizures without current treatment or use of psychostimulant drugs. His personal history referred to hypothyroidism treated with levothyroxine, morbid type 3 obesity, gastritis with a gastric ulcer, penicillin allergies, and an ambulatory endoscopy with a biopsy (7 days ago) for erosive gastropathy. On the 3rd day of admission to the Intensive Care Unit (ICU), a bronchoscopy was performed, which showed a reddened mucosa with hemorrhagic points and a cavitary area in the right main bronchus. Multiple polymerase chain reaction and mass spectrometry analyses of samples of bronchioalveolar lavage from the bronchus revealed MRSA with a mechanism of resistance to the mecA gene (1×105 colony-forming unit/mL). The laboratory results for the cerebrospinal fluid were negative for bacterial growth. CONCLUSIONS This is a rare case of cavitary pneumonia due to MRSA of clinical and epidemiological characteristics, which is unusual after an outpatient endoscopic procedure.


Subject(s)
Methicillin-Resistant Staphylococcus aureus , Pneumonia, Staphylococcal , Staphylococcal Infections , Adult , Anti-Bacterial Agents/therapeutic use , Endoscopy , Humans , Intensive Care Units , Male , Pneumonia, Staphylococcal/diagnosis , Pneumonia, Staphylococcal/drug therapy , Polymerase Chain Reaction , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy
19.
Eurasian J Med ; 53(2): 155-157, 2021 Jun.
Article in English | MEDLINE | ID: mdl-34177302

ABSTRACT

Ecuador, despite having taken aggressive and early measures to stop the progression of the pandemic (COVID-19), ended up becoming an epicenter of the pandemic in Latin America, and with the collapse of its health care system. The authors describe three patients who had confirmed COVID-19 and met the criteria for hospital admission but could not be assigned a hospital bed in a resource-limited country. The patients included a 72-year-old male, an 82-year-old female, and a 56-year-old male. They typically presented with fever, dyspnea, loss of taste and smell, diarrhea, and abdominal pain. Oxygen saturation during the initial evaluation ranged from 80-89%. Laboratory results reported lymphopenia and neutrophilia, with leukocytosis in two patients. Inflammatory markers were also elevated for all three patients. CT scan findings showed bilateral ground-glass pulmonary opacities. SARS-CoV-2 was confirmed in all three patients by real time polymerase chain reaction (RT-PCR) testing. Home-based treatment was established. At the time of writing this report, all patients remain asymptomatic and with negative COVID-19 testing. Telemedicine and home-based treatment were essential assets in the care of these severely ill patients living in a low-resource setting where not all patients who have criteria to be admitted into the hospital are able to find a place in a collapsed health care system.

20.
Cuad. psicol. deporte ; 20(3): 55-64, jul. 2020. tab
Article in English | IBECS | ID: ibc-193540

ABSTRACT

Binge-eating disorder (BED) is linked to several psychiatric disorders, such as anxiety disorders. Approximately 50-60% of BED patients are resistant to the traditional treatments available, and thus, strategies supporting the treatment of BED are needed, such as physical activity (PA). It seems to be an interesting strategy to reduce BED and anxiety symptoms. Thus, since PA has a role in reducing BED episodes and improving anxiety symptoms, then more research is needed to clarify the role of PA on BED, as correlations between anxiety-BED and anxiety-PA are established. Therefore, our aim is to examine the relationship between PA and anxiety in patients with BED. Thirty two patients we submitted to psychological and PA questionnaires. A Pearson's correlation coefficient and a multiple linear regression analysis were performed to relate eating disorder behaviour, anxiety and PA. The correlation coefficients between the dimensions of BED and anxiety were almost all significant (except restriction), positive and moderate (p < 0.001). Thus, the higher the eating disorder values, the higher the anxiety levels (p < 0.01). In conclusion, our findings support that PA correlates with anxiety in patients with BED, suggesting that PA may decrease symptoms, such as the appetite, weight and body shape concerns


El trastorno de compulsión alimentar periódico (TCAP) está vinculado a varios trastornos psiquiátricos, como los de ansiedad. Aproximadamente el 50-60% de los pacientes con TCAP son resistentes a los tratamientos tradicionales disponibles y, por lo tanto, se necesitan estrategias que apoyen el tratamiento de TCAP, como la actividad física (AF). La práctica de AF parece ser una estrategia interesante para reducir TCAP y síntomas de ansiedad. Por lo tanto, dado que la AF tiene un papel en la reducción de los episodios de TCAP y en la mejora de los síntomas de ansiedad, entonces se necesita más investigación para aclarar el rol moderador de la AF en la TCAP, ya que se establecen correlaciones entre ansiedad-TCAP y ansiedad-AF. Por lo tanto, el objetivo de este estudio fue examinar la asociación entre AF y ansiedad en pacientes con TCAP. Treinta y dos pacientes fueron sometidos a cuestionarios psicológicos y de AF. Se realizaron un coeficiente de correlación de Pearson y un análisis de regresión lineal múltiple para relacionar el comportamiento del TCAP, la ansiedad y la AF. Los coeficientes de correlación entre las dimensiones del TCAP y ansiedad fueron casi todos significativos (excepto restricción), positivos y moderados (p <0.001). Por lo tanto, cuanto más altos sean los valores del TCAP, mayores serán los niveles de ansiedad (p <0.01). En conclusión, nuestros hallazgos respaldan que la PA se correlaciona con la ansiedad en pacientes con BED, lo que sugiere que la PA puede disminuir los síntomas, como las preocupaciones sobre el apetito, el peso y la forma del cuerpo


O transtorno da compulsão alimentar periódica (TCE) está ligado a vários transtornos psiquiátricos, como os transtornos de ansiedade. Aproximadamente 50-60% dos pacientes com TCAP são resistentes aos tratamentos tradicionais disponíveis e, portanto, são necessárias estratégias de apoio ao tratamento, como a atividade física (AF). Parece ser uma estratégia interessante para reduzir os sintomas da TCAP e da ansiedade. Assim, como a AF tem um papel na redução de episódios de TCAP e melhora dos sintomas de ansiedade, são necessárias mais pesquisas para esclarecer o papel da AF na TCAP, à medida que são estabelecidas correlações entre ansiedade-TCLE e ansiedade-PA. Portanto, nosso objetivo é examinar a relação entre AF e ansiedade em pacientes com TCAP. Trinta e dois pacientes foram submetidos a questionários psicológicos e de AF. Um coeficiente de correlação de Pearson e uma análise de regressão linear múltipla foram realizadas para relacionar comportamento de transtorno alimentar, ansiedade e AF. Os coeficientes de correlação entre as dimensões do TCAP e ansiedade foram quase todos significativos (exceto restrição), positivos e moderados (p <0,001). Assim, quanto maiores os valores do transtorno alimentar, maiores os níveis de ansiedade (p <0,01). Em conclusão, nossos achados sustentam que a AF se correlaciona com a ansiedade em pacientes com TCAP, sugerindo que a AF pode diminuir os sintomas, como preocupações com apetite, peso e forma corporal


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Motor Activity/physiology , Feeding and Eating Disorders/therapy , Anxiety Disorders/therapy , Anxiety Disorders/complications , Feeding and Eating Disorders/etiology , Surveys and Questionnaires , Regression Analysis , Cross-Sectional Studies
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