ABSTRACT
Populations in isolated and small fragments lose genetic variability very fast and are usually of conservation concern because they are at greater risk of local extinction. The largest native deer in South America, Blastocerus dichotomus (Illiger, 1815), is a Vulnerable species according to the IUCN categorization, which inhabits tropical and subtropical swampy areas. In Argentina, its presence has been restricted to four isolated fragments. Here we examine the genetic diversity and differentiation among three of them, including the three different patches that form the southernmost population, using 18 microsatellite markers genotyped by Amplicon Sequencing of DNA extracted from fecal samples. Genetic diversity was low (HE < 0.45) in all three populations studied. We found three genetic clusters compatible with the geographic location of the samples. We also found a metapopulation dynamics that involves the patches that make up the southernmost population, with evidence of a barrier to gene flow between two of them. Our results point to the creation of a corridor as a necessary and urgent management action. This is the first study, at the population level, employing microsatellite genotyping by Amplicon Sequencing with non-invasive samples in an endangered species.
Subject(s)
Deer , Feces , Genetic Variation , Microsatellite Repeats , Animals , Deer/genetics , Microsatellite Repeats/genetics , Argentina , Genotype , Endangered Species , Genetics, Population , Gene FlowABSTRACT
. COL18A1 gene mutations have been associated with Knobloch syndrome, which is characterized by ocular and brain abnormalities. Here we report a 4.5 years-old male child with autism and two novel COL18A1 mutations (NM_030582.4: c.1883_1891dup and c.1787C>T). Hypermetropic astigmatism, but not brain migration disorders, was observed. However, an asymmetric pattern of cerebellar perfusion and a smaller arcuate fascicle were found. Low levels of collagen XVIII were also observed in the patient´s serum. Thus, biallelic loss-of-function mutations in COL18A1 may be a new cause of autism without the brain malformations typically reported in patients with Knobloch syndrome.
Subject(s)
Collagen Type XVIII , Endostatins , Cerebellum , Child, Preschool , Collagen Type XVIII/genetics , Encephalocele , Endostatins/genetics , Humans , Male , Mutation , Neuroimaging , Retinal Degeneration , Retinal Detachment/congenitalABSTRACT
Objetivo: Evaluar si la exposición a la violencia de género durante la gestación se relaciona con la interrupción voluntaria del embarazo y las complicaciones de salud neonatales que conlleven el ingreso en una Unidad de Cuidados Neonatales. Metodología: Estudio observacional, descriptivo y prospectivo, llevado a cabo en los dos centros de Atención a la Salud Sexual y Reproductiva de LHospitalet de Llobregat (Barcelona). Cumplimentaron el cuestionario validado de detección de violencia de género Index of Spouse Abuse las mujeres gestantes asistidas por matronas de los centros participantes. Conjuntamente, se recogieron variables sociodemográficas y obstétricas. Se realizó un análisis descriptivo, bivariante y multivariante de los datos. Resultados: Se obtuvo una muestra de 120 mujeres que solicitaron una interrupción voluntaria del embarazo y 381 que continuaron con la gestación. La prevalencia de violencia de género en el último año fue significativamente mayor (p <0,001) entre las mujeres gestantes que decidieron interrumpir el embarazo (25%) que entre las que decidieron continuar con el mismo (8,92%). La exposición a la violencia de género se asocia, después de ajustar otros factores explicativos, con un mayor riesgo de solicitar una interrupción voluntaria del embarazo (odds ratio [OR]= 4,06; intervalo de confianza [IC] del 95%: 2,23-7,48; p <0,001), y con un mayor riesgo de complicaciones neonatales (OR= 2,68; IC del 95%: 1,02-6,48). Conclusiones: La exposición a la violencia de género durante la gestación se relaciona con la interrupción voluntaria del embarazo y los ingresos del recién nacido por complicaciones de salud. Por ello, es necesario preguntar sobre violencia de género durante la asistencia sanitaria, tanto a las mujeres que continúan con el embarazo como a las que deciden interrumpirlo. (AU)
Objective: To assess whether exposure to intimate partner violence during pregnancy is associated with voluntary abortion and neonatal health complications that entail admittance to the Neonatal Care Unit. Methodology: Prospective, descriptive, observational study carried out in the two sexual and reproductive health care centers in LHospitalet de Llobregat (Barcelona, Spain). Pregnant women being assisted by midwives at the participating centres completed the Index of Spouse Abuse, the validated survey for detecting intimate partner violence. Sociodemographic and obstetrical data were collected concurrently. Bivariate, multivariate and descriptive analyses of the data were performed. Results: The sample size of women who voluntarily requested that their pregnancies be terminated was 120 and the sample size of women who brought their pregnancy to term was 381. The prevalence of intimate partner violence during the last year was significantly greater (p <0.001) among pregnant women who decided to terminate their pregnancies (25%) than among those who decided to carry their pregnancies to term (8.92%). After adjusting for other explanatory factors, exposure to intimate partner violence is associated with a greater risk of requesting an abortion (OR= 4.06; 95% CI= 2.23-7.48; p <0.001) and an increased risk of neonatal health complications (OR= 2.68; 95% CI= 1.02-6.48). Conclusions: Exposure to intimate partner violence during pregnancy is associated with voluntary abortion and neonatal health complications that entail admittance to the Neonatal Care Unit. Because of that, it is necessary to detect intimate partner violence during the provision of health care for both women who carry their pregnancies to term and those who decide to terminate them. (AU)
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Young Adult , Adult , Gender-Based Violence , Abortion, Induced , Epidemiology, Descriptive , Prospective Studies , Surveys and Questionnaires , Intensive Care Units, NeonatalABSTRACT
Resumen: Se presenta el caso de paciente masculino, de 60 años, programado para resección transuretral de próstata. Como antecedentes destacan enfermedad de Steinert e implantación de marcapasos. La enfermedad de Steinert es el antecedente principal que guiará nuestra práctica anestésica y, tras valorar el tipo de intervención prevista, se decide anestesia locorregional, dadas las potenciales complicaciones que pueden presentar estos pacientes con la anestesia general. La conducta anestésica de los pacientes con enfermedad de Steinert supone un reto para el anestesiólogo tanto por la gran cantidad de complicaciones que pueden aparecer en el intra- y en el postoperatorio, como por la baja frecuencia de esta enfermedad. Además, el estrés quirúrgico y las técnicas utilizadas pueden interferir en el curso de la enfermedad. Por todo ello, el abordaje y los cuidados intra- y postoperatorios se deben planificar y seleccionar con cuidado con el fin de obtener los mejores resultados y extremar la seguridad del paciente.
Abstract: A 60-year-old man with prostatic hypertrophy was scheduled for transurethral resection of the prostate. Steinert's disease and implantation of a pacemaker were his previous pathology. Being Steinert's disease the most relevant clinical characteristic and the type of intervention urologist has planned, we decide locoregional anesthesia technique, avoiding the potential complications that these patients may present with general anesthesia. The anesthetic management of Steinert's disease patients is a challenge for the anesthesiologist both due to the large number of complications that may appear during intra- and postoperative time as well as the low frequency of this pathology. In addition, surgical stress and the techniques we use can interfere with the course of the disease. Therefore, the approach and immediate intra-and postoperative care should be carefully planned and selected in order to obtain the best results and maximize patient safety.
ABSTRACT
Aim: Assessment of safety, tolerability and changes in global clinical impression with an multiallergen immunotherapy treatment without dilutional effect in polyallergic patients. Patients & methods: This observational prospective study included patients with allergic rhinitis-rhinoconjunctivitis with or without asthma between 5 and 60 years old receiving immunotherapy treatment with a mixture of two allergenic sources. All adverse events were recorded. Global clinical impression, tolerability subjective assessment and satisfaction were also assessed. Results: 130 patients were analyzed. Nine clinically relevant local adverse reactions were reported in six patients (4.6%). Six systemic reactions (grades 0-I) occurred in four patients (3.1%). Patients improved significantly in their global clinical impression. Good tolerability subjective assessment and satisfaction values were also observed. Conclusion: This multiallergen immunotherapy treatment without dilutional effect can be considered as a potential therapeutic alternative for polyallergic patients suffering from allergic rhinitis.
Subject(s)
Allergens/immunology , Asthma/therapy , Desensitization, Immunologic/methods , Pollen/immunology , Rhinitis, Allergic/therapy , Adolescent , Adult , Asthma/immunology , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Prospective Studies , Rhinitis, Allergic/immunology , Young AdultABSTRACT
Objetivo: Conocer a través de las narraciones de las matronas de Atención Primaria los factores que obstaculizan o contribuyen a la detección y el abordaje de la violencia de género durante el embarazo, así como sus propuestas de mejora para tal fin. Método: Estudio cualitativo con un enfoque fenomenológico interpretativo. Se hicieron entrevistas semiestructuradas a las 12 matronas que trabajan en los centros de Atención Primaria de LHospitalet de Llobregat (Barcelona). Resultados: Las dificultades en la detección se relacionan con el sistema de visitas, el contexto de las mujeres y barreras del propio profesional como el miedo. Destacan como factores facilitadores el seguimiento en el control del embarazo y la relación de confianza con la matrona. Las propuestas de mejora se relacionan con la formación y el uso de procedimientos seguros y fiables. Conclusiones: Sería deseable poner en marcha acciones de mejora, tales como ampliar la formación y consensuar un circuito interno de trabajo que incluya instrumentos objetivos de ayuda de la detección, la coordinación con otros servicios y la forma ética, y legalmente adecuada de registro en la historia clínica
Aim: To use the reflections of primary care midwives to find out the barriers and facilitators for detecting IPV during pregnancy. The second aim is to determine proposals for measures to improve detection of IPV. Method: Qualitative methodology with a interpretative phenomenological approach. In-depth interviews were conducted with 12 midwives, working in the sexual and reproductive health care centres of Hospitalet de Llobregat (Barcelona). Results: The difficulties in detection relate to the system of visits, the situation of women and barriers of practitioners themselves, such as fear. Follow-up of pregnancy and the relationship of trust with the midwife stand out as facilitators. The proposals for improvement were to increase training and use safe and reliable health care procedures. Conclusions: The complexity of IPV makes it likely that IPV during pregnancy is undetected. It would be desirable to implement actions such as expanding training and agreeing on an internal work circuit that includes objective instruments to detect IPV, coordination with other services and ethical and legally appropriate way of recording in the clinical record
Subject(s)
Humans , Female , Adult , Middle Aged , Nurse Midwives , Primary Nursing/methods , Gender-Based Violence/statistics & numerical data , Nurse's Role/psychology , 25783ABSTRACT
AIM: To use the reflections of primary care midwives to find out the barriers and facilitators for detecting IPV during pregnancy. The second aim is to determine proposals for measures to improve detection of IPV. METHOD: Qualitative methodology with a interpretative phenomenological approach. In-depth interviews were conducted with 12midwives, working in the sexual and reproductive health care centres of Hospitalet de Llobregat (Barcelona). RESULTS: The difficulties in detection relate to the system of visits, the situation of women and barriers of practitioners themselves, such as fear. Follow-up of pregnancy and the relationship of trust with the midwife stand out as facilitators. The proposals for improvement were to increase training and use safe and reliable health care procedures. CONCLUSIONS: The complexity of IPV makes it likely that IPV during pregnancy is undetected. It would be desirable to implement actions such as expanding training and agreeing on an internal work circuit that includes objective instruments to detect IPV, coordination with other services and ethical and legally appropriate way of recording in the clinical record.
Subject(s)
Gender-Based Violence , Intimate Partner Violence , Midwifery/standards , Narration , Pregnant Women , Professional Competence/standards , Adult , Communication Barriers , Female , Gender-Based Violence/psychology , Humans , Middle Aged , Pregnancy , Pregnant Women/psychology , Prenatal Care , Primary Health Care/statistics & numerical data , Professional Competence/statistics & numerical data , Qualitative Research , Time Factors , TrustABSTRACT
RESUMEN Fundamento: La investigación y la publicación de los estudiantes de Medicina siempre se han dado en la historia de la ciencia. La revista MediCiego desde su fundación ha priorizado la divulgación de las investigaciones estudiantiles. Objetivo: Evaluar la producción científica de los estudiantes de Ciencias Médicas en la revista MediCiego desde 1995 y 2018. Metodología: Se realizó un estudio bibliométrico basado en la dimensión de producción científica estudiantil. Se trabajó con el universo de números y se definió como forma de compilación el acceso y búsqueda en la página web de la revista. Resultados: Se publicaron 126 artículos con participación estudiantil en 48 números de 84 publicados. La autoría estudiantil se concentró en 170 estudiantes de Ciego de Ávila, Villa Clara y Pinar del Río. Los años 2014 y 2015 fueron los más productivos. Predominó la utilización de otras secciones (95.24 %), respecto a la estudiantil (4.76 %). La participación más alta fue en los originales (72.22 %), seguida de las presentaciones de casos (15.87 %) y los artículos de revisión (7.94 %); fue baja en los editoriales, carta al editor, imágenes destacadas de la Medicina y relatoría de eventos (0.79 %). Conclusiones: La participación estudiantil en publicaciones de la revista MediCiego se ha mantenido en más de la mitad de los números publicados en el periodo que se analizó. Se identificaron más de una centena de artículos con autoría de estudiantes en toda la tipología de artículos; sin embargo, la utilización de la Sección Estudiantil y la publicación de trabajos premiados en eventos en los últimos años han sido insuficientes.
ABSTRACT Background: Research and publication by medical students have always been present in the history of science. The MediCiego magazine since its foundation has prioritized the dissemination of student research. Objective: To evaluate the scientific production of the medical sciences students in the MediCiego journal from 1995 to 2018. Methodology: A bibliometrics study based on the dimension of student scientific production was carried out. We worked with the journal numbers universe and defined as a form of compilation access and search on the website of the magazine. Results: 126 articles were published with the student participation in 48 issues of 84 already published. The student authorship focused on 170 students from Ciego de Ávila, Villa Clara and Pinar del Río. The years 2014 and 2015 were the most productive ones. The use of other sections predominated (95.24 %), with respect to the student (4.76 %). The highest participation was in the originals (72.22 %), followed by case reports (15.87 %) and review articles (7.94 %); It was low with the editorials, letter to the editor, outstanding images of Medicine and event reporting (0.79 %). Conclusions: Student participation in MediCiego magazine publications has been maintained in more than half of the published numbers in the analyzed period. Students in all types of articles authored more than a hundred articles; however, the use of the Student Section and the publication of award-winning works in events in recent years have been insufficient.
Subject(s)
Students, Medical , Bibliometrics , Scientific Publication Indicators , PeriodicalABSTRACT
RESUMEN Fundamento: La investigación y la publicación de los estudiantes de Medicina siempre se han dado en la historia de la ciencia. La revista MediCiego desde su fundación ha priorizado la divulgación de las investigaciones estudiantiles. Objetivo: Evaluar la producción científica de los estudiantes de Ciencias Médicas en la revista MediCiego desde 1995 y 2018. Metodología: Se realizó un estudio bibliométrico basado en la dimensión de producción científica estudiantil. Se trabajó con el universo de números y se definió como forma de compilación el acceso y búsqueda en la página web de la revista. Resultados: Se publicaron 126 artículos con participación estudiantil en 48 números de 84 publicados. La autoría estudiantil se concentró en 170 estudiantes de Ciego de Ávila, Villa Clara y Pinar del Río. Los años 2014 y 2015 fueron los más productivos. Predominó la utilización de otras secciones (95.24 %), respecto a la estudiantil (4.76 %). La participación más alta fue en los originales (72.22 %), seguida de las presentaciones de casos (15.87 %) y los artículos de revisión (7.94 %); fue baja en los editoriales, carta al editor, imágenes destacadas de la Medicina y relatoría de eventos (0.79 %). Conclusiones: La participación estudiantil en publicaciones de la revista MediCiego se ha mantenido en más de la mitad de los números publicados en el periodo que se analizó. Se identificaron más de una centena de artículos con autoría de estudiantes en toda la tipología de artículos; sin embargo, la utilización de la Sección Estudiantil y la publicación de trabajos premiados en eventos en los últimos años han sido insuficientes.
ABSTRACT Background: Research and publication by medical students have always been present in the history of science. The MediCiego magazine since its foundation has prioritized the dissemination of student research. Objective: To evaluate the scientific production of the medical sciences students in the MediCiego journal from 1995 to 2018. Methodology: A bibliometrics study based on the dimension of student scientific production was carried out. We worked with the journal numbers universe and defined as a form of compilation access and search on the website of the magazine. Results: 126 articles were published with the student participation in 48 issues of 84 already published. The student authorship focused on 170 students from Ciego de Ávila, Villa Clara and Pinar del Río. The years 2014 and 2015 were the most productive ones. The use of other sections predominated (95.24 %), with respect to the student (4.76 %). The highest participation was in the originals (72.22 %), followed by case reports (15.87 %) and review articles (7.94 %); It was low with the editorials, letter to the editor, outstanding images of Medicine and event reporting (0.79 %). Conclusions: Student participation in MediCiego magazine publications has been maintained in more than half of the published numbers in the analyzed period. Students in all types of articles authored more than a hundred articles; however, the use of the Student Section and the publication of award-winning works in events in recent years have been insufficient.
Subject(s)
Humans , Students, Medical , Bibliometrics , Scientific Publication Indicators , PeriodicalABSTRACT
Aim: To evaluate tolerability of subcutaneous immunotherapy, in a polymerized mixture (Olea europaea/Phleum pratense) depot presentation. Patients & methods: A total of 47 poly-allergic patients received: an abbreviated schedule with three injections at weekly intervals or a cluster schedule with two administrations in 1 day. Both treatments continued with 3 monthly maintenance administrations. Results: Two systemic reactions, (4.3%). One grade 0 and one grade I. No local reactions. Immunoglobulin levels, increased significantly at final visit versus baseline in sIgG and sIgG4; in both schedules and allergens, no significant changes in specific immunoglobulin E levels were detected. Cutaneous reactivity at final visit decreased significantly. Conclusion: Both administration schedules with polymerized mixture of O. europaea/P. pratense, presented an excellent tolerability profile and induced preliminary efficacy changes.
Subject(s)
Asthma/therapy , Desensitization, Immunologic/methods , Rhinitis, Allergic, Seasonal/therapy , Adolescent , Adult , Allergens/immunology , Asthma/immunology , Clinical Protocols , Female , Humans , Immune Tolerance , Immunoglobulin E/metabolism , Infusions, Subcutaneous , Male , Middle Aged , Olea/immunology , Phleum/immunology , Plant Extracts , Pollen/immunology , Polymerization , Rhinitis, Allergic, Seasonal/immunology , Young AdultABSTRACT
RESUMEN Introducción: la anemia en los pacientes con enfermedad renal crónica (ERC) es frecuente y tiene una etiología multifactorial. Objetivos: determinar las características clínicas de la anemia en pacientes con ERC del Hospital Nacional en 2018. Metodología: estudio observacional, prospectivo, transversal que incluyó a pacientes adultos portadores de ERC, en etapa predialítica o con hemodiálisis, internados en el Hospital Nacional (Itauguá, Paraguay) en agosto y octubre 2018. Se determinaron variables demográficas, clínicas y laboratoriales. Resultados: se incluyeron 87 pacientes, siendo 53 varones (60%) y 35 mujeres (40%), con edad media 50±16 años. La etiología de la ERC era predominantemente hipertensiva (82%) y diabética (46%). La hemoglobina media fue 8,4±1,6 g/L en varones y 8,6±1,3 g/L en mujeres. Teniendo en cuenta la ferritina y la saturación de la transferrina, los tipos de anemia fueron: funcional (74%), anemia de ERC (23%) y anemia ferropénica (3%). Conclusión: los tipos de anemia detectados fueron: funcional (74%), anemia de ERC (23%) y anemia ferropénica (3%).
ABSTRACT Introduction: Anemia in patients with chronic kidney disease (CKD) is frequent and has a multifactorial etiology. Objectives: To determine the clinical characteristics of anemia in patients with CKD of the National Hospital in 2018. Methodology: Observational, prospective, cross-sectional study that included adult patients with CKD, predialitic stage or with hemodialysis, hospitalized in the National Hospital (Itauguá, Paraguay) from August to October 2018. Demographic, clinical and laboratory variables were determined. Results: Eighty seven patients were included, 53 men (60%) and 35 women (40%), with an average age of 50±16 years. The etiology of CKD was predominantly hypertensive (82%) and diabetic (46%). The mean hemoglobin was 8.4±1.6 g/L in men and 8.6±1.3 g/L in women. Taking ferritin and transferrin saturation into account, the types of anemia were: functional (74%), CKD anemia (23%) and iron deficiency anemia (3%). Conclusion: The types of anemia detected were: functional (74%), CKD anemia (23%) and iron deficiency anemia (3%).
ABSTRACT
OBJECTIVE: Several studies have shown that evening intake of aspirin has antihypertensive effect in healthy adults, which has not been proven in patients with cardiovascular disease, who mostly take aspirin in the morning. We have evaluated the antihypertensive effect of bedtime administration of aspirin in patients with cardiovascular disease already treated for hypertension. METHODS: This is a multicenter randomized triple-blind placebo-controlled crossover trial, with hypertensive patients treated with aspirin for secondary prevention. There was a baseline-randomized assignment to 2-month periods of bedtime aspirin (100âmg) first and morning-time aspirin later, or inversely, both periods separated by an open label 2-4 weeks period of morning-time aspirin. At the start and end of each treatment period, a 24-h ambulatory blood pressure monitoring was performed. The main outcome measure was mean 24-h blood pressure. The analyses were performed according to the intention-to-treat principle. RESULTS: Overall, 225 patients were randomized. No significant differences were observed in ambulatory blood pressure by time of intake of usual low doses of aspirin. The mean SBP/DBP was 123.2/69.9 (95% CI 121.58-124.9/68.86-76.86) with bedtime administration and 122.4/68.8 (95% CI 120.76-124.01/67.85-69.83) with daytime administration (Pâ=â0.3 and Pâ=â0.23 for SBP and DBP, respectively). CONCLUSION: Administering aspirin at bedtime rather than in the morning does not modify the 24-h ambulatory blood pressure in hypertensive patients in secondary cardiovascular prevention.The trial was registered with ClinicalTrials.gov (number NCT01741922).
Subject(s)
Aspirin/administration & dosage , Blood Pressure/drug effects , Hypertension/physiopathology , Platelet Aggregation Inhibitors/administration & dosage , Antihypertensive Agents/therapeutic use , Aspirin/therapeutic use , Blood Pressure Monitoring, Ambulatory , Cardiovascular Diseases/complications , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/prevention & control , Cross-Over Studies , Drug Administration Schedule , Female , Humans , Hypertension/drug therapy , Male , Middle Aged , Platelet Aggregation Inhibitors/therapeutic use , Secondary PreventionABSTRACT
Introducción: las revistas científicas médicas desde hace varios siglos tienen la función de difundir los resultados de las investigaciones en el campo de la salud y proporcionar información actualizada.Objetivo: identificar las evidencias históricas documentales que confirman la existencia de El Eco Científico como publicación impresa predecesora a la actual MediCiego.Método: se realizó una investigación cualitativa en la Universidad de Ciencias Médicas de Ciego de Ávila, entre enero y septiembre de 2018. Se utilizó el método histórico-lógico, la técnica de análisis documental y la entrevista.Resultados: se comprobó la existencia de la revista El Eco Científico en la Biblioteca Nacional José Martí. Esto fue corroborado en el periódico local avileño El Pueblo, conservado en la Biblioteca Provincial de Ciego de Ávila.Conclusiones: se ha rescatado del olvido, a 101 años de su fundación, la revista El Eco científico. Este hallazgo histórico la sitúa entre una de las primeras de las publicaciones biomédicas regionales en Cuba. En su primera etapa se publicó en Ciego de Ávila y contó con dos volúmenes que abarcaron los años 1917, 1918 y 1919. Luego de este trienio la publicación cesó, y vio la luz nuevamente en 1924 en su etapa habanera, con tres volúmenes que cubrieron los años 1924, 1925 y 1926(AU)
ntroduction: medical scientific journals for several centuries have the function of disseminating the results of research in the field of health and providing updated information.Objective: to identify the documentary historical evidences that confirms the existence of El Eco Científico as a printed publication predecessor to the current MediCiego.Method: qualitative research was carried out at the University of Medical Sciences of Ciego de Ávila, between January and September 2018. The historical-logical method, the documentary analysis technique and the interview were used.Results: the existence of El Eco Científico magazine was verified in the National Library José Martí. This was corroborated in the Avilanian local newspaper El Pueblo, kept in the Provincial Library of Ciego de Ávila.Conclusions: El Eco Científico magazine has been rescued from oblivion, 101 years after its founding. This historical finding places it among one of the first of the regional biomedical publications in Cuba. In its first stage was published in Ciego de Ávila and had two volumes that covered the years 1917, 1918 and 1919. After this triennium the publication ceased, and saw the light again in 1924 in its Havana stage, with three volumes that covered the years 1924, 1925 and 1926(AU)
Subject(s)
Humans , Male , Female , Publications , History , Qualitative Research , CubaABSTRACT
AIM: To evaluate tolerability and efficacy of Parietaria judaica subcutaneous immunotherapy on patients with allergic rhinoconjunctivitis. PATIENTS & METHODS: 51 patients were assigned to build-up scheme (six increasing doses) of P. judaica depot native extract, plus three maintenance monthly administrations. RESULTS: Out of 470 administered doses, only 3.8% elicited systemic reactions (1.5% nonspecific and 2.3% grade I). Concerning the exploratory efficacy parameters: cutaneous reactivity at the final visit versus baseline was significantly decreased; specific titers of IgG and IgG4 increased significantly and patients showed a significant decrease in the rhinitis symptoms score. CONCLUSION: P. judaica subcutaneous immunotherapy (Allergovac® depot ROXALL Medicina España S.A., Zamudio, Spain) with an abbreviated up-dosing scheme showed an adequate safety and tolerability profile and induced preliminary efficacy changes.
Subject(s)
Allergens/therapeutic use , Antigens, Plant/therapeutic use , Desensitization, Immunologic/methods , Plant Extracts/therapeutic use , Rhinitis, Allergic, Seasonal/therapy , Rhinitis, Allergic/therapy , Adult , Allergens/immunology , Antigens, Plant/immunology , Female , Humans , Immunoglobulin E/metabolism , Infusions, Subcutaneous , Male , Middle Aged , Parietaria/immunology , Plant Extracts/immunology , Rhinitis, Allergic/immunology , Rhinitis, Allergic, Seasonal/immunology , Skin Tests , Young AdultABSTRACT
OBJECTIVE: To examine the potential efficacy and safety of autologous platelet-rich plasma (PRP) in comparison with the conventional treatment (standard care, SoC) for the treatment of leg ulcers in patients with chronic venous insufficiency, in a primary health-care setting. METHOD: A Phase I-II, open-label, parallel-group, multicentre, randomised pilot study was conducted. The outcome variables at baseline and at weeks five and nine included reduction in the ulcer area, Chronic Venous Insufficiency Quality of Life Questionnaire score, cost of the treatment for up to nine weeks and average weekly cure rate. RESULTS: A total of eight patients, each with at least a six-month history of venous leg ulcer (VLUs), were included in the study. A total of 12 ulcers were treated with either autologous PRP or standard SoC. Patients treated with PRP required wound care only once per week. In the SoC group, patients required intervention 2-3 times per week. A reduction in the mean ulcer size in the PRP group was 3.9cm2 compared with the SoC group at 3.2cm 2 , although the sample size was insufficient to reach statistical significance. Improvement in quality of life (QoL) score was observed in the patients in the PRP group. CONCLUSION: This study offers proof-of-concept of the feasibility and safety of PRP treatment to inform larger clinical trials in patients with VLUs. Our preliminary results suggest that PRP delivers a safe and effective treatment for VLU care that can be implemented in primary health-care settings.
Subject(s)
Autografts , Bandages , Leg Ulcer/therapy , Platelet-Rich Plasma , Adult , Aged , Female , Humans , Male , Middle Aged , Pilot Projects , Primary Health Care , Research Design , Spain , Surveys and Questionnaires , Treatment Outcome , Wound HealingABSTRACT
Studies of genetic differentiation in fragmented environments help us to identify those landscape features that most affect gene flow and dispersal patterns. Particularly, the assessment of the relative significance of intrinsic biological and environmental factors affecting the genetic structure of populations becomes crucial. In this work, we assess the current dispersal patterns and population structure of Ctenomys "chasiquensis", a vulnerable and endemic subterranean rodent distributed on a small area in Central Argentina, using 9 polymorphic microsatellite loci. We use landscape genetics approaches to assess the relationship between genetic connectivity among populations and environmental attributes. Our analyses show that populations of C. "chasiquensis" are moderately to highly structured at a regional level. This pattern is most likely the outcome of substantial gene flow on the more homogeneous sand dune habitat of the Northwest of its distributional range, in conjunction with an important degree of isolation of eastern and southwestern populations, where the optimal habitat is surrounded by a highly fragmented landscape. Landscape genetics analysis suggests that habitat quality and longitude were the environmental factors most strongly associated with genetic differentiation/uniqueness of populations. In conclusion, our results indicate an important genetic structure in this species, even at a small spatial scale, suggesting that contemporary habitat fragmentation increases population differentiation.
Subject(s)
Rodentia/genetics , Animals , Argentina , Ecosystem , Gene Flow , Genetic Variation , Genotyping Techniques , Linkage Disequilibrium , Microsatellite Repeats , PhylogeographyABSTRACT
While nurses and midwives are in a unique position to identify and help victims of IPV, since they are often their first point of contact in the healthcare system, they need appropriate training. This study sought to examine the presence of IPV-related contents and the depth to which they are addressed in the bachelor's degree in Nursing and in the Midwifery specialisation programme. The study also explored lecturers' motivations for including IPV in their subjects. The methodology employed was qualitative. In-depth interviews were conducted with 16 university lecturers who teach IPV contents in the Nursing degree and Midwifery specialisation programme. The study took place in Catalonia (Spain). The research shows that lecturers feel personally committed in the training for prevention and detection of IPV. The main teaching methodology is active, experiential and requires student activity. In all cases, the lecturers call for more time and spaces to be made available to carry out this training. It would be desirable for more time to be dedicated to nurses and midwives' university training in IPV. The topic should be approached with a more cross-disciplinary, systematised focus from all perspectives: health, psychological, social, ethical and legal. It is important that the training of teaching staff in IPV should be fostered and methodised.
Subject(s)
Curriculum , Intimate Partner Violence/prevention & control , Midwifery/education , Students, Nursing/psychology , Adult , Attitude of Health Personnel , Education, Nursing, Baccalaureate , Faculty, Nursing/psychology , Female , Humans , Interviews as Topic , Midwifery/methods , Pregnancy , Qualitative Research , SpainABSTRACT
In this study we combine information from landscape characteristics, demographic inference and species distribution modelling to identify environmental factors that shape the genetic distribution of the fossorial rodent Ctenomys. We sequenced the mtDNA control region and amplified 12 microsatellites from 27 populations distributed across the Iberá wetland ecosystem. Hierarchical Bayesian modelling was used to construct phylogenies and estimate divergence times. We developed species distribution models to determine what climatic variables and soil parameters predicted species presence by comparing the current to the historic and predicted future distribution of the species. Finally, we explore the impact of environmental variables on the genetic structure of Ctenomys based on current and past species distributions. The variables that consistently correlated with the predicted distribution of the species and explained the observed genetic differentiation among populations included the distribution of well-drained sandy soils and temperature seasonality. A core region of stable suitable habitat was identified from the Last Interglacial, which is projected to remain stable into the future. This region is also the most genetically diverse and is currently under strong anthropogenic pressure. Results reveal complex demographic dynamics, which have been in constant change in both time and space, and are likely linked to the evolution of the Paraná River. We suggest that any alteration of soil properties (climatic or anthropic) may significantly impact the availability of suitable habitat and consequently the ability of individuals to disperse. The protection of this core stable habitat is of prime importance given the increasing levels of human disturbance across this wetland system and the threat of climate change.
Subject(s)
Environment , Rodentia/genetics , Animals , DNA, Mitochondrial/genetics , Genetic Variation , Models, Statistical , PhylogenyABSTRACT
AIM: To evaluate the efficacy of Dermatophagoides pteronyssinus (DPT) subcutaneous immunotherapy in allergic rhinoconjunctivitis patients. PATIENTS & METHODS: This 17-week double-blind study randomized 136 patients (95 evaluable) to five dose groups of DPT depot extract (0.0625-0.75 skin prick test [SPT] units) or placebo, administered in a six updosing schedule. RESULTS: A dose-response was observed for clinical efficacy (allergen concentration needed to induce a positive nasal provocation test response from baseline to final visit) and safety (adverse reactions). Local and systemic reactions occurred with 14.8 and 6.4% of administered doses, respectively; a single anaphylactic reaction occurred in each of Groups 3, 4 and 5 (0.3% of doses). CONCLUSION: The risk-benefit profile appeared most favorable with a DPT dose of 0.125 SPT units.
Subject(s)
Antigens, Dermatophagoides/administration & dosage , Cell Extracts/administration & dosage , Conjunctivitis, Allergic/therapy , Dermatophagoides pteronyssinus/immunology , Desensitization, Immunologic , Rhinitis, Allergic/therapy , Adult , Animals , Antigens, Dermatophagoides/adverse effects , Antigens, Dermatophagoides/immunology , Cell Extracts/adverse effects , Conjunctivitis, Allergic/immunology , Dose-Response Relationship, Immunologic , Female , Humans , Injections, Subcutaneous , Male , Rhinitis, Allergic/immunology , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: Paracetamol's solubility is achieved by adding to the excipient sodium salts, either as bicarbonate, carbonate or citrate. As the relationship between salt and hypertension is well known, due to the sodium content it has raised a hypothesis that may interfere with the control of that risk factor. Therefore, the objective of this study is to evaluate the effect on blood pressure of effervescent paracetamol compared to non-effervescent, in hypertensive patients. METHODS/DESIGN: This is the protocol of a phase IV multicenter clinical trial, randomized, controlled, crossover, open, which will compare the effect of two different formulations of paracetamol (effervescent or non-effervescent) in the blood pressure of hypertensive patients, with a seven weeks follow up. 49 controlled hypertensive patients will be included (clinical BP lower than 150 and 95 mmHg, and lower than 135 mmHg and 85 mmHg in patients with diabetes or a history of cardiovascular event, and daytime ambulatory measurements lower than 140 and 90 mmHg) and mild to moderate pain (Visual Analog Scale between 1 and 4). The study was approved by the ethics committee of the Fundació Jordi Gol i Gurina and following standards of good clinical practice. The primary endpoint will be the variations in systolic BP in 24 h Ambulatory Blood Pressure Monitoring, considering significant differences 2 or more mmHg among those treated with non-effervescent and effervescent formulations. Intention-to-treat and per-protocol analysis will be held. DISCUSSION: Despite the broad recommendation not to use effervescent drugs in patients with hypertension, there are relatively little studies that show exactly this pressor effect due to sodium in salt that gives the effervescence of the product. This is the first clinical trial designed to study the effect of effervescence compared to the non-effervescent, in well-controlled hypertensive patients with mild to moderate pain, performed in routine clinical practice. TRIAL REGISTRATION: NCT 02514538.
