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1.
Heliyon ; 10(4): e26703, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38434012

RESUMO

The crystallographic, optical, and electrical properties of manganese sulfide thin films depend on the control of the temperature precursors in the synthesis process, as shown by the results of this work. MnS thin films were deposited on glass substrates using the SILAR method and over an additional layer of CdS synthesized by chemical bath deposition (CBD) to acquire a p-n heterojunction. SILAR is an inexpensive method performed with a homemade robot in this case. Temperature in the solution precursors varied from 20 to 80 °C in four experiments. The morphology and structure of MnS and FTO/CdS/MnS thin films were studied through scanning electron microscopy (SEM) and grazing-incidence X-ray diffraction (GIXRD); the results indicate that materials showed a polycrystalline behavior, a diffraction peak of α- MnS cubic phase was observed with lattice constants values, ranging from 4.74 to 4.75 Å. Additionally, Raman spectroscopy showed a signal corresponding to the transversal optical phonons of MnS at a wavenumber near 300 cm-1. UV-vis spectroscopy showed optical bandgap values of 3.94, 4.0, 4.09, and 4.26 eV for thin films obtained at 20°, 40°, 60°, and 80 °C. respectively. Results indicated 80 °C as an optimal cationic precursor process temperature, achieving optical transmittance T% and good film quality according to SEM and GIXRD for the synthetization of MnS. The current-voltage (I-V) characterization in the heterojunction showed a characteristic diode curve with an open circuit voltage (VOC) of 300 mV under illumination, which indicated that the manganese sulfide behaves as p-type material contributing with positive charge carriers, while CdS behaves as n-type material.

2.
QJM ; 116(1): 57-62, 2023 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-36047831

RESUMO

BACKGROUND: Underlying immunodeficiency is associated with severe COVID-19, but the prognosis of persons with human immunodeficiency virus (HIV) (PWH) with COVID-19 is under debate. Aim: assessment of the mortality rate and major determinants of death in HIV-infected patients hospitalized with COVID-19 in Spain before vaccine availability. Design: Retrospective nationwide public database analysis. METHODS: Nationwide, retrospective, observational analysis of all hospitalizations with COVID-19 during year 2020 in Spain. Stratification was made according to HIV status. The National Registry of Hospital Discharges was used with the ICD-10 coding list. RESULTS: A total of 117 694 adults were hospitalized with COVID-19 during 2020. Only 234 (0.2%) were HIV-positives. More than 95% were on antiretroviral therapy. Compared to HIV-negatives, PWH were younger (mean age 53.2 vs. 66.5 years old; P<0.001) and more frequently male (74.8% vs. 56.6%; P<0.001). Most co-morbidities predisposing to severe COVID-19 (diabetes, hypertension, dementia and cardiovascular disease) were more frequent in HIV-negatives. In contrast, the rate of baseline liver disease was over 6-fold higher in PWH (27.4% vs. 4.4%; P<0.001). In-hospital mortality was lower in PWH (9.4% vs. 16%; P=0.004). In multivariate analysis, older age, dementia and especially advanced liver disease (relative risk (RR): 7.6) were the major determinants of death in PWH hospitalized with COVID-19. CONCLUSION: HIV-infected patients hospitalized in Spain with COVID-19 during 2020 had better survival than HIV-negatives, most likely explained by younger age and lower rate of co-morbidities. However, advanced liver disease was a major predictor of death in PWH hospitalized with COVID-19.


Assuntos
COVID-19 , Demência , Infecções por HIV , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , COVID-19/complicações , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Mortalidade Hospitalar , Estudos Retrospectivos , Feminino
3.
Trop Anim Health Prod ; 53(5): 504, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34622357

RESUMO

This study aimed to determine whether cows detected as tuberculosis (bTB) reactors and seropositive to brucellosis (bBR), as well as co-positive to bBR and bTB (bBR-bTB) and with a complete lactation before slaughter, were associated with reduced milk production and fertility. A total of 8068 productive and reproductive records of high-yielding Holstein cows from a single large dairy herd with a high prevalence of bTB and bBR were collected from 2012 to 2015. Lactation derived either from calving (n = 6019) or hormonally induced lactation (n = 2049), and all cows received growth hormone throughout lactation. For cows not induced into lactation, pregnancy rate to first service for healthy cows (C; 26.6%) was higher (P < 0.01) than bBR (15.2%), bTB (15.8%), and bBR-bTB (1.3%) cows. For induced cows, pregnancy rate to first service did not differ significantly among C, bBR, and bTB (14.5-17.3%) cows, but the percentage success of first service was extremely low (1.3%; P < 0.01) in bBR-bTB cows. Services per pregnancy (only pregnant cows) were lowest for C (3.3 ± 2.9; P < 0.01) and highest (6.4 ± 3.4) for bBR-bTB non-induced cows. This variable was lowest for C (2.9 ± 2.5; P < 0.01) and highest for bBR-bTB non-induced cows (6.3 ± 3.1). Pregnancy rate to all services did not differed for C (79.5%), bBR (76.7%), and bTB (75.9%) but was lower (58.9%; P < 0.01) for bBR-bTB non-induced cows. For induced cows this variable was highest for bBR (53.3%) and lowest for bBR-bTB (34.1%; P < 0.01) non-induced cows. 305-d milk production was increased by 4%, and total milk yield by 7% in TB-positive cows compared to that of the negative cows non-induced hormonally into lactation. This study showed the negative impact of the co-positivity for bTB and bBR on the reproductive efficiency of Holstein cows, although positive bTB and bBR tests enhanced milk yield.


Assuntos
Brucelose Bovina/diagnóstico , Doenças dos Bovinos , Fertilidade , Leite , Tuberculose Bovina/diagnóstico , Animais , Bovinos , Doenças dos Bovinos/diagnóstico , Feminino , Lactação , Gravidez
4.
J Therm Biol ; 81: 82-88, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30975427

RESUMO

Vulnerable animals to heat stress have been described as ones with dark or black hides due to increasing absorption of solar radiation. The effect of coat color in pluriparous contemporary Holstein cows in a hot environment (mean annual temperature 24.6 °C), on body surface temperature (infrared thermography), physiological and hematological variables as well as milk yield and reproductive performance was assessed using 178 Holstein pluriparous cows (74 predominantly white and 104 predominantly black). Data were collected in the morning and afternoon in July (mean temperature-humidity index 82 units). Body condition score at mid-lactation (128 ±â€¯32 days in milk at the start of the experiment) was higher (P < 0.01) in predominantly white than in black cows (3.3 vs. 3.2). Respiration rate did not differ between groups (72 ±â€¯23 vs. 73 ±â€¯20 breaths/min for white and black cows, respectively, sampling time combined). In contrast, rectal temperature of black cows was 0.1 °C higher (P ≤ 0.01) than white cows, regardless of sampling time. The only significant hematologic change was a slight increase in mean corpuscular volume in black cows (54.7 fL, P < 0.01) compared to white cows (53.8 fL), but it remained within the reference range. Differences due to coat color did not alter body surface temperatures at any time of the day. Conception rates, services per conception, calving intervals and fetal losses were not associated with hair coat color, but cows with predominantly white coat produced 394 kg more (P < 0.01) fat-corrected milk in 305 days compared to cows with predominantly black coat. It was concluded that in this hot-arid environment with cows housed in facilities with extensive cooling, black hair coat moderately reduces 305-d milk yield without affecting milk composition, body surface temperature, and reproductive performance.


Assuntos
Temperatura Corporal , Bovinos/fisiologia , Cor de Cabelo/fisiologia , Resposta ao Choque Térmico , Leite/metabolismo , Reprodução , Animais , Feminino , Fertilização , Temperatura Alta , Lactação , Leite/química , Paridade , Gravidez
5.
Int J Biometeorol ; 62(4): 493-500, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28986694

RESUMO

This study aimed to investigate the effect of heat stress and month of birth on growth performance, pelleted starter intake, and stress-related hormones in Holstein calves. Birth weight and growth records, representing 4735 Holstein calves from a large commercial dairy herd in northern Mexico (25° N; 22.3 °C mean annual temperature) from 2013 to 2015, were analyzed. Temperature-humidity index (THI) at calving, season of birth, and month of birth were the independent variables, whereas growth traits were the dependent variables. Increased THI at birth from < 65 to > 85 units was associated with a decrease in birth weight from 39.3 to 38.7 kg. Calves subjected to high THI (> 75 units) at calving showed lesser (P < 0.01) pre-weaning gains (405 ± 97 g/calf/day), whereas those calves born with THI < 70 units presented the highest gains (466 ± 112 g/calf/day). Birth during the fall months reduced (P < 0.01) weaning weight by about 5 kg compared with winter months. Also, the pre-weaning average daily gain for calves born in the fall was about 70 g less (P < 0.01) than calves delivered in winter months. Plasma triiodothyronine and tetraiodothyronine levels were lower (1.02 ± 0.21 and 48 ± 7.9 ng/mL, respectively; P < 0.01) in summer and highest in winter (1.64 ± 0.48 and 66 ± 11 ng/mL, respectively). Mean plasma cortisol concentration was higher in heat-stressed calves born in summer (59 ± 40 ng/mL) than calves born in winter (20 ± 28 ng/mL). Pelleted starter intake 1 week before weaning was lowest (P < 0.01) in the fall (0.82 ± 0.26 kg/calf/day; mean ± SD) and highest in spring (1.26 ± 0.43 kg/calf/day). It was concluded that in this particular environment, heat stress affects birth weight and growth rate of Holstein calves. Thus, environmental management of the newborn calf during hot spring and summer months is warranted to optimize pelleted starter intake and calf growth rates.


Assuntos
Doenças dos Bovinos , Transtornos de Estresse por Calor , Ração Animal , Animais , Peso Corporal , Bovinos/sangue , Bovinos/crescimento & desenvolvimento , Doenças dos Bovinos/sangue , Ingestão de Alimentos , Feminino , Transtornos de Estresse por Calor/sangue , Transtornos de Estresse por Calor/veterinária , Umidade , Hidrocortisona/sangue , Temperatura , Desmame
6.
Anim Reprod Sci ; 149(3-4): 204-11, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25192831

RESUMO

Equine germplasm bank management involves not only the conservation and use of semen doses, in addition it can also be a resource to study stallion semen quality and after thawing semen properties for reproductive purposes. A possible criterion to measure quality may be based on differential gene expression of loci involved during spermatogenesis and sperm quality maturation. The rapid degradation of sperm after thawing affects the integrity and availability of RNA. In this study we have analyzed genes expressed in equine cryopreserved sperm, which provided an adequate amplification, specificity, and stability to be used as future reference genes in expression studies. Live spermatozoa were selected from cryopreserved semen straws derived from 20 stallions, through a discontinuous concentration gradient. RNA purification followed a combination of the organic and column extraction methods together with a deoxyribonuclease treatment. The selective amplification of nine candidate genes was undertaken using reverse transcription and real-time polymerase chain reaction (qPCR) carried out in a one-step mode (qRT-PCR). Specificities were tested by melting curves, agarose gel electrophoresis and sequencing. In addition, gene stabilities were also calculated. Results indicated that five out of the nine candidate genes amplified properly (ß-Actin, ATP synthase subunit beta, Protamine 1, L32 ribosomal protein and Ubiquitin B), of which ß-Actin and the L32 Ribosomal protein showed the highest stability thus being the most suitable to be considered as reference genes for equine cryopreserved sperm studies, followed by the ATP synthase subunit beta and Ubiquitin B.


Assuntos
Criopreservação/veterinária , Cavalos/fisiologia , ATPases Mitocondriais Próton-Translocadoras/metabolismo , Proteínas Ribossômicas/metabolismo , Preservação do Sêmen/veterinária , Sêmen/fisiologia , Animais , Masculino , ATPases Mitocondriais Próton-Translocadoras/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa/veterinária , Proteínas Ribossômicas/genética
7.
Transpl Immunol ; 28(4): 154-8, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23684945

RESUMO

UNLABELLED: Sensitization to HLA antigens creates an obstacle for the accessibility and success of kidney transplantation (KT). Highly sensitized patients have longer waiting times and some may never receive a KT. AIM: To determine the probability of patients on the deceased donor (DD) waiting list to receive a KT based on the panel reactive antibody percentage (% PRA) in our center. METHODS: The DD waiting list from our institution was analyzed from 01/05 to 08/12 documenting the clinical variables from donor and potential recipients (ABO blood group), lymphocyte cross-match [CxM (CDC-AHG)] results, highest % PRA determination, and time on the waiting list. The patients were classified into 4 groups based on the % PRA: 0%, 1-19%, 20-79% and 80-100%. The data was analyzed using odds ratio and logistic regression (significant p<0.05). RESULTS: 58 DD (F:M 34:24, ABO group O=35, A=13, B=10) and 179 potential recipients were analyzed (F:M 98:81, ABO group O=127, A=33, B=19, participating 4.2 ± 3.8 times with different donors to receive KT). The mean PRA for the whole group was 22 ± 32%, median [md] 0 (0-98). A total of 100 patients received KT (mean waiting time 2.2 ± 1.7 years, 12 days-7 years) and their mean % PRA was 11.6 ± 24, md 0 (0-94) vs. 31.4 ± 37 md 8.5 (0-98) in those who have not received a KT. An association between the % PRA group and KT (p<0.003) was observed. The probability of receiving KT with a 0% PRA vs. >0% was higher (OR 2.12, 1.17-3.84). There was no difference between the 0% vs. 1-19% group (OR 1); differences were observed between 0% vs. 20-79% (OR 2.5, 1.18-5.3) and 0% vs. 80-100% (OR 5, 1.67-14.9). For every percent increase in the PRA above 20%, the risk of not receiving a KT increased by 5% (1-9, p<0.01). CONCLUSIONS: The probability of receiving a DD kidney transplant is inversely related to the % PRA although a higher risk for not receiving a KT becomes evident with a PRA >20%.


Assuntos
Rejeição de Enxerto/epidemiologia , Transplante de Rim/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Adulto , Cadáver , Feminino , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/imunologia , Teste de Histocompatibilidade , Humanos , Masculino , Probabilidade , Listas de Espera
8.
Anim Reprod Sci ; 134(3-4): 105-11, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22917878

RESUMO

The aim of this study was to determine, using multiple logistic models, factors affecting pregnancy per AI (P/AI) following fixed-time artificial insemination (FTAI) in repeat breeders cows (RBC) treated with rbST throughout lactation. 498 RBC received a CIDR device and 100µg of GnRH on day 0. CIDR removal and PGF(2α) (25mg) treatment were done concurrently on day 7. Estradiol benzoate (EB, 1mg) was injected on day 8 and GnRH on day 9; cows were inseminated 16-20h later. Cows with an average milk protein <3% were 43% more likely (P<0.05) to become pregnant at FTAI than cows with milk protein ≥3%. Cows with <6 services had significantly increased chances of becoming pregnant than cows with ≥6 services at FTAI (P/AI 36 vs. 27%; P<0.05). CIDR-treated cows with less than three lactations were 1.7 times more likely (P/AI 35 vs. 21%; P<0.05) to become pregnant than cows in third or greater lactation. Cows with peak milk yields lower than 55kg were 1.5 times more likely to get pregnant than cows with peak milk yields greater than 55kg (P/AI 37 vs. 28%; P<0.05). P/AI was lower (30 vs. 35%; P<0.01) for cows with dry periods <62 days than cows with dry periods ≥62 days. Cows subjected to FTAI with a temperature-humidity index (THI) <76 were 45% more likely (P<0.05) to become pregnant than cows inseminated at a THI≥76. It was concluded that an acceptable proportion (32%) of RBC can become pregnant with the protocol used in the present study. Also, subfertility in CIDR-treated cows was associated with high peak yields, high milk protein, increased service, increased lactation, high THI at AI and short dry periods.


Assuntos
Bovinos , Inseminação Artificial/veterinária , Indução da Ovulação/métodos , Resultado da Gravidez/veterinária , Prenhez , Administração Intravaginal , Animais , Cruzamento/métodos , Bovinos/fisiologia , Causalidade , Indústria de Laticínios , Sincronização do Estro/métodos , Feminino , Inseminação Artificial/fisiologia , Dispositivos Intrauterinos Medicados/veterinária , Indução da Ovulação/veterinária , Paridade/fisiologia , Gravidez , Resultado da Gravidez/epidemiologia , Progesterona/administração & dosagem
9.
J Dairy Sci ; 94(9): 4524-30, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21854924

RESUMO

Records representing data from 1,500 barren Holstein cows over an 8-yr period from a large commercial dairy farm in northern Mexico were analyzed to determine the effects of lactation number and season and year of initiation of lactation on milk production of cows induced hormonally into lactation and treated with recombinant bovine somatotropin (rbST) throughout lactation. Peak and 305-d milk yields were also assessed as predictors of total milk yield in cows induced into lactation. A significant quadratic relationship was found between 305-d milk yield and number of lactation [7,607±145 and 9,548±181 kg for first- and ≥6-lactation cows, respectively; mean ± standard error of the mean (SEM)] with the highest production occurring in the fifth lactation. Total milk yields of cows with ≤2 lactations were approximately 4,500 kg less than milk yields of adult cows (the overall average ± standard milk yield was 13,544±5,491 kg per lactation and the average lactation length was 454±154 d). Moreover, 305-d milk production was depressed in cows induced into lactation in spring (8,804±153 kg; mean ± SEM) and summer (8,724±163 kg) than in fall (9,079±151 kg) and winter (9,085±143 kg). Partial regression coefficients for 305-d milk yield and peak milk yield indicated an increment of 157 kg of milk per lactation per 1-kg increase in peak milk yield (r(2)=0.69). Neither peak milk yield (r(2)=0.18) nor 305-d milk yield (r(2)=0.29) was accurate for predicting total milk yield per lactation. Year, parity, and season effects had significant influence on milk yield of cows induced into lactation and treated with rbST throughout lactation, and peak milk yield can assist in the prediction of 305-d milk yield but not total milk yield. This study also showed that hormonal induction of lactation in barren high-yielding cows is a reliable, practical, and affordable technique in countries where rbST treatment and prolonged steroid administration of dairy cows are legally permitted.


Assuntos
Hormônio do Crescimento/farmacologia , Lactação/efeitos dos fármacos , Leite/metabolismo , Animais , Bovinos , Indústria de Laticínios/métodos , Feminino , Lactação/fisiologia , Gravidez , Estações do Ano , Fatores de Tempo
10.
Actas Esp Psiquiatr ; 37(5): 289-96, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19960388

RESUMO

Major depressive disorder is typically a chronic disorder in which the chances of suffering a single non-recurring episode are low. To date it has been uncertain how <> moderates prognosis. It has been especially difficult to separate the effect of age of first episode onset from the overall effect of age at the time of recruitment. From a methodological perspective, this question is best studied in inception cohort studies rather than naturalistic studies. In inception cohort studies, all patients receive treatment under controlled conditions and therefore the effect of age (if any) may be more apparent. In addition, the best evidence comes from comparative studies which have examined older and middle aged patients within the same study. After conducting a thorough review of the literature, we have found three comparative inception cohort studies of episode remission in older versus middle aged patients. We found only one comparative inception cohort study of relapse and recurrence in older versus middle aged patients. This evidence suggests that depression in the elderly (those of older chronological age) responds equally to the initial treatment but has a more adverse longitudinal trajectory than depression in middle age. An early age of illness onset also seems to adversely affect prognosis in comparison to those with a first onset in later life who do not have medical comorbidity. The effect of age on prognosis may be largely explained by factors such as previous episodes and medical comorbidity.


Assuntos
Depressão/terapia , Adulto , Fatores Etários , Idoso , Humanos , Prognóstico , Recidiva
11.
Neurologia ; 24(7): 465-84, 2009 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-19921557

RESUMO

We present the Spanish adaptation made by the CEIPC of the European Guidelines on Cardiovascular Disease Prevention (CVD) in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD through the management of its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care medical doctors in promoting a healthy life style, based on increasing physical activity, change dietary habits, and non smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but among patients with diabetes, chronic kidney disease, or definite CVD, the objective is <130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL<130 mg/dl, although among patients with CVD or diabetes, the objective is <100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, to reach body mass index (BMI) guided and waist circumference objectives. In diabetic type 2 patients, the objective is glycated haemoglobin <7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to transfer the recommendations established into the daily clinical practice.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Medicina Clínica/normas , Fatores Etários , Biomarcadores , Pressão Sanguínea , Índice de Massa Corporal , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/terapia , Colesterol/sangue , Ensaios Clínicos como Assunto , Diabetes Mellitus Tipo 2/prevenção & controle , Humanos , Estilo de Vida , Inibidores da Agregação Plaquetária/uso terapêutico , Padrões de Prática Médica , Fatores de Risco , Espanha
12.
Actas esp. psiquiatr ; 37(5): 289-296, sept.-oct. 2009. tab
Artigo em Espanhol | IBECS | ID: ibc-77697

RESUMO

La depresión mayor es típicamente un trastorno crónico en el cual la probabilidad de sufrir un solo episodio no recurrente es muy baja. Hasta el momento ha permanecido incierto cómo el factor «edad» modera el pronóstico. Especialmente ha sido difícil separar el efecto de la edad de comienzo de la enfermedad del efecto global de la edad en el momento de inclusión o reclutamiento para los estudios. Desde un punto de vista metodológico esta cuestión se estudia mejor mediante estudios incidentes (inception cohort studies) que mediante estudios naturalísticos (naturalistic studies). En los estudios incidentes todos los pacientes reciben tratamiento bajo condiciones controladas y, por tanto, los efectos del factor edad (si existe alguno) pueden ser más aparentes. También la mejor evidencia se consigue a través de estudios comparativos que examinen pacientes de la tercera edad y de la edad adulta más joven en el mismo estudio. Tras haber llevado a cabo una exhaustiva revisión de la literatura hemos encontrado tres estudios de episodios de remisión en pacientes en la tercera edad en comparación con la edad adulta más joven, comparativos y de incidencia. Sólo hemos encontrado uno, comparativo y de incidencia, de recaída y recurrencia en pacientes de tercera edad en comparación con edad adulta más joven. Éstos sugieren que la depresión en la tercera edad (refiriéndonos a la edad cronológica) responde igualmente al tratamiento inicial, si bien, presenta una trayectoria longitudinal más adversa que la depresión en la edad adulta más joven. La presencia de una edad más temprana de comienzo de la enfermedad también parece afectar de manera adversa al pronóstico en comparación con el comienzo en edad más avanzada, esto es, en aquellos pacientes que no presentan comorbilidad médica. El efecto de la edad en el pronóstico podría explicarse fundamentalmente por factores como la presencia de episodios previos y la comorbilidad médica (AU)


Major depressive disorder is typically a chronic disorder in which the chances of suffering a single non-recurring episode are low. To date it has been uncertain how «age» moderates prognosis. It has been especially difficult to separate the effect of age of first episode onset from the overall effect of age at the time of recruitment. From a methodological perspective, this question is best studied in inception cohort studies rather than naturalistic studies. In inception cohort studies, all patients receive treatment under controlled conditions and therefore the effect of age (if any) may be more apparent. In addition, the best evidence comes from comparative studies which have examined older and middle aged patients within the same study. After conducting a thorough review of the literature, we have found three comparative inception cohort studies of episode remission in older versus middle aged patients. We found only one comparative inception cohort study of relapse and recurrence in older versus middle aged patients. This evidence suggests that depression in the elderly (those of older chronological age) responds equally to the initial treatment but has a more adverse longitudinal trajectory than depression in middle age. An early age of illness onset also seems to adversely affect prognosis in comparison to those with a first onset in later life who do not have medical comorbidity. The effect of age on prognosis may be largely explained by factors such as previous episodes and medical comorbidity (AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Transtorno Depressivo/epidemiologia , Prognóstico , Idade de Início , Fatores de Risco , Recidiva , Remissão Espontânea , Comorbidade , Fatores Etários , Fatores Sexuais
15.
Rev Clin Esp ; 209(6): 279-302, 2009 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-19635253

RESUMO

The present CEIPC Spanish adaptation of the European Guidelines on Cardiovascular Disease Prevention in Clinical Practice 2008. This guide recommends the SCORE model for risk evaluation. The aim is to prevent premature mortality and morbidity due to CVD by means of dealing with its related risk factors in clinical practice. The guide focuses on primary prevention and emphasizes the role of the nurses and primary care doctors in promoting a healthy life style, based on increasing physical activity, changing dietary habits, and not smoking. The therapeutic goal is to achieve a Blood Pressure < 140/90 mmHg, but in patients with diabetes, chronic kidney disease, or definite CVD, the objective is < 130/80 mmHg. Serum cholesterol should be < 200 mg/dl and cLDL < 130 mg/dl, although in patients with CVD or diabetes, the objective is < 100 mg/dl (80 mg/dl if feasible in very high-risk patients). Patients with type 2 diabetes and those with metabolic syndrome must lose weight and increase their physical activity, and drugs must be administered whenever applicable, with the objective guided by body mass index and waist circumference. In diabetic type 2 patients, the objective is glycated haemoglobin < 7%. Allowing people to know the guides and developing implementation programs, identifying barriers and seeking solutions for them, are priorities for the CEIPC in order to put the recommendations into practice.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Comportamento , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/psicologia , Doenças Cardiovasculares/terapia , Humanos , Hipertensão/complicações , Hipertensão/terapia , Fatores de Risco , Fatores Socioeconômicos , Espanha
16.
Cochrane Database Syst Rev ; (4): CD004160, 2007 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-17943812

RESUMO

BACKGROUND: Many people with schizophrenia continue to experience symptoms despite conventional treatments being used. Alternative therapies such as hypnosis, in conjunction with conventional treatments, may be helpful. OBJECTIVES: To investigate the use of hypnosis for people with schizophrenia or schizophrenia-like illnesses compared with standard care and other interventions. SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group's Register (October 2006), contacted the Cochrane Complementary Medicine Field for additional searching (January 2003), hand searched references of included or excluded studies and made personal contact with authors of relevant trials. SELECTION CRITERIA: We included all randomised or double blind controlled trials that compared hypnosis with other treatments or standard care for people with schizophrenia. DATA COLLECTION AND ANALYSIS: We reliably selected studies, quality assessed them and extracted data. We excluded data where more than 50% of participants in any group were lost to follow up. For binary outcomes we calculated a fixed effects risk ratio (RR) and its 95% confidence interval (CI). MAIN RESULTS: We included three studies (total n=149). When hypnosis was compared with standard treatment no one left the studies between 1-8 weeks (n=70, 2 RCTs, Risk Difference 0.00 CI -0.09 to 0.09). Mental state scores were unaffected (n=60, 1 RCT, MD BPRS by one week -3.6 CI -12.05 to 4.8) as were measures of movement disorders and neurocognitive function. Compared with relaxation, hypnosis was also acceptable (n=106, 3 RCTs, RR leaving the study early 2.00 CI 0.2 to 2.15) and had no discernable effect on mental state (n=60, 1 RCT, MD BPRS by one week -3.4 CI -11.4 to 4.6), movement disorders or neurocognitive function. Hypnosis was as acceptable as music (Sibelius) by four weeks (n=36, RR leaving the study early 5.0, CI 0.3 to 97.4). AUTHORS' CONCLUSIONS: The studies in this field are few, small, poorly reported and outdated. Hypnosis could be helpful for people with schizophrenia. If we are to find this out, better designed, conducted and reported randomised studies are required. This current update has not revealed any new studies in this area since 2003.


Assuntos
Hipnose , Esquizofrenia/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia de Relaxamento
19.
Eur J Haematol ; 66(5): 342-6, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11422415

RESUMO

Clinical progression of B-cell chronic lymphocytic leukemia (B-CLL) depends on survival and accumulation of leukemic cells, regulated in part by physical cell contact and soluble molecules. Here we have studied the Fas/FasL system in relation to clinical progression in B-CLL. Serum levels of soluble Fas (sFas) and FasL (sFasL) were determined by ELISA in 43 progressive and 40 non-progressive B-CLL patients and in 21 control individuals. Correlation between sFas serum levels and clinical progression, stage and survival were statistically analyzed. We found high levels of sFas in B-CLL sera correlated with disease progression (p<0.01). In addition, higher sFas levels were found in patients in stages II, III and IV in comparison to patients in stage 0 (p<0.05, p<0.01, p<0.03, respectively). Survival was significantly shorter for patients with > or =6 ng/ml sFas serum levels, although a multivariate analysis did not show sFas to be a significant independent prognostic factor. Fresh B-CLL cells showed only low levels of membrane expression, which were not correlated to sFas levels in serum. In vitro activation of B-CLL cells increased Fas expression, as reported earlier, and induced cells to release sFas into the supernatant. In conclusion, our results indicate that sFas in serum may be a useful parameter for the prediction of clinical progression in B-CLL.


Assuntos
Leucemia Linfocítica Crônica de Células B/sangue , Receptor fas/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Ensaio de Imunoadsorção Enzimática , Proteína Ligante Fas , Feminino , Humanos , Leucemia Linfocítica Crônica de Células B/patologia , Contagem de Linfócitos , Masculino , Glicoproteínas de Membrana/sangue , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Solubilidade
20.
Psychother Psychosom ; 70(3): 141-4, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11340415

RESUMO

BACKGROUND: There is little if any research on the explicit contents delivered by patients in the first minutes of a psychiatric interview. METHODS: In order to study the impact of the first minutes of a psychiatric interview on final diagnosis, we gathered information from the speech during the first 5 min in 162 new psychiatric patients with a checklist including symptoms extracted from the SCAN interview. RESULTS: The area reported most frequently was life events (51.2%). The average of psychiatric symptoms cited was 2.3. An initial suspected diagnosis was done in 126 patients, and in 73 patients (57.9% of those with a suspected diagnosis, 45.1% of the total sample) the initial diagnosis was coincident with the final diagnosis. The initial clinical impression was more accurate in adjustment and 'neurotic' disorders, and less in mood disorders. Those patients who cited more symptoms received a less accurate initial diagnosis. CONCLUSION: Psychiatric patients spontaneously report a low number of symptoms. The accuracy of psychiatric diagnosis in the first minutes of an interview is unacceptably low. However, the role of short psychiatric interviewing as a screening method deserves to be further investigated.


Assuntos
Entrevista Psicológica/normas , Transtornos Mentais/diagnóstico , Adulto , Humanos , Transtornos do Humor/diagnóstico , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Fatores de Tempo
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