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1.
Sci Total Environ ; 947: 174702, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-39002602

RESUMO

The study conducted in the state of Colima, western Mexico, aimed to assess the 1) occurrence, 2) temporal variability, 3) spatial variability, and 4) potential risk for honeybees and human consumption of pesticide-contaminated honey. For that purpose, 48 pesticides were determined in bees and their honey during both dry and wet seasons. The research considered two variables: land use categorization (irrigated agriculture, rainfed agriculture, grassland, and forest area) and location (coastal, valley, and mountain). Bee and honey samples were collected, pre-treated using solid-phase extraction (SPE), and analyzed using LC-MS/MS and GC-MS techniques. Occurrence: of the total number of pesticides, 17 were detected in the bee samples and 12 in the honey samples. The pesticides with the highest concentrations in the bee samples were glufosinate ammonium, picloram, and permethrin, while in the honey samples, picloram, permethrin, and atrazine were the most prevalent. Temporal variability: analyses revealed significant differences between dry and wet seasons for glufosinate ammonium and DEET in bee samples and only for glufosinate ammonium in honey samples. Spatial variability: analyses showed a trend in the number of detected pesticides, with irrigated agriculture areas having the highest detection and grassland areas having the least. The human potential risk assessment of contaminated honey consumption indicated no risk. The bee's potential risk for consumption of pesticides contaminated honey revealed chronic effects due to permethrin in a general scenario, and carbofuran, diazinon and permethrin in the worst scenario, and potential risk of acute effects by permethrin. The findings of this study contribute to understanding the contamination levels of pesticides in bees and their honey, emphasizing the importance of monitoring and mitigating the adverse effects of pesticide exposure on bee populations and environmental health.

2.
Sci Rep ; 14(1): 15733, 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38977749

RESUMO

Online tuning of particle accelerators is a complex optimisation problem that continues to require manual intervention by experienced human operators. Autonomous tuning is a rapidly expanding field of research, where learning-based methods like Bayesian optimisation (BO) hold great promise in improving plant performance and reducing tuning times. At the same time, reinforcement learning (RL) is a capable method of learning intelligent controllers, and recent work shows that RL can also be used to train domain-specialised optimisers in so-called reinforcement learning-trained optimisation (RLO). In parallel efforts, both algorithms have found successful adoption in particle accelerator tuning. Here we present a comparative case study, assessing the performance of both algorithms while providing a nuanced analysis of the merits and the practical challenges involved in deploying them to real-world facilities. Our results will help practitioners choose a suitable learning-based tuning algorithm for their tuning tasks, accelerating the adoption of autonomous tuning algorithms, ultimately improving the availability of particle accelerators and pushing their operational limits.

3.
Trop Med Int Health ; 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38962808

RESUMO

OBJECTIVE: The objective of this study is to analyse the epidemiological profile of global climate-related disasters in terms of morbidity and mortality, as well as to examine their temporal trends. METHOD: This cross-sectional study analysed climate-related global disasters from 2000 to 2021, utilising definitions and criteria from the United Nations Strategy for Disaster Reduction and the Centre for Research on the Epidemiology of Disasters. Data were sourced from the EM-DAT database. The study assessed trends over the entire period and compared them with previous years (1978-2000). RESULTS: A total of 7398 climate-related disasters were recorded, with hydrological disasters being the most frequent, followed by meteorological and climatological disasters. Statistically significant differences were noted in the average rates of affected individuals and injuries per million inhabitants. No significant trends were found in mortality rates, but the frequency trends for the entire period (1978-2021) and the subperiod (1978-2000) were increasing and statistically significant. However, the trend from 2000 onwards showed a non-significant decrease, potentially reflecting better disaster preparedness and response strategies under the Hyogo and Sendai Framework. CONCLUSION: The study highlights hydrological disasters as the most frequent and deadliest climate-related events, with climatological disasters affecting and injuring the most people. The lack of standardised criteria for disaster inclusion in databases presents a significant challenge in comparing results and analysing trends. Establishing uniform inclusion criteria is crucial for effective data analysis and disaster management.

4.
Hum Vaccin Immunother ; 20(1): 2366353, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38925145

RESUMO

The recombinant zoster vaccine (RZV) is included in the Spanish National Immunisation Programme for adults 65 years of age (years), with a potential progressive catch-up program for adults 66-80 years, starting with 80 years. However, the risk of herpes zoster (HZ) increases significantly from 50 years. We estimated the public health impact (PHI) of vaccinating adults ≥50 years in Spain versus no vaccination, using a Markov model adapted to the Spanish setting. The model simulated a hypothetical ≥50 years cohort over a lifetime, with inputs from Spanish publications, databases, or publications from other countries where Spanish data were unavailable. Base case inputs included 67.7% RZV coverage and 61.1% second dose compliance. Outputs included clinical outcomes avoided, healthcare resource use avoided, and number-needed-to-vaccinate (NNV) to prevent one HZ case. Deterministic (DSA) and probabilistic sensitivity analyses (PSA) were also conducted. The model estimated that, compared with no vaccination, vaccinating adults ≥50 years in Spain (N = 19,850,213) with RZV could prevent 1,533,353 HZ cases, 261,610 postherpetic neuralgia episodes, 274,159 other complications, and 138 deaths through the cohorts' remaining lifetime, mostly in the 50-59 years cohort. Furthermore, 3,500,492 primary care visits and 71,156 hospitalizations could be avoided, with NNV = 9 to prevent one HZ case. DSA predicted NNV = 7 to prevent one HZ case when second dose compliance was increased to 100%. PSA demonstrated ≥200,000 and ≥1,400,000 cases could be prevented in 86.9% and 18.4% of simulations, respectively. Starting RZV from 50 years could therefore prevent a substantial number of HZ cases and complications. Increasing RZV coverage and second dose compliance could further alleviate PHI of HZ.


Assuntos
Vacina contra Herpes Zoster , Herpes Zoster , Saúde Pública , Vacinação , Humanos , Vacina contra Herpes Zoster/administração & dosagem , Vacina contra Herpes Zoster/imunologia , Espanha/epidemiologia , Herpes Zoster/prevenção & controle , Herpes Zoster/epidemiologia , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Masculino , Feminino , Vacinação/estatística & dados numéricos , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/imunologia , Cadeias de Markov , Neuralgia Pós-Herpética/prevenção & controle , Neuralgia Pós-Herpética/epidemiologia , Programas de Imunização
5.
Nutrients ; 16(11)2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38892486

RESUMO

BACKGROUND: A nationwide, prospective, multicenter, cohort study (the Disease-Related caloric-protein malnutrition EChOgraphy (DRECO) study) was designed to assess the usefulness of ultrasound of the rectus femoris for detecting sarcopenia in hospitalized patients at risk of malnutrition and to define cut-off values of ultrasound measures. METHODS: Patients at risk of malnutrition according to the Malnutrition Universal Screening Tool (MUST) underwent handgrip dynamometry, bioelectrical impedance analysis (BIA), a Timed Up and Go (TUG) test, and rectus femoris ultrasound studies. European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to define categories of sarcopenia (at risk, probable, confirmed, severe). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to determine the optimal diagnostic sensitivity, specificity, and predictive values of cut-off points of the ultrasound measures for the detection of risk of sarcopenia and probable, confirmed, and severe sarcopenia. RESULTS: A total of 1000 subjects were included and 991 of them (58.9% men, mean age 58.5 years) were evaluated. Risk of sarcopenia was detected in 9.6% patients, probable sarcopenia in 14%, confirmed sarcopenia in 9.7%, and severe sarcopenia in 3.9%, with significant differences in the distribution of groups between men and women (p < 0.0001). The cross-sectional area (CSA) of the rectus femoris showed a significantly positive correlation with body cell mass of BIA and handgrip strength, and a significant negative correlation with TUG. Cut-off values were similar within each category of sarcopenia, ranging between 2.40 cm2 and 3.66 cm2 for CSA, 32.57 mm and 40.21 mm for the X-axis, and 7.85 mm and 10.4 mm for the Y-axis. In general, these cut-off values showed high sensitivities, particularly for the categories of confirmed and severe sarcopenia, with male patients also showing better sensitivities than women. CONCLUSIONS: Sarcopenia in hospitalized patients at risk of malnutrition was high. Cut-off values for the better sensitivities and specificities of ultrasound measures of the rectus femoris are established. The use of ultrasound of the rectus femoris could be used for the prediction of sarcopenia and be useful to integrate nutritional study into real clinical practice.


Assuntos
Desnutrição , Músculo Quadríceps , Sarcopenia , Ultrassonografia , Humanos , Masculino , Sarcopenia/diagnóstico por imagem , Sarcopenia/diagnóstico , Sarcopenia/etiologia , Feminino , Ultrassonografia/métodos , Pessoa de Meia-Idade , Estudos Prospectivos , Idoso , Músculo Quadríceps/diagnóstico por imagem , Desnutrição/diagnóstico , Estado Nutricional , Força da Mão , Avaliação Nutricional , Impedância Elétrica , Curva ROC , Sensibilidade e Especificidade , Fatores de Risco , Avaliação Geriátrica/métodos
6.
Cir Esp (Engl Ed) ; 2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38908513

RESUMO

AIM: To evaluate the clinical outcome of early closure of a protective ileostomy and preoperative stimulation of the efferent limb in a cohort of patients with rectal cancer treated surgically, primarily using the laparoscopic approach. METHODS: We performed an observational retrospective cohort study in a prospectively recorded series of patients with rectal cancer who underwent laparoscopic surgery with a protective loop ileostomy between 2017 and 2022. Ileostomy closure was programmed for within 3 months after surgery. All patients underwent stimulation of the efferent limb. Primary outcomes were morbidity and mortality, length of stay (LOS), and re-admission. RESULTS: Between 2017 and 2022, 108 patients underwent resection for rectal cancer and protective ileostomy. The laparoscopic approach was performed in 84.3% of patients (n = 91). Permanent ileostomy was performed in 5 patients (4.6%). Ileostomy closure was thus performed in 95.4% of patients (n = 103). Median time to closure was 74.5 days (range 57-113). In 63.1% (n = 65) of patients, reconstructive surgery was performed within 90 days. Prior to closure, efferent limb stimulation was performed in 77.8% (n = 84) of patients. Global morbidity was 26.2% (n = 27) (85.19%, n = 23 Clavien-Dindo I and 7.41%, n = 2 Clavien-Dindo II). The main causes of morbidity were postoperative ileus (10.7%, n = 11) and rectal bleeding (8.7%, n = 9). Anastomosis leakage occurred in 2 patients. Median hospital stay was 6 days (5-7). Readmission was needed in 6.8% (n = 7) of patients. CONCLUSION: A previous laparoscopic approach, early closure and stimulation of the efferent limb could be a useful strategy to reduce the morbidity and mortality of temporary ileostomy closure.

7.
Nat Commun ; 15(1): 5175, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890325

RESUMO

The receptor-binding site of influenza A virus hemagglutinin partially overlaps with major antigenic sites and constantly evolves. In this study, we observe that mutations G186D and D190N in the hemagglutinin receptor-binding site have coevolved in two recent human H3N2 clades. X-ray crystallography results show that these mutations coordinately drive the evolution of the hemagglutinin receptor binding mode. Epistasis between G186D and D190N is further demonstrated by glycan binding and thermostability analyses. Immunization and neutralization experiments using mouse and human samples indicate that the evolution of receptor binding mode is accompanied by a change in antigenicity. Besides, combinatorial mutagenesis reveals that G186D and D190N, along with other natural mutations in recent H3N2 strains, alter the compatibility with a common egg-adaptive mutation in seasonal influenza vaccines. Overall, our findings elucidate the role of epistasis in shaping the recent evolution of human H3N2 hemagglutinin and substantiate the high evolvability of its receptor-binding mode.


Assuntos
Epistasia Genética , Evolução Molecular , Glicoproteínas de Hemaglutininação de Vírus da Influenza , Vírus da Influenza A Subtipo H3N2 , Influenza Humana , Humanos , Vírus da Influenza A Subtipo H3N2/genética , Vírus da Influenza A Subtipo H3N2/metabolismo , Glicoproteínas de Hemaglutininação de Vírus da Influenza/genética , Glicoproteínas de Hemaglutininação de Vírus da Influenza/química , Glicoproteínas de Hemaglutininação de Vírus da Influenza/metabolismo , Animais , Camundongos , Sítios de Ligação , Influenza Humana/virologia , Mutação , Cristalografia por Raios X , Vacinas contra Influenza , Ligação Proteica , Receptores Virais/metabolismo , Receptores Virais/genética , Receptores Virais/química , Feminino
8.
J Phys Condens Matter ; 36(37)2024 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-38857602

RESUMO

The study of discotic liquid crystals (DLCs) under spherical confinement has gained considerable significance due to its relevance in the design and optimization of advanced materials with tailored properties. The unique characteristics of DLC fluids, coupled with confinement within a spherical Janus surface, offer a compelling avenue for exploring novel behaviors and emergent phenomena. In this study, Monte Carlo simulations within the NpT ensemble are employed to investigate the behavior of a DLC fluid confined by a spherical Janus surface. The Janus surface is characterized by distinct hemispheres, with one promoting homeotropic (face-on) anchoring and the other planar (edge-on) anchoring. Our analysis reveals the emergence of two topological defects: one exclusively on the edge-anchoring hemisphere and the other at the boundary of both anchorings. Each topological defect possessing a topological charge ofk= +1/2. We observe that as the temperature transitions the central region of the droplet into a nematic phase, a disclination line forms, linking the two surface defects. By investigating droplets of three different sizes, we confirm that the isotropic-nematic transition is first-order for the larger droplet studied. However, this transition becomes continuous under strong confinement conditions. In contrast, the nematic-columnar transition remains first order even for smaller systems.

9.
Artigo em Inglês | MEDLINE | ID: mdl-38777579

RESUMO

BACKGROUND: Anti-CGRP monoclonal antibodies (anti-CGRP MAbs) are approved and available treatments for migraine prevention. Patients do not respond alike and many countries have reimbursement policies, which hinder treatments to those who might respond. This study aimed to investigate clinical factors associated with good and excellent response to anti-CGRP MAbs at 6 months. METHODS: European multicentre, prospective, real-world study, including high-frequency episodic or chronic migraine (CM) patients treated since March 2018 with anti-CGRP MAbs. We defined good and excellent responses as ≥50% and ≥75% reduction in monthly headache days (MHD) at 6 months, respectively. Generalised mixed-effect regression models (GLMMs) were used to identify variables independently associated with treatment response. RESULTS: Of the 5818 included patients, 82.3% were females and the median age was 48.0 (40.0-55.0) years. At baseline, the median of MHD was 20.0 (14.0-28.0) days/months and 72.2% had a diagnosis of CM. At 6 months (n=4963), 56.5% (2804/4963) were good responders and 26.7% (1324/4963) were excellent responders. In the GLMM model, older age (1.08 (95% CI 1.02 to 1.15), p=0.016), the presence of unilateral pain (1.39 (95% CI 1.21 to 1.60), p<0.001), the absence of depression (0.840 (95% CI 0.731 to 0.966), p=0.014), less monthly migraine days (0.923 (95% CI 0.862 to 0.989), p=0.023) and lower Migraine Disability Assessment at baseline (0.874 (95% CI 0.819 to 0.932), p<0.001) were predictors of good response (AUC of 0.648 (95% CI 0.616 to 0.680)). These variables were also significant predictors of excellent response (AUC of 0.691 (95% CI 0.651 to 0.731)). Sex was not significant in the GLMM models. CONCLUSIONS: This is the largest real-world study of migraine patients treated with anti-CGRP MAbs. It provides evidence that higher migraine frequency and greater disability at baseline reduce the likelihood of responding to anti-CGRP MAbs, informing physicians and policy-makers on the need for an earlier treatment in order to offer the best chance of treatment success.

10.
Eur J Neurol ; 31(8): e16349, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38770742

RESUMO

BACKGROUND AND PURPOSE: Influenza is a common cause of acute respiratory infection, with headache being one of the symptoms included in the European Commission case definition. The prevalence of headache as a symptom of influenza remains unknown. We aimed to describe the incidence and prevalence of headache in patients with influenza. METHODS: All consecutive patients who met the definition criteria of influenza-like illness during the influenza seasons 2010-2011 through 2021-2022 were included. The seasonal cumulative incidence of influenza per 1000 patients at risk and the prevalence of headache as an influenza symptom were calculated, including the 95% confidence intervals (CIs). Subgroup analyses were done based on patients' sex, age group, microbiological confirmation, vaccination status, and influenza type/subtype/lineage. RESULTS: During the study period, 8171 patients were eligible. The incidence of headache in the context of influenza varied between 0.24 cases per 1000 patients (season 2020-2021) and 21.69 cases per 1000 patients (season 2017-2018). The prevalence of headache was 66.1% (95% CI = 65.1%-67.1%), varying between 49.6% (season 2021-2022) and 80.1% (season 2010-2011). The prevalence of headache was higher in women (67.9% vs. 65.7%, p = 0.03) and higher in patients between 15 and 65 years old. Headache was more prevalent in patients infected with B subtypes than A subtypes (68.7% vs. 56.9%, p < 0.001). There were no notable differences regarding vaccination status or microbiological confirmation of the infection. CONCLUSIONS: Headache is a common symptom in patients with influenza, with a prevalence higher than that observed in other viral infections.


Assuntos
Cefaleia , Influenza Humana , Humanos , Masculino , Feminino , Incidência , Pessoa de Meia-Idade , Adulto , Cefaleia/epidemiologia , Influenza Humana/epidemiologia , Influenza Humana/complicações , Prevalência , Idoso , Adolescente , Adulto Jovem , Criança , Pré-Escolar , Idoso de 80 Anos ou mais , Lactente
11.
Materials (Basel) ; 17(7)2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38612191

RESUMO

Corrosion processes at cut edges of galvanized steels proceed as highly localized electrochemical reactions between the exposed bulk steel matrix and the protective thin metallic coating of a more electrochemically active material. Scanning microelectrochemical techniques can thus provide the spatially resolved information needed to assess the corrosion initiation and propagation phenomena, yet most methods scan cut edge sections as embedded in insulating resin to achieve a flat surface for scanning purposes. In this work, the galvanized coatings on both sides of the material were concomitantly exposed to simulated acid rain while characterizing the cut edge response using SECM and SVET techniques, thereby maintaining the coupled effects through the exposure of the whole system as rather realistic operation conditions. The cut edges were shown to strongly promote oxygen consumption and subsequent alkalization to pH 10-11 over the iron, while diffusion phenomena eventually yielded the complete depletion of oxygen and pH neutralization of the nearby electrolyte. In addition, the cathodic activation of the exposed iron was intensified with a thinner coating despite the lower presence of sacrificial anode, and preferential sites of the attack in the corners revealed highly localized acidification below pH 4, which sustained hydrogen evolution at spots of the steel-coating interface.

12.
Cephalalgia ; 44(4): 3331024241248833, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38663908

RESUMO

INTRODUCTION: Effectiveness of candesartan in migraine prevention is supported by two randomized controlled trials. We aimed to assess the effectiveness, tolerability, and response predictors of candesartan in the preventive treatment of migraine. METHODS: Observational, multicenter, prospective cohort study. The 50%, 75% and 30% responder rates, between weeks 8-12 and 20-24, were compared with the baseline. Treatment emergent adverse effects were systematically evaluated. Response predictors were estimated by multivariate regression models. RESULTS: Eighty-six patients were included, 79.1% females, aged 39.5 (inter-quartile range [IQR] 26.3-50.3), with chronic migraine (43.0%), medication overuse headache (55.8%) and a median of two (inter-quartile range: 0.75-3) prior preventive treatments. At baseline patients had 14 (10-24) headache and 8 (5-11) migraine days per month. The 30%, 50% and 75% responder rates were 40%, 34.9% and 15.1% between weeks 8-12, and 48.8%, 36%, and 18.6% between weeks 20-24. Adverse effects were reported by 30 (34.9%) and 13 (15.1%) patients between weeks 0-12 and 12-24, leading to discontinuation in 15 (17.4%) patients. Chronic migraine, depression, headache days per month, medication overuse headache, and daily headache at baseline predicted the response between weeks 20-24. CONCLUSION: Candesartan effectiveness and tolerability in migraine prevention was in line with the clinical trials' efficacy.Trial registration: The study protocol is registered in ClinicalTrials.gov (NCT04138316).


Assuntos
Benzimidazóis , Compostos de Bifenilo , Transtornos de Enxaqueca , Tetrazóis , Humanos , Transtornos de Enxaqueca/tratamento farmacológico , Feminino , Masculino , Benzimidazóis/uso terapêutico , Benzimidazóis/efeitos adversos , Adulto , Tetrazóis/uso terapêutico , Tetrazóis/efeitos adversos , Pessoa de Meia-Idade , Resultado do Tratamento , Estudos Prospectivos , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Bloqueadores do Receptor Tipo 1 de Angiotensina II/efeitos adversos , Espanha/epidemiologia , Estudos de Coortes
13.
Curr Dev Nutr ; 8(4): 102101, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38590953

RESUMO

Background: Concurrent losses in biodiversity and human dietary diversity are evident in Madagascar and across many food systems globally. Wild food harvest can mitigate nutrition insecurities but may also pose species conservation concerns. Objectives: This study aimed to examine the association of wild plant and animal species consumption during hunger season with diet diversity and child growth near the Alandraza-Agnalavelo protected forest in Southwestern Madagascar. Second, we studied the conservation status of the consumed wild plants. Methods: Methods from public health nutrition (24-h recall dietary intake, anthropometry using World Health Organization [WHO] Growth Standards), ethnobotany, and forest ecology (ecologic studies of abundance, habitat preference, associated species, food chemistry assays, and species richness) were applied. Results: Malnutrition in children (n = 305) was highly prevalent: stunting (32.3%); wasting (18.8%); and low-dietary diversity (4% meeting WHO minimum dietary diversity threshold). Animal foods were consumed in small quantities, providing <10% of Dietary Reference Intakes for all limiting nutrients. Twenty-two wild plant species were consumed during hunger season, prominently tubers (Dioscoreaceae), and leafy greens (Asteraceae, Blechnaceae, Portulacaceae, and Solanaceae). Eight of the 9 target species were identified as abundant and "Least Concern," whereas Amorphophollus taurostigma was abundant and "Vulnerable." Regression modeling showed wild food consumption was associated with an increased household dietary diversity score [ß = 0.29 (0.06 standard error); P < 0.001], and total wild animal foods positively correlated with height-for-age Z score [ß = 0.14 (0.07 standard error); P = 0.04]. Conclusions: Wild plant and animal foods may be an important element of food systems to support human nutrition while maintaining ecosystem viability.

14.
Cureus ; 16(2): e54470, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38510855

RESUMO

Obesity is one of the primary public health problems faced by children. The increased incidence of obesity in the pediatric population poses significant challenges during and after surgical procedures. This systematic review and meta-analysis aimed to understand to what extent obesity is to surgical complications in pediatric patients. A systematic database search of PubMed, Web of Science, Scopus, and Science Direct was performed in June 2023. According to the inclusion and exclusion criteria, two evaluators independently conducted literature screening, data extraction, and quality evaluation of the retrieved literature. The Newcastle-Ottawa Scale score was used for quality evaluation, and a meta-analysis was performed using Review Manager software 5.4.1. A total of 1,170 relevant articles were initially identified, and 20 articles were finally included for data extraction and meta-analysis. The results of the meta-analysis showed that compared with normal-weight individuals, obese pediatric patients had a higher risk of developing surgical site infection (SSI) (relative risk (RR) = 1.63; 95% confidence interval (CI) = 1.33-2.00), wound dehiscence (RR = 2.01; 95% CI = 1.24-3.23), and underwent procedures that were 11.32 minutes longer (95% CI = 5.36-17.29). There were no differences in bleeding requiring transfusion, deep venous thromboembolism, postoperative abscess rate, and length of stay. Obese pediatric patients have a higher risk of SSI and dehiscence, along with a longer operative time. The established risks in obese adults undergoing surgery suggest a similar risk for obese pediatric patients. The findings of this study hold significant implications for clinical practice, suggesting the potential for additional measures to prevent surgical complications in children.

15.
PLoS Negl Trop Dis ; 18(3): e0012016, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38437237

RESUMO

Bolivia has the highest incidence of Chagas disease (CD) worldwide. Caused by the parasite Trypanasoma cruzi, CD is generally a chronic condition. Diagnosis is logistically and financially challenging, requiring at least two different laboratory-based serological tests. Many CD cases are missed; in Bolivia it is estimated just 6% of individuals chronically infected with T. cruzi get diagnosed. Achieving control on the way to elimination of CD requires a radical simplification of the current CD testing pathways, to overcome the barriers to accessing CD treatment. We aimed to generate unbiased performance data of lateral flow assays (LFAs) for T. cruzi infection in Bolivia, to evaluate their usefulness for improving T. cruzi diagnosis rates in a precise and efficient manner. This retrospective, laboratory-based, diagnostic evaluation study sought to estimate the sensitivity/specificity of 10 commercially available LFAs for T. cruzi, using the current CD diagnostic algorithm employed in Bolivia as the reference test method. All tests were blinded at the study site and performed by three operators. In total, 470 serum samples were tested, including 221 and 249 characterized as CD-positive/-negative, respectively. The LFAs were scored according to their relative importance using a decision-tree-based algorithm, with the mean decrease in Gini index as the scoring metric. The estimates of sensitivities ranged from 62.2-97.7% (95% confidence interval (CI) lower bound 55.0-94.7%); for specificities the range was 78.6-100% (95% CI lower bound 72.0-97.5%); 5/10 and 6/10 tests had sensitivity >90% and specificity >95%, respectively. Four LFAs showed high values of both sensitivity (93-95%) and specificity (97-99%). The agreement between 6 LFAs and the reference tests was almost perfect (Kappa 0.83-0.94). Most LFAs evaluated thus showed performances comparable with current laboratory-based diagnostic methods.


Assuntos
Doença de Chagas , Trypanosoma cruzi , Humanos , Bolívia , Estudos Retrospectivos , Doença de Chagas/parasitologia , Sensibilidade e Especificidade
16.
Pediatr. aten. prim ; 26(101): e13-e15, ene.-mar. 2024. ilus
Artigo em Espanhol | IBECS | ID: ibc-231778

RESUMO

El priapismo es una erección peneana prolongada y dolorosa, que ocurre sin estímulo sexual previo. Existen dos tipos principales, el priapismo de alto flujo y el priapismo de bajo flujo. Aunque en la mayoría de las ocasiones la causa subyacente será desconocida, puede ser la primera manifestación de una enfermedad grave. En el paciente pediátrico con una erección prolongada se debe diferenciar entre la erección peneana recurrente y los distintos tipos de priapismo, puesto que cada entidad requiere un manejo concreto e implica un pronóstico diferente. (AU)


Priapism is a prolonged and painful penile erection, which occurs without prior sexual stimulation. There are two main types, high-flow priapism and low-flow priapism. Although on most occasions the underlying cause will be unknown, it may be the first manifestation of serious disease. In the pediatric patient with prolonged erection we must differentiate between recurrent penile erection and the different types of priapism since each entity requires a specific management and implies a different prognosis. (AU)


Assuntos
Humanos , Masculino , Lactente , Ereção Peniana/fisiologia , Priapismo/diagnóstico por imagem , Priapismo/terapia , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/terapia
17.
Eur J Neurol ; 31(5): e16215, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38323742

RESUMO

BACKGROUND AND PURPOSE: Anti-calcitonin gene-related peptide (CGRP) therapies are recent preventive therapies approved for both episodic and chronic migraine. One of the measures of effectiveness is the withdrawal of other preventive treatments. The objective of this study is to quantify the impact of anti-CGRP drugs in concomitant preventive treatment in patients with migraine. METHODS: This was an observational, retrospective, multicenter cohort study with patients from nine national headache units. Patients with migraine undergoing treatment for at least 6 months with anti-CGRP antibodies, who were initially associated with some preventive treatment (oral and/or onabotulinumtoxinA) were included. Demographic and clinical variables were collected, as well as variables related to headache. Differences according to withdrawal or nonwithdrawal were evaluated. RESULTS: A total of 408 patients were included, 86.52% women, 48.79 (SD = 1.46) years old. Preventive treatment was withdrawn in 43.87% (179/408), 20.83% partially and 23.04% totally. In 27.45% (112/408), it was maintained exclusively due to comorbidity and in 28.6% (117/408) due to partial efficacy. The most frequent time of withdrawal was between 3 and 5 months after the start of treatment. The baseline characteristics associated with nonwithdrawal were comorbidities: insomnia, hypertension and obesity, chronic migraine, and medication overuse. In the multivariate analysis, the absence of high blood pressure, a greater number of preventive treatments at the start, and a lower number of migraine days/month after anti-CGRP treatment were independently associated with withdrawal of the treatment (p < 0.05). CONCLUSIONS: Anti-CGRP antibodies allow the withdrawal of associated preventive treatment in a significant percentage of patients, which supports its effectiveness in real-life conditions.


Assuntos
Peptídeo Relacionado com Gene de Calcitonina , Transtornos de Enxaqueca , Humanos , Feminino , Lactente , Masculino , Peptídeo Relacionado com Gene de Calcitonina/uso terapêutico , Estudos Retrospectivos , Estudos de Coortes , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/prevenção & controle , Cefaleia
18.
J Headache Pain ; 25(1): 18, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38331709

RESUMO

Headache is a common symptom of influenza infection; however, its causes and consequences remain uncertain. In this manuscript, we analyzed which demographic and clinical factors were associated with the presence of headache during the course of influenza infection and whether patients with headache had a different prognosis, evaluated by need of hospitalization, sick leave or school absenteeism. The influence study (NCT05704335) was an observational study that analyzed data routinely collected from the Health Sentinel Network between 2010 and 2020. During the study period, 7832 cases were considered, among which, 5275 (67.4%) reported headache. The presence of headache was independently associated with myalgia (2.753; 95%CI: 2.456-3.087, P < 0.001), asthenia (OR: 1.958; 95%CI: 1.732-2.214, P < 0.001), shivering (OR: 1.925; 95%CI: 1.718-2.156, P < 0.001), nasopharyngeal erythema (OR: 1.505; 95%CI: 1.293-1.753, P < 0.001), fever (OR: 1.469; 95%CI: 1.159-1.861; P = 0.001), sudden onset of symptoms (OR: 1.380; 95%CI: 1.120-1.702, p = 0.004), female sex (OR: 1.134; 95%CI: 1.023-1.257, P = 0.018), and gastrointestinal symptoms (OR: 1.169; 95%CI: 1.039-1.315; P = 0.01). Patients with headache had a sex and age adjusted lower odds of being referred to the hospital (OR: 0.463; 95%CI: 0.264-0.812, P = 0.007) and a higher odd of having a sick leave and/or school absenteeism (absenteeism (OR: 1.342; 95%CI: 1.190-1.514, P < 0.001). In conclusion, the presence of headache seems associated with symptoms caused by the innate immune response. These findings support a headache pathophysiology linked with the innate immune response. Due to the potential negative consequences and its treatable nature, clinicians should systematically evaluate it and, whenever necessary, treat it too.


Assuntos
Influenza Humana , Humanos , Feminino , Influenza Humana/complicações , Influenza Humana/epidemiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Prognóstico , Hospitalização , Absenteísmo
19.
Int J Mol Sci ; 25(3)2024 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-38338859

RESUMO

Alzheimer's disease (AD) is a progressive neurodegenerative disorder and the predominant form of dementia globally. No reliable diagnostic, predictive techniques, or curative interventions are available. MicroRNAs (miRNAs) are vital to controlling gene expression, making them valuable biomarkers for diagnosis and prognosis. This study examines the transcriptome of olfactory ecto-mesenchymal stem cells (MSCs) derived from individuals with the PSEN1(A431E) mutation (Jalisco mutation). The aim is to determine whether this mutation affects the transcriptome and expression profile of miRNAs and their target genes at different stages of asymptomatic, presymptomatic, and symptomatic conditions. Expression microarrays compare the MSCs from mutation carriers with those from healthy donors. The results indicate a distinct variation in the expression of miRNAs and mRNAs among different symptomatologic groups and between individuals with the mutation. Using bioinformatics tools allows us to identify target genes for miRNAs, which in turn affect various biological processes and pathways. These include the cell cycle, senescence, transcription, and pathways involved in regulating the pluripotency of stem cells. These processes are closely linked to inter- and intracellular communication, vital for cellular functioning. These findings can enhance our comprehension and monitoring of the disease's physiological processes, identify new disorder indicators, and develop innovative treatments and diagnostic tools for preventing or treating AD.


Assuntos
Doença de Alzheimer , Células-Tronco Mesenquimais , MicroRNAs , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , Doença de Alzheimer/metabolismo , Mutação , Biomarcadores/metabolismo , Células-Tronco Mesenquimais/metabolismo
20.
Nutr. hosp ; 41(1): 47-57, Ene-Feb, 2024. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-230884

RESUMO

Introducción: las conductas alimentarias pueden modular o influir en la calidad de la dieta y el grado de adherencia a la dieta mediterráneade niños y adolescentes.Objetivos: investigar la asociación entre la calidad de la dieta y el comportamiento alimentario en un grupo de escolares españoles.Métodos: se trata de un estudio transversal descriptivo en una muestra de 283 escolares españoles de seis a 16 años. Cada sujeto fue evaluadomediante el cuestionario KIDMED de adherencia a la dieta mediterránea y el cuestionario Children’s Eating Behaviour Questionnaire (CEBQ) paraevaluar el comportamiento alimentario.Resultados: un 12,80 % de la muestra presentó baja adherencia a la dieta mediterránea; un 59,80 %, adherencia mejorable; y un 27,40 %,adherencia alta. Al relacionar las conductas alimentarias con la calidad dietética, los escolares con mayor disfrute por los alimentos y menosexigencia con la comida presentan el doble de adherencia a la dieta mediterránea, por un consumo de casi el doble de vegetales, frutos secoso pescado, así como menor ingesta de procesados de baja calidad (golosinas y dulces). La respuesta a la saciedad y la velocidad de ingestatambién tuvieron un papel importante en las elecciones alimentarias.Conclusiones: las conductas alimentarias pueden tener un importante papel en la calidad de la dieta de los escolares, destacando el disfrute y laaceptación o rechazo por los alimentos. Dada la naturaleza bidireccional de los efectos entre las conductas alimentarias y la calidad de la dieta, elanálisis conjunto puede ser la base de futuras investigaciones con el objetivo de un mejor abordaje nutricional desde las edades más tempranas.(AU)


Introduction: eating behaviors may modulate or influence diet quality and the degree of adherence to the Mediterranean diet in children andadolescents.Aims: to investigate the association between diet quality and eating behavior in a group of Spanish schoolchildren.Methods: descriptive cross-sectional study of 283 Spain schoolchildren aged six to 16. Each subject was assessed using the KIDMED question-naire for adherence to the Mediterranean diet and the Children’s Eating Behaviour Questionnaire (CEBQ) questionnaire to assess eating behavior.Results: of the sample, 12.80 % had low adherence to the Mediterranean diet, 59.80 % had poor adherence, 59.80 % could be improved, and27.40 % had high adherence. When relating eating behavior to dietary quality, it was found that, generally, schoolchildren with greater enjoymentof food and less demand for food have double the adherence to the Mediterranean diet due to almost twice the consumption of vegetables,nuts, and fish, and a lower intake of low-quality processed foods (sweets). The response to satiety and the speed of ingestion also played animportant role in food choices.Conclusions: eating behaviors may play an essential role in the quality of school children’s diets highlighting the enjoyment and acceptance orrejection of food. Given the bidirectional nature of the effects between eating behaviors and diet quality, the joint analysis may be the basis forfuture research with the aim of a better nutritional approach from the earliest ages.(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Dieta , Dieta Mediterrânea , Cooperação e Adesão ao Tratamento , Comportamento Alimentar , Obesidade Infantil , Resposta de Saciedade , Ciências da Nutrição , Inquéritos e Questionários , Estudos Transversais , Epidemiologia Descritiva , Espanha , Saúde do Adolescente , Obesidade
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