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1.
Rev. int. med. cienc. act. fis. deporte ; 23(92): 112-123, aug.-sept. 2023. tab
Artigo em Inglês | IBECS | ID: ibc-229392

RESUMO

This study aimed to analyze gender differences in athletes' perception of their coaches' authentic leadership style, perceived justice, competence, and attention to basic psychological needs. A total of 217 soccer and handball players (147 men and 70 women) participated. In contrast to male athletes, female athletes showed higher levels in the selected variables. This study should be helpful for coaches to identify their athletes' different perceptions depending on gender. Consequently, coaches may use a different approach depending on their team’s gender (AU)


El objetivo de este estudio fue analizar en función del género de los jugadores la percepción que tienen de sus entrenadores respecto a su estilo de liderazgo auténtico, justicia percibida, competencia y atención a las necesidades psicológicas básicas. Participaron en el estudio 217 jugadores de fútbol y balonmano (147 hombres y 70 mujeres). Las deportistas de género femenino a diferencias de los de género masculino, mostraron niveles más altos en las variables psicológicas seleccionadas. Este estudio debería ser útil a los entrenadores para reconocer cuales son las percepciones de sus deportistas, y de este modo, poder matizar su intervención en función del género del equipo al cual se entrene (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Esportes Juvenis/psicologia , Futebol , Fatores Sexuais
2.
Rev Gastroenterol Mex (Engl Ed) ; 86(2): 110-117, 2021.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33261942

RESUMO

INTRODUCTION AND AIMS: The controlling nutritional status (CONUT) score has previously been shown to be useful for nutritional assessment and the prediction of several inflammatory and neoplastic diseases. The aim of the present study was to evaluate the potential use of the CONUT score as a method for nutritional screening and predicting severity in ulcerative colitis (UC). MATERIALS AND METHODS: The study was conducted on 60 patients diagnosed with UC. Demographic, clinical, and biochemical patient characteristics were collected from their clinical records, and disease severity was assessed using the Truelove and Witts scale (TWS). The risks for malnutrition were evaluated through the nutritional risk index and the CONUT score. RESULTS: More than 90% of the UC patients presented with malnutrition risk, according to the scores analyzed. Patients with a high (>6points) CONUT score presented with moderate-to-severe activity on the TWS. A higher CONUT score was also associated with an increase in C-reactive protein (CRP) (P=.002) and erythrocyte sedimentation rate (ESR) (P=.009). The data analysis was performed utilizing the SPSS version 19 program. CONCLUSIONS: The CONUT score could be a promising tool for evaluating nutritional status in UC patients and predicting UC severity.

3.
Trials ; 21(1): 206, 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32075665

RESUMO

BACKGROUND: Thrice-weekly haemodialysis is the usual dose when starting renal replacement therapy; however, this schedule is no longer appropriate since it does not consider residual renal function. Several reports have suggested the potential benefit of beginning haemodialysis less frequently and incrementally increasing the dose as the residual renal function decreases. However, all the data published so far are from observational studies. Thus, this clinical trial avoids any potential selection bias and will assess the possible benefits that have been observed in observational studies. METHODS/DESIGN: This report describes the study protocol of a randomized prospective multi-centre open-label clinical trial to evaluate whether starting renal replacement therapy with twice-weekly haemodialysis sessions preserves residual renal function better than the standard thrice-weekly regimen. We also explore other clinical parameters, such as concentrations of uremic toxins, dialysis doses, control of anaemia, removal of medium-weight uremic toxins, nutritional status, quality of life, hospital admissions and mortality. Only incident haemodialysis patients who can maintain a urea clearance rate KrU ≥ 2.5 mL/min/1.73 m2 are eligible. Patient recruitment began on 1 January 2017 and will last for 2 years or until the required sample size has been recruited to ensure the established statistical power has been reached. The minimum follow-up period will be 1 year. Anuric patients with acute renal failure and patients who return to haemodialysis after a kidney transplant failure are excluded. It has been calculated that 44 patients should be recruited into each group to achieve a power of 80% in a two-sided comparison of means with a usual significance level of 0.05. A time-to-event analysis will estimate the probability of kidney function survival in both groups using the Kaplan-Meier method. Survival curves will be compared with log-rank tests. This survival analysis will be complemented with a proportional hazard model to estimate the hazard ratio of kidney function survival adjusted for any confounding factors. Analyses will be carried out in accordance with the intention-to-treat principle. DISCUSSION: The incremental initiation of dialysis may preserve residual renal function better than the conventional treatment, with similar or higher survival rates, as reported by observational studies. To our knowledge, this is the first clinical trial to evaluate whether initiating renal replacement therapy with twice-weekly haemodialysis sessions preserves residual renal function better than beginning with the standard thrice-weekly regimen. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03302546. Registered on 5 October 2017.


Assuntos
Falência Renal Crônica/terapia , Diálise Renal/métodos , Anemia/fisiopatologia , Peso Corporal , Progressão da Doença , Humanos , Rim/fisiologia , Falência Renal Crônica/mortalidade , Estudos Multicêntricos como Assunto , Estado Nutricional , Estudos Prospectivos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia de Substituição Renal , Taxa de Sobrevida , Ureia/sangue
4.
Food Chem ; 173: 495-500, 2015 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-25466051

RESUMO

Model juices at pH 3.7 were prepared with different combinations of ascorbic acid, rutin (quercetin 3-rutinoside) and concentrated anthocyanin extract of plums (cv. Black Gold). The anthocyanins in the concentrated extract were cyanidin 3-glucoside and cyanidin 3-rutinoside, in a proportion of 76% and 24% respectively. The model juices were stored during 17 weeks in darkness at 20 °C. The colour stability was improved by the presence of rutin and strongly damaged by the ascorbic acid. The fortification of anthocyanin model juices with ascorbic acid originated the degradation of most of anthocyanins. However, anthocyanins improved ascorbic acid stability during storage. The copigmentation of anthocyanin and rutin showed a beneficial effect on colour stability from the 5 weeks of storage. In model juices prepared exclusively with purified plum extract a high correlation (R(2)=0.881) between anthocyanins and antioxidant capacity was found.


Assuntos
Antocianinas/análise , Antioxidantes/farmacologia , Ácido Ascórbico/farmacologia , Bebidas/análise , Extratos Vegetais/farmacologia , Prunus/química , Rutina/farmacologia , Cor
5.
Food Chem ; 154: 199-204, 2014 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-24518333

RESUMO

The aim of the study was to evaluate the anthocyanin sources potential as natural food colouring. Model juices (MJs) of grape, strawberry and plum peel were stored during 8weeks in darkness at 6 and 23°C. The colour stability was evaluated at pH 2.4, 3.1, 4.0, 5.0, 6.0, 7.0 and 8.1, and the antioxidant capacity at pH 4.0. The plum peel MJ showed the best and more stable colour parameters. The grape MJs presented a high stability although the chroma values were very low. The storage of strawberry MJ demonstrated a low stability at 23°C. The vitamin C equivalent antioxidant capacity in grape, strawberry and plum peel MJs was 7, 40 and 50mg/L, respectively. The strawberry MJ stability was very low. Total phenolics and anthocyanins ranged between 18-101 and 2-62mg/L of MJ, respectively. The determination coefficient was R(2)=0.745 between the antioxidant capacity and total phenolics.


Assuntos
Antioxidantes/química , Bebidas/análise , Fragaria/química , Frutas/química , Extratos Vegetais/química , Prunus/química , Vitis/química , Cor , Armazenamento de Alimentos , Concentração de Íons de Hidrogênio , Temperatura
6.
Rev Clin Esp ; 211(3): 133-8, 2011 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-21382618

RESUMO

INTRODUCTION: Neurocysticercosis (NC) is the most prevalent parasitic infection in the CNS. Its frequency in our environment has increased with migratory movements. The clinical and demographic characteristics of patients with NC attended in a third level hospital in an area with a high prevalence of immigrant have been analyzed. PATIENTS AND METHODS: A retrospective study was done of the patients registered by the Coding Service of Virgen de la Arrixaca Hospital (January 2996 to December 2009), analyzing all the clinical histories of patients discharged with the primary or secondary diagnosis of neurocysticercosis. The most relevant epidemiological, diagnostic and therapeutic data were analyzed. RESULTS: 35 patients were included in the study. Of these, 24 were men, all coming from Latin America. The most prevalent onset was seizure episode (27 patients). The number of cases per year began to increase after 2002. Although only 21 of the cases had criteria to begin medical treatment with albendazole, it had been prescribed to 29 patients. CONCLUSION: In Murcia, NC is mainly an imported disease. An increase in the annual incidence has been observed since 2002, parallel to the rise in the number of immigrants. Approximately 25% of the patients received treatment in spite of not having antiparasitic treatment indication.


Assuntos
Neurocisticercose/epidemiologia , Adolescente , Adulto , Idoso , Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Bolívia/etnologia , Criança , Equador/etnologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neurocisticercose/diagnóstico , Neurocisticercose/tratamento farmacológico , Estudos Retrospectivos , Espanha/epidemiologia , Adulto Jovem
7.
Nefrologia ; 30(6): 626-32, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-21113211

RESUMO

AIMS: To describe PD outcomes over 25 years in a single centre, comparing hospitalisation rate, technique withdrawal, and survival between diabetic (DM) and non-diabetic (NonDM) patients. Differences between type 1 (DM1) and type 2 (DM2) diabetics were also analysed. PATIENTS AND METHODS: One hundred and eighteen DM patients (52 year old average, 74 men, 44 female) and 117 Non-DM (53 year old average, 64 men, 53 female), with at least 2 months on PD, 25±20 (2-109) and 29.4±27 (2-159) months respectively, were included. Diabetics were divided in 66 DM1 and 52 DM2. The survival and hospitalisation study was also analysed in two different time periods: before 1992 (1981-1992) and after 1992 (1993-2005). RESULTS: 93% Non-DM and 75% DM were self-sufficient to manage the PD technique (P<.001) as well as 65% of 44 blind patients. 28% of Non-DM and 15% of DM received a renal allograft (P<.001). There was no difference in transfer to haemodialysis. 18.6% of DM and 4.3% of Non-DM patients presented ≥4 comorbid factors on starting PD (P<.001). Hospitalisation (admissions/year) was higher in DM than in Non-DM (3.4 vs 1.8, P<.01) and also hospitalisation length (46 vs 22 days/year, P=.01), without differences between DM1 and DM2. Admissions due to cardiovascular events, infections, technical problems and peritonitis were more frequent in DM2 than in Non-DM and DM1 patients (P<.05). Mortality was 48% in DM and 22% in Non-DM (P<.001). Survival adjusted for comorbidity was higher in Non-DM (P<.001). Cerebrovascular disease was the highest risk factor for mortality in DM. Mortality was higher in DM2 than in DM1 and Non-DM (P<.001). Age (HR 1.052, P=.001), DM2 (HR 1.96, P<.01) and cerebrovascular disease (HR 4.01, P<.001) were the most important risk factors. In the post-1992 period, the hospitalisation rate and survival improved in DM1 and Non-DM patients. CONCLUSIONS: DM patients more often require outside assistance to perform PD and have more comorbidity, lower survival, and higher admissions than Non-DM, but there is no difference in HD discontinuation. Age and cardiovascular comorbidity are the factors involved in mortality. Technological advances and cumulative center experience may achieve dialysis outcome improvements in diabetic patients. 


Assuntos
Nefropatias Diabéticas/terapia , Falência Renal Crônica/terapia , Diálise Peritoneal/tendências , Adulto , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/mortalidade , Causas de Morte , Comorbidade , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/mortalidade , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/mortalidade , Nefropatias Diabéticas/mortalidade , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Humanos , Estimativa de Kaplan-Meier , Nefropatias/complicações , Falência Renal Crônica/etiologia , Falência Renal Crônica/mortalidade , Transplante de Rim/tendências , Masculino , Pessoa de Meia-Idade , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Diálise Peritoneal/métodos , Diálise Peritoneal/estatística & dados numéricos , Diálise Peritoneal Ambulatorial Contínua/estatística & dados numéricos , Diálise Peritoneal Ambulatorial Contínua/tendências , Peritonite/epidemiologia , Peritonite/prevenção & controle , Modelos de Riscos Proporcionais , Diálise Renal/estatística & dados numéricos , Autocuidado , Espanha/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/mortalidade
8.
Rev Gastroenterol Mex ; 74(3): 195-201, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19858007

RESUMO

BACKGROUND: An association between human papilloma virus (HPV) infection and progression to anal intraepithelial neoplasia (AIN) and epidermoid cancer has been established. OBJECTIVE: To know the prevalence of low and high grade AIN, as well as HPV infection in an anoreceptive patients group, infected or not, by human immunodeficiency virus (HIV). MATERIAL AND METHODS: All patients with anoreceptive sexual relations were considered in this study. Patients who accepted anal citology and high definition anoscopy and biopsies with a follow-up not minor of 3 months were included. RESULTS: Forty-four patients were included: 40 male (90.9%) with average age of 31 years. Anal cytology showed inflammatory alterations in 21 patients (28%), low grade intraepithelial lesion in 23 (52%); there were not patients with high grade epithelial lesion. According to the high definition anoscopy, there were low grade intraepithelial lesion in 42 patients (95%) and high grade in 2 (5%). Biopsy showed low grade intraepithelial in 26 patients (59%), high grade in 4 (9%) and inflammatory alterations in 14 (32%). The prevalence of AIN and HPV infection was 68% in both diseases. The HIV infection was associated with the presence of high grade AIN (p=0.002, OR 47.7) CONCLUSIONS: There is a high prevalence of AIN and HPV infection between patients with anoreceptive sexual relations. The HIV infection is a risk factor for the development of high grade AIN.


Assuntos
Neoplasias do Ânus/complicações , Carcinoma in Situ/complicações , Infecções por Papillomavirus/complicações , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Canal Anal/patologia , Neoplasias do Ânus/patologia , Biópsia , Carcinoma in Situ/patologia , Progressão da Doença , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/patologia , Fatores de Risco , Adulto Jovem
9.
Rev Gastroenterol Mex ; 74(2): 99-104, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19666290

RESUMO

INTRODUCTION: Distribution of colon and rectal tumors has been studied by many authors, which have considered that distal colon and rectum are more affected. However, its frequency and distribution have changed in recent years. OBJECTIVE: A descriptive analysis of colorectal cancer in the General Hospital of Mexico during the last 20 years (1988-2007). MATERIAL AND METHODS: This is a transversal comparative study between decades from the database of the Pathology Service of the General Hospital of Mexico, of cases of cancer diagnosed from January 1988 to December 2007. Variables included age, gender, anatomic site of the tumor,grade of differentiation, stadification and type of surgery. RESULTS: There were 222 cases from 1988 to 1997 and 400 cases from 1998 to 2007. 115 (52%) were female in the firs decade and 210 (53%) in the second. We found a prevalence of 71 cases (32%) for the proximal colon, 24 (11%) for the distal colon and 127 (57%) for the rectum in the first decade; in second decade there were 182 (45%) cases for the proximal colon, 50 (13%) for the distal colon and 168 (42%) for the rectum. CONCLUSIONS: The number of colorectal cancerduring the last decade almost doubled in our hospital (80%); we also found an increase in the number of proximal tumors and a decreasein the number of rectal tumors.


Assuntos
Neoplasias Colorretais/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Hospitais Gerais , Humanos , Masculino , México , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
10.
Blood Purif ; 28(3): 159-64, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19590183

RESUMO

BACKGROUND: End-stage renal disease is a major health problem worldwide nowadays. Although conventional hemodialysis is the most widely used modality, short daily hemodialysis has been proposed as a more physiologic treatment. The objective of this article is to compare the quality of life of patients on each hemodialysis modality. METHODS: A multicentric cross-sectional study was performed in 9 Spanish hospitals. Patients treated for at least 3 months with conventional or short daily hemodialysis were included and quality of life measured using the Euroqol-5D quality of life questionnaire. Bayesian models were used for analyzing quality of life results. RESULTS: Ninety-three patients were included, 27 were on daily hemodialysis and 66 on conventional hemodialysis. All models demonstrated a better quality of life for daily hemodialysis versus conventional hemodialysis. Only 14% of the patients on conventional hemodialysis were willing to change to a daily schedule. CONCLUSIONS: Short daily hemodialysis shows a better quality of life than conventional hemodialysis with all Bayesian approaches considered.


Assuntos
Falência Renal Crônica/terapia , Qualidade de Vida , Diálise Renal , Inquéritos e Questionários , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha
11.
Rev Neurol ; 48(2): 61-5, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19173202

RESUMO

INTRODUCTION: In a population-based study of the incidence of stroke conducted on a broad denominator, it is wise first to carry out a pilot study. AIM: To present the results of the pilot phase of the study on stroke incidence in Spain, entitled Iberictus. PATIENTS AND METHODS: Population of the study: all cases involving the first episode of acute cerebrovascular disease (stroke or transient ischaemic attack) diagnosed among residents over 17 years of age with their habitual place of abode registered in the areas of study between 15th and 31st October 2005 (total denominator: 1,440,997 inhabitants). SOURCE OF DATA: prospective, hospital records (basic minimum data set, discharge abstracts) and casualty department registers. Standardised definitions: diagnostic categorisation and pathological, topographical and aetiological classification. Inter-observer agreement analysis among researchers (kappa). RESULTS: A total of 128 cases were identified. Age range, 37-103 years; mean age, 75.7 +/- 13.4 years; 54% were females. In all, 71.1% of the cases were collected by means of a basic minimum data set. There were 91 ischaemic events (29.7% atherothrombotic and 29.7% cardioembolic). Of the 15 haemorrhagic strokes, 40% due to arterial hypertension, six were lobar hemispheric, six were deep basal ganglia, and there were three cerebellar haemorrhages. The incidence of stroke was seen to increase exponentially with age. Inter-observer agreement was good for the classifications that were employed (range of kappa indices, 0.57-0.78). Several problems were detected and corrected in the fieldwork. CONCLUSIONS: The Iberictus pilot study yielded data that were consistent with the literature and provided us with the opportunity to detect and correct issues that would hinder us from conducting the main study.


Assuntos
Acidente Vascular Cerebral/epidemiologia , Doença Aguda , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Coleta de Dados/métodos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Projetos Piloto , Estudos Prospectivos , Controle de Qualidade , Sistema de Registros , Espanha/epidemiologia , Acidente Vascular Cerebral/classificação
12.
Rev Neurol ; 47(12): 617-23, 2008.
Artigo em Espanhol | MEDLINE | ID: mdl-19085876

RESUMO

INTRODUCTION: Epidemiological data on the incidence of cerebrovascular diseases in our country are scarce. A representative population-based study with a large denominator is required. AIM: To present the design of the study on stroke incidence in Spain, entitled Iberictus. SUBJECTS AND METHODS: We conducted a prospective, population-based study on the incidence of strokes and transient ischemic attacks, in which it is possible to distinguish: 1) population with a steady risk, which was well defined and had a broad denominator. We included all the cases in which the first episode of acute cerebrovascular disease was diagnosed among those over the age of 17 years (with no upper age limit) with their habitual residence in the areas of study between the 1st January and 31st December 2006: Lugo, Segovia, Talavera de la Reina, Mallorca and Almeria (total denominator, 1,440,997 inhabitants; minimum denominator per area, 100,000 inhabitants); 2) source of multiple and complementary data: hospital records (minimum basic data set, discharge abstracts), emergency and primary care records for the area with diagnostic codes 430-39 and 674.0 (International Classification of Diseases-9), population-based mortality records; 3) standardised definitions: diagnostic categorisation (MONICA-World Health Organisation, 1987), pathological classification (ischaemia, haemorrhagic), topography and aetiology; 4) presentation of data in suitable age groups, by sex and overall; 5) pilot study and analysis of inter-observer agreement among researchers. CONCLUSIONS: With this design, the Iberictus study satisfies the methodological criteria as an 'ideal' study of the incidence of acute cerebrovascular diseases proposed by Malgrem, Sudlow and Warlow, and represents a unique opportunity to further our knowledge of the epidemiology of strokes in our country.


Assuntos
Projetos de Pesquisa , Acidente Vascular Cerebral/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos Cerebrovasculares/diagnóstico , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/patologia , Transtornos Cerebrovasculares/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Controle de Qualidade , Espanha/epidemiologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/patologia , Acidente Vascular Cerebral/fisiopatologia , Adulto Jovem
13.
Int J Sports Med ; 29(9): 764-9, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18401802

RESUMO

This study aimed to investigate the role of rest period duration (RP) on the time course of the acceleration portion (AP) and mean velocity of the concentric phase across two bench press sets to failure with a submaximal load (60% of the 1RM) using different RP. Ten elite junior kayakers performed, on four different days, two consecutive bench press sets to failure, allowing randomly 1-, 2-, 3- and 4-min RP between sets. AP reached a maximal value of 66% of the concentric movement time. This maximal AP was observed in repetition number 2 or 3, and then AP declined during the set, with a significant decrease when the number of repetitions was over 80% of the total number of repetitions performed. AP and lifting velocity patterns of the concentric phase were not altered during a second set to failure, regardless of RP. However, when velocity was expressed in absolute terms, 1-min RP was insufficient to maintain the average lifting velocity during the second set, compared to the first one. These results may be of use in selecting number of repetitions and resting duration in order to ensure optimal maintenance of the accelerative portion of concentric movement time with different resting-period durations.


Assuntos
Tolerância ao Exercício/fisiologia , Contração Isométrica/fisiologia , Músculo Esquelético/fisiologia , Descanso/fisiologia , Navios , Levantamento de Peso/fisiologia , Adaptação Fisiológica , Adolescente , Feminino , Humanos , Masculino , Força Muscular/fisiologia , Fatores de Tempo , Adulto Jovem
14.
Nefrologia ; 28(1): 56-60, 2008.
Artigo em Espanhol | MEDLINE | ID: mdl-18336132

RESUMO

UNLABELLED: Angiotensin-converting enzyme inhibitors (ACEI) have proved an antihypertensive and renoprotective effect with reduction of proteinuria in diabetic and non diabetic nephropathy, but not exempt of side effects in advanced chronic kidney disease (ACKD) patients. Angiotensin receptor blockers (ARB) have emerged as antiproteinuric, renoprotective and cardioprotective therapy. Only a few reports have been published studying ARB effects on non-diabetic ACKD patients. Our aim is to study Irbesartan (ARB) on non-diabetic ACKD patients and compare its effects with ACEI. PATIENTS AND METHODS: Forty three non-diabetic patients at ACKD stage IV NKF-DOQI (CrCl <30 ml/min) were enrolled in a prospective study. Group I: 21 received Irbesartan monodose 150-300 mg/day (63+/-17 y/o, 12 F, 9 M,ClCr 22.1+/-8 ml/m.), Group II: 22 received ACEI (65+/-13 y/o, 8 F, 14 M, CrCl 22.3+/-7 ml/m). Parameters studied: blood pressure (BP), pulse pressure (PP), renal function (CrCl), proteinuria (in patients with proteinuria >or= 0.5 g/d), serum K+ and serum uric acid, at month 0, 3, 6, 9 and 12. RESULTS: At 12 months, BP was controlled in 57% of Group I vs 39% of Group II. Mean systolic BP was decreased from 154/85 to 138/77 in G I, and from 146/85 to 133/77 in GII, with a decrease in 10.7% of mean BP in GI and 8.5% in GII (NS). Irbesartan reduced PP in 7.2% vs 8.3% with ACEI (NS). CrCl reduction with Irbesartan was 0.23 vs 0.21 ml/min/month with ACEI (NS). The antiproteinuric effect was higher with Irbesartan (from 2.1 to 1.3 g/day) vs. ACEI (from 1.35 to 1.33 gr /day), being statistically significant the reduction percentage between the two groups (p >or= 0.041). Serum K+ level do not change in Irbesartan group and increased 10% in ACEI group (p<0.001). Uric acid was decreased by Irbesartan in 17% and increased in 4% by ACEI (p<0.001). CONCLUSIONS: Irbesartan in non-diabetics patients with advanced chronic renal disease, compared with ACEI showed similar blood pressure control and similar effect on chronic kidney disease progression, with higher antiproteinuric effect. On the other side, Irbesartan showed a reduction of serum uric acid, and did not increase serum K+ levels.


Assuntos
Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Compostos de Bifenilo/uso terapêutico , Hipertensão/tratamento farmacológico , Nefropatias/complicações , Tetrazóis/uso terapêutico , Idoso , Progressão da Doença , Feminino , Humanos , Irbesartana , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
15.
An Med Interna ; 25(7): 331-4, 2008 Jul.
Artigo em Espanhol | MEDLINE | ID: mdl-19295992

RESUMO

BACKGROUND: the aim of this study was to evaluate prognostic factors in brain abscess (AB) and influence of management with antibiotic prescribing protocols (APP). PATIENTS AND METHODS: observational study of a cohort of non-paediatric patients with BA admitted at a 944-bed hospital (1976-2005). Data collection from clinical records has been done according to a standard protocol. We analysed epidemiological, clinical, radiological, microbiological and laboratory data associated with mortality. From 1976 to 1983 (Period I), antibiotic treatment was not done according to any internal APP; from 1983 (Period II), antibiotic management was done according to a APP designed by infectious diseases specialists and neurosurgeons. Predictors of mortality were identified by univariate analysis. The influence of the use of APP in outcome was assessed. RESULTS: 104 patients with BA were included (mean age 45 years; range 12-86); presumed primary pathogenic mechanism of BA was identified in 89%; microbiologic diagnosis was made in 76%. Overall mortality was 16.3%. Factors statistically associated with higher mortality were: age > 40 years, ultimately fatal underlying disease, acute severe clinical condition at the onset of BA, altered mental status and inadequate empirical treatment; 33 patients were treated in Period I and 71 in Period II; no statistically significant differences were found between epidemiological, clinical, radiological or microbiological characteristics of the groups except for mean age (> 40 years in 36% and 62% respectively in Period I and II). Rates of resolution of BA were 60 vs. 77.4% (p < 0.05); relapses 21 vs. 7% (p < 0.05) and mortality 18 vs. 15.4% (p > 0.05), in Period I and II respectively. CONCLUSIONS: main prognostic factors associated with mortality in patients with BA are age, rapidly fatal underlying disease, acute severe clinical condition at the onset of BA, altered mental status and inadequate empirical treatment. Empiric treatment according to APP was associated with greater resolution and lower relapse rates.


Assuntos
Antibacterianos/uso terapêutico , Abscesso Encefálico/tratamento farmacológico , Abscesso Encefálico/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Protocolos Clínicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Adulto Jovem
16.
Rev Neurol ; 45(11): 647-54, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-18050095

RESUMO

AIM: To assess the psychometric attributes of the stroke-adapted 30-item version of the Sickness Impact Profile, Spanish version (SA-SIP30), in stroke survivors. PATIENTS AND METHODS: 79 patients were evaluated (mean age: 68.1 years) by means of the modified Rankin Scale (m-RS), Scandinavian Stroke Scale (SSS), Barthel Index (BI), and the modified 23-item Beck-Hamilton's Depression Rating Scale (HDRS). Health-related quality of life was evaluated using the MOS-Short Form 36 (SF-36) and the SA-SIP30. RESULTS: SA-SIP30 mean score was 36.8. SA-SIP30 floor and ceiling effects were 3.8% and 0%. Regarding SA-SIP30 categories, floor effect ranged from 15.2% (social interaction) to 49.4% (alertness behavior), whereas ceiling effect ranged from 2.5% (social interaction) to 26.6% (household management). A floor effect was observed in seven SA-SIP30 categories. The internal consistency of SA-SIP30 (Cronbach's alpha = 0.87), physical (Cronbach's alpha = 0.89) and psychosocial (Cronbach's alpha = 0.75) dimensions were satisfactory. Standard error of measurement (SEM) values for each SA-SIP30 category ranged from 15.9 (household management) to 26.3 (ambulation). SEM values for overall SA-SIP30, physical and psychosocial dimensions were 8, 10 and 17.3, respectively. Corrected item-category correlations ranged from 0.17 (item 28) to 0.83 (item 23). A significant correlation (Spearman's correlation coefficient; p < 0.0001) between SA-SIP30 scores and BI (-0.71), m-RS (0.68), SSS (-0.67), HDRS (0.52), SF-36 physical (-0.67) and mental components (-0.51) was found. SA-SIP30 mean score significantly increased as m-RS increased (discriminative validity; Kruskal-Wallis, p < 0.0001). CONCLUSION: The Spanish-version of the SA-SIP30 has satisfactory internal consistency, convergent validity and discriminative validity in stroke patients.


Assuntos
Perfil de Impacto da Doença , Acidente Vascular Cerebral/psicologia , Idoso , Idoso de 80 Anos ou mais , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/etiologia , Estudos de Coortes , Humanos , Relações Interpessoais , Idioma , Pessoa de Meia-Idade , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtornos do Humor/etiologia , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/epidemiologia , Transtornos dos Movimentos/etiologia , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Espanha , Acidente Vascular Cerebral/classificação , Acidente Vascular Cerebral/epidemiologia
17.
Rev. neurol. (Ed. impr.) ; 45(11): 646-654, 1 dic., 2007. tab
Artigo em Es | IBECS | ID: ibc-65822

RESUMO

Evaluar los atributos métricos de la versión española del perfil de las consecuencias de la enfermedad de30 ítems adaptado al ictus (SIP30-AI). Pacientes y métodos. Se evaluó a 79 pacientes (edad media: 68,1 años) con la escala escandinava de ictus, el índice de Barthel (IB), la escala de Rankin modificada, la escala de depresión de Hamilton, el cuestionariode salud SF-36 y el SIP30-AI. Resultados. La puntuación media del SIP30-AI fue de 36,8. Los efectos suelo y techofueron 3,8 y 0%, respectivamente. El efecto suelo se observó en siete categorías del SIP30-AI, y osciló entre 15,2% (relaciones sociales) y 49,4% (actividad intelectual); el efecto techo varió de 2,5% (relaciones sociales) a 26,6% (tareas domésticas).La consistencia interna del SIP30-AI (alfa de Cronbach = 0,87) y de sus dimensiones física (alfa de Cronbach = 0,89) y psicosocial (alfa de Cronbach = 0,75) fue satisfactoria. Los valores del error estándar de la medida (EEM) para el SIP30-AI y sus dimensiones física y psicosocial fueron 8, 10 y 17,3, respectivamente. El EEM de las categorías osciló entre 15,9 (tareasdomésticas) y 26,3 (desplazamiento). Las asunciones escalares (correlación ítem-categoría corregida: 0,17-0,83) fueron adecuadas. El SIP30-AI se correlacionó significativamente (coeficiente de Spearman; p < 0,0001) con el IB (–0,71), Rankin (0,68), escalas escandinava (–0,67) y de Hamilton (0,52), e índices físico (–0,67) y mental (–0,51) de la SF-36. Los valores delSIP30-AI se incrementaron conforme empeoraba la situación funcional en la escala de Rankin (Kruskal-Wallis; p < 0,0001).Conclusión. La versión española del SIP30-AI tiene una consistencia interna, una validez convergente y una validez discriminativa adecuadas


To assess the psychometric attributes of the stroke-adapted 30-item version of the Sickness Impact Profile,Spanish version (SA-SIP30), in stroke survivors. Patients and methods. 79 patients were evaluated (mean age: 68.1 years) by means of the modified Rankin Scale (m-RS), Scandinavian Stroke Scale (SSS), Barthel Index (BI), and the modified 23-item Beck-Hamilton’s Depression Rating Scale (HDRS). Health-related quality of life was evaluated using the MOS-Short Form 36(SF-36) and the SA-SIP30. Results. SA-SIP30 mean score was 36.8. SA-SIP30 floor and ceiling effects were 3.8% and 0%. Regarding SA-SIP30 categories, floor effect ranged from 15.2% (social interaction) to 49.4% (alertness behavior), whereas ceiling effect ranged from 2.5% (social interaction) to 26.6% (household management). A floor effect was observed in sevenSA-SIP30 categories. The internal consistency of SA-SIP30 (Cronbach’s alpha = 0.87), physical (Cronbach’s alpha = 0.89) and psychosocial (Cronbach’s alpha = 0.75) dimensions were satisfactory. Standard error of measurement (SEM) values for each SA-SIP30 category ranged from 15.9 (household management) to 26.3 (ambulation). SEM values for overall SA-SIP30,physical and psychosocial dimensions were 8, 10 and 17.3, respectively. Corrected item-category correlations ranged from 0.17 (item 28) to 0.83 (item 23). A significant correlation (Spearman’s correlation coefficient; p < 0.0001) between SA-SIP30scores and BI (–0.71), m-RS (0.68), SSS (–0.67), HDRS (0.52), SF-36 physical (–0.67) and mental components (–0.51) was found. SA-SIP30 mean score significantly increased as m-RS increased (discriminative validity; Kruskal-Wallis, p < 0.0001). Conclusion. The Spanish-version of the SA-SIP30 has satisfactory internal consistency, convergent validity and discriminative validity in stroke patients


Assuntos
Humanos , Psicometria/instrumentação , Perfil de Impacto da Doença , Acidente Vascular Cerebral/complicações , Avaliação da Deficiência
18.
Rev Clin Esp ; 207(2): 57-63, 2007 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-17397563

RESUMO

BACKGROUND: Staphylococcus aureus bacteremia continues to be a major problem in hospitals due to its high prevalence, severity and treatment difficulties. This study aimed to evaluate epidemiological and clinical features, risk factors and influence of antibiotic choice in outcome and mortality in patients with methicillin susceptible S. aureus bacteremia (SAMSB). PATIENTS AND METHODS: A prospective, observational study of inpatients with SAMSB (2000-3). RESULTS: A total of 131 with SAMSB were included (mean age 56 years; 58% > or = 60 year-old); 56.5% were due to nosocomial bacteremia; 46% of all patients had an underlying condition (diabetes mellitus being the most frequent [28%]); a risk factor for bacteraemia was identified in 98% (intravenous catheter: 72%). Mortality rate was 16% (21/131). Comparative analysis according to nosocomial or community acquisition showed that the former was more frequent in Surgical Wards, patients with intravenous or urinary catheters, traumatic patients, dialysis and ICU patients. Initial severity and mortality were highest in community-acquired SAMSB. In multivariate analysis, risk factors associated with higher mortality were: presence of an ultimately or rapidly fatal underlying disease, acute severity of illness at onset and inadequate empirical treatment. CONCLUSIONS: SAMSB is a clinically severe infection that occurs in patients with baseline disease, especially diabetics, that is almost always related to predisposing risk factors (mainly intravenous catheters). In the presence of a serious baseline disease, the initial critical clinical condition and inadequate empirical treatment are the main prognostic factors associated to greater mortality.


Assuntos
Bacteriemia , Infecção Hospitalar , Infecções Estafilocócicas , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Bacteriemia/mortalidade , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/mortalidade , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/mortalidade , Feminino , Humanos , Masculino , Meticilina/farmacologia , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Prospectivos , Fatores de Risco , Índice de Gravidade de Doença , Espanha/epidemiologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/mortalidade , Staphylococcus aureus/efeitos dos fármacos , Resultado do Tratamento
19.
Eur J Clin Microbiol Infect Dis ; 26(4): 239-45, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17318479

RESUMO

The objective of this study was to evaluate prognostic factors and the influence of different empiric antibiotic therapies on outcome and mortality in a cohort of 100 inpatients with bacteraemia (84 cases nosocomial) caused by methicillin-resistant Staphylococcus aureus (MRSA). Patients were investigated by means of a standard protocol at a 944-bed hospital in the years 2000-2004. Empiric antibiotic therapies included vancomycin (n = 49), teicoplanin (n = 20), linezolid (n = 17), other antibiotics active in vitro (n = 7), and inactive antibiotics (n = 7). Overall mortality was 40% (12% among linezolid-treated patients; 46.3% among glycopeptide-treated patients). In bivariate analyses, the following factors were statistically associated with higher mortality: rapidly fatal underlying disease, altered mental status, metabolic acidosis, and acute severe clinical condition at the onset of bacteraemia; development of complications (septic shock, renal failure, and disseminated intravascular coagulopathy); empiric monotherapy with glycopeptides (vs combination therapy with an aminoglycoside); and inadequate empiric treatment. Empiric therapy with linezolid was associated with lower mortality. In multivariate analysis, risk factors associated with higher mortality included acute severity of illness (OR 7.49; 95%CI 1.19-25.3) and altered mental status (OR 4.83; 95%CI 1.22-19.15) at onset, complications (OR 3.42; 95%CI 1.02-17.46), and inappropriate empiric treatment (OR 7.6; 95%CI 1.87-31.14). In multivariate analysis limited to patients who received empiric therapy with either linezolid (n = 17) or glycopeptides (n = 69), linezolid was associated with greater rates of survival (OR 7.7; 95%CI 1.1-53) and microbiological eradication (OR 11.76; 95%CI 1.46-90.9) but not with fewer complications (OR 0.71; 95%CI 0.16-3.25). In conclusion, the main prognostic factors associated with mortality in patients with MRSA bacteraemia are complications, acute severe clinical condition at onset, and inappropriate empiric treatment. Empiric therapy with linezolid was associated with greater survival and more successful microbiological eradication but did not reduce complications.


Assuntos
Anti-Infecciosos/uso terapêutico , Bacteriemia/tratamento farmacológico , Resistência a Meticilina , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/microbiologia , Bacteriemia/mortalidade , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Infecção Hospitalar/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/mortalidade , Resultado do Tratamento
20.
Int J Sports Med ; 27(7): 533-9, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16802248

RESUMO

This study compared the effects of four-week training periods of electromyostimulation (EMS), plyometric training (P), or combined EMS and P training of the knee extensor muscles on 20 m sprint time (ST), jumping ability (Squat jump [SJ] and Countermovement jump [CMJ]), maximal isometric strength (MVC), and muscle cross-sectional area (CSA). Forty subjects were randomly assigned to one of the four treatment groups: electromyostimulation (EG), plyometric (PG), combined EMG, and P (EPG), that took place 4 times per week, and a control group (CG). Subjects were tested before and after the training program, as well as once more after 2 wk of detraining. A significant improvement (p < 0.05) in ST was observed after training (2.4 %) in EG while a significant slowing (p < 0.05) was observed (- 2.3 %) in EPG. Significant increases in EPG (p < 0.05) were observed in SJ (7.5 %) and CMJ (7.3 %) after training, while no significant changes in both jumps were observed after training and detraining for EG. A significant increase (p < 0.05) in MVC was observed after training (9.1 %) and after detraining (8.1 %) in EG. A significant increase (p < 0.05) in MVC was observed after training (16.3 %) in EPG. A significant increase (p < 0.01) in CSA was observed after training in EG (9.0 %) and in EPG (7.1 %). EMS combined with plyometric training increased the jumping height and sprint run in physically active men. In addition, EMS alone or EMS combined with plyometric training leads to increase maximal strength and to some hypertrophy of trained muscles. However, EMS training alone did not result in any improvement in jumping explosive strength development or even interfered in sprint run.


Assuntos
Estimulação Elétrica , Contração Isométrica/fisiologia , Joelho/fisiologia , Músculo Esquelético/fisiologia , Educação Física e Treinamento/métodos , Corrida/fisiologia , Esportes/fisiologia , Adulto , Análise de Variância , Humanos , Masculino , Movimento/fisiologia , Fatores de Tempo
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