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INTRODUCTION: Primary aldosteronism is the most frequent cause of hypertension although is undetected. The 2016 Endocrine Society guidelines (2016-ESG) recommendations for primary aldosteronism detection are unfulfilled. We aimed to ascertain the prevalence of primary aldosteronism, following the screening criteria endorsed by the 2016-ESG. METHODS: All adult patients tested for primary aldosteronism at an endocrine hypertension unit of a tertiary hospital during 2021-2023 were studied. Primary aldosteronism investigation was performed when at least one reason for its screening based on 2016-ESG was detected. When screening was positive, confirmatory tests were executed. Rates and diagnostic accuracy of the reasons for primary aldosteronism screening were analyzed. RESULTS: Two hundred and sixty-five patients were included. Mean age was 55â±â14âyears, 124 of 265 (46.8%) were women, 24.6% had hypokalemia, and 16% adrenal incidentaloma(s) as indication for screening. Primary aldosteronism was diagnosed in 122 of 265 (46%). The presence of each reason for primary aldosteronism screening increased the probability of primary aldosteronism in 2.2-fold [95% confidence interval (CI): 1.63 to 2.97; Pâ<â0.001]. The most frequent reason for primary aldosteronism screening was a blood pressure at least 150/100âmmHg on three measurements on different days, and had a sensitivity of 95%. Hypertension with spontaneous or diuretic-induced hypokalemia was the most specific reason (87.5%) but was not frequent. Adrenal incidentaloma(s) was not associated with primary aldosteronism diagnosis. CONCLUSION: Primary aldosteronism prevalence is markedly high when the 2016-ESG recommendations are rigorously implemented. The greater the number of indications for primary aldosteronism investigation, the higher its prevalence. Further studies are needed to corroborate this observed primary aldosteronism prevalence.
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Hiperaldosteronismo , Hipertensão , Humanos , Hiperaldosteronismo/epidemiologia , Hiperaldosteronismo/diagnóstico , Hiperaldosteronismo/complicações , Pessoa de Meia-Idade , Feminino , Masculino , Prevalência , Hipertensão/epidemiologia , Adulto , Idoso , Fidelidade a Diretrizes , Guias de Prática Clínica como AssuntoRESUMO
This scoping review aimed to provide an overview of the current landscape of pediatric palliative care in Latin America, including policies, regulations, available resources, challenges, barriers, and evidence-based recommendations. We conducted a comprehensive search for peer-reviewed articles related to pediatric palliative care in Latin America, considering both review and empirical articles published in English, Portuguese, or Spanish within the last decade. Our review initially identified 30 publications, which were subjected to a full-text assessment. The majority of these articles originated from Brazil, Mexico, and Chile, highlighting a regional concentration of research efforts. Notably, we observed a scarcity of comprehensive research and specific studies on pediatric palliative care in Latin America. Our findings revealed significant challenges, including resource limitations, the absence of dedicated policies, and the critical need for interdisciplinary teams to address the multifaceted aspects of pediatric palliative care. In light of our review, we emphasise the necessity for more extensive and representative research efforts, as well as the continuous updating of scientific evidence in the field of pediatric palliative care within the Latin American context. The recommendations derived from this review aim to contribute to the enhancement of pediatric palliative care services and accessibility throughout Latin America.
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Cuidados Paliativos , Humanos , Criança , América Latina , México , BrasilRESUMO
Planarians are a model animal for the study of regeneration and homeostasis. Understanding how planarians control their cellular balance is key to the knowledge of their plasticity. Both apoptotic and mitotic rates can be quantified in "whole mount" planarians. Apoptosis is usually analyzed through terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), a technique that detects cell death by identifying DNA breaks. In this chapter we detail a protocol to analyze apoptotic cells in paraffin sections of planarians, which enables a more accurate cellular visualization and quantification than in "whole mount."
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Planárias , Animais , Marcação In Situ das Extremidades Cortadas , Planárias/fisiologia , Parafina , Apoptose/genética , Coloração e RotulagemRESUMO
The COVID-19 pandemic caused disruptions in schooling and the closure of schools worldwide, how this has affected children's and youth's health and wellbeing is a current area of research. However, those who suffer a chronic or temporary disease may be attending hospital classrooms, and this scenario has received little attention in comparison to regular schools. The objective of this exploratory quantitative study focuses on exploring the quality of life and emotional well-being of students attending hospital classrooms. For this purpose, four Chilean hospital classrooms from different regions of the country were randomly selected. A total number of 248 students participated in the survey, each of whom filled out two online questionnaires. The findings show similar scores in children with mental illness and those with other health conditions. In comparison with one year before, students rate their general health as the same or somewhat better now, as well as manifesting an optimistic view of the future regarding the pandemic.
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The forkhead box (Fox) genes encode transcription factors that control several key aspects of development. Present in the ancestor of all eukaryotes, Fox genes underwent several duplications followed by loss and diversification events that gave rise to the current 25 families. However, few Fox members have been identified from the Lophotrochozoa clade, and specifically from planarians, which are a unique model for understanding development, due to the striking plasticity of the adult. The aim of this study was to identify and perform evolutionary and functional studies of the Fox genes of lophotrochozoan species and, specifically, of the planarian Schmidtea mediterranea. Generating a pipeline for identifying Forkhead domains and using phylogenetics allowed us the phylogenetic reconstruction of Fox genes. We corrected the annotation for misannotated genes and uncovered a new family, the QD, present in all metazoans. According to the new phylogeny, the 27 Fox genes found in Schmidtea mediterranea were classified into 12 families. In Platyhelminthes, family losses were accompanied by extensive gene diversification and the appearance of specific families, the A(P) and N(P). Among the newly identified planarian Fox genes, we found a single copy of foxO, which shows an evolutionary conserved role in controlling cell death.
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Evolução Biológica , Fatores de Transcrição Forkhead/metabolismo , Proteínas de Helminto/metabolismo , Planárias/genética , Morte Celular Regulada/genética , Animais , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , FilogeniaRESUMO
Drosophila subobscura is a species with a rich chromosomal polymorphism which is adaptive to different climatic conditions. Five samples of the Font Groga population (Barcelona, Spain) were sampled in autumn during 5 consecutive years (2011-2015) to obtain their inversion chromosomal polymorphism, and climatic data of several meteorological variables were also collected. The aim was to analyze the adaptive potential of inversions with regard to climatic variables, being the most relevant: mean temperature (Tmean), maximum temperature (Tmax), minimum temperature (Tmin), humidity (Hm) and rainfall (Rf). As expected, no significant variation in inversion frequencies were detected over this short period of time. However, from a climatic point of view it was possible to differentiate 'warm' and 'dry' from 'cold' and 'humid' samples. The joint study of maximum (Tmax) and minimum (Tmin) temperatures was a key element to understand the effect on adaptation of many inversions. It was also observed that temperature had to be considered in conjunction with humidity and rainfall. All these factors would condition the biota of D. subobscura habitat, and chromosomal inversions could provide an adaptive response to it.
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Adaptação Biológica/genética , Drosophila/genética , Adaptação Fisiológica/genética , Animais , Animais Selvagens/genética , Inversão Cromossômica/genética , Mudança Climática , Proteínas de Drosophila/genética , Aquecimento Global , Polimorfismo Genético/genética , Chuva , TemperaturaRESUMO
No disponible
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Humanos , Masculino , Feminino , Asma/epidemiologia , Asma/prevenção & controle , Estado Asmático/epidemiologia , Estado Asmático/prevenção & controle , Sociedades Médicas/normas , Sociedades Médicas/tendências , Sociedades Médicas , Asma/imunologia , Estado Asmático/imunologia , Sociedades Médicas/história , Sociedades Médicas/organização & administraçãoRESUMO
Antecedentes. La enfermedad crónica infantil tiene impacto en la familia y afecta al paciente física, psicoemocional y socialmente. La hipótesis de este estudio es que la identificación de tales factores puede servir para mejorar su formación y competencia comunicativa y, consecuentemente, la gestión de la enfermedad crónica. Objetivo. Identificar las necesidades formativas psicopedagógicas en pediatras y residentes en pediatría del mayor hospital público en las Islas Baleares, España. Materiales y métodos. Estudio de diseño mixto cuantitativo-cualitativo, donde 51 pediatras y residentes -71.8% del servicio- contestaron un cuestionario y 26 participaron en entrevistas analizadas con análisis de contenido. Resultados. Los pediatras consideran que el apoyo y la cohesión familiar son los factores más relevantes para gestionar adecuadamente una enfermedad crónica infantil, pero manifiestan tener escasos conocimientos sobre el desarrollo emocional y psicológico de los niños y adolescentes. Destacan la escasa comunicación entre pediatras y escuela, así como la deficiente información sobre servicios socioeducativos que se ofrecen en el hospital y también en la comunidad. Los resultados cualitativos fueron organizados en cinco bloques temáticos: impacto de la enfermedad crónica infantil en la familia, formación psicopedagógica de los pediatras, dificultades en la práctica, comunicación entre escuela y hospital y el hospital como entidad educativa. Conclusión. La pediatría hospitalaria requiere considerar las específicas necesidades psicoemocionales de la familia y del menor, para lo cual se necesita formación psicopedagógica, así como un trabajo interprofesional entre sanitarios y educadores.
Background. Chronic illness in children has a strong impact on the family, having a negative effect on the patient at a physical, psycho-emotional and social level. This study hypothesis states that the identification of such factors may serve to improve these patients' education process as well as their communicative competence, and, in consequence, the handling of their chronic disease. Objective. To identify training needs in pediatricians and pediatrics residents working in the largest public hospital in the Balearic Islands, Spain. Materials and Methods. A mixed design, quantitative and qualitative study was used, where 51 pediatricians and residents (71.8% Service) answered a questionnaire, while 26 participated in interviews that were analyzed with content analysis. Results. Pediatricians considered that family support and cohesion are the most important factors to take into account to properly manage a chronic childhood disease. Somehow, they stated that they have little knowledge about the emotional and psychological development of children and adolescents. Poor communication between pediatricians and school, as well as the lack of information regarding educative and social services offered both in the hospital and a the community are aspects to be highlighted. Qualitative data were organized into five thematic sections: impact of chronic childhood illness in the family; psychopedagogical training of pediatricians; practical difficulties; communication between school and hospital, and the hospital as an educational institution. Conclusion. Hospital pediatrics requires the consideration of the specific psycho-emotional needs of the family and the child; therefore, psychopedagogical training is needed, as well as an inter professional collaboration between health and educators.
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OBJECTIVE: To identify the psychopedagogical training needs of the pediatric nurses in the largest public hospital of the Balearic Islands, Spain. METHOD: This study was developed with a quantitative and qualitative design, where 78 nurses (97.5% of the service) answered a questionnaire, and 15 participated in interviews that were analyzed via content analysis. RESULTS: The quantitative results show gaps in the knowledge and psychopedagogical skills of the staff. These aspects could facilitate the development of tasks tailored to the personality and the psychoevolutional time of children with chronic diseases, as well as to the emotional state of families. The qualitative data was organized into four categories: family support; hospital and education; psychopedagogical training and difficulties in practice. The little communication between nurses and teachers is evident. CONCLUSION: The data reinforces the need to implement training strategies and interdisciplinary work among health professionals, educators and families.
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Atitude do Pessoal de Saúde , Doença Crônica/enfermagem , Recursos Humanos de Enfermagem Hospitalar/educação , Enfermagem Pediátrica/educação , Humanos , Recursos Humanos de Enfermagem Hospitalar/psicologiaRESUMO
OBJECTIVE To identify the psychopedagogical training needs of the pediatric nurses in the largest public hospital of the Balearic Islands, Spain. METHOD This study was developed with a quantitative and qualitative design, where 78 nurses (97.5% of the service) answered a questionnaire, and 15 participated in interviews that were analyzed via content analysis. RESULTS The quantitative results show gaps in the knowledge and psychopedagogical skills of the staff. These aspects could facilitate the development of tasks tailored to the personality and the psychoevolutional time of children with chronic diseases, as well as to the emotional state of families. The qualitative data was organized into four categories: family support; hospital and education; psychopedagogical training and difficulties in practice. The little communication between nurses and teachers is evident. CONCLUSION The data reinforces the need to implement training strategies and interdisciplinary work among health professionals, educators and families. .
OBJETIVO Identificar as necessidades formativas psicopedagógicas entre enfermeiros de pediatria do maior hospital público das Ilhas Baleares, Espanha. MÉTODO Trata-se de uma pesquisa quali-quantitativa, na qual 78 enfermeiros (97,5% do serviço) responderam a um questionário e 15 participaram de entrevistas examinadas por meio da análise de conteúdo. RESULTADOS Os resultados quantitativos mostram lacunas no conhecimento e nas competências psicopedagógicas do pessoal, embora estes aspectos possam facilitar o desenvolvimento de tarefas adaptadas à personalidade e ao momento psicoevolutivo da criança com doença crônica, além do estado emocional das famílias. Os resultados qualitativos foram organizados em quatro categorias: apoio familiar, hospital e educação, formação psicopedagógica e dificuldades na prática. Destaca-se a pouca comunicação entre enfermeiros e professores. CONCLUSÃO Os dados reforçam a necessidade de implementar estratégias de formação, assim como um trabalho interdisciplinar entre profissionais de saúde, educadores e famílias. .
OBJETIVO Identificar las necesidades formativas psicopedagógicas en enfermeras de pediatría del mayor hospital público en las Islas Baleares, España. MÉTODO Se trata de un diseño cuanti-cualitativo, donde 78 enfermeras (97,5% del servicio) contestaron un cuestionario y 15 participaron en entrevistas analizadas con análisis de contenido. RESULTADOS Los resultados cuantitativos muestran lagunas en conocimientos y competencias psicopedagógicas del personal, aunque estos aspectos podrían facilitar el desarrollo de tareas adaptadas a la personalidad y momento psicoevolutivo del niño con enfermedad crónica y el estado emocional de las familias. Los resultados cualitativos fueron organizados en cuatro categorías: apoyo familiar; hospital y la educación; formación psicopedagógica y dificultades en la práctica. Destaca la poca comunicación entre enfermeras y profesores. CONCLUSIÓN Estos datos refuerzan la necesidad de implementar estrategias de formación y un trabajo interdisciplinario entre profesionales de la salud, educadores y familias. .
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Humanos , Atitude do Pessoal de Saúde , Doença Crônica/enfermagem , Recursos Humanos de Enfermagem Hospitalar/educação , Enfermagem Pediátrica/educação , Recursos Humanos de Enfermagem Hospitalar/psicologiaAssuntos
Carcinoma/secundário , Ascite Quilosa/etiologia , Neoplasias Ovarianas/complicações , Neoplasias Peritoneais/secundário , Idoso , Líquido Ascítico/química , Líquido Ascítico/citologia , Carcinoma/complicações , Quilomícrons/análise , Feminino , Humanos , Linfócitos , Paracentese , Neoplasias Peritoneais/complicaçõesRESUMO
El objetivo de este trabajo es monitorizar la actividad realizada por el laboratorio de urgencias del Hospital Universitario Son Dureta durante el período 2000-2004 y tratar de justificar las variaciones. El estudio se basa en la comparación gráfica de la tendencia mostrada por los indicadores de demanda analítica (magnitudes/peticiones, unidades relativas de valor (URV)/peticiones y URV/magnitudes), que representan la productividad del laboratorio, y la de los indicadores que relacionan la actividad de urgencias del hospital y la del laboratorio (peticiones laboratorio/urgencias, magnitudes/urgencias, URV/urgencias). Los resultados demuestran una relación inversa entre las urgencias del hospital y las del laboratorio. Las urgencias hospitalarias han disminuido por la apertura de un segundo hospital en Palma; en cambio, la actividad del laboratorio de urgencias ha aumentado. El motivo es el incremento de las urgencias de hospitalización derivadas fundamentalmente de áreas relacionadas con nuevas acciones hospitalarias: cirugía cardíaca, unidad de reanimación, psiquiatría, desintoxicación, toxicología, hemodinámica intervencionista 24 h, etc. Se observa una tendencia hacia la complejidad por el incremento de los índices URV/magnitudes, magnitudes/urgencias y URV/urgencias; a ello han contribuido, sobre todo, los nuevos criterios diagnósticos del infarto de miocardio que conllevan realizar muchas más determinaciones de troponina, el uso de proteína C reactiva como marcador de sepsis y las determinaciones de drogas de abuso para confirmar la sospecha de ingestión en las urgencias hospitalarias(AU)
This aim of this study is to monitor the activity carried out in the emergency laboratory of Son Dureta University Hospital during the years 20002004 and to discuss the variations. This work is based on the the graphical comparison between the trends of indicators of analytical demand (tests/requests), (URV/requests), and (URV/tests) that represent the productivity of laboratory and also other indicators that associate emergency activities of the hospital with the laboratory (laboratory requests/emergencies), (tests/emergencies), and (URV/emergencies). The results show an inverse relationship between the hospital emergencies and laboratory. The hospital emergencies have decreased as there is a new hospital in Palma, on the other hand, the activity of the urgent laboratory has increased. The reason is due to the increase inpatient activity in new hospital areas: heart surgery, a significant increase of critical care, psychiatry, toxicology, etc. A trend to complexity is observed, that is due to the increase in indices: URV/tests, tests/emergencies, and URV/emergencies; that have arisen from the new diagnostic criteria for myocardial infarction. This has caused a large increase tropinin assays, the use of CRP as a sepsis marker and drug abuse testing to confirm the suspicion of drug taking(AU)