Postintensive care syndrome in patients and family members. Analysis of COVID-19 and non-COVID-19 cohorts, with face-to-face follow-up at three months and one year.

OBJECTIVE: Compare prevalence and profile of post-intensive care patient (P-PICS) and family/caregiver (F-PICS) syndrome in two cohorts (COVID and non-COVID) and analyse risk factors for P-PICS. DESIGN: Prospective, observational cohort (March 2018-2023), follow-up at three months and one year. SETTING: 14-bed polyvalent Intensive Care Unit (ICU), Level II Hospital. PATIENTS OR PARTICIPANTS: 265 patients and 209 relatives. Inclusion criteria patients: age > 18 years, mechanical ventilation > 48 h, ICU stay > 5 days, delirium, septic shock, acute respiratory distress syndrome, cardiac arrest. Inclusion criteria family: those who attended. INTERVENTIONS: Follow-up 3 months and 1 year after hospital discharge. MAIN VARIABLES OF INTEREST: Patients: sociodemographic, clinical, evolutive, physical, psychological and cognitive alterations, dependency degree and quality of life. Main caregivers: mental state and physical overload. RESULTS: 64.9% PICS-P, no differences between groups. COVID patients more physical alterations than non-COVID (P = .028). These more functional deterioration (P = .005), poorer quality of life (P = .003), higher nutritional alterations (P = .004) and cognitive deterioration (P < .001). 19.1% PICS-F, more frequent in relatives of non-COVID patients (17.6% vs. 5.5%; P = .013). Independent predictors of PICS-P: first years of the study (OR: 0.484), higher comorbidity (OR: 1.158), delirium (OR: 2.935), several reasons for being included (OR: 3.171) and midazolam (OR: 4.265). CONCLUSIONS: Prevalence PICS-P and PICS-F between both cohorts was similar. Main factors associated with the development of SPCI-P were: higher comorbidity, delirium, midazolan, inclusion for more than one reason and during the first years.

Intronic Variant of MUTYH Gene Exhibits A Strong Association with Early Onset of Breast Cancer Susceptibility in Indonesian Women Population.

OBJECTIVE: Several studies have recently indicated a huge shifting pattern toward early age onset cases in breast cancer (BC) patients. However, the studies exerted relatively limited to the Caucasian population. This preliminary study is aimed to investigate the genetic risk factors for young BC patients specifically in Indonesia population. METHODS: DNA samples were extracted from 79 BC patients aged younger than 40 years old and 90 healthy samples. These DNA samples were sequenced using Illumina NextSeq 500 platform and preprocessed to extract the single-nucleotide polymorphisms (SNPs) data. Firstly, multiple univariate logistic regressions were performed to test the association between each SNP and BC incidence in young patients. Furthermore, to analyze the polygenic effects derived from multiple SNPs, we employed a multivariate logistics regression. RESULTS: There were only 15 SNPs passed our 95% call rate threshold thus subsequently were used in the association test. One of these variants, rs3219493, emerged to be significantly associated with early-onset BC (p-value = 0.025, OR = 3.750, 95% CI = 1.178-11.938). This result is consistent with the multivariate logistic regression model, where the pertinent variant was found statistically significant (p-value = 0.008, OR = 8.398, 95% CI = 1.720-40.920). This variant was identified as an intronic variant within MUTYH gene which has been reported in several published studies to exhibit an association with the incidence of breast cancer in China, Italy and Sephardi Jews population. However, there is no evident this gene impacting the risk of developing early onset of BC in Indonesia population. CONCLUSION: Despite our limitation in terms of sample size analyzed in this preliminary study, our finding on significant association of intronic MUTHY with the early onset of BC in Indonesia led to a broadened insight of population-based unique aspect to being taken into an in-depth account for and advancement of chemotherapy.

[Study of the health education process in liver transplant recipients]. / Estudio del proceso educativo en el paciente con trasplante hepático.

We present the results of a study carried out in Bellvitge University Hospital in Barcelona (Spain) in patients who underwent orthotopic liver transplantation and who are the subject of a health education program. Throughout the years, the structure of this program has undergone several changes. Initially, only verbal information supplied by a nurse on the knowledge required for patient self-care was envisaged. Through continuous evaluation, different forms of written and audiovisual information on patient self-care were introduced. The aim of this study was to evaluate patient knowledge on self-care by comparing compliance with recommendations at discharge among the patients who received verbal information only with that among patients who received verbal as well as written and/or audiovisual information. The study population comprised 434 patients who underwent liver transplantation from February 1984 to December 31, 1998. A retrospective cohort study was designed with two groups of patients. The first group was composed by 117 patients who received verbal, written and audiovisual information. The second group comprised 107 patients who received verbal information only. Data collection was through a telephone survey. Telephone interview was possible with only 98 patients in the first group and 60 in the second.In the overall evaluation of health education level, the score obtained by the first group was 8.3 (SD = 2.2) and that obtained by the second group was 6.8 (SD = 1.8). The possible score was between 0 and 11. The differences between groups were statistically significant (p < 0.001). In general, patients who received verbal information only showed lower compliance with recommendations at discharge than those also received written and/or audiovisual information.

Estudio del proceso educativo en el paciente con trasplante hepático / Study of the health education process in liver transplant recipients

Se presentan los resultados de un estudio realizado en la Ciudad Sanitaria y Universitaria de Bellvitge (Barcelona) en pacientes sometidos a trasplante hepático ortotópico (THO) y que son objeto de un programa de educación sanitaria. El programa ha sufrido diferentes cambios en su estructura a lo largo de los años. Inicialmente el método sólo contemplaba la información verbal suministrada por la enfermera en relación con los conocimientos necesarios para el autocuidado del paciente. Mediante evaluaciones continuadas se introdujeron diferentes sistemas de soporte escrito y audiovisual sobre los cuidados. El objetivo del estudio es evaluar los conocimientos que tiene el paciente sobre su autocuidado comparando el cumplimiento de las recomendaciones al alta entre los pacientes que sólo recibieron información verbal y los que disponían de información con soporte escrito y/o audiovisual. La población estuvo formada por 434 pacientes trasplantados desde febrero de 1984 hasta el 31 de diciembre de 1998. Se diseñó un estudio de cohortes con carácter retrospectivo y con dos grupos de pacientes. El primer grupo corresponde a 117 pacientes que recibieron información verbal, escrita y audiovisual. El segundo grupo a 107, que recibieron sólo información verbal. El método utilizado para la recolección de datos fue una encuesta telefónica. Sólo se pudieron entrevistar a 98 pacientes del primer grupo y a 60 del segundo. En la valoración global del nivel educativo, el primer grupo obtuvo una puntuación de 8,3 (DE = 2,2) y el segundo 6,8 (DE = 1,8) con un rango posible de puntuación de 0-11, apreciándose diferencias significativas entre los pacientes de ambos grupos (p < 0,001). En los pacientes que sólo tenían información verbal se observa en general un menor cumplimiento de las recomendaciones al alta con referencia a los pacientes que además recibieron información con soporte escrito y/o audiovisual (AU)