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1.
Med Clin (Barc) ; 2024 Jul 03.
Artículo en Inglés, Español | MEDLINE | ID: mdl-38964970

RESUMEN

BACKGROUND: The impact of SARS-CoV-2 infection (COVID-19) on mental health has not been extensively studied in the medium and long term. This study assessed how clinical, biological, and social factors affect mental health in patients who recovered from severe COVID-19. The evaluation was done 90 days after hospital discharge and followed up at 12 and 24 months. METHODS: A retrospective-prospective cohort mixed observational study was conducted on patients over 18 years of age who required hospitalization in Internal Medicine or ICU for severe COVID-19 pneumonia during 2020 and 2021. Demographic information, clinical variables, and data for the scales were obtained from electronic medical records and telephone interviews. For comparisons of the different variables in each clinical variable (insomnia, depression, anxiety), the Student's t-test for independent samples has been used (normal distribution); otherwise, the Mann-Whitney test will be used. All tests and intervals will be performed with a confidence level of 95. Fisher's exact or Pearson's Chi-square test has been used as appropriate for qualitative variables. RESULTS: 201 patients were recruited. 37.3% presented insomnia, 22.4% anxiety, and 21.4% depressive symptoms. A direct association was established between female sex and depressive symptoms. Psychotropic history, fatigue, and C-reactive protein levels (CRP) were correlated with depression. Anosmia and ageusia, CRP, cognitive symptoms, and dyspnea predicted insomnia. Sex, orotracheal intubation (OTI), pain, fatigue, mental health history, and academic level were independent predictors of anxiety. High percentages of depressive, anxiety, and insomnia symptoms were detected in the second month after discharge and persisted at 12 and 24 months. The fatigue variable maintained a significant relationship with depressive symptoms at 2, 12 and 24 months. A possible limitation could be recall bias in retrospective data collection. CONCLUSIONS: This is a novel study to follow up on mental health for two years in patients with severe COVID-19. Clinical, biological, and psychosocial variables could be predictors of depressive symptoms, anxiety, and insomnia. The psychiatric symptoms persisted throughout the 2-year follow-up. These findings are critical for the follow-up of these patients and open the possibility of further studies in the medium and long term.

2.
J Hazard Mater ; 476: 135006, 2024 Sep 05.
Artículo en Inglés | MEDLINE | ID: mdl-38941828

RESUMEN

Water pollution from industrial or household waste, containing dyes from the textile industry, poses a significant environmental challenge requiring immediate attention. In this study, we have developed a crosslinked-smart-polymer film based on 2-(dimethylamino)ethyl methacrylate copolymerized with other hydrophilic and hydrophobic commercial monomers, and its efficacy in removing 21 different textile dyes was assessed. The smart polymer effectively interacts with and adsorbs dyes, inducing a noticeable colour change. UV-Vis spectroscopy analysis confirmed a removal efficiency exceeding 90 % for anionic dyes, with external diffusion identified as the primary influencing factor on process kinetics, consistent with both pseudo-first-order kinetics and the Crank-Dual model. Isothermal studies revealed distinct adsorption behaviors, with indigo carmine adhering to a Freundlich isotherm while others conformed to the Langmuir model. Permeation and fluorescence analyses corroborated isotherm observations, verifying surface adsorption. Significantly, our proof-of-concept demonstrated the resilience of the smart-film to common fabric softeners and detergents without compromising adsorption capacity. Additionally, the material exhibited reusability (for at least 5 cycles), durability, and good thermal and mechanical properties, with T5 and T10 values of 265 °C and 342 °C, respectively, a Tg of 168 °C, and a water swelling percentage of 54.3 %, thus confirming its stability and suitability for industrial application. ENVIRONMENTAL IMPLICATION: Dyes released during laundry processes should be classified as "hazardous materials" owing to their significant toxicity towards aquatic organisms, with the potential to disrupt ecosystems and harm aquatic biodiversity. This paper discusses the development of a novel acrylic material in film form, engineered to extract toxic anionic dyes. This study directly contributes to mitigating the environmental impact associated with the fashion industry and the domestic use of textiles. It can be implemented on both an industrial and personal scale, thereby encouraging more sustainable practices and promoting collaborative citizen science efforts towards.

3.
Vaccine ; 42(19): 4011-4021, 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-38760269

RESUMEN

OBJECTIVE: This study aimed to evaluate the effectiveness of SARS-CoV-2 mRNA vaccines in preventing infection and hospitalization among healthcare workers (HCWs) in the Valencian Community (Spain), considering vaccination timing, dose number, and predominant variant. METHODS: A test-negative case-control design estimated vaccine effectiveness against symptomatic disease and hospitalization due to SARS-CoV-2. HCWs who underwent PCR or antigen testing for SARS-CoV-2 from January 2021 to March 2022 were included. Cases had a positive diagnostic test, while controls had negative tests. Adjusted vaccine effectiveness (aVE) was calculated using the formula: aVE = (1 - Odds ratio) × 100. RESULTS: During the Delta variant's predominance, aVE against infection within 12-120 days post-second dose was 64.8 % (BNT162b2) and 59.4 % (mRNA-1273), declining to 21.2 % and 42.2 %, respectively, after 120 days. For the Omicron variant, aVE within 12-120 days post-second dose was 61.1 % (BNT162b2) and 85.1 % (mRNA-1273), decreasing to 36.7 % and 24.9 %, respectively, after 120 days. After a booster dose of mRNA-1273, aVE was 64.0 % (BNT162b2 recipients) and 65.9 % (initial mRNA-1273 recipients). Regardless of variant, aVE for hospitalization prevention after 2 doses was 87.0 % (BNT162b2) and 89.0 % (mRNA-1273). CONCLUSION: The administration of two doses of Moderna-mRNA-1273 against SARS-CoV-2 in HCWs proved to be highly effective in preventing infections and hospitalizations in the first 120 days after the second dose during the predominance of the Omicron variant. The decline in VE after 120 days since the administration of the second dose was significantly restored by the booster dose administration. This increase in VE was greater for the Pfizer vaccine. COVID-19 hospitalization prevention remained stable with both mRNA vaccines throughout the study period.


Asunto(s)
Vacuna BNT162 , Vacunas contra la COVID-19 , COVID-19 , Personal de Salud , Hospitalización , Inmunización Secundaria , SARS-CoV-2 , Eficacia de las Vacunas , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , España/epidemiología , SARS-CoV-2/inmunología , SARS-CoV-2/genética , Masculino , Femenino , Hospitalización/estadística & datos numéricos , Adulto , Persona de Mediana Edad , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/administración & dosificación , Vacuna BNT162/inmunología , Vacuna BNT162/administración & dosificación , Estudios de Casos y Controles , Vacuna nCoV-2019 mRNA-1273/inmunología , Vacunación/métodos
4.
Heart Lung ; 67: 62-69, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38703640

RESUMEN

BACKGROUND: Four phenotypes relate metabolism and obesity: metabolically healthy (MHO) and unhealthy (MUO) people with obesity and metabolically healthy (MHNO) and unhealthy (MUNO) people without obesity. No studies have addressed the association between these categories and lung function in the working population. OBJECTIVES: The aim was to determine the relationship of phenotypes to lung ageing as measured by lung age and its relationship to lung dysfunction. METHODS: A descriptive cross-sectional study was conducted in a working population. The outcome variable was lung function assessed by lung age. The four phenotypes of obesity and metabolic health (MHNO, MHO, MUO and MUNO) were determined using NCEP-ATP III criteria. Lung dysfunctions were classified into restrictive, obstructive, and mixed patterns. RESULTS: The mean age of the participants was 43.7 years, ranging from 18 to 67 years. Of the 1860 workers, 51.3 % were women. The prevalences found were 71.4 %, 12 %, 10.6 % and 6 % for MHNO, MUO, MHO, and MUNO, respectively. MHO (ß = 0.66; p = 0.591) was not associated with increased lung ageing compared with MHNO, but MUO (ß = 7.1; p < 0.001) and MUNO (ß = 6.6; p < 0.001) were. Concerning pulmonary dysfunctions, MUNO (OR = 1.93; p < 0.001) and MUO (OR = 2.91; p < 0.001) were found to be related to the presence of a restrictive pattern, and MUNO (OR = 2.40; p = 0.028) to the mixed pattern. CONCLUSION: The results show that metabolic abnormalities, not obesity, are responsible for premature lung ageing and, therefore, lung function decline. In our study, having obesity without metabolic abnormality was not significantly associated with the presence of dysfunctional respiratory patterns.


Asunto(s)
Obesidad , Fenotipo , Pruebas de Función Respiratoria , Humanos , Femenino , Estudios Transversales , Masculino , Persona de Mediana Edad , Adulto , Obesidad/epidemiología , Obesidad/fisiopatología , Obesidad/complicaciones , Anciano , Pruebas de Función Respiratoria/métodos , Adulto Joven , Adolescente , Pulmón/fisiopatología , Enfermedades Pulmonares/epidemiología , Enfermedades Pulmonares/fisiopatología , Prevalencia , Índice de Masa Corporal
5.
BJPsych Open ; 10(1): e22, 2024 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-38179604

RESUMEN

BACKGROUND: There is a lack of standardised psychometric data in electronic health record (EHR)-based research. Proxy measures of symptom severity based on patients' clinical records may be useful surrogates in mental health EHR research. AIMS: This study aimed to validate proxy tools for the short versions of the Positive and Negative Syndrome Scale (PANSS-6), Young Mania Rating Scale (YMRS-6) and Montgomery-Åsberg Depression Rating Scale (MADRS-6). METHOD: A cross-sectional, multicentre study was conducted in a sample of 116 patients with first-episode psychosis from 12 public hospitals in Spain. Concordance between PANSS-6, YMRS-6 and MADRS-6 scores and their respective proxies was evaluated based on information from EHR clinical notes, using a variety of statistical procedures, including multivariate tests to adjust for potential confounders. Bootstrapping techniques were used for internal validation, and an independent cohort from the Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne, Switzerland) for external validation. RESULTS: The proxy versions correlated strongly with their respective standardised scales (partial correlations ranged from 0.75 to 0.84) and had good accuracy and discriminatory power in distinguishing between patients in and not in remission (percentage of patients correctly classified ranged from 83.9 to 91.4% and bootstrapped optimism-corrected area under the receiver operating characteristic curve ranged from 0.76 to 0.89), with high interrater reliability (intraclass correlation coefficient of 0.81). The findings remained robust in the external validation data-set. CONCLUSIONS: The proxy instruments proposed for assessing psychotic and affective symptoms by reviewing EHR provide a feasible and reliable alternative to traditional structured psychometric procedures, and a promising methodology for real-world practice settings.

6.
Childs Nerv Syst ; 40(4): 1019-1030, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38015250

RESUMEN

PURPOSE: We aimed to determine the safety and effectiveness of intraventricular antibiotics in neonates with meningitis and/or ventriculitis and analyze the quality of available evidence. METHODS: DESIGN: Systematic review and meta-analysis. DATA SOURCES: PubMed, EMBASE, LILACS, and SCOPUS up to 17 February 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomized experimental and observational studies were included. The Cochrane methodology was used for systematic reviews. RESULTS: Twenty-six observational studies and one randomized clinical trial involving 272 patients were included. The risk of bias in both pediatric and neurosurgical studies was high, and the quality of evidence was low (evidence level C). In the pediatric studies, no significant differences in mortality were found between intraventricular antibiotics and only systemic antibiotic [25.4% vs 16.1%, OR = 0.96 (0.42-2.24), P = 0.93]. However, when analyzing the minimum administered doses, we found a lower mortality when a minimum duration of 3 days for intraventricular antibiotics was used compared to only systemic antibiotic [4.3% vs 17%, OR = 0.22 (0.07-0.72), P = 0.01]. In the neurosurgical studies, the use of intraventricular antibiotics in ventriculitis generally results in a mortality of 5% and a morbidity of 25%, which is lower than that in cases where intraventricular antibiotics were not used, with an average mortality of 37.3% and a morbidity of 50%. CONCLUSION: Considering the low quality of evidence in pediatric and neurosurgical studies, we can conclude with a low level of certainty that intraventricular antibiotics may not significantly impact mortality in neonatal meningitis and ventriculitis. However, reduced mortality was observed in cases treated with a minimum duration of 3 days of intraventricular antibiotic, particularly the multidrug-resistant or treatment-refractory infections. Higher-quality studies are needed to improve the quality of evidence and certainty regarding the use of intraventricular antibiotics for treating neonatal meningitis and ventriculitis.


Asunto(s)
Ventriculitis Cerebral , Meningitis , Humanos , Recién Nacido , Antibacterianos/uso terapéutico , Ventriculitis Cerebral/tratamiento farmacológico , Ensayos Clínicos Controlados Aleatorios como Asunto
7.
J Clin Med ; 12(22)2023 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-38002657

RESUMEN

Background: Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by central obesity, hypertension, dyslipidaemia, and dysregulation of blood glucose, which is associated with the risk of diabetes, cardiovascular disease, and overall mortality. White blood cell count is a selective marker of acute infection and inflammation, which could provide information on the metabolic status of subjects. This study aims to provide the best evidence on the association between MetS and white blood cell count by determining the effect size of this biomarker. Methods: A systematic review and meta-analysis of studies indexed in the PubMed and Scopus databases were performed. Methodological quality was assessed using the STROBE tool, overall risk of bias using RevMan (Cochrane Collaboration), and quality of evidence using Grade Pro. Results: We included 14 articles comparing leukocyte concentrations in 21,005 subjects with MetS and 66,339 controls. Subjects with MetS had a higher mean leukocyte count, 0.64 cells ×109/L; CI95% 0.55-0.72; p < 0.00001; I2 = 93%. Conclusions: An in-depth evaluation of the relationship of leukocytes in the pathophysiological process of MetS could lead to new insights into early diagnosis.

8.
Pediatr Res ; 94(5): 1824-1831, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37308682

RESUMEN

BACKGROUND: A variable percentage of children and adolescents with obesity do not have cardiometabolic comorbidities. A phenotype called metabolically healthy obese (MHO) has emerged to describe this population subgroup. Early identification of this condition may prevent the progression to metabolically unhealthy obesity (MUO). MATERIAL AND METHODS: A cross-sectional descriptive study of 265 children and adolescents from Cordoba (Spain) conducted in 2018. The outcome variables were MHO, established based on three criteria: International Criterion, HOMA-IR, and a combination of the previous two. RESULTS: The prevalence of MHO ranged from 9.4% to 12.8% of the study population, between 41% and 55.7% of the sample with obesity. The highest agreement was reached between the HOMA-IR definitions and the combined criteria. The waist-to-height ratio (WHtR) was the indicator with the highest discriminant capacity for MHO in 2 of the three criteria, with its best cut-off point at 0.47 for both. CONCLUSION: The prevalence of MHO in children and adolescents differed according to the criteria used for diagnosis. The anthropometric variable with the most remarkable discriminating capacity for MHO was WHtR, with the same cut-off point in the three criteria analysed. IMPACT STATEMENT: This research work defines the existence of metabolically healthy obesity through anthropometric indicators in children and adolescents. Definitions that combine cardiometabolic criteria and insulin resistance are used to identify metabolically healthy obesity, as well as the prediction of this phenomenon through anthropometric variables. The present investigation helps to identify metabolically healthy obesity before metabolic abnormalities begin.


Asunto(s)
Enfermedades Cardiovasculares , Resistencia a la Insulina , Síndrome Metabólico , Obesidad Metabólica Benigna , Obesidad Infantil , Humanos , Niño , Adolescente , Obesidad Metabólica Benigna/diagnóstico , Obesidad Metabólica Benigna/epidemiología , Estudios Transversales , Obesidad/diagnóstico , Obesidad/epidemiología , Fenotipo , Síndrome Metabólico/epidemiología , Índice de Masa Corporal , Obesidad Infantil/diagnóstico , Obesidad Infantil/epidemiología , Factores de Riesgo
9.
Front Psychol ; 14: 1196529, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37377694

RESUMEN

Data from international studies reveal that the mathematics literacy of Spanish students is significantly lower than that of students from nearby countries. Therefore, in recent years, interest in identifying the factors that influence students' mathematics results in Spain has grown considerably. Often, these factors are sought among the socioeconomic characteristics of the students or among variables related to the schools, ignoring the psychological and emotional factors of the students. This paper analyzes the impact of certain psychoemotional characteristics of Spanish students on their literacy in mathematics. For this purpose, multilevel regression models are applied to the data of the Spanish sample of the 2018 edition of PISA (Programme for International Student Assessment), which is composed of 35,943 15-year-old students. The instruments for data collection are the mathematics literacy tests and the contextual questionnaires on students' personal situation and well-being used by PISA. As dependent variable, students' mathematics literacy has been considered, measured through the plausible values provided by PISA, and as independent variables, different indices measuring students' psychoemotional well-being obtained from the contextual information collected by PISA. Results indicate that resilience, motivation for the achievement of learning objectives, competitiveness, perceived cooperation at school, and social connectedness with parents have a positive impact on students' mathematics literacy, while experiences related to bullying, physical self-concept, meaning in life and perceived competitiveness at school have a negative impact.

10.
J Endovasc Ther ; 30(6): 867-876, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-35735201

RESUMEN

PURPOSE: The widespread adoption of endovascular aneurysm repair (EVAR) as preferred treatment modality for abdominal aortic aneurysm (AAA) has enlarged the number of patients needing open surgical conversion (OSC). The relationship between adherence to Instructions For Use (IFU) and EVAR long-term outcomes remains controversial. The aim of this study is to compare preoperative differences and postoperative outcomes between EVAR patients not adjusted to IFU and adjusted to IFU who underwent OSC. METHODS: This multicenter retrospective study reviewed 33 explanted EVARs between January 2003 and December 2019 at 14 Vascular Units. Patients were included if OSC occurred >30 days after implantation and excluded if explantation was performed to treat an endograft infection, aortic dissection, or traumatic transections. Variables analyzed included baseline characteristics, adherence to IFU, implant and explant procedural details, secondary reinterventions, and postoperative outcomes. RESULTS: Fifteen explanted patients (15/33, 45.5%) were identified not accomplished to IFU (out-IFU) at initial EVAR vs 18 explanted patients adjusted (in-IFU). During follow-up, a mean of 1.73±1.2 secondary reinterventions were performed, with more type I endoleaks treated in the subgroup out-IFU: 16.7% vs 6.3% in-IFU patients and more type III endoleaks (8.3% vs 0%). Patients out-IFU had shorter mean interval from implant to explant: 47.60±28.8 months vs 71.17±48. Type II endoleak was the most frequent indication for explantation. Low-flow endoleaks (types II, IV, V) account for 44% of indications for OSC in subgroup of patients in-IFU, compared with 13.3% in patients out-IFU and high-flow endoleaks (types I and III) were the main indication for patients out-IFU (33.3% vs 16.7% in-IFU). Total endograft explantation was performed in 57.5% of cases (19/33) and more suprarenal clamping was required in the subgroup out-IFU. Overall, 30-day mortality rate was 12.1% (4/33): 20% for patients out-IFU and 5.6% in-IFU. CONCLUSIONS: In our experience, type II endoleak is the most common indication for conversion and differences have been found between patients treated outside IFU with explantation taking place earlier during follow-up, mainly due to high-flow endoleaks and with higher mortality in comparison with patients adjusted to IFU. Ongoing research is required to delve into these differences.


Asunto(s)
Aneurisma de la Aorta Abdominal , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Humanos , Endofuga/etiología , Endofuga/cirugía , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/cirugía , Implantación de Prótesis Vascular/efectos adversos , Reparación Endovascular de Aneurismas , Procedimientos Endovasculares/efectos adversos , Estudios Retrospectivos , Resultado del Tratamiento , Factores de Riesgo
11.
Front Nutr ; 9: 962054, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36466409

RESUMEN

Approximately one-third of overweight individuals, and half of those with obesity, do not have cardiometabolic disorders. For this reason, a phenotype called metabolically healthy obese (MHO) has emerged to describe this population group. The early detection of this situation could save costs associated with the development of comorbidities or pharmacological interventions. Therefore, the aim is to know the prevalence of MHO in the working population and propose variables for its detection. Cross-sectional descriptive study of 635 workers of the Cordoba City Council was carried out based on the results of the 2016 health surveillance. The outcome variables were the MHO, established based on the criteria of the IDF, NCEP-ATP III, and Aguilar-Salinas. In addition, the degree of agreement between the different MHO criteria was studied using Cohen's kappa (k), and the predictive capacity of the anthropometric variables was assessed with Receiver Operator Curves. The prevalence of MHO ranged from 6.6 to 9%. The highest agreement was reached between the IDF and NCEP-ATP III definitions (k = 0.811; 95% CI 0.724-0.898; p < 0.001). The waist-to-height ratio (WHtR) showed the highest discriminant capacity for MHO, with its best cut-off point at 0.55 for all criteria used. Sensitivity ranged from 84 to 93%. The prevalence of MHO in the working population differed according to the criteria used for diagnosis. The anthropometric variable with the highest discriminant capacity for MHO was WHtR, presenting the same cut-off point in the three criteria analyzed. Therefore, WHtR is the variable that best detects the presence of MHO.

12.
Polymers (Basel) ; 14(22)2022 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-36433081

RESUMEN

Polymers are extensively used in food and beverage packaging to shield against contaminants and external damage due to their barrier properties, protecting the goods inside and reducing waste. However, current trends in polymers for food, water, and beverage applications are moving forward into the design and preparation of advanced polymers, which can act as active packaging, bearing active ingredients in their formulation, or controlling the head-space composition to extend the shelf-life of the goods inside. In addition, polymers can serve as sensory polymers to detect and indicate the presence of target species, including contaminants of food quality indicators, or even to remove or separate target species for later quantification. Polymers are nowadays essential materials for both food safety and the extension of food shelf-life, which are key goals of the food industry, and the irruption of smart materials is opening new opportunities for going even further in these goals. This review describes the state of the art following the last 10 years of research within the field of food and beverage polymer's applications, covering present applications, perspectives, and concerns related to waste generation and the circular economy.

13.
Artículo en Inglés | MEDLINE | ID: mdl-36360764

RESUMEN

The duration of protection of vaccines against SARS-CoV-2 infection has been evaluated in previous studies, but uncertainty remains about the persistence of effectiveness over time and the ideal timing for booster doses. Therefore, the aim of this study was to evaluate BNT162b2 vaccine effectiveness against SARS-CoV-2 infection in health care workers (HCWs) at a tertiary hospital depending on time elapsed since the completion of a two-dose vaccination regimen. We conducted a case-control with negative test study between 25 January and 12 December 2021 that included 1404 HCWs who underwent an active infection diagnostic test (AIDT) to rule out SARS-CoV-2 infection due to COVID-19 suspicion or prior close contact with patients diagnosed with COVID-19. The adjusted vaccine effectiveness (aVE) for the prevention of SARS-CoV-2 infection 12 to 120 days after completing the full two-dose vaccination regimen was 91.9%. Then, aVE decreased to 63.7% between 121 to 240 days after completing the full two-dose regimen and to 37.2% after 241 days since the second dose. Vaccination against SARS-CoV-2 infection in HCWs remains highly effective after 12 to 120 days have elapsed since the administration of two doses of the BNT162b2 vaccine; however, effectiveness decreases as time elapses since its administration.


Asunto(s)
COVID-19 , Vacunas Virales , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Vacuna BNT162 , Vacunas contra la COVID-19/uso terapéutico , Eficacia de las Vacunas , SARS-CoV-2 , Personal de Salud
14.
Nurs Rep ; 12(1): 175-187, 2022 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-35324564

RESUMEN

To describe the experiences and expectations of Spanish women regarding breastfeeding and the support they receive from healthcare professionals, family, and friends during the breastfeeding journey, A qualitative study using an empirical-phenomenological approach was conducted. Primiparous women that had already given birth were interviewed using a purposive and snowball sampling. In-depth interviews were conducted between 1 January and 30 April 2020. The interviews were transcribed verbatim and analysed using Haase's adaptation of Colaizzi's phenomenological method. We recruited 14 women who had recently become mothers. Three major themes describing experiences of infant feeding by maternal lactation were identified-institutional influences, establishing breastfeeding, and cessation of breastfeeding-as well as the following 10 categories: hospital routines, lactation concerns (amount and infant nutrition), antenatal breastfeeding decision, embarrassment to breastfeed, and normalisation of breastfeeding. Prior education and support were identified as key elements in possible breastfeeding support strategies.

15.
Case Rep Psychiatry ; 2022: 2460492, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35223120

RESUMEN

INTRODUCTION: Autoimmune encephalitis is caused by antineuronal immune mechanisms. Its clinical presentation is heterogeneous and in many cases onset with psychiatric symptoms. Paraclinical criteria guide the approach; however, the challenge occurs when there are no detectable autoantibodies in serum or cerebrospinal fluid (CSF). Methodology. We report one case that highlights the variability of clinical manifestations, which in the absence of antibodies was treated with immunotherapy with good response. CONCLUSION: In places where there is no antibody measurement, or when its measurement is negative, the clinical suspicion supported by CSF studies, magnetic resonance imaging, and electroencephalographic recording, should guide us to start immunotherapeutic treatment early. The early initiation of treatment ensures the reversibility of the neurological disorder in the vast majority of patients.

16.
Sensors (Basel) ; 22(4)2022 Feb 21.
Artículo en Inglés | MEDLINE | ID: mdl-35214594

RESUMEN

Damage detection in structural health monitoring of metallic or composite structures depends on several factors, including the sensor technology and the type of defect that is under the spotlight. Commercial devices generally used to obtain these data neither allow for their installation on board nor permit their scalability when several structures or sensors need to be monitored. This paper introduces self-developed equipment designed to create ultrasonic guided waves and a methodology for the detection of progressive damage, such as corrosion damage in aircraft structures, i.e., algorithms for monitoring such damage. To create slowly changing conditions, aluminum- and carbon-reinforced polymer plates were placed together with seawater to speed up the corrosion process. The setup was completed by an array of 10 piezoelectric transducers driven and sensed by a structural health monitoring ultrasonic system, which generated 100 waveforms per test. The hardware was able to pre-process the raw acquisition to minimize the transmitted data. The experiment was conducted over eight weeks. Three different processing stages were followed to extract information on the degree of corrosion: hardware algorithm, pattern matching, and pattern recognition. The proposed methodology allows for the detection of trends in the progressive degradation of structures.


Asunto(s)
Transductores , Ondas Ultrasónicas , Monitoreo Fisiológico , Ultrasonido , Ultrasonografía Intervencional
17.
Angiol. (Barcelona) ; 74(1): 38-39, ene.-feb.,2022.
Artículo en Español | IBECS | ID: ibc-202752

RESUMEN

Introducción: el tratamiento de aneurismas complejos mediante FEVAR incluye entre sus objetivos un tiempoquirúrgico reducido para poder alcanzar el éxito técnico y clínico. Sin embargo, la canulación y el implante de losstents puente en múltiples arterias viscerales pueden suponer un factor limitante. Para evitar un tiempo de escopia y una dosis de radiación prolongados existen algunas maniobras que pueden ayudar a optimizar el tiempo de cateterización. Material y métodos: se realiza una revisión de los últimos casos tratados mediante endoprótesis fenestradas custom made de Zenith Cook® durante el año 2021 en un servicio de angiología, cirugía vascular y endovascular. El objetivo es mostrar las técnicas que sirven para optimizar el tratamiento de aneurismas complejos y que el cirujano puede emplear con el material habitual. Para ello se muestran varios fragmentos de vídeos de estos procedimientos grabados con el sistema OneView. Resultados: el primer paso clave consiste en la liberación del dispositivo fenestrado. La endoprótesis de Cook® presenta una o varias ligaduras de reducción que la mantienen fruncida hasta garantizar una correcta orientación y un correcto posicionamiento. Asimismo, ofrece la opción de canular las arterias viscerales entre la pared arterial y el dispositivo. Con una planifi cación adecuada y un abordaje sistematizado, el uso de guías coaxiales, catéteres de punta simple o reversa e introductores es esencial. El techo de la endoprótesis permite el avance de guías y de introductores con el soporte sufi ciente para su canulación. Los sistemas precargados permiten la canulación desde el miembro superior o el inferior. En este último caso, se utiliza una guía buddy de 0,014" que ofrece soporte al introductor, ya que lo acerca más aún a la fenestración, de tal modo que potencia el momento de torsión (torque) y el empuje del catéter.


Introduction: the treatment of complex aneurysms using FEVAR includes among its objectives a reduced surgicaltime in order to achieve technical and clinical success. However, cannulation and implantation of bridging stentsin multiple visceral arteries can be a limiting factor. To avoid a protracted scope time and radiation dose, there aresome maneuvers that can help optimize catheterization time. Material and methods: a review of the last cases treated with custom made Zenith Cook® fenestrated endoprostheses during the year 2021 is performed in an angiology, vascular and endovascular surgery service. The objective is to show video clips recorded with the OneView system of these techniques that the surgeon can use with the usual material to optimize the treatment of complex aneurysms.Results: the first key step is the release of the fenestrated device. The Cook® endoprosthesis has one or morereduction ligatures that keep it puckered until it guarantees correct orientation and positioning, as well as theoption of cannulating the visceral arteries between the arterial wall and the device.With proper planning and a systematic approach, the use of coaxial guides with single or reverse tip cathetersand introducers are essential. The roof of the endoprosthesis allows the advancement of guides and introducerswith sufficient support for their cannulation. The preloaded systems allow cannulation from the upper or lowerlimb. In the latter case, a 0.014” buddy guide is used to provide support for the introducer, bringing it even closerto fenestration in such a way as to enhance the torque and thrust of the catheter.


Asunto(s)
Humanos , Ciencias de la Salud , Cateterismo/instrumentación , Artería Gástrica , Aneurisma , Tempo Operativo
19.
Sensors (Basel) ; 21(21)2021 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-34770413

RESUMEN

The nature of wireless propagation may reduce the QoS of the applications, such that some packages can be delayed or lost. For this reason, the design of wireless control applications must be faced in a holistic way to avoid degrading the performance of the control algorithms. This paper is aimed at improving the reliability of wireless control applications in the event of communication degradation or temporary loss at the wireless links. Two controller levels are used: sophisticated algorithms providing better performance are executed in a central node, whereas local independent controllers, implemented as back-up controllers, are executed next to the process in case of QoS degradation. This work presents a reliable strategy for switching between central and local controllers avoiding that plants may become uncontrolled. For validation purposes, the presented approach was used to control a planar robot. A Fuzzy Logic control algorithm was implemented as a main controller at a high performance computing platform. A back-up controller was implemented on an edge device. This approach avoids the robot becoming uncontrolled in case of communication failure. Although a planar robot was chosen in this work, the presented approach may be extended to other processes. XBee 900 MHz communication technology was selected for control tasks, leaving the 2.4 GHz band for integration with cloud services. Several experiments are presented to analyze the behavior of the control application under different circumstances. The results proved that our approach allows the use of wireless communications, even in critical control applications.


Asunto(s)
Procedimientos Quirúrgicos Robotizados , Comunicación , Lógica Difusa , Reproducibilidad de los Resultados , Tecnología Inalámbrica
20.
Psiquiatr. biol. (Internet) ; 28(2): [100311], Mayo - Agosto 2021.
Artículo en Español | IBECS | ID: ibc-224415

RESUMEN

La relación entre dolor y depresión queda bien documentada en la literatura científica, sin embargo, resulta escasa la bibliografía que asocia manía y percepción dolorosa.En el presente artículo se realiza una revisión de la relación mencionada a propósito de 2 casos. Se trata de 2 pacientes diagnosticados de trastorno bipolar que fueron hospitalizados por episodios maníacos y, donde concurría, una lesión traumática grave. Se observó ausencia de dolor mientras persistía la alteración psicopatológica, a su vez, a medida que se estabilizaba el ánimo la sensación dolorosa aumentaba.Por ello, se plantea la utilidad que podría tener la valoración de la ausencia de dolor o la hipoalgesia como parte de la sintomatología maníaca. (AU)


The relation among pain and depression is well documented in the scientific literature, however, the bibliography that associates mania and perception of pain is scarce.In this article, a review of the aforementioned relationship is made regarding two cases. Is this about two patients diagnosed with bipolar disorder who were hospitalized for manic episodes, at the same time they were suffering a serious traumatic injury. The absence of pain was observed while the psychopathological alteration persisted, in turn, as the mood stabilized, the painful sensation increased.For this reason, it is proposed the utility of the absence of pain or hypoalgesia as an assessment of part of the manic symptoms. (AU)


Asunto(s)
Humanos , Masculino , Adulto , Trastorno Bipolar/tratamiento farmacológico , Trastorno Bipolar/patología , Trastorno Bipolar/terapia , Dolor/patología , Analgesia , Depresión
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