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This study aims to examine the 50/50 polypropylene/polyamide 6 (iPP/PA6) system molded under confined flow conditions, both in its original state and after being modified by two different interfacial agents. This study provides two main insights. Firstly, it focuses on a polymer blend close to phase inversion. Secondly, it investigates the impact of using two different types of interfacial agents (derived from polymer waste) to enhance the compatibility between iPP and PA6. Dynamic Mechanical Analysis (DMA) has been employed to achieve these objectives. It is important to note that the investigation of the 50/50 iPP/PA6 system is a crucial focus predicted in previous studies, where a series of mechanical properties were evaluated using Box-Wilson design of experiments (DOEs) over the whole compositional range on the iPP/PA6 binary system. Thus, two interfacial modifiers, namely succinic anhydride (SA)-grafted atactic polypropylene with terminal, side, and bridge SA grafts (aPP-SASA) and succinyl-fluoresceine (SF) with bridge succinic anhydride grafting atactic polypropylene (aPP-SFSA), were employed. The authors obtained and characterized these agents. The quantity of these agents used in the blend was identified as a critical coordinate in prior studies conducted by the authors. The processing method used, compression molding under confined conditions, was chosen to minimize any orientation effect on the emerging morphology. All characterization procedures were performed on samples processed by contour machining to retain the blend morphologies as they emerged from the processing stage. Results from WAXS and SAXS synchrotron tests concluded there were no changes in the crystal morphology of the iPP or the PA6 in the blends nor any co-crystallization process throughout the compositional range. These findings, and the long period fits on the PP crystalline phase for the fifty/fifty blends we are discussing, will support the present DMA study. Finally, the efficiency of these interfacial modifiers has been concluded, even in this unfavorable scenario.
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Introduction: Respiratory syncytial virus (RSV) infection is one of the main causes of morbidity and mortality from lower respiratory tract infections in children under 5 years of age worldwide. Given that, the objective of this study was estimate the effectiveness of nirsevimab (a single-dose, long-acting, human recombinant monoclonal antibody against RSV) over time for the prevention of respiratory episodes treated at different levels of care. Methods: A prospective and dynamic population-based cohort study was performed including infants born between April 1 and December 31, 2023, in the Madrid region who resided there during the follow-up period from October 1, 2023, to February 29, 2024. Infants were considered immunized from the day after receiving one dose (50 or 100 mg) of nirsevimab or nonimmunized individuals if they did not receive any dose. Results: There were 4,100 episodes of primary care, 1,954 hospital emergencies, and 509 admissions, 82 of which required intensive care in the 33,859 participants analyzed. The adjusted effectiveness of nirsevimab in preventing hospitalization due to RSV infection was 93.6% (95% CI: 89.7 to 96.1) at 30 days and 87.6% (95% CI: 67.7 to 95.3) at 150 days. The number needed to treat to prevent one hospitalization were 314.19 (95% CI: 306.22 to 327.99) at 30 days and 24.30 (95% CI: 22.31 to 31.61) at 150 days. The adjusted effectiveness of nirsevimab in avoiding admission to an intensive care unit was 94.4% (95% CI: 87.3 to 97.5) at 30 days and 92.1% (95% CI: 64.0 to 98.3) at 90 days. The adjusted effectiveness of nirsevimab for avoiding primary care consultations and hospital emergency visits was lower. Discussion: Immunization with nirsevimab is an effective measure for reducing the burden of care related to RSV at all levels of care albeit it decreases throughout follow-up. At 150 days it remained high for preventing hospital admissions. Other articles already published have also demonstrated high effectiveness although with preliminary results, short follow-up periods and wide confidence intervals. None have detected a decrease in effectiveness over time. These results can be quite useful in individual infant prevention and in the design of immunization campaigns.
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Antivirales , Infecciones por Virus Sincitial Respiratorio , Humanos , Infecciones por Virus Sincitial Respiratorio/prevención & control , Infecciones por Virus Sincitial Respiratorio/tratamiento farmacológico , España , Estudios Prospectivos , Lactante , Femenino , Masculino , Antivirales/uso terapéutico , Hospitalización/estadística & datos numéricos , Costo de Enfermedad , Anticuerpos Monoclonales Humanizados/uso terapéutico , Preescolar , Recién NacidoRESUMEN
BACKGROUND AND OBJECTIVE: This study aimed to assess the effect of continuous positive airway pressure (CPAP) on the arteriolar-to-venular ratio (AVR) in patients with diabetic retinopathy (DR) and obstructive sleep apnea (OSA). PATIENTS AND METHODS: A prospective, randomized, unblinded, and controlled clinical trial with parallel groups was performed. From a base of 138 patients, 83 were randomized to either CPAP or control. Nonstereoscopic 35º photographs were processed with Sirius software. RESULTS: The intention-to-treat analysis showed no differences in AVR, although the arteriolar diameter increased from baseline in the CPAP group. Per-protocol analysis showed a 12-month increase in AVR (P = 0.035) and arteriolar diameter (P = 0.033) in CPAP versus control group. The venular diameter showed a nonstatistically significant reduction. CONCLUSIONS: CPAP is a potentially novel treatment for individuals with DR and concomitant OSA, improving the retinopathy status, reversing the arteriolar narrowing, and therefore increasing the AVR, tending to reduce the venular diameter. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].
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BACKGROUND: Patients with multiple sclerosis (MS) have to deal with a variable disease trajectory often associated with disability and productivity loss. OBJECTIVE: This study aimed to assess illness-related uncertainty and associated correlates in patients with relapsing-remitting multiple sclerosis (RRMS) beyond the near diagnosis phase. METHODS: We conducted a multicenter, non-interventional study including patients diagnosed with RRMS (2017 revised McDonald criteria) and a disease duration of 3 to 8 years. Perceived uncertainty was measured using the Mishel Uncertainty of Illness Scale (MUIS). Associations between the MUIS and different patient-based outcome measures were analyzed using Spearman's rank correlation. RESULTS: A total of 201 patients were studied (mean age (standard deviation): 38.7 (8.4) years, 71.4 % female). The median disease duration (interquartile range) was 6.0 (4.0-7.0) years and the median EDSS score was 1.0 (0.0-2.0). The mean MUIS score was 38.2 (10.8). Perceived uncertainty was positively correlated with fatigue (p < 0.001), symptom severity (p < 0.001), anxiety (p < 0.001), depressive symptoms (p < 0.001), and a threatening illness perception (p < 0.001), and negatively correlated with self-management (p < 0.001), self-efficacy (p < 0.001), processing speed (p < 0.001), knowledge of MS (p = 0.006), and quality of life (p < 0.001). CONCLUSION: Illness-related uncertainty was common in a population of mid-stage RRMS. Identifying uncertainty and its associated factors may be useful for implementing preventive strategies to help patients cope with the disease throughout life.
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BACKGROUND AND OBJECTIVES: The 2023 criteria for myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) perform well in adults but have not been assessed in children. METHODS: This prospective observational nationwide study includes children and adults with demyelinating syndromes or encephalitis, whose serum or CSF was found MOG-immunoglobulin G (IgG) positive at Institut d'Investigacions Biomèdiques August Pi i Sunyer-Hospital Clínic of Barcelona (Spain). Exclusion criteria were lack of clinical information and follow-up <1 year, and serum unavailable for antibody testing. The primary outcome was to assess the accuracy of the 2023 MOGAD criteria, using as gold standard the most plausible diagnosis after a follow-up >1 year. MOGAD criteria were retrospectively applied assessing core syndromes, supportive clinical-radiological features, and MOG-IgG titers. Patients tested ≤3 months of a disease attack (acute phase) or afterward (remission) were considered separately. The positive predictive value (PPV) of the criteria (true-positive [patients classified as MOGAD and MOGAD diagnosis last follow-up] divided by total positive [all patients classified as MOGAD]), and its 95% CI, was calculated with the Wilson procedure. RESULTS: A total of 257 patients (133 children) were included in the study (median age 15 years [interquartile range 6-38], 54% female). Among 202 patients assessed during a disease attack, 158 (78%) had high MOG-IgG serum titers, 36 (18%) low titers, and 8 (4%) antibodies only in CSF. No differences were identified between patients with high and low titers, but those with low titers were more likely to have an alternative diagnosis at last follow-up (2/36 [6%] vs 0/158, p = 0.012). Supportive features were present in 230 of 257 (89%) patients, regardless of age, MOG-IgG titers, and core syndromes except for optic neuritis in adults whose assessment with orbital MRI was not systematic. Overall, 240 of 257 (94%) patients were well classified by the MOGAD criteria (e.g., 236 eventually having MOGAD and 4 alternative diagnoses), and 17 were wrongly classified (e.g., 11 eventually having MOGAD and 6 alternative diagnoses). Although the criteria classified better during disease attacks than during remissions (187 [96%] vs 49 [89%] serum MOG-IgG-positive patients were well-classified, p = 0.038), the PPV was high in both settings (99% [95% CI 97-100] vs 98% [95% CI 89-100]). DISCUSSION: The 2023 MOGAD criteria correctly identified most children and adults with MOGAD. The highest accuracy occurred when they were applied during disease attacks. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that the 2023 MOGAD criteria accurately identify adults and children with MOGAD.
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Autoanticuerpos , Glicoproteína Mielina-Oligodendrócito , Humanos , Glicoproteína Mielina-Oligodendrócito/inmunología , Niño , Masculino , Femenino , Adulto , Adolescente , Autoanticuerpos/sangre , Autoanticuerpos/líquido cefalorraquídeo , Adulto Joven , Estudios Prospectivos , Inmunoglobulina G/sangre , Inmunoglobulina G/líquido cefalorraquídeo , Preescolar , España , Persona de Mediana Edad , Encefalitis/inmunología , Encefalitis/diagnóstico , Encefalitis/sangre , Estudios RetrospectivosRESUMEN
Using a 1:1 cocrystal of (E)-N-(3,4-difluorophenyl)-1-(pyridin-4-yl)methanimine with acetic acid, C12H8F2N2·C2H4O2, we investigate the influence of F atoms introduced to the aromatic ring on promoting π-π interactions. The cocrystal crystallizes in the triclinic space group P1. Through crystallographic analysis and computational studies, we reveal the molecular arrangement within this cocrystal, demonstrating the presence of hydrogen bonding between the acetic acid molecule and the pyridyl group, along with π-π interactions between the aromatic rings. Our findings highlight the importance of F atoms in promoting π-π interactions without necessitating full halogenation of the aromatic ring.
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Integrase strand transfer inhibitors (INSTI) are associated with neuropsychiatric adverse events (NPAEs). The aim of this study was to evaluate improvements in NPAEs after switching an INSTI-based regimen to darunavir/cobicistat (DRV/c) or doravirine (DOR). Methods: A prospective cohort study was conducted to evaluate the reversibility of NPAEs via the Patient Health Questionnaire (PHQ-9), the Insomnia Severity Index (ISI), and the Hospital Anxiety and Depression Scale (HADS-A and D) in patients who started antiretroviral therapy with dolutegravir (DTG) or bictegravir (BIC). These patients were switched to DRV/c or DOR. Scales were compared at the moment of the switch and 12 weeks later. Results: We included 1153 treatment-naïve men, 676 (58.7%) with BIC and 477 (41.3%) with DTG. A total of 32 (2.7%) experienced NPAEs that led to discontinuation. Insomnia was found in 20 patients; depression via PHQ-9 in 21 patients, via HADS-D in 5 patients, and anxiety via HADS-A in 12 patients. All of them were evaluated by a psychiatrist at the moment of the symptoms; 7 (21.8%) started psychotropic drugs. After 12 weeks of follow-up, PHQ-9, ISI, HADS-A, and HADS-D decreased, with a p-value ≤ 0.05. Conclusions: NPAEs seem to improve after switching to a DRV/c- or DOR-based regimen after the first 4 and 12 weeks.
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Cobicistat , Darunavir , Infecciones por VIH , Piridonas , Humanos , Masculino , Darunavir/efectos adversos , Darunavir/uso terapéutico , Darunavir/administración & dosificación , Infecciones por VIH/tratamiento farmacológico , Persona de Mediana Edad , Estudios Prospectivos , Adulto , Cobicistat/efectos adversos , Cobicistat/uso terapéutico , Cobicistat/administración & dosificación , Piridonas/efectos adversos , Inhibidores de Integrasa VIH/efectos adversos , Inhibidores de Integrasa VIH/uso terapéutico , Inhibidores de Integrasa VIH/administración & dosificación , Compuestos Heterocíclicos con 3 Anillos/efectos adversos , Compuestos Heterocíclicos con 3 Anillos/uso terapéutico , Compuestos Heterocíclicos con 3 Anillos/administración & dosificación , Trastornos del Inicio y del Mantenimiento del Sueño/inducido químicamente , Sustitución de Medicamentos/efectos adversos , Fármacos Anti-VIH/efectos adversos , Fármacos Anti-VIH/uso terapéutico , Piperazinas/efectos adversos , TriazolesRESUMEN
Chitosan is a biopolymer with unique properties that have attracted considerable attention in various scientific fields in recent decades. Although chitosan is known for its poor electrical and mechanical properties, there is interest in producing chitosan-based materials reinforced with carbon-based materials to impart exceptional properties such as high electrical conductivity and high Young's modulus. This study describes the synergistic effect of carbon-based materials, such as reduced graphene oxide and carbon nanotubes, in improving the electrical, optical, and mechanical properties of chitosan-based films. Our findings demonstrate that the incorporation of reduced graphene oxide influences the crystallinity of chitosan, which considerably impacts the mechanical properties of the films. However, the incorporation of a reduced graphene oxide-carbon nanotube complex not only significantly improves the mechanical properties but also significantly improves the optical and electrical properties, as was demonstrated from the photoluminescence studies and resistivity measurements employing the four-probe technique. This is a promising prospect for the synthesis of new materials, such as biopolymer films, with potential applications in optical, electrical, and biomedical bioengineering applications.
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Excessive use of antibiotics and the formation of bacterial biofilms can lead to persistent infections caused by drug-resistant bacteria, rendering ineffective immune responses and even life-threatening. There is an urgent need to explore synergistic antibacterial therapies across all stages of infection. Drawing inspiration from the antibacterial properties of neutrophil extracellular traps (NETs) and integrating the bacterial biofilm dispersal mechanism involving boronic acid-catechol interaction, the multifunctional bismuth-based polypeptide nanonets (PLBA-Bi-Fe-TA) are developed. These nanonets are designed to capture bacteria through a coordination complex involving cationic polypeptides (PLBA) with boronic acid-functionalized side chains, alongside metal ions (bismuth (Bi) and iron (Fe)), and tannic acid (TA). Leveraging the nanoconfinement-enhanced high-contact network-driven multiple efficiency, PLBA-Bi-Fe-TA demonstrates the excellent ability to swiftly capture bacteria and their extracellular polysaccharides. This interaction culminates in the formation of a highly hydrophilic complex, effectively enabling the rapid inhibition and dispersion of antibiotic-resistant bacterial biofilms, while Fe-TA shows mild photothermal ability to further assist fluffy mature biofilm. In addition, Bi is beneficial to regulate the polarization of macrophages to pro-inflammatory phenotype to further kill escaping biofilm bacteria. In summary, this novel approach offers a promising bionic optimization strategy for treating bacterial-associated infections at all stages through synergetic treatment.
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Introduction: The available evidence regarding the treatment of acute diverticulitis (AD) with pelvic abscess using antibiotics alone is very limited. The objective of this study was to determine whether the short- and long-term outcomes of AD with pelvic abscesses treated exclusively with antibiotics are comparable to those of pericolic abscesses. Methods: A retrospective study was conducted on patients diagnosed with AD and either pelvic or pericolic abscesses, as confirmed by computed tomography, who were treated solely with antibiotic therapy between 2011 and 2021. Cases involving percutaneous drainage as part of conservative treatment were excluded. Results: Fifty-eight patients met the inclusion criteria, comprising 12 with pelvic abscesses and 46 with pericolic abscesses. Both groups exhibited similar baseline characteristics and radiological findings, except for a more frequent presence of free fluid in pelvic abscesses. The success rate of antibiotic therapy was 91.7% for pelvic abscess cases and 96.7% for pericolic cases (p = 0.508). No significant differences were observed in recurrence or elective surgery. In the subgroup of abscesses with a diameter ≥4 cm, the evolution was similar in both locations (treatment success rate of 87.5% in pelvic and 94.4% in pericolic; p = 0.529), although recurrence was slightly higher for pericolic abscesses (38.4% vs. 14.3%; p = 0.362). Conclusions: Antibiotic therapy alone proves to be effective and safe for pelvic abscesses, demonstrating a course similar to pericolic abscesses, even in the case of large abscesses. Although the analyzed patient cohort is small, this study provides additional evidence that percutaneous drainage is not always essential for treating this complication.
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Absceso , Antibacterianos , Humanos , Masculino , Estudios Retrospectivos , Femenino , Antibacterianos/uso terapéutico , Persona de Mediana Edad , Anciano , Resultado del Tratamiento , Absceso/tratamiento farmacológico , Diverticulitis/tratamiento farmacológico , Diverticulitis/complicaciones , Diverticulitis/terapia , Adulto , Pelvis , Tomografía Computarizada por Rayos X , Enfermedad Aguda , Anciano de 80 o más AñosRESUMEN
Background: Executive functions, notably inhibition, significantly influence decision-making and behavioral regulation in team sports. However, more research must be conducted on individual player characteristics such as experience and motor skills. This study assessed how accumulated practical experience moderates inhibition in response to varying task difficulty levels. Methods: Forty-four university students (age: 20.36 ± 3.13 years) participated in this study with two sessions: one followed standard 1 × 1 basketball rules ("Regular Practice"), while the other imposed motor, temporal, and spatial restrictions ("Restriction Practice"). Functional difficulty was controlled by grouping pairs with similar skill levels. Flanker and Go-Nogo tasks were used. Results: Increasing complexity worsened cognitive performance (inhibition). "Restriction Practice" showed a significantly slower and less accurate performance in both tests than "Regular Practice" (p < 0.001). Experience positively impacted test speed and accuracy (p < 0.001). Conclusion: In sports, acute cognitive impacts are intrinsically linked to the task's complexity and the athlete's cognitive resources. In this sense, it is essential to adjust individually the cognitive demands of the tasks, considering each athlete's specific cognitive abilities and capacities.
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Purpose: Shared decision-making is critical in multiple sclerosis (MS) due to the uncertainty of the disease trajectory over time and the large number of treatment options with differing efficacy, safety and administration characteristics. The aim of this study was to assess patients' decisional conflict regarding the choice of a disease-modifying therapy and its associated factors in patients with mid-stage relapsing-remitting multiple sclerosis (RRMS). Methods: A multicenter, non-interventional study was conducted. Adult patients with a diagnosis of RRMS (2017 revised McDonald criteria) and disease duration of 3 to 8 years were included. The level of uncertainty experienced by a patient when faced with making a treatment choice was assessed using the 4-item Decisional Conflict Scale. A battery of patient-reported and clinician-rated measures was administered to obtain information on symptom severity, illness perception, illness-related uncertainty, regret, MS knowledge, risk taking behavior, preferred role in the decision-making process, cognition, and self-management. Patients were recruited during routine follow-up visits and completed all questionnaires online using electronic tablets at the hospital. A multivariate logistic regression analysis was conducted. Results: A total of 201 patients were studied. Mean age (Standard deviation) was 38.7 (8.4) years and 74.1% were female. Median disease duration (Interquartile range) was 6.0 (4.0-7.0) years. Median EDSS score was 1.0 (0-2.0). Sixty-seven (33.3%) patients reported a decisional conflict. These patients had lower MS knowledge and more illness uncertainty, anxiety, depressive symptoms, fatigue, subjective symptom severity, a threatening illness perception, and poorer quality of life than their counterparts. Lack of decisional conflict was associated with MS knowledge (Odds ratio [OR]=1.195, 95% CI 1.045, 1.383, p=0.013), self-management (OR=1.049, 95% CI 1.013, 1.093, p=0.018), and regret after a healthcare decision (OR=0.860, 95% CI 0.756, 0.973, p=0.018) in the multivariate analysis. Conclusion: Decisional conflict regarding the selection of a disease-modifying therapy was a common phenomenon in patients with mid-stage RRMS. Identifying factors associated with decisional conflict may be useful to implement preventive strategies that help patients better understand their condition and strengthen their self-management resources.
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Cancer is a disease that encompasses multiple and different malignant conditions and is among the leading causes of death in the world. Therefore, the search for new pharmacotherapeutic options and potential candidates that can be used as treatments or adjuvants to control this disease is urgent. Natural products, especially those obtained from plants, have played an important role as a source of specialized metabolites with recognized pharmacological properties against cancer, therefore, they are an excellent alternative to be used. The objective of this research was to evaluate the action of the monoterpene isoespintanol (ISO) against the human tumor cell lines MDA-MB-231, A549, DU145, A2780, A2780-cis and the non-tumor line MRC-5. Experiments with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and fluorescence with propidium iodide (PI), 4',6-diamidino-2-phenylindole dilactate (DAPI) and green plasma revealed the cytotoxicity of ISO against these cells; furthermore, morphological and chromogenic studies revealed the action of ISO on cell morphology and the inhibitory capacity on reproductive viability to form colonies in MDA-MB-231 cells. Likewise, 3D experiments validated the damage in these cells caused by this monoterpene. These results serve as a basis for progress in studies of the mechanisms of action of these compounds and the development of derivatives or synthetic analogues with a better antitumor profile.
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Monoterpenos , Humanos , Línea Celular Tumoral , Monoterpenos/farmacología , Supervivencia Celular/efectos de los fármacos , Antineoplásicos/farmacología , Proliferación Celular/efectos de los fármacos , Apoptosis/efectos de los fármacosRESUMEN
Heart rate variability (HRV) is a noninvasive approach to studying the autonomic modulation of heart rate in experimental settings, such as active standing sympathetic stimulation. It is known that patients with end-stage renal disease during active standing have few changes in HRV dynamics, which are improved after hemodialysis. However, it is unknown whether the response to active standing is recovered after definitive treatment with kidney transplantation. This work aims to assess the change in HRV dynamics in the supine position and active standing through time and frequency-based metrics, as well as recurrence plot quantitative analysis (RQA). We studied HRV dynamics by obtaining 5-minute electrocardiographic recordings from kidney transplant recipients who underwent an active standing test. The mean duration of heartbeats and their standard deviation diminished in active standing, compared with the supine position. Also, the low-frequency component of HRV and the presence of diagonal and vertical structures in RQA were predominant. A larger estimated glomerular filtration rate was significantly correlated with broader HRV in the supine position and during active standing. The narrower HRV during active standing may indicate a sympathetic response to external stimuli, which is expected in a functional cardiovascular system, and may be influenced by renal function.
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Electrocardiografía , Frecuencia Cardíaca , Fallo Renal Crónico , Trasplante de Riñón , Humanos , Frecuencia Cardíaca/fisiología , Masculino , Fallo Renal Crónico/fisiopatología , Fallo Renal Crónico/cirugía , Femenino , Persona de Mediana Edad , Adulto , Tasa de Filtración Glomerular , Posición Supina , Recurrencia , Posición de PieRESUMEN
The pursuit of a doctoral degree is a challenging process that can have a negative impact on the wellbeing of PhD students. Therefore, the aim here is to offer a systematic review of the current state of the literature on wellbeing among PhD students and the variables it involves in order to build an integrative model that will enrich future research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology for systematic reviews has been used to lay out the process in a flow diagram. We systematically review studies up to 2021 (N = 38) published on the Web of Science and SCOPUS databases. The results show the current state of the literature on wellbeing in PhD students, the characteristics of the studies (location, study design, and sample), how the literature defines the concept, the variables involved, the study limitations, and future perspectives to improve the quality of life of doctoral students. Finally, a comprehensive approach to the topic is presented in an integrative model that encompasses all variables identified in the literature and offers a guide for future research.
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A multicenter study involving 204 adults with relapsing-remitting multiple sclerosis (RRMS) assessed the dimensionality and item characteristics of the Mishel-Uncertainty of Illness Scale (MUIS), a generic self-assessment tool. Mokken analysis identified two dimensions in the MUIS with an appropriate item and overall scale scalability after excluding nonclassifiable items. A refined 12-item MUIS, employing a grade response model, effectively discriminated uncertainty levels among RRMS patients (likelihood ratio test p-value = .03). These findings suggest the potential value of the 12-item MUIS as a reliable measure for assessing uncertainty associated with the course of illness in RRMS.
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PURPOSE: To evaluate the association between LASIK and early cataract phacoemulsification surgery (PE). METHODS: A matched case-control study was conducted. Cases were otherwise healthy adults with a history of LASIK. Groups were paired according to corrected-distance visual acuity (CDVA), axial length, and cataract grade. RESULTS: A total of 213 patients were included. 85 patients were classified as post-LASIK group and 128 as controls. The mean age at the time of LASIK was 42.32 ± 9.24 years. The mean CDVA before PE was 0.29 ± 0.19 Log MAR in post-LASIK group and 0.34 ± 0.22 Log MAR in controls (p = 0.07). The mean axial length was 23.99 ± 1.78 mm in post-LASIK group and 23.62 ± 0.98 mm in controls (p = 0.085). The mean nuclear cataract grading was 1.36 in post-LASIK group and 1.47 in controls (p = 0.34). The mean age at the time of PE was 60.18 ± 7.46 years in post-LASIK group and 67.35 ± 9.28 in controls (p < 0.0005). The difference between the mean age of LASIK and the mean age of PE was 17.85 ± 5.72 years. There was a positive association between the post-LASIK group and the age of PE ≤ 55 years (OR: 4.917, 95% CI: 2.21-10.90, p < 0.001). CONCLUSION: LASIK may be associated with early PE. Patients with LASIK had a 7-year earlier PE compared to a matched control group.
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Extracción de Catarata , Catarata , Queratomileusis por Láser In Situ , Facoemulsificación , Adulto , Humanos , Niño , Adolescente , Adulto Joven , Persona de Mediana Edad , Estudios de Casos y Controles , Catarata/complicacionesRESUMEN
Abstract Background: ST-elevation myocardial infarction (STEMI) systems of care have reduced inter-hospital transfer times and facilitated timely reperfusion goals. Helicopters may be an option when land transportation is not feasible; however, the safety of air transport in patients with acute coronary syndrome (ACS) is a factor to consider. Objetives: The aim of this study was to evaluate the safety of helicopter transport for patients with ACS. Methods: Prospective, observational, and descriptive study including patients diagnosed with ACS within the STEMI network of a metropolitan city transferred by helicopter to a large cardiovascular center to undergo percutaneous coronary intervention. The primary outcome of the study was the incidence of air-travel-related complications defined as IV dislodgement, hypoxia, arrhythmia, angina, anxiety, bleeding, and hypothermia. Secondary outcomes included the individual components of the primary outcome. Results: A total of 106 patients were included in the study; the mean age was 54 years and 84.9% were male. The most frequent diagnosis was STEMI after successful fibrinolysis (51.8%), followed by STEMI with failed fibrinolysis (23.7%) and non-reperfused STEMI (9.4%). Five patients (4.7%) developed at least one complication: IV dislodgement (1.8%) and hypoxemia (1.8%) in two patients and an episode of angina during flight (0.9%). A flight altitude of > 10,000 ft was not associated with complications. Conclusions: The results of this study suggest that helicopter transportation is safe in patients undergoing acute coronary syndrome, despite the altitude of a metropolitan area.
Resumen Antecedentes: Los sistemas de atención de IAMCEST han reducido los tiempos de transferencia interhospitalaria y han facilitado las metas de reperfusión oportuna. Los helicópteros pueden ser una opción cuando el transporte terrestre no es factible; sin embargo, la seguridad del transporte aéreo en pacientes con síndrome coronario agudo (SICA) es un factor a considerar. Objetivos: Evaluar la seguridad del transporte en helicóptero para pacientes con SICA. Métodos: Estudio prospectivo, observacional, descriptivo. Se incluyeron pacientes con diagnóstico de SICA dentro de la red IAMCEST en metrópolis extensa, trasladados en helicóptero a un centro cardiovascular. El resultado primario del estudio fue la incidencia de complicaciones relacionadas con los viajes aéreos definidas cómo desalojo de catéter intravenoso, hipoxia, arritmia, angina, ansiedad, sangrado e hipotermia. Resultados: Total de 106 pacientes; la edad media fue de 54 años y 84,9% eran hombres. La altitud media de vuelo fue de 10,100 pies y la distancia media de vuelo fue de 50,0 km. El diagnóstico más frecuente fue IAMCEST tras fibrinolisis exitosa (51,8%), seguido de IAMCEST con fibrinolisis fallida (23,7%). Cinco pacientes (4,7%) desarrollaron una complicación: desalojo IV (1,8%) e hipoxemia (1,8%) en dos pacientes y un episodio de angina durante el vuelo (0,9%). Una altitud de vuelo mayor de 10,000 pies no se asoció a complicaciones. Conclusiones: Los resultados de este estudio sugieren que el transporte en helicóptero es seguro en pacientes con SICA, incluso en altitudes > 10,000 pies.
RESUMEN
BACKGROUND: ST-elevation myocardial infarction (STEMI) systems of care have reduced inter-hospital transfer times and facilitated timely reperfusion goals. Helicopters may be an option when land transportation is not feasible; however, the safety of air transport in patients with acute coronary syndrome (ACS) is a factor to consider. OBJETIVES: The aim of this study was to evaluate the safety of helicopter transport for patients with ACS. METHODS: Prospective, observational, and descriptive study including patients diagnosed with ACS within the STEMI network of a metropolitan city transferred by helicopter to a large cardiovascular center to undergo percutaneous coronary intervention. The primary outcome of the study was the incidence of air-travel-related complications defined as IV dislodgement, hypoxia, arrhythmia, angina, anxiety, bleeding, and hypothermia. Secondary outcomes included the individual components of the primary outcome. RESULTS: A total of 106 patients were included in the study; the mean age was 54 years and 84.9% were male. The most frequent diagnosis was STEMI after successful fibrinolysis (51.8%), followed by STEMI with failed fibrinolysis (23.7%) and non-reperfused STEMI (9.4%). Five patients (4.7%) developed at least one complication: IV dislodgement (1.8%) and hypoxemia (1.8%) in two patients and an episode of angina during flight (0.9%). A flight altitude of > 10,000 ft was not associated with complications. CONCLUSIONS: The results of this study suggest that helicopter transportation is safe in patients undergoing acute coronary syndrome, despite the altitude of a metropolitan area.
ANTECEDENTES: Los sistemas de atención de IAMCEST han reducido los tiempos de transferencia interhospitalaria y han facilitado las metas de reperfusión oportuna. Los helicópteros pueden ser una opción cuando el transporte terrestre no es factible; sin embargo, la seguridad del transporte aéreo en pacientes con síndrome coronario agudo (SICA) es un factor a considerar. OBJETIVOS: Evaluar la seguridad del transporte en helicóptero para pacientes con SICA. MÉTODOS: Estudio prospectivo, observacional, descriptivo. Se incluyeron pacientes con diagnóstico de SICA dentro de la red IAMCEST en metrópolis extensa, trasladados en helicóptero a un centro cardiovascular. El resultado primario del estudio fue la incidencia de complicaciones relacionadas con los viajes aéreos definidas cómo desalojo de catéter intravenoso, hipoxia, arritmia, angina, ansiedad, sangrado e hipotermia. RESULTADOS: Total de 106 pacientes; la edad media fue de 54 años y 84,9% eran hombres. La altitud media de vuelo fue de 10,100 pies y la distancia media de vuelo fue de 50,0 km. El diagnóstico más frecuente fue IAMCEST tras fibrinolisis exitosa (51,8%), seguido de IAMCEST con fibrinolisis fallida (23,7%). Cinco pacientes (4,7%) desarrollaron una complicación: desalojo IV (1,8%) e hipoxemia (1,8%) en dos pacientes y un episodio de angina durante el vuelo (0,9%). Una altitud de vuelo mayor de 10,000 pies no se asoció a complicaciones. CONCLUSIONES: Los resultados de este estudio sugieren que el transporte en helicóptero es seguro en pacientes con SICA, incluso en altitudes > 10,000 pies.