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1.
Notas enferm. (Córdoba) ; 25(43): 62-65, jun.2024.
Artículo en Español | LILACS, BDENF - Enfermería, UNISALUD, InstitutionalDB, BINACIS | ID: biblio-1561284

RESUMEN

El síndrome compartimental agudo requiere de la descompresión quirúrgica, mediante fasciotomía, esta técnica debe ser urgente y será clave para evitar la instauración de graves secuelas. El posterior abordaje de estas heridas de difícil y lenta cicatrización suponen un reto para los profesionales de la salud y un problema para la salud pública debido a los altos costes y elevada morbilidad. La terapia de presión negativa (TPN) o cura por vacío (VAC, "vacuum assisted closure") es un tratamiento no invasivo que consigue la curación de las heridas favoreciendo la vascularización, la aparición del tejido de granulación y eliminación del exceso de exudado[AU]


Acute compartment syndrome requires surgical decompression by fasciotomy, this technique must be urgent and will be key to avoid the establishment of serious sequels. The subsequent approach to these wounds, which are difficult and slow to heal, is a challenge for health professionals and a problem for public health due to high costs and high morbidity. Negative pressure therapy (NPWT) or vacuum assisted closure (VAC) is a non-invasive treatment that achieves wound healing by promoting vascularization, the appearance of granulation tissue and elimination of excess exudate[AU]


A síndrome compartimental aguda requer descompressão cirúrgica, por fasciotomia, esta técnica deve ser urgente e será fundamental para evitar o estabelecimento de sequelas graves. O tratamento subsequente destas feridas difíceis e de cicatrização lenta é um desafio para os profissionais de saúde e um problema desaúde pública devido aos elevados custos e à elevada morbilidade. A terapia por pressão negativa (NPWT) ou o encerramento assistido por vácuo (VAC) é um tratamento não invasivo que permite a cicatrização de feridas através da promoção da vascularização, do aparecimento de tecido de granulação e da remoção do excesso de exsudado[AU]


Asunto(s)
Humanos , Fasciotomía
2.
HSS J ; 20(2): 187-194, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-39281996

RESUMEN

Background: Bundled payments for total joint arthroplasty (TJA) were instituted by the Centers for Medicare and Medicaid Services (CMS) to reimburse providers a lump sum for operative and 90-day postoperative costs. Gaining a better understanding of which TJA patients are at risk for early return to the operating room (OR) is critical in preoperative optimization of those with modifiable risks, which could improve bundled-payment performance. Purpose: We sought to identify the most common reason for readmissions, as well as patient characteristics and costs, associated with early return to the OR among TJA patients. Methods: This was a retrospective cohort study of Medicare patients who had undergone primary total hip or knee arthroplasty (THA or TKA) between 2013 and 2018 at a tertiary care hospital. We used the CMS research identifiable files database to identify the most common reasons for readmissions and revisions within 90 days of surgery. Total billing claims were used to determine the cost of early readmissions and revisions. Multivariate regression analysis was used to determine the characteristics associated with early readmission or revision. Results: Out of 20 166 primary TJA patients identified, we found 1349 readmissions (5.6%) and 163 (0.8%) revisions within 90 days of surgery. Dislocation was the most common indication for readmission, and periprosthetic joint infection was the most common indication for revision. Early return to the OR was associated with a mean $105,988 (standard deviation [SD] = $76,865) in CMS claims for the inpatient stay. Factors associated with a higher risk of early reoperation were female sex, THA, longer length of stay, and discharge to long-term care facility. Conclusions: This retrospective cohort study found that early return to the OR after TJA increased overall 90-day costs by 260%, suggesting that early reoperation might have a significant impact on bundled payments. Further study is warranted.

3.
Animals (Basel) ; 14(17)2024 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-39272325

RESUMEN

Menbutone is a choleretic agent currently used in Europe to treat digestive disorders in livestock and dogs. Pharmacokinetic parameters were established in 4-month Holstein calves after intravenous (IV) and intramuscular (IM) administration. The drug was administered to 12 animals (10 mg/kg) for both IV and IM routes following a crossover design. Plasma samples were collected at various time points over 24 h and analyzed by reverse-phase high-performance liquid chromatography with a photodiode-array detector, following a method validated according to European Medicines Agency guidelines. Pharmacokinetic parameters were calculated using compartmental and non-compartmental methods. Menbutone followed a two-compartment open model after IV injection, with a total clearance (Cl) of 71.9 ± 13.5 mL/h/kg, an elimination half-life (t½ß) of 4.53 ± 2.45 h, and a volume of distribution at steady-state (Vss) of 310.4 ± 106.4 mL/kg. Non-compartmental elimination half-life (t½λ) was 4.2 ± 1.1 h. After IM administration, drug pharmacokinetics was best described by a one-compartment open model. The peak plasma concentration (Cmax) was 15.1 ± 4.3 µg/mL; the time to reach Cmax (tmax), 1.66 ± 0.55 h; and the mean absorption time (MAT), 2.50 ± 1.42 h. Absorption was high, with a fraction of the dose absorbed (F) of 83.5 ± 22.4%. Menbutone was rapidly eliminated from plasma for both routes of administration, with a fast and high IM bioavailability.

4.
PRiMER ; 8: 42, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39238487

RESUMEN

Peer review is primarily thought of as the process used to determine whether manuscripts are published in medical or other academic journals. While a publication may be one outcome of peer review, this article shares a model of 4 Ps to remind faculty of some important additional applications of peer review. The 4 Ps are publication, presentation, promotion, and practice. The medical literature offers few reasons why faculty should get involved in peer review. In this article, we define peer review, illustrate the role of peer review in four important processes, describe how the volume of material to review has changed over time, and share how participation in these processes promotes career advancement. Understanding the peer review process and its benefits can encourage professionals to participate in peer review in any of the four Ps as they recognize the benefits to their discipline and their career.

6.
Eur Geriatr Med ; 2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39227556

RESUMEN

BACKGROUND: Muscle ultrasound is increasingly popular thanks to its advantages over other techniques. However, its usefulness in the diagnosis of sarcopenia in older adults with aortic stenosis (AS) has not been studied to date. OBJECTIVES: to analyze the prevalence of sarcopenia using muscle ultrasound and its impact on the health outcomes in older patients with AS. METHODS: The single-center FRESAS (FRailty-Evaluation-in-Severe-Aortic-Stenosis) registry was used to study patients over 75 years with severe AS susceptible to valve replacement. Sarcopenia was suspected in those individuals with diminished grip strength, and the diagnosis was confirmed in the presence of reduced ultrasound quadriceps muscle thickness, following the recommendations of the EWGSOP2 (European-Working-Group-on-Sarcopenia-in-Older-People). The primary composite endpoint was urgent hospital admission and mortality of cardiac cause 6 months after the diagnosis. RESULTS: Of the 150 patients studied, 55.3% were females, and only 17.3% were frail; the mean age was 83.4 years. Sarcopenia was diagnosed in 42 patients (28%). The overall survival rate at 6 months was 92%. The primary endpoint was recorded in 23.2% of the cases and was more frequent in the sarcopenic patients (33.3%) than in the non-sarcopenic individuals (17.6%) (p = 0.01). The regression analysis found that sarcopenia was associated with an increased risk of the primary endpoint (HR: 2.25; 95% CI 1.19-4.45; p = 0.02), adjusting for potential confounding factors. CONCLUSIONS: The incidence of serious cardiac complications in older patients with sarcopenia and severe AS is significant. The present study describes a noninvasive, ultrasound-guided diagnostic technique that may prove efficient in its predictive capacity.

7.
J Sport Rehabil ; : 1-5, 2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39244193

RESUMEN

CONTEXT: Adductor longus muscle strains are one of the most common injuries occurring in intermittent sports such as soccer. OBJECTIVE: The purpose of this study was to know the effect of a specific rehabilitation and reconditioning program, which was previously validated, after adductor longus injury in professional soccer players. METHODS: A specific rehabilitation and reconditioning program was applied to 11 injured male professional soccer players. PARTICIPANTS: Eleven male professional soccer players (age = 29.18 [4.45] y; height = 179.64 [4.97] cm; mass = 75.33 [3.84] kg). INTERVENTIONS: In the first place, the days taken to return to full team training and to return to competition (RTP) was analyzed; second, the most important performance parameters were analyzed and compared in the preinjury match (PRE) and after the return to competition at 2 different points in time (RTP1-RTP2). RESULTS: The return to full team training recorded was 11.91 (1.92) days and the RTP was 15.36 (3.04) days. Match performance parameters showed significant improvements after injury. Significant improvements were observed during RTP2, in the variables of high-speed running (P = .002), very high-speed running (P = .006), acceleration (>3 m/s2; P = .048), and high metabolic load distance (P = .009). CONCLUSION: The results allow us to conclude that this program was very effective, as it allowed the players to obtain similar and/or higher performance values in a reduced period of time after the injury.

8.
Front Med (Lausanne) ; 11: 1439338, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39247640

RESUMEN

Introduction: Non-infectious inflammatory ocular diseases pose significant challenges in diagnosis and management, often requiring systemic immunosuppressive therapy. Since Janus kinase (JAK) inhibitors may represent a novel therapeutic option for these disorders, the present study aimed to expand current knowledge about their efficacy and safety in patients with these conditions. Methods: This prospective cohort study included 12 adult patients from the international AutoInflammatory Disease Alliance (AIDA) Network registries dedicated to non-infectious ocular inflammatory conditions. We assessed ocular flares, visual acuity, disease course, and complications before and after initiating JAK inhibitor therapy. Results: Ocular inflammation was related to a systemic disease in 8 (66.7%) patients as follows: spondyloarthritis (n = 3), peripheral psoriatic arthritis (n = 1), rheumatoid arthritis (n = 1), antinuclear antibodies (ANA) positive juvenile idiopathic arthritis (n = 1), Behçet's syndrome (n = 1), Vogt-Koyanagi-Harada syndrome (n = 1). In total, 4 patients received baricitinib, 1 patient received tofacitinib, and 7 patients underwent upadacitinib treatment. The overall average duration of JAK inhibitors treatment was 8.6 ± 5.5 months (ranging from 3 to 20 months). At the last assessment, ocular disease control was complete in 12/12 patients. One patient discontinued baricitinib due to poor compliance after a 12-month relapse-free period. The incidence of ocular flares was 125 episodes/1.000 person-months prior to the initiation of JAK inhibitors and 28.6 episodes/1.000 person-months thereafter. The incidence rate ratio for experiencing a relapse before starting a JAK inhibitor compared to the following period was 4.37 (95% CI 1.3-14.7, p-value: 0.02). Conclusion: JAK inhibitors demonstrate efficacy and safety in controlling ocular inflammatory relapses, confirming that they represent a valuable treatment option for patients with non-infectious inflammatory ocular diseases resistant to conventional treatments.

9.
Pediatr Dermatol ; 2024 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-39258307

RESUMEN

5q14.3 microdeletion syndrome is a rare condition involving multiple genes such as MEF2C and RASA1 and is potentially classified as a neurocutaneous syndrome. Deletion of the MEF2C gene accounts for the majority of clinical manifestations, including global developmental delay, intellectual disability, seizures, and behavioral disorders. RASA1 deletion is linked to capillary malformations with arteriovenous malformations (CM-AVM). Until now, only 17 cases have been described with deletions of both genes. We present the first case described in Spain with the microdeletion in the 5q14.3 cytoband simultaneously affecting both MEF2C and RASA1, exhibiting the typical manifestations of this entity, and review the published cases to date.

10.
ACS Omega ; 9(30): 33224-33238, 2024 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-39100322

RESUMEN

Protein tyrosine phosphatase 1B (PTP1B) is a promising drug target for treating type 2 diabetes (T2DM) and obesity. As a result, developing new therapies that target PTP1B is an attractive strategy for treating these diseases. Herein, we detail the synthesis of 15 lithocholic acid (LA) derivatives, each containing different benzylaminomethyl groups attached to the C3 position of the steroid skeleton. The derivatives were assessed against two forms of PTP1B enzyme (hPTP1B1-400 and hPTP1B1-285), and the most potent compounds were then tested against T-cell protein tyrosine phosphatase (TCPTP) to determine their selectivity. The results showed that compounds 6m and 6n were more potent than the reference compounds (ursolic acid, chlorogenic acid, suramin, and TCS401). Additionally, both compounds exhibited greater potency over hPTP1B1-400. Furthermore, enzyme kinetic studies on hPTP1B1-400 revealed that these two lithocholic acid derivatives have an uncompetitive inhibition against hPTP1B1-400 with K i values of 2.5 and 3.4 µM, respectively. Interestingly, these compounds were around 75-fold more selective for PTP1B over TCPTP. Finally, docking studies and molecular dynamics simulations (MDS) were conducted to determine how these compounds interact with PTP1B. The docking studies revealed hydrophobic and H-bond interactions with amino acid residues in the unstructured region. MDS showed that these interactions persisted throughout the 200 ns simulation, indicating the crucial role of the unstructured zone in the biological activity and inhibition of PTP1B.

11.
Brain ; 2024 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-39101570

RESUMEN

The potential of combining serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) levels to predict disability worsening in multiple sclerosis (MS) remains underexplored. We aimed to investigate whether sNfL and sGFAP values identify distinct subgroups of patients according to the risk of disability worsening and their response to disease-modifying treatments (DMTs). This multicentre study, conducted across thirteen European hospitals, spanned from July 15, 1994, to August 18, 2022, with follow-up until September 26, 2023. We enrolled MS patients who had serum samples collected within 12 months from disease onset and before initiating DMTs. Multivariable regression models were used to estimate the risk of relapse-associated worsening (RAW), progression independent of relapse activity (PIRA), and Expanded Disability Status Scale (EDSS) score of 3. Of the 725 patients included, median age was 34.2 years (IQR, 27.6-42.4), and 509 patients (70.2%) were female. Median follow-up duration was 6.43 years (IQR, 4.65-9.81). Higher sNfL values associated with an elevated risk of RAW (HR of 1.45; 95% CI 1.19-1.76; P < 0.001), PIRA (HR of 1.43; 95% CI 1.13-1.81; P = 0.003), and reaching an EDSS of 3 (HR of 1.55; 95% CI 1.29-1.85; P < 0.001). Moreover, higher sGFAP levels were linked to a higher risk of achieving an EDSS score of 3 (HR of 1.36; 95% CI 1.06-1.74; P = 0.02) and, in patients with low sNfL values, to PIRA (HR of 1.86; 95% CI 1.01-3.45; P = 0.04). We further examined the combined effect of sNfL and sGFAP levels. Patients with low sNfL and sGFAP values (NLGL) exhibited a low risk of all outcomes and served as reference. Untreated patients with high sNfL levels showed a higher risk of RAW, PIRA, and reaching an EDSS of 3. Injectable or oral DMTs reduced the risk of RAW in these patients but failed to mitigate the risk of PIRA and reaching an EDSS of 3. Conversely, high-efficacy DMTs counteracted the heightened risk of these outcomes, except for the risk of PIRA in patients with high sNfL and sGFAP levels. Patients with low sNfL and high sGFAP values (NLGH) showed an increased risk of PIRA and achieving an EDSS of 3, which remained unchanged with either high-efficacy or other DMTs. In conclusion, evaluating sNfL and sGFAP levels at disease onset in MS may identify distinct phenotypes associated with diverse immunological pathways of disability acquisition and therapeutic response.

12.
Eur J Dermatol ; 34(4): 392-397, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39193676

RESUMEN

Non-melanoma skin cancer (NMSC) is the most -common skin cancer in Spain, yet national data on its incidence trends are limited. To analyse the trends in NMSC incidence in Spain from 1990 to 2019, examining variations by sex, age, period, and birth cohort. Data on NMSC incidence was sourced from the Global Health Data Exchange. Age-standardized incidence rates (ASIRs) were calculated using the direct method. Trends and average annual percentage changes were identified using Joinpoint regression analysis. Age-period-cohort analysis was applied to assess age-specific, period-specific, and cohort-specific relative risks. From 1990 to 2019, Spain reported 2,302,399 NMSC cases. ASIRs significantly declined post-2005, with men exhibiting slightly higher rates than women. Joinpoint analysis revealed distinct trends between genders, with men experiencing an initial rise followed by a decline, while women exhibited periods of increase interspersed with decline. APC analysis showed a net decrease in age-adjusted NMSC rates for both sexes. Local drift analysis showed a downward trend in most age groups, indicating a broad decrease at the population level. However, no decrease was observed in young men (20-24 years). Both sexes showed an increased risk of NMSC between 1990 and 2002, followed by a decrease. In particular, those born at the beginning of the 21st century showed a significant decrease in NMSC risk compared with earlier cohorts, suggesting a possible cohort effect. A comprehensive analysis of NMSC trends in Spain highlights the need for ongoing research and interventions to address the evolving burden.


Asunto(s)
Neoplasias Cutáneas , Humanos , España/epidemiología , Neoplasias Cutáneas/epidemiología , Masculino , Incidencia , Femenino , Persona de Mediana Edad , Anciano , Adulto , Adulto Joven , Distribución por Edad , Distribución por Sexo , Carcinoma Basocelular/epidemiología , Carcinoma de Células Escamosas/epidemiología , Factores de Edad , Factores Sexuales , Anciano de 80 o más Años
13.
Org Lett ; 26(33): 6944-6949, 2024 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-39116344

RESUMEN

Microcrystal electron diffraction (microED) is an emerging technique for rapid crystallographic analysis of small molecule micro- and nanocrystals. In this report, we evaluate the applicability of microED to pharmaceutical compounds through the analysis of 30 samples obtained from the process and medicinal chemistry groups at Amgen Inc. Using only 40 h of microscope time, 15 of 30 crystal structures were elucidated. From these crystal structures, all chiral compounds had the correct absolute stereochemistry assigned by dynamical refinement of continuous rotation electron diffraction data, confirming dynamical refinement as a promising tool for the absolute stereochemistry determination of pharmaceutically relevant compounds.


Asunto(s)
Nanopartículas , Estereoisomerismo , Estructura Molecular , Preparaciones Farmacéuticas/química , Cristalografía por Rayos X , Nanopartículas/química , Modelos Moleculares
14.
Comput Biol Med ; 180: 108976, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39116714

RESUMEN

Keratoconus is a non-inflammatory bilateral disease, that usually occurs in the inferior-temporal region, where the cornea bulges out and becomes thinner, due to the gradual loss of structural organization in corneal tissue. Degenerated extracellular matrix and fibers breakage have been observed in keratoconic corneas, that may promote the progression of the pathology. While keratoconus histopathology has been widely described in literature, its etiology is still not clear. Being able to fully understand keratoconus growing process could be crucial to detect its development and improve prevention strategies. This work proposes a novel continuum-based keratoconus growth model. The proposed framework accounts for the structural changes occurring in the underlying tissue during the progression of the disease, as indicated in experiments. The developed formulation is able to replicate the typical bulging and thinning of keratoconic corneas, as well as different forms in terms of shape, as they are commonly classified in clinics (nipple, oval and globus cones). The cone that is obtained constitutes a permanent deformed state, not pressure dependent. The resulting model may help to better understand the etiology of the behavior of this disease with the aim of improving the diagnosis and the treatment of the pathology.


Asunto(s)
Córnea , Queratocono , Modelos Biológicos , Queratocono/metabolismo , Queratocono/patología , Humanos , Córnea/patología , Córnea/metabolismo
15.
Sci Adv ; 10(34): eadp1295, 2024 Aug 23.
Artículo en Inglés | MEDLINE | ID: mdl-39178261

RESUMEN

Megaliths represent the earliest form of monumental stone architecture. The earliest megalithic chambers in Europe appeared in France in the fifth millennium BCE. Menga is the oldest of the great dolmens in Iberia (approximately 3800 to 3600 BCE). Menga's capstone #5 weighing 150 tons is the largest stone ever moved in Iberia as part of the megalithic phenomenon and one of the largest in Europe. The research presented here proposes a completely innovative interpretation of how this colossal monument was built. It comprises a geoarchaeological analysis encompassing three major components: (i) the angles of the planes of each stone, (ii) the stratigraphic polarity of each structural element, and (iii) the depth of the foundations. Our results show that Menga is a unique example of creative genius and early science among Neolithic societies. It was designed as a completely original engineering project, for which we know of no precedents in Iberia.

16.
medRxiv ; 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-39148840

RESUMEN

Dissecting biological pathways highlighted by Mendelian gene discovery has provided critical insights into the pathogenesis of Parkinson's disease (PD) and neurodegeneration. This approach ultimately catalyzes the identification of potential biomarkers and therapeutic targets. Here, we identify PSMF1 as a new gene implicated in PD and childhood neurodegeneration. We find that biallelic PSMF1 missense and loss-of-function variants co-segregate with phenotypes from early-onset PD and parkinsonism to perinatal lethality with neurological manifestations across 15 unrelated pedigrees with 22 affected subjects, showing clear genotype-phenotype correlation. PSMF1 encodes the proteasome regulator PSMF1/PI31, a highly conserved, ubiquitously expressed partner of the 20S proteasome and neurodegeneration-associated F-box-O 7 and valosin-containing proteins. We demonstrate that PSMF1 variants impair mitochondrial membrane potential, dynamics and mitophagy in patient-derived fibroblasts. Additionally, we develop models of psmf1 knockdown Drosophila and Psmf1 conditional knockout mouse exhibiting age-dependent motor impairment, with diffuse gliosis in mice. These findings unequivocally link defective PSMF1 to early-onset PD and neurodegeneration and suggest mitochondrial dysfunction as a mechanistic contributor.

17.
Stem Cells Int ; 2024: 9999155, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39148939

RESUMEN

Gastric cancer (GC) is the fourth leading cause of cancer-related death, associated with late diagnosis and treatment resistance. Currently, screening tests for GC are not cost-effective or have low accuracy. Previously, we described an extended phenotype of gastric cancer stem cells (GCSCs; CD24+CD44+CD54+EpCAM+) that is associated with metastasis and tumor stage in GC patients. The goal of the current research is to evaluate the presence of these GCSCs in the peripheral blood of GC patients and healthy volunteers. A total of 73 blood samples were collected from 32 GC patients and 41 healthy volunteers. After peripheral blood mononuclear cell (PBMC) extraction, multiparametric flow cytometry was performed looking for GCSCs. Using clustering data through artificial intelligence (AI), we defined high/low levels of circulating GCSCs (cGCSCs) and proceeded to evaluate its association with clinical and prognostic variables. Finally, a diagnostic test analysis was performed evaluating patients and healthy volunteers. We found that cGCSCs are present in most GC patients with a mean concentration of 0.48%. The AI clustering showed two groups with different cGCSC levels and clinical characteristics. Through statistical analysis, we confirmed the association between cGCSC levels and lymph node metastasis, distant metastasis, and overall survival. The diagnostic test analysis showed sensibility, specificity, and area under the curve (AUC) of 83%, 95%, and 0.911, respectively. Our results suggest that the assessment of cGCSCs CD24+CD44+CD54+EpCAM+ could be a potential noninvasive test, with prognostic value, as well as highly sensitive and specific for screening or diagnosis of GC; however, a larger scale study will be necessary to confirm this.

18.
Rev Esp Salud Publica ; 982024 Jul 17.
Artículo en Español | MEDLINE | ID: mdl-39162603

RESUMEN

OBJECTIVE: COVID-19 has evidenced the importance of a Primary and Community Care (PCC), able to respond in the front line with capacity and adaptation to health and social crises. In order to reinforce its role, the Strategic Framework for Primary and Community Care was created in 2019, and one of its lines of action is to consolidate a budgetary and human resources policy. This translates into the Primary Care Action Plan 2022 and 2023, which includes the adequacy of HHRR based on the morbidity attended, health outcomes and sociodemographic characteristics. For this purpose, the development of the model for its calculation is urged. The objective of this paper was to offer a model as a guideline for the adequacy of the needs of Family Care Units (FAU). METHODS: The study was carried out in the Tenerife Health Area, which has 41 ZBS with 97 health care centers. The variables weighted in the model were: percentage of people over 65 years of age; utilization index; complexity by GMA (Adjusted Morbidity Groups) and frequentation. An Adequate Quota Index was calculated to establish the quota for each health care center between 1,200 and 1,600 per UAF and projection to 2025. RESULTS: The total need for UAF increase was 62, compared to 57 with the capita criterion of 1,500, at the extremes of the model range there were 12 centers of 1,200 and 11 of 1,600. CONCLUSIONS: In a very heterogeneous Health Area, the model achieves a more equitable allocation without increasing in practice the need for FAUs compared to the capitated criterion.


OBJECTIVE: La COVID-19 ha evidenciado la importancia de una Atención Primaria y Comunitaria (APyC), capaz de responder en primera línea con capacidad y adaptación ante las crisis sanitarias y sociales. A fin de reforzar su papel, en 2019 surge el Marco Estratégico para la Atención Primaria y Comunitaria, que entre sus líneas plantea consolidar una política presupuestaria y de Recursos Humanos. Ello se traduce en el Plan de Acción de Atención Primaria 2022 y 2023, que recoge la adecuación de los RR. HH. en base a la morbilidad atendida, los resultados en salud y las características sociodemográficas. Con este propósito se insta a la elaboración del modelo para su cálculo. El objetivo de este trabajo fue ofrecer un modelo como orientación a la adecuación de necesidades de las Unidades de Atención Familiar (UAF). METHODS: El estudio se desarrolló en el Área de Salud de Tenerife, que consta de 41 ZBS con 97 centros asistenciales. Las variables ponderadas en el modelo fueron porcentaje de mayores de sesenta y cinco años, índice de utilización, complejidad por GMA (Grupos de Morbilidad Ajustados) y frecuentación. Se calculó un Índice de cupo adecuado que permitiera establecer el cupo para cada centro asistencial entre 1.200 y 1.600 por UAF y proyección a 2025. RESULTS: La necesidad total de incremento de UAF fue de 62, frente a 57 con el criterio capitativo de 1.500. En los extremos de la horquilla del modelo hubo 12 centros de 1.200 y 11 de 1.600. CONCLUSIONS: En un Área de Salud muy heterogénea, el modelo consigue una asignación más equitativa sin incrementar en la práctica la necesidad de UAF frente al criterio capitativo.


Asunto(s)
COVID-19 , Atención Primaria de Salud , Humanos , Atención Primaria de Salud/organización & administración , Atención Primaria de Salud/normas , COVID-19/epidemiología , España , Anciano , Factores Sociodemográficos , Factores Socioeconómicos , Necesidades y Demandas de Servicios de Salud , Salud de la Familia
19.
J Am Chem Soc ; 2024 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-39145676

RESUMEN

In the pursuit of selective conversion of methane directly to methanol in the liquid-phase, a common challenge is the concurrent formation of undesirable liquid oxygenates or combustion byproducts. However, we demonstrate that monometallic Pd-CeO2 catalysts, modified by carbon, created by a simple mechanochemical synthesis method exhibit 100% selectivity toward methanol at 75 °C, using hydrogen peroxide as oxidizing agent. The solvent free synthesis yields a distinctive Pd-iC-CeO2 interface, where interfacial carbon (iC) modulates metal-oxide interactions and facilitates tandem methane activation and peroxide decomposition, thus resulting in an exclusive methanol selectivity of 100% with a yield of 117 µmol/gcat at 75 °C. Notably, solvent interactions of H2O2 (aq) were found to be critical for methanol selectivity through a density functional theory (DFT)-simulated Eley-Rideal-like mechanism. This mechanism uniquely enables the direct conversion of methane into methanol via a solid-liquid-gas process.

20.
Materials (Basel) ; 17(15)2024 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-39124509

RESUMEN

In this study, the maximum CO2 capture capacity of an ordered mesoporous carbon (CMK-3) was evaluated at high pressure (35 atm) and several temperatures (0, 10, 20, and 35 °C). CMK-3 was synthesized with the hard template method (silica SBA-15) using furfuryl alcohol and toluene as carbon sources. The CO2 adsorption isotherms were fitted to the following adsorption theories: Freundlich, Langmuir, Sips, Toth, Dubinin-Radushkevich, and Temkin. The maximum capture capacity (726.7 mg·g-1) was achieved at 0 °C and 34 atm. The results of the study of successive adsorption-desorption cycles showed that multi-cycle reversible gas capture processes could be used in optimal temperature and pressure conditions. It was determined that 0.478 g of CMK-3 would be required to reduce the CO2 concentration in 1 m3 of air to pre-industrial levels (280 ppm). The obtained results may contribute to technological developments for the mitigation of human impacts on the environment through the capture of atmospheric CO2.

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