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Efectividad del tratamiento periodontal no quirúrgico en personas viviendo con VIH: protocolo de una revisión sistemática
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San Juan-Raffo, María de los Ángeles

; Quintana-Vega, Maximiliano

; Veloso-Casado, Valentina

; Ramos-Rojas, José Tomás

ARS medica (Santiago)

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sep 2024, Volume 49 N. 3 Pages 44 - 50

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Infection by the human immunodeficiency virus (HIV) poses a significant challenge to global health, profoundly impacting the quality of life of millions of people. Among the associated complications, periodontal diseases stand out due to their high prevalence and impact on the oral and systemic health of people living with HIV (PLWH). This systematic review aims to analyze the impact of non-surgical periodontal treatment in PLWH on quality of life, immunological status, and oral health outcomes. An exhaustive search will be conducted in multiple databases, complemented by a manual review of references. Comparative primary studies evaluating the effect of non-surgical periodontal therapy in PLWH will be included. Data synthesis will be performed through a narrative synthesis and descriptive tables to address the expected heterogeneity in the results. The certainty of the evidence will be assessed using the GRADE approach. This review will provide crucial information to guide clinical and policy decisions and identify areas for future research in this field.

Resumen La infección por el virus de la inmunodeficiencia humana (VIH) constituye un desafío significativo para la salud global, con un impacto profundo en la calidad de vida de millones de personas. Entre las complicaciones asociadas, las enfermedades periodontales destacan por su alta prevalencia y su impacto en la salud bucal y sistémica de las personas viviendo con VIH (PVVIH). Esta revisión sistemática tiene como objetivo analizar el impacto del tratamiento periodontal no quirúrgico en PVVIH en desenlaces relacionados con la calidad de vida, estado inmunológico y salud oral. Se realizará una búsqueda exhaustiva en múltiples bases de datos, complementada con una revisión manual de referencias. Se incluirán estudios primarios comparativos que evalúen el efecto de la terapia periodontal no quirúrgica en PVVIH. La síntesis de datos se realizará mediante una síntesis narrativa junto con tablas descriptivas para abordar la heterogeneidad esperada en los resultados. La evaluación de la certeza de la evidencia se realizará utilizando el enfoque GRADE. Esta revisión proporcionará información crucial para orientar decisiones clínicas y de políticas, así como identificar áreas para futuras investigaciones en este campo.

https://doi.org/10.11565/arsmed.v49i3.2077

O sagrado, o profano e Frida Kahlo: uma cosmovisão religiosa no corpo grotesco sagrado Kahlo
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Oliveira, William Brenno dos Santos

; Alves, Maria da Penha Casado

; Melo Júnior, Orison Marden Bandeira de

; Souza, Matheus Silva de

; Coutinho, Renata Karolyne Gomes

; Costa, Júlia Dayane Ribeiro da

Bakhtiniana: Revista de Estudos do Discurso

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apr 2024, Volume 19 N. 2 elocation e63572p

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O presente artigo tem como objetivo analisar, sob a perspectiva bakhtiniana, a construção grotesca do corpo fridiano por meio de uma cosmovisão religiosa. Para tanto, são analisados dois autorretratos produzidos pela pintora mexicana Frida Kahlo, levando em consideração as relações dialógicas construídas entre as representações grotescas e as simbologias católicas. Nos enunciados analisados, nos quais são depreendidas as especificidades da competência criativa da autora-criadora em sua atividade estética, percebe-se o correlacionamento entre a pintura El venado herido e a narrativa do santo católico São Sebastião e o diálogo entre a tela Las dos fridas e a imagem do Sagrado Coração de Jesus. analisar bakhtiniana religiosa tanto Kahlo católicas autoracriadora autora criadora estética percebese percebe se Jesus

ABSTRACT This article aims to analyze, from a Bakhtinian perspective, the grotesque construction of Mexican artist Frida Kahlo’s body through a religious worldview. Therefore, we analyze two of her self-portraits, taking into account the dialogic relations constructed between the grotesque representations and Catholic symbology. The analyzed utterances, in which the specificities of the creative competence of the author-creator in her aesthetic activity are inferred, showed that a dialogue is established between the painting El venado herido and Catholic Saint Sebastian and between the painting Las dos fridas and the image of the Sacred Heart of Jesus. perspective Kahlos Kahlo s worldview Therefore selfportraits, selfportraits self portraits, portraits self-portraits symbology utterances authorcreator author creator inferred Jesus

https://doi.org/10.1590/2176-4573p63572

Assessment and indicators of kinematic behavior and perceived fatigability
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Silva-Migueis, Helena

; Martínez-Jiménez, Eva María

; Casado-Hernández, Israel

; Dias, Adriano

; Monteiro, Ana Júlia

; Martins, Rodrigo Brandão

; Bernardes, João Marcos

; López-López, Daniel

; Gómez-Salgado, Juan

Revista da Associação Médica Brasileira

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2024, Volume 70 N. 2 elocation e20230924

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: The objective of this study was to investigate the relationship between upper limb kinetics and perceived fatigability in elderly individuals during an upper limb position sustained isometric task. METHODS: A total of 31 elderly participants, 16 men (72.94±4.49 years) and 15 women (72.27±6.05 years), performed a upper limb position sustained isometric task. Upper-limb acceleration was measured using an inertial measurement unit. Perceived fatigability was measured using the Borg CR10 scale. RESULTS: Higher mean acceleration in the x-axis throughout the activity was associated with higher final perceived fatigability scores. Moderate correlations were observed between perceived fatigability variation and mean acceleration cutoffs in all axes during the second half of the activity. In women, significant correlations were found between all perceived fatigability cutoffs and mean acceleration in the y- and x-axes. However, in men, the relationships between perceived fatigability variation and mean acceleration were more extensive and stronger. CONCLUSION: The acceleration pattern of the upper limb is linked to perceived fatigability scores and variation, with differences between sexes. Monitoring upper limb acceleration using a single inertial measurement unit can be a useful and straightforward method for identifying individuals who may be at risk of experiencing high perceived fatigability or task failure. OBJECTIVE METHODS 3 participants 1 72.94±4.49 7294449 72 94 4 49 (72.94±4.4 years 72.27±6.05 7227605 27 6 05 (72.27±6.0 years, , Upperlimb Upper CR CR1 scale RESULTS xaxis x axis y xaxes. xaxes axes. x-axes However stronger CONCLUSION sexes failure 72.94±4.4 729444 7 9 (72.94±4. 72.27±6.0 722760 2 0 (72.27±6. 72.94±4. 72944 (72.94±4 72.27±6. 72276 (72.27±6 72.94±4 7294 (72.94± 72.27±6 7227 (72.27± 72.94± 729 (72.94 72.27± 722 (72.27 72.94 (72.9 72.27 (72.2 72.9 (72. 72.2 72. (72 (7 (

https://doi.org/10.1590/1806-9282.20230924

Situación y necesidades de las y los intérpretes que trabajan con víctimas de violencia de género sordas, migrantes, refugiadas y solicitantes de asilo en el contexto español sordas migrantes
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Cabeza-Pereiro, María del Carmen

; Pérez-Freire, Silvia

; Casado-Neira, David

; Longa-Alonso, Beatriz

; del-Pozo-Triviño, Maribel

Cadernos de Tradução

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2024, Volume 44 N. spe1 elocation e95267

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract This article analyses some of the responses to a questionnaire developed in the framework of the JUSTISIGNS2 European project, which aimed to understand the situation and needs of interpreters working with deaf, migrant, refugee and asylum seeking victims of gender-based violence. The analysis has particularly focused on the case of Sign Language interpreting in Spain. In this regard, a selection of items from the questionnaire has been made which, in the opinion of the authors, can best contribute to the understanding of the context in which interpreter-mediated exchanges take place in the case of deaf victims. The data have been presented, for most of the questions, contrasting those obtained from the total number of responses with those referring specifically to Spanish Sign Language interpreting. Both oral and sign language interpreters highlight the need for specific training as a fundamental tool for better assistance to gender-based violence victims. JUSTISIGNS project migrant genderbased gender based Spain regard authors interpretermediated interpreter mediated presented questions

Resumen En este artículo se han analizado respuestas a un cuestionario, que tenía como objetivo conocer la situación y las necesidades de intérpretes que trabajan con víctimas de violencia de género sordas, migrantes, refugiadas y solicitantes de asilo, en el marco del proyecto europeo JUSTISIGNS2. El análisis se ha focalizado en el caso de la interpretación de lengua de signos en España. Se ha hecho una selección de ítems del cuestionario que contribuye a una mejor comprensión del contexto en que se producen los intercambios mediados por intérprete en el caso de víctimas sordas. Los datos se han presentado estableciendo un contraste entre los obtenidos del total de respuestas recibidas y los que se refieren específicamente a la interpretación de la lengua de signos española en la mayoría de las preguntas. Las y los intérpretes, tanto de lenguas orales como signadas, destacan la necesidad de formación específica como un instrumento fundamental para la mejor atención a las víctimas de violencia de género. sordas migrantes asilo JUSTISIGNS2 JUSTISIGNS España preguntas signadas

https://doi.org/10.5007/2175-7968.2024.e95267

Percepciones y creencias sobre etiología, complicaciones y eficacia de las medidas generales en pacientes con estreñimiento crónico
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Peña Vidal, Reynaldo

; Casado Méndez, Pedro Rafael

; León Fajardo, Anny María

; Santos Fonseca, Rafael Salvador

; Gonçalves Monteiro, Admir

; Fonseca Sosa, Fernando Karel

Acta Médica del Centro

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dec 2023, Volume 17 N. 4 Pages 763 - 772

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN Introducción: el estreñimiento crónico es un trastorno funcional gastrointestinal con una prevalencia considerable sobre el que se tienen creencias y percepciones erróneas. Objetivo: establecer las creencias y las percepciones de los pacientes con estreñimiento crónico sobre su etiología, sus complicaciones y la eficacia de las medidas generales. Métodos: se realizó un estudio transversal, observacional y descriptivo en un universo de 49 pacientes con diagnóstico de estreñimiento crónico en el Hospital General “Félix Lugones Ramírez” entre los años 2020 y 2022. Se midieron las variables edad, sexo, mejoría con el tratamiento, creencias y percepciones. Resultados: los pacientes con diagnóstico de estreñimiento crónico fueron mayormente del sexo femenino (57,14%), con una edad media de 60,73 años, y el 75,51% de los pacientes experimentaron mejoría con el tratamiento. El estreñimiento como causa de cáncer de colon (46 pacientes) y de hemorroides (41 pacientes) fueron las creencias y las percepciones más prevalentes, mientras que es causado por no ir al baño todos los días (ocho pacientes) fueron la creencia y la percepción (o ambas) menos reconocidas. Conclusiones: el estreñimiento crónico es un trastorno funcional gastrointestinal sujeto a múltiples creencias y percepciones populares no sustentadas científicamente que se relaciona ampliamente con la aparición de hemorroides y cáncer colorrectal fundamentalmente.

ABSTRACT Introduction: chronic constipation is a functional gastrointestinal disorder with a considerable prevalence about which there are erroneous beliefs and perceptions. Objective: to establish the beliefs and perceptions of patients with chronic constipation about its etiology, its complications and the efficacy of general measures. Methods: a cross-sectional, observational and descriptive study was conducted in a universe of 49 patients with a diagnosis of chronic constipation at the “Felix Lugones Ramirez” General Hospital between 2020 and 2022. The variables age, sex, improvement with treatment, beliefs and perceptions were measured. Results: patients diagnosed with chronic constipation were mostly female (57.14%), with a mean age of 60.73 years, and 75.51% of patients experienced improvement with treatment. Constipation as a cause of colon cancer (46 patients) and hemorrhoids (41 patients) were the most prevalent beliefs and perceptions, while it is caused by not going to the bathroom every day (eight patients) were the least recognized belief and perception (or both). Conclusions: chronic constipation is a functional gastrointestinal disorder subject to multiple popular beliefs and perceptions that are not scientifically supported and that is widely related to the occurrence of hemorrhoids and colorectal cancer fundamentally.

Efecto de vesículas extracelulares derivadas de células madre mesenquimales humanas precondicionadas en hipoxia sobre la osteoblastogénesis y la adipogénesis in vitro
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Jiménez-Navarro, Carolina

; Torrecillas-Baena, Bárbara

; Camacho-Cardenosa, Marta

; Quesada-Gómez, José Manuel

; Gálvez-Moreno, María Ángeles

; Casado-Díaz, Antonio

Revista de Osteoporosis y Metabolismo Mineral

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jun 2023, Volume 15 N. 2 Pages 54 - 65

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Objectives: mesenchymal stem cells (MSC) are characterized by their anti-inflammatory, immunosuppressive activity, and their ability to differentiate. This makes them an interesting therapeutic tool in cell therapy and regenerative medicine. In part, the therapeutic effect of MSC is mediated by the secretion of extracellular vesicles (EV). The preconditioning of MSC in hypoxia can enhance the regenerative capacity of the secreted EV. In this context, the aim of the study was to evaluate whether EV derived from human MSC cultured in normoxic and hypoxic conditions affect the osteoblastogenesis and adipogenesis of MSC. Material and methods: EV were isolated from MSC maintained for 48 hours in normoxic or hypoxic conditions (3 % O2) using ultrafiltration and size exclusion chromatography. The EV were characterized by Western blot, electron microscopy, and nanoparticle tracking analysis. In MSC cultures, the effect of the EV on viability was evaluated using an MTT assay, migration was assessed with the Oris assay while differentiation into osteoblasts and adipocytes was also studied. Results: the EV increased viability and migration, but no differences were seen between those derived from normoxic and hypoxic culture conditions. The EV, mainly those derived from hypoxia, increased both mineralization, and the expression of osteoblastic genes. However, they did not affect adipogenesis significantly. Conclusions: the EV derived from MSC in hypoxia do not affect adipogenesis but have a greater ability to induce osteoblastogenesis. Therefore, they could potentially be used in bone regeneration therapies and treatments for bone conditions like osteoporosis.

Resumen Objetivos: las células madre mesenquimales (MSC) se caracterizan por su actividad antiinflamatoria, inmunosupresora y su capacidad de diferenciación. Esto las convierten en una interesante herramienta terapéutica en terapia celular y medicina regenerativa. En parte, el efecto terapéutico de las MSC, está mediado por la secreción de vesículas extracelulares (EV). El precondicionamiento en hipoxia de las MSC puede mejorar la capacidad regenerativa de las EV secretadas. En este contexto, el objetivo del estudio ha sido evaluar si EV derivadas de MSC humanas cultivadas en hipoxia y normoxia afectan a la osteoblastogénesis y adipogénesis de las MSC. Material y métodos: se aislaron EV de MSC mantenidas 48 h en normoxia o hipoxia (3 % O2) mediante ultrafiltración y cromatografía de exclusión por tamaño. Las EV fueron caracterizadas por “Western blot”, microscopía electrónica y análisis de seguimiento de nanopartículas. En cultivos de MSC se evaluó el efecto de las EV sobre la viabilidad por ensayo con MTT, la migración por “Oris assay” y la diferenciación a osteoblastos y adipocitos. Resultados: las EV aumentaron la viabilidad y migración, pero no hubo diferencias entre las derivadas de normoxia e hipoxia. Las EV, principalmente las derivadas de hipoxia, aumentaron la mineralización y la expresión de genes osteoblásticos. Sin embargo, no afectaron significativamente a la adipogénesis. Conclusiones: las EV derivadas de MSC en hipoxia no afectan a la adipogénesis, pero tienen una mayor capacidad de inducir la osteoblastogénesis. Por lo tanto, podrían potencialmente ser utilizadas en terapias de regeneración ósea y tratamientos de patologías óseas como la osteoporosis.

https://doi.org/10.20960/revosteoporosmetabminer.00012

Seguridad de las drogas biológicas y sintéticas dirigidas utilizadas en pacientes con enfermedades reumáticas inmunomediadas.
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Isnardi, Carolina A

; Roberts, Karen

; Exeni, Ida

; De La Sota, Mercedes

; Soriano, Enrique

; Dubinsky, Diana

; Medina, Gustavo

; Berbotto, Guillermo A

; Velozo, Edson J

; Papasidero, Silvia

; Gamba, Julieta

; Saurit, Verónica

; Citera, Gustavo

; Díaz, Mónica

; Catay, Erika

; Gómez, Graciela

; Sacnun, Mónica

; Larroude, María S

; Cavillon, Emilia

; Secco, Anastasia

; Aste, Nora

; Pons-Estel, Bernardo

; García, Mercedes A

; Pisoni, Cecilia

; Bovea, Gladys

; Morales, Liliana

; Granel, Amelia

; Gobbi, Carla

; Savio, Verónica

; Álvarez, Analia P

; Casado, Gustavo

; Soares Souza, Sidney

; Petkovic, Ingrid

; Castro, Cecilia

; Kerzberg, Osvaldo

; Gallardo, María de los Ángeles

; Brigante, Alejandro

; Haye Salinas, María

; Alfaro, María Agustina

; Pons-Estel, Guillermo J

; de la Vega, María Celina

Revista argentina de reumatología

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jan 2023, Volume 34 N. 1 Pages 3 - 15

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción: conocer la seguridad de las drogas actualmente disponibles para el tratamiento de las enfermedades reumáticas es muy importante al momento de tomar decisiones terapéuticas objetivas e individualizadas en la consulta médica diaria. Asimismo, datos de la vida real amplían el conocimiento revelado por los ensayos clínicos. Objetivos: describir los eventos adversos (EA) reportados, estimar su frecuencia e identificar los factores relacionados con su desarrollo. Materiales y métodos: se utilizaron datos BIOBADASAR, un registro voluntario y prospectivo de seguimiento de EA de tratamientos biológicos y sintéticos dirigidos en pacientes con enfermedades reumáticas inmunomediadas. Los pacientes son seguidos hasta la muerte, pérdida de seguimiento o retiro del consentimiento informado. Para este análisis se extrajeron datos recopilados hasta el 31 de enero de 2023. Resultados: se incluyó un total de 6253 pacientes, los cuales aportaron 9533 ciclos de tratamiento, incluyendo 3647 (38,3%) ciclos sin drogas modificadoras de la enfermedad biológicas y sintéticas dirigidas (DME-b/sd) y 5886 (61,7%) con DME-b/sd. Dentro de estos últimos, los más utilizados fueron los inhibidores de TNF y abatacept. Se reportaron 5890 EA en un total de 2701 tratamientos (844 y 1857 sin y con DME-b/sd, respectivamente), con una incidencia de 53,9 eventos cada 1000 pacientes/año (IC 95% 51,9-55,9). La misma fue mayor en los ciclos con DME-b/sd (71,1 eventos cada 1000 pacientes/año, IC 95% 70,7-77,5 versus 33,7, IC 95% 31,5-36,1; p<0,001). Las infecciones, particularmente las de la vía aérea superior, fueron los EA más frecuentes en ambos grupos. El 10,9% fue serio y el 1,1% provocó la muerte del paciente. El 18,7% de los ciclos con DME-b/sd fue discontinuado a causa de un EA significativamente mayor a lo reportado en el otro grupo (11,5%; p<0,001). En el análisis ajustado, las DME-b/sd se asociaron a mayor riesgo de presentar al menos un EA (HR 1,82, IC 95% 1,64-1,96). De igual manera, la mayor edad, el mayor tiempo de evolución, el antecedente de enfermedad pulmonar obstructiva crónica, el diagnóstico de lupus eritematoso sistémico y el uso de corticoides se asociaron a mayor riesgo de EA. Conclusiones: la incidencia de EA fue significativamente superior durante los ciclos de tratamientos que incluían DME-b/sd.

Abstract Introduction: knowing the efficacy and safety of the drugs currently available for the treatment of rheumatic diseases is very important when making objective and individualized therapeutic decisions in daily medical consultation. Likewise, real-life data extends the knowledge revealed by clinical trials. Objectives: to describe the reported adverse events (AEs), estimate their frequency and identify factors associated to them. Materials and methods: BIOBADASAR data were used, which is a voluntary, prospective follow-up registry of AEs of biological and synthetic treatments in patients with immune-mediated rheumatic diseases. Patients are followed until death, loss of followup, or withdrawal of informed consent. To carry out this analysis, the data collected up to January 31, 2023 was extracted. Results: a total of 6253 patients were included, who contributed with 9533 treatment periods, including 3647 (38.3%) periods without b/ts-DMARDs and 5886 (61.7%) with b/ts-DMARDs. Among the latter, the most used were TNF inhibitors and abatacept. A total of 5890 AEs were reported in a total of 2701 treatments (844 and 1857 without and with b/ts-DMARDs, respectively), with an incidence of 53.9 events per 1000 patients/ year (95% CI 51.9-55.9). It was higher during the periods with b/ts-DMARDs (71.1 events per 1000 patients/year, 95% CI 70.7-77.5 vs 33.7, 95% CI 31.5-36.1, p<0.001). Infections, particularly those of the upper respiratory tract, were the most frequent AEs in both groups. 10.9% were severe and 1.1% were associated with the death of the patient. 18.7% of the periods with b/ts-DMARDs were discontinued due to an AE, significantly higher than that reported in the other group (11.5%; p<0.001). In the adjusted analysis, b/ts-DMARDs were associated with a higher risk of presenting at least one AE (HR 1.82, 95% CI 1.64-1.96). Similarly, older age, longer evolution time, history of chronic obstructive pulmonary disease, diagnosis of systemic lupus erythematosus, and use of corticosteroids were associated with a higher risk of AE. Conclusions: the incidence of AEs was significantly higher during those treatment periods that included DME-b/sd.

https://doi.org/10.47196/rar.v34i1.726

Impact of COVID-19 on physical and mental functioning in adolescents with disabilities in a sports nongovernmental organization
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Laurentino, Moisés de Freitas

; Lindoso, Livia

; Astley, Camilla

; Lavorato, Sofia Simão Martins

; Ihara, Bianca Pires

; Lima, Dandara Carvalho Casado de

; Gualano, Bruno

; Queiroz, Lígia Bruni

; Pereira, Rosa Maria Rodrigues

; Polanczyk, Guilherme Vanoni

; Camargo, Olavo Pires de

; Silva, Clovis Artur

; Grangeiro, Patricia Moreno

Revista Paulista de Pediatria

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2023, Volume 41 elocation e2021334

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivo: Avaliar os parâmetros de saúde física e mental, de qualidade de vida relacionada à saúde (QVRS), em adolescentes com deficiência física matriculados em organização não governamental (ONG) esportiva vs. em adolescentes sem deficiência, durante a pandemia da doença do coronavírus 2019 (COVID-19). Métodos: Este estudo transversal incluiu 30 adolescentes com deficiência e 86 adolescentes sem deficiência que responderam a questionário online com dados sociodemográficos e informações de rotina de saúde autoavaliadas durante a quarentena da COVID-19. Versões validadas de autorrelato do Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), Pittsburgh Sleep Quality Index (PSQI) e Pediatric Outcome Data Collection Instrument (PODCI) também foram aplicadas. Resultados: A mediana de problemas emocionais [4(0–10) vs. 5(0–10),p=0,018] e pró-social [7(0–10) vs. 9(3–10),p=0,006] foi menor em adolescentes com deficiência vs. adolescentes sem deficiência. Adolescentes com deficiência tiveram função global significantemente inferior [68(21–99) vs. 94(67–100),p <0,001] e pontuações de felicidade mais altas do PODCI [90(65–100) vs. 80(0–100),p=0,016] em comparação com o grupo sem deficiências. A análise de regressão logística demonstrou que a atividade física/semana (odds ratio — OR=1,03; intervalo de confiança — IC95%=1,01–1,05,p=0,002) foi maior nos adolescentes com deficiência. No entanto, atividades domésticas (OR=0,14; IC95%=0,04–0,43,p=0,001) e tempo de tela ≥3 horas/dia (OR=0,09; IC95%=0,02–0,38,p=0,001) foram menores nos adolescentes com deficiência. Conclusões: Os adolescentes com deficiência que frequentam uma organização não governamental (ONG) esportiva não tiveram maior risco de apresentar indicadores adversos à saúde; apesar de apresentarem função física reduzida, relataram mais atividade física, maior felicidade e menos tempo de tela em comparação com adolescentes sem deficiência durante a pandemia da COVID-19.

Abstract Objective: This study aimed to assess physical and mental health, and health-related quality of life (HRQL) parameters in adolescents with physical disabilities enrolled in a sports nongovernmental organization (NGO) versus adolescents without disabilities during coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study included 30 adolescents with disabilities and 86 adolescents without disabilities who responded to an online questionnaire with sociodemographic data and self-rated healthcare routine information during the COVID-19 quarantine. Validated self-report versions of the Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Outcome Data Collection Instrument (PODCI) were also applied. Results: The median of emotional [4 (0–10) vs. 5 (0–10), p=0.018] and prosocial [7 (0–10) vs. 9 (3–10), p=0.006] problems was lower in adolescents with disabilities versus adolescents without disabilities. Adolescents with disabilities had significantly lower global function [68 (21–99) vs. 94 (67–100), p<0.001] and higher happiness scores in the PODCI scale [90 (65–100) vs. 80 (0–100), p=0.016] compared to controls. Logistic regression analysis demonstrated that physical activity/week (OR=1.03; 95%CI 1.01–1.05, p=0.002) was higher in adolescents with disabilities compared to adolescents without disabilities. However, housework activities (OR=0.14; 95%CI 0.04–0.43, p=0.001) and screen time ≥3 h/day (OR=0.09; 95%CI 0.02–0.38, p=0.001) were lower in adolescents with disabilities compared to adolescents without disabilities. Conclusion: Adolescents with disabilities attending a sports NGO were not at higher risk of adverse health-related indicators; despite showing reduced physical function, they reported more physical activity, higher happiness, and less screen time compared to adolescents without disabilities during the COVID-19 pandemic.

https://doi.org/10.1590/1984-0462/2023/41/2021334

Editorial del dosier
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Rial-Sebbag, Emmanuelle

; Casado, María

Revista de Bioética y Derecho

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2023, N. 57 Pages 4 - 6

Abstract: Fr | Text: Fr | PDF: Fr

10.

Fluid administration in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: neither too much nor too little
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Garijo, Maria Elvira Castellanos

; Blanco, Ana Sepúlveda

; Gonzalez, José Tinoco

; Casado, Alicia Merinero

; Moya, Juan Ignacio Medina de

; Vidal, Gabriel Yanes

; Rodriguez, Ana Forastero

; García, Cristobalina Ángeles Martín

; Muñoz-Casares, Francisco Cristobal

; Ruiz, Javier Padillo

Brazilian Journal of Anesthesiology

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dec 2022, Volume 72 N. 6 Pages 695 - 701

Abstract: En | Text: En | PDF: En

Abstract Introduction Intraoperative fluid therapy in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy plays an important role in postoperative morbidity. Studies have found an association between overload fluid therapy and increased postoperative complications, advising restrictive intraoperative fluid therapy. Our objective in this study was to compare the morbidity associated with restrictive versus non-restrictive intraoperative fluid therapy. Methods Retrospective analysis of a database collected prospectively in the Anesthesiology Service of Virgen del Rocío Hospital, from December 2016 to April 2019. One hundred and six patients who underwent complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were divided into two cohorts according to Fluid Therapy received 1. Restrictive ≤ 9 mL.kg-1.h-1 (34 patients), 2. Non-restrictive ≥ 9 mL.kg-1.h-1 (72 patients). Percentage of major complications (Clavien-Dindo grade III-IV) and length hospital stay were the main outcomes variables. Results Of the 106 enrolled patients, 68.9% were women; 46.2% had ovarian cancer, 35.84% colorectal cancer, and 7.5% peritoneal cancer. The average fluid administration rate was 11 ± 3.58 mL.kg-1.h-1. The restrictive group suffered a significantly higher percentage of Clavien-Dindo grade III-IV complications (35.29%) compared with the non-restrictive group (15.27%) (p= 0.02). The relative risk associated with restrictive therapy was 1.968 (95% confidence interval: 1.158-3.346). We also found a significant difference for hospital length of stay, 20.91 days in the restrictive group vs 16.19 days in the non-restrictive group (p= 0.038). Conclusions Intraoperative fluid therapy restriction below 9 mL.kg-1.h-1 in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy was associated with a higher percentage of major postoperative complications.

https://doi.org/10.1016/j.bjane.2021.07.018

11.

El beneficio del paciente como objetivo de la humanización
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Gil-Sierra, Manuel David

; Briceño-Casado, María del Pilar

; López-Briz, Eduardo

Farmacia Hospitalaria

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dec 2022, Volume 46 N. 6 Pages 367 - 371

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen El empoderamiento del paciente supone uno de los principales pilares de la humanización. Por ello, la consideración de las preferencias y expectativas de los pacientes debería ser tenida en cuenta durante el ejercicio de cualquiera de los profesionales de la salud. Mejorar la supervivencia global y la calidad de vida son los deseos principales de los pacientes. De hecho, la reciente aparición de los llamados Patient Reported Outcomes ha supuesto un importante foco para los agentes involucrados en la asistencia sanitaria. El farmacéutico hospitalario especializado en la evaluación de medicamentos es un profesional que evalúa la eficacia, seguridad, adecuación y eficiencia de los tratamientos prescritos por facultativos, y debe basar la toma de decisiones tanto en factores técnicos como en los cuatro principios bioéticos. La correcta aplicación de la práctica clínica basada en la evidencia permite proveer a los pacientes de incrementos de supervivencia y/o calidad de vida, adecuando la conveniencia y costes a la situación actual. Teniendo en cuenta esto, podría decirse que la evaluación de medicamentos supone un fuerte compromiso con la humanización. Por otra parte, las organizaciones que promueven la evaluación y selección de medicamentos rigurosamente se erigen como aliados de los pacientes, ya que repercuten de forma directa en éstos y de forma indirecta en la sociedad. Las agencias reguladoras encargadas de la aprobación y financiación de medicamentos en los sistemas sanitarios protagonizan un papel fundamental en el proceso de humanización de la toma de decisiones clínicas y empoderamiento de pacientes, ya que si aprueban el uso de nuevos medicamentos según datos que no miden la calidad de vida o supervivencia de los pacientes cuando ya existen otras alternativas terapéuticas para estas patologías, indirectamente no estarán dando respuesta a las expectativas de los pacientes y conculcarán los principios bioéticos. Esto puede tener una considerable influencia en la relación beneficio-riesgo de los fármacos, pudiendo tratar a pacientes con esquemas que no aportan beneficio, o incluso podrían perjudicarles. Por tanto, ¿hacia dónde debiera ir orientado el proceso de humanización? Parece razonable que el beneficio del paciente sea el objetivo fundamental del proceso de humanización de la asistencia sanitaria, evidentemente.

Abstract Patient empowerment is one of the main pillars of humanisation. Therefore, consideration of patients’ preferences and expectations should be taken into account during the practice of any healthcare professional. Improving overall survival and quality of life are the main wishes of patients. Indeed, the recent emergence of Patient Reported Outcomes has become an important focus for healthcare providers. The hospital pharmacist specialised in drug evaluation is a professional who evaluates the efficacy, safety, appropriateness and efficiency of treatments prescribed by physicians, and decision-making must be based on both technical factors and the four principles of bioethics. The correct application of evidence-based clinical practice allows to provide patients with increases in survival and/or quality of life, adapting the convenience and costs to the current situation. With this in mind, it could be said that the evaluation of medicines involves a strong commitment to humanisation. On the other hand, organisations that promote the rigorous evaluation and selection of medicines stand as allies of patients, as they have a direct impact on them and an indirect impact on society. Regulatory agencies in charge of approving and financing medicines in healthcare systems play a key role in the process of humanising clinical decision-making and empowering patients. If these agencies approve the use of new medicines based on data that do not measure quality of life or survival of patients when there are already other therapeutic alternatives for these pathologies, they are indirectly failing to meet patients’ expectations and are infringing bioethical principles. This can have a considerable influence on the benefit-risk ratio of drugs, and patients may be treated with regimens that do not provide benefit, or may even harm them. Therefore, where should the process of humanisation be oriented? It seems reasonable that the benefit of the patient should be the fundamental objective of the process of humanisation of healthcare, evidently.

https://doi.org/10.7399/fh.13171

12.

La experiencia del paciente en el cáncer de pulmón y de mama a través del recorrido del paciente
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Rubio, Ana Rosa

; Mareque, María

; Soto, Javier

; Casado, Miguel Ángel

; Álvarez, Ruth

; Andrade, Jesús

; Esteban, Carmen

; Chacón, José Ignacio

Farmacia Hospitalaria

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aug 2022, Volume 46 N. 4 Pages 215 - 223

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Objetivo: Analizar la experiencia aportada por los pacientes con cáncer de mama y pulmón utilizando la metodología del recorrido del paciente en un hospital español. Método: Se empleó un diseño mixto, con entrevistas a 16 profesionales sanitarios y 25 pacientes (método cualitativo), y un cuestionario basado en el indicador Net Promoter Score a 127 pacientes (método cuantitativo). Criterios de inclusión: pacientes oncológicos > 18 años tratados en el hospital entre febrero y mayo de 2019. Criterios de exclusión: pacientes pediátricos, en cuidados paliativos o que estaban hospitalizados en el momento del estudio. Resultados: Se identificaron seis fases a partir de los datos obtenidos en el método cualitativo: mi vida antes del diagnóstico, descubrir, comenzar, tratamiento, seguimiento y mi vida hoy. En la fase mi vida antes del diagnóstico se estableció un nivel de experiencia funcional, ya que la vida cumplía las expectativas de los pacientes. En la fase de descubrir se observó que las expectativas de los pacientes se cumplían, aunque se encontraron varias experiencias satélite. En la fase comenzar, la experiencia tendió a ser negativa debido a los largos tiempos de espera y al estrés emocional y físico. La fase de tratamiento se consideró como una experiencia de nivel básico-deficiente, debido a los tiempos de espera y a la falta de apoyo institucional. La experiencia en la fase de seguimiento fue positiva respecto a las pruebas y las visitas, pero se observaron puntos críticos en los tiempos de espera. En la fase mi vida hoy se mencionó el esfuerzo realizado por los profesionales sanitarios para garantizar el mejor tratamiento y atención posibles. En cuanto al análisis cuantitativo, se obtuvo una puntuación positiva (46%) para el indicador Net Promoter Score, ya que el 60% de los pacientes pertenecían a la categoría de promotores, es decir, estaban satisfechos con el servicio ofrecido por el hospital. Conclusiones: Este estudio permite conocer la experiencia de los pacientes oncológicos en las seis etapas principales de la enfermedad. Las fases más positivas fueron “mi vida antes del diagnóstico” y “seguimiento”, mientras que las fases con tendencia negativa fueron “inicio” y “tratamiento” debido a los tiempos de espera y la carga emocional que suponen para el paciente.

Abstract Objective: To analyse a patient journey based on the experience reported by breast and lung cancer patients at Spanish hospital. Method: A mixed design was used, with interviews with 16 health professionals and 25 patients (qualitative method) and a Net Promoter Score questionnaire to 127 patients (quantitative method). Inclusion criteria: oncology patients > 18 years treated in hospital between February- May 2019. Exclusion criteria: paediatric patients, in palliative care or who were hospitalised at the time of the study. Results: Six phases were identified from the data obtained in the qualitative method: my life before diagnosis; discovery; initiation; treatment; follow- up; and my current life. In the my life before diagnosis phase, a functional level of experience was established, as patients’ lives met their expectations. In the discovery phase, patients’ expectations were observed to be met, although several satellite experiences were found. In the initiation phase, the experience tended to be negative due to long waiting times and emotional and physical stress. The treatment phase was defined as a basic-poor experience, due to waiting times and lack of institutional support. The experience in the follow-up phase was positive in terms of tests and visits, but critical points were observed in waiting times. In the current phase, the effort made by health professionals to ensure the best possible treatment and care was mentioned. In terms of quantitative analysis, a positive score (46%) was obtained for the Net Promoter Score indicator, as 60% of patients were promoters, i.e., they were satisfied with the service offered by the hospital. Conclusions: This study provides insight into the experience of cancer patients in the six main stages of the disease. The most positive phases were “my life before diagnosis” and “follow-up” while the phases with a negative trend were “initiation” and “treatment” due to the waiting times and the emotional burden on the patient.

https://doi.org/10.7399/fh.13191

13.

Safety and Revisit Related to Discharge the Sixty-one Spanish Emergency Department Medical Centers Without Hospitalization in Patients with COVID-19 Pneumonia. A Prospective Cohort Study UMC-Pneumonia COVID-19
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Jacob, Javier

; Albert-Casado, Arantxa

; Castillo, Juan G. Del

; Llorens-Soriano, Pere

; Jiménez-Hernández, Sonia

; Burillo-Putze, Guillermo

; Martín-Martínez, Alfonso

; Martín-Sánchez, Francisco J.

; García-Lamberechts, Eric J.

; Piñera-Salmerón, Pascual

; Alquézar-Arbé, Aitor

; Ferre-Losa, Carles

; Juan-Gómez, María Á.

; Serrano-Lázaro, Leticia

; Noceda-Bermejo, José

; Salido-Mota, Manuel

; Fortuny-Bayarri, María J.

; González-Tejera, Matilde

; Ferreras-Amez, José M.

; Díaz-Fernández, Elena

; Quero-Motto, Eva

; Peiró-Gómez, Ana

; Martín-Mojarro, Enrique

; Llopis-Roca, Ferran

; Huerta-García, Arturo

; Pedraza-García, Jorge

; Meléndez-Cálix, Napoleón

; Brazó-Aznar, José V.

; Cano-Cano, María J.

; Miró, Óscar

Revista de investigación clínica

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jun 2022, Volume 74 N. 3 Pages 135 - 146

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Information is needed on the safety and efficacy of direct discharge from the emergency department (ED) of patients with COVID-19 pneumonia. Objectives: The objectives of the study were to study the variables associated with discharge from the ED in patients presenting with COVID-19 pneumonia, and study ED revisits related to COVID-19 at 30 days (EDR30d). Methods: Multicenter study of the SIESTA cohort including 1198 randomly selected COVID patients in 61 EDs of Spanish medical centers from March 1, 2020, to April 30, 2020. We collected baseline and related characteristics of the acute episode and calculated the adjusted odds ratios (aOR) for ED discharge. In addition, we analyzed the variables related to EDR30d in discharged patients. Results: We analyzed 859 patients presenting with COVID-19 pneumonia, 84 (9.8%) of whom were discharged from the ED. The variables independently associated with discharge were being a woman (aOR 1.890; 95%CI 1.176-3.037), age < 60 years (aOR 2.324; 95%CI 1.353-3.990), and lymphocyte count > 1200/mm3 (aOR 4.667; 95%CI 1.045-20.839). The EDR30d of the ED discharged group was 40.0%, being lower in women (aOR 0.368; 95%CI 0.142-0.953). A total of 130 hospitalized patients died (16.8%) as did two in the group discharged from the ED (2.4%) (OR 0.121; 95%CI 0.029-0.498). Conclusion: Discharge from the ED in patients with COVID-19 pneumonia was infrequent and was associated with few variables of the episode. The EDR30d was high, albeit with a low mortality.

https://doi.org/10.24875/ric.22000021 8 downloads

14.

Recomendaciones conjuntas sobre el manejo del paciente con osteoporosis y/o fracturas por fragilidad durante y después de la pandemia por COVID-19 de la SEIOMM, SEFRAOS, SER, SEMI, SEGG, SEMG, SEMERGEN y SEEN
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Naves Díaz, Manuel

; Peris Bernal, Pilar

; Montoya García, María José

; Casado Burgos, Enrique

; Caeiro Rey, José Ramón

; Guañabens Gay, Núria

; Torregrosa Suau, Óscar

; Cuadra Llopart, Leonor

; Bastida Calvo, José Carlos

; Micó Pérez, Rafael

; Rozas Moreno, Pedro

Revista de Osteoporosis y Metabolismo Mineral

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jun 2022, Volume 14 N. 2 Pages 69 - 73

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

https://doi.org/10.4321/s1889-836x2022000200002

15.

mRNA Expression of Myosin Heavy Chain Isoforms in the Sphenomandibularis Portion of the Temporalis Muscle
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Ciurana, Neus

; Artells, Rosa

; Casado, Aroa

; Potau, Josep Maria

International Journal of Morphology

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jun 2022, Volume 40 N. 3 Pages 728 - 734

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

SUMMARY: The main objective of this study was to analyze by real-time quantitative polymerase chain reaction (RT-qPCR) the expression patterns of the myosin heavy chain (MHC) isoforms (MHC-I, MHC-IIa, MHC-IIx) in the sphenomandibularis portion of the temporalis muscle. We expected to find differences between the sphenomandibularis and the other portions of the temporalis that could be related to the functional characteristics of the sphenomandibularis identified by electromyography. We dissected the right temporalis muscle of ten adult human individuals (five men and five women). Samples of the anterior and posterior temporalis and of the sphenomandibularis portion were obtained from each dissected muscle. These samples were analyzed by RT-qPCR to determine the percentages of expression of the MHC-I, MHC-IIa and MHC-IIx isoforms. No significant differences were identified between the anterior and the posterior temporalis in the expression patterns of the MHC-I, MHC-IIa and MHC-IIx isoforms. However, there were significant differences between the sphenomandibularis and the anterior temporalis. Specifically, the sphenomandibularis portion had a higher percentage of expression of the MHC-I isoform (P=0.04) and a lower percentage of expression of the MHC-IIx isoform (P=0.003). The pattern of expression that we observed in the sphenomandibularis reflects a greater resistance to fatigue, a lower contraction speed, and a lower capacity of force generation in the sphenomandibularis compared to the anterior temporalis. These characteristics are consistent with electromyographic findings on the functional differences between these two portions.

RESUMEN: El principal objetivo de este estudio fue analizar mediante real-time quantitative polymerase chain reaction (RT-qPCR) los patrones de expresión de las isoformas de la cadena pesada de la miosina (MHC-I, MHC-IIa y MHC-IIx) en la porción esfenomandibular del músculo temporal. Se esperó encontrar diferencias entre el esfenomandibular y las otras porciones del músculo temporal que se pudieran relacionar con las características funcionales del esfenomandibular, identificadas mediante electromiografía. Para obtener estos resultados, se diseccionó el músculo temporal derecho en diez humanos adultos (cinco hombres y cinco mujeres) y se obtuvieron muestras de la porción anterior y posterior del músculo temporal y de su porción esfenomandibular. Estas muestras fueron analizadas mediante RT-qPCR para determinar los porcentajes de expresión de las isoformas MHC-I, MHC- IIa y MHC-IIx. No se identificaron diferencias significativas de los patrones de expresión entre la porción anterior y la porción posterior del músculo temporal, pero sí que se observaron diferencias significativas entre la porción anterior del músculo temporal y su porción esfenomandibular. Concretamente, la porción esfenomandibular presentó un mayor porcentaje de expresión de la isoforma MHC-I (P=0.04) y un menor porcentaje de expresión de la isoforma MHC-IIx (P=0.003). El patrón de expresión que hemos observado en la porción esfenomandibular del músculo temporal refleja una mayor resistencia a la fatiga, una velocidad de contracción más lenta y una menor capacidad de generar fuerza si se compara esta porción con la porción anterior del músclo temporal. Estas características son consistentes con las diferencias funcionales que presentan estas dos porciones, que han sido descritas mediante electromiografía.

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