581 research outputs found
IBD and Motherhood: A Journey through Conception, Pregnancy and Beyond
Inflammatory Bowel Disease (IBD) presents distinct challenges during pregnancy due to
its influence on maternal health and pregnancy outcomes. This literature review aims to dissect the
existing scientific evidence on pregnancy in women with IBD and provide evidence-based recommendations
for clinical management. A comprehensive search was conducted across scientific databases,
selecting clinical studies, systematic reviews, and other pertinent resources. Numerous studies have
underscored an increased risk of complications during pregnancy for women with IBD, including
preterm birth, low birth weight, neonates small for gestational age, and congenital malformations.
Nevertheless, it’s evident that proactive disease management before and throughout pregnancy can
mitigate these risks. Continuation of IBD treatment during pregnancy and breastfeeding is deemed
safe with agents like thiopurines, anti-TNF, vedolizumab, or ustekinumab. However, there’s a call
for caution when combining treatments due to the heightened risk of severe infections in the first
year of life. For small molecules, their use is advised against in both scenarios. Effective disease management,
minimizing disease activity, and interdisciplinary care are pivotal in attending to women
with IBD. The emphasis is placed on the continual assessment of maternal and infant outcomes and
an expressed need for further research to enhance the understanding of the ties between IBD and
adverse pregnancy outcomes
Evolution of Acute Respiratory Distress Syndrome in Emergency and Critical Care: Therapeutic Management before and during the Pandemic Situation
Background and Objectives: Acute respiratory distress syndrome is a life-threatening lung
condition that prevents enough oxygen from getting to the lungs and blood. The causes can be varied,
although since the COVID-19 pandemic began there have been many cases related to this virus.
The management and evolution of ARDS in emergency situations in the last 5 years was analyzed.
Materials and Methods: A systematic review was carried out in the PubMed and Scopus databases.
Using the descriptors Medical Subject Headings (MeSH), the search equation was: “Emergency health
service AND acute respiratory distress syndrome”. The search was conducted in December 2021.
Quantitative primary studies on the care of patients with ARDS in an emergency setting published in
the last 5 years were included. Results: In the initial management, adherence to standard treatment
with continuous positive airway pressure (CPAP) is recommended. The use of extracorporeal
membrane reduces the intensity of mechanical ventilation or as rescue therapy in acute respiratory
distress syndrome (ARDS). The prone position in both intubated and non-intubated patients with
severe ARDS is associated with a better survival of these patients, therefore, it is very useful in these
moments of pandemic crisis. Lack of resources forces triage decisions about which patients are most
likely to survive to start mechanical ventilation and this reflects the realities of intensive care and
emergency care in a resource-limited setting. Conclusions: adequate prehospital management of
ARDS and in emergency situations can improve the prognosis of patients. The therapeutic options in
atypical ARDS due to COVID-19 do not seem to vary substantially from conventional ARDS
Diagnostic and Prognostic Value of Cardiac Imaging in Amyloidosis
[Abstract]
Amyloidosis is an infiltrative disease caused by extracellular protein deposition
that has accumulated a lot of scientific production in recent years. Different types
of amyloidosis can affect the heart. Transthyretin amyloidosis and light chain
amyloidosis are the two most common types of cardiac amyloidosis. These
entities have a poor prognosis, so accurate diagnostic techniques are imperative
for determining an early therapeutic approach. Recent advances in cardiac
imaging and diagnostic strategies show that these tools are safe and can avoid the
use of invasive diagnostic techniques to histological confirmation, such as
endomyocardial biopsy. We performed a review on the diagnostic and prognostic
implications of different cardiac imaging techniques in cardiac amyloidosis. We
mainly focus on reviewing echocardiography, cardiac magnetic resonance,
computed tomography and nuclear imaging techniques and the different safety
measurements that can be done with each of them
Amiloidosis cardiaca por cadenas ligeras y por transtirretina: características clínicas, historia natural y predictores pronósticos
[Abstract]
Introduction and objectives.
Light-chain amyloidosis (AL-CA) and transthyretin amyloidosis (ATTR-CA) are the most common types of cardiac amyloidosis (CA). We sought to study the clinical characteristics and prognosis of both diseases.
Methods.
We conducted a single-centre, retrospective review of all patients diagnosed with CA between 1998 and 2018. Clinical characteristics, complementary tests, survival and other adverse clinical events were studied.
Results.
We identified 105 patients with CA, 65 ATTR-CA and 40 AL-CA. Mean age was 74.4 years; 24.8% were women. In both groups, heart failure was the most frequent clinical presentation (55.2%). The most prevalent electrocardiographic findings were the pseudoinfarct pattern (68.5%) and a Sokolow-Lyon index <1.5 mV (67.7%), with no differences between the two subtypes of CA. One-year, 3-year, and 5-year survival was 43.3%, 40.4% and 35.4%, respectively, in AC-AL patients, and 85.1%, 57.3% and 31.4% in AC-ATTR patients (p = .004). AL-CA subtype (HR 3.41, CI95% 1.45−8.06, p = .005), previous admission for heart failure (HR 4.25, 95% CI 1.63−11.09, p = .003) and a NYHA class III-IV (HR 2.76, 95% CI 1.09−7.03, p = .033) were independent predictors of mortality, while beta-blocker therapy was associated with longer survival (HR .23, 95% CI .09–.59, p = .002).
Conclusions.
Differences exist between the clinical presentation of AL-CA and ATTR-CA patients. Both diseases, particularly AL-CA, are associated with poor life prognosis.[Resumen]
Antecedentes y objetivos.
La amiloidosis cardiaca (AC) por cadenas ligeras (AC-AL) y por transtirretina (AC-ATTR) son los dos subtipos más frecuentes de la enfermedad. Nos propusimos caracterizar clínicamente estas entidades y analizar su pronóstico.
Material y métodos.
Realizamos una revisión retrospectiva de todos los pacientes diagnosticados de AC entre 1998 y 2018 en un centro español. Además de recoger las características clínicas y los resultados de las pruebas complementarias al diagnóstico, analizamos la supervivencia y la incidencia de desenlaces clínicos adversos.
Resultados.
Identificamos 105 pacientes con AC, 65 AC-ATTR y 40 AC-AL. La edad media era de 74,4 años; el 24,8% eran mujeres. En ambos grupos la insuficiencia cardiaca (IC) fue la forma de presentación clínica más frecuente (55,2%). Los hallazgos electrocardiográficos más prevalentes fueron el patrón de pseudoinfarto (68,5%) y un índice de Sokolow-Lyon <1,5 mV (67,7%), sin diferencias entre los dos subtipos. La supervivencia a 1, 3 y 5 años fue del 43,3%, 40,4% y 35,4%, respectivamente, en pacientes con AC-AL y de 85,1%, 57,3% y 31,4% en pacientes con AC-ATTR (p = 0,004). El subtipo AC-AL (HR 3,41, IC95% 1,45-8,06, p = 0,005), el ingreso previo por IC (HR 4,25, IC95% 1,63-11,09, p = 0,003) y una clase NYHA III-IV (HR 2,76, IC95% 1,09-7,03, p = 0,033) fueron predictores independientes de mortalidad, mientras que el tratamiento betabloqueante se asoció con una mayor supervivencia (HR 0,23, IC95% 0,09-0,59, p = 0,002).
Conclusiones.
Existen ciertas diferencias en la presentación clínica de los pacientes con AC-AL y AC-ATTR. Ambas entidades, y muy especialmente la AC-AL, presentan un pobre pronóstico vital
Prevalence and Risk Factors of Respiratory Syncytial Virus in Children under 5 Years of Age in the WHO European Region: A Systematic Review and Meta-Analysis
A respiratory syncytial virus (RSV) is the major cause of respiratory tract infection in
children under 5 years. However, RSV infection in the European Region of the World Health
Organization has not been systematically reviewed. The aim was to determine the prevalence and
factors associated with RSV in children under 5 years of age in European regions. A systematic
review and meta-analysis was performed. CINAHL, Medline, LILACS, ProQuest, SciELO, and
Scopus databases were consulted for studies published in the last 5 years, following Preferred
Reporting Items for Systematic Reviews and Meta-analysis guidelines. The search equation was
“respiratory syncytial virus AND (newborn OR infant OR child) AND (prevalence OR risk factors)”.
Studies reporting the prevalence of RSV were eligible for inclusion in the meta-analysis. A total
of 20 articles were included. The meta-analytic prevalence estimation of RSV, with a sample of
n = 16,115 children, was 46% (95% CI 34–59%). The main risk factors were age, male gender,
winter season, and environmental factors such as cold temperatures, higher relative humidity, high
concentrations of benzene, exposure to tobacco, and living in urban areas. Robust age-specific
estimates of RSV infection in healthy children should be promoted in order to determine the optimal
age for immunization. In addition, it is necessary to analyse in greater depth the potentially predictive
factors of RSV infection, to be included in prevention strategies
Morbilidad por infecciones de partes blandas superficiales en el servicio de clínicas pediátricas de Manzanillo, Granma 2018
Introduction: infections in the skin and soft tissues are common health concerns in children, with a wide range of severity from patient to patient. Objective: to describe the clinical-epidemiological characteristics of the patients with soft tissue infections hospitalized in the Pediatric Teaching Hospital “Hermanos Cordové”.Method: an observational, descriptive, cross-sectional study was carried out in the services of pediatric clinic in the Pediatric Teaching Hospital “Hermanos Cordové”, in Manzanillo, Cuba, during the year 2018. All discharged patients who had a confirmed diagnosis of this type of infection were studied (n=298). The following variables were taken into account: anatomical location, classifications of the different types of skin and soft tissue infections, treatment used and hospitalization. Results: male gender prevailed in the patients (57.7 %), and also the ages ranging between 10 to 14 years old (34.9 %). Infections located on the limbs were described in 113 patients (37.9 %). Impetigo was the most common diagnosis (42.3 %), and the most frequently used antibiotic was cefazolin (77.2 %). Most of the patients were hospitalized up to 7 days (293), with a satisfactory evolution of the disease. Conclusions: patients with soft tissue infections in the services of pediatric clinic in the Pediatric Teaching Hospital “Hermanos Cordové” are mainly characterized for being male, especially from ages raging between 10 to 14 years old, with impetigo being the most common infection, mostly located on the limbs. Cefalozin resulted very effective for the treatment of these infections, making possible the hospitalization time to be lesser than a week.Introducción: las infecciones de la piel y partes blandas son frecuentes en los niños, con un amplio espectro de gravedad.Objetivo: describir las características clínico-epidemiológicas de los pacientes con infecciones de partes blandas superficiales hospitalizados en el servicio de clínicas pediátricas del Hospital Pediátrico Docente“Hermanos Cordové”.Método: se realizó un estudio observacional, descriptivo y transversal en el servicio de clínicas pediátricas del Hospital Pediátrico Docente “Hermanos Cordové”, de Manzanillo durante el 2018. Se estudiaron todos los pacientes egresados (n=298) con el diagnóstico confirmado de este tipo de infecciones. Se tomaron en cuenta las siguientes variables: localización anatómica, clasificación del tipo de infección de piel y tejidos blandos, terapéutica utilizada y estadía hospitalaria. Resultados: predominó el sexo masculino (57,7 %) y el grupo de edad de 10-14 años (34,9 %). Las infecciones en las extremidades estuvieron presentes en 113 pacientes (37,9 %). El impétigo fue la entidad clínica más frecuente (42,3 %), la cefazolina fue el antibiótico más utilizado (77,2 %). Se observó que la mayoría de los pacientes (293) solo permaneció hasta 7 días ingresados, con una evolución satisfactoria. Conclusiones: en el servicio de clínicas pediátricas del Hospital Pediátrico Docente “Hermanos Cordové”, los pacientes con IPTB se caracterizan por ser sobre todo varones, más comúnmente con edad entre 10 y 14 años, las lesiones predominaron en las extremidades y la más común fue el impétigo. La cefazolina resultó eficaz para el tratamiento estas infecciones, lo que hizo posible que la estadía hospitalaria generalmente no excediera de siete días
Risk Factors for Short-Term Lung Cancer Survival
Institutional Review Board Statement: The study was conducted according to the guidelines of the
Declaration of Helsinki, and approved by the Ethics Committee of the Andalusian Health Service
(LUNG CA SURV 2180-N-20).Data Availability Statement: The data presented in this study are available on request from the
corresponding author. The data are not publicly available due to ethical.Background: Lung cancer is typically diagnosed in an advanced phase of its natural history.
Explanatory models based on epidemiological and clinical variables provide an approximation of
patient survival less than one year using information extracted from the case history only, whereas
models involving therapeutic variables must confirm that any treatment applied is worse than surgery
in survival terms. Models for classifying less than one year survival for patients diagnosed with lung
cancer which are able to identify risk factors and quantify their effect for prognosis are analyzed.
Method: Two stepwise binary logistic regression models, based on a retrospective study of 521 cases
of patients diagnosed with lung cancer in the Interventional Pneumology Unit at the Hospital “Virgen
de las Nieves”, Granada, Spain. Results: The first model included variables age, history of pulmonary
neoplasm, tumor location, dyspnea, dysphonia, and chest pain. The independent risk factors age
greater than 70 years, a peripheral location, dyspnea and dysphonia were significant. For the second
model, treatments were also significant. Conclusions: Age, history of pulmonary neoplasm, tumor
location, dyspnea, dysphonia, and chest pain are predictors for survival in patients diagnosed with
lung cancer at the time of diagnosis. The treatment applied is significant for classifying less than
one year survival time which confirms that any treatment is markedly inferior to surgery in terms of
survival. This allows to consider applications of more or less aggressive treatments, anticipation of
palliative cares or comfort measures, inclusion in clinical trials, etc
Cambio climático a nivel de nicho y caña de azúcar. I Tamazula, Jalisco, México
Rev. iberoam. bioecon. cambio clim. Vol.1(1) 2015; 185-206El presente trabajo tuvo como objetivo estudiar las variaciones relacionadas con la gran sequía invernal (GSI), la sequía intraestival (SI), la ocurrencia de heladas, golpes de calor y excesos de lluvia, aprovechando datos históricos disponibles de la localidad de Tamazula, Jalisco como un espacio dentro de un nicho; así mismo, comparar las variaciones antes y después de 1975, año tomado como referencia de la manifestación del último cambio climático según la Figura 2. Otro objetivo colateral fue vincular dicho desarrollo histórico con un experimento de variedades de caña realizado en 2011-2013 cerca de Tamazula, Jalisco.Rev. iberoam. bioecon. cambio clim. Vol.1(1) 2015; 185-20
Cambio climático a nivel de nicho y caña de azúcar. I Tamazula, Jalisco, México
El presente trabajo tuvo como objetivo estudiar las variaciones relacionadas con la gran sequía invernal (GSI), la sequía intraestival (SI), la ocurrencia de heladas, golpes de calor y excesos de lluvia, aprovechando datos históricos disponibles de la localidad de Tamazula, Jalisco como un espacio dentro de un nicho; así mismo, comparar las variaciones antes y después de 1975, año tomado como referencia de la manifestación del último cambio climático según la Figura 2. Otro objetivo colateral fue vincular dicho desarrollo histórico con un experimento de variedades de caña realizado en 2011-2013 cerca de Tamazula, Jalisc
Autonomous aerial robot for high-speed search and intercept applications
In recent years, high-speed navigation and environment interaction in the context of
aerial robotics has become a field of interest for several academic and industrial research studies. In
particular, Search and Intercept (SaI) applications for aerial robots pose a compelling research
area due to their potential usability in several environments. Nevertheless, SaI tasks involve a
challenging development regarding sensory weight, onboard computation resources, actuation design,
and algorithms for perception and control, among others. In this work, a fully autonomous aerial
robot for high-speed object grasping has been proposed. As an additional subtask, our system is able
to autonomously pierce balloons located in poles close to the surface. Our first contribution is the
design of the aerial robot at an actuation and sensory level consisting of a novel gripper design with
additional sensors enabling the robot to grasp objects at high speeds. The second contribution is
a complete software framework consisting of perception, state estimation, motion planning, motion
control, and mission control in order to rapidly and robustly perform the autonomous grasping
mission. Our approach has been validated in a challenging international competition and has shown
outstanding results, being able to autonomously search, follow, and grasp a moving object at 6 m/s
in an outdoor environment.Agencia Estatal de InvestigaciónKhalifa Universit
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