Uso de la adrenalina autoinyectable (AAI) en pacientes con antecedentes de anafilaxia

La adrenalina autoinyectable (AAI) es un tratamiento que debe prescribirse a aquellos pacientes que han sufrido una reacción anafiláctica y son susceptibles de sufrir otra. En nuestro estudio, mediante una encuesta, valoramos el uso y el manejo de la AAI en pacientes a los que se les prescribió AAI y que siguen controles en nuestras consultas.L'adrenalina autoinjectable (AAI) és un tractament que s'ha de prescriure a aquells pacients que han patit una reacció anafilàctica i que són susceptibles de patir-ne una altra. Al nostre estudi, mitjançant una enquesta, valorem l'ús i el maneig de l'AAI en pacients als que se'ls ha prescrit AAI i que segueixen controls a les nostres consultes

La Salut el Segle XXI : una Responsabilitat per Compartir. Una experiència per crear cultura de treball interprofessional

La Salut el Segle XXI: una Responsabilitat a Compartir és una assignatura d'universitat que pretén capacitar els estudiants de diferents titulacions a comprendre i construir els conceptes de salut i benestar des d'una perspectiva global i a donar respostes interdisciplinàries als problemes de salut més freqüents. La capacitat per al treball interdisciplinari es proposa assolir mitjançant l'adquisició de competències com la responsabilitat, les habilitats de diàleg i de pacte, la integració de coneixement, l'adaptació als canvis, la tolerància i la gestió de la incertesa. Per treballar aquestes competències s'ha utilitzat la metodologia de l'aprenentatge basat en problemes (ABP). Amb aquests objectius, un equip de docents de diverses titulacions i centres adscrits a la UAB va proposar la creació d'aquesta assignatura el curs acadèmic 2004-2005. Aquesta publicació presenta els resultats de tres anys d'experiència, del 2004 al 2007.La Salud el Siglo XXI: una Responsabilidad a Compartir es una asignatura de universidad que pretende capacitar a los estudiantes de diferentes titulaciones a comprender y construir los conceptos de salud y bienestar desde una perspectiva global y a dar respuestas interdisciplinarias a los problemas de salud más frecuentes. La capacidad para el trabajo interdisciplinario se propone alcanzar mediante la adquisición de competencias como la responsabilidad, las habilidades de diálogo y de pacto, la integración de conocimiento, la adaptación a los cambios, la tolerancia y la gestión de la incertidumbre. Para trabajar estas competencias se ha utilizado la metodología del aprendizaje basado en problemas (ABP). Con estos objetivos, un equipo de docentes de diversas titulaciones y centros adscritos a la UAB propuso la creación de esta asignatura el curso académico 2004-2005. Esta publicación presenta los resultados de tres años de experiencia, del 2004 al 2007.Health in the Twenty-First Century: a Shared Responsibility is a university course that aims to provide students studying various courses with the skills to understand and construct the concepts of health and welfare from an overall perspective and to provide interdisciplinary answers to the most frequent health problems. The aim was to attain capacity for interdisciplinary work by means of acquiring skills such as responsibility, dialogue and agreement skills, knowledge integration, adaptation to changes, tolerance and uncertainty management. Problem-based learning (PBL) methodology was used for working on these skills. With these objectives, a team of teachers from various courses and attached centres of the UAB suggested the creation of this course in the 2004-2005 academic year. This publication presents the results of three years of experience, from 2004 to 2007

Growth of ferroelectric Ba0.8Sr0.2TiO3 epitaxial films by UV pulsed laser irradiation of chemical solution derived precursor layers

© 2015 AIP Publishing LLC. Highly crystalline epitaxial Ba0.8Sr0.2TiO3 (BST) thin-films are grown on (001)-oriented LaNiO3-buffered LaAlO3 substrates by pulsed laser irradiation of solution derived barium-zirconium-titanium precursor layers using a UV Nd:YAG laser source at atmospheric conditions. The structural analyses of the obtained films, studied by X-ray diffractometry and transmission electron microscopy, demonstrate that laser processing allows the growth of tens of nm-thick BST epitaxial films with crystalline structure similar to that of films obtained through conventional thermal annealing methods. However, the fast pulsed nature of the laser employed leads to crystallization kinetic evolution orders of magnitude faster than in thermal treatments. The combination of specific photothermal and photochemical mechanisms is the main responsible for the ultrafast epitaxial laser-induced crystallization. Piezoresponse microscopy measurements demonstrate equivalent ferroelectric behavior in laser and thermally annealed films, being the piezoelectric constant ∼25 pm V-1.This work was financed by the Ministry of Economy and Competitiveness under the Project Nos. MAT2011-28874-C02-01, ENE2014-56109-C3-3-R, and MAT2014-51778-C2-1-R and Consolider Nanoselect CSD2007-00041 by Generalitat de Catalunya (2009 SGR 770, 2014 SGR 753 and Xarmae) and by the Spanish National Research Council under the Contract No. 200960I015. A.Q. and M.d.l.M. are also grateful for JAE-Predoc fellowship and European Social Fund program. Fruitful discussions with Dr. Susagna Ricart for solution synthesis are also acknowledged.Peer Reviewe

Electrocardiogram sensitivity in left ventricular hypertrophy according to gender and cardiac mass

BACKGROUND: Several factors are known to interfere with electrocardiogram (ECG) sensitivity when diagnosing Left Ventricular Hypertrophy (LVH), with gender and cardiac mass being two of the most important ones OBJECTIVE: To evaluate the influence of gender on the sensitivity of some of the criteria used to detect LVH, according to the progression of ventricular hypertrophy degree. METHODS: According to gender and the degree of LVH at the echocardiogram, the patients were divided in three groups: mild, moderate and severe LVH. ECG sensitivity to detect LVH was assessed between men and women, according to the LVH degree. RESULTS: Of the 874 patients, 265 were males (30.3%) and 609, females (69.7%). The [(S + R) X QRS], Sokolow-Lyon, Romhilt-Estes, Perugia and strain criteria showed high discriminatory power in the diagnosis of LVH between men and women in the three groups with LVH, with a superior performance in the male population and highlighting the importance of the [(S + R) X QRS] and Perugia scores. Conclusion: The diagnostic sensitivity of the ECG increases with the cardiac mass. The examination is more sensitive in men, highlighting the importance of the [(S + R) X QRS] and Perugia scores. CONCLUSION: The diagnostic sensitivity of the ECG increases with the cardiac mass. The examination is more sensitive in men, highlighting the importance of the [(S + R) X QRS] and Perugia scores.FUNDAMENTO: Sabe-se que vários fatores interferem na sensibilidade do Eletrocardiograma (ECG) no diagnóstico da Hipertrofia Ventricular Esquerda (HVE), sendo o gênero e a massa cardíaca alguns dos principais. OBJETIVO: Avaliar a influência do sexo na sensibilidade de alguns dos critérios utilizados para a detecção de HVE, de acordo com a progressão do grau de hipertrofia ventricular. MÉTODOS: De acordo com o gênero e com o grau de HVE ao ecocardiograma, os pacientes foram divididos em três grupos: HVE leve, moderada e severa. Avaliou-se a sensibilidade do ECG para detectar HVE entre homens e mulheres, conforme o grau de HVE. RESULTADOS: Dos 874 pacientes, 265 eram homens (30,3%) e 609, mulheres (69,7%). Os critérios [(S + R) X QRS], Sokolow-Lyon, Romhilt-Estes, Perúgia e padrão strain mostraram alto poder discriminatório no diagnóstico de HVE entre homens e mulheres nos três grupos de HVE, com desempenho superior na população masculina e destaque para os escores [(S + R) X QRS] e Perúgia. CONCLUSÃO: A sensibilidade diagnóstica do ECG é maior com o aumento da massa cardíaca. O exame é mais sensível entre homens, destacando-se os escores [(S + R) X QRS] e Perúgia.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPMSciEL

Higher incidence of adverse events in isolated patients compared with non-isolated patients: a cohort study

Objective To determine whether isolated patients admitted to hospital have a higher incidence of adverse events (AEs), to identify their nature, impact and preventability. Design Prospective cohort study with isolated and non-isolated patients. Setting One public university hospital in the Valencian Community (southeast Spain). Participants We consecutively collected 400 patients, 200 isolated and 200 non-isolated, age ≥18 years old, to match according to date of entry, admission department, sex, age (±5 years) and disease severity from April 2017 to October 2018. Exclusion criteria: patients age <18 years old and/or reverse isolation patients. Primary and secondary outcome measures The primary outcome as the AE, defined according to the National Study of Adverse Effects linked to Hospitalisation (Estudio Nacional Sobre los Efectos Adversos) criteria. Cumulative incidence rates and AE incidence density rates were calculated. Results The incidence of isolated patients with AEs 16.5% (95% CI 11.4% to 21.6%) compared with 9.5% (95% CI 5.4% to 13.6%) in non-isolated (p<0.03). The incidence density of patients with AEs among isolated patients was 11.8 per 1000 days/patient (95% CI 7.8 to 15.9) compared with 4.3 per 1000 days/patient (95% CI 2.4 to 6.3) among non-isolated patients (p<0.001). The incidence of AEs among isolated patients was 18.5% compared with 11% for non-isolated patients (p<0.09). Among the 37 AEs detected in 33 isolated patients, and the 22 AEs detected in 19 non-isolated patients, most corresponded to healthcare-associated infections (HAIs) for both isolated and non-isolated patients (48.6% vs 45.4%). There were significant differences with respect to the preventability of AEs, (67.6% among isolated patients compared with 52.6% among non-isolated patients). Conclusions AEs were significantly higher in isolated patients compared with non-isolated patients, more than half being preventable and with HAIs as the primary cause. It is essential to improve training and the safety culture of healthcare professionals relating to the care provided to this type of patient

¿Qué presencia tienen las personas receptoras en las investigaciones de Aprendizaje-Servicio en actividad física y deportiva?

Les experiències d’aprenentatge-servei en les que estan implicades les activitats físiques i els esports són cada vegada més nombroses a la universitat. Això ha comportat un augment de les publicacions. En ser una metodologia en què la participació de l’alumnat és clau, moltes d’aquestes publicacions se centren en el seu procés d’aprenentatge, quedant en un segon pla les persones a les que es dirigeix el servei. L’objectiu principal d’aquest treball és conèixer quin tipus de presència tenen les persones receptores dels serveis en les publicacions. S’ha realitzat una revisió narrativa de la literatura en què es van analitzar 310 documents amb el software NVivo Release 14.1. Només es van trobar referències sobre les persones receptores en 55. Els resultats mostren que la presència dels col·lectius receptors és escassa a la literatura, i que en ocasions, altres persones parlen per ells. Per tant, la presència de les seves veus és mínima. Davant la diversitat de les persones a les que es dirigeixen els serveix, es creu necessari desenvolupar instruments de recerca ad hoc per recollir-ne els seus testimonis fent atenció a les seves característiques i necessitats.There has been an increase in Service-Learning (SL) experiences involving physical activities and sports at university. This has led to a rising in publications on the topic. As SL is a methodology in which the students’ participation is key, many of these publications focus on the students’ learning process, leaving aside the people to whom the service is addressed. The main objective of this work is thus to know what type of presence people who received the services had in the publications. To do so, a narrative review of the literature was carried out in which 310 documents were analysed through the NVivo Release 14.1 software. References of recipients were found in only 55 of the documents. The results show that the presence of the receiving groups in the literature is scarce, and that in many cases, the information came from people who were not receivers themselves, so the presence of their voices is minimal. Facing the diversity of people who receive the services, it is strongly recommended to develop ad hoc research instruments to collect their testimonies in accordance with their characteristics and needs.Las experiencias de aprendizaje-servicio en las que están implicadas las actividades físicas y los deportes son cada vez más numerosas en la universidad. Esto ha traído consigo que las publicaciones aumenten. Al ser una metodología en la que la participación del alumnado es clave, muchas de estas publicaciones ponen el foco en su proceso de aprendizaje, quedando en un segundo plano las personas a las que se dirige el servicio. El objetivo principal de este trabajo es conocer qué tipo de presencia tienen las personas receptoras de los servicios en las publicaciones. Por ello, se ha realizado una revisión narrativa de la literatura en la que se analizaron 310 documentos a través del software NVivo Release 14.1. Tan solo se encontraron referencias sobre las personas receptoras en 55 de ellos. Los resultados muestran que la presencia de los colectivos receptores es escasa en la literatura y que, en ocasiones, son otras las personas que hablan en su lugar, siendo mínima la presencia de sus voces. Ante la diversidad de las personas a las que se dirigen los servicios, se ve necesario desarrollar instrumentos de investigación ad hoc para recoger sus testimonios atendiendo a sus características y necesidades

Deep learning-based overall survival prediction model in patients with rare cancer: a case study for primary central nervous system lymphoma

Purpose Primary central nervous system lymphoma (PCNSL) is a rare, aggressive form of extranodal non-Hodgkin lymphoma. To predict the overall survival (OS) in advance is of utmost importance as it has the potential to aid clinical decision-making. Though radiomics-based machine learning (ML) has demonstrated the promising performance in PCNSL, it demands large amounts of manual feature extraction efforts from magnetic resonance images beforehand. deep learning (DL) overcomes this limitation.Methods In this paper, we tailored the 3D ResNet to predict the OS of patients with PCNSL. To overcome the limitation of data sparsity, we introduced data augmentation and transfer learning, and we evaluated the results using r stratified k-fold cross-validation. To explain the results of our model, gradient-weighted class activation mapping was applied.Results We obtained the best performance (the standard error) on post-contrast T1-weighted (T1Gd)-area under curve = 0.81(0.03), accuracy = 0.87(0.07), precision = 0.88(0.07), recall = 0.88(0.07) and F1-score = 0.87(0.07), while compared with ML-based models on clinical data and radiomics data, respectively, further confirming the stability of our model. Also, we observed that PCNSL is a whole-brain disease and in the cases where the OS is less than 1 year, it is more difficult to distinguish the tumor boundary from the normal part of the brain, which is consistent with the clinical outcome.Conclusions All these findings indicate that T1Gd can improve prognosis predictions of patients with PCNSL. To the best of our knowledge, this is the first time to use DL to explain model patterns in OS classification of patients with PCNSL. Future work would involve collecting more data of patients with PCNSL, or additional retrospective studies on different patient populations with rare diseases, to further promote the clinical role of our model

Induction of ABCG2/BCRP restricts the distribution of zidovudine to the fetal brain in rats

Safety concerns for fetus development of zidovudine (AZT) administration as prophylaxis of vertical transmission of HIV persist. We evaluated the participation of the ATP-binding cassette efflux transporter ABCG2 in the penetration of AZT into the fetal brain and the relevance for drug safety. Oral daily doses of AZT (60 mg/kg body weight) or its vehicle were administered between post gestational days 11 (E11) and 20 (E20) to Sprague-Dawley pregnant rats. At E21, animals received an intravenous bolus of 60 mg AZT/kg body weight in the presence or absence of the ABCG2 inhibitor gefitinib (20 mg/kg body weight, ip) and AZT in maternal plasma and fetal brain were measured by HPLC-UV. ABCG2 protein expression in placenta and fetal brain, as well as mitochondrial function and ultrastructure in fetal brain were also analyzed. In utero chronic exposure to AZT markedly induced ABCG2 expression in placenta and fetal brain whereas did not significantly alter mitochondrial functionality in the fetal brain. The area-under-the-concentration-time-curve of AZT significantly decreased in fetal brains isolated from AZT-exposed fetuses compared to control group, but this effect was abolished by ABCG2 inhibition. Our results suggest that the absence of mitochondrial toxicity in the fetal brain after chronic in utero administration of AZT could be attributed to its low accumulation in the tissue caused, at least in part, by ABCG2 overexpression. We propose that any interference with ABCG2 activity due to genetic, pathological or iatrogenic factors would increase the amount of AZT reaching the fetal brain, which could increase the risk of toxicity of this drug on the tissue.Fil: Filia, Maria Fernanda. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Farmacológicas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Investigaciones Farmacológicas; ArgentinaFil: Marchini, Timoteo Oscar. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Bioquímica y Medicina Molecular; ArgentinaFil: Minoia, Juan Mauricio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Farmacológicas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Investigaciones Farmacológicas; ArgentinaFil: Roma, Martin Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Farmacológicas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Investigaciones Farmacológicas; ArgentinaFil: de Fino, Fernanda Teresa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Farmacológicas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Investigaciones Farmacológicas; ArgentinaFil: Rubio, Modesto Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Farmacológicas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Investigaciones Farmacológicas; ArgentinaFil: Copello, Guillermo Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Química y Metabolismo del Fármaco. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Química y Metabolismo del Fármaco; ArgentinaFil: Evelson, Pablo Andrés. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Bioquímica y Medicina Molecular; ArgentinaFil: Peroni, Roxana Noemi. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Farmacológicas. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Investigaciones Farmacológicas; Argentin