Musicoterapia en una Unidad de Cuidados Intensivos Neonatales: experiencia benéfica para el binomio

ResumenIntroducciónDesde hace varios años se está utilizando la música como herramienta terapéutica y preventiva en la neonatología, se han documentado en un gran número de artículos de investigación, sin embargo, en México esta técnica es poco utilizada.ObjetivoMejorar las condiciones de los neonatos atendidos en una Unidad de Cuidados Intensivos (UCIN) y sus familiares, mediante el uso de musicoterapia, para minimizar el estrés y los daños colaterales.Materiales y métodosUn grupo de 2 neonatólogos, 3 residentes de pediatría, 10 enfermeras y un concertista profesional de violín, llevaron a cabo 6 sesiones musicales semanales en la Unidad de Cuidados Intensivos Neonatales Externos del Hospital Civil de Guadalajara. Durante el concierto se valoró individualmente a cada neonato, registrando los signos vitales por monitorización electrónica, además se registró el estado anímico de los familiares.ResultadosDurante las sesiones de música los neonatales no presentaron cambios significativos en sus constantes vitales, en el personal de la UCIN y en los padres de recién nacidos hospitalizados se vieron efectos benéficos, refiriendo disminución del estrés y altos índices de satisfacción.ConclusionesLa música puede tener un efecto positivo como terapia coadyuvante en neonatos de alto riesgo, principalmente en prematuros. Se recomienda difundir y aplicar esta metodología en las UCIN del país.AbstractIntroductionSince several years ago, music has been used as a therapeutic and preventive tool in neonatology. A great number of research papers have been written on the subject; however, this technique is rarely used in Mexico.ObjectiveTo improve the condition of neonates at Neonatal Intensive Care Units (NICU) and their relatives, in order to minimize any stress and collateral damage.Material and methods: A group of two neonatologists, 3 residents, 10 nurses and a professional concert violinist, conducted six weekly music sessions in the Outpatient Neonatal Intensive Care Unit (ONICU) of our institution. During the concert, we individually assessed each newborn, recording vital signs through electronic monitoring; additionally, we recorded the mood of any other family members present.ResultsDuring the music sessions, the neonatal patients showed no significant changes in vital signs; yet, ONICU staff and the parents/relatives of hospitalized newborns showed beneficial effects, reporting decreased stress and high levels of satisfaction.ConclusionsMusic can have a positive effect as adjunctive therapy in high-risk newborns, especially in premature babies. We therefore recommend applying this methodology in the ONICU

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

Effect of antispasmodic agents, alone or in combination, in the treatment of Irritable Bowel Syndrome: Systematic review and meta-analysis

Introduction: Irritable bowel syndrome (IBS) is characterized by recurrent abdominal pain, bloating, and changes in bowel habit. Aims: To determine the clinical effectiveness of the antispasmodic agents available in Mexico for the treatment of IBS. Methods: We carried out a systematic review and meta-analysis of randomized controlled clinical trials on antispasmodic agents for IBS treatment. Clinical trials identified from January 1960 to May 2011 were searched for in MEDLINE, the Cochrane Library, and in the ClinicalTrials.gov registry. Treatment response was evaluated by global improvement of symptoms or abdominal pain, abdominal distention/bloating, and frequency of adverse events. The effect of antispasmodics vs placebo was expressed in OR and 95% CI. Results: Twenty-seven studies were identified, 23 of which fulfilled inclusion criteria. The studied agents were pinaverium bromide, mebeverine, otilonium, trimebutine, alverine, hyoscine, alverine/simethicone, pinaverium/simethicone, fenoverine, and dicyclomine. A total of 2585 patients were included in the meta-analysis. Global improvement was 1.55 (CI 95%: 1.33 to 1.83). Otilonium and the alverine/simethicone combination produced significant values in global improvement while the pinaverium/simethicone combination showed improvement in bloating. As for pain, 2394 patients were included with an OR of 1.52 (IC 95%: 1.28 a 1.80), favoring antispasmodics. Conclusions: Antispasmodics were more effective than placebo in IBS, without any significant adverse events. The addition of simethicone improved the properties of the antispasmodic agents, as seen with the alverine/simethicone and pinaverium/simethicone combinations

Meteoric 10Be in aerosol filters in the city of Seville

Cosmogenic radionuclides in the one-million-year half-life range, like 10Be, find application fields in several Sciences. They are powerful tools in Geology and Geochronology, as they are very important tracers on the Earth, being utilized as chronometer. Meteoric 10Be (T1/2 = 1.39 × 106 y) associated to aerosols can be used as a tracer of atmospheric processes and specifically as indicators of the cosmogenic interactions in lower Stratosphere, upper Troposphere, the air exchange between both and deposition processes on the Earth surface. The applications of 10Be are even more relevant when combined with other radionuclides such as 26Al. In order to provide new data about concentration 10Be in this type of samples, the first atmospheric air filters in Spain have been analysed. Values around 104 at/m3 (atoms per cubic meter of air) for 10Be have been obtained. Due to the location and the features of the sampling site (urban area, at sea level and mid latitude), a new radiochemical procedure was designed and developed in our laboratory for the Accelerator Mass Spectrometry (AMS) measurement of 10Be in this kind of samples. The samples were measured in SARA, the 1 MV AMS system at Centro Nacional de Aceleradores (CNA).Ministerio de Economía y Competitividad FIS2012-31853Ministerio de Economía y Competitividad FIS2015-69673-

Optimization of an aroma sensor for assessing grape quality for wine making

El control de la materia prima tiene una gran influencia sobre la calidad final del vino. El objetivo de este trabajo es desarrollar un sensor capaz de estimar la calidad del mosto a la entrada de las bodegas. La respuesta del sensor se ha correlacionado con los resultados de distintos análisis químicos convencionales mediante técnicas de tratamiento estadístico multivariante. El sensor de aromas se compone de 14 sensores de gases tipo MOS (sensores de óxidos metálicos) más uno de temperatura y otro de humedad relativa. El trabajo realizado demuestra que el sensor de aromas representa una herramienta adecuada para detectar la presencia de podredumbres en el mostoControl of the raw material has considerable influence on final wine quality. The objective of this work was to develop a sensor capable of assessing grape juice quality in the cellar. Sensor response was compared with conventional chemical analysis using multivariate data techniques. The aroma sensor array is composed of 14 metal oxide sensors (MOS) gas transducers plus a temperature and a relative humidity sensor. This work showed that the sensor could detect rotten flavours in grape juice

Optimization of an aroma sensor for assessing grape quality for wine making

El control de la materia prima tiene una gran influencia sobre la calidad final del vino. El objetivo de este trabajo es desarrollar un sensor capaz de estimar la calidad del mosto a la entrada de las bodegas. La respuesta del sensor se ha correlacionado con los resultados de distintos análisis químicos convencionales mediante técnicas de tratamiento estadístico multivariante. El sensor de aromas se compone de 14 sensores de gases tipo MOS (sensores de óxidos metálicos) más uno de temperatura y otro de humedad relativa. El trabajo realizado demuestra que el sensor de aromas representa una herramienta adecuada para detectar la presencia de podredumbres en el mostoControl of the raw material has considerable influence on final wine quality. The objective of this work was to develop a sensor capable of assessing grape juice quality in the cellar. Sensor response was compared with conventional chemical analysis using multivariate data techniques. The aroma sensor array is composed of 14 metal oxide sensors (MOS) gas transducers plus a temperature and a relative humidity sensor. This work showed that the sensor could detect rotten flavours in grape juice

Estado actual de los neonatólogos certificados en México

Introducción: La especialidad de neonatología se inició en México a finales de la década de 1960. Primero se crearon programas de entrenamiento en servicio de duración variable, después se creó la residencia médica de un año, hasta en la actualidad en que la residencia se realiza en un periodo bianual. Con el objetivo principal de garantizar la competencia profesional, se creó dentro del Consejo Mexicano de Certificación en Pediatría (CMCP-SN), la Sección de Certificación en Neonatología. Objetivo: Conocer el estado actual de los neonatólogos certificados en México. Métodos: A partir de la base de datos del Consejo Mexicano de Certificación en Neonatología, se tomaron variables para caracterizar al grupo de neonatólogos certificados. Resultados: Existen en México 1,529 neonatólogos con certificación oficial. El 55% (854) son mujeres y 675 son varones. La edad promedio fue de 38, con un rango entre 25-84 años. Las ciudades con mayor número de neonatólogos fueron: Distrito Federal y Estado de México con 565 (37%), Monterrey con 131 (8.5%) y Guadalajara con 93 (6%). Las universidades que avalan en su formación a un mayor número de neonatólogos son: La Universidad Nacional Autónoma de México 605 (45%), Universidad Autónoma del Estado de Nuevo León 86 (5%), Universidad La Salle 63 (4%), Universidad de Guadalajara 58 (4%). Los hospitales que han formado a un mayor número de estos subespecialistas son: el Instituto Nacional de Perinatología 350 (25%), IMSS 220 (15%), ISSSTE 183 (13%), Hospitales Universitarios de Monterrey 58 (4%) y Hospitales Civiles de Guadalajara 35 (2.5%). De los 1,529 neonatólogos certificados, 1,076 (70%) se encuentran vigentes por haber cumplido con los requerimientos del CMCP-SN. Conclusiones: En México hay un neonatólogo por cada 1,823 recién nacidos, 55% de ellos son mujeres, 10 hospitales han formado al 85% de los subespecialistas, el 70% trabaja en hospitales públicos y el 12% en privados

Prediction of long-term outcomes of HIV-infected patients developing non-AIDS events using a multistate approach

Outcomes of people living with HIV (PLWH) developing non-AIDS events (NAEs) remain poorly defined. We aimed to classify NAEs according to severity, and to describe clinical outcomes and prognostic factors after NAE occurrence using data from CoRIS, a large Spanish HIV cohort from 2004 to 2013. Prospective multicenter cohort study. Using a multistate approach we estimated 3 transition probabilities: from alive and NAE-free to alive and NAE-experienced ("NAE development"); from alive and NAE-experienced to death ("Death after NAE"); and from alive and NAE-free to death ("Death without NAE"). We analyzed the effect of different covariates, including demographic, immunologic and virologic data, on death or NAE development, based on estimates of hazard ratios (HR). We focused on the transition "Death after NAE". 8,789 PLWH were followed-up until death, cohort censoring or loss to follow-up. 792 first incident NAEs occurred in 9.01% PLWH (incidence rate 28.76; 95% confidence interval [CI], 26.80-30.84, per 1000 patient-years). 112 (14.14%) NAE-experienced PLWH and 240 (2.73%) NAE-free PLWH died. Adjusted HR for the transition "Death after NAE" was 12.1 (95%CI, 4.90-29.89). There was a graded increase in the adjusted HRs for mortality according to NAE severity category: HR (95%CI), 4.02 (2.45-6.57) for intermediate-severity; and 9.85 (5.45-17.81) for serious NAEs compared to low-severity NAEs. Male sex (HR 2.04; 95% CI, 1.11-3.84), ag