The Concept of Quality of Life in the Perception of Older Uruguayans: a qualitative study

The research objective was to investigate the conception of quality of life in Uruguayan older adults, trying to build a model adapted to them. Based on Grounded Theory, a qualitative study was carried out between 2017-2018 in several regions of Uruguay. Semi-structured interviews were conducted in older adults (mean age 71 years, SD 5.4) with theoretical and snowball sampling. Theory emerged through the core category “living as best as possible”, interpreted as the conception of older adults about quality of life. The emerging themes were: “context events”, “link with others”, “activities facing life” and “adaptation strategies”. When facing stressful events, participants develop coping strategies through social support and internal locus of control, to achieve quality of life and successful aging. The empirical evidence developed from this qualitative research portrays a model established from a specific age and cultural context, in which social and psychological dimensions interact to face aging and achieve quality of life.El objetivo de este trabajo fue investigar la concepción de calidad de vida en adultos mayores uruguayos, procurando construir un modelo adaptado a ellos. Basado en Teoría Fundamentada, se realizó un estudio cualitativo entre 2017-2018 en varios departamentos de Uruguay. Se realizaron entrevistas semiestructuradas a adultos mayores (edad promedio 71 años, DE 5,4) con muestreo teórico y por bola de nieve. Emergió teoría a través de la categoría madre “vivir lo mejor que se puede”, interpretada como la concepción de adultos mayores sobre calidad de vida. Los temas emergentes fueron: “eventos del contexto”, “vínculo con otros”, “actividades frente a la vida” y “estrategias de adaptación”. Al enfrentar eventos estresantes, los participantes desarrollan estrategias de adaptación por medio del soporte social y locus interno de control, para alcanzar calidad de vida y un envejecimiento exitoso. La evidencia empírica desarrollada a partir de esta investigación cualitativa retrata un modelo establecido en un contexto etario y cultural específico, en el que interactúan dimensiones sociales y psicológicas para enfrentar el envejecimiento y alcanzar calidad de vida

Potential role of intermittent fasting on decreasing cardiovascular disease in human immunodeficiency virus patients receiving antiretroviral therapy

Cardiovascular disease (CVD) has become one of the commonest causes of comorbidity and mortality among People living with human immunodeficiency virus (HIV) (PLWH) on antiretroviral therapy (ART). Nearly 50% of PLWH are likely to have an increased risk of developing CVD, including coronary heart disease, cerebrovascular disease, peripheral artery disease and aortic atherosclerosis. Aside from the common risk factors, HIV infection itself and side effects of antiretroviral therapy contribute to the pathophysiology of this entity. Potential non-pharmacological therapies are currently being tested worldwide for this purpose, including eating patterns such as Intermittent fasting (IF). IF is a widespread practice gaining high level of interest in the scientific community due to its potential benefits such as improvement in serum lipids and lipoproteins, blood pressure (BP), platelet-derived growth factor AB, systemic inflammation, and carotid artery intima-media thickness among others cardiovascular benefits. This review will focus on exploring the potential role of intermittent fasting as a non-pharmacological and cost-effective strategy in decreasing the burden of cardiovascular diseases among HIV patients on ART due to its intrinsic properties improving the main cardiovascular risk factors and modulating inflammatory pathways related to endothelial dysfunction, lipid peroxidation and aging. Intermittent fasting regimens need to be tested in clinical trials as an important, cost-effective, and revolutionary coadjutant of ART in the fight against the increased prevalence of cardiovascular disease in PLWH.Revisión por pare

Prevalence of small intestinal bacterial overgrowth in patients with gastroparesis: a systematic review and meta-analysis

Aim: We performed a systematic review and meta-analysis to identify the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with gastroparesis. Background: Several studies have suggested an association between SIBO and gastroparesis, which is characterized by delayed gastric emptying in the absence of mechanical obstruction. Methods: A comprehensive search was performed using MEDLINE, EMBASE, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) through January, 2022 for randomized controlled trials and observational studies reporting the prevalence of SIBO in gastroparesis. Pooled prevalence was estimated using a random effects model. Heterogeneity was assessed by using the inconsistency index (I2). Results: Among the 976 articles identified, 43 studies were selected for full text review. Six studies, with 385 patients, were deemed eligible for inclusion, with a perfect agreement between investigators (kappa=1.0). Overall, 379 patients were diagnosed with gastroparesis by gastric emptying scintigraphy and six were diagnosed with a wireless motility capsule. The pooled prevalence of SIBO was 41% (95% confidence interval 0.23-0.58). SIBO was diagnosed using jejunal aspirate cultures (N=15, 8.4%), lactulose breath test (N=80, 44.7%), glucose breath test (N=30, 16.8%), D-xylose breath test (N=52, 29.1%), and hydrogen breath test (N=2, 1.1%). Heterogeneity was significant and noted to be high at 91%. Only one study reported SIBO diagnosis in controls, therefore no pooled odds ratio was calculated. Conclusion: SIBO was present in almost half of the patients with gastroparesis. Future studies should examine and identify the association between SIBO and gastroparesis.Revisión por pare

Multicenter evaluation of mycobacteria growth indicator tube (MGIT) compared with the BACTEC radiometric method, BBL biphasic growth medium and Löwenstein—Jensen medium

ObjectiveTo evaluate the new BBL mycobacteria growth indicator tube (MGIT) in comparison with other media.MethodsMGIT was evaluated in 10 Italian centers on 433 clinical samples, mainly of respiratory origin and mainly smear positive, in comparison with Löwenstein—Jensen and with one or more other methods represented, according to participating centers, by the BACTEC radiometric method or by the biphasic BBL Septi-Chek AFB system. While MGIT and Löwenstein—Jensen were used for all the samples, 285 of them were also inoculated in BACTEC vials and 274 in biphasic bottles. Of these samples, 132 were investigated with all the four methods.ResultsAlthough less rapid and sensitive than the radiometric method, the results of MGIT were equal when compared with the other two media with respect to overall isolation yield; furthermore, it allowed the detection of growth in significantly shorter times.ConclusionsThe results of this study indicate the value of MGIT for the detection of mycobacteria and, thanks to its extreme simplicity of use, its suitability for small and large laboratories. Its combined use with a solid medium can substantially improve the diagnosis of mycobacterial infection

Ricerca di HPV-DNA e tipizzazione virale nella diagnostica di prevenzione del carcinoma della cervice uterina

Papillomaviruses are relatively ubiquitous and have been described as causative agents for epithelial lesions in a wide variety of animals as well as in humans. Approximately 30 HPV types have been isolated from anogenital epithelium (cervix, vagina, vulva, rectum and penis). HPVs induce a variety of proliferative lesions, but only the “high-risk” types are associated with anogenital cancers. “Low-risk” viral types include HPV-6 and HPV-11; “high-risk” types include HPV-16, 18, 31 and 56. HPVs “high-risk” types are more strongly associated with high-grade lesions (HSIL) than they are with low-grade lesions (LSIL). The traditional process for cervical cancer screening programs (PAP test) is vulnerable to air drying artifacts and has limits to sensitivity, since as many as 90 percent of collectet cells can be discarted with collection device. The present study was undertaken to assess the screening performance of HPV-DNA typing in a sample of 142 women drawn from a routine screening for the prevention of cervical cancer. The results indicate that HPV-DNA screening and typing, used together with PAP test, can improve the detection of patients with cervical disease and can serve as a quality assurance indicator in cervical cancer screening programs

Asymptotic Behavior of the Solution to a Nonisentropic Hydrodynamic Model of Semiconductors

AbstractWe study the asymptotic behavior of the solution for a hydrodynamic model of semiconductors where the energy equation is included. We study the case where the flow is subsonic and the doping profile is close to a negative constant, depending on the spacial variablex. We shall show that a given steady state solution is asymptotically stable or unstable depending on whether or not the density of the initial data satisfiesP=0, wherePis defined in (3.5)

Genetic profiling of Trypanosoma cruzi directly in infected tissues using nested PCR of polymorphic microsatellites.

The investigation of the importance of the genetics of Trypanosoma cruzi in determining the clinical course of Chagas disease will depend on precise characterisation of the parasites present in the tissue lesions. This can be adequately accomplished by the use of hypervariable nuclear markers such as microsatellites. However the unilocal nature of these loci and the scarcity of parasites in chronic lesions make it necessary to use high sensitivity PCR with nested primers, whose design depends on the availability of long flanking regions, a feature not hitherto available for any known T. cruzi microsatellites. Herein, making use of the extensive T. cruzi genome sequence now available and using the Tandem Repeats Finder software, it was possible to identify and characterise seven new microsatellite loci ? six composed of trinucleotide (TcTAC15, TcTAT20, TcAAT8, TcATT14, TcGAG10 and TcCAA10) and one composed of tetranucleotide (TcAAAT6) motifs. All except the TcCAA10 locus were physically mapped onto distinct intergenic regions of chromosome III of the CL Brener clone contigs. The TcCAA10 locus was localised within a hypothetical protein gene in the T. cruzi genome. All microsatellites were polymorphic and useful for T. cruzi genetic variability studies. Using the TcTAC15 locus it was possible to separate the strains belonging to the T. cruzi I lineage (DTU I) from those belonging to T. cruzi II (DTU IIb), T. cruzi III (DTU IIc) and a hybrid group (DTU IId, IIe). The long flanking regions of these novel microsatellites allowed construction of nested primers and the use of full nested PCR protocols. This strategy enabled us to detect and differentiate T. cruzi strains directly in clinical specimens including heart, blood, CSF and skin tissues from patients in the acute and chronic phases of Chagas disease

Wix y desarrollo de la escritura digital académica en estudiantes universitarios de primer año

El objetivo de esta experiencia de aprendizaje digital fue replantear los cursos de Comprensión y Producción de Lenguaje 1 y Comprensión y Producción de Lenguaje 2 sobre la base de la inclusión de la herramienta WIX (herramienta en línea gratuita que permite la creación de páginas web personalizables). Para ello, se trazaron dos hipótesis de trabajo. La construcción de un espacio virtual denominado boletín y bitácora respectivamente aumentaría la motivación de los estudiantes y la publicación de contenido en línea complejizaría su escritura digital académica. Siguiendo los principios del enfoque de investigación basado en el diseño (Educational Design Research, EDR por sus siglas en inglés), esta experiencia está atravesando por ciclos iterativos de análisis y evaluación con el fin de fortalecer un diseño que atienda a las necesidades heterogéneas de los estudiantes. En este artículo, se presentan el desarrollo de esta experiencia digital durante los ciclos 2018-2 y 2019-1

Molecular Mechanisms Generating and Stabilizing Terminal 22q13 Deletions in 44 Subjects with Phelan/McDermid Syndrome

In this study, we used deletions at 22q13, which represent a substantial source of human pathology (Phelan/McDermid syndrome), as a model for investigating the molecular mechanisms of terminal deletions that are currently poorly understood. We characterized at the molecular level the genomic rearrangement in 44 unrelated patients with 22q13 monosomy resulting from simple terminal deletions (72%), ring chromosomes (14%), and unbalanced translocations (7%). We also discovered interstitial deletions between 17–74 kb in 9% of the patients. Haploinsufficiency of the SHANK3 gene, confirmed in all rearrangements, is very likely the cause of the major neurological features associated with PMS. SHANK3 mutations can also result in language and/or social interaction disabilities. We determined the breakpoint junctions in 29 cases, providing a realistic snapshot of the variety of mechanisms driving non-recurrent deletion and repair at chromosome ends. De novo telomere synthesis and telomere capture are used to repair terminal deletions; non-homologous end-joining or microhomology-mediated break-induced replication is probably involved in ring 22 formation and translocations; non-homologous end-joining and fork stalling and template switching prevail in cases with interstitial 22q13.3. For the first time, we also demonstrated that distinct stabilizing events of the same terminal deletion can occur in different early embryonic cells, proving that terminal deletions can be repaired by multistep healing events and supporting the recent hypothesis that rare pathogenic germline rearrangements may have mitotic origin. Finally, the progressive clinical deterioration observed throughout the longitudinal medical history of three subjects over forty years supports the hypothesis of a role for SHANK3 haploinsufficiency in neurological deterioration, in addition to its involvement in the neurobehavioral phenotype of PMS

Solid Organ Transplantation During COVID-19 Pandemic: An International Web-based Survey on Resources’ Allocation

Background. Solid organ transplants (SOTs) are life-saving interventions, recently challenged by coronavirus disease 2019 (COVID-19). SOTs require a multistep process, which can be affected by COVID-19 at several phases. Methods. SOT-specialists, COVID-19-specialists, and medical ethicists designed an international survey according to CHERRIES guidelines. Personal opinions about continuing SOTs, safe managing of donors and recipients, as well as equity of resources' allocation were investigated. The survey was sent by e-mail. Multiple approaches were used (corresponding authors from Scopus, websites of scientific societies, COVID-19 webinars). After the descriptive analysis, univariate and multivariate ordinal regression analysis was performed. Results. There were 1819 complete answers from 71 countries. The response rate was 49%. Data were stratified according to region, macrospecialty, and organ of interest. Answers were analyzed using univariate- multivariate ordinal regression analysis and thematic analysis. Overall, 20% of the responders thought SOTs should not stop (continue transplant without restriction); over 70% suggested SOTs should selectively stop, and almost 10% indicated they should completely stop. Furthermore, 82% agreed to shift resources from transplant to COVID-19 temporarily. Briefly, main reason for not stopping was that if the transplant will not proceed, the organ will be wasted. Focusing on SOT from living donors, 61% stated that activity should be restricted only to "urgent"cases. At the multivariate analysis, factors identified in favor of continuing transplant were Italy, ethicist, partially disagreeing on the equity question, a high number of COVID-19- related deaths on the day of the answer, a high IHDI country. Factors predicting to stop SOTs were Europe except-Italy, public university hospital, and strongly agreeing on the equity question. Conclusions. In conclusion, the majority of responders suggested that transplant activity should be continued through the implementation of isolation measures and the adoption of the COVID-19-free pathways. Differences between professional categories are less strong than supposed