4 research outputs found
Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2
The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality
Caracterización clínica y genética de las ataxias hereditarias en una muestra de pacientes
IP 1203-04-149-98Incluye anexos.: Londres, Inglaterra). -- Londres. -- p. -- 28 cm. -- Molecularanalysisof spinocerebellar ataxia types;PONENCIA(S) EN CONGRESO: Intra and interrater reliabilityof theinternational cooperative ataxia rating;scale (ICARS) / Mariluz Gomez Rodriguez. ... [et. al]. --En:World Congress of Neurology (17 2001 Jun : 17-22;1,2,3,6,7, and 8 genes in a Colombian / Mariluz Gomez Rodriguez.... [et.al]. -- En: World Congress of;Neurology (17 2001 Jun : 17-22 : Londres, Inglaterra). --Londres. -- p. -- 28 cm. -- Reaction (RT) and;movement time (MT) in cerebellar atrophy: differences betweenlegs and arms / Mariluz Gomez Rodriguez. ...;[et. al]. -- En: World Congress of Neurology (17 2001 Jun: 17-22 : Londres, Inglaterra). -- Londres. -- p. --;28 cm. -- ARTICULO(S) EN REVISTA: Moleclar analysis of spinocerebellar ataxia types 1,2,3,6,7, and 8 genes in;a Colombian population / Olga Lucia Pedraza. ... [et. al].--En: Journalof Neurosurgery: Spine Journal of;Neurosurgery: spine. -- Vol. 187, sup. 1. (Jun 2001); p. S517.-'- Intra and interrater reliability of the;international cooperative ataxia rating scale (ICARS) / Olga Lucia Pedraza. ... [et. al]. -- En: Journal of;Neurosurgery: Spine Journal of Neurosurgery: spine. -- Vol. 187sup. 1. (Jun 2001); p. S515. -- Reaction (RT);and movement time (MT) in cerebellar atrophy: differencesbetween legs andarms / Olga Lucia Pedraza. ... [et.;al]. -- En: Journal of Neurosurgery: Spine Journal of Neurosurgery: spine.-- Vol. 187, sup. 1. (Jun 2001); p.;S518
MoCA and MMSE scores in patients with mild cognitive impairment and dementia in a memory clinic in Bogotá
Introducción. Diferentes pruebas neuropsicológicas permiten explorar las funciones cognitivas del adulto mayor,
en un tiempo corto. En Colombia se dispone de pocos estudios sobre puntuaciones y puntos de corte para el
MMSE y para el MoCA en relación al diagnóstico de deterioro cognitivo.
Objetivo. Describir la distribución de las puntuaciones del MMSE y el MoCA y los puntos de corte con mejor
discriminación, para el diagnóstico de deterioro cognitivo leve y demencia, en una muestra de pacientes de Bogotá.
Material y métodos. Se evaluaron 248 pacientes por un equipo multidisciplinario, que consultaron a la Clínica
de Memoria del HIUSJ entre 2009-2012, siguiendo un protocolo establecido. Se identificaron las puntuaciones del
MoCA y MMSE, que permitieron obtener el mayor porcentaje de pacientes correctamente clasificados.
Resultados. En el 70% de los pacientes con DCL y en el 69 % de los sujetos normales, se encontraron puntuaciones
del MMSE inferiores o iguales a 28. En 91% de pacientes con DCL y 84% de los sujetos normales,
se presentaron puntuaciones del MoCA inferiores o iguales a 25. Los pacientes con cualquier tipo de demencia,
presentaron puntuaciones del MMSE inferiores o iguales a 27 e inferiores o iguales a 24 en el MoCA.
Conclusión. Según el presente estudio, el tamizaje de funciones cognitivas, utilizando el MoCA, clasifica de manera
más acertada que el MMSE, a los sujetos con deterioro cognitivo. Creemos que en atención primaria, estos puntos deIntroduction. Some cognitive tests allow the evaluation of cognitive functions on the elderly in a short period
of time. There are few studies in Colombia about cut-off point for the MMSE and the MoCA test.
Objectives. To describe the distribution on scores on MMSE and MoCA test and the cut-off point with a better
discrimination criteria for the diagnosis of mild cognitive impairment and dementia, in a sample of patients from
Bogotá.
Materials and Methods. Two hundred forty eight patients were included in this study, being evaluated by a
multidisciplinary team that followed an established protocol, on patients who attended to the Memory Clinic of
HIUSJ between 2009-2012. MoCA test and MMSE scores that allow higher percentages of correctly classified
patients were identified.
Results. Seventy percent of patients with mild cognitive impairment and 69% of normal individuals had scores
on MMSE below or equal to 28. Ninety-one percent of patients with MCI and 89% of normal patients, had
scores below or equal to 25. Patients with any type of dementia had scores on MMSE below or equal to 27 and
below or equal to 24 in MoCA test.
Conclusion. According to the study, the screening of cognitive functions, using MoCA test, is more accurate than
MMSE in patients with cognitive decline. The cut-off points, identified in our study, can be considered useful until
now in primary attention, in patients with a high level of education
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Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study
We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care