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Healthcare workers (HCWs) not fulfilling the coronavirus disease 2019 (COVID-19) case definition underwent severe acute respiratory coronavirus virus 2 (SARS-CoV-2) screening. Risk of exposure, adherence to personal protective equipment (PPE), and symptoms were assessed. In total, 2,000 HCWs were screened: 5.5% were positive for SARS-CoV-2 by polymerase chain reaction (PCR). There were no differences in PPE use between SARS-CoV-2–positive and –negative HCWs (adherence, >90%). Nursing and kitchen staff were independently associated with positive SARS-CoV-2 results.
The rate of bleeding complications following arterial switch operation is too low to independently justify a prospective randomised study for benefit from recombinant factor VIIa. We aimed to evaluate factor VIIa in a pilot study.
We performed a retrospective cohort study of patients undergoing arterial switch operation from 2012 to 2017. Nearest-neighbour propensity score matching on age, gender, weight, and associated cardiac defects was used to match 27 controls not receiving recombinant factor VIIa to 30 patients receiving recombinant factor VIIa. Fisher’s exact test was performed to compare categorical variables. Wilcoxon’s rank-sum test was used to compare continuous variables between cohorts.
Post-operative thrombotic complications were not associated with factor VIIa administration (Odds Ratio (OR) 0.28, 95% CI 0.005–3.77, p = 0.336), nor was factor VIIa administration associated with any re-explorations for bleeding. No intraoperative transfusion volumes were different between the recombinant factor VIIa cohort and controls. Post-operative prothrombin time (10.8 [10.3–12.3] versus 15.9 [15.1–17.2], p < 0.001) and international normalised ratio (0.8 [0.73–0.90] versus 1.3 [1.2–1.4], p < 0.001]) were lower in recombinant factor VIIa cohort relative to controls.
In spite of a higher post-bypass packed red blood cell transfusion requirement, patients receiving recombinant factor VIIa had a similar incidence of bleeding post-operatively. With no difference in thrombotic complications, and with improved post-operative laboratory haemostasis, a prospective randomised study is warranted to evaluate recombinant factor VIIa.
Review a single-centre experience with pulmonary artery sling repair and evaluate risk factors for re-intervention.
Patients with surgically repaired pulmonary artery sling at a single institution between 1996 and 2018 were retrospectively reviewed. A univariate Cox regression analysis was used to evaluate variables for association with freedom from re-intervention.
Eighteen patients had pulmonary artery sling repair. At operation, median age and weight were 6.9 months (interquartile range 4.1–18.1) and 9.5 kg (interquartile range 6.5–14.5), respectively. A median hospital length of stay was 12 days (interquartile range 5.8–55.3). Twelve patients (67%) had complete tracheal rings, of whom six (50%) underwent tracheoplasty (five concurrently with pulmonary artery sling repair). Airway re-intervention was required in five (83%) of the six patients who underwent tracheoplasty. One patient had intraoperative diagnosis and repair of pulmonary artery sling during unrelated lesion repair and required tracheoplasty 24 days post-operatively. One patient died 55 days after pulmonary artery sling repair and tracheoplasty following multiple arrests and re-interventions. Median post-operative follow-up for surviving patients was 6.3 years (interquartile range 11 months–13 years), at which time freedom from re-intervention was 61%. When controlling for patient and tracheal size, initial tracheoplasty was associated with decreased freedom from re-intervention (hazard ratio 21.9, 95% confidence interval 1.7–284.3, p = 0.018).
In patients with pulmonary artery sling, tracheoplasty is associated with decreased freedom from re-intervention. In select patients with pulmonary artery sling and complete tracheal rings, conservative management without tracheoplasty is feasible. Further study is necessary to delineate objective indications for tracheoplasty.
Brain derived neurotrophic factor (BDNF) is the most widely distributed and highly expressed neurotrophin in the CNS. BDNF gene have been associated with increased risk psychiatric disorders. It has been described interaction between BDNF and serotonin system at a neural and genetic level. Neuroticism as a personality trait relevant in borderline personality disorder (BPD) has genetic inheritance and is associated with serotonergic dysfunction. Has been reported that BDNF Val66Met variant is associated with neuroticism in general population. The aim of this study is to test the association between Val66Met and neuroticism and evaluate if the presence of Val66Met allele interacts with polymorphism in promoter region of serotonin transporter gene (5-HTTLPR) for develop neuroticism in BPD. We evaluate personality with NEO PI R in 104 BPD subjects that did not meet criteria for axis I diagnoses and other personality disorders. Genetic analysis of BDNF was performed determining the presence of Val/Val Val/Met and Met/Met BDNF variants. 5-HTTLPR was performed determining the presence of L and S 5-HTTLPR alleles. Statistical analysis were tested with parametric and correlation method with Stata10. We did not found differences in neuroticism between BDNF variants, but when controlled by BDNF alleles we found that Met/Met modulate the expression of 5-HTTLPR, with S-carriers (LS+SS) having higher neuroticism than LL (F = 6.36, p = 0.0031). We found no differences in expression of 5-HTTLPR in other BDNF variants. We conclude that BDNF have a differential modulating effect of 5-HTTLPR in neuroticism in BPD.
Neuroticism is characterized by emotional instability and the tendency to experience negative emotions such as anger, anxiety and depressed mood. Subjects with borderline personality disorder (BPD) present this personality dimension as a temperamental core trait. There has been proposed that neuroticism can appropriately describe the most important characteristics of BPD. The polymorphism in the promoter region of the serotonin transporter gene (5-HTTLPR) has been implicated in depression, anxiety and suicide. It is estimated that 5-HTTLPR polymorphism account to 7 to 9% of inherited variance of neuroticism in personality. The aim of this study is to evaluate the association between neuroticism and 5-HTTLPR polymorphism in BPD. We evaluate personality with NEO PI R inventory in 104 BPD subjects (76 female/28 male) that did not meet criteria for axis I diagnoses and other personality disorders. The genetic analysis of 5-HTTLPR were performed determining the presence of long and short alleles, subjects were grouped in long/long (LL) and S-carriers (LS+SS). Statistical analysis were tested with parametric and correlation method with Stata10. We found significant difference in neuroticism between the genotype groups (F = 8.57, p = 0.0004) and lower levels of neuroticism in LL than S-carriers. Female have higher neuroticism than male. 5-HTTLPR polymorphism explains 18.02% of inherited variance in neuroticism. The S-carriers had 11.9 times higher risk of presenting elevated neuroticism compared with LL. We conclude that there are relation between 5-HTTLPR polymorphism and neuroticism in BPD. These results should contribute to the genetic study of BPD.
To test whether firstly, different parental rearing components were associated with different dimensions of psychiatric symptoms in adulthood, secondly BDNF-Val66Met polymorphism moderated this association and thirdly, this association was due to genetic confounding.
Perceived parental rearing according to Parental Bonding Instrument (PBI), psychiatric symptoms evaluated with the Brief Symptom Inventory (BSI) and the BDNF-Val66Met polymorphism were analyzed in a sample of 232 adult twins from the general population.
In the whole sample, paternal care was negatively associated with depression. Maternal overprotection was positively associated with paranoid ideation, obsession-compulsion and somatization. Gene-environment interaction effects were detected between the BDNF-Val66Met polymorphism and maternal care on phobic anxiety, paternal care on hostility, maternal overprotection on somatization and paternal overprotection also in somatization. In the subsample of MZ twins, intrapair differences in maternal care were associated with anxiety, paranoid ideation and somatization.
Met carriers were, in general, more sensitive to the effects of parental rearing compared to Val/Val carriers in relation to anxiety and somatization. Contra-intuitively, our findings suggest that high rates of maternal care might be of risk for Met carriers regarding anxiety. Results from analyses controlling for genetic confounding were in line with this finding.
In schizophrenic patients the atypical antipsychotics are the first choice of treatment to avoid serious side effects of neuroleptics on D2 classic motor pathways, however, can cause a major disruption in weight, glucose homeostasis and lipid, resulting in the dreaded metabolic syndrome.
Showing that the combination of aripiprazole with clozapine is a very useful therapeutic option in patients with schizophrenia who have risk factors for developing metabolic disorders.
To increase the scientific literature to help the investigation of neuroleptic drugs free of metabolic risks.
We describe the case of a 22 year old male patient with paranoid schizophrenia affection of 3 years of evolution with the development of iatrogenic metabolic disorders.
The occurrence of overweight and diabetes incipient efforts aimed at minimizing the side effects of clozapine and improve neuropsychological performance. It starts with aripiprazole 5 mg/d up to 30 mg in 3 weeks. We maintain 250 mg dose of clozapine in the blood, decreasing the metabolic dysfunctions and improving the affective flattening.
Aripiprazole is a new generation drug that facilitates ad integrum restitution of premorbid function in psychotic patients.
We must continue research on this molecule and the like Receptor affinities which make them attractive to work in partnership with other antipsychotics with proven efficacy but devastating metabolic effects.
Several studies have suggested variations in the prevalence of schizophrenia spectrum disorders diagnosis across time. This could be due to a change in diagnostic practice motivated either for changes in DSM criteria as for local culture factors. The aim of this study is to explore the evolution of the schizophrenia spectrum disorders. We hypothesize that we would observe a transference from the schizophrenia diagnosis to psychosis not otherwise specified.
A retrospective review of all psychiatric discharges in acute unit in the INAD of Parc de Salut Mar of Barcelona, between 2002 and 2014 was performed, relating each discharge to its axis I psychiatric diagnostic. An ANOVA analysis was used to calculate the differences between the months and the frequency of the diagnosis.
We have not been able to observe any transference between diagnoses across years. We observe a decrease of the proportion of schizophrenic spectrum disorders in its prevalence at discharge from 2012 to 2014. The proportion of not otherwise specified psychosis remains quite constant as a third of the schizophrenia diagnoses.
Disclosure of interest
The authors report no conflict of interest in this study. LG is funded by the Instituto.de.Salud.Carlos.III (CM14/00111).
The use of ALG beads and ALG-ZEO beads for the removal of Cd2+ was evaluated in a batch system, was determined the effect of pH, kinetics and adsorption isotherm. The characterization was carried out by FTIR, SEM and EDS. The EDS analysis showed that the main elements are C, O and Ca, these are associated with the chemical composition of alginate while the ALG-ZEO bead showed characteristic crystals of the zeolite. Cd2+ adsorption was carried out at pH 6 using ALG beads and ALG-ZEO beads as adsorbent. The suggested mechanism to explain the removal of the Cd2+ ion was is through a chemisorption process. Finally the adsorption process was adjusted to kinetic and isotherm models.
The disease caused by the influenza virus is a global public health problem due to its high rates of morbidity and mortality. Thus, analysis of the information generated by epidemiological surveillance systems has vital importance for health decision making. A retrospective analysis was performed using data generated by the four molecular diagnostic laboratories of the Mexican Social Security Institute between 2010 and 2016. Demographics, influenza positivity, seasonality, treatment choices and vaccination status analyses were performed for the vaccine according to its composition for each season. In all cases, both the different influenza subtypes and different age groups were considered separately. The circulation of A/H1N1pdm09 (48.7%), influenza A/H3N2 (21.1%), influenza B (12.6%), influenza A not subtyped (11%) and influenza A/H1N1 (6.6%) exhibited well-defined annual seasonality between November and March, and there were significant increases in the number of cases every 2 years. An inadequate use of oseltamivir was determined in 38% of cases, and the vaccination status in general varied between 12.1 and 18.5% depending on the season. Our results provide current information about influenza in Mexico and demonstrate the need to update both operational case definitions and medical practice guidelines to reduce the inappropriate use of antibiotics and antivirals.
The aim of this randomized clinical trial follow-up at three months was to evaluate the effectiveness of an educational intervention with a focus on diet and physical activity (PA) to change the amount of PA, body mass index (BMI) and the waist circumference (WC) in patients with severe mental illness.
We recruited 332 outpatients with severe mental disorders undergoing treatment with antipsychotic medication from Mental Healthcare Centers of Barcelona. They were randomly assigned to an intervention or a control group. The patients in the intervention group participated in a group PA and diet educational program. The blinded measurements at 0 and 3 months were: the level of PA (IPAQ questionnaire), BMI, WC, blood pressure, dietary habits (PREDIMED questionnaire), quality of life (SF-36 questionnaire) and laboratory parameters (cholesterol, triglycerides, glucose).
The average age was 46.7 years and 55% were males. Schizophrenia had been diagnosed in 67.1% of them. At 3 months, the average weekly walking METs rose significantly in the IG 266.05 METs (95%CI: 16.86 to 515.25; P = 0.036). The total MET average also rose although not significantly: 191.38 METs (95%CI: 1.38 to 381.38; P = 0.086). However, the BMI decreased significantly more in the CG, by 0.26 kg/m2 (95%CI: 0.02 to 0.51; P = 0.038), than in the IG. There were no significant differences in the WC.
The short-term results suggest that the intervention increases the level of PA, but does not improve physical or laboratory parameters.
Clinicaltrials.gov NCT01729650 (effectiveness of a physical activity and diet program in patients with psychotic disorder [CAPiCOR]).
Understanding the biological parameters of some triatomine subspecies of Meccus phyllosomus (Burmeister) is a crucial first step in estimating the epidemiological importance of this group. Biological parameters related to egg eclosion, egg-to-adult development time, number of blood meals to moult, percentage of females at the end of the cycle, number of laid eggs, and the accumulative mortality for each instar of three M. phyllosomus subspecies [Meccus phyllosomus pallidipennis (Stål), Meccus phyllosomus longipennis (Usinger), and Meccus phyllosomus picturatus (Usinger)] as well as their laboratory hybrids were evaluated and compared. No significant differences (P > 0.05) were recorded among the experimental hybrids (M. p. longipennis × M. p. pallidipennis, M. p. longipennis × M. p. picturatus, M. p. pallidipennis × M. p. picturatus) and reciprocal cohorts. In five of the six studied parameters (egg eclosion, egg-to-adult development time, number of blood meals to moult, number of laid eggs and accumulative mortality), with the exception of the non-significant percentage of females obtained among all the studied cohorts, at least one of the parental cohorts in each set of crosses exhibited better fitness results than by those of their hybrid descendants. The lack of hybrid fitness in our study indicates the maintenance of reproductive isolation of parental genotypes. Moreover, the results lead us to propose that an incipient speciation process by distance is currently developing among the three studied subspecies, increasing the differences between them that modify the transmission efficiency of Trypanosoma cruzi to human beings in Mexico.
One of the most severe extinction events in Earth history, the Triassic–Jurassic extinction, struck against a backdrop of radical increases in atmospheric CO2 and supercontinent breakup. This juxtaposition of first-order geophysical and biotic changes produced excellent case studies in Earth-Life Transitions. Recent recognition of a worldwide “carbonate gap” following the extinction has focused attention on causes, often invoked as eustacy or ocean acidification, but the ecology of the extinction aftermath remains poorly understood. Results from paleoecological studies on three separate Triassic–Jurassic records are presented and incorporated into regional depositional models. Examination of the Penarth Group of Great Britain reveals a widespread, laterally homogenous, level-bottom microbial stromatolite regime across the innermost ramp. The Sunrise Formation in Nevada, USA, was deposited during a biosiliceous (“glass”) regime dominated by demosponges across the inner ramp that lasted at least two million years. Investigations of the Pucará group in the central Andes of Peru revealed a demosponge-dominated level-bottom glass ramp with many similarities to the Nevada deposits, but offering broader regional extent and variation in recorded depositional settings. This suite of studies demonstrates state-shifts in marine ecological systems that also profoundly altered regional sedimentation regimes. The sponge-dominated systems produced glass ramp conditions instead of carbonate ramps, and indicate the importance of marine silica concentrations. The post-extinction changes in regional marine ecology demonstrate connectivity to changes in global climate and terrigenous weathering driven by global-scale geophysical processes.
Neurological pathologies and nerve damage are two problems of significant medical and economic impact because of the hurdles of losing nerve functionality in addition to significant mortality and morbidity, and demanding rehabilitation. There are currently a number of examples of how nanotechnology can provide new solutions for biomedical problems. Current strategies for nerve repair rely on the use of functionalized scaffolds working as “nerve guidance channels” to improve axonal regeneration and to direct axonal re-growth across the nerve lesion site. Since low invasiveness and high selectivity of the growth stimulation are usually conflicting requirements, new approaches are being pursued in order to overcome such limitations. Engineered magnetic nanoparticles (MNPs) have emerged from this need for noninvasive therapies for both positioning and guiding neural cells in response to an external magnetic field. Here, we review the current state of the use of MNPs for neuroprotective and magnetically guided therapies. We discuss some conceivable outcomes of current magnetically driven strategies seeking integrated platforms for regenerative action on damaged tissues.
In this paper the spore-crystal complex of Bacillus thuringiensis var. israelensis (Bti) was immobilized by the sol-gel process in a hybrid polymer using as precursors the inorganic tetraethyl orthosilicate (TEOS) and the organic Polydimethylsiloxane (PDMS); in order to combine the advantages of both materials in a hybrid matrix to improve aspects such as the thermal stability, the hydrophobic properties and the porosity. Bti produces different crystals during sporulation phase; these are of protein nature and are used as bio-insecticides. It is important to mention that the insecticide attack is specific to the mosquito larva that causes dengue and black flies. The samples were characterized to ensure viability by performing growth kinetics with fermentations immersed in a flask, this microbial growth was monitored by dry weight, glucose consumption and characterized by Fourier Transform Infrared Spectroscopy (FTIR) to observe the interaction of materials with spore-crystal complex.
The density, Vickers microhardness and crystallization fraction of glass-ceramic materials synthesized from parent glasses are determined in which CaO is gradually substituted by SrO. The chemical composition (in mol.%) of the parent glasses is 54SiO2-(23-X)CaO-12MgO-5Al2O3-6CaF2-XSrO, where X is the employed CaO substitution level (X = 0, 3, 6 and 9 mol.%, with X = 0 corresponding to the reference material). In order to determine the type of crystallization occurring in the glass-ceramic samples, as well as the crystalline phases formed in them, these are characterized by both Scanning Electron Microscopy (SEM/EDS) and X-Ray Diffraction (XRD). Independently of the CaO substitution level employed, the glass-ceramics show the formation of a solid solution corresponding to diopside-type pyroxene, with chemical formula Ca(Mg,Al)(Al,Si)2O6, as a single crystalline phase. The synthesized glass-ceramic materials with the reference composition show the highest Vickers microhardness and crystallization fraction, as well as the lowest density.
Osteoarthritis is a very complex illness of the joints that affects cartilage and subcondral bone. At the last years, researching has been focused in the development and characterization of composite materials, evaluating their structural properties. Some o those composite materials are constituted by organic and inorganic compounds forming hybrids. These materials can improve their properties due to the interaction of reinforcement hard particles in the polymeric matrix. The interest on the composite biomaterials has been increased on the biomedical applications such as tissue regenerating based in synthetic polymers with biodegradable and biocompatible properties whose can be reinforced by calcium phosphates. In this sense, hydroxyapatite [Ca10(PO4)6(OH)2] is often used for biological implants due its mineral phase similitude with bone microstructure and tissue compatibility. Similarly, polylactic acid (PLA) is a used polymer for implant applications due physicochemical and biocompatibility properties, and short degradation time also. In order to obtain a composite that can be used as a regenerating material on the osteoarthritis problem, in this work a (90/10 wt.%) polylactic/hydroxyapatite hybrid composite was produced by chemical synthesis and characterized by X-ray diffraction, SEM, FT-IR and TGA/DSC techniques.