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Caregiver Burden in the Management of Frail Elderly Patients with Diabetes in Internal Medicine

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Health 2018年第10期10卷 1383-1391页

作者： jose Miguel Segui Ripoll Vicente Jesús Segui Llinares Miguel J.Reig Pérez Carles García Cervera Juan Manuel Núnez Cruz Pedro Esteve Atiénzar Sara Banón Escandell Alberto López Serrano mar.a Dolores Jover Ríos Juan Méndez Mora Carmen Segui Pérez mar.a josefa Navarro Navarro Pablo Roig Rico Department of Internal Medicine University Hospital of San JuanAlicanteSpain Department of Clinical Medicine Miguel Hernández UniversityElcheSpain Institute of Design and Manufacturing Polytechnic University of ValenciaCampus of AlcoyAlicanteSpain Department of Internal Medicine Hospital La Vega Baja of OrihuelaAlicanteSpain Secondary School Marist Brothers High SchoolAlicanteSpain Primary Medicine BenillobaSpain

Aim: Advanced age and fragility often lead to dependence, making caregiver assistance necessary for performing the activities of daily living. Patients with diabetes are characterized by an elevated presence of comorbidities and subsequent frailty—a relevant consideration when making decisions regarding treatment goals. Health professionals may overlook the caregiver experience when assessing the circumstances surrounding frail elderly patients with diabetes, but this factor can have a large impact on relevant caregiver and patient outcomes. Methods: An observational, retrospective study was carried out to assess the impact of improved management in diabetes on caregiver burden. We assessed patients’ performance of activities of daily living using the Barthel scale. Our primary outcome was caregiver burden, as assessed using the Zarit scale. Results: At baseline, 81.4% of the caregivers reported severe overburden (>55 points on the Zarit scale). At three months, the proportion of caregivers reporting this level of burden had dropped to 76.7% and remained stable at six months (77.1%). In contrast, 8.5% of the caregivers reported moderate overburden (47 to 55 points) at baseline, compared to 13.3% at three months and 12.5% at six. The proportion of caregivers reporting no overburden (Conclusions: Caregiver burden remained persistently high, decreasing only slightly after six months.

关键词： Elderly Diabetes Frail Patient Overload Caregiver

Unlocking the in vitro anti-Trypanosoma cruzi activity of halophyte plants from the southern Portugal

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Asian Pacific Journal of Tropical Medicine 2016年第8期9卷 714-719页

作者： mar.a Oliveira Policarpo Ademar Sales Junior mar.a Joao Rodrigues marina DellaGreca Luisa Barreira Silvane mar.a Fonseca Murta Alvaro jose Romanha Luisa Custodio Center of marine Sciences (CCmar) University of AlgarveCampus de Gambelas 8005-139 FaroPortugal Centro de Pesquisas Rene Rachou FIOCRUZ Belo HorizonteMinas GeraisBrazil Dipartimento di Chimica Organica e Biochimica Universita` Federico Ⅱ Complesso Universitario Monte Sant'AngeloVia Cintia 4I-80126NapoliItaly

Objective:To evaluate the in vitro anti-Trypanosoma cruzi（***） activity of organic extracts prepared from halophyte species collected in the southern coast of Portugal（Algarve）,and chemically characterize the most active ***:Acetone,dichloromethane and methanol extracts were prepared from 31 halophyte species and tested in vitro against trypomastigotes and intracellular amastigotes of the Tulahuen strain of *** most active extract was fractionated by preparative HPLC-DAD,affording 11 *** most selective fraction was fully characterized by ***:From 94 samples tested,one was active,namely the root dichloromethane extract of Juncus acutus(IC50 < 20 μg/mL).This extract was fractionated by HPLC,affording 11 fractions,one of them containing only a pure compound（juncunol）,and tested for anti-parasitic *** 8(IC50 = 4.1 μg/mL) was the most active,and was further characterized by *** major compounds were phenanthrenes,9,10-dihydrophenanthrenes and ***:Our results suggest that the compounds identified in fraction 8 are likely responsible for the observed anti parasitic *** research is in progress aiming to isolate and identify the specific active *** the best of our knowledge,this is the first report on the in vitro anti *** activity of halophyte species.

关键词： Chagas disease Halophytes Trypanosoma cruzi Phenanthrenes Juncunol

Selective Fetal Growth Restriction in MonochorionicDiamniotic Twins: Diagnosis and Management:Erratum

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Maternal-Fetal Medicine 2023年第1期5卷 57-57页

作者： Zumaeta, Alicia Mazer mar Gil, mar.a Rodriguez-Fernandez, Miguel Carretero, Pilar Hector Ochoa, jose Cristina Casanova, mar.a Sonia Molina, Francisca Hosp Univ Clin San Cecilio Dept Obstet & Gynecol Granada 18016 Spain Hosp Materno Prov Dr Raul Felipe Lucini Dept Obstet & Gynecol RA-5000 Cordoba Argentina Diagnus SA Prenatal Diag & Fetal Med Ctr RA-5000 Cordoba Argentina Inst Invest Biosanitaria Ibs GRANADA Granada 18016 Spain Hosp Univ Torrejon Obstet & Gynecol Dept Madrid 28223 Spain Univ Francisco Vitoria Sch Med Madrid 28223 Spain

Following the original article’s publication,1the authors identified an error in the published *** authors and institution section should be corrected as follows:Alicia Mazer Zumaeta1,2,3,mar.amarGil4,5,*,Miguel Rod... 详细信息

关键词： institution corrected Management

The macrophage soluble receptor AIM/Api6/CD5L displays a broad pathogen recognition spectrum and is involved in early response to microbial aggression

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Cellular & Molecular Immunology 2014年第4期11卷 343-354页

作者： Vanesa G. martinez Cristina Escoda-Ferran Ines Tadeu Simees Satoko Arai marc Orta Mascaro Esther Carreras mario martinez-Florensa jose Yelamos Toru Miyazaki Francisco Lozano Grup d'Immunoreceptors del Sistema Innat i Adaptatiu Institut d'Investigacions Biomediques August Pii Sunyer (IDIBAPS) Barcelona Spain Center for Disease Biology and Integrative Medicine Faculty of Medicine University of Tokyo Tokyo Cancer Research Program Hospital del Mar Medical Research Institute and Department of Immunology Hospital del Mar Barcelona Spain Servei d'Immunologia Centre de DiagnOstic Biomedic Hospital Clinic Barcelona Barcelona Spain Departament de Biologia Cellular Immunologia i Neurociencies Facultat de Medicina Universitat de Barcelona Barcelona Spain

Apoptosis inhibitor of macrophages （AIMs）, a homologue of human Spa, is a mouse soluble member of the scavenger receptor cysteine-rich superfamily （SRCR-SF）. This family integrates a group of proteins expressed by innate and adaptive immune cells for which no unifying function has yet been described. Pleiotropic functions have been ascribed to AIM, from viability support in lymphocytes during thymic selection to lipid metabolism and anti-inflammatory effects in autoimmune pathologies. In the present report, the pathogen binding properties of AIM have been explored. By using a recombinant form of AIM （rAIM） expressed in mammalian cells, it is shown that this protein is able to bind and aggregate Gram-positive and Gram-negative bacteria, as well as pathogenic and saprophytic fungal species. Importantly, endogenous AIM from mouse serum also binds to microorganisms and secretion of AIM was rapidly induced in mouse spleen macrophages following exposure to conserved microbial cell wall components. Cytokine release induced by well-known bacterial and fungal Toll-like receptor （TLR） ligands on mouse splenocytes was also inhibited in the presence of rAIM. Furthermore, mouse models of pathogen-associated molecular patterns （PAMPs）-induced septic shock of bacterial and fungal origin showed that serum AIM levels changed in a time-dependent manner. Altogether, these data suggest that AIM plays a general homeostatic role by supporting innate humoral defense during pathogen aggression.

关键词： innate immunity pattern recognition receptor scavenger receptor

Culture Mixed-Sex and Monosex of Tilapia in Ponds in Mexico City

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Agricultural Sciences 2015年第2期6卷 187-194页

作者： jose Luis Gomez-Márquez Bertha Pena-Mendoza mar.a del Carmen Alejo-Plata jose Luis Guzmán-Santiago Laboratorio de Limnología Facultad de Estudios Superiores ZaragozaUniversidad Nacional Autónoma de MéxicoMéxicoD.F.México Campus Puerto Angel Universidad del MarCiudad UniversitariaPuertoángelMéxico

In this study, the growth of Oreochromis niloticus both mixed sex and males sexually reversed were analyzed in concrete ponds in the FES Zaragoza, UNAM, under the environmental conditions of the Mexico City. The experiment was carried from May to November 2013, in two concrete ponds of 50 m2. Similar feeding regime and stocking density of fish were maintained for the culture systems. Different growth parameters like body weight, length, daily weight gain (DWG), specific growth rate (SGR), feed conversion rate (FCR), Fulton’s condition index (K) and survival were analyzed during six months culture period. It was found that culture with monosex males tilapias yielded the highest weight, length, DWG and SGR compared to mixed sex populations tilapias. Water quality was monitored along the experiment. Based on the results, there were statistically significant differences in size (W = 20942.5, p 5 mg/L), warm water (>20°C), productive (3) and slightly basic (pH > 8). Acceptable growth of fish and a yield of 3 ton/ha/6 months were obtained in both two ponds;therefore, the culture of tilapia under conditions of Mexico City was recommended.

关键词： Tilapia Culture Growth Survival Mexico City

More Erratic and More Extreme: Trends in Precipitation in the State of São Paulo, Brazil

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American Journal of Climate Change 2023年第1期12卷 140-171页

作者： Lucí Hidalgo Nunes Guilherme Henrique Gabriel jose A. marengo Universidade do Estado do Rio de Janeiro (UERJ) Rio de Janeiro Brasil Universidade Estadual de Campinas (UNICAMP) São Paulo Brasil Centro Nacional de Monitoramento e Alertas de Desastres Naturais (CEMADEN) São José dos Campos Brazil

The study assessed changes in rainfall variability and the frequency of extreme events (very wet and very dry) in the state of S?o Paulo, Brazil, for a 40-year period that divided into two sub-groups: 1973-1992 (P1) and 1993-2012 (P2). Data of 79 rain gauge stations were selected to represent the different climatic and geomorphological domains of the state. The annual pattern was evaluated through the scale and the shape parameters of the gamma distribution and the 95th and the 5th percentiles thresholds, the latter also employed to evaluate the seasonal spatial patterns (rainy season, Oct.-mar. and sub-humid to dry season, Apr.-Sep.). Results showed that the average precipitation was similar in P1 and P2, but S?o Paulo evolved to a pattern of increased irregularity in the rainfall distribution, with a rise of approximately 10% in the number of extremes between 1973 and 2012, especially in the very dry occurrences, and in the north and west of the state, which are the least rainy regions. Moreover, while 55% of the evaluated rain gauges recorded more extreme wet episodes in P2, 76% registered more dry extreme episodes in the same period. Some very dry or very wet events recorded after the 40-year period evaluated were discussed in terms of the associated weather patterns and their impacts on society and attested to the validity of the results found in the quantitative assessment. The qualitative analysis indicates that if the trends of more irregular distribution of rain and increase in extreme events persist, as pointed out by the gamma and percentile analyses, they would continue to bring serious effects on the natural and social systems in the state, which is the most populous and has the strongest and most diversified economy in Brazil.

关键词： Rainfall Extremes São Paulo Gamma Distribution Percentiles Impacts

Aplastic anemia and severe pancytopenia during treatment with peg-interferon,ribavirin and telaprevir for chronic hepatitis C

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World Journal of Gastroenterology 2015年第17期21卷 5421-5426页

作者： Sabela Lens jose L Calleja Ana Campillo jose A Carrion Teresa Broquetas Christie Perello Juan de la Revilla Zoe marino mar.a-Carlota Londono jose M Sanchez-Tapias Alvaro Urbano-Ispizua Xavier Forns Liver Unit Hospital ClinicIDIBAPSCIBERehd08036 BarcelonaSpain Liver Unit Hospital Puerta del HierroIDIPHIMCIBERehd28222 MajadahondaMadridSpain Gastroenterology Department Hospital Reina Sofia31500 TudelaNavarraSpain Liver Unit Hospital Del MarIMIMCIBERehd08003 BarcelonaSpain Hematology Unit Hospital Clinic08036 BarcelonaSpain

Telaprevir and Boceprevir are the first direct acting antivirals approved for chronic hepatitis C in combination with peg-interferon alfa and *** due to myelotoxicity caused by these drugs may occur,but severe hematological abnormalities or aplastic anemia(AA) have not been *** collected all cases of severe pancytopenia observed during triple therapy with telaprevir in four Spanish centers since approval of the drug in *** 142 cirrhotic patients receiving treatment,7 cases of severe pancytopenia(5%) were identified and three were consistent with the diagnosis of *** age was 59 years,five patients had compensated cirrhosis and two patients had severe hepatitis C recurrence after liver *** pancytopenia was diagnosed a median of 10 wk after the initiation of *** patients had pre-treatment hematological abnormalities related to *** six patients,antiviral treatment was interrupted at the onset of hematological *** patients died due to septic complications and one patient due to acute alveolar *** remaining patients *** pancytopenia and especially AA,are not rare during triple therapy with telaprevir in patients with advanced liver *** monitoring is imperative in this setting to promptly detect serious hematological disorders and to prevent further complications.

关键词： Aplastic anemia Hepatitis C Telaprevir Interferon Protease inhibitors

A prospective study of patient reported urinary incontinence among American, Norwegian and Spanish men 1 year after prostatectomy

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Asian Journal of Urology 2020年第2期7卷 161-169页

作者： Anne Holck Storas martin GSanda Olatz Garin Peter Chang Dattatraya Patil Catrina Crociani jose Francisco Suarez Milada Cvancarova Jon Havard Loge Sophie DFossa Department of Oncology Oslo University HospitalThe Norwegian Radium HospitalOsloNorway Department of Urology Emory University HospitalAtlantaUSA IMIM Hospital del mar Medical Research Institute CIBER en Epidemiologıa y Salud PublicaCIBERESPUniversitat Pompeu FabraBarcelonaSpain Beth Israel Deaconess Medical Center Harvard Medical SchoolBostonUSA Emory University Hospital AtlantaUSA Hospital Universitary de Bellvitge BarcelonaSpain University of Oslo OsloNorway

Objective:To compare pre-and post-radical prostatectomy(RP)responses in the urinary incontinence domain of Expanded Prostate Cancer Index Composite-26(EPIC-26)in cohorts from the USA,Norway and ***:A prospective study of pre-and 1-year post-treatment responses in American(nZ537),Norwegian(nZ520)and Spanish(nZ111)patients,establishing the prevalence of urinary incontinence defined according to published *** we focused on the response alternatives“occasional dribbling”,pad use and problem experience.A multivariate logistic regression analysis(significance level≤0.01)considered risk factors for“not retaining total control”.

关键词： Prostate cancer Radical prostatectomy Urinary incontinence Adverse effects

Anemia in patients with high-risk acute coronary syndromes admitted to Intensive Cardiac Care Units

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Journal of Geriatric Cardiology 2020年第1期17卷 35-42页

作者： Victoria Lorente Jaime Aboal Cosme Garcia Jordi Sans-Rosello Antonia Sambola Rut Andrea Carlos Tomas Gil Bonet David Vinas Nabil el Ouaddi Santiago Montero Javier Cantalapiedra mar.arida Pujol Isabel Hernandez mar.a Perez-Rodriguez Isaac Llao jose C Sanchez-Salado Miquel Gual Albert Ariza-Sole 无 Hospital Universitari de Bellvitge L’Hospitalet de LlobregatBarcelonaSpain Hospital Unversitari josep Trueta GironaSpain Hospital Universitari Germans Trias i Pujol Badalona BarcelonaSpain Hospital de la Santa Creu i Sant Pau Instituto de Investigación Biomedica IIB Sant PauUniversitat Autonoma de Barcelona(UAB)BarcelonaSpain Hospital Universitari de la Vall d’Hebron BarcelonaSpain Hospital Clinic i Provicial BarcelonaSpain Hospital Arnau de Vilanova LleidaSpain Hospital Joan XXIII TarragonaSpain the Grup de Treball de Cures Agudes Cardiologiques de la Societat Catalana de Cardiologia

Background Little information exists about the role of anemia in patients with acute coronary syndromes(ACS)admitted to Intensive Cardiac Care Units(ICCU).The aim of this study was to assess the prevalence of anemia and its impact on management and outcomes in this clinical *** All consecutive patients admitted to eight different ICCUs with diagnosis of non-ST segment elevation ACS(NSTEACS)were prospectively *** was defined as hemoglobin<130 g/L in men and<120 g/L in *** association between anemia and mortality or readmission at six months was assessed by the Cox regression *** A total of 629 patients were *** age was 66.6 years.A total of 197 patients(31.3%)had *** angiography was performed in most patients(96.2%).Patients with anemia were significantly older,with a higher prevalence of comorbidities,poorer left ventricle ejection fraction and higher GRACE score *** with anemia underwent less often coronary angiography,but underwent more often intraaortic counterpulsation,non-invasive mechanical ventilation and renal replacement *** ICCU and hospital stay were significantly longer in patients with *** the incidence of mortality(HR=3.36,95%CI:1.43–7.85,P=0.001)and the incidence of mortality/readmission were significantly higher in patients with anemia(HR=2.80,95%CI:2.03–3.86,P=0.001).After adjusting for confounders,the association between anemia and mortality/readmission remained significant(P=0.031).Conclusions Almost one of three NSTEACS patients admitted to ICCU had *** patients underwent coronary *** was independently associated to poorer outcomes at 6 months.

关键词： Acute coronary syndromes Anemia Intensive cardiac care units Prognosis