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Latest developments in early diagnosis and specific treatment of severe influenza infection

journal of Intensive Medicine 2024年第2期4卷 160-174页

作者： Francisco Valenzuela-sánchez Blanca Valenzuela-Méndez Juan Francisco Rodríguez-Gutiérrez Ángel Estella Intensive Care Unit University Hospital of JerezRonda de Circunvalación s/nJerez de la FronteraSpain Haematology department University Hospital of JerezRonda de Circunvalación s/nJerez de la FronteraSpain centro de Investigación Biomédica en Red Enfermedades respiratoriasCIBERESInstituto de Salud Carlos IIIAv.de Monforte de LemosMadridSpain department of oncological surgery Institut du Cancer de Montpellier(ICM)Parc Euromédecine208 Av.des ApothicairesMontpellierFrance department of Medicine Faculty of MedicineUniversity of CádizCalle Doctor MarañónCádizSpain Instituto de Investigación e Innovación Biomédica de Cádiz(INIBiCA) Avenida Ana de Viya 21CádizSpain

Influenza pandemics are unpredictable recurrent events with global health,economic,and social *** objective of this review is to provide an update on the latest developments in early diagnosis and specific treatment of the disease and its complications,particularly with regard to respiratory organ *** advances in treatment,the rate of mortality in the intensive care unit remains approximately 30%.Therefore,early identification of potentially severe viral pneumonia is extremely important to optimize treatment in these *** pathogenesis of influenza virus infection depends on viral virulence and host ***,in some patients,it is associated with an excessive systemic response mediated by an authentic cytokine *** process leads to severe primary pneumonia and acute respiratory distress *** prognostication in the emergency department based on comorbidities,vital signs,and biomarkers(e.g.,procalcitonin,ferritin,human leukocyte antigen-DR,mid-regional proadrenomedullin,and lactate)is *** of these biomarkers on admission may facilitate clinical decision-making to determine early admission to the hospital or the intensive care *** decisions are reached considering pathophysiological circumstances that are associated with a poor prognosis(e.g.,bacterial co-infection,hyperinflammation,immune paralysis,severe endothelial damage,organ dysfunction,and septic shock).Moreover,early implementation is important to increase treatment *** on a limited level of evidence,all current guidelines recommend using oseltamivir in this *** possibility of drug resistance should also be *** options include other antiviral drugs and combination therapies with monoclonal ***,it is not recommended to use corticosteroids in the initial treatment of these ***,the implementation of supportive measures for respiratory failure is ***

关键词： Influenza Pandemic Respiratory failure Acute respiratory distress syndrome Intensive care unit admission

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Effect of music therapy on short-term psychological and physiological outcomes in mechanically ventilated patients:A randomized clinical pilot study

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journal of Intensive Medicine 2024年第4期4卷 515-525页

作者： Mark Ettenberger Rosangela Casanova-Libreros josefina Chávez-Chávez jose Gabriel Cordoba-silva William Betancourt-Zapata Rafael Maya Lizeth Alexa Fandino-Vergara Mario Valderrama Ingrid silva-Fajardo sandra Milena Hernández-Zambrano soNo-centro de Musicoterapia BogotáColombia Vice-Rectorate for Research Fundación Universitaria de Ciencias de la SaludBogotáColombia department of Biomedical Engineering University of Los AndesBogotáColombia department of Rehabilitation Sociedad de Cirugía de Bogotá Hospital de San JoséBogotáColombia Faculty of Nursing Fundación Universitaria de Ciencias de la SaludBogotáColombia

Background:Elevated anxiety levels are common in patients on mechanical ventilation(MV)and may challenge *** suggests music-based interventions may reduce anxiety during ***,studies inves-tigating specific music therapy techniques,addressing psychological and physiological well-being in patients on MV,are ***:This three-arm randomized clinical pilot study was conducted with MV patients admitted to the intensive care unit(ICU)of hospital san joséin Bogotá,Colombia between March 7,2022,and July 11,*** were divided into three groups:intervention group 1(IG1),music-assisted relaxation;intervention group 2(IG2),patient-preferred therapeutic music listening;and control group(CG),standard *** main outcome measure was the 6-item state-Anxiety *** outcomes were:pain(measured with a visual analog scale),resilience(measured with the Brief Resilience scale),agitation/sedation(measured with the Richmond Agitation-sedation scale),vital signs(including heart rate,blood pressure,oxygen saturation,and respiratory rate),days of MV,extubation success,and days in the ***,three patients underwent electroencephalography during the ***:Data from 23 patients were analyzed in this *** age range of the patients was 24.0-84.0 years,with a median age of 66.0 years(interquartile range:57.0-74.0).of the 23 patients,19 were female(82.6%).No statistically significant differences between the groups were observed for anxiety(P=0.330),pain(P=0.624),resilience(P=0.916),agitation/sedation(P=0.273),length of ICU stay(P=0.785),or vital signs.A statistically significant difference between the groups was found for days of MV(P=0.019).Electroencephalography mea-surements showed a trend toward delta and theta band power decrease for two patients and a power increase on both beta frequencies(slow and fast)in the frontal areas of the brain for one ***:In this pilot study,music therapy did not sig

关键词： Music therapy Mechanical ventilation Intensive care unit Anxiety Pain

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Dietary(poly)phenol intake is associated with cardiometabolic health parameters in adolescents

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Food science and Human Wellness 2024年

作者： Emily P.Laveriano-santos sara Castro-Barquero Camila Arancibia-Riveros Ana María Ruiz-León Rosa Casas Ramón Estruch Patricia Bodega Mercedes de Miguel Amaya de Cos-Gandoy Jesús Martínez-Gómez Gloria santos-Beneit Juan M.Fernández-Alvira Rodrigo Fernández-Jiménez Rosa M.Lamuela-Raventós Anna Tresserra-Rimbau The Zena and Michael A.Wiener Cardiovascular Institute， Icahn school of Medicine at Mount sinai department de Nutrició， Ciències de l'Alimentació I Gastronomia， XIA， Facultat de Farmàcia i Ciències de l'alimentació， Institut de Recerca en Nutrició i seguretat Alimentària (INsA-UB)， Universitat de Barcelona department of Internal Medicine， hospital Clínic， Institutd'Investigacions Biomèdiques August Pi I sunyer (IDIBAPs)， University of Barcelona Consorcio CIBER， M.P.Fisiopatología de la obesidad y Nutrición (CIBERobn)， Instituto de salud Carlos III (IsCIII) Mediterranean Diet Foundation 5. Foundation for science， Health and Education (sHE) 6. centro Nacional de Investigaciones Cardiovasculares (CNIC) CIBER de Enfermedades Cardiovasculares (CIBERCV) 9. hospital Universitario Clínico san Carlos

Background: The protective role of (poly)phenols against metabolic disorders has been extensively studied in adults but not in ***: To assess associations of dietary (poly)phenols and their subclasses with cardiometabolic health parameters in adolescents. Methods: A cross-sectional study was conducted in 944 individuals aged 11 to 14 years enrolled in the sI! Program for secondary schools trial (NCT03504059). (Poly)phenol intake was assessed using semi-quantitative food frequency questionnaires and the Phenol-Explorer database. The measured cardiometabolic parameters were waist circumference (WC) age-sex z-score， blood pressure (BP) age-sex z-score， blood glucose (BG)， triglycerides (TG)， and high-density lipoprotein cholesterol (HDL-c). Multilevel mixed-effect linear regression models were applied to examine the association between (poly)phenol quintiles and cardiometabolic health ***: Compared to the lowest quintile， adolescents in the highest quintile of total (poly)phenol intake had lower WC z-scores (β=-0.09， 95%CI=-0.09;-0.08， P-for trend=0.002)， mean arterial pressure z-scores (β =-0.11， 95%CI=-0.12;-0.09， P-for trend=0.206)， and HDL-c (β=-1.52， 95%CI=-2.90;-0.14， P-for trend=0.108)， after multivariable adjustment. The WC z-scores (β=-0.11， 95%CI=-0.19;-0.03， P-for trend=0.013) and HDL-c (β=-2.16， 95%CI=-3.78;-0.53， P-for trend=0.046) were lower in the highest quintile of flavonoid intake compared to the lowest quintile. The highest quintile of phenolic acid intake was associated with a lower WC z-score (β=-0.14， 95%CI=-0.26;-0.02， P-for trend=0.011) and TG levels (β=-8.83， 95%CI=-12.37;-5.30， P-for trend st quintile of stilbene intake with lower BG (β=-1.83， 95%CI= -3.103;-0.64， P-for trend or trend=0.034)， and with higher HDL-c (β=2.328， 95%CI= 1.40;3.17， P-for trend=0.466) compared to the lowest quintile. Conclusion: A higher intake of (poly)phenols， espe

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Liver manifestations and complications in inflammatory bowel disease:A review

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World journal of Hepatology 2021年第12期13卷 1956-1967页

作者： Rui Gaspar Catarina Castelo Branco Guilherme Macedo department of Gastroenterology and Hepatology Centro Hospitalar de São JoãoPorto 4200Portugal Internal Medicine department Centro Hospitalar e Universitário do PortoPorto 4200Portugal

Hepatobiliary manifestations are common in inflammatory bowel disease(IBD),with 30%of patients presenting abnormal liver tests and 5%developing chronic liver *** range from asymptomatic elevated liver tests to lifethreatening disease and usually follow an independent course from *** pathogenesis of liver manifestations or complications and IBD can be closely related by sharing a common auto-immune background(in primary sclerosing cholangitis,IgG4-related cholangitis,and autoimmune hepatitis),intestinal inflammation(in portal vein thrombosis and granulomatous hepatitis),metabolic impairment(in non-alcoholic fatty liver disease or cholelithiasis),or drug toxicity(in drug induced liver injury or hepatitis B virus infection reactivation).Their evaluation should prompt a full diagnostic workup to identify and readily treat all complications,improving management and outcome.

关键词： Hepatobiliary manifestations Inflammatory bowel disease Drug induced liver injury Primary sclerosing cholangitis Viral hepatitis Crohn's disease Ulcerative colitis

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Conscience imperative of providing information and knowledge in hepatology:The Portuguese approach

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World journal of Clinical Cases 2017年第1期5卷 24-26页

作者： Guilherme Macedo Marco silva department of Gastroenterology the Centro Hospitalar São JoãoWGO Training CenterFaculty of MedicineUniversity of Porto4200-319 PortoPortugal

The last 25 years have been a thrilling time for the Portuguese hepatologists. our national meetings have been providing the forum for the exchange of scientific ideas and the presentation of clinical research in clinical Hepatology, a growing world of knowledge in medical care. Bridging the gaps between technology and clinical daily practice, the latest development and the almost humble bedside care, has been a challenge for the increasing numbers of doctors devoted to the diagnostic and treatment of liver disease. We have been trying to be very persuasive among the Portuguese medical community in demonstrating that cultural vectors may influence the origin and pattern of liver disease among us. Viral hepatitis and alcoholic liver disease are paradigms of this assumption. Chronic liver disease is responsible for 3% of the deaths in Portugal, which accounts for the top ten causes of death in our country. The recognition by public health authorities of this fact along with the national net of hepatology outpatient consultation in public hospitals, has brought liver diseases under the lights of doctors concerns and an increased public awareness of its dimension.

关键词： Alcohol Cirrhosis Hepatology Liver Public health

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Change in neoadjuvant chemotherapy could alter the prognosis of patients with pancreatic adenocarcinoma: A case report

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World journal of Clinical Cases 2021年第14期9卷 3418-3423页

作者： Alberto Meyer Bárbara J Carvalho Kayo AA Medeiros Leonardo Z Pipek Fernanda s Nascimento Milena o suzuki joão VT Munhoz Leandro R Iuamoto Luiz A Carneiro-D'Alburquerque Wellington Andraus Gastroenterologia Hospital das Clínicas HCFMUSPFaculdade de MedicinaUniversidade de São PauloSão Paulo 01426-010Brazil Gastroenterologia Faculdade de Medicinada Universidade de São PauloSão Paulo 05403-000Brazil orthopaedics and Traumatology Faculdade de Medicinada Universidade de São PauloSão Paulo 05403-000Brazil

BACKGRoUND Neoadjuvant treatment has become a standard of care for borderline or locally advanced pancreatic cancer and is increasingly considered even for up-front resectable *** aim of this article is to present the case of a 62-year-old patient with locally advanced pancreatic adenocarcinoma who was successfully treated with gemcitabine plus nab-paclitaxel after the failure of the first line *** sUMMARY Computerized tomography scan and magnetic resonance imaging demonstrated a nodular lesion of ill-defined limits in the body of the pancreas,measuring approximately 4.2 cm×2.7 cm,with an infiltrative *** tumor had contact with the superior mesenteric vein,splenomesenteric junction and the proximal segment of the splenic artery,causing focal reduction of its *** to vascular involvement,neoadjuvant chemotherapy treatment with eight cycles of“folinic acid,5-fluorouracil,irinotecan and oxa-liplatine”(FoLFIRINoX)were *** the end of the cycles,surgery was performed,but the procedure was interrupted due to finding of lesions suspected of *** plus nab-paclitaxel was then successfully used for neoadjuvant treatment with subsequent R0 surgical *** Gemcitabine plus nab-paclitaxel may be effective as an alternative regimen when FoLFIRINoX fails as the first line of treatment,suggesting the need for further studies to identify which patients would benefit from each type of therapeutic approach.

关键词： Neoadjuvant chemotherapy Pancreatic cancer Resectable pancreatic cancer Borderline resectable Neoadjuvant Pancreas Case report

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How mesenchymal stem cell cotransplantation with hematopoietic stem cells can improve engraftment in animal models

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World journal of stem Cells 2022年第8期14卷 658-679页

作者： Murilo Montenegro Garrigós Fernando Anselmo de oliveira Mariana Penteado Nucci Leopoldo Penteado Nucci Arielly da Hora Alves olivia Furiama Metropolo Dias Lionel Fernel Gamarra hospital Israelita Albert Einstein São Paulo 05652-900São PauloBrazil Instituto de Química Universidade de São PauloSão Paulo 05508-900São PauloBrazil LIM44-hospital das Clínicas Faculdade Medicina da Universidade de São PauloSão Paulo 05403-000Brazil centro Universitário do Planalto Central Área Especial para Industria nº02 Setor Leste-Gama-DFBrasília 72445-020Distrito FederalBrazil

BACKGRoUND Bone marrow transplantation(BMT)can be applied to both hematopoietic and nonhematopoietic diseases;nonetheless,it still comes with a number of challenges and limitations that contribute to treatment *** this in mind,a possible way to increase the success rate of BMT would be cotransplantation of mesenchymal stem cells(MsCs)and hematopoietic stem cells(HsCs)to improve the bone marrow niche and secrete molecules that enhance the hematopoietic *** To analyze HsC and MsC characteristics and their interactions through cotransplantation in murine *** We searched for original articles indexed in PubMed and scopus during the last decade that used HsC and MsC cotransplantation and in vivo BMT in animal models while evaluating cell *** excluded in vitro studies or studies that involved graft versus host disease or other hematological diseases and publications in languages other than *** PubMed,we initially identified 555 articles and after selection,only 12 were *** scopus,2010 were identified,and six were left after the screening and eligibility *** of the 2565 articles found in the databases,only 18 original studies met the eligibility *** distribution by source showed similar ratios,with human umbilical cord blood or animal bone marrow being administered mainly with a dose of 1×10^(7) cells by intravenous or intrabone ***,MsCs had a high prevalence of human donors with a variety of sources(umbilical cord blood,bone marrow,tonsil,adipose tissue or fetal lung),using a lower dose,mainly 106 cells and ranging 104 to 1.5×107 cells,utilizing the same *** were characterized prior to administration in almost every *** recipient used was mostly immunodeficient mice submitted to low-dose irradiation or *** main technique of engraftment for HsC and MsC cotransplantation evaluation was chimerism,followed by hematopoietic reconstitution and survival anal

关键词： Mesenchymal stem cells Hematopoietic stem cells Bone marrow transplantation Cotransplantation Hematopoietic reconstitution Engraftment

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Exerkine response to acute exercise:still much to discover

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journal of sport and Health science 2024年第6期13卷 759-760页

作者： Pedro L.Valenzuela Beatriz Rivas-Baeza Carmen Fiuza-Luces Alejandro Lucia Physical Activity and Health Research Group(“PaHerg”) Research Institute of Hospital“12 de Octubre”(“imas12”)Madrid 28041Spain department of systems Biology University of AlcalaMadrid 28871Spain centro de salud Luis Vives Alcala de HenaresMadrid 28803Spain Faculty of sport sciences Universidad Europea de MadridMadrid 28670Spain

strong evidence supports the benefits of regular physical activity/exercise for the prevention and management of numerous non-communicable diseases.^(1,2)However,despite important advances(particularly the implementation of complex“omics”approaches),the underlying molecular mechanisms remain to be clearly *** the past decade,the role of exerkines—a myriad of signaling moieties(e.g.,mainly cytokines but also other small peptides,peptides,nucleic acids,lipids,or metabolites,among others)released by muscles(myokines)and other tissues in response to exercise that induces endocrine(at the multisystem level),paracrine,or autocrine effects—has gained attention.^(3,4)Indeed it has been proposed that some of the salutary effects of regular exercise(i.e.,repeated sessions of acute exercise)might be due,at least partly,to the progressive accumulation of frequent,acute episodes of exerkine release.^(5)

关键词： gained multisystem prevention

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Assessment of the Indirect Cost of Drug Resistant Tuberculosis Treatment to Patients in a High Burden, Low Income setting in Mozambique

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journal of Tuberculosis Research 2024年第2期12卷 91-104页

作者： Júlia Malache António Domingas Pacala Isabelle Munyangaju Isaías Benzana Claudia Mutaquiha Dulce osório Benedita josé Edy Nacarapa Pereira Zindoga Faculdade de Cincias de sade Universidade Catlica de Moambique Beira Moambique Programa Nacional de Controlo da Tuberculose Ministrio da Sade de Moambique Maputo Moambique IsGlobal Hospital Clnic Universitat de Barcelona Barcelona Spain Tinpswalo Association Vincentian Association to Fight AIDS and TB Chokwe Mozambique centro de Estudos e Apoio Psicolgico (CEAP) Universidade Eduardo Mondlane Maputo Moambique

Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psy

关键词： Economic Costs Drug Resistance Tuberculosis Catastrophic Costs

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Association of Helicobacter pylori infection and giardiasis: Results from a study of surrogate markers for fecal exposure among children

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World journal of Gastroenterology 2005年第18期11卷 2759-2763页

作者： Edson Duarte Moreira Jr Victor Bastos Nassri Rafaela sousa santos Junísia Ferraz Matos Wilson Andrade de Carvalho Célia stolve silvani Círia santana e sant'Ana Núcleo de Apoio à Pesquisa Fundac■o Irm■ Dulce Salvador Bahia Brazil Centro de Pesquisas Goncalo Moniz Fundac■o Oswaldo Cruz Salvador Bahia Brazil Diretoria Científica e Laboratório do Hospital S■o Rafael Salvador Bahia Brazil Núcleo de Apoio à Pesquisa Fundac■o Irm■Dulce Salvador Bahia Brazil Centro de Pesquisas Goncalo Moniz Fundac■o Oswaldo Cruz Salvador Bahia Brazil Diretoria Científica e Laboratório do Hospital S■o Rafael Salvador Bahia Brazil Diretoria Científica e Laboratório do hospital s■o Rafael salvador Bahia Brazil Diretoria Científica e Laboratório do hospital s(?)o Rafael salvador Bahia Brazil Núcleo de Apoio à Pesquisa Fundac(?)o Irm(?) Dulce Salvador Bahia Brazil

AIM: To investigate whether Helicobacter pylori (H pylori) infection is associated with hepatitis A virus (HAV) infection, presence of enteroparasites, and other surrogates of fecal exposure. METHoDs: We conducted a cross-sectional study in 121 children consecutively admitted at a pediatric hospital in salvador, Brazil. H pyloriand HAV infection were identified by the presence of serum antibodies. stool specimens were examined for the presence of ova and parasites. A structured questionnaire inquiring about sanitary conditions and life style was applied to each subject. REsULTs: Fifty-one of the 121 children (42.1%) were found to be seropositive for H pylori, and 45 (37.2%) for HAV. The seroprevalence of Hpyloriand HAV both increased significantly with age. Cross-tabulation of data showed that 26 (21.5%) were seropositive and 51 (42.1%) were negative for both H py/lriand HAV antibodies (x^2=7.18, oR=2.8, CI 1.30-5.97). The age adjusted oR for an HAV-infected child being H pylori positive was 2.3 (CI 1.02-5.03). The agreement between H pylori and HAV seropositivity was fair (k=0.24). After controlling for possible confounding, the variables remaining independently associated with seropositivity to H pylori were age, presence of Giardia lamblia in feces (oR=3.2, 95%CI, 1.1-9.5) and poor garbage disposal quality (oR=2.4, 95%CI, 1.1-5.1). CoNCLUsIoN: our data suggest that H pylori infection is associated with surrogate markers of fecal exposure. Thus, we conclude that the fecal-oral route is relevant in the transmission of HP among children in an urban setting of a developing country. The association observed between G. lamblia and H pylori infection may have several explanations. Further studies to investigate this relationship are warranted.

关键词： H pylori Hepatitis A virus Epidemiology Transmission Enteroparasites Brazil

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