Título del artículo:

Establishing the Noise: Interday Ecological Reliability of Countermovement Jump Variables in Professional Rugby Union Players

Howarth, DJ, Cohen, DD, McLean, BD, and Coutts, AJ. Establishing the noise: interday ecological reliability of countermovement jump variables in professional rugby union players. J Strength Cond Res 36(11): 3159-3166, 2022 - The purpose of this study was to examine the interday \"ecological\" reliability of a wide range of ground reaction force-derived countermovement jump (CMJ) variables. Thirty-six male, professional rugby union players performed 3 CMJs on 4 separate days over an 8-day period during the first week of preseason. We calculated reliability for 86 CMJ variables across 5 interday combinations using 2 criteria: mean output across 3 jump trials (Mean3) and single output from the highest jump (BestJH). Interday coefficient of variation (CV) of the 86 variables in each CMJ phase, for Mean3and BestJH, respectively, ranged between concentric = 2-11% and 2-13%; eccentric = 1-45% and 1-107%; and landing = 4-32% and 6-45%. Mean3interday CV was lower in all 86 variables across every interday combination, compared with BestJH. CVs were lower in our cohort than previous studies, particularly for eccentric phase variables. There was no meaningful difference between interday conditions, suggesting any 2-day combination conducted within the first 8 days of preseason, represents a measure of \"noise.\" We did not apply arbitrary reliability \"cut-offs\" used in previous work (e.g., CV <10%); therefore, our analysis provides reference reliability for a wide range of CMJ variables. However, we recommend that practitioners assess reliability in their athletes, as it is likely to be environment, protocol, and cohort specific.

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Journal of Strength and Conditioning Research

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Histopathological aspects in ripe fruits of Tahiti lime Citrus citrus x latifolia (Rutaceae) affected by phytophagous mites

This study describes in detail the anatomical and histochemical aspects of the phytophagous mites-Tahiti lime pathosystem. More than 300 healthy pieces of fruit affected by these mites were collected from agricultural crops in the province of Santander-Colombia. Identification of the mites associated with the lesions observed was conducted via specialized literature and consultations with expert taxonomists of this group. The pericarps were processed according to standard protocols for embedding and sectioning in paraffin, and the sections obtained were stained with Safranin-Alcian Blue, Fast Blue B, Floroglucinol, Lacmoid, and PAS-Amido Black. Additional sections were processed in resin and stained with Toluidine Blue. For observation under scanning electron microscopy (SEM), the material was fixed and dehydrated in 2,2-dimethoxypropane, then in critical point dried and coated with gold. The surface of healthy fruit was smooth, with a bright, intense green color and stomata. The exocarp is composed of various cell layers; the outermost being the epidermal tissue, which is formed of a single layer of cells covered by a thick cuticle. The remaining layers consist of photosynthetic and reserve parenchyma with abundant starch grains. The fruit affected by the three mites showed deterioration of the exocarpal layers varying according to the severity of the attack and the species of mite responsible. In general, there were fissures and/or cracks on the surface of the fruit in addition to structures such as circular whitish spots in the case of Schizotetranychus hindustanicus. The affected tissues tested positive for polyphenols and lignin, but not for callose. The primary walls were positive for PAS-Amidoblack but no proteins or starch granules were detected. Likewise, staining with Toluidine Blue indicated the presence of primary wall components, lignin, and polyphenols. Phytophagous mite attack affects mainly the exocarpal layers. The histopathological response of the plant to the attack of these mites is similar among the three, and results in the formation of periderm, lignin deposits, and polyphenols in the affected tissues. Greater severity of tissue damage was observed in the case of attack by Polyphagotarsonemus latus.

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Persian Journal of Acarology

Título del artículo:

Talaromyces santanderensis: A New Cadmium-Tolerant Fungus from Cacao Soils in Colombia

Inorganic pollutants in Colombian cocoa (Theobroma cacao L.) agrosystems cause problems in the production, quality, and exportation of this raw material worldwide. There has been an increased interest in bioprospecting studies of different fungal species focused on the biosorption of heavy metals. Furthermore, fungi constitute a valuable, profitable, ecological, and efficient natural soil resource that could be considered in the integrated management of cadmium mitigation. This study reports a new species of Talaromyces isolated from a cocoa soil sample collected in San Vicente de Chucurí, Colombia. T. santanderensis is featured by Lemon Yellow (R. Pl. IV) mycelium on CYA, mono-to-biverticillade conidiophores, and acerose phialides. T. santanderensis is distinguished from related species by its growth rate on CYAS and powdery textures on MEA, YES and OA, high acid production on CREA and smaller conidia. It is differentiated from T. lentulus by its growth rate on CYA medium at 37 °C without exudate production, its cream (R. PI. XVI) margin on MEA, and dense sporulation on YES and CYA. Phylogenetic analysis was performed using a polyphasic approach, including different phylogenetic analyses of combined and individual ITS, CaM, BenA, and RPB2 gene sequences that indicate that it is new to science and is named Talaromyces santanderensis sp. nov. This new species belongs to the Talaromyces section and is closely related to T. lentulus, T. soli, T. tumuli, and T. pratensis (inside the T. pinophilus species complex) in the inferred phylogeny. Mycelia growth of the fungal strains was subjected to a range of 0–400 mg/kg Cd and incorporated into malt extract agar (MEA) in triplicates. Fungal radial growth was recorded every three days over a 13-day incubation period and In vitro cadmium tolerance tests showed a high tolerance index (0.81) when the mycelium was exposed to 300 mg/kg of Cd. Results suggest that T. santanderensis showed tolerance to Cd concentrations that exceed the permissible limits for contaminated soils, and it is promising for its use in bioremediation strategies to eliminate Cd from highly contaminated agricultural soils.

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Journal of Fungi

Título del artículo:

Essential Oils from Colombian Plants: Antiviral Potential against Dengue Virus Based on Chemical Composition, In Vitro and In Silico Analyses

Currently, there are no therapies to prevent severe dengue disease. Essential oils (EOs) can serve as primary sources for research and the discovery of phytomedicines for alternative therapy. Fourteen EOs samples were obtained by distillation from six plants used in Colombian folk medicine. GC/MS analysis identified 125 terpenes. Cytopathic effect (CPE) reduction assays revealed differences in antiviral activity. EOs of Lippia alba, citral chemotype and carvone-rich fraction; Lippia origanoides, phellandrene chemotype; and Turnera diffusa, exhibited strong antiviral activity (IC50: 29 to 82 µg/mL; SI: 5.5 to 14.3). EOs of Piper aduncum, Ocimum basilicum, and L. origanoides, carvacrol, and thymol chemotypes, exhibited weak antiviral activity (32 to 53% DENV-CPE reduction at 100 µg/mL; SI > 5.0). Cluster and one-way ANOVA analyses suggest that the strong antiviral activity of EOs could be attributed to increased amounts of non-phenolic oxygenated monoterpenes and sesquiterpene hydrocarbons. Docking analyses (AutoDock Vina) predicted binding affinity between the DENV-2 E protein and terpenes: twenty sesquiterpene hydrocarbons (−8.73 to −6.91 kcal/mol), eight oxygenated monoterpenes (−7.52 to −6.98 kcal/mol), and seven monoterpene hydrocarbons (−7.60 to −6.99 kcal/mol). This study reports for the first time differences in the antiviral activity of EOs against DENV, corresponding to their composition of monoterpenes and sesquiterpenes.

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Molecules

Título del artículo:

SARS-CoV-2 seroprevalence and associated factors among migrants with a vocation for permanence, Bucaramanga, Colombia

Introduction: There are few reports assessing anti-SARS-CoV-2 seroprevalence in the migrant population in the world. These studies help to understand the exposure of populations to the virus to take actions to reduce the impact of SARS-CoV-2 infection. Objective: To determine the anti-SARS-CoV-2 seroprevalence in migrants with a vocation for permanence in Bucaramanga and to identify factors associated with previous SARS-CoV-2 infection. Methods: Analytical cross-sectional study using consecutive sampling, which included adult migrants in Bucaramanga in February 2021. Surveys were conducted, and chemiluminescent immunoassays were performed to detect IgM and IgG antibodies to SARS-CoV-2 in serum samples. Prevalence ratios (PR) were estimated using a log-binomial regression model. Results: The study enrolled 462 participants. IgM seroprevalence was 11.7% (95% CI 9.1–14.9), IgG seroprevalence was 32.9% (95% CI 28.8–37.3), and IgM or IgG seroprevalence was 36.1% (95% CI 31.9–40.6). Contact with a confirmed case of COVID-19 (PR:1.54; 95% CI 1.04-2.29) or suspected case (PR:1.56; 95% CI 1.13–2.16); living with six or more people (PR: 1.52; 95% CI 1.05–2.20); stay in Colombia ≥ 2 years (PR:1.43; 95% CI 1.11–1.92), and presence of symptoms (PR:1.62; 95%CI 1.26–2.10) were some factors associated with higher IgG seroprevalence. Discussion: In Bucaramanga, SARS-CoV-2 seroprevalence among migrants was similar to the seroprevalences of migrants in Kuwait but lower than migrants in Paris and Singapore. Conclusions: The anti-SARS-CoV-2 seroprevalence among migrants with a vocation for permanence was similar to that reported among residents of Bucaramanga. Contact with suspected or confirmed COVID-19 cases and crowded conditions were some of the factors associated with seroprevalence.

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Revista Cuidarte

Título del artículo:

Psychosis in Parkinson’s Disease: Looking Beyond Dopaminergic Treatments

Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide. The symptoms of PD are characterized not only by motor alterations but also by a spectrum of nonmotor symptoms. Some of these are psychiatric manifestations such as sleep disorders; depression; cognitive difficulties that can evolve into dementia; and symptoms of psychosis, which include hallucinations, illusions, and delusions. Parkinson’s disease psychosis (PDP) occurs in 18-50% of patients with PD. Treating PDP is challenging because antipsychotic drugs tend to be inefficient or may even worsen the disease\'s motor symptoms. Objective: This review aims to summarize the current understanding of the molecular mechanisms involved in PDP and recent innovative alternatives for its treatment. Methods: This is a narrative review in which an extensive literature search was performed on the Scopus, EM-BASE, PubMed, ISI Web of Science, and Google Scholar databases from inception to August 2021. The terms “Parkinson’s disease psychosis”, “Parkinson psychosis,” “neurodegenerative psychosis”, and “dopamine psychosis” were among the keywords used in the search. Results: Recently, views on the etiology of hallucinations and illusions have evolved remarkably. PDP has been cemented as a multifactorial entity dependent on extrinsic and novel intrinsic mechanisms, including genetic factors, neurostructural alterations, functional disruptions, visual processing disturbances, and sleep disorders. Consequently, innovative pharmacological and biological treatments have been proposed. Pimavanserin, a selective 5-HT2A inverse agonist, stands out after its approval to treat PDP-associated hallucinations and illusions. Conclusion: Future results from upcoming clinical trials should further characterize the role of this drug in the management of PDP as well as other treatment options with novel mechanisms of action, such as saracatinib, SEP-363856, cannabidiol, electroconvulsive therapy, and transcranial magnetic stimulation.

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Current Pharmaceutical Design

Título del artículo:

Complications in patients with tracheostomy in intensive care units. A Scoping Review

Introduction: Tracheostomy procedures in intensive care units are on the rise; however, they can lead to both perioperative and postoperative complications, with a variable incidence from 5 to 40% and even death in up to 1.4% of individuals. Despite this, few studies address causal concepts or mechanical and non-mechanical risk factors about this important topic. Objective: To review the scope of the available scientific literature on complications of mechanical and non-mechanical origin associated with a tracheostomy. Materials and Methods: The research question and inclusion criteria were established to conduct the search in PubMed and EBSCO databases between 2015 and 2020. The PRISMA-ScR checklist was used in the present study as a methodological and quality guideline. Results: The most frequent complications were bleeding 61%, tracheal stenosis 28.5%, decannulation 23.6% (5/21), stoma infection 19%, death 19%, and difficult tracheostomy tube insertion 19%. Regarding mechanical risk factors, only the use of the Bjork flap (OR=0.4) was identified as a protective factor. Among the non-mechanical factors, obesity (OR=5.15), tube diameter >6 (OR=2.6), and preoperative mechanical ventilation (OR=3.14) were found. Conclusions: It was possible to identify that the highest incidence of tracheostomy-related complications were bleeding, tracheal stenosis, accidental decannulation, and death; however, it is still unknown whether they originate from a mechanical or non-mechanical cause during intensive care management.

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Revista Cuidarte

Título del artículo:

Incidence of Diaphragmatic Paralysis Secondary to Supraclavicular Brachial Plexus Blockade Measured by Ultrasound in a Fourth Level Institution

Introduction. Regional anesthesia is an important, innovative, and popular technique for anesthetic and painkiller management. In supraclavicular brachial plexus blockade, there is a 50-60% rate of diaphragmatic paralysis. Clinical presentation is variable according to the patient\'s internal and external factors. There are multiple radiological techniques in diagnosis, with ultrasounds being very useful due to their easy access. The objective is to determine the incidence of diaphragmatic paralysis secondary to supraclavicular brachial plexus blockade guided by ultrasound in a fourth level institution. Methodology. Prospective, longitudinal, analytical study. 110 patients were selected. Inclusion criteria: patients over 18 years of age subject to upper limb surgery with supraclavicular brachial plexus blockade. Exclusion criteria: ASA (American Society of Anesthesiologists) 4 and 5 patients, pregnant women BMI >35 kg/m2 patients with neuromuscular background, restrictive or obstructive pulmonary disease, phrenic nerve paralysis, or diaphragmatic dysfunction. An analysis was carried out via statistical tests, describing the different degrees of diaphragmatic paralysis. Results. In patients who met the inclusion criteria, the incidence of diaphragmatic paralysis was 65% (37% with total and 28% with partial paralysis), 1.81% showed respiratory symptoms without hemodynamic changes. Discussion. Supraclavicular brachial plexus blockade is a technique related to diaphragmatic paralysis. Ultrasound has allowed for the incidence of this complication to be reduced. It is a useful method in post-operative diagnosis. Conclusions. Diaphragmatic paralysis after supraclavicular brachial plexus blockade is a complication mainly observed in patients with previous pulmonary problems. Therefore, it must be strictly monitored.

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MedUNAB

Título del artículo:

A review of hard ticks (Acari: Ixodidae) in Colombia: The risk of tick-borne diseases

This paper reviews the ixodid tick species that are present in Colombia. The different databases reported 50 species of ticks, of which 29 belong to Amblyomma: A. auricularium, A. cajennense sensu lato (s.l.); for Colombia A. calcaratum, A. coelebs, A. crassum, A. dissimile, A. geayi, A. goeldii, A. humerale, A. longirostre, A. maculatum, A. tigrinum, A. triste, A. mixtum, A. multipunctum, A. naponense, A. neumanni, A. nodosum, A. oblongoguttatum, A. ovale, A. pacae, A. pecarium, A. patinoi, A. rotundatum, A. sabanerae, A. scalpturatum, A. tapirellum, A. varium, A. incisum, A. parvum; two Haemaphysalis species: H. juxtakochi, H. leporispalustris, two Rhipicephalus species: R. (Boophilus) microplus, R. sanguineus s.s., two Dermacentor species: Anocentor (D.) nitens, D. imitans, and 15 species of Ixodes: I. affinis, I. andinus, I. auritulus, I. bocatorensis, I. boliviensis, I. brunneus, I. fuscipes, I. lasallei, I. loricatus, I. luciae, I. montoyanus, I. pararicinus, I. tapirus, I. tropicalis, I. venezuelensis. Some of these species need to be validated, their presence confirmed, and their role as a risk for human and animal health studied. Therefore, a countrywide survey of Ixodidae ticks would be of great value to update the information presented in this work.

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Persian Journal of Acarology

Título del artículo:

Neglected Tropical Diseases and Sudden Cardiac Death: The NET-Heart Project

Sudden cardiac death (SCD) is responsible for approximately 6% of global mortality and 25% of cardiovascular (CV) deaths. SCD has been traditionally linked to coronary artery disease, valvular heart disease, cardiomyopathies, and genetic arrhythmia disorders. However, advancements in care for these diseases have not translated to a proportional reduction in SCD. This suggests an important role of underrecognized contributing pathologies. Neglected tropical diseases (NTDs) are a group of illnesses prevalent in tropical and sub-tropical regions which have been understudied partially due to their high prevalence in marginalized populations. The relationship between SCD and Chagas disease has been well-established, though emerging literature suggests that other NTDs with CV involvement may lead to fatal arrhythmias. Additionally, specific therapies for a subset of NTDs put patients at increased risk of malignant arrhythmias and other cardiac complications. This review aims to summarize the association between a group of selected NTDs and SCD.

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Reviews in Cardiovascular Medicine

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A literature review about post-COVID-19 syndrome

Introduction: COVID-19 is a viral disease that has caused great affectation in the health of the global population. Several studies have shown that two to three months after coronavirus infection patients continue to report symptoms, fatigue, dyspnea and headache being the most frequent. Objective: To present relevant scientific information on post-COVID-19 syndrome. Development: A literature review was conducted between November 2020 and February 2021, consisting of the phases of planning, design and management, analysis, elaboration and formalization. The strategic search was carried out using ScienceDirect, PubMed/Medline, NusrginsOvid, SciELO and Google Scholar, through the combination of the Boolean operators OR, AND and NOT. Full texts were considered, in Spanish, English and Portuguese, from 2019 to 2021. After the selection and an in-depth review, 38 articles were obtained that met the set objective, which were processed with the PRISMA methodology. Conclusions: There is a post-COVID-19 syndrome, directly related to a multisystem inflammatory process, which shows symptoms in patients three months after the end of the infectious process. Among these, fatigue, dyspnea and headache are the most frequent, in addition to cardiac, psychological and neurobiological consequences.

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Revista Cubana de Educacion Medica Superior

Título del artículo:

ICT competence of university teachers from the perspective of students

The level of skills of teachers in relation to the use of information and communication technologies has aroused the concern of researchers in recent years. This work aims to describe the level of ICT skills presented by the teachers of the Occupational Therapy program at the University of Santander, Cúcuta campus from the perspective of their students. The methodology was quantitative with a descriptive approach with the application of a questionnaire to active students assigned to the Academic Program of Occupational Therapy of the Faculty of Health of the University of Santander in 2021. The results show that according to the opinion of the majority of students teachers exhibit high levels of ICT skills in its 5 dimensions. It is concluded that the high levels of ICT skills in the staff constitute a strength of the institution, as well as the need to promote student participation initiatives in the evaluation of teachers’ performance as part of participatory management strategies.

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Revista Venezolana de Gerencia

Título del artículo:

Determining factors with regard to physical functional impairment in revascularized patients with acute coronary syndrome

Introduction: Functional physical capacity is indirectly associated with mortality, and may be compromised after a cardiovascular event, hence the importance of considering its prognostic factors during treatment in heart disease patients. Aim: To identify the prognostic factors of functional physical limitation in patients with myocardial revascularization for acute coronary syndrome. Material and method: A retrospective analysis was carried out of 29 medical records taken from patients submitted to a stress test (Bruce, modified Bruce) after myocardial revascularization during the months of January to December 2019. For the statistical analysis, a univariate and multivariate logistic regression (Odds Ratio-OR) was performed, as well as a simple linear regression analysis between the variables of interest. Results: the analyzed patients had a mean age of 60 ± 9,2 years, and 76% were men. The presence of systemic arterial hypertension (SAH), lower values of Maximum Heart Rate (HR) (ß = 0,112; CI: 0,074, 0,149; p <0.001), high values of Systolic Arterial Pressure (SBP) (ß = - 0,083; CI 95%: -0,152, -0,014; p <0.020), and a greater number of risk factors (ß = - 1,580; CI 95%: -2,456-0,868; p <0.001), are considered predictors of functional limitation (<7 METs). Conclusion: The presence of SAH, a greater number of risk factors, as well as high maximum SBP levels and lower maximum HR values reached during the stress test, were shown to be prognostic factors of functional limitation in subjects revascularized for ACS.

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Archivos de Medicina del Deporte

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A randomized clinical trial of lipid metabolism modulation with fenofibrate for acute coronavirus disease 2019

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cytotoxicity may involve inhibition of peroxisome proliferator-activated receptor alpha. Fenofibrate activates peroxisome proliferator-activated receptor alpha and inhibits SARS-CoV-2 replication in vitro. Whether fenofibrate can be used to treat coronavirus disease 2019 (COVID-19) infection in humans remains unknown. Here, we randomly assigned inpatients and outpatients with COVID-19 within 14 d of symptom onset to 145 mg of oral fenofibrate nanocrystal formulation versus placebo for 10 d, in a double-blinded fashion. The primary endpoint was a severity score whereby participants were ranked across hierarchical tiers incorporating time to death, mechanical ventilation duration, oxygenation, hospitalization and symptom severity and duration. In total, 701 participants were randomized to fenofibrate (n = 351) or placebo (n = 350). The mean age of participants was 49 ± 16 years, 330 (47%) were female, mean body mass index was 28 ± 6 kg/m2 and 102 (15%) had diabetes. Death occurred in 41 participants. Compared with placebo, fenofibrate had no effect on the primary endpoint. The median (interquartile range) rank in the placebo arm was 347 (172, 453) versus 345 (175, 453) in the fenofibrate arm (P = 0.819). There was no difference in secondary and exploratory endpoints, including all-cause death, across arms. There were 61 (17%) adverse events in the placebo arm compared with 46 (13%) in the fenofibrate arm, with slightly higher incidence of gastrointestinal side effects in the fenofibrate group. Overall, among patients with COVID-19, fenofibrate has no significant effect on various clinically relevant outcomes (NCT04517396).

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Nature Metabolism

Título del artículo:

Colchicine and aspirin in community patients with COVID-19 (ACT): an open-label, factorial, randomised, controlled trial

Background: The large number of patients worldwide infected with the SARS-CoV-2 virus has overwhelmed health-care systems globally. The Anti-Coronavirus Therapies (ACT) outpatient trial aimed to evaluate anti-inflammatory therapy with colchicine and antithrombotic therapy with aspirin for prevention of disease progression in community patients with COVID-19. Methods: The ACT outpatient, open-label, 2 × 2 factorial, randomised, controlled trial, was done at 48 clinical sites in 11 countries. Patients in the community aged 30 years and older with symptomatic, laboratory confirmed COVID-19 who were within 7 days of diagnosis and at high risk of disease progression were randomly assigned (1:1) to receive colchicine 0·6 mg twice daily for 3 days and then 0·6 mg once daily for 25 days versus usual care, and in a second (1:1) randomisation to receive aspirin 100 mg once daily for 28 days versus usual care. Investigators and patients were not masked to treatment allocation. The primary outcome was assessed at 45 days in the intention-to-treat population; for the colchicine randomisation it was hospitalisation or death, and for the aspirin randomisation it was major thrombosis, hospitalisation, or death. The ACT outpatient trial is registered at ClinicalTrials.gov, NCT04324463 and is ongoing. Findings: Between Aug 27, 2020, and Feb 10, 2022, 3917 patients were randomly assigned to colchicine or control and to aspirin or control; after excluding 36 patients due to administrative reasons 3881 individuals were included in the analysis (n=1939 colchicine vs n=1942 control; n=1945 aspirin vs 1936 control). Follow-up was more than 99% complete. Overall event rates were 5 (0·1%) of 3881 for major thrombosis, 123 (3·2%) of 3881 for hospitalisation, and 23 (0·6%) of 3881 for death; 66 (3·4%) of 1939 patients allocated to colchicine and 65 (3·3%) of 1942 patients allocated to control experienced hospitalisation or death (hazard ratio [HR] 1·02, 95% CI 0·72–1·43, p=0·93); and 59 (3·0%) of 1945 of patients allocated to aspirin and 73 (3·8%) of 1936 patients allocated to control experienced major thrombosis, hospitalisation, or death (HR 0·80, 95% CI 0·57–1·13, p=0·21). Results for the primary outcome were consistent in all prespecified subgroups, including according to baseline vaccination status, timing of randomisation in relation to onset of symptoms (post-hoc analysis), and timing of enrolment according to the phase of the pandemic (post-hoc analysis). There were more serious adverse events with colchicine than with control (34 patients [1·8%] of 1939 vs 27 [1·4%] of 1942) but none in either group that led to discontinuation of study interventions. There was no increase in serious adverse events with aspirin versus control (31 [1·6%] vs 31 [1·6%]) and none that led to discontinuation of study interventions. Interpretation: The results provide no support for the use of colchicine or aspirin to prevent disease progression or death in outpatients with COVID-19. Funding: Canadian Institutes for Health Research, Bayer, Population Health Research Institute, Hamilton Health Sciences Research Institute, and Thistledown Foundation. Translations: For the Portuguese, Russian and Spanish translations of the abstract see Supplementary Materials section.

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The Lancet Respiratory Medicine

Título del artículo:

Colchicine and the combination of rivaroxaban and aspirin in patients hospitalised with COVID-19 (ACT): an open-label, factorial, randomised, controlled trial

Background: COVID-19 disease is accompanied by a dysregulated immune response and hypercoagulability. The Anti-Coronavirus Therapies (ACT) inpatient trial aimed to evaluate anti-inflammatory therapy with colchicine and antithrombotic therapy with the combination of rivaroxaban and aspirin for prevention of disease progression in patients hospitalised with COVID-19. Methods: The ACT inpatient, open-label, 2 × 2 factorial, randomised, controlled trial was done at 62 clinical centres in 11 countries. Patients aged at least 18 years with symptomatic, laboratory confirmed COVID-19 who were within 72 h of hospitalisation or worsening clinically if already hospitalised were randomly assigned (1:1) to receive colchicine 1·2 mg followed by 0·6 mg 2 h later and then 0·6 mg twice daily for 28 days versus usual care; and in a second (1:1) randomisation, to the combination of rivaroxaban 2·5 mg twice daily plus aspirin 100 mg once daily for 28 days versus usual care. Investigators and patients were not masked to treatment allocation. The primary outcome, assessed at 45 days in the intention-to-treat population, for the colchicine randomisation was the composite of the need for high-flow oxygen, mechanical ventilation, or death; and for the rivaroxaban plus aspirin randomisation was the composite of major thrombosis (myocardial infarction, stroke, acute limb ischaemia, or pulmonary embolism), the need for high-flow oxygen, mechanical ventilation, or death. The trial is registered at www.clinicaltrials.gov, NCT04324463 and is ongoing. Findings: Between Oct 2, 2020, and Feb 10, 2022, at 62 sites in 11 countries, 2749 patients were randomly assigned to colchicine or control and the combination of rivaroxaban and aspirin or to the control. 2611 patients were included in the analysis of colchicine (n=1304) versus control (n=1307); 2119 patients were included in the analysis of rivaroxaban and aspirin (n=1063) versus control (n=1056). Follow-up was more than 98% complete. Overall, 368 (28·2%) of 1304 patients allocated to colchicine and 356 (27·2%) of 1307 allocated to control had a primary outcome (hazard ratio [HR] 1·04, 95% CI 0·90–1·21, p=0·58); and 281 (26·4%) of 1063 patients allocated to the combination of rivaroxaban and aspirin and 300 (28·4%) of 1056 allocated to control had a primary outcome (HR 0·92, 95% CI 0·78–1·09, p=0·32). Results were consistent in subgroups defined by vaccination status, disease severity at baseline, and timing of randomisation in relation to onset of symptoms. There was no increase in the number of patients who had at least one serious adverse event for colchicine versus control groups (87 [6·7%] of 1304 vs 90 [6·9%] of 1307) or with rivaroxaban and aspirin versus control groups (85 [8·0%] vs 91 [8·6%]). Among patients assigned to colchicine, 8 (0·61%) had adverse events that led to discontinuation of study drug, mostly gastrointestinal in nature. 17 (1·6%) patients assigned to the combination of rivaroxaban and aspirin had bleeding compared with seven (0·66%) of those allocated to control (p=0·042); the number of serious bleeding events was two (0·19%) versus six (0·57%), respectively (p=0·18). No patients assigned to rivaroxaban and aspirin had serious adverse events that led to discontinuation of study drug. Interpretation: Among patients hospitalised with COVID-19, neither colchicine nor the combination of rivaroxaban and aspirin prevent disease progression or death. Funding: Canadian Institutes for Health Research, Bayer, Population Health Research Institute, Hamilton Health Sciences Research Institute, Thistledown Foundation. Translations: For the Portuguese, Russian and Spanish translations of the abstract see Supplementary Materials section.

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The Lancet Respiratory Medicine

Título del artículo:

Effect of a phytobiotic additive on the productive performance and quality of broiler meat in a tropical breeding environment

The aim of this study was to evaluate the effect of the inclusion of a phytobiotic composed of essential oil of Rosmarinus officinalis, herbal choline, Cynara scolymus meal and Silybum marianum on the productive parameters and the drip losses of the carcass of broilers raised in the humid tropics. In total, 4800 male Ross AP chickens were used, housed in 10 open poultry shed and at ambient temperature (27-37 °C). The birds were distributed in a completely random model composed of five repetitions and two treatments: (D1) control diet with commercial base feed, (D2) commercial base feed with the inclusion of the phytobiotic at 400 g/t. The experimental period lasted 42 days and weight gain, feed intake, feed conversion rate and productivity index were determined. For the evaluation of meat quality, drip losses and malondialdehyde production were measured. On day 42, the animals that consumed the phytobiotic presented a better feed conversion rate and higher productivity index (1.50 and 96.78 respectively), compared to the control group (1.60 and 81.33, respectively). Regarding meat quality, the animals supplemented with the phytobiotic had lower drip losses. In conclusion, animals raised in the humid tropics supplemented with phytobiotics showed better efficiency in the production process.

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Revista de Investigaciones Veterinarias del Peru

Título del artículo:

Characterization of eating habits and physical activity in young people in the Colombian Caribbean Region

Introduction: Life habits have an important influence on the environment in which the young person develops. The university environment becomes an environment that influences behaviors related to physical activity and food. Objective: to identify habits related to eating and physical activity practices in young university adults in the Colombian Caribbean. Materials and Methods: Cross-sectional descriptive study in university students from four cities in the Colombian Caribbean region. A self-administered questionnaire was applied, which inquired about sociodemographic and academic characteristics, while the PEVP-II questionnaire was used to quantify lifestyles. For the analysis of this publication, the information corresponding to the dimensions of nutrition and physical activity was observed. Results: 61.26% of the participants were women, the range of age with the highest predominance was between 15 and 26 years, with greater representation of of the health sciences, of low socioeconomic stratum. Sex is related to the nutritional habits associated with higher consumption of carbohydrates, sugars, as well as low consumption of fruits and vegetables. A relationship was observed between sex and the low practice of physical activity. Conclusion: the lack of healthy habits in youth is given by the behaviors apprehended and influenced by the environment in which the human being grows and develops in early stages of life. It is important to think about the ways in which the university environment could positively influence better attitudes and behaviors related to the general well-being of the young person.

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Nutricion Clinica y Dietetica Hospitalaria

Título del artículo:

Life expectancy and the beginning of old age

At present, the population exceeds the chronological barriers that man has defined as a stage of old age, and the older adult population is increasing, therefore, population aging has become a challenge for modern societies and governments, to cause of not having public policies that guarantee healthy years of life on the growth of the average life expectancy to which the population is currently reaching. Therefore, it is important to characterize life expectancy in European and South American countries in relation to the beginning of the older adult stage, as determinants of public health policies. Materials and methods: Correlational and retrospective observational study. Variables such as mean life expectancy, population density, mortality rate and global aging index were included. Statistical software R version 4.0.3 was used for data analysis. Results: From the age of 60, the older adult stage begins. The average life expectancy in 6 European countries exceeded 80 years and in South American countries it is in the range of 71.24 to 80.04 years. Conclusions: Without differentiation between regions, a growth in the average life expectancy is observed and the design of a model in public health policies that guarantees years of healthy life in the elderly population was not evident.

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Salud Uninorte

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May Measurement Month 2019: An analysis of blood pressure screening results from Colombia

Hypertension awareness and control is poor in low- and middle-income countries. Thus, implementing strategies to increase hypertension detection is needed. Colombia participated as one of the 92 countries involved in the third campaign of the May Measurement Month in 2019. Blood pressure (BP) was measured in 48 324 volunteers from 13 departments in Colombia. In total, 27.9% individuals were identified with hypertension. Of those with hypertension, 63.7% were aware of their condition, 60.0% were on antihypertensive medication, and 38.4% had controlled BP. These results showed low levels of awareness, treatment, and control of hypertension in this sample of subjects volunteered to participate, suggest the urgent necessity of implementing programmes to improve the diagnosis and management of hypertension in Colombia.

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European Heart Journal, Supplement

Título del artículo:

Failure of pygmalion effect in preventing bronchoaspiration in intubated and mechanically ventilated patients

Gastroesophageal reflux (GER) broncho-aspiration is one of the main risk factors for nosocomial pneumonia (NP) and ventilator-associated pneumonia (VAP). In the real-life clinical setting, identification of the causes of GER involves indisputable diagnostic complexity, which varies as the patient is under critical care. GER is modifiable in these patients, but therapeutic interventions require the consideration of a comprehensive diagnosis of its causes. Our impression is that there is a conformism that interprets that «we already do everything necessary» to prevent aspiration and GER in these patients. If this is true, we can only have the expectation that the Pygmalion effect will turn our current actions into an «ideal of prevention» in the face of the risk of NP. The Pygmalion effect arises from a myth of Greek origin. Pygmalion was a sculptor who fell in love with Galatea, one of his works. His love was so intense that he believed her to be a real woman. The sculpture came to life after a dream by the sculptor. This event was called the «Pygmalion effect» in which expectations were exceeded, and believing that the statue was alive actually brought it to life. Nevertheless, this Pygmalion myth will not actually solve the serious problem that NP represents in all hospitals on the planet. The «oil well» analogy allows a comprehensive interpretation of the causes of GER, and can be useful to improve and speed up the diagnostic and therapeutic process in critically ill patients, and highlights the dynamic nature of these causes of GER. The usual treatment of a simple prokinetic or the semi-recumbent position is insufficient to avoid NP, for which other multiple additional prevention strategies have been proposed and identified. Translational research (not the Pygmalion effect) should identify additional innovative strategies, such as continuous or intermittent suction devices, artificial intelligence, augmented reality, or the application of information and communication technologies (ICTs), among others, in order to design new forms of preventive and therapeutic intervention before the risk of NP in patients hospitalised in the ICU due to various causes, as well as its serious consequences.

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Acta Colombiana de Cuidado Intensivo

Título del artículo:

Workload of intensive care unit nurses. Descriptive study: “CARETIME”

Introduction: Nursing workload in intensive care units is directly related to the efficiency and quality of care. However, there is limited data on this subject in Colombia, despite the importance of the administration and management of these units. Objective: To describe the workload of nurses in a high complexity ICU in Santander, Colombia. Methodology: A descriptive study was carried out with the professional nursing staff of an ICU of a high complexity hospital between July and November 2018. Nursing Activities Score (NAS) was used to measure the workload. The information was entered into the software EpiData 3.1, and then exported to the statistical package Stata 14.0 where it was analysed using descriptive statistics. Results: The most prevalent type of diagnosis was in the infectious category, with 24.0% (n=12). The mean stay in ICU stay was 11 days (Q1:7- Q3:17) and the degree of criticality was calculated with the Sequential Organ Failure Assessment (SOFA) score for each patient, obtaining a mean of 8.1±3.44 points. The mean overall NAS score was 60.51±12.13 (min: 36.6 and max: 92.7). The activity in which nurses spent the most time in the ICU is monitoring and control, with 16.18±4.34 according NAS categories, including mobilisation and positional changes with 9.69±3.97, followed by renal support with 8.71±3.30. Conclusion: The ICU nursing staff use more than half of their shift time to a single patient in the intensive care unit (61). Similarly, direct care activities occupy the largest percentage of their time during this period.

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Acta Colombiana de Cuidado Intensivo

Título del artículo:

Characterisation of hematology-oncology patients admitted to a paediatric intensive care unit. Cartagena, Colombia 2014-2016

Objective: To present a profile of patients with diagnosed with haematology-oncology diseases admitted to the Paediatric Intensive Care Unit of the Hospital Infantil Napoleón Franco Pareja, Cartagena, during the period between January 2014 and December 2016. Methods: A retrospective descriptive study was conducted that included all patients aged between 0-18 years diagnosed with a haematology-oncology disease. A qualitative, descriptive analysis was performed using absolute frequencies and related variables, whereas the quantitative variables were calculated using central tendency and dispersion measurements. Results: The analysis included 117 patients out of a total 166 admissions. The median age was 8 years and median number of admissions per patient was 1. The oncological diseases that required admission were acute lymphoid leukaemia (29.1%), tumours of the central nervous system (27.4%), and acute myeloid leukaemia (10.26%). The median hospital stay was 9 days, and mortality in the three years of study was 14.5%, with the most frequent cause being sepsis in 62.5%. Conclusions: The main cause of mortality in paediatric oncology patients in the PICU was sepsis. Therefore, management measures should be directed towards prevention and early recognition of signs of severity in infections to avoid fatal outcomes.

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Acta Colombiana de Cuidado Intensivo

Título del artículo:

Gastroesophageal reflux in patients receiving mechanical ventilation: a comprehensive management based on the “oil well analogy”

Gastroesophageal reflux (GER) is one of the major risk factors for nosocomial pneumonia, mainly in patients on mechanical ventilation. In a “real life” setting, identifying the causes of GER involves an indisputable diagnostic complexity, which varies as the patient is under critical care. The “oil well” analogy is a comprehensive conceptualisation of the causes of GER, which is potentially modifiable in these patients, although therapeutic interventions require a comprehensive assessment of its causes. The analogy appears to be useful to improve and expedite the diagnostic and therapeutic process in critically ill patients. The simple usual prokinetic and/or antacid treatment appears to be insufficient. Patients may require and benefit from specific, differential, and additional strategies that change with the time according to each case and its progression. The oil well analogy is an aid to the multifactorial diagnosis, and highlights the dynamic nature of these causes of GER, thus allowing the clinicians to offer therapeutic target both individually and dynamically in each patient.

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Acta Colombiana de Cuidado Intensivo

Título del artículo:

Critical perspectives on rehabilitation education, practice and process: northern Honduras case study

Background: Rehabilitation services are an integral part of patient care, but in many developing countries, they are not prioritized and either unavailable or easily accessible to those who need them. Although the need for rehabilitation services is increasing in Honduras, rehabilitation workers are not included in the health care model that guides the care provided to communities, particularly in rural and remote areas. To understand the need for providing impactful rehabilitation services in disadvantaged communities, we explored the education and perception of the community relating to rehabilitation, investigated training available for rehabilitation workers, and examined the rehabilitation processes and practices in Northern Honduras from stakeholders’ experiences. Methods: We utilized a qualitative descriptive and interpretive approach grounded in case study methodology to understand rehabilitation education, process, and practice in Northern Honduras. Three rehabilitation centres were purposefully selected as the cases, and participants consisted of rehabilitation workers and managers from these centres. We collected data via interviews and focus group sessions. We analyzed the data via thematic analysis using NVivo version 12. Results: In Northern Honduras, rehabilitation workers\' limited training and continuing education, along with awareness about rehabilitation by community members and other health providers influence rehabilitation care. Although policies and initiatives to support people with disabilities and the broader community in need of rehabilitation exist, most policies are not applied in practice. The sustainability of rehabilitation services, which is rooted in charity, is challenged by the small range of funding opportunities strongly affecting rehabilitation care processes and clinical practices. The lack of trust and awareness from the medical profession towards rehabilitation workers sets a major barrier to referrals, interdisciplinary work, and quality of life for individuals in need of rehabilitation. Conclusion: This study advances knowledge of the need to increase understanding of rehabilitation care among community members and health providers, improve care processes and resources, and foster interprofessional practice, to enhance the quality of care and promote equitable care delivery, especially in rural and remote communities.

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BMC Health Services Research