Abstract Hospitalization for heart failure (HF) places a major burden on healthcare services worldwide, and is a strong predictor of increased mortality especially in the first three months after ...discharge. Though undesirable, hospitalization is an opportunity to optimize HF therapy and advise clinicians and patients about the importance of continued adherence to HF medication and regular monitoring. The Optimize Heart Failure Care Program ( www.optimize-hf.com ), which has been implemented in 45 countries, is designed to improve outcomes following HF hospitalization through inexpensive initiatives to improve prescription of appropriate drug therapies, patient education and engagement, and post-discharge planning. It includes best practice clinical protocols for local adaptation, pre- and post-discharge checklists, and ‘My HF Passport’, a printed and smart phone application to improve patient understanding of HF and encourage involvement in care and treatment adherence. Early experience of the Program suggests that factors leading to successful implementation include support from HF specialists or ‘local leaders’, regular educational meetings for participating healthcare professionals, multidisciplinary collaboration, and full integration of pre- and post-hospital discharge checklists across care services. The Program is helping to raise awareness of HF and generate useful data on current practice. It is showing how good evidence-based care can be achieved through the use of simple clinician and patient-focused tools. Preliminary results suggest that optimization of HF pharmacological therapy is achievable through the Program, with little new investment. Further data collection will lead to a greater understanding of the impact of the Program on HF care and key indicators of success.
Mexico has the largest number of the genus salvia plant species, whose main chemical compounds of this genus are diterpenes, these chemical compounds have shown important biological activities such ...as: antimicrobial, anti-inflammatory and immunomodulatory.
This study aimed to evaluate the immunomodulatory activity of three diterpenes: 1) icetexone, 2) anastomosine and 3) 7,20-dihydroanastomosine, isolated from Salvia ballotiflora, over innate immunity and cytokine production in a human alveolar epithelial cell line infected with Mycobacterium tuberculosis.
The immunomodulatory activity of diterpenes over innate immunity included reactive oxygen and nitrogen species (ROS and RNS) induction in response to infection; cytokine production included TNF-α and TGF-β induction in response to infection.
The diterpenes anastomosine and 7,20-dihydroanastomosine showed a statically significant (p < 0.01) increase of RNS after 36 h of infection and treatment of 2.0 μg/mL. Then, the ROS induction in response to infection showed a consistent statically significant (p < 0.01) increase after 12 h of diterpenes treatments. The cell cultures showed an anti-inflammatory effect, in the case of TGF-β induction, in response to infection when treated with the diterpenes. On the other hand, there was not any significant effect on TNF-α release.
The diterpenes anastomosine and 7,20-dihydroanastomosine increased the production of RNS after 36 h of infection and treatment. Besides, the three diterpenes increased the production of ROS after 12 h. This RNS and ROS modulation can be considered as an in vitro correlation of innate immunity in response to Mycobacterium tuberculosis infection; and an indicator of the damage of epithelial lung tissue. This study also showed an anti-inflammatory immune response by means of TGF-β modulation when compared with control group.
Peak expiratory flow vs. spirometry for the diagnosis of asthma in adults Herrera-Sánchez, Andrea; Álvarez-Chávez, Fabián Eduardo; Castillo-Hernández, María C ...
Revista alergia Mexico (Tecamachalco, Pueblo, Mexico : 1993),
2019 Jul-Sep, 20190701, 2019-07-01, Volume:
66, Issue:
3
Journal Article
Peer reviewed
Open access
The diagnosis of asthma is confirmed with a spirometry: FEV1 ratio (forced expiratory volume in one second)/FVC (forced vital capacity) <80% with reversibility (FEV1 >12% or 200 mL) after using ...salbutamol. The peak expiratory flow is cheap and easy to use; it measures the forced expiratory flow, of which reversibility > 20% suggests asthma.
To know the sensitivity, specificity, and the positive and negative predictive values of the flowmeter.
A cross-sectional, observational, comparative study. Individuals aged >18 years without contraindications for spirometry were included. They underwent spirometry and peak expiratory flow, and the ACT (Asthma Control Test) questionnaire was applied to them. Sensitivity, specificity, positive predictive value and negative predictive value of the flowmetry were calculated. ROC curve was carried out in order to know the cut-off point of greater sensitivity and specificity.
Of 150 patients, 66% were male; the median age was 38 years. According to the guidelines of GINA 2018 (Global Initiative for Asthma); 58.7% were controlled. The sensitivity of the peak expiratory flow was 47%, and the specificity was 87%, with a positive predictive value of 54.8% and a negative predictive value of 84%. The peak expiratory flow showed higher specificity with FEV1 <59%. The cut-off point of greater sensitivity and specificity was a reversibility of 8%, with an area under the curve of 0.70.
The flowmeter has got greater sensitivity in airway obstructions; it is useful when a spirometer is not available.
Antecedentes: El diagnóstico de asma se confirma con espirometría: VEF1 (volumen espiratorio forzado del primer segundo)/CVF (capacidad vital forzada) < 80 %, con reversibilidad (VEF1 >12 % o 200 mL) ...tras utilizar salbutamol. El flujómetro es barato y fácil de utilizar, mide el flujo espiratorio forzado, cuya reversibilidad > 20 % sugiere asma.Objetivo: Conocer sensibilidad, especificidad y valores predictivos positivos y negativo del flujómetro.Métodos: Estudio transversal, observacional, comparativo. Se incluyó a individuos > 18 años sin contraindicaciones para espirometría, quienes fueron sometidos a espirometría y flujometría y se les aplicó el Asthma Control Test. Se calculó sensibilidad, especificidad y valores predictivos positivo y negativo de la flujometría. Se realizó curva ROC para conocer el punto de corte de mayor sensibilidad y especificidad.Resultados: De 150 pacientes, 66 % fue del sexo masculino; la mediana de edad fue de 38 años. Conforme los criterios de Global Initiative for Asthma 2018, 58.7 % estaba controlado. La sensibilidad de la flujometría fue de 47 %, la especificidad de 87 %, valor predictivo positivo de 54.8 % y negativo de 84 %. La flujometría mostró mayor especificidad con VEF1 < 59 %. El punto de corte de mayor sensibilidad y especificidad fue una reversibilidad de 8 %, con área bajo la curva de 0.70.Conclusiones: El flujómetro tiene mayor sensibilidad en obstrucciones de vía aérea; es de utilidad cuando no se cuenta con un espirómetro.
To study the clinical characteristics of a cohort of Spanish patients diagnosed with Behcet disease and who also presented ocular inflammation.
Thirty cases of Behçet disease were studied ...retrospectively. The authors studied age distribution, distribution by sex, clinical course, laterality, type of uveitis, secondary glaucoma, corneal involvement, hypopyon, iris-lens synechiae, secondary cataract, cystoid macular edema (CME), and papillitis (optic neuritis).
Fourteen of the patients were men and 16 were women (ratio 0.875:1). The mean age of the patients was 35.24 years (+/-10.917; 21-61 years). In 23 patients, the disease course was recurrent. In 9 patients, the disease manifested unilaterally. In 5 patients showing unilateral onset, the contralateral eye became affected. In 2 of the 30 patients, uveitis exclusively affected the anterior segment. In 8 patients, uveitis was solely posterior. There was one case of intermediate uveitis. The remaining 19 patients showed panuveitis. Three had focal chorioretinitis. One had diffuse chorioretinitis. Fifteen showed signs of diffuse vasculitis. Eight patients showed focal vasculitis.
Women were slightly more affected than men, although the authors found no significant correlation between sex and the clinical variables examined. Apart from one unexpected case of intermediate uveitis, the observations are similar to those reported for other patient series.
Assessment of needs in schizophrenia patients Rosales Varo, C; Torres González, F; Luna-Del-Castillo, Juan ...
Actas españolas de psiquiatría,
2002 May-Jun, Volume:
30, Issue:
3
Journal Article
Peer reviewed
To optimise appropriate planning of services, the care needs in patients with chronic mental illness, the organisms or individuals that cover these needs, and the relationships between specific needs ...and sociodemographic variables should be identified. This study was designed to assess needs in a population of persons with mental illness.
The Camberwell Assessment of Need (CAN) questionnaire was used to obtain and report quantitative information on needs. A total of 246 patients diagnosed as having schizophrenic disorder and 246 staff members of public mental health services, all living and working in the province of Granada (southern Spain, n = 187) or the city of Madrid (central Spain, n = 56), completed the questionnaire. Regression analysis was used to identify correlations between needs and sociodemographic variables.
Mean needs score was 6.5; the most frequent needs were those related with daytime activities, company, psychotic symptoms, psychological distress, basic education and money management. The sociodemographic variables most closely associated with these needs were: not living with a life partner, low educational level, and receiving state benefits. The type of help these patients received was mainly from the family (informal help); public services (formal help) covered mainly clinical needs.
The needs of persons with schizophrenic disorder do not differ from those of members of the more marginalised groups in Spanish society. Care provided by family members often represents a considerable burden on relatives.
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