Background
Because of the coronavirus disease 2019 (COVID‐19) pandemic, the use of prone positioning has dramatically increased in the intensive care unit (ICU). Because this manoeuvre is related to ...several complications, it must be performed in a protocolized manner by the appropriate personnel.
Aim
To determine the prevalence of adverse events (AEs) in patients admitted to the ICU with a diagnosis of COVID‐19‐related acute respiratory distress syndrome (C‐ARDS) undergoing mechanical ventilation in prone position (PP).
Design
Descriptive ambispective study of patients admitted to the ICU diagnosed with C‐ARDS undergoing mechanical ventilation who were in the PP at least once.
The number of PP manoeuvres and the time spent in the PP were recorded for each subject. AEs proportions and frequencies were calculated, and analysis of variance was used to assess mean differences in the number of manoeuvres and total hours in PP stratified by the number of facial pressure ulcers. IBM SPSS Statistics v.25.0. and EPIDAT 4.1 software were used.
Results
Forty‐four patients were analysed, and 130 PP manoeuvres were performed. The most frequently observed AEs were facial oedema in 26 patients (80.3%) and facial pressure ulcers in 20 (60.6%). There was a significant positive association between the time spent in PP and the development of facial pressure ulcers (P < .001). Enteral nutrition was well tolerated, and no serious AEs or sentinel events were noted.
Conclusion
Despite the stressful, demanding situation during the peak of the pandemic, the large number of PP manoeuvres, and long duration spent in this position, no serious AEs occurred. This study highlights the need to implement preventive measures to avoid the development of pressure ulcers secondary to prone positioning.
Relevance to practice
Prone positioning requires a nursing protocol to prevent the occurrence of AEs that may reduce the quality of nursing care.
Aims and Objectives
This study examined the predictors of caregiver burden based on patient and caregiver characteristics in a sample of Spanish caregivers looking after adult patients with chronic ...disease. The effect of task type and patient–caregiver interaction is also analysed.
Background
Specific predictors of caregiver burden have been widely examined in the literature. Few studies, however, jointly analyse a wide range of factors, including the effect of task type and patient–caregiver interaction.
Design
Correlational study.
Methods
One hundred and thirty five informal caregivers for 148 care recipients were recruited from primary health care centres. The caregivers responded to the short version of the Zarit Burden Interview (ZBI), the DEPendency index‐6 Dimensions (DEP‐6D), and reported how long they spent on caregiving on a daily basis. Sociodemographic and health characteristics were also recorded. Linear and logistic regression models were used to evaluate factors associated with ZBI scores and the likelihood of being severely burdened, respectively. This research complies with STROBE guidelines for observational studies.
Results
Severe burden was present in 62% of the caregivers. Regression analysis shows that burden severity increases significantly with the level of dependence when the latter is measured either by DEP‐6D or by time spent on basic activities. Care related to incontinence and mobility has the greatest effect on burden, which is aggravated when the patient has behavioural problems. Poor caregiver health or not being retired also contributes to burden levels.
Conclusions
These results establish that caregiver burden is related to characteristics of both the caregiver and the care recipient as well as to their interaction.
Relevance to clinical practice
The findings indicate that the socio‐sanitary attention focused on reducing caregiver burden must address the caregiver and patient as a dyad. Identifying the dependence level and the patient's aggressive behaviour can be a good predictor of caregiver burden.
•IL-8 is a chemokine frequently produced in the tumor microenvironment by human malignant cells.•IL-8 plays key roles in the immunobiology of human malignancies and resistance to ...treatments.•Circulating IL-8 concentration reflects tumor burden.•Change in serum IL-8 is a biomarker to follow immunotherapy with checkpoint inhibitors.
Interleukin-8 (CXCL8) was originally described asa chemokine whose main function is the attraction of a polymorphonuclear inflammatory leukocyte infiltrate acting on CXCR1/2. Recently, it has been found that tumors very frequently coopt the production of this chemokine, which in this malignant context exerts different pro-tumoral functions. Reportedly, these include angiogenesis, survival signaling for cancer stem cells and attraction of myeloid cells endowed with the ability to immunosuppress and locally provide growth factors. Given the fact that in cancer patients IL-8 is mainly produced by tumor cells themselves, its serum concentration has been shown to correlate with tumor burden. Thus, IL-8 serum concentrations have been shown to be useful asa pharmacodynamic biomarker to early detect response to immunotherapy. Finally, because of the roles that IL-8 plays in favoring tumor progression, several therapeutic strategies are being developed to interfere with its functions. Such interventions hold promise, especially for therapeutic combinations in the field of cancer immunotherapy.
The 21st-century problem of Internet addiction is increasing globally, but especially among university students. Not surprisingly, then, problematic Internet use is associated with university ...students' academic procrastination. Because studies are scarce in Mexico and Spain has one of the highest rates of Internet addiction in Europe, this paper (i) analyzed the presence and degree of Internet addiction among university students in Mexico and Spain, (ii) determined potential sociodemographic factors influencing Internet addiction, and (iii) established the type of correlation between Internet addiction and academic procrastination. The cross-sectional study design used an online questionnaire to measure problematic Internet use and academic procrastination through convenience sampling at one university in Mexico and one in Spain. The questionnaire contained three sections: participants' sociodemographic data, the Internet Addiction Test, and the Academic Procrastination Scale. The final sample comprised 758 university students, 387 from Mexico, and 371 from Spain, aged from 18 to 35 (M = 20.08, SD = 3.16). Results revealed similar prevalence rates of problematic and daily Internet use for leisure, potentially influencing Internet addiction in all three models (i.e., Mexico, Spain, and Total). Additionally, significant positive correlation was revealed between problematic Internet use and academic procrastination (p < .001). Finally, findings showed relevant data on Internet addiction's prevalence in Mexican and Spanish university contexts, along with its influential sociodemographic factors.
Gold atomic clusters of only two and three atoms were prepared by a simple electrochemical technique based on the anodic dissolution of a gold electrode in the presence of PVP, and subsequent ...electroreduction of the Au-PVP complexes. These clusters show stable photoluminescent and magnetic properties, which make them the smallest and most elemental gold (0) building blocks in nature (after atoms) bringing new possibilities to construct novel nano/microstructures with large potential interest in biomedicine, catalysis, and so forth.
Limosilactobacillus fermentum CECT5716, a probiotic strain isolated from human milk, has reported beneficial effects on different gastrointestinal disorders. Moreover, it has shown its ability to ...restore altered immune responses, in association with microbiome modulation in different pathological conditions. Therefore, our aim was to assess the effects of a Limosilacbacillus fermentum CECT5716 in a rat experimental model of irritable bowel syndrome (IBS) that resembles human IBS. The experimental IBS was induced by deoxycholic acid (DCA) in rats and then, Limosilactobacillus fermentum CECT5716 (109 CFU/day/rat) was administered. Behavioral studies, hyperalgesia and intestinal hypersensitivity determinations were performed and the impact of the probiotic on the inflammatory and intestinal barrier integrity was evaluated. Additionally, the gut microbiota composition was analyzed. Limosilactobacillus fermentum CECT5716 attenuated the anxiety-like behavior as well as the visceral hypersensitivity and referred pain. Moreover, this probiotic ameliorated the gut inflammatory status, re-establishing the altered intestinal permeability, reducing the mast cell degranulation and re-establishing the gut dysbiosis in experimental IBS. Therefore, our results suggest a potential use of Limosilactobacillus fermentum CECT5716 in clinical practice for the management of IBS patients.
Different species can find convergent solutions to adapt their genome to the same evolutionary constraints, although functional convergence promoted by chromosomal rearrangements in different species ...has not previously been found. In this work, we discovered that two domesticated yeast species, Saccharomyces cerevisiae, and Saccharomyces uvarum, acquired chromosomal rearrangements to convergently adapt to the presence of sulfite in fermentation environments. We found two new heterologous chromosomal translocations in fermentative strains of S. uvarum at the SSU1 locus, involved in sulfite resistance, an antimicrobial additive widely used in food production. These are convergent events that share similarities with other SSU1 locus chromosomal translocations previously described in domesticated S. cerevisiae strains. In S. uvarum, the newly described VIIXVI and XIXVI chromosomal translocations generate an overexpression of the SSU1 gene and confer increased sulfite resistance. This study highlights the relevance of chromosomal rearrangements to promote the adaptation of yeast to anthropic environments.
Summary
Background
The long‐term outcome of patients after antitumour necrosis factor alpha (anti‐TNF) discontinuation is not well known.
Aims
To assess the risk of relapse in the long‐term after ...anti‐TNF discontinuation.
Methods
This was an extension of the evolution after anti‐TNF discontinuation in patients with inflammatory bowel disease (EVODIS) study (Crohn's disease or ulcerative colitis patients treated with anti‐TNFs in whom these drugs were withdrawn after achieving clinical remission) based in the same cohort of patients whose outcome was updated. Clinical remission was defined as a Harvey–Bradshaw index ≤4 points in Crohn's disease, a partial Mayo score ≤2 in ulcerative colitis and the absence of fistula drainage despite gentle finger compression in perianal disease.
Results
This was an observational, retrospective, multicenter study. A total of 1055 patients were included. The median follow‐up time was 34 months. The incidence rate of relapse was 12% per patient‐year (95% confidence interval CI = 11‐14). The cumulative incidence of relapse was 50% (95% CI = 47‐53): 19% at one year, 31% at 2 years, 38% at 3 years, 44% at 4 years and 48% at 5 years of follow‐up. Of the 60% patients retreated with the same anti‐TNF after relapse, 73% regained remission. Of the 75 patients who did not respond, 48% achieved remission with other therapies. Of the 190 patients who started other therapies after relapse, 62% achieved remission with the new treatment.
Conclusions
A significant proportion of patients who discontinued the anti‐TNF remained in remission. In case of relapse, retreatment with the same anti‐TNF was usually effective. Approximately half of the patients who did not respond after retreatment achieved remission with other therapies.
More than 1000 patients discontinued the anti‐TNF therapy after having achieved clinical remission. Half of them relapsed during follow‐up. After relapse, 60% of the patients restarted the same anti‐TNF, 36% received other therapeutic options, and 4% were operated on. Of the patients who restarted the same anti‐TNF, 73% achieved remission. Of the patients who received other therapeutic options, two‐thirds achieved remission.
Chronic inflammatory skin diseases such as psoriasis have a significant impact on society. Currently, the major topical treatments have many side effects, making their continued use in patients ...difficult. Microalgae have emerged as a source of bio-active molecules such as glycolipids with potent anti-inflammatory properties. We aimed to investigate the effects of a glycolipid (
) and a glycolipid fraction (
) obtained from the microalga
on a TPA-induced epidermal hyperplasia murine model. In a first set of experiments, we examined the preventive effects of
and
dissolved in acetone on TPA-induced hyperplasia model in mice. In a second step, we performed an in vivo permeability study by using rhodamine-containing cream, ointment, or gel to determinate the formulation that preserves the skin architecture and reaches deeper. The selected formulation was assayed to ensure the stability and enhanced permeation properties of the samples in an ex vivo experiment. Finally,
-containing cream was assessed in the hyperplasia murine model. The results showed that pre-treatment with acetone-dissolved glycolipids reduced skin edema, epidermal thickness, and pro-inflammatory cytokine production (TNF-α, IL-1β, IL-6, IL-17) in epidermal tissue. The in vivo and ex vivo permeation studies showed that the cream formulation had the best permeability profile. In the same way,
-cream formulation showed better permeation than acetone-dissolved preparation.
-cream application attenuated TPA-induced skin edema, improved histopathological features, and showed a reduction of the inflammatory cell infiltrate. In addition, this formulation inhibited epidermal expression of COX-2 in a similar way to dexamethasone. Our results suggest that an
-containing cream could be an emerging therapeutic strategy for the treatment of inflammatory skin pathologies such as psoriasis.
Background
Waist circumference has been suggested as predictor for metabolic syndrome (MetS) in adolescents but it has not been compared with newly proposed anthropometric indexes. This study aimed ...to disclose the capacity of ten classic and novel anthropometric indexes to discriminate by the presence of MetS in this young population.
Materials and methods
A cross‐sectional study was performed on 981 adolescents (13.2 ± 1.2 years) randomly recruited from eighteen schools in south‐east Spain. Body fat percentage (BF%), abdominal volume index (AVI), body roundness index (BRI), body mass index (BMI), body adiposity index (BAI), body adiposity index for paediatrics (BAIp), conicity index (C‐Index), waist circumference (WC), waist‐to‐hip ratio (WHR), waist‐to‐height ratio (WHtR) and body shape index (ABSI) were measured and calculated. Receiver‐operator curves (ROC) were created to determine the discriminatory capacity of these anthropometric parameters for MetS.
Results
The prevalence of MetS was 7.0% for boys and 6.1% in girls. Participants with MetS had significantly higher levels of blood pressure and plasma levels of lipids, glucose and insulin. All anthropometric indexes were elevated in MetS individuals compared to the non‐MetS group. AVI and WC showed the highest AUC values (0.83 for boys and 0.86 for girls). In contrast, according to ROC analyses, no anthropometric index was capable of discriminating the components of MetS (hypertension, hypertriglyceridemia, hyperglycaemia and low‐HDL levels), except for abdominal obesity.
Conclusion
We suggest the use of WC and AVI, with the cut‐off points presented herein, for the discrimination between adolescents with or without MetS.
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