Search

Summary: Background: The clinical relevance of recurrent venous thromboembolism (VTE) after discontinuing anticoagulation in patients with COVID-19-associated VTE remains uncertain. We estimated the incidence rates and mortality of VTE recurrences developing after discontinuing anticoagulation in patients with COVID-19-associated VTE. Methods: A prospective, multicenter, non-interventional study was conducted between March 25, 2020, and July 26, 2023, including patients who had discontinued anticoagulation after at least 3 months of therapy. All patients from the registry were analyzed during the study period to verify inclusion criteria. Patients with superficial vein thrombosis, those who did not receive at least 3 months of anticoagulant therapy, and those who were followed for less than 15 days after discontinuing anticoagulation were excluded. Outcomes were: 1) Incidence rates of symptomatic VTE recurrences, and 2) fatal PE. The rate of VTE recurrences was defined as the number of patients with recurrent VTE divided by the patient-years at risk of recurrent VTE during the period when anticoagulation was discontinued. Findings: Among 1106 patients with COVID-19-associated VTE (age 62.3 ± 14.4 years; 62.9% male) followed-up for 12.5 months (p25-75, 6.3–20.1) after discontinuing anticoagulation, there were 38 VTE recurrences (3.5%, 95% confidence interval [CI]: 2.5–4.7%), with a rate of 3.1 per 100 patient-years (95% CI: 2.2–4.2). No patient died of recurrent PE (0%, 95% CI: 0–7.6%). Subgroup analyses showed that patients with diagnosis in 2021–2022 (vs. 2020) (Hazard ratio [HR] 2.86; 95% CI 1.45–5.68) or those with isolated deep vein thrombosis (vs. pulmonary embolism) (HR 2.31; 95% CI 1.19–4.49) had significantly higher rates of VTE recurrences. Interpretation: In patients with COVID-19-associated VTE who discontinued anticoagulation after at least 3 months of treatment, the incidence rate of recurrent VTE and the case-fatality rate was low. Therefore, it conceivable that long-term anticoagulation may not be required for many patients with COVID-19-associated VTE, although further research is needed to confirm these findings. Funding: Sanofi and Rovi, Sanofi Spain.

Introduction: Bronchiolitis poses a considerable challenge during its seasonal peak, overwhelming the material and human resources available to care for affected patients. As a result, interhospital transfers increase exponentially. We did not find any studies analysing the characteristics of patients with bronchiolitis managed in out-of-hospital urgent care (OHUC) services and the impact of the COVID-19 pandemic on the epidemiology of bronchiolitis. Objective: To establish the characteristics of paediatric and neonatal patients with acute bronchiolitis (AB) managed in OHUC services in the Community of Madrid and to analyse the impact of the COVID-19 pandemic on the epidemiology of bronchiolitis. Methods: Retrospective cross-sectional observational and descriptive study carried out in OHUC settings in the Community of Madrid between 2016 and 2023. We included patients with a diagnosis of acute bronchiolitis based on the ICD-10 codes documented in the electronic records of urgent care visits and interhospital transports. We collected data on sociodemographic, clinical and treatment (ventilation and medication) variables. Results: The sample included 630 patients with AB: 343 managed in non-neonatal OHUC (non-neo) services and 287 by the mobile neonatal intensive care unit transport team (NTT). The median age was 3.7 months (IQR, 2.8–4.7) in patients in the non-neo OHUC group and 19 days (IQR, 14.2−23.7) in the NTT group. There was a statistically significant increase in age in the 2020/2021 season in the non-neo OHUC group. The severity score was significantly higher in the NTT group. There was an unusual peak in bronchiolitis cases in June 2021, coinciding with the end of the 4th wave of the COVID-19 pandemic. The incidence of bronchiolitis was highest after the 6th wave of the pandemic (13.5 cases per 10 000 children aged < 2 years). Conclusions: The median age of paediatric patients with AB managed in OHUC services increased following the end of the lockdown imposed due to the COVID-19 pandemic, which was probably associated with the lack of exposure to the viruses that cause it. This also may explain why the incidence of bronchiolitis was highest in the season following the 6th wave of the pandemic. The severity score was higher in neonatal patients. Epidemiological surveillance, the introduction of protocols and the implementation of an ongoing training programme for non-specialized health care staff involved in the transport of these patients could improve their management. Resumen: Introducción: La bronquiolitis se convierte en todo un reto durante su pico estacional, desbordando los recursos materiales y humanos para poder atender los pacientes afectados. A consecuencia de ello, se multiplican exponencialmente los traslados interhospitalarios. No se han encontrado estudios que hayan analizado las características de los pacientes con bronquiolitis aguda (BA) en los Servicios de Urgencias Extrahospitalarios (SUEH) y la influencia de la pandemia en su epidemiología. Objetivo: Conocer las características de los pacientes pediátricos y neonatales con bronquiolitis en los SUEH de la Comunidad de Madrid y analizar la influencia de la pandemia COVID-19 en su epidemiología. Material y métodos: Estudio observacional descriptivo, transversal y retrospectivo realizado en los SUEH de la Comunidad de Madrid entre 2016–2023. Se incluyeron pacientes con diagnóstico de BA según CIE-10 en la Historias Clínicas de las asistencias y traslados interhospitalarios. Se registraron variables sociodemográficas, clínicas y de tratamiento (ventilatorio y farmacológico). Resultados: Se incluyeron 630 pacientes con BA: 343 atendidos por los SUEH no especializados en neonatología (no-neo) y 287 por el equipo de transporte neonatal (TN). La mediana de edad fue de 3,7 meses [2,8–4,7] en SUEH no-neo y de 19 días [14,2–23,7] en TN. Hubo un aumento de la edad estadísticamente significativa en la temporada 2020/2021 en el grupo de SUEH no-neo. La escala de gravedad fue estadísticamente mayor en el grupo de TN. Hubo un pico inusual de casos de bronquiolitis en junio de 2021 coincidiendo con el fin de la 4ª ola de COVID-19. La incidencia de bronquiolitis, tras la 6ª ola de pandemia, fue la mayor de todas las temporadas (13,5 casos por cada 10.000 niños ≤ 2 años). Conclusiones: La mediana de edad en los pacientes pediátricos con bronquiolitis aguda en los SUEH aumentó tras finalizar el confinamiento de la pandemia COVID-19, en probable relación con la ausencia de exposición a los virus causantes de la misma. Esto podría explicar también que la incidencia de bronquiolitis tras la 6ª ola de pandemia fue la mayor de todas las temporadas. La escala de gravedad fue mayor en los pacientes neonatales. La vigilancia epidemiológica, implantación de protocolos e implementación de un programa de formación continuada a los profesionales no especializados encargados de los traslados de este tipo de pacientes podría mejorar su manejo.

ABSTRACT: During the poultry sperm cryopreservation process, an excess of reactive oxygen species is generated resulting in oxidative stress which harms the quality of avian spermatozoa. To counteract this effect, the addition of exogenous antioxidants, such as Pectoliv-80A (a by-product of olive oil), to the cryopreservation diluent is interesting. For this purpose, 16 roosters belonging to the Utrerana avian breed were used. Six semen pools (from the 6 different replicates) were divided into 4 aliquots corresponding to different concentrations of Pectoliv-80A that were tested (0, 300, 400, and 500 μg/mL), and the cryopreservation process was carried out. To evaluate post-thawing semen quality, different parameters such as motility, membrane functionality, reactive oxygen species production, lipid peroxidation, and acrosome integrity were studied. A discriminant canonical analysis was used to determine both the differences between the Pectoliv-80A concentration groups and the discriminant power of the aforementioned parameter used for semen evaluation. Total motility and membrane functionality were reported to be the most discriminant variables for differentiating the different antioxidant enrichment groups and concluded that concentrations of 300 μg/mL showed the most desirable quality of post-thawing semen. The present study could lead to the optimization of both cryopreservation and quality evaluation techniques of the sperm of rooster species, that support the conservation program of endangered local breeds.

Introduction: Helicobacter pylori infection affects more than 50% of the world population. Increased antibiotic resistance is the main cause of treatment failure. The main objective was to analyze the eradication success after the application of the new ESPGHAN treatment recommendations and the introduction of PCR as a direct diagnosis technique, describe the evolution of the local pattern of antibiotic resistance, and assess the cost-effectiveness of PCR application, isolated or in conjunction with culture as a diagnostic strategy. Patients and methods: Retrospective descriptive study of all microbiological isolates of Helicobacter pylori in 2013–2019 in our center, by comparing the percentage of resistance and eradication success between the periods 2013−2016 and 2017−2019. Cost-effectiveness study of direct diagnostic tests, comparing 3 different options: culture and PCR; only culture; PCR only. Results: 192 patients were included, 98 were detected by culture (2013−2016) and 94 by culture and/or PCR (2017−2019). Antibiotic treatment was established in 153 patients, 90 in the first period (2011 ESPGHAN guidelines: eradication percentage 62.2%), 63 in the second (2017 ESPGHAN guidelines: eradication percentage: 73%). An increase in resistance to clarithromycin was observed, going from 16.3% (n = 16) in the first period, to 53.2% (n = 48) in 2017−2019 (98% detected by PCR, 60% by culture). There were no differences in the rest of antibiotic resistances. The isolated PCR application presented a cost-effectiveness analysis ratio (CEAR) of 71.91, compared to 92.16 for the culture and 96.35 for the culture and PCR combined. Conclusions: The application of the ESPGHAN 2017 guidelines achieved greater eradication success, although less than that observed in previous publications, without reaching the target of at least 90%. An increase in resistance to macrolides was observed, without being able to discriminate whether it is a real increase or a greater diagnostic sensitivity of molecular techniques, with the isolated request for PCR being the most cost-effective strategy. Resumen: Introducción: La infección por Helicobacter pylori afecta a más del 50% de la población mundial. El aumento en las resistencias antibióticas es la principal causa del fracaso del tratamiento. El objetivo principal fue analizar el éxito erradicador tras la aplicación de las nuevas recomendaciones de tratamiento ESPGHAN e introducción de la PCR como técnica de diagnóstico directo, describir la evolución del patrón local de resistencias antibióticas y valorar el coste-efectividad de la aplicación de la PCR aislada o en conjunto con el cultivo como estrategia diagnóstica. Pacientes y métodos: Estudio descriptivo retrospectivo del total de aislamientos microbiológicos de Helicobacter pylori entre 2013–2019 en nuestro centro, mediante comparación del porcentaje de resistencias y éxito erradicador entre los periodos 2013−2016 y 2017−2019. Estudio de coste-efectividad de las pruebas de diagnóstico directo, comparando 3 opciones distintas: cultivo y PCR; solo cultivo; solo PCR. Resultados: Se incluyeron 192 pacientes, 98 fueron detectados por cultivo (2013−2016) y 94 por cultivo y/o PCR (2017−2019). Se instauró tratamiento antibiótico en 153 pacientes, 90 en el primer periodo (pautas ESPGHAN 2011: porcentaje erradicación 62.2%), 63 en el segundo (pautas ESPGHAN 2017: porcentaje erradicación: 73%). Se observó un aumento en las resistencias a claritromicina, pasando de un 16.3% (n = 16) en el primer periodo, a un 53.2% (n = 48) entre 2017−2019 (98% detectadas por PCR, 60% por cultivo). No hubo diferencias en el resto de resistencias antibióticas. La solicitud aislada de la PCR presentó un ratio de análisis de coste-efectividad (CEAR) de 71.91, en comparación con un 92,16 del cultivo y un 96.35 del cultivo y la PCR de forma conjunta. Conclusiones: La aplicación de las pautas ESPGHAN 2017 consiguió un mayor éxito de erradicación, aunque menor que lo observado en publicaciones previas, sin llegar al objetivo marcado de al menos un 90%. Se observó un incremento en las resistencias a macrólidos, sin poder discriminar si se trata de un aumento real o de una mayor sensibilidad diagnóstica de las técnicas moleculares, siendo la solicitud aislada de la PCR la estrategia más coste efectiva.

Resumen: Introducción: La infección por Helicobacter pylori (H. pylori) afecta a más del 50% de la población mundial. El aumento en las resistencias antibióticas es la principal causa del fracaso del tratamiento. El objetivo principal fue analizar el éxito erradicador tras la aplicación de las nuevas recomendaciones de tratamiento ESPGHAN e introducción de la PCR como técnica de diagnóstico directo, describir la evolución del patrón local de resistencias antibióticas y valorar el coste-efectividad de la aplicación de la PCR aislada o en conjunto con el cultivo como estrategia diagnóstica. Pacientes y métodos: Estudio descriptivo retrospectivo del total de aislamientos microbiológicos de H. pylori entre 2013-2019 en nuestro centro, mediante comparación del porcentaje de resistencias y éxito erradicador entre los periodos 2013-2016 y 2017-2019. Estudio de coste-efectividad de las pruebas de diagnóstico directo, comparando 3 opciones distintas: cultivo y PCR, solo cultivo, y solo PCR. Resultados: Se incluyó a 192 pacientes, 98 fueron detectados por cultivo (2013-2016) y 94 por cultivo o PCR (2017-2019). Se instauró tratamiento antibiótico en 153 pacientes, 90 en el primer periodo (pautas ESPGHAN 2011: porcentaje erradicación 62,2%), 63 en el segundo (pautas ESPGHAN 2017: porcentaje erradicación: 73%). Se observó un aumento en las resistencias a claritromicina, pasando de un 16,3% (n = 16) en el primer periodo a un 53,2% (n = 48) entre 2017-2019 (98% detectadas por PCR, 60% por cultivo). No hubo diferencias en el resto de resistencias antibióticas. La solicitud aislada de la PCR presentó una ratio de análisis de coste-efectividad (CEAR) de 71,91, en comparación con un 92,16 del cultivo y un 96,35 del cultivo y la PCR de forma conjunta. Conclusiones: La aplicación de las pautas ESPGHAN 2017 consiguió un mayor éxito de erradicación, aunque menor que lo observado en publicaciones previas, sin llegar al objetivo marcado de al menos un 90%. Se observó un incremento en las resistencias a macrólidos, sin poder discriminar si se trata de un aumento real o de una mayor sensibilidad diagnóstica de las técnicas moleculares, siendo la solicitud aislada de la PCR la estrategia más coste efectiva. Abstract: Introduction: Helicobacter pylori (H. pylori) infection affects more than 50% of the world population. Increased antibiotic resistance is the main cause of treatment failure. The main objective was to analyze the eradication success after the application of the new ESPGHAN treatment recommendations and the introduction of PCR as a direct diagnosis technique, describe the evolution of the local pattern of antibiotic resistance, and assess the cost-effectiveness of PCR application, isolated or in conjunction with culture as a diagnostic strategy. Patients and methods: retrospective descriptive study of all microbiological isolates of H. pylori in 2013-2019 in our center, by comparing the percentage of resistance and eradication success between the periods 2013-2016 and 2017-2019. Cost-effectiveness study of direct diagnostic tests, comparing 3 different options: culture and PCR; only culture; PCR only. Results: 192 patients were included, 98 were detected by culture (2013-2016) and 94 by culture and / or PCR (2017-2019). Antibiotic treatment was established in 153 patients, 90 in the first period (2011 ESPGHAN guidelines: eradication percentage 62.2%), 63 in the second (2017 ESPGHAN guidelines: eradication percentage: 73%). An increase in resistance to clarithromycin was observed, going from 16.3% (n = 16) in the first period, to 53.2% (n = 48) in 2017-2019 (98% detected by PCR, 60% by culture). There were no differences in the rest of antibiotic resistances. The isolated PCR application presented a cost-effectiveness analysis ratio (CEAR) of 71.91, compared to 92.16 for the culture and 96.35 for the culture and PCR combined. Conclusions: the application of the ESPGHAN 2017 guidelines achieved greater eradication success, although less than that observed in previous publications, without reaching the target of at least 90%. An increase in resistance to macrolides was observed, without being able to discriminate whether it is a real increase or a greater diagnostic sensitivity of molecular techniques, with the isolated request for PCR being the most cost-effective strategy.

This study was aimed to develop and validate a short scale to measure satisfaction with virtual courses (SVC–S) in a sample of higher education students during the covid-19 pandemic; specifically, in the year 2021. A total of 3080 students between 16 and 56 years of age participated (Mean = 25.71; SD = 8.83); 1836 were female (59.60 %) and 1244 male (40.40 %). The participants were students from three cities in Peru (77.90% from Lima, 12.70% from Trujillo and 9.42% from Cajamarca). Qualitative and quantitative procedures were followed for the construction of the SVC-S. Item response theory (IRT) considering Samejima's two-parameter Graded Response Model (GRM) (2PL) and the test-item information function was used to establish accuracy/reliability, and the relationship of the SVC-S with a similar measure was examined to demonstrate convergence and discrimination. The results reveal that the data present an optimal fit (M2 (2) = 3.62; RMSEA = .016; CFI = 1.00). Reliability is excellent (rxx = .93) and the information function suggests that the instrument is more accurate at low levels of the latent trait. Regarding convergence with an academic satisfaction scale, the SVC-S showed an appropriate correlation (r = .70) whose average variance extracted (AVE) reported good discrimination of the constructs; despite being conceptually similar. SVC-S is concluded to be a valid and reliable measure that can be used in future studies in higher education.

Job satisfaction is related to better physical and mental health, as well as to factors specifically related to work. In this context, the measurement of work satisfaction is important for organizations that profess an interest in engaged and satisfied workers. Therefore, this study aims to examine the psychometric properties of the Satisfaction with Job Life Scale (SWJLS) in Portuguese workers by combining the procedures of the Classical Test Theory (CTT) and the Item Response Theory (IRT). Specifically, internal structure of the scale was studied, its reliability (consistency), correlations with other measures of wellbeing (life satisfaction, loneliness, emotional wellbeing at work, and job satisfaction) were also estimated, and finally, the sacle waqs tested for gender measurement invariance. Participants were 404 workers, 61% women and 39% men, aged between 18 and 64 years (M = 36.85; SD = 14.50). Confirmatory Factor Analysis indicated that the one-dimensional model of the SWJLS was adequate (Robust χ2(5) = 9.89, p = .078; CFI = .993; RMSEA = .049, 90% CI [.000 - .094]; SRMR = .011.) and had good internal consistency (ω = .947, 95% CI [.936, 956]; α = .947, 95% CI [.935, .955]). Subsequent analyses revealed that the scores of the SWJLS were related to other measures of job satisfaction (r = .742), job-related emotional well-being (r = .628), satisfaction with life (r = .808) and loneliness (r = -.455). Factorial invariance suggests that the structure of the SWJLS measures the same construct (satisfaction with work-life) in both female and male workers. Moreover, IRT analysis suggests that higher levels of work-life satisfaction are needed to choose the upper response options, while a very low level of work-life satisfaction is required to increase the likelihood of choosing the lower response options. In this sense, the SWJLS is useful and reliable, especially for identifying people with low levels of job satisfaction. These findings support the validity of the SWJLS and indicate that the Portuguese version is a brief instrument with good psychometric characteristics for measuring work-life satisfaction.