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2,548 results on '"A. Gallegos"'

2. A sex- and gender-based analysis of factors associated with linear growth in infants in Ecuadorian Andes

Author

Emily C. Evers, William F. Waters, Carlos Andres Gallegos-Riofrío, Chessa K. Lutter, Christine P. Stewart, and Lora L. Iannotti

Subjects
Medicine, Science
Abstract

Abstract Although female infants may have an early life biological advantage over males, gendered treatment can alter health outcomes. Ecuador has an unusually high ratio of male to female infant mortality, but gender norms have been reported to favor boys. This analysis of baseline data from the Lulun Project, a randomized controlled trial conducted in rural Andean communities of Ecuador, investigates the roles of sex and gender in undernutrition among infants 6 to 9 months of age. Twenty-four-hour recall frequencies were used to assess dietary intake. Food outcome models were analyzed as prevalence ratios calculated using a binomial distribution with a log link or robust Poisson regression. Linear regression was used to analyze the continuous growth outcome length-for-age z score. Socioeconomic and health history variables were comparable between male and female infants. Boys were more often fed liquids other than breastmilk within their first 3 days of life (17.1% vs. 5.2%, P = 0.026). Compared with girls, boys were less likely to be fed eggs by 33% (95% CI 0.46, 0.96), cheese, yogurt, or other milk products by 40% (95% CI 0.39, 0.92), yellow fruit by 44% (95% CI 0.33, 0.97), water by 37% (95% CI 0.45, 0.88), thin porridge by 29% (95% CI 0.56, 0.92), and tea without milk by 67% (95% CI 0.11, 0.99). Prevalence of boys with an adequate dietary diversity score (≥ 4) was reduced by 27% relative to girls (95% CI 0.54, 0.99). Males fared worse in length-for-age z scores (− 2.16 vs. − 1.56, P = 0.000), weight-for-age z scores (− 0.86 vs. − 0.33, P = 0.002), prevalence of stunting (50.6% vs. 23.4%, P = 0.000), and plasma concentrations of dimethylglycine (1.25 vs. 1.65 µg/mL, P = 0.021). After adjusting for demographic, caregiver perceptions of appetite, and biological factors, length-for-age z score for a male child was 0.62 units lower than for a female (95% CI − 0.98, − 0.26). Male infants were shown to receive lower quality complementary foods and have worse anthropometric measures than female infants. Trial registration clinicaltrials.gov, NCT02446873. Registered February 28, 2015, https://clinicaltrials.gov/ct2/show/NCT02446873 .

Published
2022
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3. Three novel quantum-inspired swarm optimization algorithms using different bounded potential fields

Author

Manuel S. Alvarez-Alvarado, Francisco E. Alban-Chacón, Erick A. Lamilla-Rubio, Carlos D. Rodríguez-Gallegos, and Washington Velásquez

Subjects
Medicine, Science
Abstract

Abstract Based on the behavior of the quantum particles, it is possible to formulate mathematical expressions to develop metaheuristic search optimization algorithms. This paper presents three novel quantum-inspired algorithms, which scenario is a particle swarm that is excited by a Lorentz, Rosen–Morse, and Coulomb-like square root potential fields, respectively. To show the computational efficacy of the proposed optimization techniques, the paper presents a comparative study with the classical particle swarm optimization (PSO), genetic algorithm (GA), and firefly algorithm (FFA). The algorithms are used to solve 24 benchmark functions that are categorized by unimodal, multimodal, and fixed-dimension multimodal. As a finding, the algorithm inspired in the Lorentz potential field presents the most balanced computational performance in terms of exploitation (accuracy and precision), exploration (convergence speed and acceleration), and simulation time compared to the algorithms previously mentioned. A deeper analysis reveals that a strong potential field inside a well with weak asymptotic behavior leads to better exploitation and exploration attributes for unimodal, multimodal, and fixed-multimodal functions.

Published
2021
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4. Percutaneous edge-to-edge tricuspid valve repair in congenitally corrected transposition of the great arteries

Author

Alejandra Salinas Gallegos, Eduardo Pozo Osinalde, Luis Nombela-Franco, Pilar Jiménez Quevedo, Rodrigo Estévez-Loureiro, and José Alberto de Agustín

Subjects
Medicine
Abstract

To the Editor, The congenitally corrected transposition of the great arteries is a rare congenital defect characterized by atrioventricular and ventriculoarterial discordance. As a result, the tricuspid valve and the anatomical right ventricle sustain the systemic circulation. Typically, the patient remains asymptomatic at an early age, but the right ventricle and the tricuspid valve deteriorate with the passing of time. The only curative treatment for this condition is heart transplant. In this setting, percutaneous edge-to-edge tricuspid valve repair has been traditionally used to treat tricuspid regurgitation in patients who are ineligible for heart transplantation; however, to this date, the evidence available is scarce and based on case reporting in heterogeneous clinical settings.1-3

Published
2022
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5. ESR2 gene variants (rs1256049, rs4986938, and rs1256030) and their association with breast cancer risk

Author

Martha Patricia Gallegos-Arreola, Guillermo M. Zúñiga-González, Luis E. Figuera, Ana María Puebla-Pérez, María Guadalupe Márquez-Rosales, Belinda Claudia Gómez-Meda, and Mónica Alejandra Rosales-Reynoso

Subjects
Variants, ESR2, Breast cancer, rs1256049, rs4986938, rs1256030, Medicine, Biology (General), QH301-705.5
Abstract

Background Variants of the estrogen receptor b (ESR2) gene have been associated with different types of cancer. However, these associations have been inconsistent. We genotyped the ESR2 variants (rs1256049, rs4986938, and rs1256030) in breast cancer (BC) patients and in healthy women. Results The variants rs1256049 and rs4986938 in the ESR2 gene were not associated with risk susceptibility in BC patients. However, the rs1256030 variant had an association as a risk factor for BC patients when compared with controls and BC patients for the TT genotype (odds ratio (OR) 1.86, 95% confidence intervals (CI) [1.05–3.28], p = 0.042). In addition, differences were observed in patients and controls carrying the TT genotype under 50 years of age (OR 1.85, 95% CI [1.05–3.27], p = 0.043). Thus, evident differences showed the rs1256030 variant in patients with TT, TC, and TC+TT genotypes with: (1) Stage IV (OR 1.60, 95% CI [1.06–2.54], p = 0.033), and (2) Luminal A (OR 1.60, 95% CI [0.47–0.21], p = 0.041), as well as in BC carriers of the TT genotype with indices of cellular proliferative (Ki-67) elevated (>20%) and overweight (OR 1.67, 95% CI [0.85–3.28], p = 0.041), respectively. In BC HER2 with lymph node metastasis, the TT genotype was a protective factor (OR 0.38, 95% CI [0.18–0.78], p = 0.005). The identification of haplotypes included two common GAT as risk factors (OR 3.1, 95% CI [1.31–7.72], p = 0.011) and GGC as a protective factor (OR 0.7, 95% CI [0.60–0.97], p = 0.034). The haplogenotype GGGATC was a risk factor (OR 2.5, 95% CI [1.28–5.0], p = 0.008). Conclusion The variant rs1256030 (TT) of the ESR2 gene and haplotype GAT were associated with susceptibility to BC as risk factors in this sample from the Mexican population.

Published
2022
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6. Calidad de vida en reconstrucción mamaria postmastectomía. Aplicación del instrumento Breast-Q®

Author

Cuauhtly Gallegos Sierra, Edgar A Morales Flores, José L Villarreal Salgado, Gricelda Hernández Gómez, Jorge A Ramos Guerrero, and Stefan Danilla

Subjects
Cáncer de mama, Calidad de vida, Reconstrucción mamaria, Breast-Q®, Medicine, Surgery, RD1-811
Abstract

Resumen Introducción y objetivo A diferencia de los resultados oncológicos, no existen métodos estándar para evaluar los resultados estéticos. Muchos estudios han evaluado resultados cosméticos y calidad de vida después de la cirugía de cáncer de mama; los resultados fueron muy inconsistentes, tal vez debido al uso de evaluaciones subjetivas no confirmadas, al pequeño tamaño poblacional del estudio, al diseño retrospectivo y las diferencias en las medidas de calidad de vida. El objetivo del presente estudio es determinar el estado de calidad de vida con el instrumento Breast-Q® (previamente autorizado por 2018 Mapi Research Trust© y validado también para su aplicación en español) en mujeres sometidas a reconstrucción mamaria postmastectomía entre 2013-2018. Material y método Estudio de cohorte que incluye pacientes con diagnóstico de cáncer de mama sometidas a reconstrucción mamaria. Medimos su calidad de vida con el instrumento Breast-Q® en su versión en español. Mostramos las variables cuantitativas como promedios y desviación estándar. Los datos cualitativos como frecuencias y porcentajes. El análisis del antes y después de la reconstrucción mamaria con la prueba de Wilcoxon. Tomamos como significativo un valor p

Published
2020
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7. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE)

Author

Pham, Tài, Heunks, Leo, Bellani, Giacomo, Madotto, Fabiana, Aragao, Irene, Beduneau, Gaëtan, Goligher, Ewan C, Grasselli, Giacomo, Laake, Jon Henrik, Mancebo, Jordi, Peñuelas, Oscar, Piquilloud, Lise, Pesenti, Antonio, Wunsch, Hannah, van Haren, Frank, Brochard, Laurent, Laffey, John G, Abrough, Fekri, Acharya, Subhash P, Amin, Pravin, Arabi, Yaseen, Bauer, Philippe, Beitler, Jeremy, Berkius, Johan, Bugedo, Guillermo, Camporota, Luigi, Cerny, Vladimir, Cho, Young-Jae, Clarkson, Kevin, Estenssoro, Elisa, Goligher, Ewan, Gritsan, Alexey, Hashemian, Seyed Mohammadreza, Hermans, Greet, Heunks, Leo M, Jovanovic, Bojan, Kurahashi, Kiyoyasu, Matamis, Dimitrios, Moerer, Onnen, Molnar, Zsolt, Ozyilmaz, Ezgi, Panka, Bernardo, Papali, Alfred, Peñuelas, Óscar, Perbet, Sébastien, Qiu, Haibo, Razek, Assem Abdel, Rittayamai, Nuttapol, Roldan, Rollin, Serpa Neto, Ary, Szuldrzynski, Konstanty, Talmor, Daniel, Tomescu, Dana, Van Haren, Frank, Villagomez, Asisclo, Zeggwagh, Amine Ali, Abe, Toshikazu, Aboshady, Abdelrhman, Acampo-de Jong, Melanie, Acharya, Subhash, Adderley, Jane, Adiguzel, Nalan, Agrawal, Vijay Kumar, Aguilar, Gerardo, Aguirre, Gaston, Aguirre-Bermeo, Hernan, Ahlström, Björn, Akbas, Türkay, Akker, Mustafa, Al Sadeh, Ghamdan, Alamri, Sultan, Algaba, Angela, Ali, Muneeb, Aliberti, Anna, Allegue, Jose Manuel, Alvarez, Diana, Amador, Joaquin, Andersen, Finn H, Ansari, Sharique, Apichatbutr, Yutthana, Apostolopoulou, Olympia, Arellano, Daniel, Arica, Mestanza, Arikan, Huseyin, Arinaga, Koichi, Arnal, Jean-Michel, Asano, Kengo, Asín-Corrochano, Marta, Avalos Cabrera, Jesus Milagrito, Avila Fuentes, Silvia, Aydemir, Semih, Aygencel, Gulbin, Azevedo, Luciano, Bacakoglu, Feza, Badie, Julio, Baedorf Kassis, Elias, Bai, Gabriela, Balaraj, Govindan, Ballico, Bruno, Banner-Goodspeed, Valerie, Banwarie, Preveen, Barbieri, Rosella, Baronia, Arvind, Barrett, Jonathan, Barrot, Loïc, Barrueco-Francioni, Jesus Emilio, Barry, Jeffrey, Bawangade, Harshal, Beavis, Sarah, Beck, Eduardo, Beehre, Nina, Belenguer Muncharaz, Alberto, Belliato, Mirko, Bellissima, Agrippino, Beltramelli, Rodrigo, Ben Souissi, Asma, Benitez-Cano, Adela, Benlamin, Mohamed, Benslama, Abdellatif, Bento, Luis, Benvenuti, Daniela, Bernabe, Laura, Bersten, Andrew, Berta, Giacomo, Bertini, Pietro, Bertram-Ralph, Elliot, Besbes, Mohamed, Bettini, Lisandro Roberto, Beuret, Pascal, Bewley, Jeremy, Bezzi, Marco, Bhakhtiani, Lakshay, Bhandary, Rakesh, Bhowmick, Kaushik, Bihari, Shailesh, Bissett, Bernie, Blythe, David, Bocher, Simon, Boedjawan, Narain, Bojanowski, Christine M, Boni, Elisa, Boraso, Sabrina, Borelli, Massimo, Borello, Silvina, Borislavova, Margarita, Bosma, Karen J, Bottiroli, Maurizio, Boyd, Owen, Bozbay, Suha, Briva, Arturo, Bruel, Cédric, Bruni, Andrea, Buehner, Ulrike, Bulpa, Pierre, Burt, Karen, Buscot, Mathieu, Buttera, Stefania, Cabrera, Jorge, Caccese, Roberta, Caironi, Pietro, Canchos Gutierrez, Ivan, Canedo, Nancy, Cani, Alma, Cappellini, Iacopo, Carazo, Jesus, Cardonnet, Luis Pablo, Carpio, David, Carriedo, Demetrio, Carrillo, Ramón, Carvalho, João, Caser, Eliana, Castelli, Antonio, Castillo Quintero, Manuel, Castro, Heloisa, Catorze, Nuno, Cengiz, Melike, Cereijo, Enrique, Ceunen, Helga, Chaintoutis, Christos, Chang, Youjin, Chaparro, Gustavogcha, Chapman, Carmel, Chau, Simon, Chavez, Cecilia Eugenia, Chelazzi, Cosimo, Chelly, Jonathan, Chemouni, Frank, Chen, Kai, Chena, Ariel, Chiarandini, Paolo, Chilton, Phil, Chiumello, Davide, Chou-Lie, Yvette, Chudeau, Nicolas, Cinel, Ismail, Cinnella, Gilda, Clark, Michele, Clark, Thomas, Clementi, Stefano, Coaguila, Luis, Codecido, Alexis Jaspe, Collins, Amy, Colombo, Riccardo, Conde, Juan, Consales, Guglielmo, Cook, Tim, Coppadoro, Andrea, Cornejo, Rodrigo, Cortegiani, Andrea, Coxo, Cristina, Cracchiolo, Andrea Neville, Crespo Ramirez, Mónica, Crova, Philippe, Cruz, José, Cubattoli, Lucia, Çukurova, Zafer, Curto, Francesco, Czempik, Piotr, D'Andrea, Rocco, da Silva Ramos, Fernando, Dangers, Laurence, Danguy des Déserts, Marc, Danin, Pierre-Eric, Dantas, Fabianne, Daubin, Cédric, Dawei, Wu, de Haro, Candelaria, de Jesus Montelongo, Felipe, De Mendoza, Diego, de Pablo, Raúl, De Pascale, Gennaro, De Rosa, Silvia, Decavèle, Maxens, Declercq, Pierre-Louis, Deicas, Alberto, del Carmen Campos Moreno, María, Dellamonica, Jean, Delmas, Benjamin, Demirkiran, Oktay, Demirkiran, Hilmi, Dendane, Tarek, di Mussi, Rossella, Diakaki, Chrysi, Diaz, Anatilde, Diaz, Willy, Dikmen, Yalim, Dimoula, Aikaterini, Doble, Patricia, Doha, Nagwa, Domingos, Guilherme, Dres, Martin, Dries, David, Duggal, Abhijit, Duke, Graeme, Dunts, Pavel, Dybwik, Knut, Dykyy, Maksym, Eckert, Philippe, Efe, Serdar, Elatrous, Souheil, Elay, Gülseren, Elmaryul, Abubaker S, Elsaadany, Mohamed, Elsayed, Hany, Elsayed, Samar, Emery, Malo, Ena, Sébastien, Eng, Kevin, Englert, Joshua A, Erdogan, Elif, Ergin Ozcan, Perihan, Eroglu, Ege, Escobar, Miguel, Esen, Figen, Esen Tekeli, Arzu, Esquivel, Alejandro, Esquivel Gallegos, Helbert, Ezzouine, Hanane, Facchini, Alberto, Faheem, Mohammad, Fanelli, Vito, Farina, Maria Fernanda, Fartoukh, Muriel, Fehrle, Lutz, Feng, Feng, Feng, Yufeng, Fernandez, Irene, Fernandez, Borja, Fernandez-Rodriguez, Maria Lorena, Ferrando, Carlos, Ferreira da Silva, Maria João, Ferreruela, Mireia, Ferrier, Janet, Flamm Zamorano, Matias Jesús, Flood, Laura, Floris, Leda, Fluckiger, Martin, Forteza, Catalina, Fortunato, Antonella, Frans, Eric, Frattari, Antonella, Fredes, Sebastian, Frenzel, Tim, Fumagalli, Roberto, Furche, Mariano Andres, Fusari, Maurizio, Fysh, Edward, Galeas-Lopez, Juan Luis, Galerneau, Louis-Marie, Garcia, Analía, Garcia, María Fernanda, Garcia, Elisabet, Garcia Olivares, Pablo, Garlicki, Jaroslaw, Garnero, Aude, Garofalo, Eugenio, Gautam, Prabha, Gazenkampf, Andrey, Gelinotte, Stéphanie, Gelormini, Domenico, Ghrenassia, Etienne, Giacomucci, Angelo, Giannoni, Robert, Gigante, Andrea, Glober, Nancy, Gnesin, Paolo, Gollo, Yari, Gomaa, Dina, Gomero Paredes, Rosita, Gomes, Rui, Gomez, Raúl Alejandro, Gomez, Oscar, Gomez, Aroa, Gondim, Louise, Gonzalez, Manuel, Gonzalez, Isabel, Gonzalez-Castro, Alejandro, Gordillo Romero, Orlando, Gordo, Federico, Gouin, Philippe, Graf Santos, Jerónimo, Grainne, Rooney, Grando, Matilde, Granov Grabovica, Sanja, Grasso, Salvatore, Grasso, Rinaldo, Grimmer, Lisa, Grissom, Colin, Gu, Qing, Guan, Xiang-Dong, Guarracino, Fabio, Guasch, Neus, Guatteri, Luca, Gueret, Renaud, Guérin, Claude, Guerot, Emmanuel, Guitard, Pierre-Gildas, Gül, Fethi, Gumus, Ayca, Gurjar, Mohan, Gutierrez, Patricia, Hachimi, Abdelhamid, Hadzibegovic, Adi, Hagan, Samantha, Hammel, Clare, Han Song, Joo, Hanlon, Gabrielle, Heines, Serge, Henriksson, Johanna, Herbrecht, Jean-Etienne, Heredia Orbegoso, Gabriel Omar, Hermon, Andrew, Hernandez, Rosana, Hernandez, Carmen, Herrera, Luis, Herrera-Gutierrez, Manuel, Hidalgo, Juan, Hill, Dianne, Holmquist, Dagmar, Homez, Marcela, Hongtao, Xia, Hormis, Anil, Horner, Daniel, Hornos, M Carmen, Hou, Meihong, House, Stacy, Housni, Brahim, Hugill, Keith, Humphreys, Sally, Humbert, Louis, Hunter, Stephanie, Hwa Young, Lee, Iezzi, Nicolas, Ilutovich, Santiago, Inal, Volkan, Innes, Richard, Ioannides, Panagiotis, Iotti, Giorgio Antonio, Ippolito, Mariachiara, Irie, Hiromasa, Iriyama, Hiroki, Itagaki, Taiga, Izura, Javier, Izza, Santiago, Jabeen, Rakhshanda, Jamaati, Hamidreza, Jamadarkhana, Sunil, Jamoussi, Amira, Jankowski, Milosz, Jaramillo, Luis Alberto, Jeon, Kyeongman, Jeong Lee, Seok, Jeswani, Deepak, Jha, Simant, Jiang, Liangyan, Jing, Chen, Jochmans, Sébastien, Johnstad, Bror Anders, Jongmin, Lee, Joret, Aurélie, Junhasavasdikul, Detajin, Jurado, Maria Teresa, Kam, Elisa, Kamohara, Hidenobu, Kane, Caroline, Kara, Iskender, Karakurt, Sait, Karnjanarachata, Cherdkiat, Kataoka, Jun, Katayama, Shinshu, Kaushik, Shuchi, Kelebek Girgin, Nermin, Kerr, Kathryn, Kerslake, Ian, Khairnar, Prakash, Khalid, Abidi, Khan, Akram, Khanna, Ashish K, Khorasanee, Reza, Kienhorst, Dieneke, Kirakli, Cenk, Knafelj, Rihard, Kol, Mark Kol, Kongpolprom, Napplika, Kopitko, Csaba, Korkmaz Ekren, Pervin, Kubisz-Pudelko, Agnieszka, Kulcsar, Zoltan, Kumasawa, Junji, Kuriyama, Akira, Kutchak, Fernanda, Labarca, Eduardo, Labat, Françoise, Laborda, César, Laca Barrera, Manuel Alberto, Lagache, Laurie, Landaverde Lopez, Antonio, Lanspa, Michael, Lascari, Valeria, Le Meur, Matthieu, Lee, Su Hwan, Lee, Young Ju, Lee, Jinwoo, Lee, Won-Yeon, Lee, Jarone, Legernaes, Terje, Leiner, Tamaas, Lemiale, Virginie, Leonor, Tiago, Lepper, Philipp M, Li, Dahuan, Li, Hongbin, Li, Oleg, Lima, Ana Raquel, Lind, Dan, Litton, Edward, Liu, Ning, Liu, Ling, Liu, Jialin, Llitjos, Jean-François, Llorente, Beatriz, Lopez, Rodolfo, Lopez, Claudia Elizabeth, Lopez Nava, Claudia, Lovazzano, Pablo, Lu, Min, Lucchese, Francesca, Lugano, Manuela, Lugo Goytia, Gustavo, Luo, Hua, Lynch, Ceri, Macheda, Sebastiano, Madrigal Robles, Victor Hugo, Maggiore, Salvatore Maurizio, Magret Iglesias, Mònica, Malaga, Peter, Mallapura Maheswarappa, Harish, Malpartida, Guillermo, Malyarchikov, Andrey, Mansson, Helena, Manzano, Anaid, Marey, Ismael, Marin, Nathalie, Marin, Maria del Carmen, Markman, Eliana, Martin, Felix, Martin, Alex, Martin Dal Gesso, Cristina, Martinez, Felipe, Martínez-Fidalgo, Conchita, Martin-Loeches, Ignacio, Mas, Arantxa, Masaaki, Sakuraya, Maseda, Emilio, Massa, Eleni, Mattsson, Anna, Maugeri, Jessica, McCredie, Victoria, McCullough, James, McGuinness, Shay, McKown, Andrew, Medve, László, Mei, Chengqing, Mellado Artigas, Ricard, Mendes, Vitor, Mervat, Mohamed Khalaf Ebraheim, Michaux, Isabelle, Mikhaeil, Michael, Milagros, Olga, Milet, Igor, Millan, Maria Teresa, Minwei, Zhang, Mirabella, Lucia, Mishra, Sanghamitra, Mistraletti, Giovanni, Mochizuki, Katsunori, Moghal, Arif, Mojoli, Francesco, Molin, Alexandre, Montiel, Raquel, Montini, Luca, Monza, Gianmario, Mora Aznar, Maria, Morakul, Sunthiti, Morales, Maria, Moreno Torres, Daniel, Morocho Tutillo, Diego Rolando, Motherway, Catherine, Mouhssine, Doumiri, Mouloudi, Eleni, Muñoz, Tapia, Munoz de Cabo, Carlos, Mustafa, Mohamed, Muthuchellappan, Radhakrishnan, Muthukrishnan, Muraleekrishnan, Muttini, Stefano, Nagata, Isao, Nahar, Dick, Nakanishi, Misuzu, Nakayama, Izumi, Namendys-Silva, Silvio Antonio, Nanchal, Rahul, Nandakumar, Sivakumar, Nasi, Alessandra, Nasir, Kamal, Navalesi, Paolo, Naz Aslam, Tayyba, Nga Phan, Thuy, Nichol, Alistair, Niiyama, Shuhei, Nikolakopoulou, Sofia, Nikolic, Elena, Nitta, Kenichi, Noc, Marko, Nonas, Stephanie, Nseir, Saad, Nur Soyturk, Ayse, Obata, Yukako, Oeckler, Richard, Oguchi, Moe, Ohshimo, Shinichiro, Oikonomou, Marina, Ojados, Agueda, Oliveira, Maria Teresa, Oliveira Filho, Wilson, Oliveri, Carlo, Olmos, Aitor, Omura, Kazuya, Orlandi, Maria Cristina, Orsenigo, Francesca, Ortiz-Ruiz De Gordoa, Laura, Ota, Kei, Ovalle Olmos, Rainier, Öveges, Nándo, Oziemski, Peter, Ozkan Kuscu, Ozlem, Özyilmaz, Ezgi, Pachas Alvarado, Fernando, Pagella, Gonzalo, Palaniswamy, Vijayanand, Palazon Sanchez, Eugenio Luis, Palmese, Salvatore, Pan, Guojun, Pan, Wensen, Papanikolaou, Metaxia, Papavasilopoulou, Theonymfi, Parekh, Ameet, Parke, Rachael, Parrilla, Francisco J, Parrilla, Dácil, Pasha, Taha, Pasin, Laura, Patão, Luis, Patel, Mayur, Patel, Grisma, Pati, Basanta Kumar, Patil, Jayaprakash, Pattnaik, Saroj, Paul, Daniel, Pavesi, Maurizio, Pavlotsky, Vanesa Alejandra, Paz, Graciela, Paz, Enrique, Pecci, Elisabetta, Pellegrini, Carlos, Peña Padilla, Andrea Gabriela, Perchiazzi, Gaetano, Pereira, Tiago, Pereira, Vera, Perez, Manuel, Perez Calvo, Cesar, Perez Cheng, Meisy, Perez Maita, Ronald, Pérez-Araos, Rodrigo, Perez-Teran, Purificación, Perez-Torres, David, Perkins, Gavin, Persona, Paolo, Petnak, Tananchai, Petrova, Marina, Pham, Tai, Philippart, François, Picetti, Edoardo, Pierucci, Elisabetta, Piervincenzi, Edoardo, Pinciroli, Riccardo, Pintado, Maria-Consuelo, Piraino, Thomas, Piras, Stephanie, Piras, Claudio, Pirompanich, Pattarin, Pisani, Luigi, Platas, Enrique, Plotnikow, Gustavo, Porras, Willy, Porta, Virginia, Portilla, Mariana, Portugal, José, Povoa, Pedro, Prat, Gwenael, Pratto, Romina, Preda, Gabriel, Prieto, Isidro, Prol-Silva, Estefania, Pugh, Richard, Qi, Yupeng, Qian, Chuanyun, Qin, Tiehe, Qu, Hongping, Quintana, Teobaldo, Quispe Sierra, Rosari, Quispe Soto, Rocio, Rabbani, Raihan, Rabee, Mohamed, Rabie, Ahmed, Rahe Pereira, Maria Augusta, Rai, Ashish, Raj Ashok, Sundar, Rajab, Mostafa, Ramdhani, Navin, Ramey, Elizabeth, Ranieri, Marco, Rathod, Darshana, Ray, Banambar, Redwanul Huq, Shihan Mahmud, Regli, Adrian, Reina, Rosa, Resano Sarmiento, Natalia, Reynaud, Faustine, Rialp, Gemma, Ricart, Pilar, Rice, Todd, Richardson, Angus, Rieder, Marcelo, Rinket, Martin, Rios, Fernando, Risso Vazquez, Alejandro, Riva, Ivano, Rivette, Monaly, Roca, Oriol, Roche-Campo, Ferran, Rodriguez, Covadonga, Rodriguez, Gabriel, Rodriguez Gonzalez, Daniel, Rodriguez Tucto, Xandra Yanina, Rogers, Angela, Romano, María Elena, Rørtveit, Linda, Rose, Alastair, Roux, Damien, Rouze, Anahita, Rubatto Birri, Paolo Nahuel, Ruilan, Wang, Ruiz Robledo, Aldana, Ruiz-Aguilar, Antonio Luis, Sadahiro, Tomohito, Saez, Ignacio, Sagardia, Judith, Saha, Rajnish, Saha, Rohit, Saiphoklang, Narongkorn, Saito, Shigeki, Salem, Maie, Sales, Gabriele, Salgado, Patricia, Samavedam, Srinivas, Sami Mebazaa, Mhamed, Samuelsson, Line, San Juan Roman, Nandyelly, Sanchez, Patricia, Sanchez-Ballesteros, Jesus, Sandoval, Yazcitk, Sani, Emanuele, Santos, Martin, Santos, Carla, Sanui, Masamitsu, Saravanabavan, Lakshmikanthcharan, Sari, Sema, Sarkany, Agnes, Sauneuf, Bertrand, Savioli, Monica, Sazak, Hilal, Scano, Riccardo, Schneider, Francis, Schortgen, Frédérique, Schultz, Marcus J, Schwarz, Gabriele Leonie, Seçkin Yücesoy, Faruk, Seely, Andrew, Seiler, Frederik, Seker Tekdos, Yasemin, Seok Chan, Kim, Serano, Luca, Serednicki, Wojciech, Setten, Mariano, Shah, Asim, Shah, Bhagyesh, Shang, You, Shanmugasundaram, Pradeep, Shapovalov, Konstantin, Shebl, Eman, Shiga, Takuya, Shime, Nobuaki, Shin, 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Short, Jack, Shuhua, Chen, Siddiqui, Sughrat, Silesky Jimenez, Juan Ignacio, Silva, Daniel, Silva Sales, Betania, Simons, Koen, Sjøbø, Brit Ågot, Slessor, David, Smiechowicz, Jakub, Smischney, Nathan, Smith, Paul, Smith, Tim, Smith, Mark, Snape, Sarah, Snyman, Lindi, Soetens, Filiep, Sook Hong, Kyung, Sosa Medellin, Miguel Ángel, Soto, Giovanna, Souloy, Xavier, Sousa, Elsa, Sovatzis, Stefania, Sozutek, Didem, Spadaro, Savino, Spagnoli, Marco, Spångfors, Martin, Spittle, Nick, Spivey, Mike, Stapleton, Andrew, Stefanovic, Branislava, Stephenson, Lorraine, Stevenson, Elizabeth, Strand, Kristian, Strano, Maria Teresa, Straus, Slavenka, Sun, Chenliang, Sun, Rongqing, Sundaram, Venkat, SunPark, Tai, Surlemont, Elisabeth, Sutherasan, Yuda, Szabo, Zsuzsanna, Tainter, Christopher, Takaba, Akihiro, Tallott, Mandy, Tamasato, Tamasato, Tang, Zhanhong, Tangsujaritvijit, Viratch, Taniguchi, Leandro, Taniguchi, Daisuke, Tarantino, Fabio, Teerapuncharoen, Krittika, Temprano, Susana, Terragni, Pierpaolo, Terzi, Nicola, Thakur, Anand, Theerawit, Pongdhep, Thille, Arnaud W, Thomas, Matt, Thungtitigul, Poungrat, Thyrault, Martial, Tilouch, Nejla, Timenetsky, Karina, Tirapu, Juna, Todeschini, Manuel, Tomas, Roser, Tomaszewski, Christian, Tonetti, Tommaso, Tonnelier, Alexandre, Trinder, John, Trongtrakul, Konlawij, Truwit, Jonathon, Tsuei, Betty, Tulaimat, Aiman, Turan, Sema, Turkoglu, Melda, Tyagi, Sanjeev, Ubeda, Alejandro, Vagginelli, Federica, Valenti, María Florencia, Vallverdu, Imma, Van Axel, Alisha, van den Hul, Ingrid, van der Hoeven, Han, Van Der Meer, Nardo, Vanhoof, Marc, Vargas-Ordoñez, Mónica, Vaschetto, Rosanna, Vascotto, Ettore, Vatsik, Maria, Vaz, Ana, Vazquez-Sanchez, Antonia, Ventura, Sara, Vermeijden, Jan Wytze, Vidal, Anxela, Vieira, Jocyelle, Vilela Costa Pinto, Bruno, Villagra, Ana, Villegas Succar, Cristina, Vinorum, Ole Georg, Vitale, Giovanni, Vj, Ramesh, Vochin, Ana, Voiriot, Guillaume, Volta, Carlo Alberto, von Seth, Magnu, Wajdi, Maazouzi, Walsh, Don, Wang, Shouhong, Wardi, Gabriel, Ween-Velken, Nils Christian, Wei, Bi-Lin, Weller, Dolf, Welsh, Deborah, Welters, Ingeborg, Wert, Michael, Whiteley, Simon, Wilby, Elizabeth, Williams, Erin, Williams, Karen, Wilson, Antoinette, Wojtas, Jadwiga, Won Huh, Jin, Wrathall, David, Wright, Christopher, Wu, Jian-Feng, Xi, Guo, Xing, Zheng-Jiang, Xu, Hongyang, Yamamoto, Kotaro, Yan, Jie, Yáñez, Julio, Yang, Xiaobo, Yates, Elliot, Yazicioglu Mocin, Ozlem, Ye, Zhenglong, Yildirim, Fatma, Yoshida, Norifumi, Yoshido, Hector Higo Leon, Young Lee, Bo, Yu, Rongguo, Yu, Gong, Yu, Tao, Yuan, Boyun, Yuangtrakul, Nadwipa, Yumoto, Tetsuya, Yun, Xie, Zakalik, Graciela, Zaki, Ahmad, Zalba-Etayo, Begoña, Zambon, Massimo, Zang, Bin, Zani, Gianluca, Zarka, Jonathan, Zerbi, Simone Maria, Zerman, Avsar, Zetterquist, Harald, Zhang, Jiuzhi, Zhang, Hongwen, Zhang, Wei, Zhang, Guoxiu, Zhang, Weixin, Zhao, Hongsheng, Zheng, Jia, Zhu, Bin, Zumaran, Ronald, Pham T., Heunks L., Bellani G., Madotto F., Aragao I., Beduneau G., Goligher E. C., Grasselli G., Laake J. H., Mancebo J., et al., Intensive Care Medicine, ACS - Diabetes & metabolism, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, AII - Inflammatory diseases, Intensive Care, Econometrics, Neurosurgery, Cardiothoracic Surgery, and Internal Medicine

Subjects
Pulmonary and Respiratory Medicine, Internal Medicine Sciences, Klinik Tıp, RESPIRATORY SYSTEM, Dahili Tıp Bilimleri, Göğüs Hastalıkları ve Allerji, CLINICAL MEDICINE, Sağlık Bilimleri, Clinical Medicine (MED), Tıp, SOLUNUM SİSTEMİ, Mechanical ventilation, N/A, Health Sciences, Settore MED/41 - ANESTESIOLOGIA, Akciğer ve Solunum Tıbbı, Medicine, Klinik Tıp (MED), Chest Diseases and Allergy
Abstract

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society.

Published
2023

8. Faculty Recruitment, Retention, and Representation in Leadership: An Evidence-Based Guide to Best Practices for Diversity, Equity, and Inclusion from the Council of Residency Directors in Emergency Medicine

Author

Dayle Davenport, Al’ai Alvarez, Sreeja Natesan, Martina T. Caldwell, Moises Gallegos, Adaira Landry, Melissa Parsons, and Michael Gottlieb

Subjects
Medicine, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Improving the recruitment, retention, and leadership advancement of faculty who are under-represented in medicine is a priority at many academic institutions to ensure excellence in patient care, research, and health equity. Here we provide a critical review of the literature and offer evidence-based guidelines for faculty recruitment, retention, and representation in leadership. Recommendations for recruitment include targeted recruitment to expand the candidate pool with diverse candidates, holistic review of applications, and incentivizing stakeholders for success with diversity efforts. Retention efforts should establish a culture of inclusivity, promote faculty development, and evaluate for biases in the promotion and tenure process. We believe this guide will be valuable for all leaders and faculty members seeking to advance diversity, equity, and inclusion in their institutions.

Published
2022
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9. A Brief Coaching Pilot Enhances Professional Identity Formation and Clinical Skills Acquisition During Emergency Medicine Clerkships Shortened by COVID-19

Author

William Dixon, Moises Gallegos, and Sarah Williams

Subjects
Medicine, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Introduction: The Covid-19 pandemic limited educational and career development opportunities for medical students, requiring innovative programs to accelerate professional identity formation and clinical skills acquisition. Methods: We developed a brief coaching intervention that took place over the advanced (sub-internship) emergency medicine rotation at our institution. We trained coaches using a newly developed workshop, who met with students for an average of 4.5 hours over 3 weeks. Impact/effectiveness: We showed that this coaching program was both feasible and impactful for faculty coaches and medical students.

Published
2022
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10. Sera from women with different metabolic and menopause states differentially regulate cell viability and Akt activation in a breast cancer in-vitro model.

Author

Laura C Flores-García, José L Ventura-Gallegos, Sandra L Romero-Córdoba, Alfredo J Hernández-Juárez, María A Naranjo-Meneses, Eduardo García-García, Juan Pablo Méndez, Alberto J Cabrera-Quintero, Antonio Ramírez-Ruíz, Sigifredo Pedraza-Sánchez, Noemi Meraz-Cruz, Felipe Vadillo-Ortega, and Alejandro Zentella-Dehesa

Subjects
Medicine, Science
Abstract

Obesity is associated with an increased incidence and aggressiveness of breast cancer and is estimated to increment the development of this tumor by 50 to 86%. These associations are driven, in part, by changes in the serum molecules. Epidemiological studies have reported that Metformin reduces the incidence of obesity-associated cancer, probably by regulating the metabolic state. In this study, we evaluated in a breast cancer in-vitro model the activation of the IR-β/Akt/p70S6K pathway by exposure to human sera with different metabolic and hormonal characteristics. Furthermore, we evaluated the effect of brief Metformin treatment on sera of obese postmenopausal women and its impact on Akt and NF-κB activation. We demonstrated that MCF-7 cells represent a robust cellular model to differentiate Akt pathway activation influenced by the stimulation with sera from obese women, resulting in increased cell viability rates compared to cells stimulated with sera from normal-weight women. In particular, stimulation with sera from postmenopausal obese women showed an increase in the phosphorylation of IR-β and Akt proteins. These effects were reversed after exposure of MCF-7 cells to sera from postmenopausal obese women with insulin resistance with Metformin treatment. Whereas sera from women without insulin resistance affected NF-κB regulation. We further demonstrated that sera from post-Metformin obese women induced an increase in p38 phosphorylation, independent of insulin resistance. Our results suggest a possible mechanism in which obesity-mediated serum molecules could enhance the development of luminal A-breast cancer by increasing Akt activation. Further, we provided evidence that the phenomenon was reversed by Metformin treatment in a subgroup of women.

Published
2022
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11. COVID-19 vaccination readiness among multiple racial and ethnic groups in the San Francisco Bay Area: A qualitative analysis

Author

Jonathan Z. Butler, Mariam Carson, Francine Rios-Fetchko, Roberto Vargas, Abby Cabrera, Angela Gallegos-Castillo, Monique LeSarre, Michael Liao, Kent Woo, Randi Ellis, Kirsten Liu, Arun Burra, Mario Ramirez, Brittney Doyle, Lydia Leung, Alicia Fernandez, and Kevin Grumbach

Subjects
Medicine, Science
Abstract

Background COVID-19 vaccination rates are lower among historically marginalized populations, including Black/African American and Latinx populations, threatening to contribute to already high COVID-19 morbidity and mortality disparities for these groups. We conducted a community-based participatory research study using qualitative methods to explore knowledge and beliefs about COVID-19 vaccination among Black/African American, Latinx, and Chinese American residents of the San Francisco Bay Area and assess their views on vaccination outreach and delivery strategies. Methods and findings Data were collected from January 14, 2021, to February 24, 2021, with adult residents (N = 109 [Female: N = 76; 70%]) in San Francisco. Focus groups (N = 10) and in-depth interviews (N = 25) were conducted among Black/African Americans (N = 35), Latinx (N = 40), and Chinese Americans (n = 34) in English, Spanish, Cantonese, or Mandarin. Themes were identified using grounded field theory, and included misinformation, mistrust of government and health institutions, and linguistic and other barriers to vaccine access. All three racial/ethnic groups had experiences with vaccine misinformation and information overload. Many African American and Latinx participants cited structural and interpersonal racism, and anti-immigrant discrimination, as factors reducing their trust in government and public health disseminated information and their willingness to be vaccinated. Participants expressed trust in community-based organizations, including faith-based organizations and community-run clinics. Participants often experienced barriers to vaccine access, such as transportation to drive-in sites, with Latinx and Chinese American groups also frequently citing language barriers. Conclusions Vaccine outreach strategies must acknowledge how longstanding systemic, institutional, and structural racism contributes to mistrust in government and health institutions and engage with and support trusted messengers from the community to eliminate cultural, linguistic, and other barriers to vaccine access.

Published
2022

12. Household water and food insecurity negatively impacts self-reported physical and mental health in the Vietnamese Mekong Delta.

Author

Thuy Ngoc Vuong, Chinh Van Dang, Simon Toze, Paul Jagals, Danielle Gallegos, and Michelle L Gatton

Subjects
Medicine, Science
Abstract

IntroductionHousehold food insecurity and inadequate water, sanitation, and hygiene (WASH) contribute to ill health. However, the interactions between household food insecurity, WASH and health have been rarely assessed concurrently. This study investigated compounded impacts of household food insecurity and WASH on self-reported physical and mental health of adults in the Vietnamese Mekong Delta.Materials and methodsThis cross-sectional survey interviewed 552 households in one northern and one southern province of the Vietnamese Mekong Delta. The survey incorporated previously validated tools such as the Short Form 12-item Health Survey, Household Food Insecurity Assessment Scale, and the Access and Behavioural Outcome Indicators for Water, Sanitation, and Hygiene. Physical and mental health were quantified using the physical health composite score (PCS) and mental health composite score (MCS), respectively. These measures were the dependent variables of interest for this study.ResultsStatistical analysis revealed that household food insecurity and using ConclusionThis study is one of only a few that have established a link between potable water availability, food insecurity and poorer physical and mental health. The results also indicate a need to validate national data with fine-scale investigations in less populous regions to evaluate national initiatives with local populations that may be at higher risk. Adopting joint dual-action policies for interventions that simultaneously address water and food insecurity should result in larger improvements in health, particularly mental health, compared to targeting either food or water insecurity in isolation.

Published
2022
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15. Epidemiología del paciente pediátrico quemado en el Hospital Baca Ortiz, Quito, Ecuador

Author

Pablo Gallegos Torres, Thalía Argüello Gordillo, Regina Real Flores, and Olimpia Trujillo Orbe

Subjects
Quemaduras, Quemaduras pediátricas, Epidemiología quemados, Medicine, Surgery, RD1-811
Abstract

Resumen Introducción y Objetivo Las quemaduras son un problema mundial de salud pública por su gran impacto físico, psicológico, económico y social. El objetivo de este trabajo es describir las características epidemiológicas de los pacientes pediátricos con quemaduras en nuestro entorno asistencial. Material y método Realizamos un estudio descriptivo retrospectivo tomando como universo al total de pacientes pediátricos con quemaduras atendidos en el Hospital Baca Ortiz de Quito, Ecuador, de enero a diciembre del 2016. Resultados Recogimos un total de 343 pacientes pediátricos con quemaduras de los que 180 requirieron hospitalización (52.48%), con predominio de menores de 5 años (67.6%). El género masculino fue el más afectado (55.7%) y las quemaduras por líquido caliente representaron el 70.6%. Las de mayor estancia hospitalaria fueron las quemaduras eléctricas. Registramos una mortalidad del 1.1% relacionada con quemaduras por fuego, de más del 50% de superficie corporal y con compromiso de vía aérea. Conclusiones Los menores de 5 años son más vulnerables para sufrir quemaduras. La principal etiología fue líquido hirviente. Los casos fatales tuvieron relación con quemaduras por fuego y lesión de vía aérea. Las quemaduras eléctricas son devastadoras, la severidad de sus lesiones ocasiona mayor estancia hospitalaria y un aumento de la necesidad de amputación de la extremidad afectada.

Published
2019
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16. Left ventricular myocardial strain and tissue characterization by cardiac magnetic resonance imaging in immune checkpoint inhibitor associated cardiotoxicity.

Author

Angela Y Higgins, Amit Arbune, Aaron Soufer, Elio Ragheb, Jennifer M Kwan, Jerome Lamy, Mariana Henry, Jason R Cuomo, Ahmad Charifa, Cesia Gallegos, Sarah Hull, Jessica Shank Coviello, Anna S Bader, Dana C Peters, Steffen Huber, Hamid R Mojibian, Albert J Sinusas, Harriet Kluger, and Lauren A Baldassarre

Subjects
Medicine, Science
Abstract

BackgroundImmune checkpoint inhibitors (ICIs) are highly effective in treating cancer; however, cardiotoxicity can occur, including myocarditis. Cardiac magnetic resonance (CMR) imaging is useful for evaluation of myocarditis, although it has not been well studied in ICI cardiotoxicity.MethodsWe identified patients referred for CMR evaluation of ICI cardiotoxicity from September 2015 through September 2019. We assessed structural and functional parameters, feature tracking (FT) left ventricular and atrial strain, T2- weighted ratios and quantitative late gadolinium enhancement (LGE). We also applied the Updated Lake Louise Criteria for diagnosis of myocarditis.ResultsOf the 20 patients referred, the median left ventricular ejection fraction (LVEF) was 52.5% ± 19.1 and 50% had a normal LVEF (≥53%). FT strain analysis revealed an average abnormal global longitudinal strain (GLS) of -9.8%± 4.2%. In patients with a normal LVEF, the average GLS remained depressed at -12.3%± 2.4%. In all patients, GLS demonstrated a significant negative correlation with LVEF (rs = -0.64, p 0.002). Sixteen patients (80%) had presence of LGE (14 non-ischemic pattern and 2 ischemic). Percent LGE did not correlate with any CMR parameters and notably did not correlate with LVEF (rs = -0.29, p = 0.22) or GLS (rs = 0.10, p = 0.67), highlighting the value of tissue characterization beyond functional assessment. Nine patients (45%) met full Updated Lake Louise Criteria and 85% met at least one criterion, suggestive of myocarditis in the correct clinical context. Thirteen patients (65%) were treated for ICI-associated myocarditis and, of these, 54% (n = 7) had recovery of LVEF to normal. There was no correlation between LVEF (p = 0.47), GLS (0.89), or % LGE (0.15) and recovery of LVEF with treatment.ConclusionIn patients with suspected ICI cardiotoxicity, CMR is an important diagnostic tool, even in the absence of overt left ventricular dysfunction, as abnormalities in left ventricular strain, T2 signal and LGE can identifying disease.

Published
2021
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18. Living in the midst of miasmas: The social issue of Chile between 1880 and 1920

Author

Marcos Parada-Ulloa, Karina Vásquez-Burgos, Pedro Villasana-López, Andrés Meza-Prambs, Ada Lucía Gallegos Ruiz-Conejo, Juan Pablo Catalán-Cueto, Sandra Garrido-Osses, and Juan Bautista Abello-Romero

Subjects
social medicine, public health, environment, history of medicine, Medicine, Medicine (General), R5-920
Abstract

Introduction The social issue in Chile stems from an accumulation of social problems resulting from the migratory movements of the countryside-city and mining areas. The cities did not have the hygienic conditions necessary to receive migrants, which caused housing and health problems within the population. Objective To analyze the problems of housing, hygiene, and health in Chile between 1880-1920. Method We conduct a qualitative, analytical, and interpretive study using primary sources for the categories of analysis around housing, hygiene, and health of the following cities in Chile: Santiago, Valparaíso, Concepción and Chillán. Results The economic modernization led to the development of public works in the main cities of Chile, which also experienced a demographic phenomenon known as field-city migration, with urban growth never before seen. In the cities, there were problems of housing, hygiene, and health for the popular urban sectors. Conclusion The State passed laws to regulate the conditions of the conventillos and public spaces to mitigate diseases and vices of the population.

Published
2020
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19. Identification and in silico structural and functional analysis of a trypsin-like protease from shrimp Macrobrachium carcinus

Author

José M. Viader-Salvadó, José Alberto Aguilar Briseño, Juan A. Gallegos-López, José A. Fuentes-Garibay, Carlos Alfonso Alvarez-González, and Martha Guerrero-Olazarán

Subjects
Brachyurins, Macrobrachium carcinus, Serine proteases, Threonine proteases, Trypsin-like protease, Medicine, Biology (General), QH301-705.5
Abstract

Macrobrachium carcinus (Linnaeus, 1758) is a species of freshwater shrimp widely distributed from Florida southwards to southern Brazil, including southeast of Mexico. In the present work, we identified a putative trypsin-like protease cDNA fragment of 736 nucleotides from M. carcinus hepatopancreas tissue by the 3′RACE technique and compared the deduced amino acid sequence to other trypsin-related proteases to describe its structure and function relationship. The bioinformatics analyses showed that the deduced amino acid sequence likely corresponds to a trypsin-like protease closely related to brachyurins, which comprise a subset of serine proteases with collagenolytic activity found in crabs and other crustacea. The M. carcinus trypsin-like protease sequence showed a global sequence identity of 94% with an unpublished trypsin from Macrobrachium rosenbergii (GenBank accession no. AMQ98968), and only 57% with Penaeus vannamei trypsin (GenBank accession no. CAA60129). A detailed analysis of the amino acid sequence revealed specific differences with crustacean trypsins, such as the sequence motif at the beginning of the mature protein, activation mechanism of the corresponding zymogen, amino acid residues of the catalytic triad and residues responsible for substrate specificity.

Published
2020
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22. Síndrome de burnout en personal de salud de la ciudad de Arequipa (Perú)

Author

Walter L. Arias Gallegos, Agueda Muñoz del Carpio Toia, Yesary Delgado Montesinos, Mariela Ortiz Puma, and Mario Quispe Villanueva

Subjects
Síndrome de burnout, personal de salud, riesgo psicosocial, estrés laboral, Medicine, Internal medicine, RC31-1245, Industrial medicine. Industrial hygiene, RC963-969
Abstract

RESUMEN Introducción: El síndrome de burnout fue descrito por primera vez en 1974 por Freudenberger, y desde entonces ha generado una gran cantidad de investigación sobre sus síntomas más característicos como son el agotamiento emocional, la despersonalización y la baja realización personal. Entre las tres profesiones de mayor riesgo se tiene al personal de salud, los profesores y los policías. Objetivo: El objetivo de la presente investigación fue valorar la prevalencia del síndrome de burnout en personal de salud de la ciudad de Arequipa (Perú), y analizar comparativamente los datos en función del sexo, los ingresos económicos, el estado civil, el tiempo de servicio, el cargo, la profesión y la institución de procedencia. Método: Se trabajó con un diseño de investigación de tipo descriptivo y se aplicó el Inventario de Burnout de Maslach, que consta de 22 ítems y cuenta con adecuados índices de validez y confiabilidad (α= .76). Resultados: Se evaluaron a 213 trabajadores del sector salud que laboran en hospitales y postas de salud de la ciudad. El 35.7% son varones y el 63.8% son mujeres, con 37 años de edad como promedio. Los resultados indican que altos porcentajes de profesionales del sector salud tienen algunos síntomas del síndrome de burnout, y solo un 5.6% tiene el síndrome de burnout en nivel severo. Además, se registraron diferencias entre los trabajadores en función del sexo, el tiempo de servicio, el cargo, la profesión y la institución en la que laboran. Discusión: Se concluye que el síndrome de burnout tiene una presencia preocupante entre el personal de salud, sobre todo en la dimensión de despersonalización, y que las diferencias encontradas en función de las variables demográficas se explican en función del entorno laboral y las condiciones de trabajo.

Published
2017

24. A novel c-di-GMP binding domain in glycosyltransferase BgsA is responsible for the synthesis of a mixed-linkage β-glucan

Author

Daniel Pérez-Mendoza, Daniela Bertinetti, Robin Lorenz, María-Trinidad Gallegos, Friedrich W. Herberg, and Juan Sanjuán

Subjects
Medicine, Science
Abstract

Abstract BgsA is the glycosyltransferase (GT) involved in the synthesis of a linear mixed-linkage β-glucan (MLG), a recently described exopolysaccharide activated by c-di-GMP in Sinorhizobium meliloti and other Rhizobiales. Although BgsA displays sequence and structural homology with bacterial cellulose synthases (CS), it does not contain any predictable c-di-GMP binding domain. In this work we demonstrate that the cytoplasmic C-terminal domain of BgsA (C-BgsA) binds c-di-GMP with both high affinity (KD = 0.23 μM) and specificity. C-BgsA is structurally different to the otherwise equivalent cytoplasmic C-terminal domain of CS, and does not contain PilZ motifs for c-di-GMP recognition. A combination of random and site-directed mutagenesis with surface plasmon resonance (SPR) allowed identification of the C-BgsA residues which are important not only for c-di-GMP binding, but also for BgsA GT activity. The results suggest that the C-BgsA domain is important for both, c-di-GMP binding and GT activity of BgsA. In contrast to bacterial CS where c-di-GMP has been proposed as a derepressor of GT activity, we hypothesize that the C-terminal domain of BgsA plays an active role in BgsA GT activity upon binding c-di-GMP.

Published
2017
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25. Kca3.1 Activation Via P2y2 Purinergic Receptors Promotes Human Ovarian Cancer Cell (Skov-3) Migration

Author

L. Robles-Martínez, E. Garay, M. G. Martel-Gallegos, A. Cisneros-Mejorado, D. Pérez-Montiel, A. Lara, and R. O. Arellano

Subjects
Medicine, Science
Abstract

Abstract Disorders in cell signaling mediated by ATP or histamine, activating specific membrane receptors, have been frequently associated with tumorigenesis. Among the elements of response to purinergic (and histaminergic) signaling, ion channel activation controls essential cellular processes in cancer, such as cell proliferation, motility, and death. Here, we studied the effects that ATP had on electrical properties of human ovarian adenocarcinoma cells named SKOV-3. ATP caused increase in intracellular Ca2+ concentration ([Ca2+]i) and, concurrently, it evoked a complex electrical response with a conspicuous outward component. This current was generated through P2Y2 receptor activation and opening of K+ channels, KCa3.1, as indicated by electrophysiological and pharmacological analysis, as well as by immunodetection and specific silencing of P2Y2 or KCa3.1 gene by esiRNA transfection. Low µM ATP concentration increased SKOV-3 cell migration, which was strongly inhibited by KCa3.1 channel blockers and by esiRNA-generated P2Y2 or KCa3.1 downregulation. Finally, in human ovarian tumors, the P2Y2 and KCa3.1 proteins are expressed and co-localized in neoplastic cells. Thus, stimulation of P2Y2 receptors expressed in SKOV-3 cells promotes motility through KCa3.1 activation. Since P2Y2 and KCa3.1 are co-expressed in primary tumors, our findings suggest that they may play a role in cancer progression.

Published
2017
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26. Impacto de la corrección temprana de la hiponatremia en el pronóstico de la infección del síndrome respiratorio agudo grave del coronavirus 2 (SARS-CoV-2)

Author

Cristina Albarracin, Gioconda Gallegos, Andrea de los Santos, Tania Linares, A Marschall, Miguel Rodeles, Elisa Ruiz, Francisco Valga, José C De La Flor, Ana Gomez-Berrocal, and Alberto Gómez

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine, nutritional and metabolic diseases, General Medicine, business
Abstract

Resumen Introduccion La infeccion por el coronavirus del sindrome respiratorio agudo grave de tipo 2 (SARS-CoV-2) se asocia con frecuencia con hiponatremia (sodio plasmatico Material y metodo Estudio de cohorte observacional y retrospectivo. Se incluyeron pacientes que ingresaron con diagnostico de infeccion por COVID-19 e hiponatremia en el periodo marzo-mayo de 2020. Registramos variables epidemiologicas, demograficas, clinicas, analiticas y radiologicas de la infeccion por SARS-CoV-2 e hiponatremia en el momento del diagnostico y durante la hospitalizacion. El seguimiento clinico comprendio desde el ingreso hasta el exitus o el alta. Resultados Noventa y un pacientes (21,8%) de los 414 ingresados por infeccion del SARS-CoV-2 presentaron hiponatremia (81,32% hiponatremia leve, 9,89% moderada y 8,79% grave). La ausencia de correccion de la hiponatremia a las 72-96 horas del ingreso hospitalario estuvo asociado a mayor mortalidad en los pacientes con COVID-19 (odds ratio 0,165; 95% intervalo de confianza: 0,018-0,686; p = 0,011). Fallecieron 19 pacientes (20,9%). Se observo un aumento de la mortalidad en pacientes con hiponatremia grave en comparacion con hiponatremia moderada y leve durante el ingreso (37,5% versus 11,1% versus 8,1%, respectivamente; p = 0,041). Conclusiones La persistencia de la hiponatremia tras las primeras 72-96 horas del ingreso hospitalario se asocio a mayor mortalidad en los pacientes con SARS-CoV-2.

Published
2022

27. Costo-beneficio de cribado de adenocarcinoma gástrico por pepsinógeno sérico en la población mexicana

Author

A. E. Contreras-Pacheco, L.B. Enríquez-Sánchez, J.J. Montelongo-Santiesteban, David A. Aguirre-Baca, L.G. Gallegos-Portillo, J. Camarillo-Cisneros, A. I. Pérez-Echavarría, and M. Cisneros-Castolo

Subjects
medicine.medical_specialty, Cost effectiveness, Population, Gastroenterology, Serology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Gastric mucosa, Medicine, 030212 general & internal medicine, Stage (cooking), education, education.field_of_study, medicine.diagnostic_test, biology, business.industry, Esophagogastroduodenoscopy, Cancer, Helicobacter pylori, medicine.disease, biology.organism_classification, digestive system diseases, medicine.anatomical_structure, 030228 respiratory system, business
Abstract

INTRODUCTION AND AIM Helicobacter pylori (H. pylori) is known to be capable of causing chronic inflammation of the gastric mucosa that slowly progresses through the premalignant stages, reaching localized gastric adenocarcinoma (GAC). Its outcome is closely related to the stage at which diagnosis is made. The aim of the present study was to determine cost-benefit by comparing esophagogastroduodenoscopy, serum pepsinogen detection, and no screening at all. MATERIAL AND METHODS Utilizing Markov chains and Monte Carlo simulation, the costs and effects of various detection modalities were simulated to analyze the cost-benefit of each strategy. For our population, we used the published data of patients with gastric cancer, applicable to the Mexican population. RESULTS The results were reported as incremental cost-effectiveness ratios. The best strategy was serum pepsinogen determination, followed by the strategy of endoscopic examination with continued monitoring every 3 years. CONCLUSIONS The performance of serum pepsinogen serology and directed endoscopic examination (and continued monitoring, if necessary) for GAC screening could be a cost-effective intervention in Mexico, despite the low-to-moderate general prevalence of the disease.

Published
2022

29. Fracture of a Heterotopic Ossification of the Syndesmosis in a Collegiate Football Player: A Case Report

Author

Stephen A. Cage, Brandon J. Warner, and Diana M. Gallegos

Subjects
Medicine, Sports medicine, RC1200-1245
Abstract

Objective: Present a clinical case detailing the assessment and management of a collegiate football player suffering from the fracturing of a heterotopic ossification of the syndesmosis. Background: Heterotopic ossifications are not uncommon following surgical fixation of the tibiofibular syndesmosis. Typically, properly healed fibular fractures do not result in further complications associated with heterotopic ossification. Treatment: A 21-year-old collegiate football player (1.8 m, 77.1 kg) reported to the athletic training staff complaining of acute lateral ankle pain following a plant and twist mechanism while running receiving routes. Initial evaluation led to a diagnosis of a syndesmotic ankle sprain, with a plan to pursue conservative management. When patient was unable to participate in the following practice due to intensity of pain, the patient was referred for x-rays a revealed poorly healed Weber Type C fracture that had been mislabeled as a Maisonneuve fracture at the patient’s previous university. This previous injury led to a heterotopic ossification of the syndesmosis that had fractured during the more recent injury. With this new diagnosis, the patient consented to conservative treatment that allowed the patient to return to football activities the following offseason. Uniqueness: While heterotopic ossification of the ankle syndesmosis has been reported in literature, there has yet to be extensive research on the condition. Generally, when these ossifications become symptomatic best practices involve surgical removal. In spite of presenting with symptoms, the patient was able to return to full participation following conservative treatment. Conclusion: When providing patient care, accurate diagnosis is crucial to optimal outcomes. Caring for patients in a collegiate setting presents a unique number of instances of patient care transfer, which may make previous misdiagnosis hard to recognize. Diligent health care practitioners should always ensure that a comprehensive medical history is obtained in order to make an accurate assessment.

Published
2019
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30. Haptic sound-symbolism in young Spanish-speaking children.

Author

Alberto Falcón, Ulianov Montano, Mariel Tavira, and Osmara Domínguez-Gallegos

Subjects
Medicine, Science
Abstract

Haptic sound symbolism has been found in adults, between ideophones and various textures, between words and shape, and between written words and texture. However, associations between the sound of nonwords and features other than shape and in early stages of development have been less explored. The present study investigates the haptic manifestation of sound symbolism in an early developmental stage. We examined associations between nonwords and the rough-smooth tactile dimension in 3.5-to-4.5-year-old children. Two experiments were conducted: a pointing selection task and a naming task. Sound symbolic associations were found in the naming task, but not in the pointing task. On the other hand an unexpected bias towards smoothness was found in the pointing task. We explain these results by suggesting that the articulation of nonwords may facilitate or intensify sound symbolism, and that hedonic biases are manifested in the pointing task.

Published
2019
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31. Head & neck cancer. Its impact on the history of mankind

Author

José Francisco Gallegos-Hernández

Subjects
medicine.medical_specialty, History, Cancer, General Medicine, History of medicine, Head neck cancer, medicine.disease, Cancer treatment, Head and Neck Neoplasms, Family medicine, Carcinoma, Squamous Cell, medicine, Humans, Basal cell, Socioeconomic status
Abstract

Squamous cell carcinoma is the most common headneck malignancy, and its first descriptions date from the pharaonic era. It has impacted humanity by affecting labor, scientific and cultural productivity and, sometimes, it has influenced the course of history. Headneck cancer is more common in economically impoverished countries and individuals; however, it can affect any socioeconomic stratum; it has been suffered by known, famous, economically powerful celebrities, intellectuals and artists. Headneck cancer treatment has been controversial since its initial description up to the present day. Therapeutic decisions have been influenced not only by the stage but by the patient's environment and, sometimes, in an effort to reduce the morbidity resulting from the various oncological treatments, erroneous decisions have been made that have implied the loss of the patient's life. Unfortunately, currently we continue to see these behaviors. A synthesis of cases of renowned celebrities that suffered from this cancer is presented, and the impact this implied in the society of their times is described.El cáncer epidermoide es el más frecuente en cabeza y cuello y sus primeras descripciones datan de la época faraónica. Ha impactado en la humanidad al afectar la productividad laboral, científica y cultural y, en ocasiones, ha influido en el derrotero de la historia. El cáncer de cabeza y cuello es más frecuente en países e individuos depauperados económicamente, sin embargo, puede afectar cualquier estrato socioeconómico; lo han padecido personajes conocidos, famosos, económicamente poderosos, intelectuales y artistas. El tratamiento del cáncer de cabeza y cuello ha sido motivo de controversia desde su descripción inicial hasta la actualidad. En la decisión terapéutica ha influido no solo el estadio del cáncer sino el entorno del paciente; en ocasiones, en un afán de disminuir la morbilidad derivada de los diversos tratamientos oncológicos, se han tomado decisiones erróneas que han implicado la pérdida de la vida del enfermo. Infortunadamente, en la actualidad seguimos viendo estas conductas. Se presenta una síntesis de casos de connotados personajes que presentaron este cáncer y se describe el impacto que ello implicó en la sociedad de ese momento.

Published
2023

36. Adenomioepitelioma de la mama desde una perspectiva radiológica

Author

Marcela Uchida, M. Gallegos, M.Á Pinochet, D. Hasson, and C. Gatica

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine, Radiology, Nuclear Medicine and imaging, Doppler ultrasound, business, Ecografia doppler
Abstract

Resumen El adenomioepitelioma mamario (AME) es un tumor poco frecuente que se caracteriza por la proliferacion bifasica de celulas epiteliales y mioepiteliales. Los hallazgos radiologicos de los AME se encuentran escasamente descritos en la literatura cientifica. El objetivo de nuestro estudio es evaluar las caracteristicas de imagen del adenomioepitelioma de mama con un enfoque en la apariencia ecografica y mamografica. Se realizo un estudio retrospectivo y descriptivo a partir de las biopsias realizadas en nuestra institucion entre 2007 y 2019. Se analizaron retrospectivamente los hallazgos en mamografia y ultrasonido, de acuerdo con el lexico del sistema de informes y datos de imagenes mamarias (BI-RADS), de aquellas lesiones que resultaron con histologia positiva para adenomioepitelioma. En el periodo de estudio se encontraron 13 AME en 13 mujeres. Se realizo ecografia a todas las pacientes; 12 lesiones se presentaron como nodulos ovalados y en un caso con forma irregular. Los margenes fueron circunscritos (n = 8), angulados (n = 3) o microlobulados (n = 2), el patron de eco fue hipoecoico (n = 8) y complejo solido-quistico (n = 5). En cuanto a la vascularizacion, 11 fueron nodulos vascularizados en Doppler color y 2 resultaron avasculares. En conclusion, presentamos las caracteristicas imagenologicas de una serie de casos de AME. Es poco probable sospechar esta lesion exclusivamente en funcion de los hallazgos por imagen; sin embargo, es importante conocer esta lesion para realizar una buena correlacion radiopatologica.

Published
2022

37. Thoracic Surgery Foundation Research Awards: Leading the Way to Excellence

Author

Walter Navid, Derek Serna-Gallegos, George J. Arnaoutakis, Wilson Y. Szeto, Sarah Yousef, Arman Kilic, Ibrahim Sultan, Joseph E. Bavaria, and Edgar Aranda-Michel

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Biomedical Research, media_common.quotation_subject, education, Awards and Prizes, Scopus, MEDLINE, Excellence, Humans, Medicine, Early career, Scholarly work, Academic medicine, health care economics and organizations, media_common, business.industry, Thoracic Surgery, Research Personnel, United States, humanities, National Institutes of Health (U.S.), Cardiothoracic surgery, Family medicine, Female, Surgery, Cardiology and Cardiovascular Medicine, business, Citation
Abstract

Background Combining clinical and research excellence has become an increasingly difficult endeavor for thoracic surgeons, with typical success rates for the National Heart, Lung and Blood Institute and the National Cancer Institute being 25.1% and 11.3%, respectively. The Thoracic Surgery Foundation (TSF), which is an arm of The Society of Thoracic Surgeons, provides research awards and grants aimed at early career faculty to assist in securing federal peer-reviewed funding. The aim of this study was to assess the impact of these awards. Methods Faculty awardees of the TSF research awards from 1995 to 2019 were included in the study. The scholarly work of awardees was assessed by using Scopus , MEDLINE, and Google Scholar for publications, citations, and h-index. The National Institutes of Health (NIH) RePorter and the Federal RePorter were used to search for any grants awarded to these individuals. For publications and citations associated with a TSF grant, a 4-year window from the time of the research award was used. Results Fifty-two research awards were given to early career faculty during this study period, and 8 (15%) were awarded to MD PhDs. Six (12%) of awardees were female. Cardiac faculty members were awarded 27 (52%) awards, and general thoracic faculty members were awarded 25 (48%); of the cardiac faculty, 4 (17.4%) were congenital cardiac faculty. In the 4-year period after the TSF grant award, the mean number of published articles per awardee was 23 (interquartile range [IQR], 12 to 36), with a median citation count of 147 (IQR, 32 to 327). The current median h-index was 26 (IQR, 15 to 36), with 2323 (IQR, 1173 to 4568) median citations. Forty-eight percent of all awardees received at least 1 subsequent grant; 40.4% of these awardees received grants from the NIH, and 25% had 2 or more NIH grants. Comparing academic position at the time of the award with current position, 54% of awardees had an advancement in their professional rank. On analyzing leadership positions, 42% of awardees were division chiefs, 21% were associate clinical directors, and 28% were clinical directors. Conclusions Being a recipient of the TSF award may position an individual to excel in academic medicine, with a large portion of awardees improving their academic standing with time. The rate of successful NIH grant funding after being a TSF awardee is higher than typical institutional success rates.

Published
2022

38. Management of Decompensated Cirrhosis and Associated Syndromes

Author

Eduardo Rodriguez Zarate, Juan F. Gallegos-Orozco, and Shaun Chandna

Subjects
Liver Cirrhosis, medicine.medical_specialty, Hepatorenal Syndrome, Cirrhosis, Critical Care, Hypertension, Pulmonary, Esophageal and Gastric Varices, law.invention, Hepatorenal syndrome, law, medicine, Humans, Intensive care medicine, Hepatopulmonary syndrome, Clinical syndrome, Hepatic encephalopathy, business.industry, Acute-On-Chronic Liver Failure, medicine.disease, Decompensated cirrhosis, Combined Modality Therapy, Pulmonary hypertension, Intensive care unit, Liver Transplantation, Hepatic Encephalopathy, Surgery, Gastrointestinal Hemorrhage, business, Hepatopulmonary Syndrome
Abstract

Patients with cirrhosis account for 3% of intensive care unit admissions with hospital mortality exceeding 50%; however, improvements in survival among patients with acutely decompensated cirrhosis and organ failure have been described when treated in specialized liver transplant centers. Acute-on-chronic liver failure is a distinct clinical syndrome characterized by decompensated cirrhosis associated with one or more organ failures resulting in a significantly higher short-term mortality. In this review, we will discuss the management of common life-threatening complications in the patient with cirrhosis that require intensive care management including neurologic, cardiovascular, gastrointestinal, pulmonary, and renal complications.

Published
2022

39. Heart rate variability-guided training in professional runners: Effects on performance and vagal modulation

Author

Alberto González-Quílez, Marco Altini, María Carrasco-Poyatos, Antonio Granero-Gallegos, AMS - Sports, and Physiology

Subjects
medicine.medical_specialty, education, Experimental and Cognitive Psychology, law.invention, Endurance, Behavioral Neuroscience, Oxygen Consumption, Randomized controlled trial, Ventilatory threshold, Heart Rate, law, Heart rate, Professional, Humans, Medicine, Heart rate variability, rMSSD, Treadmill, Respiratory exchange ratio, business.industry, VO2 max, Vagus Nerve, Adaptation, Physiological, VOmax, Intensity (physics), Exercise Test, Physical Endurance, Physical therapy, business
Abstract

Purpose: To analyze the training structure following a heart rate variability (HRV) -guided training or traditional training protocol, determining their effects on the cardiovascular performance of professional endurance runners, and describing the vagal modulation interaction. Methods: This was an 8-week cluster-randomized controlled trial. Twelve professional endurance runners were randomly assigned to an HRV-guided training group (HRV-G; n = 6) or a traditional training group (TRAD-G; n = 6). The training methodology followed by the HRV-G was determined by their daily HRV scores. Training intensities were recorded daily. HRV4Training was used to register the rMSSD every morning and during a 60-second period. Cardiovascular outcomes were obtained through an incremental treadmill test. The primary outcome was the maximal oxygen uptake (VO2max). Results: Total training volume was significantly higher in TRAD-G, but moderate intensity training was significantly higher in HRV-G (X ± SDDif=1.98 ± 0.1%; P = 0.006; d = 1.22) and low intensity training in TRAD-G (X ± SDDif=2.03 ± 0.74%; P = 0.004; d = 1.36). The maximal velocity increased significantly in HRV-G (P = 0.027, d = 0.66), while the respiratory exchange ratio increased in TRAD-G (P = 0.017, d = 1). There was a small effect on the LnRMSSD increment (P = 0.365, d = 0.4) in HRV-G. There were statistical inter-group differences in the ∆maximal heart rate when ∆LnrMSSD was considered as a covariable (F = 7.58; P = 0.025; d = 0.487). There were significant and indirect correlations of LnRMSSDTEST with VO2max (r =-0.656, P = 0.02), ∆LnrMSSD with ∆VO2max (r = -0.606, P = 0.037), and ∆LnrMSSDCV with ∆VENT (r = -0.790, P = 0.002). Conclusions: higher HRV scores suggest better cardiovascular adaptations due to higher training intensities, favoring HRV as a measure to optimize individualized training in professional runners.

Published
2022

40. Testicular Germ-Cell Tumors with Spermatic Cord Involvement: A Retrospective International Multi-Institutional Experience

Author

George J. Netto, Sofia Canete-Portillo, Jeffrey S. So, Hiroshi Miyamoto, Diego F. Sanchez, Maria Del Carmen Rodriguez Pena, Debra L. Zynger, Dilek Ertoy Baydar, Shi Wei, Manju Aron, Maria Rosaria Raspollini, Květoslava Michalová, Francesca Khani, Piergiuseppe Colombo, Adeboye O. Osunkoya, Ali Amin, Federico Scarfò, Iván Gallegos, Roni M. Cox, Roberta Lucianò, and Cristina Magi-Galluzzi

Subjects
medicine.medical_specialty, Pathology, Cord, business.industry, Lymphovascular invasion, Urology, Soft tissue, Cancer, Histology, medicine.disease, Spermatic cord, Pathology and Forensic Medicine, medicine.anatomical_structure, Medicine, Stage (cooking), business, Testicular cancer
Abstract

The 8th Edition of the American Joint Committee on Cancer (AJCC) Staging Manual designates discontinuous involvement of spermatic cord soft tissue by testicular germ cell tumors as a metastatic deposit. We conducted a retrospective international multi-institutional study to validate the current recommendations. Thirty-three (72%) nonseminomatous and 13 (28%) seminomatous testicular germ cell tumors were collected from 15 institutions in America, Europe, and Asia. Testicular tumor size ranged from 1.3 to 18.0 cm (mean: 6.1). Cases were classified as discontinuous involvement of spermatic cord soft tissue (n = 26), continuous cord involvement (n = 17), or cord lymphovascular invasion (n = 3). The mean follow-up was 39 months. Clinical stage for discontinuous involvement of spermatic cord soft-tissue patients was I (local disease) in 2/24 (8%), II (regional disease) in 6/24 (25%), and III (distant disease) in 16/24 (67%) cases; 16 (67%) patients presented with distant metastasis. Clinical stage for continuous cord involvement patients was I in 9/17 (53%), II in 4/17 (23%), and III in 4/17 (23%); 4 (23%) patients presented with distant metastasis. Disease progression was seen in 4 patients with discontinuous involvement of spermatic cord soft tissue and 5 with continuous cord-involvement (p = 0.699). When comparing discontinuous and continuous cord involvement, a significant difference was found in cord margin status (p = 0.044), spermatic cord tumor size (p = 0.016), lymph-node involvement (p = 0.037), distant metastasis (p = 0.010), individual clinical stage (p = 0.003), and nonadvanced vs. advanced disease (p = 0.003) at presentation. In multivariate analysis, after adjusting for age, histology, testicular tumor size, percent of embryonal carcinoma, lymphovascular invasion, and cord margin status, discontinuous involvement of spermatic cord soft tissue was significantly associated (p = 0.011) with advanced clinical stage at presentation. Our findings support the designation of metastatic disease for discontinuous involvement of spermatic cord soft tissue, as introduced by the 8th edition of the AJCC staging.

Published
2022

41. Malignant Hyperthermia Preparedness Training: Using Cognitive Aids and Emergency Checklists in the Perioperative Setting

Author

Bryan Hennen and Elizabeth Gallegos

Subjects
business.industry, Cognition, Perioperative, medicine.disease, Checklist, Medical–Surgical Nursing, Willingness to use, Acquired immunodeficiency syndrome (AIDS), Multidisciplinary approach, Preparedness, Ambulatory, Humans, Medicine, Computer Simulation, Medical emergency, Malignant Hyperthermia, business
Abstract

Purpose The purpose of this project was to prepare perioperative staff at a military ambulatory surgical center to respond to a malignant hyperthermia crisis effectively with the assistance the Stanford emergency manual cognitive aid. Design This is an evidence-based practice improvement project. Methods Multidisciplinary perioperative staff at a military ambulatory surgical center participated in an in-service about the Stanford emergency manual cognitive aid tool, and a simulation exercise was conducted to practice using the tool during a malignant hyperthermia crisis. Preproject and postproject implementation surveys were to used to measure staff perceptions of and willingness to use cognitive aids/emergency checklists during perioperative emergencies. Findings Staff positive perception of and willingness to use the Stanford emergency manual cognitive aid improved after implementation of an education session and simulation exercise with the checklist tool. Conclusions Introduction of the Stanford emergency manual cognitive aid to multidisciplinary perioperative staff with an in-service and simulated malignant hyperthermia scenario improved staff perception of cognitive aid use during emergencies. Use of cognitive aid checklists during simulated perioperative emergencies was shown to reduce missed critical treatment steps.

Published
2022

42. Impact of Thoracic Radiation on Patients Undergoing Cardiac Surgery

Author

Valentino Bianco, Derek Serna-Gallegos, Ibrahim Sultan, Arman Kilic, Floyd Thoma, James A. Brown, and Edgar Aranda-Michel

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Heart Diseases, Heart disease, medicine.medical_treatment, 030204 cardiovascular system & hematology, Malignancy, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Interquartile range, medicine, Humans, Cardiac Surgical Procedures, Radiation Injuries, Retrospective Studies, Ejection fraction, business.industry, Hazard ratio, Percutaneous coronary intervention, General Medicine, medicine.disease, Surgery, Cardiac surgery, Treatment Outcome, 030228 respiratory system, Cohort, Cardiology and Cardiovascular Medicine, business
Abstract

Prior thoracic radiation has been associated with worse outcomes after cardiac surgery. This study sought to report long-term outcomes in patients undergoing surgery for radiation-associated heart disease. This was an observational study of open cardiac surgeries from 2011 and 2018. Patients with a history of malignancy that required thoracic radiation were identified, and this cohort was matched against a non-irradiated comparison group via Mahalanobis distance matching. Kaplan-Meier survival estimation and multivariable Cox regression analysis was performed to assess the long-term impact of thoracic radiation in patients undergoing cardiac surgery. Of the 15,284 patients receiving cardiac surgery in this time-frame, 269 were identified with a history of thoracic radiation for prior malignancy. Patients with prior radiation had increased 1-year and 5-year mortality (P0.001), despite no difference for 30-day mortality (P = 0.719), compared to non-irradiated patients. Mahalanobis distance matching yielded 269 equitably matched pairs. On multivariable analysis, patients with prior radiation demonstrated significantly increased hazard of death, as compared to the non-irradiated group (hazard ratio 1.40, 95% confidence interval: 1.02, 1.94, P = 0.038). Patients with radiation for breast cancer demonstrated a non-significant trend toward reduced hazard of death, as compared to patients with more extensive radiation exposure. There was an increase in long-term mortality in patients with prior radiation undergoing cardiac surgery, however open cardiac surgery can safely be performed in these patients with similar operative mortality. These findings may serve as a useful adjunct in shared decision-making for patients and surgeons alike.

Published
2022

43. Midterm Outcomes of Stented Versus Stentless Bioprosthetic Valves After Aortic Root Replacement

Author

Arman Kilic, Derek Serna-Gallegos, Danny Chu, James A. Brown, Ibrahim Sultan, Forozan Navid, Yancheng Dai, and Courtenay Dunn-Lewis

Subjects
Pulmonary and Respiratory Medicine, Aortic valve, medicine.medical_specialty, Regurgitation (circulation), Prosthesis Design, Aortic aneurysm, Aortic valve replacement, medicine.artery, medicine, Humans, Bioprosthesis, Heart Valve Prosthesis Implantation, Aorta, Ejection fraction, business.industry, Aortic Valve Stenosis, General Medicine, medicine.disease, Surgery, Treatment Outcome, medicine.anatomical_structure, Aortic Valve, Heart Valve Prosthesis, Propensity score matching, Stents, Implant, Cardiology and Cardiovascular Medicine, business
Abstract

To determine the impact of aortic root replacement (ARR) with a stentless bioprosthetic valve on midterm outcomes compared to a stented bioprosthetic valve-graft conduit. This was an observational study of aortic root operations from 2010 to 2018. All patients with a complete ARR for nonendocarditis reasons were included, while patients undergoing valve-sparing root replacements or primary aortic valve replacement or repair were excluded. Of the patients with a complete ARR, bioprosthetic valve implants were included, while mechanical valve implants were excluded. Patients were dichotomized into the stented ARR group and the stentless ARR group. A total of 1:1 nearest neighbor propensity matching was employed to assess the association of stentless valves with short-term and midterm outcomes. A total of 455 patients underwent a complete ARR with a bioprosthetic valve implant for nonendocarditis reasons, of which 212 (46.6%) received a stented valve, while 243 (53.4%) received a stentless valve. After matching, postoperative outcomes were similar across each group (P > 0.05), including operative mortality and adverse neurologic events. Median follow-up for the entire cohort was 4.41 years (95% CI: 4.01, 4.95). At 1 year follow-up, aortic regurgitation ≥ 2+ and ejection fraction were similar across each group (P > 0.05); however, the stentless valve group had lower aortic valve velocity and transvalvular pressure gradient. Finally, reoperations and survival were similar for each group over the study's follow-up (P > 0.05). Stentless valves may provide hemodynamic benefits after ARR; however, the clinical impact of those benefits for survival and reoperation may not yet be evident in the midterm.

Published
2022

44. Role of normothermic perfusion with ECMO in donation after controlled cardiac death in Spain

Author

J. J. Rubio Munoz, B. Dominguez-Gil González, F. del Rio Gallegos, E. Miñambres García, and J.M. Pérez-Villares

Subjects
Lung, business.industry, Thoracic cavity, Organ Preservation, Hypothermia, Death, Perfusion, Transplantation, Extracorporeal Membrane Oxygenation, Normothermic perfusion, medicine.anatomical_structure, Spain, Donation, Anesthesia, medicine, Humans, medicine.symptom, Cerebral perfusion pressure, business
Abstract

Spain has become one of the most active countries in donation after controlled cardiac death, using normothermic abdominal perfusion with ECMO in more than 50% of all donors - a situation contributed to by the creation of mobile teams to support hospitals lacking this technology. The donation process must be respectful of the wishes and values of the patients and their relatives, especially if there is pre mortem manipulation, and the absence of cerebral perfusion should be guaranteed. The liver is the most benefited organ by reducing biliary complications as well as the loss of grafts. In renal transplantation, the technique could contribute to reduce the incidence of delayed graft function. In addition, the procedure is compatible with surgical rapid recovery in hypothermia when there is also lung donation. The future lies in the consolidation of cardiac donation by extending normothermic perfusion to the thoracic cavity.

Published
2022

45. Papel de la perfusión normotérmica con oxigenación de membrana extracorpórea en la donación en asistolia controlada en España

Author

J.M. Pérez-Villares, B. Dominguez-Gil González, E. Miñambres García, F. del Rio Gallegos, and J. J. Rubio Munoz

Subjects
03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, business.industry, Medicine, 030208 emergency & critical care medicine, Critical Care and Intensive Care Medicine, business, Humanities
Abstract

Resumen Espana se ha convertido en uno de los paises mas activos en donacion en asistolia controlada incorporando la perfusion abdominal normotermica con ECMO en mas del 50% de los donantes, a lo que ha contribuido la creacion de equipos moviles para apoyo a hospitales carentes de esta tecnologia. El proceso de donacion debe ser respetuoso con los deseos y valores del paciente y sus familiares, especialmente si hay manipulacion pre mortem, y debe asimismo garantizar la ausencia de flujo cerebral. El higado es el organo mas beneficiado al reducirse las complicaciones biliares, asi como la perdida de injertos. En el trasplante renal podria contribuir a reducir la incidencia de retraso en la funcion inicial del injerto; ademas, el procedimiento es compatible con la cirugia super rapida en hipotermia cuando tambien hay donacion pulmonar. El futuro pasa por la consolidacion de la donacion cardiaca al extender la perfusion normotermica a la cavidad toracica.

Published
2022

46. Attachment and In Vitro Transfection Efficiency of an Anti-Rabies Chitosan-DNA Nanoparticle Vaccine

Author

Jorge Ortega, María del Pilar Ramos-Godínez, Citlali Cecilia Mendoza-Guevara, Alejandro Martinez-Escobar, Rogelio A. Alonso-Morales, and Eva Ramón-Gallegos

Subjects
Rabies, Biomedical Engineering, Pharmaceutical Science, Medicine (miscellaneous), Bioengineering, Transfection, Chitosan, chemistry.chemical_compound, Dogs, Rabies vaccine, medicine, Animals, Viability assay, Electrical and Electronic Engineering, biology, DNA, medicine.disease, biology.organism_classification, Virology, Computer Science Applications, Vaccination, Rabies Vaccines, chemistry, Vampire bat, Nanoparticles, Biotechnology, Conjugate, medicine.drug
Abstract

In Mexico, urban rabies has been reduced during the last decade thanks to intensive canine control and vaccination campaigns; however, rabies transmitted by wild animals, especially by bats, has been increasing due to vampire bats feeding on livestock. Vampire bat populations has been controlled by culling with vampiricides, reducing indiscriminately other bat species. Hence, bat vaccination for rabies offers an alternative for culling. Nevertheless, available rabies vaccines are not suitable for their use in wildlife from emerging countries. This project presents an alternative for the use of plasmid vaccines using bio-nanotechnology, to create low-cost and accessible vaccines. To accomplish this goal, chitosan nanoparticles were synthesized by ionic gelation and conjugated by coacervation with a pDNA rabies vaccine to test their attachment efficiency. Also, the conjugate was functionalized with Protoporphyrin IX and Folic acid as biomarkers. The nanoparticles complex was characterized by ultraviolet visible spectroscopy, infrared spectroscopy, transmission electron microscopy, dynamic light scattering, and the Z potential was obtained. In vitro tests were performed on cell viability and transfection. The nanoparticles possessed a low polydispersity, a mean size of 118.5 ± 13.6 nm and a Z potential of 17.3 mV. The attachment efficiency was of 100% independent of pDNA added. In contrast to functionalized nanoparticles which showed a max attachment efficiency of 99.6% dependent of pDNA concentration and the method of functionalization. The conjugate did not influence the viability and they improved the transfection efficiency. Results suggest that these nanoparticles are easy to prepare, inexpensive, and exhibit potential for plasmid delivery as it improves transfection efficiency of pDNA vaccines.

Published
2022

47. Costo día cama servicio pensionado para una enfermedad en un hospital de Chile

Author

Alex Medina Giacomozzi, Cecilia Gallegos Muñoz, Carolina Leyton Pavez, and Berta Torres Morales

Subjects
Asignación de costos, Costos directos de servicios, Costos de la atención en salud, Hospitalización, Neumonía, Medicine
Abstract

Uno de los temas de mayor complejidad en salud es la determinación de los costos involucrados en una atención de una enfermedad, por la gran cantidad de costos indirectos incurridos que provienen de los diversos servicios que directa o indirectamente intervienen, por lo que su asignación al usuario requirente, afectado por un problema de salud, ya sea de recuperación o rehabilitación, es sin lugar a dudas el problema más importante a resolver de cualquier sistema de costos. Además, es un problema ineludible pues la organización necesita tener información confiable, oportuna y lo más exacta posible sobre el costo de sus productos, para una correcta toma de decisiones, por lo que el objetivo del presente artículo es calcular el costo indirecto incurrido por procedimiento y su asignación por inductor de costos a un caso real para una atención cerrada en la unidad de pensionado de un hospital público chileno. La metodología seguida implicó identificar todas las actividades y costos involucrados en una atención, mediante la identificación de los inductores de costos y su distribución a una enfermedad en particular, siguiendo el criterio de costo por paciente-enfermedad. El resultado demuestra que es posible incorporar la valorización del día cama y, por tanto, reconocer los costos indirectos incurridos en la atención de una enfermedad en particular, lo que permite contar con un instrumento de identificación de costos, que responda a las necesidades de información para un establecimiento en concreto y que es posible replicar, con las adecuaciones pertinentes, a otros establecimientos de salud.

Published
2015

48. Addressing internet gaming disorder in children and adolescents

Author

Lauren Zuba, Kelley Connor, and Cara Gallegos

Subjects
Behavioral addiction, medicine.medical_specialty, Adolescent, media_common.quotation_subject, MEDLINE, chemical and pharmacologic phenomena, Assessment and Diagnosis, Emergency Nursing, Critical Care Nursing, stomatognathic system, Risk Factors, hemic and lymphatic diseases, mental disorders, medicine, Nursing Interventions Classification, Humans, Child, Psychiatry, media_common, Advanced and Specialized Nursing, Internet, business.industry, Addiction, hemic and immune systems, LPN and LVN, Behavior, Addictive, Internet addiction disorder, Video Games, The Internet, medicine.symptom, business, Psychology, Internet Addiction Disorder
Abstract

Internet gaming disorder (IGD) has been recognized as a potential behavioral addiction that warrants further research. This article discusses the signs, symptoms, and risk factors of this behavioral addiction as well as nursing interventions to support children and adolescents with IGD and their families.

Published
2021

49. Investigation of amino acid specificity in the CydX small protein shows sequence plasticity at the functional level.

Author

Jessica J Hobson, Austin S Gallegos, Benjamin W Atha, John P Kelly, Christina D Lein, Cailtin E VanOrsdel, John E Weldon, and Matthew R Hemm

Subjects
Medicine, Science
Abstract

Small proteins are a new and expanding area of research. Many characterized small proteins are composed of a single hydrophobic α-helix, and the functional requirements of their limited amino acid sequence are not well understood. One hydrophobic small protein, CydX, has been shown to be a component of the cytochrome bd oxidase complex in Escherichia coli, and is required for enzyme function. To investigate small protein sequence specificity, an alanine scanning mutagenesis on the small protein CydX was conducted using mutant alleles expressed from the E. coli chromosome at the wild-type locus. The resulting mutant strains were assayed for CydX function. No single amino acid was required to maintain wild-type resistance to β-mercaptoethanol. However, substitutions of 10-amino acid blocks indicated that the N-terminus of the protein was required for wild-type CydX activity. A series of double mutants showed that multiple mutations at the N-terminus led to β-mercaptoethanol sensitivity in vivo. Triple mutants showed both in vivo and in vitro phenotypes. Together, these data provide evidence suggesting a high level of functional plasticity in CydX, in which multiple amino acids may work cooperatively to facilitate CydX function.

Published
2018
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50. Low-cost three-dimensional printed phantom for neuraxial anesthesia training: Development and comparison to a commercial model.

Author

Azad Mashari, Mario Montealegre-Gallegos, Jelliffe Jeganathan, Lu Yeh, Joshua Qua Hiansen, Massimiliano Meineri, Feroze Mahmood, and Robina Matyal

Subjects
Medicine, Science
Abstract

METHODS:Anonymized CT DICOM data was segmented to create a 3D model of the lumbar spine. The 3D model was modified, placed inside a digitally designed housing unit and fabricated on a desktop 3D printer using polylactic acid (PLA) filament. The model was filled with an echogenic solution of gelatin with psyllium fiber. Twenty-two staff anesthesiologists performed a spinal and epidural on the 3D printed simulator and a commercially available Simulab phantom. Participants evaluated the tactile and ultrasound imaging fidelity of both phantoms via Likert-scale questionnaire. RESULTS:The 3D printed neuraxial phantom cost $13 to print and required 25 hours of non-supervised printing and 2 hours of assembly time. The 3D printed phantom was found to be less realistic to surface palpation than the Simulab phantom due to fragility of the silicone but had significantly better fidelity for loss of resistance, dural puncture and ultrasound imaging than the Simulab phantom. CONCLUSION:Low-cost neuraxial phantoms with fidelity comparable to commercial models can be produced using CT data and low-cost infrastructure consisting of FLOS software and desktop 3D printers.

Published
2018
Full Text
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