Repercusiones del confinamiento por COVID-19 en pacientes crónicos de Andalucía

ObjectiveTo understand the consequences of the COVID-19 pandemic lockdown on the self-care of people living with chronic diseases and on their self-perceived health, and to identify factors that may influence the management of their disease in emergency situations.MethodA qualitative study conducted in 2020 (March and April) in Andalusia (Spain) during the COVID-19 pandemic lockdown, through virtual focus groups, using the Zoom telematics tool. Three virtual focus groups were conducted, including 34 patients from Andalusia with different chronic conditions such as arthritis, diabetes, cardiovascular disease, inflammatory bowel disease, breast cancer and fibromyalgia.ResultsPeople with chronic diseases reported effects of the lockdown in relation to their emotional experience, their coping resources, the information they received, the difficulties to manage self-care, and the contact or access to health services. They also suggested some lessons learned for the future. The need for more and better information, patient training, involving patient associations, and improving telematics access to health services are the main areas for improvement to minimize the impact of future quarantines on the self-care and the health of people with chronic diseases.ConclusionsBesides the risk of contracting COVID-19, the difficulties encountered by people with chronic diseases during the lockdown include interferences in the self-care and the health care received. Health crisis situations demand more information, training for patients and improvements in the health services accessibility for patients with chronic conditions.     

Health dynamics shape life-cycle incomes

This paper empirically investigates the long-run effects of major health improvements on income growth in the United States. To isolate exogenous changes in health, the econometric model uses quasi-experimental variation in cardiovascular disease mortality across states over time. Based on data for the white population, the results show that there is a causal link between health and income per person, and they provide novel evidence that health dynamics shape life-cycle incomes. Life-cycle income profiles slope more strongly at the beginning and at the end of work life in 2000 than in 1960, indicating that age becomes a more prominent determinant of income dynamics over this period. The channels for this transformation include better health, higher educational attainment, and changing labor supply.     

Percepción de profesionales de la salud sobre la intervención grupal socioeducativa con mujeres que presentan síntomas somáticos sin causa orgánica

ObjectiveTo know the perception and opinion of primary care health professionals on the impact of non-medicalizing group educational intervention (GRUSE) with women who present somatic symptoms without organic cause.DesignQualitative phenomenological study.SettingPrimary care health centers in Andalusia, during 2017 and 2018.Participants and/or contextsTwenty-four health professionals, selected according to their level of involvement in the GRUSE strategy (socio-educational groups).MethodA qualitative methodology is applied, through the phenomenological method. The technique used to collect the information is the discussion group, and a content analysis is carried out on it. The software Atlas.ti 8.0 is used as a support resource for the analysis.ResultsHealth professionals highlight group work as a means of achieving change, and point to the importance of intervention as a non-medicalizing strategy. They perceive that the participants obtain some benefits: the improvement of their personal well-being, the increase of their self-esteem and self-determination, and the generation of social networks, benefits that also affect their immediate surroundings.ConclusionsIn the opinion of the professionals, the strategy has positive effects on women and does not mean an increase in resources for the health system. In addition, they express the importance of provide women with tools to cope with daily life problems derivates mostly from gender mandates of a patriarchal society.     

社会活动对老年人认知功能的影响

目的 探讨社会活动对不同性别和年龄的中国老年人认知功能的影响。方法 运用2018年“中国老年健康影响因素跟踪调查”的15424份数据。通过MMSE-R量表评价老人认知功能。控制居住地、受教育水平、配偶、自评健康状态、慢性病等因素,运用二元logistic回归分析社会活动对不同性别、年龄段老人认知功能的作用。结果 我国60岁以上老年人认知障碍发生率为34.88%,串门/与朋友交往、家务、看电视听广播和棋牌是所有性别和年龄段的老人认知功能的保护因素。阅读书报是＞85岁组男性老年人认知功能的保护因素,健身运动、旅游是60~85岁组男性认知功能的保护因素;社会组织活动是＞85岁组女性老人认知功能的保护因素。结论 根据老人的状态和需求提供适宜的社会活动方案,重视老年人社会活动的指导和推广。     

Interleukin-6 and selected plasma proteins in healthy persons of different ages

In the present study, interleukin-6(IL-6) and several acute phase proteins were measured in healthy participants (23–87 years of age). A linear correlation between IL-6 and age was established with an increase of 0.016 pg/ml(00.004) per year of life. Whereas CRP remained below 0.5 mg/dl in all participants, an increase with age for fibrinogen and an inverse relation for albumin as well as transferrin were obtained. However, the increase of IL-6 did not correlate with any of these changes. IL-6 associated diseases may therefore occur more often with advancing age, but in healthy participants IL-6 does not explain the changing plasma protein pattern resembling that of an acute phase reaction.     

Action potentials of the rat diaphragm and their sensitivity to tetrodotoxin during postnatal development and old age

Summary Using the microelectrode technique, parameters of action potentials obtained from the diaphragm muscle fibres were studied at 3, 7, 14, 30 and 90 days of age and on 28–30 month old rats. The maximum rate of rise was always greater at the end-plate zone than at the extrajunctional parts of muscle fibre at all ages examined. A maximum difference of 40% was found in animals aged 7–30 days. Sensitivity to tetrodotoxin (TTX) was maximal 3 days after birth at the extrajunctiona zone (5×10^–8 M) and minimal at the end-plate zone (5×10^–6 M). This difference declined during the postnatal life until it had disappeared in old rats. The greater resistance of the end-plate zone action potentials to TTX and their greater maximum rate of rise is not apparently connected with the presence of acetylcholine sensitivity.     

The nucleotide excision repair epistasis group in Neurospora crassa

Summary DNA repair mutants in eucaryotes are normally assigned to three epistasis groups. Each epistasis group represents a pathway for DNA repair. The pathways are commonly designated (1) nucleotide excision repair, (2) recombination repair and (3) mutagenic repair. An excision repair epistasis group has been established in Neurospora and the mutants assigned to this group should be limited in their ability to excise pyrimidine dimers and other bulky lesions from DNA. Using a pyrimidine dimer-specific assay, we have found that all Neurospora crassa mutants assigned to the excision repair epistasis group are capable of removing pyrimidine dimers from the DNA at a rate similar to the wild-type organism.     

Human acetylator genotype: Relationship to colorectal cancer incidence and arylamine N-acetyltransferase expression in colon cytosol

Polymorphic expression of arylamine N-acetyltransferase (EC 2.3.1.5) may be a differential risk factor in metabolic activation of arylamine carcinogens and susceptibility to cancers related to arylamine exposures. Human epidemiological studies suggest that rapid acetylator phenotype may be associated with higher incidences of colorectal cancer. We used restriction fragment length polymorphism analysis to determine acetylator genotypes of 44 subjects with colorectal cancer and 28 non-cancer subjects of similar ethnic background (i.e., approximately 25% Black and 75% White). The polymorphic N-acetyltransferase gene (NAT2) was amplified by the polymerase chain reaction from DNA templates derived from human colons of colorectal and non-cancer subjects. No significant differences inNAT2 allelic frequencies (i.e., WT, M1, M2, M3 alleles) or in acetylator genotypes were found between the colorectal cancer and non-cancer groups. No significant differences inNAT2 allelic frequencies were observed between Whites and Blacks or between males and females. Cytosolic preparations from the human colons were tested for expression of arylamine N-acetyltransferase activity. Although N-acetyltransferase activity was expressed for each of the arylamines tested (i.e., p-aminobenzoic acid, 4-aminobiphenyl, 2-aminofluorene, -naphthylamine), no correlation was observed between acetylator genotype and expression of human colon arylamine N-acetyltransferase activity. Similarly, no correlation was observed between subject age and expression of human colon arylamine N-acetyltransferase activity. These results suggest that arylamine N-acetyltransferase activity expressed in human colon is catalyzed predominantly by NAT1, an arylamine N-acetyltransferase that is not regulated byNAT2 acetylator genotype. The ability to determine acetylator genotype from DNA derived from human surgical samples should facilitate further epidemiological studies to assess the role of acetylator genotype in various cancers.     

Pretreatment prognostic factors for survival in small-cell lung cancer: A new prognostic index and validation of three known prognostic indices on 341 patients

Aims: a) To identify which pretreatment clinical or blood parameters werepredictive of patient survival in small-cell lung cancer (SCLC) in aretrospective analysis. b) To validate three known prognostic indices: RoyalMarsden Model (index 1), London Group (index 2) and Manchester Score (index3).Patients and methods: From 1981 to 1993, 341 SCLC patients were treatedwith chemotherapy with or without surgery or radiotherapy. Univariate andmultiple regression analyses of survival were performed and the feasibilityof these models was explored, index 1: Karnofsky index, albumin, sodium andalkaline phosphatase; index 2: ECOG performance status (PS), albumin andalanine transaminase; and index 3: lactate dehydrogenase (LDH), diseaseextent, sodium, Karnofsky index, alkaline phosphatase and bicarbonate.Results: Significant prognostic factors for survival after univariate andmultiple regression analysis were: disease extent, PS, creatine kinase,neutrophilia, LDH, hypoalbuminemia, hyperglycemia and bicarbonate. A newprognostic index was performed that included LDH, hypoalbuminemia,neutrophilia, disease extent and PS. It defined three prognostic groups (PG).Median survival and two-year survival for these PG were 12.3, 8 and 3.4 monthsand 16.5%, 2.3% and 0%, respectively. The following PGwere identified after application of the three models proposed: Index 1identified two PG with 0% and 16.6% two-year survival (P <0.001); index 2 detected three PG with 0%, 5% and 15.7%two-year survival (P < 0.001) and index 3 detected three PG with 0%,2.5% and 16.2% two-year survivals, respectively (P < 0.001).Conclusion: A new prognostic index is proposed allowing identification ofthree different PG. The feasibility of three known prognostic models wasvalidated and demonstrated. Variables other than disease extent or PS (albuminor LDH) should be taken into account in designing future clinical trials.     

A comparison of perinatal mortality between ethnic Chinese and ethnic whites: Why the Chinese rate was lower

Objectives. To confirm the observation that has been occasionally reported in the literature that perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and to assess the reasons for this lower perinatal mortality rate.

Methods. Secondary‐analysis based on published data.

Results. This exercise demonstrates that the perinatal mortality rate was lower in ethnic Chinese than in ethnic whites. The birth weight distribution in ethnic Chinese was more favourable with reduced births at two extremes of the distribution, and the exposure to risk factors for perinatal death by their mothers was also lower.

Conclusion: Perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and the lower perinatal mortality rate in ethnic Chinese is probably caused by their favourable birth weight distribution and lower exposure to risk factors of perinatal death by their mothers.