Now showing 1 - 10 of 14
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    Quality of clinical practice guidelines about red blood cell transfusion
    (Wiley, 2018-12-03) ;
    Nadia Montero‐Oleas
    ;
    Robin W.M. Vernooij
    ;
    Ingrid Arevalo‐Rodriguez
    ;
    Paulina Fuentes
    <jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Red blood cell (RBC) transfusions are essential in health care. The quality of recommendations included in clinical practice guidelines (CPG), regarding this intervention, has not been systematically evaluated. This paper systematically assessed CPGs for RBC‐transfusion, to appraise their methodological quality, to explore changes in quality over time, and to assess the consistency of the hemoglobin threshold (HT) recommendations.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We searched for CPGs that included recommendations of RBC‐transfusion in generic databases, compiler entities, registries, clearinghouses and guideline developers. Three reviewers extracted data on CPGs characteristics and HT recommendations, independently appraised the quality of the studies using AGREE II and resolved disagreements by consensus.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We examined 16 CPGs. Mean scores (mean ± SD) were: scope and purpose (59.4% ± 19.8%), stakeholder involvement (43.2% ± 22.6%), rigor of development (50% ± 25%), clarity of presentation (74.4% ± 12.6%), applicability (19.4% ± 18.8%), and editorial independence (41% ± 30%). Seven CPGs recommended a restrictive strategy for RBC transfusion; four CPGs gave a guarded statement considering an HT of 7 g/dL, as safe to prescribe an RBC transfusion. Eight CPGs did not provide an HT stating that RBC transfusions should not be prescribed by HT alone.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Only 3 out of the 16 evaluated CPGs were “recommended” by the independent evaluators. Four domains “stakeholder involvement,” “rigor of development,” applicability,” and “editorial independence” had serious shortcomings. Recommendations about the use of an HT for RBC‐transfusion were heterogeneous among guidelines. Greater efforts are needed to provide high‐quality CPGs in the RBC‐transfusion practice.</jats:p></jats:sec>
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    Exercise training for adult lung transplant recipients
    (Wiley, 2021-07-20)
    Ruvistay Gutierrez-Arias
    ;
    Maria José Martinez-Zapata
    ;
    Monica C Gaete-Mahn
    ;
    Dimelza Osorio
    ;
    Luis Bustos
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    Identification of mutations on the EMD and EYA4 genes associated with Emery–Dreifuss muscular dystrophy and deafness: a case report
    (Frontiers Media SA, 2023-05-12) ;
    Rita Ibarra-Castillo
    ;
    ; ;
    José Luis Laso-Bayas
    <jats:sec><jats:title>Introduction</jats:title><jats:p>Hearing loss is the most common sensory disability, and it is estimated that 50% of cases are caused by genetic factors. One of the genes associated with deafness is the eyes absent homolog 4 (<jats:italic>EYA4</jats:italic>) gene, a transcription factor related to the development and function of the inner ear. Emery–Dreifuss muscular dystrophy is a rare inherited disease characterized by atrophy and weakness of the humeroperoneal muscles, multi-joint contractures, and cardiac manifestations. It is inherited in an autosomal-dominant, X-linked, or less frequently autosomal recessive manner; one of the genes associated with EDMD is the emerin (<jats:italic>EMD)</jats:italic> gene.</jats:p></jats:sec><jats:sec><jats:title>Case description</jats:title><jats:p>A total of two Ecuadorian siblings aged 57 (Subject A) and 55 (Subject B) were diagnosed with deafness and an unspecified type of muscular dystrophy based on family history and clinical findings. Next-generation sequencing (NGS) using the TruSight Cardio and Inherited Disease kits at the Centro de Investigación Genética y Genómica CIGG, Universidad UTE, was performed. The genetic analyses showed two mutations: a stop mutation in exon 11/20 (NM_004100.4:c.940G&amp;gt;T) of the <jats:italic>EYA4</jats:italic> gene and a missense mutation in exon 6 (NM_000117.2:c.548C&amp;gt;G) of the <jats:italic>EMD</jats:italic> gene.</jats:p></jats:sec><jats:sec><jats:title>Discussion and conclusion</jats:title><jats:p>The <jats:italic>in silico</jats:italic> predictions described the <jats:italic>EYA4</jats:italic> variant as likely pathogenic and the <jats:italic>EMD</jats:italic> variant as a variant of uncertain significance (VUS). Moreover, an ancestry analysis was performed using 46 Ancestry Informative Insertion/Deletion Markers (AIM-InDels), and the ancestral composition of subject A was 46% African, 26.1% European, and 27.9% American Indian ancestry, whereas the ancestral composition of subject B was 41.3% African, 38.2% European, and 20.5% American Indian ancestry. The present case report describes two Ecuadorian siblings with a mainly African ancestral component, muscular dystrophy, and deafness phenotypes. Moreover, using next-generation sequencing (NGS), a mutation in the <jats:italic>EMD</jats:italic> and a novel mutation in <jats:italic>EYA4</jats:italic> genes possibly associated with the subjects' phenotype were identified and discussed.</jats:p></jats:sec>
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    Weighty matters: Unraveling the impact of obesity on colorectal cancer and nutritional interventions
    (Elsevier BV, 2025-09-01)
    SIMANCAS RACINES, DANIEL ALEJANDRO
    ;
    REYTOR GONZÁLEZ, CLAUDIA MARÍA
    ;
    Evelyn Frias-Toral
    ;
    Christos S. Katsanos
    ;
    This narrative review explores the influence of obesity on colorectal cancer, focusing on obesity-related factors, including chronic inflammation, metabolic dysregulation, and gut microbiota imbalance, which collectively create a pro-carcinogenic environment that increases colorectal cancer risk and complicates treatment outcomes. The findings indicate that obesity not only accelerates tumor progression but also presents challenges in colorectal cancer treatment, such as higher rates of surgical complications due to excess adipose tissue and altered pharmacokinetics that can reduce chemotherapy efficacy. Nutritional and lifestyle interventions, particularly weight management and anti-inflammatory nutritional therapies, are highlighted as effective strategies to reduce colorectal cancer risk and support treatment in patients with obesity. The study emphasizes the importance of personalized colorectal cancer treatment approaches for individuals with obesity and calls for public health policies targeting obesity prevention, which could significantly decrease colorectal cancer incidence and healthcare burdens associated with this high-risk population.
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    El papel de las revisiones sistemáticas. Comentarios
    (Ovid Technologies (Wolters Kluwer Health), 2011-11)
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    Leukodepleted Packed Red Blood Cells Transfusion in Patients Undergoing Major Cardiovascular Surgical Procedure: Systematic Review and Meta-Analysis
    (Hindawi Limited, 2019-02-25) ;
    Ingrid Arevalo-Rodriguez
    ;
    Gerard Urrutia
    ;
    Diana Buitrago-Garcia
    ;
    Solange Núñez-González
    <jats:p><jats:italic>Background</jats:italic>. Leukocytes contained in the allogeneic packed red blood cell (PRBC) are the cause of certain adverse reactions associated with blood transfusion. Leukoreduction consists of eliminating leukocytes in all blood products below the established safety levels for any patient type. In this systematic review, we appraise the clinical effectiveness of allogeneic leukodepleted (LD) PRBC transfusion for preventing infections and death in patients undergoing major cardiovascular surgical procedures.<jats:italic>Methods</jats:italic>. We searched randomized controlled trials (RCT), enrolling patients undergoing a major cardiovascular surgical procedure and transfused with LD-PRBC. Data were extracted, and risk of bias was assessed according to Cochrane guidelines. In addition, trial sequential analysis (TSA) was used to assess the need of conducting additional trials. Quality of the evidence was assessed using the GRADE approach.<jats:italic>Results</jats:italic>. Seven studies met the eligibility criteria. Quality of the evidence was rated as moderate for both outcomes. The risk ratio for death from any cause comparing the LD-PRBC versus non-LD-PRBC group was 0.69 (CI 95% = 0.53 to 0.90;<jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0%). The risk ratio for infection in the same comparison groups was 0.77 (CI 95% = 0.66 to 0.91;<jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0%). TSA showed a conclusive result in this outcome.<jats:italic>Conclusions</jats:italic>. We found evidence that supports the routine use of leukodepletion in patients undergoing a major cardiovascular surgical procedure requiring PRBC transfusion to prevent death and infection. In the case of infection, the evidence should be considered sufficient and conclusive and hence indicated that further trials would not be required.</jats:p>
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    Cross-sectional study of child and adolescent growth in Ecuador
    (Universidad Nacional de La Plata, 2019-06-18)
    Wilmer Alexander Tarupi
    ;
    Yvan Lepage
    ;
    Roland Hauspie
    ;
    ;
    Claude Monnier
    <jats:p>Child growth is internationally recognized as an important indicator for monitoring health in populations. There exists a wide controversy regarding the use of international growth standards versus local references. This study seeks to construct reference growth curves for school-age Ecuadorian children and adolescents, and to compare them with World Health Organization (WHO) standards, in order to identify the differences and their public health implications. The study authors enrolled 2891 children (1644 girls and 1247 boys) aged 5 to 18 years, from a variety of climatic zones and ethnic groups. LMS method was used to construct Ecuadorian curves for height, weight and Body Mass Index. Comparisons of Ecuadorian and WHO curves were graphically illustrated. U.S children were taller than Ecuadorian children across all age ranges, with larger differences between the two populations in children over 13 years. Consequently, estimates of low height and extremely low height, as well as overweight, obese and undernourished, were significantly different between WHO standards and the Ecuadorian references. Population-specific growth curves may be more adequate for growth monitoring of Ecuadorian children than WHO growth curves. We advocate for the construction of an Ecuadorian growth reference for clinical use based on national population, from conception to maturity, as an accurate instrument for monitoring growth.</jats:p>
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    Unlocking the potential: very-low-energy ketogenic therapy in obesity-related disorders
    (Informa UK Limited, 2025-01-16)
    Daniel Simancas-Racines
    ;
    Claudia Reytor-González
    ;
    ;
    Giuseppe Annunziata
    ;
    Angelo Michele Carella
    The Very Low-Energy Ketogenic Therapy (VLEKT) is a structured, multi-phase dietary regimen characterized by a carbohydrate intake of less than 50 g/day and a daily caloric intake of fewer than 800 kcal, which induces ketosis and facilitates significant weight loss. Evidence suggests that this nutritional therapy can improve glycemic control, lipid profiles, and blood pressure, making it a promising option for managing type 2 diabetes (T2D) and reducing cardiovascular risk. These benefits are achieved through reductions in triglycerides and low-density lipoprotein cholesterol (LDL-c), alongside increases in high-density lipoprotein cholesterol (HDL-c). However, the effects of the VLEKT on lipid metabolism remain controversial. The review emphasizes the urgent need for further research to validate the long-term safety and efficacy of the VLEKT. It also highlights the critical role of personalized dietary plans, supervised by healthcare professionals, to optimize health outcomes and address individual patient needs.
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    Imatinib for treating patients with chronic myelogeneous leukemia
    (Wiley, 2015-10-30)
    Vinicio Navas
    ;
    ;
    Andrés Felipe Cardona
    ;
    ;
    Luis Ernesto González