The role of very early (≤12 hours) endoscopy in nonvariceal upper gastrointestinal bleeding is controversial. We aimed to compare results of very early and early (12-24 hours) endoscopy in patients with upper gastrointestinal bleeding demonstrating low-risk versus high-risk features and nonvariceal versus variceal bleeding. This retrospective study included patients with nonvariceal and variceal upper gastrointestinal bleeding. The primary outcome was a composite of inpatient death, rebleeding, or need for surgery or intensive care unit admission. Endoscopy timing was defined as very early and early. We performed the analysis in two subgroups: (1) high-risk vs. low-risk patients and (2) variceal vs. nonvariceal bleeding. A total of 102 patients were included, of whom 59.8% underwent urgent endoscopy. Patients who underwent very early endoscopy received endoscopic therapy more frequently (p=0.001), but there was no improvement in other clinical outcomes. Furthermore, patients at low risk and with nonvariceal bleeding who underwent very early endoscopy had a higher risk of the composite outcome. Very early endoscopy does not seem to be associated with improved clinical outcomes and may lead to poorer outcomes in specific populations with upper gastrointestinal bleeding. The actual benefit of very early endoscopy remains controversial and should be further clarified.

Purpose: To assess the spiritual well-being (SWB) of cancer patients undergoing chemotherapy in an outpatient setting. Method: Quantitative, cross-sectional, and descriptive study. A convenience sample of 150 participants was obtained. Data collection instrument was a self-reported questionnaire that included the SWB Questionnaire (SWBQ), whose scores range from 20 to 100. SPSS software, version 21, was used in data analysis. The study was approved by the institutional ethics committee. Results: Patients’ ages ranged between 35 and 83 years; most were female (64.7%), married (68.0%), Catholic (86.7%), and with breast cancer (35.3%) and colorectal cancer (25.3%). The average SWBQ total score was 65.91 (SD = 12.177). The highest score of the SWBQ was obtained in females, widows and singles, Evangelic and Catholic, and with lower educational level and professional occupation. The Cronbach α was 0.89, and the subscales αs ranged between 0.78 and 0.94. Conclusion: The SWBQ scores were reasonable. These results can guide nurses’ clinical reasoning, as the assessment of SWB may precede the diagnosis of risk for spiritual distress, readiness for enhanced SWB, or spiritual distress. Thus, the use of this instrument may facilitate spirituality being effectively implemented in clinical practice, favoring holistic health care.

• Anti-Leptospira IgG seroprevalence was estimated on cats from Lisbon, Portugal via ELISA. • A mathematical model was applied to raw data to establish the real cut-off value of seroprevalence. • Of the 243 samples, 59.3% tested positive for anti-Leptospira IgG. • A positive correlation between low anti-Leptospira IgG and FIV+ was detected (p = 0.02). • No correlation was detected between anti-Leptospira IgG values and outdoor lifestyle.

Finite mixture models have been widely used in antibody (or serological) data analysis in order to help classifying individuals into either antibody-positive or antibody-negative. The most popular models are the so-called Gaussian mixture models which assume a Normal distribution for each component of a mixture. In this work, we propose the use of finite mixture models based on a flexible class of scale mixtures of Skew-Normal distributions for serological data analysis. These distributions are sufficiently flexible to describe right and left asymmetry often observed in the distributions associated with hypothetical antibody-negative and antibody-positive individuals, respectively. We illustrate the advantage of these alternative mixture models with a data set of 406 individuals in which antibodies against six different human herpesviruses were measured in the context of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Introduction. Malnutrition is underdiagnosed in chronic obstructive pulmonary disease. Objectives. This study aimed to evaluate the nutritional status of COPD patients and the link between dyspnea and nutritional status. Methods. This longitudinal observational study included patients hospitalized with exacerbated COPD. Nutritional status was assessed using Nutrition Risk Screening 2002, anthropometric, and biochemical assessments, in the first 48 hours of hospitalization. Results. Thirty patients were evaluated. According to the Nutrition Risk Screening 2002, half of the patients were at increased risk of malnutrition. 36.7% were classified as malnourished if we only considered the body mass index. From the evaluation of the tricipital skin fold, 69.0% were classified as malnourished, with 48.3% having severe malnutrition. According to the serum albumin level, 29.6% had malnutrition criteria. A significant association between dyspnea and increasing age ( ) was found. There was a strong association between the fold classification and the degrees of severity of dyspnea (Fisher exact test: 13.60, , V Cramer = 0.826). Most patients were malnourished and had higher grades of dyspnea. Tricipital skinfold reflects subcutaneous adipose tissue; this anthropometric measurement seems to be a good method to classify the nutritional status of COPD patients. It classified the biggest portion of patients as malnourished. Conclusion. The number of patients classified as malnourished changed with the method under analysis. The tricipital skin fold parameter was strongly associated with the dyspnea score. Most patients had adipose tissue and muscular mass depletion.