Técnica microquirúrgica de anastomosis vascular sin sutura en el trasplante experimental de órganos

Las anastomosis vasculares para e! trasplante de órganos en pequeños animales se realizan habitualmente por sutura manual ya sea continua o discontinua, aunque en los últimos años se ha difundido una técnica sin sutura consistente en la utilización de «cuffs». En e! presente trabajo se describe la técnica de! cuff que nuestro equipo utilizó para la realización de las anastomosis vasculares en e! trasplante experimental de órganos. El cuff consta de un tubo o cuerpo, que se prolonga por una pestaña, y su tamaño es diferente según el calibre del vaso que se pretende anastornosar. Entre las ventajas que ofrece su utilización respecto de la sutura manual, destacan su sencillo aprendizaje, bajo coste y el reducido tiempo en que se realizan las anastomosis, que siempre son estancas. Se concluye que esta técnica constituye una alternativa a las ya clásicas técnicas de sutura manual y no aumenta al porcentaje de complicaciones, permitiendo además supervivencias a largo plazo en los modelos experimentales que fueron estudiados.Vascular anastornoses in organ transplants of small anirnals are usually performed with a manual suture using interrupted or continuous stitcbes, although over the last few years a suturefree technique has been deueloped consisting of the use of cuffs. In this paper, the cuff technique which our team used to perform vascular anastomoses in experimental organ transplants, is described. The cuff is made up oi a tube or body wich has a prolongation or up, tbe size varying according to the calibre of the blood vessel to be anastomosed. The advantages of this method in cornparison with manual sutures, is the ease with which the tecbnique is learnt, its low cost, and the speed with which the anastomoses are carried out, all of which are watertight. In conclusion, this technique constitutes an alternative to the classical manual suture techniques without increasing the percentage of cornplications, and allowing long-term suruiual rates in the experimental models studied

Association of sepsis-related mortality with early increase of TIMP-1/MMP-9 ratio

Objective: Higher circulating levels of tissue inhibitor of matrix metalloproteinases (TIMP)-1 at the time of severe sepsis diagnosis have been reported in nonsurviving than in surviving patients. However, the following questions remain unanswered: 1) Does TIMP-1/MMP-9 ratio differ throughout the first week of intensive care between surviving and nonsurviving patients? 2) Is there an association between TIMP-1/MMP-9 ratio and sepsis severity and mortality during such period? 3) Could TIMP-1/MMP-9 ratio during the first week be used as an early biomarker of sepsis outcome? 4) Is there an association between TIMP-1/MMP-9 ratio and coagulation state and circulating cytokine levels during the first week of intensive care in these patients? The present study sought to answer these questions. Methods: Multicenter, observational and prospective study carried out in six Spanish Intensive Care Units (ICUs) of 295 patients with severe sepsis. Were measured circulating levels of TIMP-1, MMP-9, tumour necrosis factor (TNF)-alpha, interleukin (IL)-10 and plasminogen activator inhibitor (PAI)-1 at day 1, 4 and 8. End-point was 30-day mortality. Results: We found higher TIMP-1/MMP-9 ratio during the first week in non-surviving (n = 98) than in surviving patients (n = 197) (p, 0.01). Logistic regression analyses showed that TIMP-1/MMP-9 ratio at days 1, 4 and 8 was associated with mortality. Receiver operating characteristic (ROC) curves showed that TIMP-1/MMP-9 ratio at days 1, 4 and 8 could predict mortality. There was an association between TIMP-1/MMP-9 ratio and TNF-alpha, IL-10, PAI-1 and lactic acid levels, SOFA score and platelet count at days 1, 4 and 8. Conclusions: The novel findings of our study were that non-surviving septic patients showed persistently higher TIMP-1/ MMP-9 ratio than survivors ones during the first week, which was associated with severity, coagulation state, circulating cytokine levels and mortality; thus representing a new biomarker of sepsis outcome

Evaluation of the immunogenicity and efficacy of BCG and MTBVAC vaccines using a natural transmission model of tuberculosis

International audienceAbstractEffective vaccines against tuberculosis (TB) are needed in order to prevent TB transmission in human and animal populations. Evaluation of TB vaccines may be facilitated by using reliable animal models that mimic host pathophysiology and natural transmission of the disease as closely as possible. In this study, we evaluated the immunogenicity and efficacy of two attenuated vaccines, BCG and MTBVAC, after each was given to 17 goats (2 months old) and then exposed for 9 months to goats infected with M. caprae. In general, MTBVAC-vaccinated goats showed higher interferon-gamma release than BCG vaccinated goats in response to bovine protein purified derivative and ESAT-6/CFP-10 antigens and the response was significantly higher than that observed in the control group until challenge. All animals showed lesions consistent with TB at the end of the study. Goats that received either vaccine showed significantly lower scores for pulmonary lymph nodes and total lesions than unvaccinated controls. Both MTBVAC and BCG vaccines proved to be immunogenic and effective in reducing severity of TB pathology caused by M. caprae. Our model system of natural TB transmission may be useful for evaluating and optimizing vaccines

Modificación de conocimiento sobre salud ambiental en estudiantes de 9º grado

RESUMEN Introducción: como todos los seres vivos, los seres humanos dependen del medio ambiente que los rodea, para satisfacer sus necesidades de salud y supervivencia. Objetivo: implementar un programa de intervención educativo sobre salud ambiental en los estudiantes de 9º grado de la escuela secundaria básica Pedro Véliz Hernández, de Yara correspondiente al curso escolar 2013-2014. Método: estudio experimental de intervención educativa, para modificar conocimientos sobre salud ambiental, en 203 estudiantes de 9º grado de la ESBU Pedro Véliz Hernández, del área de salud del policlínico Luis E. de la Paz, Yara, curso escolar 2013-2014. Se aplicó un cuestionario inicial, que permitió la detección de necesidades de aprendizaje, se diseñó un programa educativo, que estuvo compuesto por cinco encuentros por cada grupo, con tres frecuencias semanales y duración de una hora, se emplearon técnicas participativas que hicieron más entendibles los temas impartidos y se efectuó la evaluación final con el mismo instrumento inicial. Resultados: se alcanzó menos del 80 % de conocimientos correctos en los alumnos, situación que se modificó después de la capacitación, pues se obtuvo más del 90 % de conocimientos acertados en todas las variables evaluadas. Se recomienda la extensión de estos tipos de estudios a otros centros escolares para contribuir a la formación de una cultura ambientalista, en aras de lograr la participación de los estudiantes en los problemas locales y de la comunidad. Conclusiones: el programa educativo resultó efectivo pues logró modificar los conocimientos que sobre la salud ambiental tenían los estudiantes de 9º grado. ABSTRACT Introduction: as all living things, human beings depend on environment surrounds, in order to fulfill his needs of health and survival. Objective: implementing an intervention educational program on environmental health for 9 th graders from Pedro Véliz Hernandez high school, Yara municipality corresponding to the school year 2013-2014. Method: experimental study of educational intervention, to modify knowledge on environmental health, in 203 9 th graders from Pedro Véliz Hernandez high school, from health area, Luis E. de la Paz polyclinic, Yara, school period 2013-2014. It was applied an initial questionnaire, for the detection of learning needs, it was designed an educational program, composed by five meetings for each group with three weekly frequencies, an hour duration, there were used communicative techniques that did understandable the given topics, and a final evaluation employing the same initial instrument took effect . Results: less than 80% of correct knowledge in students was achieved, situation that was modified after receiving the training, it was obtained more than 90 % of knowledge guessed in all evaluated variables. It is recommended the extension of these types of studies to other school centers to contribute to the formation of an environmental culture, to achieve student’s participation in local and community problems. Conclusions: it proved the effectiveness because we could modify knowledge on environmental health 9 th graders had

Sandwich-Type Electrochemical Paper-Based Immunosensor for Claudin 7 and CD81 Dual Determination on Extracellular Vesicles from Breast Cancer Patients

This study is focused on identifying novel epithelial markers in circulating extracellular vesicles (EVs) through the development of a dual sandwich-type electrochemical paper-based immunosensor for Claudin 7 and CD81 determination, as well as its validation in breast cancer (BC) patients. This immunosensor allows for rapid, sensitive, and label-free detection of these two relevant BC biomarkers. Under optimum conditions, the limit of detection for Claudin 7 was 0.4 pg mL-1, with a wide linear range of 2 to 1000 pg mL-1, while for CD81, the limit of detection was 3 pg mL-1, with a wide linear range of 0.01 to 10 ng mL-1. Finally, we validated Claudin 7 and CD81 determination in EVs from 60 BC patients and 20 healthy volunteers, reporting higher diagnostic accuracy than the one observed with classical diagnostic markers. This analysis provides a low-cost, specific, versatile, and user-friendly strategy as a robust and reliable tool for early BC diagnosis.Fil: Ortega, Francisco G.. Balearic Islands Health Research Institute; EspañaFil: Regiart, Matías D.. Universidade de Sao Paulo; BrasilFil: Rodríguez Martínez, Alba. Universidad de Granada; EspañaFil: De Miguel-Pérez, Diego. Universidad de Granada; EspañaFil: Serrano, María J.. Universidad de Granada; EspañaFil: Lorente, José A.. Universidad de Granada; EspañaFil: Tortella, Gonzalo. Universidad de La Frontera; ChileFil: Rubilar, Olga. Universidad de La Frontera; ChileFil: Sapag, Manuel Karim. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich". Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich"; ArgentinaFil: Bertotti, Mauro. Universidade de Sao Paulo; BrasilFil: Fernández Baldo, Martín Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Química de San Luis. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Química de San Luis; Argentin

Modificación de conocimiento sobre salud ambiental en estudiantes de 9º grado

Introduction: as all living things, human beings depend on environment surrounds, in order to fulfill his needs of health and survival. Objective: implementing an intervention educational program on environmental health for 9th graders from Pedro Véliz Hernandez high school, Yara municipality corresponding to the school year 2013-2014. Method: experimental study of educational intervention, to modify knowledge on environmental health, in 203 9th graders from Pedro Véliz Hernandez high school, from health area, Luis E. de la Paz polyclinic, Yara, school period 2013-2014.  It was applied an initial questionnaire, for the detection of learning needs, it was designed an educational program, composed by five meetings for each group with three weekly frequencies, an hour duration, there were used communicative techniques that did understandable the given topics, and a final evaluation employing the same initial instrument took effect . Results: less than 80% of correct knowledge in students was achieved, situation that was modified after receiving the training, it was obtained more than 90 % of knowledge guessed in all evaluated variables. It is recommended the extension of these types of studies to other school centers to contribute to the formation of an environmental culture, to achieve student’s participation in local and community problems.Conclusions:  it proved the effectiveness because we could modify knowledge on environmental health 9th graders had.  Introducción: como todos los seres vivos, los seres humanos dependen del medio ambiente que los rodea, para satisfacer sus necesidades de salud y supervivencia. Objetivo: implementar un programa de intervención educativo sobre salud ambiental en los estudiantes de 9º grado de la escuela secundaria básica Pedro Véliz Hernández, de Yara correspondiente al curso escolar 2013-2014.Método: estudio experimental de intervención educativa, para modificar  conocimientos  sobre salud ambiental, en 203 estudiantes de 9º grado de la ESBU Pedro Véliz Hernández, del área de salud del policlínico Luis E. de la Paz, Yara, curso escolar 2013-2014.  Se  aplicó un cuestionario inicial, que permitió la detección de necesidades de aprendizaje, se diseñó un programa educativo, que estuvo compuesto por cinco encuentros por cada grupo,  con tres frecuencias semanales y  duración de una hora, se emplearon técnicas participativas que hicieron más entendibles los temas impartidos y se efectuó la evaluación final con el mismo instrumento inicial.Resultados: se alcanzó menos del 80 % de conocimientos correctos en los alumnos, situación que se modificó después de la capacitación, pues se obtuvo más del 90 % de conocimientos acertados en todas las variables evaluadas. Se recomienda la extensión de estos  tipos de estudios a  otros centros escolares para contribuir a la formación de una cultura ambientalista, en aras de lograr  la participación de los estudiantes en los problemas locales y de la comunidad.Conclusiones: el programa educativo resultó  efectivo pues logró modificar los conocimientos que sobre  la salud ambiental tenían los estudiantes de 9º grado

¿ES NECESARIA Y EFECTIVA LA PROMOCIÓN DE LA SALUD EN LA ESCUELA? A PROPÓSITO DE UNA INTERVENCIÓN SOBRE HÁBITOS TÓXICOS.

Introduction: Health Education in the community is one of the least developed activities in Primary Care. This activity is the responsibility of Community Nursing, and its aim is the primary prevention of a healthy lifestyle. Methodology and Materials: During 2002 and 2003, we developed an educational project together with a school. Lessons in Health Education were given to two hundred and fifty one 10 to 12 year olds on the subject of “Drugs, tobacco and alcohol”. They were based on a showingand- participating methodology, which included a pre- and post-lesson questionnaire, researching family environment and attitudes. Simultaneously, an experiment was carried out, showing the effects of tobacco. Results: Awareness: The subjects the students knew least about were the differences and similarities between legal and illegal drugs, and the concept of the abstinence syndrome. Family environment and attitudes: Seven percent of the respondents admitted they have smoked once at least. Twenty four percent had friends who smoke. Fifty-five percent had drunk alcohol at least once. Everyone knew someone who smokes, and eighty-seven percent knew someone who drinks alcohol. Fifty-four percent of parents and nine percent of brothers or sisters smoke. Conclusions: Although the school is placed in a middle-high level zone of the city, the percentage of children that have smoked or drunk at least once and unhealthy family environments are a cause for concern. The awareness, satisfaction and motivation of the pupils increased notably after the sessions. This fact should encourage us to continue with these educational activities and monitor their effectiveness.Introducción: La educación sanitaria en la comunidad es una de las actividades menos desarrolladas en A.P. Esta actividad es responsabilidad de la enfermería comunitaria y su objetivo es la prevención primaria de hábitos de vida poco saludables. Material y Método: Durante los años 2002-2003 desarrollamos un proyecto educativo con un colegio de la ZBS. Se impartieron sesiones de educación sanitaria a 251 alumnos de entre 10-12 años sobre el tema “Drogas, tabaco, alcohol”. Se utilizó una metodología expositiva-participativa con realización de una encuesta de conocimientos pre y post-sesión y otra sobre ambiente familiar y actitudes. Simultáneamente se realizó un experimento demostrativo de los efectos del tabaco. Resultados: Conocimientos: Los dos contenidos que menos conocen los escolares son las diferencias y semejanzas entre drogas legales e ilegales y el concepto de síndrome de abstinencia. Ambiente y actitudes: el 7% de los niños reconoce haber fumado. El 24 % tiene amigos que fuman. Han bebido alcohol el 54%. Todos conocen a algún fumador y el 87% conoce a alguien que beba alcohol. El 54% de los padres y el 9% de los hermanos fuman. Conclusiones: A pesar de que el colegio pertenece a una zona urbana de nivel adquisitivo medio-alto, preocupa el porcentaje de niños que han fumado o han bebido alcohol y el ambiente familiar poco saludable. Los conocimientos, satisfacción y motivación de los alumnos creció notablemente tras las sesiones, lo que debe animarnos a fomentar estas actividades educativas y a hacer un seguimiento prospectivo de la efectividad de las intervenciones