Novel Findings about Double-Loaded Curcumin-in-HPβcyclodextrin-in Liposomes: Effects on the Lipid Bilayer and Drug Release

In this study, the encapsulation of curcumin (Cur) in “drug-in-cyclodextrin-in-liposomes (DCL)” by following the double-loading technique (DL) was proposed, giving rise to DCL–DL. The aim was to analyze the effect of cyclodextrin (CD) on the physicochemical, stability, and drug-release properties of liposomes. After selecting didodecyldimethylammonium bromide (DDAB) as the cationic lipid, DCL–DL was formulated by adding 2-hydroxypropyl-α/β/γ-CD (HPβCD)–Cur complexes into the aqueous phase. A competitive effect of cholesterol (Cho) for the CD cavity was found, so cholesteryl hemisuccinate (Chems) was used. The optimal composition of the DCL–DL bilayer was obtained by applying Taguchi methodology and regression analysis. Vesicles showed a lower drug encapsulation efficiency compared to conventional liposomes (CL) and CL containing HPβCD in the aqueous phase. However, the presence of HPβCD significantly increased vesicle deformability and Cur antioxidant activity over time. In addition, drug release profiles showed a sustained release after an initial burst effect, fitting to the Korsmeyer-Peppas kinetic model. Moreover, a direct correlation between the area under the curve (AUC) of dissolution profiles and flexibility of liposomes was obtained. It can be concluded that these “drug-in-cyclodextrin-in-deformable” liposomes in the presence of HPβCD may be a promising carrier for increasing the entrapment efficiency and stability of Cur without compromising the integrity of the liposome bilayer

Experiences of geriatric nurses in nursing home settings across four countries in the face of the COVID-19 pandemic

Aim: To explore the emotional impact and experiences of geriatric nurses working in nursing homes and caring for patients with coronavirus 2019 disease (COVID-19). Design: This is a qualitative study with phenomenological method and data were gathered through in-depth interview. Methods: The experiences and expectations that nurses are facing during their care duties were explored via video conference, using a semi-structured interview guide. We have followed the Consolidated criteria for reporting qualitative research COREQ. Results: Interviews (N=24) were conducted with nurses from four countries (Spain, Italy, Peru, and Mexico) during April 2020. Three main categories were extracted: fear of the pandemic situation, the sense of duty and professional commitment, and emotional exhaustion. Conclusions: Regardless of the country and situation, in the face of the pandemic, dramatic situations have been experienced in nursing homes worldwide, with nursing staff feeling exhausted and overwhelmed, and reflection is urged on a global level to consider the most appropriate model of care in nursing homes

Polysialylated neuropilin-2 enhances human dendritic cell migration through the basic C-terminal region of CCL21.

Free Access at: http://glycob.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=20488940Dendritic cell (DC) migration to secondary lymphoid organs is a critical step to properly exert its role in immunity; and predominantly depends on the interaction of the chemokine receptor CCR7 with its ligands CCL21 and CCL19. Polysialic acid (PSA) has been recently reported to control CCL21-directed migration of mature DCs. Here; we first demonstrate that PSA present on human mature monocyte-derived dendritic cells did not enhance chemotactic responses to CCL19. We have also explored the molecular mechanisms underlying the selective enhancing effect of PSA on CCL21-driven chemotaxis of DCs. In this regard; we found out that prevention of DC polysialylation decreased CCL21 activation of JNK and Akt signaling pathways; both associated with CCR7-mediated chemotaxis. We also report that the enhanced PSA-mediated effect on DC migration towards CCL21 relied on the highly basic C-terminal region of this chemokine; and depended on the PSA acceptor molecule neuropilin-2 (NRP2) and on the polysialyltransferase ST8SiaIV. Altogether; our data indicate that the CCR7/CCL21/NRP2/ST8SiaIV functional axis constitutes an important guidance clue for DC targeting to lymphoid organs.This work was supported by research grant from Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo (FISPI0708879 to MAV).Peer reviewe

Impact of ovarian endometrioma and surgery on reproductive outcomes: a single-center Spanish cohort study

Anti-Müllerian hormone (AMH) and antral follicular count (AFC) decrease in women with ovarian endometrioma (OMA) and in vitro fertilization (IVF). In addition, these parameters drop even further when women with OMA undergo surgery. In this study, the primary aim was to compare the reproductive variables in IVF-treated women with and without endometriosis. The secondary aim was to explore if the reproductive variables were modified by endometrioma surgery. In this retrospective study, 244 women undergoing IVF were enrolled at the Hospital Universitario La Paz (Madrid, Spain). Women were categorized as OMA not surgically treated (OMA; n = 124), OMA with surgery (OMA + S; n = 55), and women with infertility issues not related to OMA (control; n = 65). Demographic and clinical variables, including age, body mass index (BMI), and reproductive (AMH, AFC, number of extracted oocytes, and transferred embryos) and obstetrical data (biochemical pregnancy and fetal heart rate at 6 weeks) were collected. Adjusted logistic regression models were built to evaluate reproductive and pregnancy outcomes. The models showed that women with OMA (with and without surgery) had significantly decreased levels of AMH and AFC and numbers of cycles and C + D embryos. Women with OMA + S had similar rates of pregnancy to women in the control group. However, women with OMA had lower biochemical pregnancy than controls (aOR = 0.08 [0.01; 0.50]; p-value = 0.025). OMA surgery seems to improve pregnancy outcomes, at least until 6 weeks of gestation. However, it is important to counsel the patients about surgery expectations due to the fact that endometrioma itself reduces the quality of oocytesThis research was funded by Health National Project from Instituto de Salud Carlos III (Spain; Ref. PI-20-01368

Impact of a public health intervention for active surveillance and mitigation of SARS-CoV-2 in a district from Buenos Aires province, Argentina: a descriptive epidemiological study

Background The first case of SARS-CoV-2 was reported in Argentina on 3 March 2020. Measures to limit the spread of the virus were implemented, including complete lockdown (26 March). Nonetheless, the virus spread throughout the country, with a first peak of almost a million cases in October. On 30 November, the government's recommendation switched from social, preventive and compulsory isolation, to social, preventive and compulsory distancing. Objectives To describe a tailored public health strategy to mitigate the spread of SARS-CoV-2 and determine its behaviour in San Antonio de Areco district from Buenos Aires province (Argentina) through a private-public association. Design, setting and participants Surveillance of the virus was performed with the local healthcare system, through early identification of cases and the systematic study of each infected individual and contact, regardless of symptomatology, using telemedicine and a COVID-19-specific outpatient clinic. Real-time PCR was used for detection using both individual and pooled samples, with a 12-hour turnaround time. Results Up to 30 November, a total of 2426 suspected cases were analysed and 578 were confirmed. Surveillance of health personnel and at-risk populations proved effective, mitigating viral spread. Pooling samples allowed reduction of operator time, helped reduce costs, and allowed detection of both symptomatic and asymptomatic cases. Conclusion After 8 months of protocol implementation, the strategy to intensively survey groups at higher epidemiological risk and the systematic search for asymptomatic cases with the incorporation of pooled PCR for diagnosis, in combination with individual testing, is an efficient and viable option in populations with similar characteristics, in the frame of social isolation.Fil: Crudo, Favio. Fundación Mundo Sano; ArgentinaFil: Fernández, Mariana. Fundación Mundo Sano; ArgentinaFil: Rodríguez Fermepín, Marcelo. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Fisiopatología y Bioquímica Clínica; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Entrocassi, Andrea Carolina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Fisiopatología y Bioquímica Clínica; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Cardone, Karina Angela. No especifíca;Fil: Spina Markmann, Fernando. No especifíca;Fil: Periago, Maria Victoria. Fundación Mundo Sano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Chuit, Roberto. Academia Nacional de Medicina de Buenos Aires; ArgentinaFil: Abril, Marcelo Claudio. Fundación Mundo Sano; Argentin

Propuesta de implementación de una guía para la aplicación del procedimiento administrativo sancionatorio (Ley 1437 de 2011).

Elaborar una propuesta que reúna de manera unificada el procedimiento administrativo sancionatorio que debe aplicar cada una de las territoriales y las oficinas especiales del Ministerio del Trabajo del País en materia de Riesgos Laborales.Dar aplicación, al procedimiento administrativo sancionatorio, establecido en la “Ley 1437 de 2011” Código de Procedimiento Administrativo y de lo Contencioso Administrativo “CPACA” y el Código General del Proceso “Ley 1564 de 2012”, en cada una de las actuaciones administrativas llevadas a cabo, frente a las vulneraciones de la normatividad en materia de Riesgos Labores. La Dirección de Riesgos laborales, a través del Grupo de Atención a Recursos de Segunda Instancia, recibe por parte de las 32 Direcciones Territoriales y las dos oficinas Especiales del Ministerio del Trabajo, los recursos de apelación interpuestos contra las multas impuestas a las empresas y empleadores, por incumplimiento en la aplicación del procedimiento administrativo sancionatorio y normativo. A través del análisis realizado a los recursos, se evidencian falencias frente a la aplicación del procedimiento administrativo sancionatorio, regulado por la Ley 1437 de 2012, aplicado a las Investigaciones Administrativas, generadas por la vulneración de normas de Seguridad y Salud del Trabajo y Riesgos Laborales

Quality in the Birth Rate and Mortality Certification at a College Hospital in Colombia, 2014

El objetivo de este estudio fue describir y analizar el proceso de certificación de muerte y nacimiento de un hospital docente en Bogotá en el año 2014, tanto en términos de flujo de información como de calidad de la causa de muerte asignada. Se diseñó una metodología para monitorear la calidad y cobertura de las estadísticas de nacimientos y muertes hospitalarias. Durante su práctica de salud pública, diecisiete estudiantes de noveno semestre de Medicina participaron en la recopilación de información sobre 511 registros clínicos de muertes no fetales, excluyendo las muertes por una causa externa que ocurrieron en 2014 (58 % de todas las muertes no fetales ocurridas en el hospital ese año). Los estudiantes, previamente entrenados, completaron los certificados de defunción, supervisados por profesores de diferentes especialidades, de acuerdo con el diagnóstico, mediante el acceso a los registros médicos de los fallecidos. La causa básica de muerte asignada después de la revisión se comparó con la causa básica originalmente certificada por médicos del hospital, en el sistema de registro en línea en uso en Colombia: RUAF-ND. Se estimó el acuerdo en la identificación de la causa básica de muerte. Se obtuvo una concordancia bruta del 80 % y un acuerdo de Kappa entre el 57 % y el 95 %, todos superiores, estadísticamente, a cero, al agrupar las causas básicas de muerte por capítulos de la CIE10, con un 6 % de códigos inutilizables en las dos bases. Este estudio podría ser replicado en otros hospitales universitarios y así fortalecer la capacitación de estudiantes de medicina en estadísticas vitales mientras se monitorea la calidad del registro de nacimientos y muertes en hospitales docentes.Q41-25This study aimed to describe and analyze the birth and death certification process in a medicine-teaching hospital in Bogotá during 2014, regarding both the information flow and the quality of the reported death cause. A methodology was designed to monitor the quality and coverage of the birth and death hospital statistics. Seventeen final-year medicine students attending to their public health training took part in the data collection about 511 clinical records of non-fetal deaths, and excluding the deaths due to external causes occurring in 2014, (it accounts for 58 % of all non-fetal deaths in the hospital during this year). Being granted access to the medical records of the deceased patients, the duly instructed students completed the death certificate forms and were supervised by different specialist teachers according to the diagnosis. The basic death cause attributed after the supervision was compared to the death cause originally certified by the hospital physicians in the online record system currently used in Colombia: RUAF-ND. The agreement in identifying the basic death cause was estimated and a gross matching of 80 % was found, with a Kappa index between 57 % and 95 %, being all statistically above zero after grouping the basic death causes as per CIE10 chapter, and obtaining 6 % of unusable codes in both databases. This study could be replicated in other medicine-teaching hospital in order to strengthen the medical student training in vital statistics while monitoring the quality of the birth and death records in the medicine-teaching hospitals

Unraveling Bicuspid Aortic Valve Enigmas by Multimodality Imaging: Clinical Implications

Aortic aneurysm; Bicuspid aortic valve; Computed tomographyAneurisma aòrtic; Vàlvula aòrtica bicúspide; Tomografia computadaAneurisma aórtico; Válvula aórtica bicúspide; Tomografía computadaMultimodality imaging is the basis of the diagnosis, follow-up, and surgical management of bicuspid aortic valve (BAV) patients. Transthoracic echocardiography (TTE) is used in our clinical routine practice as a first line imaging for BAV diagnosis, valvular phenotyping and function, measurement of thoracic aorta, exclusion of other aortic malformations, and for the assessment of complications such are infective endocarditis and aortic. Nevertheless, TTE is less useful if we want to assess accurately other aortic segments such as mid-distal ascending aorta, where computed tomography (CT) and magnetic resonance (CMR) could improve the precision of aorta size measurement by multiplanar reconstructions. A major advantage of CT is its superior spatial resolution, which affords a better definition of valve morphology and calcification, accuracy, and reproducibility of ascending aorta size, and allows for coronary artery assessment. Moreover, CMR offers the opportunity of being able to evaluate aortic functional properties and blood flow patterns. In this setting, new developed sequences such as 4D-flow may provide new parameters to predict events during follow up. The integration of all multimodality information facilitates a comprehensive evaluation of morphologic and dynamic features, stratification of the risk, and therapy guidance of this cohort of patients

Factores asociados al índice de reprobación de asignaturas de ciencias básicas del ITSLP

The purpose of the study was to find the factors associated with the failure rate of subjects included in the Basic Science Department that affect students of the “Instituto Tecnológico de San Luis Potosí”, to propose strategies that increase the approval rate in this area. This research had a quantitative approach; statistics were used as a basic tool for the analysis of the data and its relationships, with a descriptive scope. Data from the Comprehensive Information System (Sistema Integral de Información, SII) was used to obtain the failure rates of the subjects in the period from January to June 2020. Through an online survey, the data and their relationships were obtained and analyzed, related to social, personal and institutional factors within their different dimensions. According to the results obtained, the hypothesis established in this research is fulfilled as true: "The social, personal and institutional factors are associated with the failure rate in subjects included in the Basic Sciences Department". Being the Instituto Tecnológico de San Luis Potosí a professional training institution, strategies are suggested, such as forming support groups for consultancies from teachers of the Basic Sciences Department in each subject and following up with students to help lower the high failure rate.La finalidad del estudio fue encontrar los factores asociados al índice de reprobación de las asignaturas del Departamento de Ciencias Básicas que afectan a los estudiantes del Instituto Tecnológico de San Luis Potosí, para proponer estrategias que incrementen el índice de aprobación en esta área. Esta investigación tuvo un enfoque cuantitativo, se utilizó la estadística como herramienta básica para el análisis de los datos y sus relaciones, con un alcance descriptivo. Se emplearon los datos del Sistema Integral de Información (SII), para obtener los porcentajes de reprobación de las asignaturas en el periodo de enero a junio 2020. Mediante una encuesta en línea se obtuvieron y analizaron los datos y sus relaciones, en los factores de origen social, personal e institutional en sus diferentes dimensiones. De acuerdo a los resultados obtenidos “Los factores de origen social, personal e institucional, se encuentran asociados al índice de reprobación en las asignaturas del Departamento de Ciencias Básicas”. De tal manera que siendo una Institución formadora de profesionistas se sugieren estrategias, tales como formar grupos de apoyo para asesorías por parte de los docentes del área de Ciencias Básicas y dar seguimiento a los estudiantes para coadyuvar a bajar el alto índice de reprobación