Patient – practitioner communication and contact lens compliance during a prolonged COVID-19 lockdown

Purpose Ocular manifestations and ocular transmission of SARS-CoV-2 in contact lens (CL) wearers may be fostered by non-compliance with care and maintenance instructions which, in turn, may be aggravated by inadequate patient-practitioner communication. The purpose of this research was to determine CL use, compliance and patient-practitioner communication during a 3-month long COVID-19 lockdown in Spain. Methods An online survey (developed using Google Forms) retrospectively evaluated CL compliance during the 3-month lockdown (responses captured between 15th July and 10th August, 2020), with particular emphasis on patient-practitioner communication, handwashing practices and CL case hygiene and replacement. Results A total of 247 responses were collected and analysed. Most participants used monthly replacement soft lenses (64.8 %) and multipurpose solutions (75.7 %), with 86.6 % of them owning a storage case for their lenses. During lockdown, a significant percentage of participants ceased lens wear (28.4 %) or reduced wearing time (49.2 %). Regarding patient-practitioner communication, 54.3 % of respondents received specific instructions, mostly about handwashing (93.3 %) and storage case hygiene (48.5 %). The most frequent non-compliant practices were inadequate handwashing (36.4 %), and overextending monthly or two-weekly replacement lenses (35.2 %). Many respondents never cleaned (23.0 %) nor replaced (16.3 %) their storage case, and 27.8 % of them reported not having been informed about case hygiene by their practitioners. Conclusion Contact lens compliance, particularly in terms of handwashing and storage case hygiene, was poor during a prolonged COVID-19 lockdown, thus stressing the need to foster patient-practitioner communication strategies to curtail the possibility of ocular transmission and the risk of virus tropism.Peer ReviewedPostprint (author's final draft

Effect of Cancer-Related Cachexia and Associated Changes in Nutritional Status, Inflammatory Status, and Muscle Mass on Immunotherapy Efficacy and Survival in Patients with Advanced Non-Small Cell Lung Cancer

Immune checkpoint inhibitor (ICI)-based immunotherapy has significantly improved the survival of patients with advanced non-small cell lung cancer (NSCLC); however, a significant percentage of patients do not benefit from this approach, and predictive biomarkers are needed. Increasing evidence demonstrates that cachexia, a complex syndrome driven by cancer-related chronic inflammation often encountered in patients with NSCLC, may impair the immune response and ICI efficacy. Herein, we carried out a prospective study aimed at evaluating the prognostic and predictive role of cachexia with the related changes in nutritional, metabolic, and inflammatory parameters (assessed by the multidimensional miniCASCO tool) on the survival and clinical response (i.e., disease control rate) to ICI-based immunotherapy in patients with advanced NSCLC. We included 74 consecutive patients. Upon multivariate regression analysis, we found a negative association between IL-6 levels (odds ratio (OR) = 0.9036; 95%CI = 0.8408–0.9711; p = 0.0025) and the miniCASCO score (OR = 0.9768; 95%CI = 0.9102–0.9999; p = 0.0310) with the clinical response. As for survival outcomes, multivariate COX regression analysis found that IL-6 levels and miniCASCO-based cachexia severity significantly affected PFS (hazard ratio (HR) = 1.0388; 95%CI = 1.0230–1.0548; p < 0.001 and HR = 1.2587; 95%CI = 1.0850–1.4602; p = 0.0024, respectively) and OS (HR = 1.0404; 95%CI = 1.0221–1.0589; p < 0.0001 and HR = 2.3834; 95%CI = 1.1504–4.9378; p = 0.0194, respectively). A comparison of the survival curves by Kaplan–Meier analysis showed a significantly lower OS in patients with cachexia versus those without cachexia (p = 0.0323), as well as higher miniCASCO-based cachexia severity (p = 0.0428), an mGPS of 2 versus those with a lower mGPS (p = 0.0074), and higher IL-6 levels (>6 ng/mL) versus those with lower IL-6 levels (≤6 ng/mL) (p = 0.0120). In conclusion, our study supports the evidence that cachexia, with its related changes in inflammatory, body composition, and nutritional parameters, is a key prognostic and predictive factor for ICIs. Further larger studies are needed to confirm these findings and to explore the potential benefit of counteracting cachexia to improve immunotherapy efficacy

Elección de la Carrera de Enfermería a partir de la incorporación de la misma a la EURHES – FCM – UNLP

La Facultad de Ciencias Médicas de la UNLP ha incorporado, a través de la EURHES, la carrera de Enfermería Universitaria entre sus carreras de grado. Este año la EURHES ha sumado a los alumnos de la mencionada carrera, junto a los de las carreras de Licenciatura en Obstetricia, Licenciatura en Nutrición y Tecnicatura en Prácticas Cardiológica, a los alumnos de formación universitaria de la Facultad de Ciencias Médicas. Esto ha llevado a un incremento de la matrícula en cantidad, en 281 alumnos respecto al año 2015, donde coexistía el convenio con el Ministerio de Salud. Debemos mencionar que, en ambos casos, para promover a segundo año, los alumnos deben tener todas las cursadas de primer año y el final de Enfermería Materno – Infantil -1.Facultad de Ciencias Médica

The ESCRT-III machinery participates in the production of extracellular vesicles and protein export during Plasmodium falciparum infection

Infection with Plasmodium falciparum enhances extracellular vesicle (EV) production in parasitized red blood cells (pRBCs), an important mechanism for parasite-to-parasite communication during the asexual intraerythrocytic life cycle. The endosomal sorting complex required for transport (ESCRT), and in particular the ESCRT-III sub-complex, participates in the formation of EVs in higher eukaryotes. However, RBCs have lost the majority of their organelles through the maturation process, including an important reduction in their vesicular network. Therefore, the mechanism of EV production in P. falciparum-infected RBCs remains to be elucidated. Here we demonstrate that P. falciparum possesses a functional ESCRT-III machinery activated by an alternative recruitment pathway involving the action of PfBro1 and PfVps32/PfVps60 proteins. Additionally, multivesicular body formation and membrane shedding, both reported mechanisms of EV production, were reconstituted in the membrane model of giant unilamellar vesicles using the purified recombinant proteins. Moreover, the presence of PfVps32, PfVps60 and PfBro1 in EVs purified from a pRBC culture was confirmed by super-resolution microscopy and dot blot assays. Finally, disruption of the PfVps60 gene led to a reduction in the number of the produced EVs in the KO strain and affected the distribution of other ESCRT-III components. Overall, our results increase the knowledge on the underlying molecular mechanisms during malaria pathogenesis and demonstrate that ESCRT-III P. falciparum proteins participate in EV production

Presentación de un estudio de intervención de estrategias de refuerzo pedagógico en una población de alumnos de Anatomía

Los nuevos paradigmas en la educación médica, se orientan a un modelo constructivista, en el que los estudiantes no solo participan sino que además puedan desarrollar un pensamiento crítico que les permita la autoformación ulterior. En ese sentido, es posible determinar algunas características personales de adherencia al estudio, en pos de aplicar estrategias personalizadas para un mejor rendimiento En esta comunicación presentamos nuestro estudio de estrategias de intervención a alumnos con adherencia inferior a la media del grupo.Facultad de Ciencias Médica