Retinal and Optic Nerve Degeneration in Patients with Multiple Sclerosis Followed up for 5 Years

Purpose: To quantify retinal nerve fiber layer (RNFL) changes in patients with multiple sclerosis (MS) and healthy controls with a 5-year follow-up and to analyze correlations between disability progression and RNFL degeneration. Design: Observational and longitudinal study. Participants: One hundred patients with relapsing-remitting MS and 50 healthy controls. Methods: All participants underwent a complete ophthalmic and electrophysiologic exploration and were re-evaluated annually for 5 years. Main Outcome Measures: Visual acuity (Snellen chart), color vision (Ishihara pseudoisochromatic plates), visual field examination, optical coherence tomography (OCT), scanning laser polarimetry (SLP), and visual evoked potentials. Expanded Disability Status Scale (EDSS) scores, disease duration, treatments, prior optic neuritis episodes, and quality of life (QOL; based on the 54-item Multiple Sclerosis Quality of Life Scale score). Results: Optical coherence tomography (OCT) revealed changes in all RNFL thicknesses in both groups. In the MS group, changes were detected in average thickness and in the mean deviation using the GDx-VCC nerve fiber analyzer (Laser Diagnostic Technologies, San Diego, CA) and in the P100 latency of visual evoked potentials; no changes were detected in visual acuity, color vision, or visual fields. Optical coherence tomography showed greater differences in the inferior and temporal RNFL thicknesses in both groups. In MS patients only, OCT revealed a moderate correlation between the increase in EDSS and temporal and superior RNFL thinning. Temporal RNFL thinning based on OCT results was correlated moderately with decreased QOL. Conclusions: Multiple sclerosis patients exhibit a progressive axonal loss in the optic nerve fiber layer. Retinal nerve fiber layer thinning based on OCT results is a useful marker for assessing MS progression and correlates with increased disability and reduced QOL

Improving the quality of publications in and advancing the paradigms of clinical and social pharmacy practice research: The Granada statements

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care. Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors selection of the most appropriate pharmacy practice journal to submit their work. (c) 2023 FIP

Improving the Quality of Publications in and Advancing the Paradigms of Clinical and Social Pharmacy Practice Research: The Granada Statements

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care. Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors selection of the most appropriate pharmacy practice journal to submit their work.</jats:p

Improving the quality of publications in and advancing the entire paradigms of clinical and social pharmacy practice research: the Granada statements; [Améliorer la qualité des publications et faire progresser l'ensemble des paradigmes de la recherche sur la pratique clinique et sociale de la pharmacie: les déclarations de Grenade]

Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care. Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors selection of the most appropriate pharmacy practice journal to submit their work. Copyright (c) 2023 John Libbey Eurotext

Absence of R-Ras1 and R-Ras2 causes mitochondrial alterations that trigger axonal degeneration in a hypomyelinating disease model

Fast synaptic transmission in vertebrates is critically dependent on myelin for insulation and metabolic support. Myelin is produced by oligodendrocytes (OLs) that maintain multilayered membrane compartments that wrap around axonal fibers. Alterations in myelination can therefore lead to severe pathologies such as multiple sclerosis. Given that hypomyelination disorders have complex etiologies, reproducing clinical symptoms of myelin diseases from a neurological perspective in animal models has been difficult. We recently reported that R-Ras1 and/or R-Ras2 mice, which lack GTPases essential for OL survival and differentiation processes, present different degrees of hypomyelination in the central nervous system with a compounded hypomyelination in double knockout (DKO) mice. Here, we discovered that the loss of R-Ras1 and/or R-Ras2 function is associated with aberrant myelinated axons with increased numbers of mitochondria, and a disrupted mitochondrial respiration that leads to increased reactive oxygen species levels. Consequently, aberrant myelinated axons are thinner with cytoskeletal phosphorylation patterns typical of axonal degeneration processes, characteristic of myelin diseases. Although we observed different levels of hypomyelination in a single mutant mouse, the combined loss of function in DKO mice lead to a compromised axonal integrity, triggering the loss of visual function. Our findings demonstrate that the loss of R-Ras function reproduces several characteristics of hypomyelinating diseases, and we therefore propose that R-Ras1 and R-Ras2 neurological models are valuable approaches for the study of these myelin pathologies.Spanish Ministry of Economy and Competitiveness (RTI2018-096303B-C33) to B. C., (RTI2018-096303B-C31) to F. W., and RTI2018-095166B-I00 to C. G. R. and P. L. and Instituto de Salud Carlos III and co-funded by the European Regional Development Fund (ERDF) within the “Plan Estatal de Investigación Científica y Técnica y de Innovación 2017–2020” (RD16/0008/0020; FIS/PI 18-00754

Staff training influence on non-invasive ventilation outcome for acute hypercapnic respiratory failure

Background. Although non-invasive ventilation (NIV) efficacy in the treatment of acute hypercapnic respiratory failure (AHRF) have been previously demonstrated, not all the studies reveal this fact in the same degree, with some variability in the results. This study aimed to analyse variables related to NIV outcome for AHRF. Methods. A group of consecutive patients requiring NIV due to AHRF were included in a prospective observational cohort study performed in conventional wards. Variables considered included those reported in the literature, as well as staff problems during the management of the ventilators. The study aimed to include all patients during one year, but after the initial results, it had to be suspended. Results. Fifteen patients were included in the study: 10 males, mean age 68 ± 12. APACHE-II score was 17.6 ± 6.5. pH and pCO2 before NIV were 7.22 ± 0.11 and 110 ± 72 mmHg respectively. pH, corticosteroids use, APACHE score, and EPAP were found to influence outcome. Besides, an inadequate use of NIV due to lack of personnel training was detected in all patients with NIV failure (RR 3.5; 95% CI: 1.08-11.2; p = 0.007). In the light of these results, the study had to be suspended and patients were transferred to the respiratory ward. Conclusions. NIV is a life-saving respiratory treatment influenced by several factors, of which staff training is a key one. Centres attending acute respiratory patients should have an area in which this requirement is fulfilled

Intervenciones Psicosociales en las Inundaciones de Sierras Chicas

En el marco de las Prácticas Profesionales en Servicio de la Facultad de Psicología, UNC, en las localidades afectadas por las inundaciones de Sierras Chicas: Mendiolaza, Río Ceballos y Unquillo, se presentan las intervenciones desarrolladas durante el 2015. Se trabajó a partir de la perspectiva de gestión psicosocial de riesgo, realizando asistencia clínica y trabajo en comunidad. Acompañar a las comunidades en su proceso de rehabilitación psicosocial, en conjunto con los equipos de salud locales. Investigación Acción Participativa. Se logró acompañar y asistir a los damnificados de las inundaciones. Se promovió la articulación de redes entre las comunidades y entre las comunidades y las instituciones. Se reforzó el trabajo de los equipos locales de salud en la asistencia de los damnificados. Se promovió el fortalecimiento de la participación activa en la toma de decisiones y autogestión de los vecinos. Considerando la complejidad de trabajar con comunidades vulnerabilizadas por diversos factores sumado al fuerte impacto del evento y a la desestructuración-irrupción del tejido social, es importante discutir la construcción del rol del psicólogo en esta área emergente. En este sentido se entiende que uno de los aspectos fundamentales a tener en cuenta es el trabajo interdisciplinario y la articulación intersectorial. Finalmente se resalta la necesidad de la continuidad del equipo de trabajo para pensar y proponer nuevas estrategias y líneas de acción preventivas, de capacitación, y de promoción de la salud integral

HTLV-1 infection in solid organ transplant donors and recipients in Spain

Background: HTLV-1 infection is a neglected disease, despite infecting 10–15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. Methods: All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. Results: A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. Conclusion: The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopath

Enhancement of myeloma development mediated though myeloma cell-Th2 cell interactions after microbial antigen presentation by myeloma cells and DCs

Microbial agents are regarded as a potential cause of tumors, but their direct effects on tumors, such as myeloma, are not well studied. Our studies demonstrated that expression of HLA-DR and CD40 on the myeloma cell membrane surface is upregulated by interferon-γ and/or microbial antigens (Ags). Unlike prior studies, our study showed that Th2 cells cannot promote myeloma growth directly. However, Bacillus Calmette–Guerin Vaccine (BCGV)-specific Th2 cells stimulated by BCGV-loaded dendritic cells (DCs) promoted myeloma clonogenicity directly when the myeloma cells expressed major histocompatibility complex Class-II molecules (MHC-II) and took up BCGV Ag. B-cell lymphoma 6 (Bcl-6) protein expression and the proportion of HLA-DR+ or CD40+ cells were higher in colonies of Th2 cell-stimulated myeloma cells. Furthermore, anti-HLA-DR or neutralizing CD40 antibody could prevent this increase in Bcl-6 expression and colony number. These results indicate that microbes and microbial Ag-specific Th2 cells may directly impact the biology of myeloma and contribute to tumor progression. Activation may be limited to MHC-II+ myeloma cells that retain B cell and stem cell characteristics. Taken together, our data suggest that factors involved in microbial Ag presentation, such as DCs, Th2 cells and so on, are potential targets for myeloma therapeutic intervention