Valoración de las escalas de dolor en pacientes con ventilación mecánica en Unidad de Cuidados Intensivos

Introducción: El dolor es un factor estresante durante la estancia hospitalaria, especialmente en las Unidades de Cuidados Intensivos (UCI), y detectarlo es primordial para el cuidado. Objetivo: Realizar una puesta al día sobre la utilidad de las distintas escalas de dolor que se emplean para el manejo de los pacientes ingresados en las UCIs sometidos a ventilación mecánica Método: 22 artículos encontrados en la base de datos PubMed y en el metabuscador Mergullador Discusión: Hay escalas específicas para pacientes críticos inconscientes: la Behavioral Pain Scale (BPS, Escala Conductual del Dolor), Critical-Care Pain Observation Tool (CPOT, Escala Observacional del Dolor en Cuidados Críticos), escala de Campbell Escala Sobre Conductas Indicadoras de Dolor (ESCID) y The Adult Non-Verbal Pain Scale (NVPS, Escala de Dolor en el adulto No Comunicativo) Conclusión: Mostraron ser útiles y válidas para detectar el dolor en estos pacientes, pero se necesitan realizar más estudios.Introdución: A dor é un factor estresante durante a estancia hospitalaria, especialmente nas Unidades de Coidados Intensivos (UCIs), e detectala é primordial para o coidado. Obxectivo: Realizar unha posta ó dia sobre a utilidade das distintas escalas de dor que se empregan para o manexo dos pacientes ingresados nas UCIs sometidos a ventilación mecánica. Método: 22 artigos atopados na base de datos PubMed e no metabuscador Mergullador. Discusión: Hay escalas específicas para pacientes críticos inconscientes: la Behavioral Pain Scale (BPS, Escala Conductual da Dor), Critical-Care Pain Observation Tool (CPOT, Escala Observacional da Dor en Coidados Críticos), escala de Campbell Escala Sobre Conductas Indicadoras de Dor (ESCID) e The Adult Non-Verbal Pain Scale (NVPS, Escala de Dor no adulto Non Comunicativo) Conclusión: Mostraron ser útiles e válidas para detectaral dor nestos pacientes, pero necesitanse realizar máis estudos.Introduction: Pain is a stressor during the hospitalization, especially in Intensive Care Units (ICU), and it’s very important to detect it. Objective: To update on the usefulness of different pain scales that are uses for the management of patients admitted to ICUs receiving mechanical ventilation. Method: 22 articles found in the PubMed database and the Mergullador metasearch. Discussion: specific scales for unconscious critical patients: la Behavioral Pain Scale (BPS,) Critical-Care Pain Observation Tool (CPOT), Campbell scale, Escala Sobre Conductas Indicadoras de Dolor (ESCID) y The Adult Non-Verbal Pain Scale (NVPS) Conclusion: They showed to be useful and valid to detect pain in these patients, but more studies are necessary.Traballo fin de grao (UDC.ENFC). Enfermaría. Curso 2013/201

Functionalization and Characterization of Magnetic Nanoparticles for the Detection of Ferritin Accumulation in Alzheimer's Disease

Early diagnosis in Alzheimer's disease (AD), prior to the appearance of marked clinical symptoms, is critical to prevent irreversible neuronal damage and neural malfunction that lead to dementia and death. Therefore, there is an urgent need to generate new contrast agents which reveal by a noninvasive method the presence of some of the pathological signs of AD. In the present study, we demonstrate for the first time a new nanoconjugate composed of magnetic nanoparticles bound to an antiferritin antibody, which has been developed based on the existence of iron deposits and high levels of the ferritin protein present in areas with a high accumulation of amyloid plaques (particularly the subiculum in the hippocampal area) in the brain of a transgenic mouse model with five familial AD mutations. Both in vitro and after intravenous injection, functionalized magnetic nanoparticles were able to recognize and bind specifically to the ferritin protein accumulated in the subiculum area of the AD transgenic mice.Fil: Fernández Cabada, Tamara. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Politécnica de Madrid; EspañaFil: Martínez Serrano, Alberto. Consejo Superior de Investigaciones Científicas; España. Universidad Autónoma de Madrid; EspañaFil: Cussó, Lorena. Instituto de Investigacion Sanitaria Gregorio Marañón; España. Universidad Carlos III de Madrid; España. Centro de Investigación Biomédica en Red de Salud Mental; EspañaFil: Desco, Manuel. Instituto de Investigacion Sanitaria Gregorio Marañón; España. Centro de Investigación Biomédica en Red de Salud Mental; España. Universidad Carlos III de Madrid; EspañaFil: Ramos Gómez, Milagros. Universidad Politécnica de Madrid; Españ

Apoyo social percibido, autoconcepto e implicación escolar de estudiantes adolescentes

The study of school engagement is currently a topic of great interest in psychoeducational research, since it offers a new vision of students’ development. The aim of this study is to analyze the relationship between perceived social support, general self-concept and school engagement. Participants were 1,250 students (49% boys; 51% girls) aged between 12 and 15 (M = 13.72, SD = 1.09), who were selected randomly for the sample group. The study tests a structural model for analyzing the effects of perceived social support and general self-concept on school engagement. The results provide evidence in favor of the influence of family and peer support on school engagement, through the mediating variable general self-concept. Support from teachers and family was found to have a direct influence on school engagement. The results are discussed within the framework of positive psychology, along with the implications for future research.; El estudio de la implicación escolar constituye en la actualidad una temática de gran interés en el ámbito de la investigación psicoeducativa al aportar una renovada visión del desarrollo del alumnado. El objetivo de este estudio es analizar las relaciones entre apoyo social percibido, autoconcepto general e implicación escolar. Participaron 1250 estudiantes (49% chicos; 51% chicas), de entre 12 y 15 años (M =13.72, DT = 1.09), seleccionados aleatoriamente. Se somete a prueba un modelo estructural para analizar los efectos del apoyo social percibido y el autoconcepto general sobre la implicación escolar. Los resultados aportan evidencias a favor de la influencia que el apoyo familiar y el apoyo de los iguales ejercen sobre la implicación escolar a través del autoconcepto general como variable mediadora, mientras que el apoyo del profesorado y de la familia inciden directamente sobre la implicación escolar. Se discuten los resultados en el marco de la psicología positiva y las implicaciones para futuras investigaciones

Sustained Cytotoxic Response of Peripheral Blood Mononuclear Cells from Unvaccinated Individuals Admitted to the ICU Due to Critical COVID-19 Is Essential to Avoid a Fatal Outcome

The main objective of this study was to determine the influence of the cytotoxic activity of peripheral blood mononuclear cells (PBMCs) on the outcome of unvaccinated individuals with critical COVID-19 admitted to the ICU. Blood samples from 23 individuals were collected upon admission and then every 2 weeks for 13 weeks until death (Exitus group) (n = 13) or discharge (Survival group) (n = 10). We did not find significant differences between groups in sociodemographic, clinical, or biochemical data that may influence the fatal outcome. However, direct cellular cytotoxicity of PBMCs from individuals of the Exitus group against pseudotyped SARS-CoV-2-infected Vero E6 cells was significantly reduced upon admission (−2.69-fold; p = 0.0234) and after 4 weeks at the ICU (−5.58-fold; p = 0.0290), in comparison with individuals who survived, and it did not improve during hospitalization. In vitro treatment with IL-15 of these cells did not restore an effective cytotoxicity at any time point until the fatal outcome, and an increased expression of immune exhaustion markers was observed in NKT, CD4+, and CD8+ T cells. However, IL-15 treatment of PBMCs from individuals of the Survival group significantly increased cytotoxicity at Week 4 (6.18-fold; p = 0.0303). Consequently, immunomodulatory treatments that may overcome immune exhaustion and induce sustained, efficient cytotoxic activity could be essential for survival during hospitalization due to critical COVID-19.This work was supported by the Coordinated Research Activities at the National Center of Microbiology (CNM, Instituto de Salud Carlos III) (COV20_00679) to promote an integrated response against SARS-CoV-2 in Spain (Spanish Ministry of Science and Innovation) that is coordinated by Dr Inmaculada Casas (WHO National Influenza Center of the CNM); a generous donation provided by Chiesi España, S.A.U. (Barcelona, Spain); the Spanish Ministry of Science and Innovation (PID2019-110275RB-I00). The work of Guiomar Casado is financed by CIBERINFEC, co-financed by the European Regional Development Fund (FEDER) “A way to make Europe”. The work of Montserrat Torres is supported by Instituto de Salud Carlos III (COV20_00679). The work of Fernando Ramos Martín is financed by the Spanish Ministry of Science and Innovation (PID2019-110275RB-I00). The work of Mario Manzanares is supported by a pre-doctoral grant from Instituto de Salud Carlos III (ISCIII-PFIS FI20CIII/00021). The work of Lorena Vigón is supported by a pre-doctoral grant from Instituto de Salud Carlos III (FIS PI16CIII/00034-ISCIII-FEDER). The work of Sara Rodríguez-Mora is financed by NIH grant R01AI143567.N

Influence of Medium Viscosity and Intracellular Environment on the Magnetization of Superparamagnetic Nanoparticles in Silk Fibroin Solutions and 3T3 Mouse Fibroblast Cell Cultures

IOP also requests that you include the following statement of provenance: "This is an author-created, un-copyedited versíon of an article published in Nanotechnology. IOP Publishing Ltd is not responsíble for any errors or omissíons in this versíon of the manuscript or any versíon derived from it. The Versíon of Record is available online at https://doi.org/10.1088/1361-6528/aacf4a.[EN] Biomedical applications based on the magnetic properties of superparamagnetic iron oxide nanoparticles (SPIONs) may be altered by the mechanical attachment or cellular uptake of these nanoparticles. When nanoparticles interact with living cells, they are captured and internalized into intracellular compartments. Consequently, the magnetic behavior of the nanoparticles is modified. In this paper, we investigated the change in the magnetic response of 14 nm magnetic nanoparticles (Fe3O4) in different solutions, both as a stable liquid suspension (one of them mimicking the cellular cytoplasm) and when associated with cells. The field-dependent magnetization curves from inert fluids and cell cultures were determined by using an alternating gradient magnetometer, MicroMagTM 2900. The equipment was adapted to measure liquid samples because it was originally designed only for solids. In order to achieve this goal, custom sample holders were manufactured. Likewise, the nuclear magnetic relaxation dispersion profiles for the inert fluid were also measured by fast field cycling nuclear magnetic relaxation relaxometry. The results show that SPION magnetization in inert fluids was affected by the carrier liquid viscosity and the concentration. In cell cultures, the mechanical attachment or confinement of the SPIONs inside the cells accounted for the change in the dynamic magnetic behavior of the nanoparticles. Nevertheless, the magnetization value in the cell cultures was slightly lower than that of the fluid simulating the viscosity of cytoplasm, suggesting that magnetization loss was not only due to medium viscosity but also to a reduction in the mechanical degrees of freedom of SPIONs rotation and translation inside cells. The findings presented here provide information on the loss of magnetic properties when nanoparticles are suspended in viscous fluids or internalized in cells. This information could be exploited to improve biomedical applications based on magnetic properties such as magnetic hyperthermia, contrast agents and drug delivery.The authors are thankful to their supporters: a grant from Universidad Politecnica de Madrid to Ana Lorena Urbano-Bojorge and a grant from Universidad Nacional Experimental del Tachira (UNET)- Venezuela to Oscar Casanova-Carvajal. This study was also financially supported in part by CIBER-BBN (Spain) and Madr.ib-CM (Spain).Urbano-Bojorge, AL.; Casanova-Carvajal, O.; González, N.; Fernández, L.; Madurga, R.; Sánchez-Cabezas, S.; Aznar, E.... (2018). Influence of Medium Viscosity and Intracellular Environment on the Magnetization of Superparamagnetic Nanoparticles in Silk Fibroin Solutions and 3T3 Mouse Fibroblast Cell Cultures. Nanotechnology. 29(38):1-13. https://doi.org/10.1088/1361-6528/aacf4aS113293

Influence of Medium Viscosity and Intracellular Environment on the Magnetization of Superparamagnetic Nanoparticles in Silk Fibroin Solutions and 3T3 Mouse Fibroblast Cell Cultures

IOP also requests that you include the following statement of provenance: "This is an author-created, un-copyedited versíon of an article published in Nanotechnology. IOP Publishing Ltd is not responsíble for any errors or omissíons in this versíon of the manuscript or any versíon derived from it. The Versíon of Record is available online at https://doi.org/10.1088/1361-6528/aacf4a.[EN] Biomedical applications based on the magnetic properties of superparamagnetic iron oxide nanoparticles (SPIONs) may be altered by the mechanical attachment or cellular uptake of these nanoparticles. When nanoparticles interact with living cells, they are captured and internalized into intracellular compartments. Consequently, the magnetic behavior of the nanoparticles is modified. In this paper, we investigated the change in the magnetic response of 14 nm magnetic nanoparticles (Fe3O4) in different solutions, both as a stable liquid suspension (one of them mimicking the cellular cytoplasm) and when associated with cells. The field-dependent magnetization curves from inert fluids and cell cultures were determined by using an alternating gradient magnetometer, MicroMagTM 2900. The equipment was adapted to measure liquid samples because it was originally designed only for solids. In order to achieve this goal, custom sample holders were manufactured. Likewise, the nuclear magnetic relaxation dispersion profiles for the inert fluid were also measured by fast field cycling nuclear magnetic relaxation relaxometry. The results show that SPION magnetization in inert fluids was affected by the carrier liquid viscosity and the concentration. In cell cultures, the mechanical attachment or confinement of the SPIONs inside the cells accounted for the change in the dynamic magnetic behavior of the nanoparticles. Nevertheless, the magnetization value in the cell cultures was slightly lower than that of the fluid simulating the viscosity of cytoplasm, suggesting that magnetization loss was not only due to medium viscosity but also to a reduction in the mechanical degrees of freedom of SPIONs rotation and translation inside cells. The findings presented here provide information on the loss of magnetic properties when nanoparticles are suspended in viscous fluids or internalized in cells. This information could be exploited to improve biomedical applications based on magnetic properties such as magnetic hyperthermia, contrast agents and drug delivery.The authors are thankful to their supporters: a grant from Universidad Politecnica de Madrid to Ana Lorena Urbano-Bojorge and a grant from Universidad Nacional Experimental del Tachira (UNET)- Venezuela to Oscar Casanova-Carvajal. This study was also financially supported in part by CIBER-BBN (Spain) and Madr.ib-CM (Spain).Urbano-Bojorge, AL.; Casanova-Carvajal, O.; González, N.; Fernández, L.; Madurga, R.; Sánchez-Cabezas, S.; Aznar, E.... (2018). Influence of Medium Viscosity and Intracellular Environment on the Magnetization of Superparamagnetic Nanoparticles in Silk Fibroin Solutions and 3T3 Mouse Fibroblast Cell Cultures. Nanotechnology. 29(38):1-13. https://doi.org/10.1088/1361-6528/aacf4aS113293

Persistent Overactive Cytotoxic Immune Response in a Spanish Cohort of Individuals With Long-COVID: Identification of Diagnostic Biomarkers

Long-COVID is a new emerging syndrome worldwide that is characterized by the persistence of unresolved signs and symptoms of COVID-19 more than 4 weeks after the infection and even after more than 12 weeks. The underlying mechanisms for Long-COVID are still undefined, but a sustained inflammatory response caused by the persistence of SARS-CoV-2 in organ and tissue sanctuaries or resemblance with an autoimmune disease are within the most considered hypotheses. In this study, we analyzed the usefulness of several demographic, clinical, and immunological parameters as diagnostic biomarkers of Long-COVID in one cohort of Spanish individuals who presented signs and symptoms of this syndrome after 49 weeks post-infection, in comparison with individuals who recovered completely in the first 12 weeks after the infection. We determined that individuals with Long-COVID showed significantly increased levels of functional memory cells with high antiviral cytotoxic activity such as CD8+ TEMRA cells, CD8±TCRγδ+ cells, and NK cells with CD56+CD57+NKG2C+ phenotype. The persistence of these long-lasting cytotoxic populations was supported by enhanced levels of CD4+ Tregs and the expression of the exhaustion marker PD-1 on the surface of CD3+ T lymphocytes. With the use of these immune parameters and significant clinical features such as lethargy, pleuritic chest pain, and dermatological injuries, as well as demographic factors such as female gender and O+ blood type, a Random Forest algorithm predicted the assignment of the participants in the Long-COVID group with 100% accuracy. The definition of the most accurate diagnostic biomarkers could be helpful to detect the development of Long-COVID and to improve the clinical management of these patients.This work was supported by the Coordinated Research Activities at the National Center of Microbiology (CNM, Instituto de Salud Carlos III) (COV20_00679) to promote an integrated response against SARS-CoV-2 in Spain (Spanish Ministry of Science and Innovation), which is coordinated by Dr Inmaculada Casas (WHO National Influenza Center of the CNM); a generous donation provided by Chiesi España, S.A.U. (Barcelona, Spain); the Spanish Ministry of Science and Innovation (PID2019-110275RB-I00); and the Spanish AIDS Research Network RD16CIII/0002/0001 that is included in Acción Estratégica en Salud, Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica 2016-2020, Instituto de Salud Carlos III, European Region Development Fund (ERDF). The work of ML-H and SR-M is financed by NIH grant R01AI143567. The work of MT is supported by Instituto de Salud Carlos III (COV20_00679). The work of LV is supported by a pre-doctoral grant from Instituto de Salud Carlos III (FIS PI16CIII/00034-ISCIII-FEDER). The work of FR-M is financed by the Spanish Ministry of Science and Innovation (PID2019-110275RB-I00).S

Early Cellular and Humoral Responses Developed in Oncohematological Patients after Vaccination with One Dose against COVID-19

Individuals with oncohematological diseases (OHD) may develop an impaired immune response against vaccines due to the characteristics of the disease or to its treatment. Humoral response against SARS-CoV-2 has been described to be suboptimal in these patients, but the quality and efficiency of the cellular immune response has not been yet completely characterized. In this study, we analyzed the early humoral and cellular immune responses in individuals with different OHD after receiving one dose of an authorized vaccine against SARS-CoV-2. Humoral response, determined by antibodies titers and neutralizing capacity, was overall impaired in individuals with OHD, except for the cohort of chronic myeloid leukemia (CML), which showed higher levels of specific IgGs than healthy donors. Conversely, the specific direct cytotoxic cellular immunity response (DCC) against SARS-CoV-2, appeared to be enhanced, especially in individuals with CML and chronic lymphocytic leukemia (CLL). This increased cellular immune response, developed earlier than in healthy donors, showed a modest cytotoxic activity that was compensated by significantly increased numbers, likely due to the disease or its treatment. The analysis of the immune response through subsequent vaccine doses will help establish the real efficacy of COVID-19 vaccines in individuals with OHD.This work was supported by the Strategic Action in Health 2017–2020 of the Instituto de Salud Carlos III (PI21/00877); the Coordinated Research Activities at the National Center of Microbiology (CNM, Instituto de Salud Carlos III) (COV20_00679) to promote an integrated response against SARS-CoV-2 in Spain (Spanish Ministry of Science and Innovation) that is coordinated by Dr Inmaculada Casas (WHO National Influenza Center of the CNM); a generous donation provided by Chiesi España, S.A.U. (Barcelona, Spain). The work of Sara Rodríguez-Mora is financed by NIH grant R01AI143567. The work of Montserrat Torres is financed by the Hematology and Hemotherapy Service of the Hospital Universitario Ramón y Cajal. The work of Fernando Ramos-Martín is financed by the Spanish Ministry of Science and Innovation (PID2019-110275RB-I00). The work of Lorena Vigón is supported by a pre-doctoral grant from Instituto de Salud Carlos III (FIS PI16CIII/00034-ISCIII-FEDER). The work of Mario Manzanares is supported by a pre-doctoral grant from Instituto de Salud Carlos III (ISCIII-PFIS FI20CIII/00021).S

Revisión bibliográfica del proyecto "en mi casa" de la junta de Castilla y León

Introduction: the increase in life expectancy and the number of people over 65 years of age implies a change in sociodemographic patterns, which is why health services are evolving, the “In my house” project being a great example. The objective of this work is to investigate and investigate the “In my house” project, as well as determine the role of nursing and the scientific basis of said project. Material and methods: of the 147 articles found in metasearch engines such as Tripdatabase or secondary information sources such as Pubmed, 12 were selected, in addition to the use of other scientific search engines to complete the research. Results: Around 90% of the elderly state their desire to reside in their homes during the fullness of their lives and 4 out of 5 older people report that home care has a more structured support network than residential care. 14% of the elderly living alone report family abandonment. In 2031, 33.2% of the elderly will live alone at home. Discussion: due to the loss of family contact, as well as decision-making and changes in the lifestyle of the elderly living in residences, the project “In my house”emerges, which isinspired and followsthefoundations of the Nordic model Housing, which aims to eradicate those negative items mentioned above, favoring the individuality, autonomy and family intimacy of each of these elderly people. Conclusions: both the “In my house” and “At home in my house” project carry out a series of activities and aids to promote independence whether they are institutionalized or live in their own home.Introducción: el aumento de la esperanza de vida y del número de personas mayores de 65 años, suponen un cambio en los patrones sociodemográficos, por ello los servicios sanitarios están evolucionando, siendo un gran ejemplo el proyecto “En mi casa”. El objetivo de este trabajo consiste en indagar e investigar el proyecto “En mi casa”, así como determinar el papel de enfermería y las bases científicas de dicho proyecto. Material y métodos: de los 147 artículos encontrados en metabuscadores como Tripdatabase o fuentes de información secundaria como Pubmed, 12 fueron los seleccionados, además de la utilización de otros buscadores científicos para completar la investigación. Resultados: en torno el 90% de los ancianos manifiesta su deseo de residir en  sus domicilios durante la plenitud desu viday 4 decada 5 mayoresrefieren que la atención domiciliaria posee una red de apoyo más estructurada que la atención residencial. El 14 % de los ancianos que viven solos refieren abandono familiar. En el 2031, el 33,2% de las personas mayores vivirán solas en su domicilio. Discusión: debido a la pérdida de contacto familiar, así como de toma de decisiones y cambios en el estilo de vida de los ancianos que conviven en residencias, surge el proyecto “En mi casa”, que se inspira y sigue las bases del modelo nórdico Housing, el cual pretende erradicar esos ítems negativos mencionados con anterioridad, favoreciendo la individualidad, autonomía e intimidad familiar de cada una de esas personas de avanzada edad. Conclusiones: tanto el proyecto “En mi casa” como “A gusto en mi casa” llevan a cabo una serie de actividades y ayudas para promover la independencia tanto si están institucionalizados o habitan en su propio domicilio