Medicaments: quin, quan, com...Projecte d’Aprenentatge i Servei per a secundària. Guia didàctica

Il·lustracions originals de Roser Bosch Mestres.La unitat didàctica que hem realitzat té com objectiu principal dissenyar un projecte d’Aprenentatge i Servei (APS) centrat en el bon ús dels medicaments. El projecte es caracteritza per ser una proposta educativa adreçada a joves d’ESO o de 1r curs de Batxillerat que combina activitats d’aprenentatge amb activitats de servei a la comunitat. Pensem que és un enfocament metodològic que ajuda a desenvolupar i a assolir determinades competències bàsiques, a la vegada que motiva l’alumnat, ja que es presenta un ensenyament contextualitzat i significatiu per a la comunitat. Els projectes d’APS responen a una necessitat concreta i rellevant de l’entorn social i, sempre que es pugui, ha d’implicar un acord de col·laboració entre diferents agents o institucions socials que possibilitin aquesta reciprocitat de beneficis d’aprenentatge i de servei. En aquest cas hem treballat com “partners” amb el Col·legi de farmacèutics, amb les farmàcies del barri i amb el SIGRE (responsable del reciclatge dels medicaments)

Linking In Vitro Models of Endothelial Dysfunction with Cell Senescence

Disfunció endotelial; Envellliment cel·lularDisfunción endotelial; Envejecimiento celularEndothelial dysfunction; SenescenceEndothelial cell dysfunction is the principal cause of several cardiovascular diseases that are increasing in prevalence, healthcare costs, and mortality. Developing a standardized, representative in vitro model of endothelial cell dysfunction is fundamental to a greater understanding of the pathophysiology, and to aiding the development of novel pharmacological therapies. We subjected human umbilical vein endothelial cells (HUVECs) to different periods of nutrient deprivation or increasing doses of H2O2 to represent starvation or elevated oxidative stress, respectively, to investigate changes in cellular function. Both in vitro cellular models of endothelial cell dysfunction-associated senescence developed in this study, starvation and oxidative stress, were validated by markers of cellular senescence (increase in β-galactosidase activity, and changes in senescence gene markers SIRT1 and P21) and endothelial dysfunction as denoted by reductions in angiogenic and migratory capabilities. HUVECs showed a significant H2O2 concentration-dependent reduction in cell viability (p < 0.0001), and a significant increase in oxidative stress (p < 0.0001). Furthermore, HUVECs subjected to 96 h of starvation, or exposed to concentrations of H2O2 of 400 to 1000 μM resulted in impaired angiogenic and migratory potentials. These models will enable improved physiological studies of endothelial cell dysfunction, and the rapid testing of cellular efficacy and toxicity of future novel therapeutic compounds.This research was funded by Beca de Investigacion Basica en Cardiologia from the Sociedad Española de Cardiologia, Fondo de Investigacion en Salud (grants PI18/00277, PI16/00742, PI19/00264, PI18/00960 and PI15/00553) from the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III–Fondo Europeo de Desarrollo Regional (FEDER), and Spanish Society of Respiratory Medicine (SEPAR) and Catalan Society of Pneumology (SOCAP) grants. FRJT and OTC are the recipients of the Ayudas para la formación de profesorado universitario (FPU19/04925) and Miguel Servet (CP17/00114) grants, respectively, from the Spanish Ministry of Science and Innovation. IDIBAPS belongs to the CERCA Programme, and receives partial funding from the Generalitat de Catalunya. Cofunding was provided by the Fondo Europeo de Desarrollo Regional (FEDER); “Una manera de hacer Europa”

Medicamentos: cuál, cuándo, cómo. Proyecto de Aprendizaje y Servicio para secundaria. Guía didáctica.

La unidad didáctica que hemos realizado tiene como objetivo principal diseñar un proyecto de Aprendizaje y Servicio (APS) centrado en el uso adecuado de los medicamentos. El proyecto se caracteriza por ser una propuesta educativa dirigida a jóvenes de ESO o de primer curso de Bachillerato que combina actividades de aprendizaje con actividades de servicio a la comunidad. El enfoque metodológico de esta unidad didáctica ayudará a desarrollar y alcanzar determinadas competencias básicas, al tiempo que motivará al alumnado, ya que se presenta una enseñanza contextualizada y significativa para la comunidad. Los proyectos de APS responden a una necesidad concreta y relevante del entorno social y, siempre que se pueda, deben implicar un acuerdo de colaboración entre distintos agentes o instituciones sociales que posibiliten esta reciprocidad de beneficios de aprendizaje y servicio. En este caso, hemos trabajado como partners con el Colegio de Farmacéuticos de Barcelona, las farmacias de barrio y SIGRE Medicamento y Medio Ambiente (entidad sin ánimo de lucro responsable del reciclado de los envases y restos de medicamentos de origen domiciliario). Hemos decidido centrarnos en el ámbito del «uso de los medicamentos», un ámbito de actuación que favorece en especial el aprendizaje y la aplicación de conocimientos del currículo de ciencias, puesto que estamos convencidos de la importancia de que la escuela forme a los jóvenes para ser competentes (lúcidos, eficientes y responsables) en dicho aspecto, de gran transcendencia para la salud, en la esfera personal, familiar y social, así como para el medio ambiente. El objetivo principal del proyecto es tomar consciencia de la importancia de utilizar correctamente los medicamentos, tanto desde el punto de vista de la salud como del medio ambiente. Para lograrlo se han diseñado actividades de enseñanza/aprendizaje de tipo «experiencial», en el sentido de que los alumnos se impliquen y puedan adquirir y aplicar conocimientos en distintos contextos. Hemos diseñado distintas actividades: estudio de casos, trabajo cooperativo, análisis de etiquetas de medicamentos, reciclado de los medicamentos en el domicilio y en la escuela, organización del contenido adecuado de un botiquín doméstico, entre otras. En cuanto a lo referente al servicio, se propone la revisión del botiquín de casa y de la escuela, así como acudir al punto SIGRE de la farmacia a llevar los medicamentos que ya no se utilicen o estén caducados, tanto si están vacíos como no. Además, se sugieren otras actividades, como una campaña de sensibilización para los compañeros y demás escuelas de niveles inferiores, en la que se haga referencia a cuáles son los medicamentos básicos necesarios en un botiquín, pero también se argumente la necesidad de realizar una recogida especial de los mismos, relacionándolo con el medio ambiente Este proyecto se puede aplicar tanto a 3º de ESO por el tema de Salud y enfermedades, como a 1º de Bachillerato, dentro de la materia Ciencias para el Mundo Contemporáneo

Classification Models for Neurocognitive Impairment in HIV Infection Based on Demographic and Clinical Variables

Objective: We used demographic and clinical data to design practical classification models for prediction of neurocognitive impairment (NCI) in people with HIV infection. Methods: The study population comprised 331 HIV-infected patients with available demographic, clinical, and neurocognitive data collected using a comprehensive battery of neuropsychological tests. Classification and regression trees (CART) were developed to obtain detailed and reliable models to predict NCI. Following a practical clinical approach, NCI was considered the main variable for study outcomes, and analyses were performed separately in treatment-naı¨ve and treatment-experienced patients. Results: The study sample comprised 52 treatment-naı¨ve and 279 experienced patients. In the first group, the variables identified as better predictors of NCI were CD4 cell count and age (correct classification [CC]: 79.6%, 3 final nodes). In treatment-experienced patients, the variables most closely related to NCI were years of education, nadir CD4 cell count, central nervous system penetration-effectiveness score, age, employment status, and confounding comorbidities (CC: 82.1%, 7 final nodes). In patients with an undetectable viral load and no comorbidities, we obtained a fairly accurate model in which the main variables were nadir CD4 cell count, current CD4 cell count, time on current treatment, and past highest viral load (CC: 88%, 6 final nodes). Conclusion: Practical classification models to predict NCI in HIV infection can be obtained using demographic and clinical variables. An approach based on CART analyses may facilitate screening for HIV-associated neurocognitive disorders and complement clinical information about risk and protective factors for NCI in HIV-infected patients

Methylglyoxal Produced by Amyloid- Peptide-Induced Nitrotyrosination of Triosephosphate Isomerase Triggers Neuronal Death in Alzheimer’s Disease

Amyloid-β peptide (Aβ) aggregates induce nitro-oxidative stress, contributing to the characteristic neurodegeneration found in Alzheimer's disease (AD). One of the most strongly nitrotyrosinated proteins in AD is the triosephosphate isomerase (TPI) enzyme which regulates glycolytic flow, and its efficiency decreased when it is nitrotyrosinated. The main aims of this study were to analyze the impact of TPI nitrotyrosination on cell viability and to identify the mechanism behind this effect. In human neuroblastoma cells (SH-SY5Y), we evaluated the effects of Aβ42 oligomers on TPI nitrotyrosination. We found an increased production of methylglyoxal (MG), a toxic byproduct of the inefficient nitro-TPI function. The proapoptotic effects of Aβ42 oligomers, such as decreasing the protective Bcl2 and increasing the proapoptotic caspase-3 and Bax, were prevented with a MG chelator. Moreover, we used a double mutant TPI (Y165F and Y209F) to mimic nitrosative modifications due to Aβ action. Neuroblastoma cells transfected with the double mutant TPI consistently triggered MG production and a decrease in cell viability due to apoptotic mechanisms. Our data show for the first time that MG is playing a key role in the neuronal death induced by Aβ oligomers. This occurs because of TPI nitrotyrosination, which affects both tyrosines associated with the catalytic center

Sensitivity of a tonne-scale NEXT detector for neutrinoless double beta decay searches

The Neutrino Experiment with a Xenon TPC (NEXT) searches for the neutrinoless double-beta decay of Xe-136 using high-pressure xenon gas TPCs with electroluminescent amplification. A scaled-up version of this technology with about 1 tonne of enriched xenon could reach in less than 5 years of operation a sensitivity to the half-life of neutrinoless double-beta decay decay better than 1E27 years, improving the current limits by at least one order of magnitude. This prediction is based on a well-understood background model dominated by radiogenic sources. The detector concept presented here represents a first step on a compelling path towards sensitivity to the parameter space defined by the inverted ordering of neutrino masses, and beyond.Comment: 22 pages, 11 figure

Ventricular arrhythmias in patients with functional mitral regurgitation and implantable cardiac devices: implications of mitral valve repair with Mitraclip

Background: Limited information has been reported regarding the impact of percutaneous mitral valve repair (PMVR) on ventricular arrhythmic (VA) burden. The aim of this study was to address the incidence of VA and appropriate antitachycardia implantable cardiac defibrillator (ICD) therapies before and after PMVR. Methods: We retrospectively analyzed all consecutive patients with heart failure with reduce left ventricular ejection fraction (LVEF), functional mitral regurgitation (FMR) grade 3+ or 4+ and an active ICD or cardiac resynchronizer who underwent PMVR in any of the eleven recruiting centers. Only patients with complete available device VA monitoring from one-year before to one year after PMVR were included. Baseline clinical and echocardiographic characteristics were collected before PMVR and at 12-months follow-up. Results: Ninety-three patients (68.2+/-10.9 years old, male 88.2%) were enrolled. PMVR was successfully performed in all patients and device success at discharge was 91.4%. At 12-month follow-up, we observed a significant reduction in mitral regurgitation severity, NT-proBNP and prevalence of severe pulmonary hypertension and severe kidney disease. Patients also referred a significant improvement in NYHA functional class and showed a non-significant trend to reserve left ventricular remodeling. After PMVR a significant decrease in the incidence of non-sustained ventricular tachycardia (VT) (5.0+/-17.8 vs. 2.7+/-13.5, P=0.002), sustained VT or ventricular fibrillation (0.9+/-2.5 vs. 0.5+/-2.9, P=0.012) and ICD antitachycardia therapies (2.5+/-12.0 vs. 0.9+/-5.0, P=0.033) were observed. Conclusions: PMVR was related to a reduction in arrhythmic burden and ICD therapies in our cohort

Memory in low-grade glioma patients treated with radiotherapy or temozolomide: a correlative analysis of EORTC study 22033-26033.

EORTC study 22033-26033 showed no difference in progression-free survival between high-risk low-grade glioma receiving either radiotherapy (RT) or temozolomide (TMZ) chemotherapy alone as primary treatment. Considering the potential long-term deleterious impact of RT on memory functioning, this study aims to determine whether TMZ is associated with less impaired memory functioning. Using the Visual Verbal Learning Test (VVLT), memory functioning was evaluated at baseline and subsequently every 6 months. Minimal compliance for statistical analyses was set at 60%. Conventional indices of memory performance (VVLT Immediate Recall, Total Recall, Learning Capacity, and Delayed Recall) were used as outcome measures. Using a mixed linear model, memory functioning was compared between treatment arms and over time. Neuropsychological assessment was performed in 98 patients (53 RT, 46 TMZ). At 12 months, compliance had dropped to 66%, restricting analyses to baseline, 6 months, and 12 months. At baseline, patients in either treatment arm did not differ in memory functioning, sex, age, or educational level. Over time, patients in both arms showed improvement in Immediate Recall (P = 0.017) and total number of words recalled (Total Recall; P &lt; 0.001, albeit with delayed improvement in RT patients (group by time; P = 0.011). Memory functioning was not associated with RT gross, clinical, or planned target volumes. In patients with high-risk low-grade glioma there is no indication that in the first year after treatment, RT has a deleterious effect on memory function compared with TMZ chemotherapy