Posible efecto protector de la s-adenosil-l-metionina en un modelo isquemia reperfusión hepática

Tesis Univ. Complutense de Madrid, 1996Las situaciones de isquemia-reperfusión hepática en la práctica clínica son frecuentes (transplantes, clampaje del pedículo hepático). Los radicales libres del oxigeno desempeñan un papel fundamental en la producción de la lesión microvascular o parenquimatosa que se asocia a la reperfusión de los tejidos isquémicos. El glutation, a través de diversos mecanismos, entre ellos la disminución de la producción de radicales libres podría proteger a los hepatocitos frente a los mediadores de la inflamación. Por otra parte, samet es capaz de incrementar el contenido en glutation de los hepatocitos. Hemos evaluado el posible efecto protector de samet en un modelo de isquemia-reperfusión hepática en ratas, y nuestros resultados apuntan a que ese efecto beneficioso, efectivamente, existe.Depto. de CirugíaFac. de MedicinaTRUEpu

El pabellón de oficiales (2001)

Adrien Fournier; un joven teniente francés de ingenieros, es herido por uno de los primeros obuses de la Primera Guerra Mundial. Aunque sobrevive, presenta unas importantes lesiones en cara y cavidad oral por lo que es trasladado a un hospital de Paris. En el pabellón de oficiales del hospital, hay otros soldados con importantes heridas faciales. En la película se refleja el miedo al rechazo social, los intentos de suicidio, la labor de las enfermeras y del cirujano así como la camaradería y el apoyo entre pacientes

Assessment of the Economic and Health-Care Impact of COVID-19 (SARS-CoV-2) on Public and Private Dental Surgeries in Spain: A Pilot Study

Objectives: The COVID-19 (SARS-CoV-2) pandemic is an ongoing public health challenge, also for the dentistry community. The main objective of this paper was to determine the economic and health-care impact of COVID-19 on dentists in the Autonomous Region of Galicia (Spain). Methods: This was a descriptive observational study in which the data was collected by means of a self-administered survey (from 1 April 2020 to 30 April 2020). Results: A total of 400 dentists from Galicia responded to the survey. Only 12.3% of the participants could obtain personal protective equipment (PPE) including FFP2 masks. Of the male respondents, 33.1% suffered losses >€15,000 compared to 19.4% of female respondents (OR = 3.121, p < 0.001). Economic losses seem to have contributed to the applications for economic help as 29.5% of the respondents who applied for this measure recorded losses in excess of €15,000 (p = 0.03). Patients complained more about the fact that only emergency care was available during the State of Alarm, in dental surgeries that do not work with insurance companies or franchises. Only 4 professionals tested positive, 50% of whom worked exclusively in private practice and the other 50% who practised in both private and public surgeries. Dentists who practise in the public sector saw more urgent patients per week than those practising in private surgeries (p = 0.013). Conclusions: The COVID-19 pandemic has had economic repercussions in dentistry as only urgent treatment was available during the State of Alarm. These repercussions seem to be higher in male participants, as the majority of the participants have revealed higher economic losses than females. The level of assistance has also been affected, reducing the number of treated patients, although this quantity has been different in private and public surgeries. By presenting these findings we look to highlight the role that dentists play in society in treating dental emergencies in our surgeries, and this must be recognised and addressed by the relevant authorities, who must provide PPEs as a priority to this group as well as providing special economic aid in accordance with the losses incurred by the sectorS

Cardiac dysfunction and remodeling regulated by anti-angiogenic environment in patients with preeclampsia : the ANGIOCOR prospective cohort study protocol

Background: Cardiovascular diseases (CVD) are cause of increased morbidity and mortality in spite of advances for diagnosis and treatment. Changes during pregnancy affect importantly the maternal CV system. Pregnant women that develop preeclampsia (PE) have higher risk (up to 4 times) of clinical CVD in the short- and long-term. Predominance of an anti-angiogenic environment during pregnancy is known as main cause of PE, but its relationship with CV complications is still under research. We hypothesize that angiogenic factors are associated to maternal cardiac dysfunction/remodeling and that these may be detected by new cardiac biomarkers and maternal echocardiography. Methods: Prospective cohort study of pregnant women with high-risk of PE in first trimester screening, established diagnosis of PE during gestation, and healthy pregnant women (total intended sample size n = 440). Placental biochemical and biophysical cardiovascular markers will be assessed in the first and third trimesters of pregnancy, along with maternal echocardiographic parameters. Fetal cardiac function at third trimester of pregnancy will be also evaluated and correlated with maternal variables. Maternal cardiac function assessment will be determined 12 months after delivery, and correlation with CV and PE risk variables obtained during pregnancy will be evaluated. Discussion: The study will contribute to characterize the relationship between anti-angiogenic environment and maternal CV dysfunction/remodeling, during and after pregnancy, as well as its impact on future CVD risk in patients with PE. The ultimate goal is to improve CV health of women with high-risk or previous PE, and thus, reduce the burden of the disease. Trial registration: NCT04162236

Cryopreservation of unrelated donor hematopoietic stem cells: the right answer for transplantations during the COVID-19 pandemic?

Cryopreservation was recommended to ensure continuity of unrelated donor (UD) hematopoietic stem cell transplantation (HSCT) during COVID-19 pandemic. However, its impact on clinical outcomes and feasibility was not well known. We compared 32 patients who underwent UD HSCT using cryopreserved peripheral blood stem cells (PBSC) during the COVID-19 pandemic with 32 patients who underwent UD HSCT using fresh PBSC in the previous period. Median neutrophil engraftment was 17.5 and 17.0 days with cryopreserved and fresh grafts, respectively. Non-significant delays were found in platelet recovery days (25.5 versus 19.0; P = 0.192) and full donor chimerism days (35.0 and 31.5; P = 0.872) using cryopreserved PBSC. The rate of acute graft-versus-host disease at 100 days was 41% (95% CI [21-55%]) in cryopreserved group versus 31% (95% CI [13-46%]) in fresh group (P = 0.380). One-hundred days progression-relapse free survival and overall survival did not differ significantly. During COVID-19 pandemic, six frozen UD donations were not transfused and logistical and clinical issues regarding cryopreservation procedure, packaging, and transporting appeared. In summary, UD HSCT with cryopreserved PBSC was safe during this challenging time. More efforts are needed to ensure that all frozen grafts are transplanted and cryopreservation requirements are harmonized

Nanomechanical Phenotypes in Cardiac Myosin-Binding Protein C Mutants That Cause Hypertrophic Cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is a disease of the myocardium caused by mutations in sarcomeric proteins with mechanical roles, such as the molecular motor myosin. Around half of the HCM-causing genetic variants target contraction modulator cardiac myosin-binding protein C (cMyBP-C), although the underlying pathogenic mechanisms remain unclear since many of these mutations cause no alterations in protein structure and stability. As an alternative pathomechanism, here we have examined whether pathogenic mutations perturb the nanomechanics of cMyBP-C, which would compromise its modulatory mechanical tethers across sliding actomyosin filaments. Using single-molecule atomic force spectroscopy, we have quantified mechanical folding and unfolding transitions in cMyBP-C domains targeted by HCM mutations that do not induce RNA splicing alterations or protein thermodynamic destabilization. Our results show that domains containing mutation R495W are mechanically weaker than wild-type at forces below 40 pN and that R502Q mutant domains fold faster than wild-type. None of these alterations are found in control, nonpathogenic variants, suggesting that nanomechanical phenotypes induced by pathogenic cMyBP-C mutations contribute to HCM development. We propose that mutation-induced nanomechanical alterations may be common in mechanical proteins involved in human pathologies.J.A.C. acknowledges funding from the Ministerio de Ciencia e Innovación (MCIN) through grants BIO2014– 54768-P, BIO2017–83640-P (AEI/FEDER, UE), EIN2019–102966, RYC-2014–16604, and BFU2017–90692­ REDT, the European Research Area Network on Cardiovascular Diseases (ERA-CVD/ISCIII, MINOTAUR, AC16/00045), and the Comunidad de Madrid (consortium Tec4Bio-CM, S2018/NMT-4443, FEDER). This work was supported by NIH grants RM1 GM33289 and HL117138 to J.A.S.; a Stanford Dean’s Postdoctoral Fellowship to D.P. and N.N.; and a Stanford Maternal and Child Health Research Institute (MCHRI) Postdoctoral Fellowship (1220552–140-DHPEU) to N.N. Financial support to D.D.S. comes from Eusko Jaurlaritza (Basque Government) through the project IT1254–19, and grants RYC-2016–19590 and PGC2018–099321-B-I00 from the MCIN (FEDER). The CNIC is supported by the Instituto de Salud Carlos III (ISCIII), MCIN, and the Pro CNIC Foundation and was a Severo Ochoa Center of Excellence (SEV-2015–0505). We acknowledge funding from ISCIII to the Centro de Investigación Biomédica en Red (CIBERCV), CB16/11/00425. C.S.C. is the recipient of an FPI-SO predoctoral fellowship, BES-2016–076638. M.R.P. was the recipient of a Ph.D. fellowship from the Italian Ministry of Education, Universities and Research (MIUR). C.P.L. was a recipient of a CNIC Master Fellowship. We thank N. Vicente for excellent technical support (through grant PEJ16/MED/TL-1593 from Consejería de Educación, Juventud y Deporte de la Comunidad de Madrid and the European Social Fund). We thank the Spectroscopy and Nuclear Magnetic Resonance Core Unit at CNIO for access to CD instrumentation and discussion about protein binding assays. We thank A. Thompson and S. Day for their insights. We thank all members of the Molecular Mechanics of the Cardiovascular System team for helpful discussions and the contribution of five anonymous reviewers.S

PriTec Tool: Adaptation for the selection of technologies to be assessed prior entry into the health care benefits basket

O obxectivo deste documento é desenvolver unha ferramenta que facilite á Comisión de Prestacións, Aseguramento e Financiación seleccionar e priorizar, dunha forma obxectiva e sistemática, as tecnoloxías sanitarias a avaliar pola RedETS de cara á súa inclusión/exclusión ou modificación de condicións de uso en carteira de servizosEl objetivo de este documento es desarrollar una herramienta que facilite a la Comisión de Prestaciones, Aseguramiento y Financiación seleccionar y priorizar, de una forma objetiva y sistemática, las tecnologías sanitarias a evaluar por la RedETS de cara a su inclusión/exclusión o modificación de condiciones de uso en cartera de servicio

The avoidance of G-CSF and the addition of prophylactic corticosteroids after autologous stem cell transplantation for multiple myeloma patients appeal for the at-home setting to reduce readmission for neutropenic fever

Autologous stem cell transplantation (ASCT) remains the standard of care for young multiple myeloma (MM) patients; indeed, at-home ASCT has been positioned as an appropriate therapeutic strategy. However, despite the use of prophylactic antibiotics, neutropenic fever (NF) and hospital readmissions continue to pose as the most important limitations in the outpatient setting. It is possible that the febrile episodes may have a non-infectious etiology, and engraftment syndrome could play a more significant role. The aim of this study was to analyze the impact of both G-CSF withdrawal and the addition of primary prophylaxis with corticosteroids after ASCT. Between January 2002 and August 2018, 111 MM patients conditioned with melphalan were managed at-home beginning +1 day after ASCT. Three groups were established: Group A (n = 33) received standard G-CSF post-ASCT; group B (n = 32) avoided G-CSF post-ASCT; group C (n = 46) avoided G-CSF yet added corticosteroid prophylaxis post-ASCT. The incidence of NF among the groups was reduced (64%, 44%, and 24%; P2 (OR 6.1; P = 0.002) and G-CSF avoidance plus corticosteroids (OR 0.1; P<0.001); and for hospital readmission: age �60 years (OR 14.6; P = 0.04) and G-CSF avoidance plus corticosteroids (OR 0.07; P = 0.05. G-CSF avoidance and corticosteroid prophylaxis post ASCT minimize the incidence of NF in MM patients undergoing at-home ASCT. This approach should be explored in a prospective randomized clinical trial

Instagram como herramienta de aprendizaje en Fisiología: @fisiofarma_us

Las redes sociales (RR.SS.) forman parte de nuestra vida diaria convirtiéndose en una de las principales vías de comunicación y búsqueda de información, especialmente entre los más jóvenes. Entre los usuarios que usan de las RR.SS., un gran número son estudiantes universitarios; y entre los temas más tratados se encuentran aquellos relativos a temáticas de ciencias de la salud. Es por ello por lo que desde el Departamento de Fisiología de la Facultad de Farmacia de la Universidad de Sevilla se desarrolló un proyecto de innovación docente durante el curso 2021-2022 cuyo objetivo era la utilización de las RR.SS. para el aprendizaje de las materias impartidas en nuestro departamento, analizando los posibles beneficios derivado del uso de esta por parte de nuestros estudiantes y profesores. Esta actividad consistió en el desarrollo de contenido divulgativo relativo a la Fisiología por parte de estudiantes del Grado en Farmacia, Grado en Óptica-optometría y Doble Grado en ambos, de nuestro Centro para posteriormente ser publicado en una cuenta de Instagram creada para tal fin (@fisiofarma_us). La opinión tanto de los estudiantes como del profesorado sobre el proyecto fue recogida a través de la encuesta al finalizar el proyecto, y se realizó un registro del impacto en la RR.SS. (seguidores, interacciones, etc). Nuestra cuenta Instagram tuvo un gran impacto en RR.SS. Entre los resultados a destacar, los estudiantes consideran que esta actividad ha favorecido su interés por la Fisiología y tanto estudiantes como profesores creen que esta actividad favoreció diferentes herramientas de aprendizaje. Estos resultados nos hacen concluir que el uso adecuado de las RR.SS. puede ser un método efectivo de aprendizaje e incentivo para fomentar una mejor compresión de las asignaturas de Fisiología en grados universitarios de ciencias de la salud, como Farmacia u Óptica-optometría.: Social networks (RR.SS.) have become an integral part of our daily lives and serve as one of the primary means of communication and information retrieval, particularly among younger. A significant proportion of RR.SS. users are university students, and health science topics are among the most frequently discussed subjects. Considering this, the Department of Physiology at the Facultyof Pharmacy at the University of Seville initiated a teaching innovation project during the 2021-2022 academic year. This project aimed to use RR.SS. as a tool for learning the subjects taught within our department and to analyse the potential benefits that could be derived from its use by our students and members of the physiology department. This initiative involved the creation of informative content related to Physiology by students enrolled in the Degree in Pharmacy, Degree in OpticsOptometry, and Double Degree programs at our faculty. This content was subsequently published on an Instagram account created explicitly for this purpose (@fisiofarma_us). At the end of the project, feedback was obtained from both students and professors of the physiology department via a survey, and data about the impact of our initiative on RR.SS. (e.g., number of followers, interactions, and others) was recorded. Our Instagram account generated considerable interest on RR.SS. Notably, students reported that this activity increased their stake in Physiology, and both students and faculty members indicated that it facilitated the use of various learning tools. Based on these findings, we conclude that the use of RR.SS. can effectively enhance learning and promote a deeper understanding of Physiology-related subjects among students enrolled in university-level health science programs such as Pharmacy or Optics-Optometr

Primary and Secondary Immunodeficiency Diseases in Oncohaematology: Warning Signs, Diagnosis, and Management

Background: Immunodeficiencies (ID), in particular primary immunodeficiencies (PID), are often associated with haematological manifestations, such as peripheral cytopenias or lymphoproliferative syndromes. Early diagnosis and management have significant prognostic implications. Secondary immunodeficiencies (SID) may also be induced by oncohaematological diseases and their treatments. Haematologists and oncologists must therefore be aware of the association between blood disorders and cancer and ID, and be prepared to offer their patients appropriate treatment without delay. Our aim was to define the warning signs of primary and secondary IDs in paediatric and adult patients with oncohaematological manifestations.Methods: A multidisciplinary group of six experts (2 haematologists, 2 immunologists, and 2 paediatricians specializing in ID) conducted a literature review and prepared a document based on agreements reached an in-person meeting. An external group of 44 IDs specialists from all over Spain assessed the document and were consulted regarding their level of agreement.Results: This document identifies the haematological and extra-haematological diseases that should prompt a suspicion of PIDs in adults and children, in both primary care and haematology and oncology departments. Cytopenia and certain lymphoproliferative disorders are key diagnostic pointers. The diagnosis must be based on a detailed clinical history, physical exploration, complete blood count and standard laboratory tests. The immunological and haematological tests included in the diagnostic process will depend on the care level. Patients who are candidates for immunoglobulin replacement therapy must be carefully selected, and treatment should be offered as soon as possible to avoid the development of complications. Finally, this document recommends procedures for monitoring these patients.Conclusions: This document combines scientific evidence with the opinion of a broad panel of experts, and emphasizes the importance of an early diagnosis and treatment to avoid complications. The resulting document is a useful tool for primary care physicians and specialists who see both adult and paediatric patients with oncohaematological diseases