Programa formativo para mejorar las competencias enfermeras en cuidados paliativos en atención primaria

Introducción: Los CP constituyen en la actualidad un importante reto debido al aumento de las enfermedades crónicas avanzadas y complejas. El escenario actual en el que se desarrollan los CP en España se encuentra con una carencia de formación específica en enfermería, de forma que la regulación académica no va pareja a la necesidad social y sanitaria. Esto deriva en una inseguridad por parte de los profesionales y un déficit de asistencia paliativa. Las características de la AP garantizan el marco idóneo de la asistencia a las personas que requieren CP pero esta formación continua siendo un desafío.Objetivo: Diseñar un programa de formación para profesionales de enfermería que trabajen en AP para mejorar sus competencias en la atención a personas en CP. Metodología: Se ha llevado a cabo una revisión bibliográfica en diferentes bases de datos. Se han consultado diversas páginas web oficiales, guías de práctica clínica y libros para actualizar la evidencia disponible sobre la formación de las enfermeras en CP. Se ha realizado con el objetivo de diseñar un programa formativo sobre dichos cuidados para enfermería en respuesta a la deficitaria formación específica en AP.Conclusiones: Es imprescindible generar un aprendizaje transformador que mejore las competencias enfermeras y mejore así la seguridad de la persona al final de la vida y la satisfacción del profesional. Esto solo será posible desde una formación actualizada de las competencias propias y de la investigación basada en evidencias científicas que garantizaría una práctica enfermera de calidad y de un trabajo profesional y humanizado en el ámbito paliativo. Palabras clave: “cuidados paliativos”, “cuidados al final de la vida”, “enfermería”, “atención primaria”, “formación” y “comunicación”.<br /

Recent Advances in the Prins Reaction

The Prins reaction is a very convenient synthetic platform for the preparation of oxygen-containing heterocyclic compounds, especially tetrahydropyrans and tetrahydrofurans. While this reaction has been extensively used by synthetic chemists since its discovery, the last years have witnessed impressive improvements in its performance and scope and especially in the development of new catalytic and enantioselective versions. This mini-review presents these recent advances through selected representative examples.The authors thank the Spanish Agencia Estatal de Investigacion (FEDER-PID2020-118422-GB-I00) and the Basque Government (Grupos IT1558-22) for financial support

Recent Developments in Transannular Reactions

Transannular reactions have shown a remarkable performance for the construction of polycyclic scaffolds from medium- or large-sized cyclic molecules in an unconventional manner. Recent examples of transannular reactions reported from 2011 have been reviewed, emphasizing the excellent performance of this approach when accessing the target compounds. This review also highlights how this methodology provides an alternative approach to other commonly used strategies for the construction of cyclic entities such as cyclization or cycloaddition reactions.MCIU (FEDER-PID2020-118422-gb-100), Basque Government (IT908-16

Desymmetrization of Oxabenzonorbornadienes through Brønsted Acid-Catalyzed Enantioselective (3+2) Cycloaddition with Hydrazones

This work presents the desymmetrization of oxabenzonorbornadienes through the (3+2) cycloaddition reaction with hydrazones using a chiral Brønsted acid such as a BINOL-derived phosphoramide. This chiral acid catalyst appears as the most effective mediator for the activation of the hydrazone via hydrazonium cation that reacts in a (3+2) fashion with the oxabenzonorbornadiene as the olefinic counterpart. Under the optimized conditions, the reaction provided selectively exo cycloaddition products in satisfactory yields and moderate stereoselectivities. The scope of the reaction was explored displaying 21 examples of these highly functionalized tetrahydroepoxybenzoindazole compounds. A reaction mechanism is proposed to explain the outcome of the reaction.Grant PID2020-118422GB-I00 funded by MCIN/AEI/10.13039/501100011033 and by “ESF Investing in your future” is gratefully acknowledged. Financial support by the the Basque Government (Grupos IT1558-22) is also gratefully acknowledged

Asymmetric Dual Enamine Catalysis/Hydrogen Bonding Activation

Asymmetric enamine base activation of carbonyl compounds is a well-known and widely used strategy for providing functionalization of organic compounds in an efficient way. The use of solely organic substances, which in most cases are commercially available primary or secondary amines that are easy to obtain, avoids the use of hazardous substances or metal traces, making this type of catalysis a highly convenient methodology from a sustainable point of view. In many cases, the reactivity or the stereoselectivity obtained is far from being a practical and advantageous strategy; this can be improved by using a hydrogen bonding co-catalyst that can help during the activation of one species or by using a bifunctional catalyst that can direct the approximation of reagents during the reaction outcome. In this review, we describe the most efficient methodologies that make use of a dual activation of reagents for performing α-functionalization (enamine activation) or remote functionalization (such as dienamine or trienamine activation) of carbonyl compounds.PID2020-118422GB-I00 funded by MCIN/AEI/10.13039/501100011033 and by “ESF Investing in your future” are gratefully acknowledged together with the Basque Government (Grupos IT1558-22) and the University of the Basque Country (UPV/EHU)

Ion-pairing catalysis in the enantioselective addition of hydrazones to N-acyldihydropyrrole derivatives

We have demonstrated that dihydropyrrole-based enamide derivatives can act as efficient precursors of chiral quaternary N-acyliminium salts under Brønsted acid catalysis that undergo reactions with hydrazones, the latter participating as masked nucleophilic carbonyl group equivalents. The optimized methodology provides a variety of enantiopure α-substituted proline derivatives in excellent yields, being even compatible with disubstituted β-enamides that generate two contiguous stereocentres.Spanish MINECO(FEDER-CTQ201783633-P), the Basque Government (IT908-16) and UPV/EHU (EHUA15/24 and a fellowship to N.Z.

Impact of Recommended Maternal Vaccination Programs on the Clinical Presentation of SARS-CoV-2 Infection: A Prospective Observational Study

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Vacunes; EmbaràsCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Vacunas; EmbarazoCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Vaccines; PregnancyThe COVID-19 pandemic has raised questions about the possible cross immunity resulting from common vaccination programs and SARS-CoV-2 infection. Therefore, the Spanish Obstetric Emergency group performed a multicenter prospective study on the vaccination status of Influenza and Tdap (diphtheria, tetanus and pertussis vaccine boost administered in adulthood) in consecutive cases of SARS-CoV-2 infection in a pregnancy cohort, in order to assess its possible association with the clinical presentation and severity of symptoms of SARS-CoV-2 infection, as well as to determine the factors that may affect vaccination adherence. A total of 1150 SARS-CoV-2 positive pregnant women from 78 Spanish hospitals were analyzed: 183 had not received either vaccine, 23 had been vaccinated for Influenza only, 529 for Tdap only and 415 received both vaccines. No association was observed between the vaccination status and the clinical presentation of SARS-CoV-2 infection and/or the severity of symptoms. However, a lower adherence to the administration of both vaccines was observed in the Latin-American subgroup. Based on the results above, we reinforce the importance of maternal vaccination programs in the actual pandemic. Health education campaigns should be specially targeted to groups less likely to participate in these programs, as well as for a future SARS-CoV-2 vaccination campaign.This research was supported by public funds obtained in competitive calls: Grant COV20/ 00021 from the Instituto de Salud Carlos III-Spanish Ministry of Health, and co-financed with Fondo Europeo de Desarrollo Regional (FEDER) funds

Catalytic Enantioselective Transannular Morita–Baylis–Hillman Reaction

Catalytic and enantioselective approaches to transannular reactions are very limited and mostly are based on chiral Lewis acid catalyzed pericyclic reactions. In this report, we present an efficient and straightforward methodology to access bicyclic carbo- and heterocyclic scaffolds combining different ring sizes through transannular Morita–Baylis–Hillman reaction catalyzed by a chiral enantiopure bifunctional phosphine. The reaction is remarkably wide in scope and enables the use of a variety of medium and large size ketoenone substrates leading to the final products in high yields and providing excellent stereocontrol in the formation of a quaternary stereogenic center at the ring fusion. Moreover, its potential as a general tool in organic synthesis has been highlighted through the accomplishment of the first enantioselective total synthesis of (−)-γ-gurjunene, a sesquiterpene natural product.Spanish MICINN (FEDER-CTQ2017-83633-P 52107-P) and the Basque Government (GruposIT908-16 and fellowship to R. Mato

An Approach to the Synthesis of a Hepatitis C Virus Inhibitor through a Proline-Catalyzed 1,3-Dipolar Cycloaddition Using Acrolein

An efficient and easy protocol for performing 1,3-dipolar cycloaddition using azomethine ylides and acrolein is presented. The reaction catalyzed by d-proline allows the synthesis of C-3 unsubstituted pyrrolidines. The application of this methodology to the synthesis of an advanced intermediate in the preparation of a Hepatitis C virus inhibitor is presented. Final attempts to complete the synthesis of the target inhibitor results in the preparation of its C-4 epimer in good overall yieldSpanish MCIU (FEDER-CTQ2017-83633P y FEDERPID2020-118422-GB-100), Basque Government (Grupos IT908-16

Organocatalytically Generated Donor − Acceptor Cyclopropanes in Domino Reactions. One-Step Enantioselective Synthesis of Pyrrolo[1,2 ‑ a ]quinolines

An easy and straightforward procedure has been developed for the synthesis of highly enantioenriched pyrrolo-[1,2-a]quinolines through a one-pot process that comprises a domino cyclopropane ring opening/aza-Michael/aldol reaction followed by acid-promoted lactamization. The key feature of the synthetic approach relies on the ability of conveniently functionalized cyclopropaneacetaldehydes to undergo organocatalytic activation by a chiral secondary amine that enables the catalytic generation of a donor acceptor cyclopropane. This intermediate has the potential to undergo a ring opening that generates an electrophilic alpha,beta-unsaturated iminium ion that subsequently reacts through the already mentioned domino sequence and in which stereochemical information is very efficiently transferred from the amine catalyst to the final products. Moreover, one of the alkoxycarbonyl moieties can be easily removed by standard hydrolysis/decarboxylation, providing access to the target adducts as single stereoisomers.This research was supported by the Spanish MINECO (FEDER-CTQ2014-52107-P), the Basque Government (Grupos IT328-10), and UPV/EHU (fellowship to E.S. and UFI QOSYC 11/22). Membership in the COST action CM1407 (NatChemDrugs) is also acknowledged