Waiting room of the bone marrow transplant outpatient clinic: patient and companion experiences

O transplante de células-tronco hematopoiéticas é um procedimento de alta complexidade que vem se constituindo como uma alternativa para algumas doenças potencialmente graves e desencadeadoras de uma série de afecções. A proposta deste estudo é examinar aquilo que o paciente experimenta durante o processo do transplante, especificamente, enquanto aguarda atendimento na sala de espera. Utilizando a narrativa como método de pesquisa, trabalha com o conceito de inconsciente, cuja referência é a teoria psicanalítica. Os resultados encontrados remetem a dois pontos axiais: a imisção do sujeito, isto é, como a questão da identidade passa pela alteridade; e a expectativa por respostas em uma clínica em que as alterações orgânicas podem ser muito ameaçadoras em sua evolução. O percurso feito dá ensejo à pergunta sobre o lugar da palavra na instituição hospitalar e conclui com a proposta que ampliemos nosso olhar sobre aqueles de quem cuidamos.La transplantation de cellules-souches hématopoïétiques est une procédure très complexe, qui réprésente une alternative pour certaines maladies pottentiellement graves et capables de déclancher une séries d’affections. Le but de cette étude est de s’attarder sur ce que le patient éprouve lorsqu’il se trouve dans la salle d’attente pour se faire soigner. Prenant le récit comme méthode de recherche, l’étude s’utilise du concept d’insconscient, emprunté à la théorie psychanalytique. Les résultats nous remettent à deux points axiaux: l’immixtion du sujet, c’est-à-dire, la manière dont la question de l’identité passe par l’altérité et l’espoir d’entendre des réponses au sein d’une clinique où les altérations de l’organisme peuvent se révéler très menaçantes au cours de leur évolution. Le chemin parcouru soulève la question de la place occupée par la parole dans l’institution hospitalière et conclut par la recommandation d’amplifier notre regard sur tous ceux à qui nous apportons des soins.El trasplante de células madre hematopoyéticas es un procedimiento de alta complejidad, que se constituye como alternativa para algunas enfermedades potencialmente graves y desencadenantes de una serie de afecciones. La propuesta de este estudio es examinar lo que el paciente experimenta durante el proceso de trasplante, específicamente mientras aguarda en la sala de espera. Utilizando la narrativa como método de investigación, se trabaja con el concepto de inconsciente, cuya referencia teórica es la teoría psicoanalítica. Los resultados encontrados remiten a dos puntos centrales: la intromisión del sujeto, es decir, como la cuestión de la identificación pasa por la alteridad; y la expectativa por la respuesta en una clínica en que las alteraciones orgánicas pueden ser muy impactantes en su evolución. El recorrido realizado da lugar a la pregunta sobre el lugar de la palabra en el hospital, y concluye con una propuesta para que ampliemos nuestra mirada sobre aquellos que cuidamos.Hematopoietic stem cell transplantation is a highly complex procedure that is becoming an alternative to some potentially serious diseases that trigger a series of conditions. The purpose of this study is to examine what the patient experiences during the transplant process, specifically while awaiting care in the waiting room. Using the narrative as a method of research, we work with the concept of unconscious, whose reference is the psychoanalytic theory. Results found refer to two axial points: the subject’s immixing, i.e., how the issue of identity passes through the otherness; and the expectation of answers in a clinic where organic changes can be very threatening in their evolution. The path traversed gives rise to questions on the role of the word in hospital institutions and concludes with the proposal that we expand our view on those of whom we care

Layered double hydroxide based active corrosion protective sealing of plasma electrolytic oxidation/sol-gel composite coating on AA2024

This work reports a novel approach for growing layered double hydroxide (LDH) films on any plasma electrolytic oxidation (PEO) coated AA2024 independently of the nature of the PEO coating. The specific PEO coating chosen to carry out this work is considered to be not suitable for direct LDH growth because of phase composition and morphological features. In this paper, we describe a new methodology that consists of covering the PEO coating with a thin layer of aluminum oxide based xerogel as the source of aluminate ions for subsequent in-situ LDH growth. X-ray diffraction (XRD) and scanning electron microscope (SEM) images showed a successful formation of LDHs on the surface. An improvement in terms of active corrosion protection was also demonstrated by electrochemical impedance spectroscopy (EIS) and scanning vibrating electrode technique (SVET).publishe

Methyltrimethoxysilane-based elastic aerogels: effects of the supercritical medium on structure-sensitive properties

Effects caused by the type of solvent used for supercritical drying on the properties of methyltrimethoxysilane-based aerogels were studied. All of the aerogel samples studied were found to be hydrophobic and to efficiently adsorb nonpolar organic compounds

Сверхвысокомолекулярный полиэтилен (СВМПЭ) как основа клеточного матрикса для создания 3D клеточной культуры

The study is devoted to the development of an artificial material based on the ultrahigh-molecular weight polyethylene (UHMWPE) with a porous or cellular 3D structure as a cellular matrix – a framework for growing cell cultures. The development of such matrix provides support for neuronal cell culture under conditions that mimick those that exist in the living body. Typically, in vitro cellular studies are conducted in a 2D format, which limits intercellular interactions, morphology, differentiation, survival, signaling responses, gene expression and proliferation that are found in vivo. Here, we propose to use UHMWPE as a material of the cellular matrix, the ultra-high molecular weight polyethylene. UHMWP is a bioinert substance, wich allows forming a system of open connected pores needed to provide cellular life conditions with supply of nutrients and oxygen as well as the removal of waste products, the possibility of intercellular communication, etc. As a result, the use of UHMWPE as a cellular matrix will allow to study the processes occurring in cells in the 3D environment.Работа посвящена анализу свойств искусственного материала на основе сверхвысокомолекулярного полиэтилена (СВМПЭ) с пористой или ячеистой 3D-структурой, который используется в качестве клеточного матрикса – каркаса для выращивания культуры клеток. Разработка такого каркаса обеспечивает культивирование клеточной культуры в условиях, приближенных к тем, которые существуют в живом организме. Как правило, клеточные исследования in vitro проводят в 2D-формате, который по своей природе ограничивает межклеточные взаимодействия, морфологию, дифференцировку, выживаемость, сигнальные ответы, экспрессию генов и пролиферацию, наблюдаемые in vivo. В качестве материала клеточного матрикса предлагается использовать биоинертный сверхвысокомолекулярный полиэтилен (СВМПЭ), который позволяет сформировать систему открытых связанных пор с целью обеспечения клеточной жизнедеятельности – “подвод” питания и кислорода, удаление продуктов жизнедеятельности, возможность осуществления межклеточных связей и т.д. В результате использование СВМПЭ в качестве клеточного матрикса позволит изучить процессы, протекающие в клетках в условиях 3D-среды

Demonstration of an algorithm to overcome health system-related barriers to timely diagnosis of breast diseases in rural Zambia

Background Long delays to diagnosis is a major cause of late presentation of breast diseases in sub-Saharan Africa. Aims We designed and implemented a single-visit breast care algorithm that overcomes health system-related barriers to timely diagnosis of breast diseases. Methods A multidisciplinary team of Zambian healthcare experts trained a team of mid- and high-level Zambian healthcare practitioners how to evaluate women for breast diseases, and train trainers to do likewise. Working collaboratively, the two teams then designed a clinical platform that provides multiple breast care services within a single visit. The service platform was implemented using a breast outreach camp format, during which breast self-awareness, psychosocial counseling, clinical breast examination, breast ultrasound, ultrasound-guided biopsy, imprint cytology of biopsy specimens and surgical treatment or referral, were offered within a single visit. Results Eleven hundred and twenty-nine (1129) women attended the camps for breast care. Mean age was 35.9 years. The majority were multiparous (79.4%), breast-fed (76.0%), and reported hormone use (50.4%). Abnormalities were detected on clinical breast examination in 122 (10.8%) women, 114 of whom required ultrasound. Of the 114 who underwent ultrasound, 48 had identifiable lesions and were evaluated with ultrasound-guided core needle biopsy (39) or fine-needle aspiration (9). The concordance between imprint cytology and histopathology was 100%, when breast specimens were classified as either benign or malignant. However, when specimens were classified by histopathologic subtype, the concordance between imprint cytology and histology was 85.7% for benign and 100% for malignant lesions. Six (6) women were diagnosed with invasive cancer. Eighteen (18) women with symptomatic breast lesions had next-day surgery. Significance Similar to its impact on cervical cancer prevention services, a single visit breast care algorithm has the potential to overcome health system-related barriers to timely diagnosis of breast diseases, including cancer, in rural African settings