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)

Low-Cost, User-Friendly, All-Integrated Smartphone-Based Microplate Reader for Optical-Based Biological and Chemical Analyses

The quantitative detection of different molecular targets is of utmost importance for a variety of human activities, ranging from healthcare to environmental studies. Bioanalytical methods have been developed to solve this and to achieve the quantification of multiple targets from small volume samples. Generally, they can be divided into two different classes: point of care (PoC) and laboratory-based approaches. The former is rapid, low-cost, and user-friendly; however, the majority of the tests are semiquantitative, lacking in specificity and sensitivity. On the contrary, laboratory-based approaches provide high sensitivity and specificity, but the bulkiness of experimental instruments and complicated protocols hamper their use in resource-limited settings. In response, here we propose a smartphone-based device able to support laboratory-based optical techniques directly at the point of care. Specifically, we designed and fabricated a portable microplate reader that supports colorimetric, fluorescence, luminescence, and turbidity analyses. To demonstrate the potential of the device, we characterized its analytical performance by detecting a variety of relevant molecular targets (ranging from antibodies, toxins, drugs, and classic fluorophore dyes) and we showed how the estimated results are comparable to those obtained from a commercial microplate reader. Thanks to its low cost (< $3 00), portability (27 cm [length] × 18 cm [width] × 7 cm [height]), commercially available components, and open-source-based system, we believe it represents a valid approach to bring high-precision laboratory-based analysis at the point of care

Crohn’s Disease Increases the Mesothelial Properties of Adipocyte Progenitors in the Creeping Fat

Malaltia de Crohn; Teixit adipós; MesoteliEnfermedad de Crohn; Tejido adiposo; MesotelioCrohn’s disease; Adipose tissue; MesotheliumOur understanding of the interplay between human adipose tissue and the immune system is limited. The mesothelium, an immunologically active structure, emerged as a source of visceral adipose tissue. After investigating the mesothelial properties of human visceral and subcutaneous adipose tissue and their progenitors, we explored whether the dysfunctional obese and Crohn’s disease environments influence the mesothelial/mesenchymal properties of their adipocyte precursors, as well as their ability to mount an immune response. Using a tandem transcriptomic/proteomic approach, we evaluated the mesothelial and mesenchymal expression profiles in adipose tissue, both in subjects covering a wide range of body-mass indexes and in Crohn’s disease patients. We also isolated adipose tissue precursors (adipose-derived stem cells, ASCs) to assess their mesothelial/mesenchymal properties, as well as their antigen-presenting features. Human visceral tissue presented a mesothelial phenotype not detected in the subcutaneous fat. Only ASCs from mesenteric adipose tissue, named creeping fat, had a significantly higher expression of the hallmark mesothelial genes mesothelin (MSLN) and Wilms’ tumor suppressor gene 1 (WT1), supporting a mesothelial nature of these cells. Both lean and Crohn’s disease visceral ASCs expressed equivalent surface percentages of the antigen-presenting molecules human leucocyte antigen—DR isotype (HLA-DR) and CD86. However, lean-derived ASCs were predominantly HLA-DR dim, whereas in Crohn’s disease, the HLA-DR bright subpopulation was increased 3.2-fold. Importantly, the mesothelial-enriched Crohn’s disease precursors activated CD4+ T-lymphocytes. Our study evidences a mesothelial signature in the creeping fat of Crohn’s disease patients and its progenitor cells, the latter being able to present antigens and orchestrate an immune response.This work was supported by grants from the Spanish Ministry of Science, Innovation and Universities (PI14/00228 and PI17/01503 to JV, SAF2015-65019-R to SF-V, BFU2015-70454-REDT and BFU2017-90578-REDT to SF-V and MMM, BFU2016-76711-R to MMM and PI15/00143 and PI18/00037 to CS) co-financed by the European Regional Development Fund (ERDF) and by Fundació La Marató de TV3 (PV170125) to SF-V and the European Crohn’s and Colitis Organization (ECCO) grant to CS. The Spanish Biomedical Research Center in Diabetes and Associated Metabolic Disorders (CIBERDEM) (CB07708/0012) is an initiative of the Instituto de Salud Carlos III. AM is a recipient of a postdoctoral fellowship from FJCI-2014-23060 and IJCI-2016-30572. SF-V acknowledges support from the Miguel Servet tenure-track program (CP10/00438 and CPII16/00008) of the Fondo de Investigación Sanitaria, co-financed by the ERDF. C.S. acknowledges support from the ‘Ramón y Cajal’ program from MINECO (RYC2013-13186), co-financed by the ERDF

Descritpion of a double mutant strain of Drosophila melanogaster useful for genetic laboratory courses.

Many years ago, individuals showing drastically reduced eyes arose in our laboratory e (ebony) strain (Bridges and Morgan, 1923). We selected those flies presenting both traits and constituted a new double mutant strain e su (e, ebony; su, 'sense ulls', eyes drastically reduced). Both mutations were linked and located in the chromosome III. We used this strain in linkage analyses with our undergraduate students. [...

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

HIV-1/HAART-Related Lipodystrophy Syndrome (HALS) Is Associated with Decreased Circulating sTWEAK Levels

Background and Objectives Obesity and HIV-1/HAART-associated lipodystrophy syndrome (HALS) share clinical, pathological and mechanistic features. Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is a multifunctional cytokine that plays an important role in obesity and related diseases. We sought to explore the relationship between HALS and circulating levels of soluble (s) TWEAK and its scavenger receptor sCD163. Methods This was a cross-sectional multicenter study of 120 HIV-1-infected patients treated with a stable HAART regimen; 56 with overt HALS and 64 without HALS. Epidemiological and clinical variables were determined. Serum levels of sTWEAK and sCD163 levels were measured by ELISA. Results were analyzed with Student's t-test, Mann-Whitney U and χ2 test. Pearson and Spearman correlation were used to estimate the strength of association between variables. Results Circulating sTWEAK was significantly decreased in HALS patients compared with non-HALS patients (2.81±0.2 vs. 2.94±0.28 pg/mL, p = 0.018). No changes were observed in sCD163 levels in the studied cohorts. On multivariate analysis, a lower log sTWEAK concentration was independently associated with the presence of HALS (OR 0.027, 95% CI 0.001-0.521, p = 0.027). Conclusions HALS is associated with decreased sTWEAK levels

Adipose tissue mitochondrial dysfunction in human obesity is linked to a specific DNA methylation signature in adipose-derived stem cells

Background: A functional population of adipocyte precursors, termed adipose-derived stromal/stem cells (ASCs), is crucial for proper adipose tissue (AT) expansion, lipid handling, and prevention of lipotoxicity in response to chronic positive energy balance. We previously showed that obese human subjects contain a dysfunctional pool of ASCs. Elucidation of the mechanisms underlying abnormal ASC function might lead to therapeutic interventions for prevention of lipotoxicity by improving the adipogenic capacity of ASCs. Methods: Using epigenome-wide association studies, we explored the impact of obesity on the methylation signature of human ASCs and their differentiated counterparts. Mitochondrial phenotyping of lean and obese ASCs was performed. TBX15 loss- and gain-of-function experiments were carried out and western blotting and electron microscopy studies of mitochondria were performed in white AT biopsies from lean and obese individuals. Results: We found that DNA methylation in adipocyte precursors is significantly modified by the obese environment, and adipogenesis, inflammation, and immunosuppression were the most affected pathways. Also, we identified TBX15 as one of the most differentially hypomethylated genes in obese ASCs, and genetic experiments revealed that TBX15 is a regulator of mitochondrial mass in obese adipocytes. Accordingly, morphological analysis of AT from obese subjects showed an alteration of the mitochondrial network, with changes in mitochondrial shape and number. Conclusions: We identified a DNA methylation signature in adipocyte precursors associated with obesity, which has a significant impact on the metabolic phenotype of mature adipocytes

Personal non-commercial use only

ABSTRACT. Objective. To determine the level of residual inflammation [synovitis, bone marrow edema (BME), tenosynovitis, and total inflammation] quantified by hand magnetic resonance imaging (h-MRI) in patients with rheumatoid arthritis (RA) in remission according to 3 different definitions of clinical remission, and to compare these remission definitions. Methods. A cross-sectional study. To assess the level of residual MRI inflammation in remission, cutoff levels associated to remission and median scores of MRI residual inflammatory lesions were calculated. Data from an MRI register of patients with RA who have various levels of disease activity were used. These were used for the analyses: synovitis, BME according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system, tenosynovitis, total inflammation, and disease activity composite measures recorded at the time of MRI. Receiver-operating characteristic analysis was used to identify the best cutoffs associated with remission for each inflammatory lesion on h-MRI. Median values of each inflammatory lesion for each definition of remission were also calculated. Results. A total of 388 h-MRI sets of patients with RA with different levels of disease activity, 130 in remission, were included. Cutoff values associated with remission according to the Simplified Disease Activity Index (SDAI) ≤ 3.3 and the Boolean American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) definitions for BME and tenosynovitis (1 and 3, respectively) were lower than BME and tenosynovitis (2 and 5, respectively) for the Disease Activity Score on 28 joints (DAS28) ≤ 2.6. Median scores for synovitis, BME, and total inflammation were also lower for the SDAI and Boolean ACR/EULAR remission criteria compared with DAS28. Conclusion. Patients with RA in remission according to the SDAI and Boolean ACR/EULAR definitions showed lower levels of MRI-detected residual inflammation compared with DAS28

A Prospective Cohort of SARS-CoV-2-Infected Health Care Workers: Clinical Characteristics, Outcomes, and Follow-up Strategy

Background. During the coronavirus disease 2019 (COVID-19) outbreaks, health care workers (HCWs) are at a high risk of infection. Strategies to reduce in-hospital transmission between HCWs and to safely manage infected HCWs are lacking. Our aim was to describe an active strategy for the management of COVID-19 in severe acute respiratory syndrome coronavirus 2 (SARSCoV-2)-infected HCWs and investigate its outcomes. Methods. A prospective cohort study of SARS-CoV-2-infected health care workers in a tertiary teaching hospital in Barcelona, Spain, was performed. An active strategy of weekly polymerase chain reaction screening of HCWs for SARS-CoV-2 was established by the Occupational Health department. Every positive HCW was admitted to the Hospital at Home Unit with daily assessment online and in-person discretionary visits. Clinical and epidemiological data were recorded. Results. Of the 590 HCWs included in the cohort, 134 (22%) were asymptomatic at diagnosis, and 15% (89 patients) remained asymptomatic during follow-up. A third of positive cases were detected during routine screening. The most frequent symptoms were cough (68%), hyposmia/anosmia (49%), and fever (41%). Ten percent of the patients required specific treatment at home, while only 4% of the patients developed pneumonia. Seventeen patients required a visit to the outpatient clinic for further evaluation, and 6 of these (1%) required hospital admission. None of the HCWs included in this cohort required intensive care unit admission or died. Conclusions. Active screening for SARS-CoV-2 among HCWs for early diagnosis and stopping in-hospital transmission chains proved efficacious in our institution, particularly due to the high percentage of asymptomatic HCWs. Follow-up of HCWs in Hospital at Home units is safe and effective, with low rates of severe infection and readmission. Keywords. coronavirus; COVID-19; health care workers; Hospital at Home; SARS-CoV-2

Localized Plasticity in the Streamlined Genomes of Vinyl Chloride Respiring Dehalococcoides

Vinyl chloride (VC) is a human carcinogen and widespread priority pollutant. Here we report the first, to our knowledge, complete genome sequences of microorganisms able to respire VC, Dehalococcoides sp. strains VS and BAV1. Notably, the respective VC reductase encoding genes, vcrAB and bvcAB, were found embedded in distinct genomic islands (GEIs) with different predicted integration sites, suggesting that these genes were acquired horizontally and independently by distinct mechanisms. A comparative analysis that included two previously sequenced Dehalococcoides genomes revealed a contextually conserved core that is interrupted by two high plasticity regions (HPRs) near the Ori. These HPRs contain the majority of GEIs and strain-specific genes identified in the four Dehalococcoides genomes, an elevated number of repeated elements including insertion sequences (IS), as well as 91 of 96 rdhAB, genes that putatively encode terminal reductases in organohalide respiration. Only three core rdhA orthologous groups were identified, and only one of these groups is supported by synteny. The low number of core rdhAB, contrasted with the high rdhAB numbers per genome (up to 36 in strain VS), as well as their colocalization with GEIs and other signatures for horizontal transfer, suggests that niche adaptation via organohalide respiration is a fundamental ecological strategy in Dehalococccoides. This adaptation has been exacted through multiple mechanisms of recombination that are mainly confined within HPRs of an otherwise remarkably stable, syntenic, streamlined genome among the smallest of any free-living microorganism