Tratamiento actual de las metástasis hepáticas de origen colorrectal

Con este trabajo queremos resaltar la importancia del impacto que consiguen tanto el tratamiento quirúrgico (siendo el único curativo) como las distintas terapias complementarias a éste, a la hora de abordar las metástasis hepáticas de origen cáncer colorrectal (MHCCR). Algo que unos años atrás era imposible, por no decir casi impensable con los medios, estudios y técnicas que existían en el momento. No es necesario pensar en un pasado muy lejano, ya que los avances en este campo han sido en un período de tiempo relativamente corto. Nuestro trabajo es el resultado de una revisión bibliográfica de artículos adquiridos en: medline, uptodate y revistas de gran impacto como Lancet. Con un gran volumen inicial de artículos, hemos analizado aquellos que nos parecen de mayor impacto para llevar llevar a cabo nuestra revisión.Grado en Medicin

COVID‑19 vaccine literacy in patients with systemic autoimmune diseases

Funding for open access charge: Universidad de Granada/CBUA.COVID-19 related infodemic is a threat to the successful COVID-19 vaccination campaigns. This might be especially apparent for patients with autoimmune diseases since there is no data available about the balance between benefits and risks of the newly developed COVID-19 vaccines in this population. We aim (i) to evaluate vaccine literacy skills in a population of patients with systemic autoimmune diseases, (ii) to examine the potential associations between vaccine literacy skills and sociodemographic characteristics and (iii) to analyze the relationships between attitudes, perceptions and beliefs about current vaccinations and vaccine literacy skills and sociodemographic characteristics. A cross-sectional study was conducted among 319 patients with systemic autoimmune diseases (92% females; 49.5% of patients in the 31–50 years age category). The vaccine literacy levels were determined using the Health Literacy about Vaccination in adulthood in Italian (HLVa-IT). Sociodemographic characteristics including gender, age, country and area of residence, civil status, socioeconomic status, educational attainment and occupational status were evaluated. The mean vaccine literacy functional and interactive-critical scores were 2.59 ± 0.74 and 3.07 ± 0.60, respectively. The vaccine literacy interactive-critical score was higher in females than in males (p = 0.048). Interactive-critical scores were associated with the area of residence, civil status and socioeconomic status, with the highest score in urban area of ≥ 100.000 inhabitants (p = 0.045), in widow patients (p = 0.023) and in patients with high socioeconomic status (p = 0.018). Significant differences were observed between the different education levels, for both the functional and the interactive-critical scores (p = 0.002 and p < 0.001, respectively), the highest score was observed in patients who completed a university degree. The level of vaccine literacy for functional and interactive-critical scales were medium. Area of residence, civil status and socioeconomic status represented determinants of vaccine literacy interactive-critical scale. Educational attainment also contributes to vaccine literacy functional scale. Insight into these factors is required to ensure an optimal vaccine literacy level in patients with autoimmune diseases.Universidad de Granada/CBU

The Prognostic Nutritional Index and Nutritional Risk Index Are Associated with Disease Activity in Patients with Systemic Lupus Erythematosus

The prognostic nutritional index (PNI), controlling nutritional status (CONUT) score and nutritional risk index (NRI) have been described as useful screening tools for patient prognosis in several diseases. The aim of this study was to examine the relationship between PNI, CONUT and NRI with clinical disease activity and damage in 173 patients with systemic lupus erythematous (SLE). Disease activity was assessed with the SLE disease activity index (SLEDAI-2K), and disease-related organ damage was assessed using the SLICC/ACR damage index (SDI) damage index. PNI and NRI were significantly lower in active SLE patients than in inactive SLE patients (p < 0.001 and p = 0.012, respectively). PNI was inversely correlated with the SLEDAI score (p < 0.001) and NRI positively correlated with SLEDAI and SDI scores (p = 0.027 and p < 0.001). Linear regression analysis adjusting for age, sex and medications showed that PNI was inversely correlated with SLEDAI ( (95% CI) = -0.176 (-0.254, -0.098), p < 0.001) and NRI positively correlated with SLEDAI ( (95% CI) = 0.056 (0.019, 0.093), p = 0.003) and SDI ( (95% CI) = 0.047 (0.031, 0.063), p < 0.001). PNI (odds ratio (OR) 0.884, 95% confidence interval (CI) 0.809–0.967, p = 0.007) and NRI ((OR) 1.067, 95% CI 1.028–1.108, p = 0.001) were independent predictors of active SLE. These findings suggest that PNI and NRI may be useful markers to identify active SLE in clinical practice.This study was supported by the grant PI0523-2016 from “Consejería de igualdad, salud y políticas sociales” (Junta de Andalucía) and is part of the research group LyDIMED “Lupus y Dieta Mediterránea”. G. Pocovi-Gerardino is a predoctoral fellow from the doctoral program “Medicina clínica y salud pública” of the University of Granad

Literature review of evaluation methods of the clinicalinterview in health sciences

La entrevista clínica se considera de gran importancia en la educación de los profesionales de la salud para que estos posean las habilidades necesarias para afrontar con éxito la relación terapeuta-paciente. Los objetivos de esta revisión bibliográfica exploratoria consisten en averiguar si, en la literatura actual, existen métodos de evaluación de forma escrita que permitan medir la entrevista clínica en Fisioterapia y en otras carreras de Ciencias de la Salud como Medicina o Enfermería. Y como segundo objetivo, si coinciden los métodos de evaluación utilizados en cada una de ellas, observando, además, la posible existencia o no desigualdades entre las mismas. Se revisó la información existente en los buscadores PubMed, Cochrane, PEDro, Google Académico o ScienceDirect, entre otros. Se utilizaron estudios realizados entre los años 2000 y 2020. Finalmente se aplicaron los criterios de inclusión y exclusión mediante la Declaración PRISMA. Se encontraron un total de 9 trabajos que expresan la existencia de cuestionarios o escalas en las titulaciones anteriormente referidas (Medicina, Enfermería y Fisioterapia) y nos permiten ver las diferencias entre unos métodos y otros. Además, la escala PRISMA aporta información de calidad que nos permite observar las similitudes y diferencias en cuanto al contenido de los artículos. Existe evidencia disponible en las distintas disciplinas y en todas ellas existe una coincidencia en cuanto a los cuestionarios o escalas utilizados. Se necesita mayor investigación futura en este campo, sobre todo en Fisioterapiathe clinical interview is considered of great importance in the education of healthprofessionals so that they have the necessary skills to successfully face the therapist-patientrelationship. The objectives of this exploratory bibliographical review consist of finding out if, in thecurrent literature, there are written evaluation methods that allow measuring the clinical interviewin Physiotherapy and in other Health Sciences careers such as Medicine or Nursing. And as asecond objective, if the evaluation methods used in each of them coincide, observing, in addition,the possible existence or not of inequalities between them. The existing information in the PubMed,Cochrane, PEDro, Google Scholar or ScienceDirect search engines, among others, was reviewed.Studies carried out between the years 2000 and 2020 were used. Finally, the inclusion and exclusioncriteria were applied through the PRISMA Declaration. A total of 9 works were found that expressthe existence of questionnaires or scales in the aforementioned degrees (Medicine, Nursing andPhysiotherapy) and allow us to see the differences between some methods and others. In addition,the PRISMA scale provides quality information that allows us to observe the similarities and differences in terms of the content of the articles. There is evidence available in the differentdisciplines and in all of them there is a coincidence in terms of the questionnaires or scales used.More future research is needed in this field, especially in Physiotherap

Novel potential scaffold for periodontal tissue engineering.

Objective: Characterization of novel calcium and zinc loaded electrospun matrices for periodontal regeneration. Materials and Methods: A polymethylmetacrylate-based membrane was calcium or zinc loaded. Matrices were characterized morphologically by atomic force and scanning electron microscopy, and mechanically probed by a nanoindenter. Biomimetic calcium phosphate precipitation on polymeric tissues was assessed. Cell viability tests were performed using oral mucosa fibroblasts. Data were analyzed by Kruskal-Wallis and Mann-Whitney tests or by ANOVA and Student- Newman-Keuls multiple comparisons. Results: Zinc and calcium loading on matrices did not modify their morphology but increased nanomechanical properties and decreased nanoroughness. Precipitation of calcium and phosphate on the matrices surfaces was observed in zinc-loaded specimens. Matrices were found to be non-toxic to cells in all the assays. Calcium and zinc-loaded scaffolds presented a very low cytotoxic effect. Conclusions: Zinc-loaded membranes permit cells viability and promoted mineral precipitation in physiological conditions. Based on the tested nanomechanical properties and scaffold architecture, the proposed membranes may be suitable for cell proliferation. Clinical Relevance: The ability of zinc-loaded matrices to promote precipitation of calcium phosphate deposits, together with their observed non-toxicity and its surface chemistry allowing covalent binding of proteins, may offer new strategies for periodontal regeneration.Project MAT2014-52036-P supported by the Ministry of Economy and Competitiveness (MINECO) and European Regional Development Fund (FEDER)

Video-analysis in health sciences: a simulation experience in the clinical interview in physical therapy

Las tecnologías posibilitan la supresión de las barreras espaciales y temporales que la educación superior ha sufrido por la actual pandemia COVID-19, aportando nuevos escenarios educativos. El vídeo-análisisabre una ventana para la evaluación en la enseñanza clínica en Ciencias de la Salud. El objetivo de esta investigación es estudiar la viabilidad del vídeo-análisis para analizar habilidades en la entrevista clínica en fisioterapia. Se realizó un estudio exploratorio con análisis de video y lista de cotejo en estudiantes de primer año .Gracias a los videos recopilados, se determinó que los alumnos analizados tienen mejor desarrolladas las habilidades relacionadas con realizar preguntas apropiadas en la entrevista, mientras que por el contrario existen más dificultades en las habilidades de saber escuchar. Los resultados muestran que el video-análisis es una herramienta práctica y válida para analizar tareas en entornos de simulación en ciencias de la salud, como ha sidoen esta actividad de entrevista clínica. Esta nueva forma de evaluación docente, además de aportar datos cuantificables, supone una nueva forma de justificar al alumno sus errores y aciertos durante la prueba, permitiendo establecer un potencial feedback para mejorar en sus habilidades clínicas. Así mismo, la posibilidad de evaluarse con un paciente simulado supone un acercamiento a la realidad profesional a la que se deben enfrentar una vez egresadosTechnologies make it possible to remove the spatial and temporal barriers that higher education has suffered due to the current COVID-19 pandemic, due to provide new educational scenarios. Video-analysis opens a window for evaluation in clinical teaching in Health Sciences. The objective of this research is to study the feasibility of video-analysis to analyze skills in the clinical interview in physiotherapy. An exploratory study with video analysis and checklist was conducted on first-year students. Thanks to the videos collected, it was determined that the students analyzed have better developed skills related to asking appropriate questions in the interview, while on the contrary there are more difficulties in listening skills. The results show that video-analysis is a practical and valid tool to analyze tasks in simulation environments in health sciences, as it has been in this clinical interview activity. Moreover, this innovative kind of evaluation provides quantifiable data, it is also a new way of justifying the student's mistakes and successes during the test, allowing them to establish potential feedback to improve their clinical skills. Likewise, the possibility of being evaluated with a simulated patient supposes an approach to the professional reality that they must face once they graduate.Fisioterapi

El trabajo y la salud mental de las profesoras de preescolar de la zona metropolitana de Guadalajara

 Objetivo: Identificar la relación entre el trabajo y la salud mental de las profesoras de preescolar de la zona metropolitana de Guadalajara (ZMG). Materiales y métodos:Se realizó un estudio transversal analítico en profesoras de nivel preescolar. Los datos se obtuvieron con un formulario de datos sociolaborales y el Cues- tionario General de Salud de Goldberg (GHQ 30) punto de corte 7/8 considerado con trastorno o “si caso”. Para identificar la asociación se utilizó el chi cuadrado y el OR con una significancia &lt; 0.05. Resultados: Participaron en el estudio 286 profesoras, con una media de edad de 38.30 años (± 8.298). En promedio tenían 15 años (±9.1) como educadoras. El 25 % de las profesoras fueron consideradas como “si caso”; según los resultados de la prueba GQH-30, 45.5% presentó perturbación del sueño y 43.0 % síntomas somáticos. Se observó asociación y riesgo cuando se percibe que el trabajo tiene que ver con problemas de salud y faltar al trabajo por estos problemas, cuando se tiene más edad y más antigüedad como educadora p&lt;0.05. Conclusión: Al haber identificado 1 de cada 4 profesoras como “si caso” y los trastornos del sueño y los síntomas somáticos como los más prevalentes, nos orientan a considerar esta población con sufrimiento psíquico, que requiere atención especial y evaluaciones periódicas con instrumentos psicométricos adecuados para favorecer la detección oportuna de casos y la prevención de enfermedades mentales

Targeting metabolic plasticity in glioma stem cells in vitro and in vivo through specific inhibition of c-Src by TAT-Cx43266-283

Background: Glioblastoma is the most aggressive primary brain tumour and has a very poor prognosis. Inhibition of c-Src activity in glioblastoma stem cells (GSCs, responsible for glioblastoma lethality) and primary glioblastoma cells by the peptide TAT-Cx43266-283 reduces tumorigenicity, and boosts survival in preclinical models. Because c-Src can modulate cell metabolism and several reports revealed poor clinical efficacy of various antitumoral drugs due to metabolic rewiring in cancer cells, here we explored the inhibition of advantageous GSC metabolic plasticity by the c-Src inhibitor TAT-Cx43266-283. Methods: Metabolic impairment induced by the c-Src inhibitor TAT-Cx43266-283 in vitro was assessed by fluorometry, western blotting, immunofluorescence, qPCR, enzyme activity assays, electron microscopy, Seahorse analysis, time-lapse imaging, siRNA, and MTT assays. Protein expression in tumours from a xenograft orthotopic glioblastoma mouse model was evaluated by immunofluorescence. Findings: TAT-Cx43266-283 decreased glucose uptake in human GSCs and reduced oxidative phosphorylation without a compensatory increase in glycolysis, with no effect on brain cell metabolism, including rat neurons, human and rat astrocytes, and human neural stem cells. TAT-Cx43266-283 impaired metabolic plasticity, reducing GSC growth and survival under different nutrient environments. Finally, GSCs intracranially implanted with TAT-Cx43266-283 showed decreased levels of important metabolic targets for cancer therapy, such as hexokinase-2 and GLUT-3. Interpretation: The reduced ability of TAT-Cx43266-283-treated GSCs to survive in metabolically challenging settings, such as those with restricted nutrient availability or the ever-changing in vivo environment, allows us to conclude that the advantageous metabolic plasticity of GSCs can be therapeutically exploited through the specific and cell-selective inhibition of c-Src by TAT-Cx43266-283.Spanish Ministerio de Economía y Competitividad (FEDER BFU2015-70040-R and FEDER RTI2018-099873-B-I00), Fundación Ramón Areces. Fellowships from the Junta de Castilla y León, European Social Fund, Ministerio de Ciencia and Asociación Española Contra el Cáncer (AECC)

Mitochondrial bioenergetic is impaired in Monocarboxylate transporter 1 deficiency: a new clinical case and review of the literature

Background: Monocarboxylate transporter 1 (MCT1) deficiency has recently been described as a rare cause of recurrent ketosis, the result of impaired ketone utilization in extrahepatic tissues. To date, only six patients with this condition have been identified, and clinical and biochemical details remain incomplete. Results: The present work reports a patient suffering from severe, recurrent episodes of metabolic acidosis and psychomotor delay, showing a pathogenic loss-of-function variation c.747_750del in homozygosity in SLC16A1 (which codes for MCT1). Persistent ketotic and lactic acidosis was accompanied by an abnormal excretion of organic acids related to redox balance disturbances. Together with an altered bioenergetic profile detected in patient-derived fibroblasts, this suggests possible mitochondrial dysfunction. Brain MRI revealed extensive, diffuse bilateral, symmetric signal alterations for the subcortical white matter and basal ganglia, together with corpus callosum agenesia. Conclusions: These findings suggest that the clinical spectrum of MCT1 deficiency not only involves recurrent atacks of ketoacidosis, but may also cause lactic acidosis and neuromotor delay with a distinctive neuroimaging pattern including agenesis of corpus callosum and other brain signal alterationsThis work was funded by grant PI19/01155, B2017/BMD-3721 and the European Regional Development Fund. Open Acces is supported by Fundación Ramón Areces (Grant No. CIVP17A2827

Ciencia abierta y la producción científica de la Universidad de Camagüey en redes sociales académicas

Objetivo. Analizar la presencia de la comunidad científica de la Universidad de Camagüey y su producción científica en ResearchGate y Google Scholar, herramientas de elevado uso social, también se han extendido al contexto académico y tienen un papel esencial en el desarrollo de la ciencia abierta.Diseño/Metodología/Enfoque. La investigación se desarrolla a partir del análisis empírico del comportamiento de toda la actividad que se genera en ResearchGate y Google Scholar a través de los indicadores almétricos presentes en estos espacios digitales. Resultados/Discusión. Los resultados obtenidos muestran la existencia de los investigadores dicha institución y su labor científica y académica en ResearchGate y Google Scholar, así como el aprovechamiento de sus prestaciones para la difusión de resultados científicos. Además, se observó poca presencia de la comunidad científica de la institución en ambas plataformas. Conclusiones. Posicionar la producción científica de las universidades en plataformas de colaboración científica como las redes sociales académicas, esta es una práctica de vital importancia para visibilidad de la ciencia en la web y de cara a dar nuevos pasos en el desarrollo de la ciencia abierta.  A pesar de ello, la presencia de la Universidad de Camagüey en ResearchGate y Google Scholar es discreta y no se corresponden con la capacidad científico- investigativa de la institución académica. Originalidad/Valor. El enfoque de la investigación permite apreciar la sinergia entre ciencia abierta, investigación científica, comunicación científica y redes sociales académicas. A través de la estructura científica del centro, se analiza su comportamiento en ResearchGate y Google Scholar.