Reconstrucción de productos hematopoyéticos criopreservados : control de calidad, estabilidad osmótica y lavado de DMSO /

Consultable des del TDXTítol obtingut de la portada digitalitzadaLa logística de un Trasplante de Progenitores Hematopoyéticos (TPH) incluye en la mayoría de casos (TPH autólogo y de Sangre de Cordón Umbilical (SCU)), una etapa de criopreservación a temperaturas de -196ºC. Las técnicas de congelación más extendidas utilizan DMSO como crioprotector para optimizar la viabilidad y funcionalidad de las células reduciendo la proporción de agua congelada y la deshidratación intracelular durante el proceso de congelación. La presencia del crioprotector hace que las suspensiones celulares descongeladas sean hipertónicas y como las células responden importando y exportando agua frente a un cambio de osmolaridad, el retorno a condiciones isotónicas puede resultar en la superación de los límites mecánicos de las membranas plasmáticas por una entrada masiva de agua al citoplasma (choque osmótico). Este fenómeno es de especial importancia durante la reconstitución y manipulación de células descongeladas debido a que la membrana celular es un conjunto de lípidos y proteínas organizados que por debajo de los 20ºC pierde fluidez, limitando su resistencia y por tanto su capacidad de respuesta osmótica. En 1978, el profesor John Goldman95 publicó las primeras evidencias del fenómeno de choque osmótico sobre la reducción de capacidad clonogénica en médula ósea (MO) descongelada. Sin embargo, este trabajo no ha tenido una gran repercusión en los protocolos de criopreservación seguramente porque el número de Células Progenitoras Hematopoyéticas (CPH) en MO y en Aféresis (CPH-A) está por encima del umbral mínimo definido para uso clínico. Esta situación cambia en el momento que la SCU se define como fuente de células progenitoras debido a su limitada proporción en estos productos. Así, en 1995 el Dr. Pablo Rubinstein139 reabre el debate de la relevancia del choque osmótico en productos hematopoyéticos descongelados e introduce la estabilidad osmótica previa a la infusión para reducir el efecto del cambio brusco de osmolaridad durante el retorno a condiciones isotónicas. Para la práctica diaria de un laboratorio de procesamiento celular, y por extensión para el equipo clínico de trasplante, el choque osmótico afecta a los controles de calidad del descongelado si estos incluyen manipulaciones que impliquen cambios bruscos de osmolaridad. En este sentido, un caso muy llamativo es el de la citometría de flujo (CMF), no en vano, casi ningún laboratorio realiza este tipo de análisis en muestras descongeladas debido seguramente a la falta de correlación con los datos precongelación. Más alarmante es el hecho de que la infusión directa de los inóculos descongelados pueda ser también una fuente de choque osmótico que comprometa la viabilidad celular resultando, en el caso de TPH con dosis límite de CPH, determinante para el éxito de la recuperación hematopoyética. En este ámbito se ha desarrollado el trabajo experimental de esta Tesis Doctoral que proporciona evidencias, cuantifica el efecto del choque osmótico en los controles de calidad de productos hematopoyéticos descongelados, propone un método de CMF para su análisis y valida dos sistemas automáticos aptos para la clínica que rinden productos estabilizados osmóticamente, listos para trasplante y sin pérdida celular ni de viabilidad significativas.Current logistics of Hemopoetic Progenitor Cells Transplant (HPT) usually includes (Autologous HPT and Umbilical Cord Blood Cells (UCB) Transplant) a cryopreservation step at temperatures of -196ºC. Dimethyl sulfoxide, the most used cryoprotector raises cellular viability and function both by reducing frozen water proportion as well as intracellular dehydration during the freezing process of cells. Presence of cryoprotector makes thawed cellular suspension hypertonic and as cells respond importing and exporting water from their cytoplasm in front of changes of osmolarity, the return to isotonic conditions may surpass the mechanical limits of plasmatic membranes by means of a massive entry of water into the cytoplasm (osmotic shock).This is specially important during the reconstitution and manipulation of thawed cells because cell membrane is a set of organized lipids and proteins that below of 20ºC loose fluidity thus limiting resistance and so capacity of response in front of an osmotic shock. In 1978, first evidences about the reduced clonogenicity in thawed cells from Bone Marrow (BM) were published by professor John Goldman. However, these results have not had great repercussion on cryopreservation protocols possibly because the huge number of progenitor cells in BM and Apheresis (HPC-A). This situation changes when UCB is defined as a suitable source of progenitor cells due to the limited number of cells in these products. In this regard, Dr. Pablo Rubinstein reopens in 1995 the debate about the relevance of osmotic shock in thawed progenitor cells grafts. In that work, osmotic stability before infusion was introduced to reduce deleterious effect of sudden changes in osmolarity during the return to isotonic conditions. Considering Cell Processing laboratories current practices, osmotic shock concerns quality controls of thawed cells when sudden changes in osmolarity are included in these techniques. It is specially relevant when Flow Cytometry is considered because almost no laboratory uses this technique to analyze thawed samples because of the lack of correlation with pre freeze data. In addition, direct infusion of thawed grafts could be a source of osmotic shock altering cells viability which, in case of limiting number of progenitor cells in the graft, could affect hemopoètic recovery of the transplanted patient. In this field has been developed the experimental of the present Doctoral Thesis which provides evidences and quantify the effect of the osmotic shock in quality controls of thawed hemopoetic grafts as well as proposes a method of Flow Cytometry to analyze them. Finally, in this work two automatic systems available for the clinic were validated to wash DMSO and producing osmotically stabilized products without significant looses of viability and progenitor cells

A poesía de Aquilino Iglesia Alvariño

[Resumen] La tesis que bajo el titulo a poesía de Aquilino Iglesia Alvariño, leida en la facultade de humanidades da Universidade da Coruña, el dia 22 de octubre de 1993, responde a la siguiente línea investigadora: a través de ocho capítulos estructurados en dos partes - o autor e o contexto literario y unha lectura da poética aquiliniana - tratamos de situar la obra de este autor lucense en las coordenadas vitales, poéticas y sociales de su época. Nos centramos en la biografía mínima que nos permitiera entender ciertas actitudes y comportamientos del autor frente a la sociedad literaria. A continuación pasamos revista al contexto literario poniendo de manifiesto las principales direcciones literarias del momento. Despules nos ocupamos de la lectura individual de cada poemario - Señarda (1930), Corazón ao vento (1933), Comaros verdes (1947), De dia a dia (1960), Lanza de soleda (1961) y nenias (1961) - respondiendo a una propuesta tematico-estilistica que desenvolvimos bajo estos epígrafes: recepción de la obra por sus coetáneos y fortuna literaria posterior, diseño editorial, lectura temática e intertextualidades, el sistema expresivo y los símbolos configurativos de su mundo poético. La obra de Aquilino Iglesia Alvariño (1909-1961) representa un ejemplo claro dentro de la literatura gallega de sabia conjunción entre tradición y modernidad, pasado y presente, sabiendo aprovechar las enseñanzas de la literatura greco-latina, no sin por eso dejar de dar respuesta a una serie de preocupaciones e interrogantes de hombre del siglo XX

Maternal and fetal risks of planned vaginal breech delivery vs planned caesarean section for term breech birth: A systematic review and meta-analysis

Background Breech presentation delivery approach is a controversial issue in obstetrics. How to cope with breech delivery (vaginal or C-section) has been discussed to find the safest in terms of morbidity. The aim of this study was to assess the risks of foetal and maternal mortality and perinatal morbidity associated with vaginal delivery against elective caesarean in breech presentations, as reported in observational studies. Methods Studies assessing perinatal morbidity and mortality associated with breech presentations births. Cochrane, Medline, Scopus, Embase, Web of Science, and Cuiden databases were consulted. This protocol was registered in PROSPERO CRD42020197598. Selection criteria were: years between 2010 and 2020, in English language, and full-term gestation (37-42 weeks). The methodological quality of the eligible articles was assessed according to the Newcastle-Ottawa scale. Meta-analyses were performed to study each parameter related to neonatal mortality and maternal morbidity. Results The meta-analysis included 94 285 births with breech presentation. The relative risk of perinatal mortality was 5.48 (95% confidence interval (CI) = 2.61-11.51) times higher in the vaginal delivery group, 4.12 (95% CI = 2.46-6.89) for birth trauma and 3.33 (95% CI = 1.95-5.67) for Apgar results. Maternal morbidity showed a relative risk 0.30 (95% CI = 0.13-0.67) times higher in the planned caesarean group. Conclusions An increment in the risk of perinatal mortality, birth trauma, and Apgar lower than 7 was identified in planned vaginal delivery. However, the risk of severe maternal morbidity because of complications of a planned caesarean was slightly higher

Antenatal Fear of Childbirth as a Risk Factor for a Bad Childbirth Experience

Giving birth is one of the most impressive experiences in life. However, many pregnant women suffer from fear of childbirth (FOC) and experience labour in very different ways, depending on their personality, previous life experiences, pregnancy, and birth circumstances. The aim of this study was to analyse how fear of childbirth affects the childbirth experience and to assess the related consequences. For this, a descriptive cross-sectional study was carried out in a sample of 414 women between 1 July 2021 and 30 June 2022. The Birth Anticipation Scale (BAS) was used to measure fear of childbirth and the Childbirth Experience Questionnaire (CEQ-E) was applied to measure satisfaction with the childbirth experience. Fear of childbirth negatively and significantly predicted the childbirth experience. In addition, women who were more fearful of childbirth were found to have worse obstetric outcomes and a higher likelihood of having a caesarean delivery (p = 0.008 C. I 95%). Fear behaved as a risk factor for the birth experience, so the greater the fear, the higher the risk of having a worse birth experience (OR 1.1). Encouraging active listening and support strategies may increase pregnant women's confidence, thus decreasing their fear of the process and improving their childbirth experience

Compliance with Good Manufacturing Practice in the Assessment of Immunomodulation Potential of Clinical Grade Multipotent Mesenchymal Stromal Cells Derived from Wharton’s Jelly

Cell culture; Cellular therapy; Good manufacturing practiceCultiu cel·lular; Teràpia cel·lular; Bones pràctiques de manufacturaCultivo celular; Terapia celular; Buenas prácticas de fabricaciónThe selection of assays suitable for testing the potency of clinical grade multipotent mesenchymal stromal cell (MSC)-based products and its interpretation is a challenge for both developers and regulators. Here, we present a bioprocess design for the production of Wharton's jelly (WJ)-derived MSCs and a validated immunopotency assay approved by the competent regulatory authority for batch release together with the study of failure modes in the bioprocess with potential impact on critical quality attributes (CQA) of the final product. Methods: The lymphocyte proliferation assay was used for determining the immunopotency of WJ-MSCs and validated under good manufacturing practices (GMP). Moreover, failure mode effects analysis (FMEA) was used to identify and quantify the potential impact of different unexpected situations on the CQA. Results: A production process based on a two-tiered cell banking strategy resulted in batches with sufficient numbers of cells for clinical use in compliance with approved specifications including MSC identity (expressing CD73, CD90, CD105, but not CD31, CD45, or HLA-DR). Remarkably, all batches showed high capacity to inhibit the proliferation of activated lymphocytes. Moreover, implementation of risk management tools led to an in-depth understanding of the manufacturing process as well as the identification of weak points to be reinforced. Conclusions: The bioprocess design showed here together with detailed risk management and the use of a robust method for immunomodulation potency testing allowed for the robust production of clinical-grade WJ-MSCs under pharmaceutical standards

Adaptation and psychometric study of the scale for the measurement of fear and anxiety of COVID-19 disease in pregnant women (AMICO_Pregnant)

https://www.frontiersin.org/articles/10.3389/fpubh.2023.1225822/full#supplementary-materialObjective: The aim of this research was to adapt and explore the psychometric properties of a specific scale to assess the levels of fear and anxiety of COVID-19 disease in pregnant women. Methods: An adaptation phase, by a panel of experts, and a psychometric descriptive cross-sectional study were carried out on the final version of the 16- item, self-administered AMICO_Pregnant scale. Univariate and bivariate analyses were carried out, followed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The consistency of the scale was assessed using the Omega coefficient and Cronbach’s Alpha. Results: With a sample of 1,013 pregnant women living in Spain and over 18 years of age, the mean age was 33 years. The scale showed a bifactor structure (anxiety and fear) that was confirmed with good fit parameters. Reliability was assessed in terms of internal consistency by calculating Cronbach’s Alpha coefficient (0.95) and McDonald’s Omega coefficient (0.94) as indicators of robustness of the scale’s reliability. Conclusion: The AMICO_Pregnant scale of 16 items with scores ranging from 1 to 10 is a valid and reliable tool to assess levels of anxiety and fear of COVID_19 in Spanish pregnant women. Pregnant women have shown moderate levels of anxiety and fear regarding the COVID_19 disease in the final phase of the pandemic

Influence of Pregnancy on Sexual Desire in Pregnant Women and Their Partners: Systematic Review

Objectives: Pregnancy is a stage in which different physical and psychological changes take place that can affect the sexuality of the couple. The aim of the study is to identify how the physical and psychological changes derived from pregnancy affect the sexual desire of women and men. Methods: A systematic review of the literature was carried out in five databases, from which a total of 16,126 documents were obtained. After applying the PRISMA selection criteria, a total of 19 documents were selected. Results: Levels of sexual desire fluctuate during pregnancy, being the second trimester of gestation the period in which desire is at its highest and in which physical limitations and emotional changes decrease. Women have lower levels of sexual desire in the first trimester, while men have the lowest levels of desire in the third trimester. Conclusion: Pregnancy is a stage marked by physiological and psychological changes that modify several areas, including sexuality. Healthcare professionals should promote a healthy sexuality, avoiding the appearance of fears or sexual dysfunctions caused by the changes that occur during pregnancy

Propuesta metodológica con enfoque lúdico en la enseñanza de la aritmética en los estudiantes del tercer grado de educación básica en el Centro Escolar Doctor Mauricio Guzmán, Centro Escolar Cantón las Acostas y el Centro Escolar San Nicolás la encarnación, del Departamento de La Libertad, año 2018”

En la actualidad las exigencias educativas comprometen a los maestros a buscar y enriquecer nuevas estrategias para la enseñanza y los docentes encargados de enseñar matemática no son la excepción. Se sabe que la matemática tiene sentido para los alumnos hasta cierta edad pero se convierte en una pesadilla para ellos cuando las bases de la matemática no son bien cimentadas en su educación inicia

Calidad de vida relacionada con la salud en una población de gestantes sanas tras un programa de actividad física en el medio acuático (PAFMAE)

Fundamentos: El ejercicio físico moderado aporta beneficios a la mujer gestante durante el embarazo. La finalidad de este trabajo fue evaluar el efecto sobre la calidad de vida de un programa de actividad física en el medio acuático, de seis semanas de duración, en mujeres gestantes sanas. Métodos: Se llevó a cabo un programa de actividad física en el medio acuático, desde mayo hasta julio de 2016 en un centro deportivo, de seis semanas de duración a un total de 46 mujeres embarazadas, que fueron distribuidas en grupo Experimental (n=18) y grupo Control (n=28), a las que se le aplicó el cuestionario de calidad de vida relacionada con la salud “SF- 36 v2” antes y después del programa. Estadísticamente se aplicó para medias intragrupo la prueba t-student para muestras pareadas, y para las diferencias entre grupos, la prueba t-student para muestras independientes. Resultados: Al finalizar el programa de actividad física se constató como el mismo actuó positivamente sobre las siguientes dimensiones, cuyos valores de la media fueron: percepción de Dolor Corporal (DC) antes 66,1 y después 68,4 percepción de Salud General (SG) antes 81,3 y después 83,6, Rol Emocional (RE) antes 89,0 y después 93,5 y Salud Mental (SM) 80,7 antes y 84,2 después. Conclusión: La práctica de un programa de actividad física en el medio acuático para embarazadas sanas brinda beneficios relacionados con la percepción de calidad de vida relacionada con la salud.Background: Moderate physical exercise brings benefits to pregnant women during pregnancy. The aim of this research is to evaluate the effect on the quality of life of a six-week aquatic physical activity program in healthy pregnant women Methods: A six-week physical activity program was conducted in the aquatic environment, from May to July 2016 in a sports center, to a total of 46 pregnant women, who were distributed in Experimental (n = 18) and Control (n = 28) groups, to which the health-related quality of life questionnaire “SF-36 v2” was applied before and after the program. The t-student test for paired samples was statistically applied for intragroup means, and for the differences between groups, the t-student test for independent samples. Results: At the end of the physical activity program, it was clearly established that it acted positively on the following dimensions whose mean values were: perception of Body Pain (BP) before 66.1 and after 68.4 perception of General Health (GH) before 81.3 and then 83.6, Emotional Role (ER) before 89.0 and Then 93.5 and Mental Health (MH) 80.7 before and 84.2 after. Conclusion: The practice of a program of physical activity in the aquatic environment for pregnant women provides benefits related to the perception of health-related quality of life

Assessment of levels of anxiety and fear of Covid-19 in a population of pregnant women in Spain

Objective: The aim of the study was to assess the levels of fear and anxiety in the particularly vulnerable population group of women during pregnancy.Methods: Cross-sectional study between March 2022 and July 2022 involving 978 pregnant women aged 16 to 50 years. It was carried out based on the scale for the assessment of fear and anxiety in pregnant women (AMICO_Pregnant) and the collection of sociodemographic data. Normality analysis was performed prior to univariate and bivariate statistical analysis.Results: The sample was composed of a total of 978 pregnant women. The mean of the AMICO_Pregnant scale was intermediate (5.04 points; SD=2.36). The bivariate analysis showed a statistically significant relationship between the AMICO_Pregnant scale and the following variables: vaccination schedule status, contact with the disease, weeks of gestation, altered delivery or birth plan.Conclusion: Women with pregnancies closer to term, with no contact with the disease, without a complete vaccination schedule, or who had undergone changes in their delivery or birth plans, showed higher levels of fear and anxiety.info:eu-repo/semantics/publishedVersio