Influencers With Intellectual Disability in Digital Society: An Opportunity to Advance in Social Inclusion

Abstract: Social networks are appointed as an opportunity to socially normalize disability, as demonstrated by the growing number of influencers with a disability who are followed by millions of users. Likewise, intellectual disability has its place in the networks, with special relevance among influencers with Down syndrome. In this study, a content analysis of 10 accounts of influencers with Down syndrome from seven different countries was performed. Images, videos, comments, and other interactions with their followers were analyzed. The preliminary results described the influencer profiles, the type of content posted, and their relationship with sponsoring brands. These results indicate that social networks allow them to make their interests visible, take part in the digital environment, and interact with their audience, being a positive influence that promotes respect for diversity. These platforms are positioned as powerful tools for the construction and dissemination of inclusive values and the empowerment of disabled people, minimizing controversial questions such as the instrumentalization of the disability and its association with clichés. With all the analyzed results, it is possible to evidence that Instagram can be considered a privileged network that could be utilized for the eradication of barriers and to ease the inclusion of people with intellectual disabilities in the public sphere. The conclusions are relevant for the scientific community given that they will allow us to achieve social inclusion, thanks to the impact of the posts from the influencers with disability.This work was conducted within the framework of Alfamed (Euro‐American Network of Researchers), with the support of the R+D Project Youtubers and Instagrammers: Media Competence in Emerging Prosumers (RTI2018–093303‐B‐I00), financed by the State Research Agency of the Spanish Ministry of Science, Innovation and Universities and the European Regional Development Fund

Melanoma mucoso de tabique nasal

ResumenLos melanomas mucosos son tumores raros y de mal pronóstico. Representan alrededor del 1% del total de melanomas y el 0,5% de los tumores malignos de cabeza y cuello. Cuando se localiza en las fosas nasales, produce sintomatología tardía e inespecífica como obstrucción respiratoria, epistaxis o dolor facial. El tratamiento de elección es la cirugía combinada con quimio y radioterapia. Presentamos un caso con sobrevida de 4 años y realizamos una revisión de la literatura.AbstractHead and neck mucosal melanoma is a rare entity with poor prognosis. This tumour represents less than 1% of malignant melanomas and 0.5% of head and neck malignancies. Melanomas that arise in the nasal cavity present with non-specific symptoms and have a poor prognosis. Wide local excision is the treatment of choice combined with postoperative chemoradiotherapy. We present a case with an unusual survival (4 years) and perform a review of the literature

Cuentos escogidos

[ES]Con la presente edición se quiere dar a conocer una selección de cuentos de Constance Fenimore Woolson, una de las escritoras más populares y admiradas del último cuarto del siglo diecinueve que, por distintas circunstancias, hasta hace unos pocos años fue una gran desconocida. Incluida dentro de lo que se conoce como literatura regionalista o de color local, Woolson fue ante todo una auténtica pionera de las letras no solo porque abordó sin complejos temas y asuntos no muy frecuentes hasta entonces en la literatura norteamericana sino, sobre todo, porque no se conformó con tratar literariamente una región específica de su país, a diferencia a lo que hicieron la mayoría de las coloristas locales, e inauguró nuevos espacios geográficos para su obra. Woolson es la primera escritora realista que emplea la región de los Grandes Lagos del medio oeste, como se podrá comprobar, pasó luego a escribir abundantemente sobre el Sur, en pleno período de la Reconstrucción, y fue también una de las primeras en emplear el tema internacional, el estudio de expatriados norteamericanos en la cultura europea, al vivir durante catorce años en Europa, preparando el camino para otras autoras.Este libro se enmarca en el proyecto de investigación financiado por la Consejería de Educación de la Junta de Castilla y León y el Fondo Europeo de Desarrollo Regional (SA019P17), con el título “Escritoras inéditas en español en los albores del s. XX (1880-1920). Renovación pedagógica del canon literario” dirigido por la profesora Milagro Martín Clavijo de la Universidad de Salamanc

Experimental study on the use of a chlorhexidine-loaded carboxymethylcellulose gel as antibacterial coating for hernia repair meshes

21 p.Purpose: Biomaterials with an antimicrobial coating could avoid mesh-associated infection following hernia repair. This study assesses the use of a chlorhexidine-loaded carboxymethylcellulose gel in a model of Staphylococcus aureus mesh infection. Methods: A 1% carboxymethylcellulose gel containing 0.05% chlorhexidine was prepared and tested in vitro and in vivo. The in vitro tests were antibacterial activity (S. aureus; agar diffusion test) and gel cytotoxicity compared to aqueous 0.05% chlorhexidine (fibroblasts; alamarBlue). For the in vivo study, partial abdominal wall defects (5 × 2 cm) were created in New Zealand white rabbits (n = 15) and inoculated with 0.25 mL of S. aureus ( 106 CFU/mL). Defects were repaired with a lightweight polypropylene mesh (Optilene) without coating (n = 3) or coated with a carboxymethylcellulose gel (n = 6) or chlorhexidine-loaded carboxymethylcellulose gel (n = 6). Fourteen days after surgery, bacterial adhesion to the implant (sonication, immunohistochemistry), host tissue incorporation (light microscopy) and macrophage reaction (immunohistochemistry) were examined. Results: Carboxymethylcellulose significantly reduced the toxicity of chlorhexidine (p < 0.001) without limiting its antibacterial activity. While control and gel-coated implants were intensely contaminated, the chlorhexidine-gel-coated meses showed a bacteria-free surface, and only one specimen showed infection signs. The macrophage reaction in this last group was reduced compared to the control (p < 0.05) and gel groups. Conclusions: When incorporated in the carboxymethylcellulose gel, chlorhexidine showed reduced toxicity yet maintained its bactericidal effect at the surgery site. Our findings suggest that this antibacterial gel-coated polypropylene meshes for hernia repair prevent bacterial adhesion to the mesh surface and have no detrimental effects on wound repair.Ministerio de Ciencia, Innovación y Universidade

Preclinical bioassay of a novel antibacterial mesh for the repair of abdominal hernia defects

25 p.Background: In hernia surgery, soaking of meshes in antibiotics before implantation is a prophylactic strategy for minimizing the risk of infection while providing minimal, local, drug doses. This study describes the development and application of an antibacterial mesh coating comprising a carboxymethylcellulose gel loaded with rifampicin in a preclinical model of Staphylococcus aureus and S. epidermidis infection in rabbits. Methods: Antibacterial activity and cytocompatibility (with fibroblasts) of unloaded carboxymethylcellulose gel and 0.13 mg/mL rifampicin-carboxymethylcellulose gel were assessed in vitro. Then, partial abdominal wall defects (5 x 2 cm) were created in New Zealand white rabbits (n = 34), the wound inoculated with 0.25 mL of 106 CFU Staphylococcus aureus/ S. epidermidis (n = 17 each), and the defect then repaired with a lightweight, monofilament, large pore polypropylene mesh either uncoated (n = 3) or coated with carboxymethylcellulose gel (n = 7) or rifampicin-carboxymethylcellulose gel (n = 7). By postoperative day 14, coating performance was evaluated by determining bacterial adhesion (via sonication), host tissue incorporation (via histology), macrophage response via immunostaining), and bloodstream drug diffusion (via high-performance liquid chromatography). Results: In vitro, rifampicin-carboxymethylcellulose gel demonstrated great activity against Staphylococcus aureus/S. epidermidis, while being innocuous for fibroblasts. In vivo, rifampicincarboxymethylcellulose gel-coated implants displayed full bacterial clearance and optimal tissue integration, irrespective of the strain of Staphylococcus. In contrast, uncoated and carboxymethylcellulose gel-coated implants exhibited macro/microscopic signs of infection and impaired tissue integration. Macrophage responses were less in rifampicin-carboxymethylcellulose gel implants than in uncoated mesh (Staphylococcus aureus/S. epidermidis; P < .01) and carboxymethylcellulose gel (S. epidermidis; P < .05) implants. Bloodstream levels of rifampicin were undetectable. Conclusion: Soaking meshes in rifampicin-carboxymethylcellulose gel inhibited effectively the bacterial adhesion to the mesh without compromising the tissue repair. This antibiotic gel constitutes an easy-touse and effective prophylactic strategy that potentially reduce the prevalence of postoperative mesh infectionMinisterio de Ciencia, Innovación y Universidade

Mesh fixation using a cyanoacrylate applied as a spray improves abdominal wall tissue repair

19 p.Background: Tissue adhesives are a feasible option to fix a hernia repair mesh, avoiding tissue trauma of suture fixation. Classically, they are applied in the form of a drop, although novel applications such as spray are emerging. This study compares the use of a new experimental cyanoacrylate (n-butyl) in the form of a spray or drops. Materials and methods: Three study groups of New Zealand White rabbits were established (n ? 6 each) according to the method used to fix a 5 3 cm polypropylene mesh in a partial abdominal wall defect model: control group (polypropylene stitches), adhesive drops group, and adhesive spray group. Morphological, immunohistochemical, and biomechanical strength studies were performed at 14 d postimplant. Collagen 1/3 gene ratio was determined by quantitative reverse transcription polymerase chain reaction. Results: In the drops group, the adhesive obstructed the mesh pores and prevented tissue infiltration at the points of application. When the adhesive was applied as a spray, although more numerous, adhesive deposits were smaller and allowed for better host tissue infiltration into the mesh. The inflammatory response was similar in the adhesive groups and more intense than in the control group. Collagen 1/3 mRNA ratio was significantly higher in the spray than the control group. The mechanical resistance of the meshes was similar in all three groups. * Corresponding author. Department of Surgery, Medical and Social Sciences. Faculty of Medicine and Health Sciences, University of Alcala, Ctra. Madrid-Barcelona, Km 33,600, Alcala de Henares, 28871 Madrid, Spain. Tel.: þ34 91 8854540; fax: þ34 91 8854885. E-mail address: [email protected] (J.M. Bellon). 1 These authors contributed equally to this work. 0022-4804/$ e see front matter ª 2019 Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.jss.2019.08.020 Conclusions: The application of the cyanoacrylate adhesive in the form of spray to fix polypropylene meshes in an animal model had a similar inflammatory response compared with droplet application. Neither application impacted the mechanical strength of the repaired area. An increased in collagen 1/3 ratio was found with cyanoacrylate spray compared with suture, and future studies should focus on this pathway.Ministerio de Economía y Competitivida

Behaviour at the peritoneal interface of next generation prosthetic materials for hernia repair

22 p.Background When using a prosthetic material in hernia repair, the behaviour of the mesh at the peritoneal interface is especially important for implant success. Biomaterials developed for their intraperitoneal placement are known as composites and are made up of two different-structure materials, one is responsible for good integration within host tissue and the other is responsible to make contact with the viscera. This study examines the behaviour at the peritoneal level of two composites, the fully degradable Phasix-ST® and the partially degradable Symbotex®. A polypropylene mesh (Optilene®) served as control. Methods Sequential laparoscopy from 3 to 90 days, in a preclinical model in the New Zealand white rabbit, allowed monitoring adhesion formation. Morphological studies were performed to analyse the neoperitoneum formed in the repair process. Total macrophages were identified by immunohistochemical labelling. To identify the different macrophage phenotypes, complementary DNAs were amplified by qRT-PCR using specific primers for M1 (TNF-?/CXCL9) and M2 (MRC1/IL-10) macrophages. Results The percentage of firm and integrated adhesions remained very high in the control group over time. Both composites showed a significant decrease in adhesions at all study times and in qualitative terms were mainly loose. Significant differences were also observed from 7 days onwards between the two composites, increasing the values in Phasix over time. Neoperitoneum thickness for Phasix was significantly greater than those of the other meshes, showing mature and organized neoformed connective tissue. Immunohistochemically, a significantly higher percentage of macrophages was observed in Symbotex. mRNA expression levels for the M2 repair-type macrophages were highest for Phasix but significant differences only emerged for IL-10. Conclusions Fewer adhesions formed to the Symbotex than Phasix implants. Ninety days after implant, total macrophage counts were significantly higher for Symbotex, yet Phasix showed the greater expression of M2 markers related to the tissue repair process.Ministerio de Economía y Competitivida

MiR-19 family impairs adipogenesis by the downregulation of the PPARγ transcriptional network

[Abstract] microRNAs (miRNAs) are a class of small endogenous RNA that play pivotal roles in both the differentiation and function of adipocytes during the development of obesity. Despite this, only a few miRNA families have been identified as key players in adipogenesis. Here, we show the relevance of the miR-19 family, miR-19a and miR-19b, in lipid accumulation and the expansion of the adipose tissue in obesity. We observed that miR-19s were upregulated in the abdominal subcutaneous adipose tissue (aSAT) of human patients with morbid obesity, whereas after bariatric surgery, their expression was reduced. In vitro experiments identified miR-19a and b as crucial actors in adipogenesis and lipid accumulation. Overall, our results suggest a novel role of the miR-19 family in the regulatory networks underlying adipogenesis and, therefore, adipose tissue dysfunction.Instituto de Salud Carlos III; PI16/0088

Hemorragia intraventricular en recién nacido. Presentación de un caso

La hemorragia intraventricular es una grave enfermedad que suele presentarse en las primeras horas o días después del nacimiento pretérmino en niños con peso inferior a 1 500 g. Se presenta el caso de un recién nacido a término, con peso adecuado, masculino, producto de parto no institucional, que a los 17 días fue remitido al Hospital Paquito González Cueto, con fiebre y convulsiones. Ingresó en Unidad de Cuidados Intensivos Pediátricos. Se constató aumento del perímetro cefálico, fontanela anterior tensa e hipertonía global. La ecografía transfontanelar reveló hemorragia subependimaria/intraventricular. Se realizó tomografía computarizada y resonancia magnética para confirmar diagnóstico. La sintomatología y resultados ecoencefalográficos presentaron una evolución satisfactoria como ocurre en el 65 % de casos. Se decidió la presentación del caso por manifestarse la entidad en un recién nacido a término y con peso adecuado, lo que es poco usual y por darse la circunstancia de haber nacido fuera de una institución hospitalaria, por lo que, aunque no se pudo establecer la relación entre este hecho y la enfermedad, contribuye a que los médicos generalistas desarrollen la habilidad de sospechar diagnósticos de tal gravedad en casos que no necesariamente se ajusten a lo que está clásicamente descrito como más frecuente

Conocimientos sobre la enfermedad renal crónica y el proceder de hemodiálisis. Importancia del consentimiento informado

Introduction: informed knowledge involves a process that goes beyond the signing of an authorization document.Objective: to determine the level of knowledge about the chronic kidney disease and the hemodialysis procedure by the patients of Abel Santamaría Cuadrado General Teaching Hospital of Pinar del Río, in the period between March and May 2012.Material and method: an observational, descriptive, cross-sectional and applied study was performed. The universe was made up of the patients undergoing hemodialysis (n=120). The sample was composed by the patients who underwent hemodialysis on the days chosen for applying the survey, which should coincide with the second session of hemodialysis within the week, using the random simple method (n=85), whom were conducted the questionnaire-survey on. To determine association amongst variables, the statistical chi-square test was used at 95% of confidence.Results: the sample came to be mostly young, with low schooling, being also low their knowledge on the disease, and even more critical their knowledge about potential complications in hemodialysis, matters evitable to occur in an authorization document before this procedure.Conclusions: patients with chronic kidney disease and with purifying treatments, as hemodialysis, need to know about a proper informed concernment, applicable to each patient, in order to better prepare them and in doing so to achieve welfare, comfort and their total recovery.Introducción: el consentimiento informado supone un proceso que va más allá de la firma de un documento de autorización. Objetivo: determinar el nivel de conocimientos sobre la enfermedad renal crónica y el proceder de hemodiálisis de los pacientes del Hospital Abel Santamaría Cuadrado de Pinar del Río en el período comprendido de marzo – mayo del 2012. Material y método: se realizó un estudio observacional, descriptivo, transversal y aplicado. El universo estuvo constituido por los pacientes que reciben hemodiálisis (N = 102). La muestra estuvo integrada por los pacientes que recibieron hemodiálisis el día escogido para aplicar la encuesta que debió coincidir con la segunda sesión de hemodiálisis de la semana, utilizando un método aleatorio simple (n= 85), a los que se aplicó una encuesta formulario. Para determinar la asociación entre variables se utilizó el estadígrafo Chi- Cuadrado al 95 % de confianza. Resultados: la muestra resultó ser mayoritariamente joven, con bajo nivel educacional, siendo el dominio de la enfermedad bastante bajo, y aún más crítico el conocimiento sobre posibles complicaciones durante la hemodiálisis, cuestiones evitables de existir un documento informador previo a este proceder.  Conclusiones: los pacientes con enfermedad renal crónica y con tratamientos depuradores, como la hemodiálisis, necesitan la existencia de un consentimiento informado, que sea adaptable a cada paciente, para prepararlos mejor y así lograr bienestar, confort y su total cooperación.