Papel de enfermería en la atención a pacientes con sistemas de asistencia mecánica ventricular izquierda de larga duración

Introducción. La insuficiencia cardiaca (IC) se considera actualmente un problema sanitario de primer orden. Para la IC avanzada o refractaria el trasplante cardiaco constituye el tratamiento más eficaz y consolidado, sin embargo, la progresiva escasez de donantes ha motivado el desarrollo de los dispositivos de asistencia ventricular izquierda (DAVI). Objetivo. Determinar el papel de enfermería en los cuidados y en la educación al paciente portador de un DAVI de larga duración. Metodología. Consiste en una revisión bibliográfica para cuya elaboración se han consultado artículos científicos en español y en inglés incluidos en bases de datos como PubMed, Elsevier y SciELO. Resultados. Se analizan los tipos de DAVI y sus principales indicaciones, como puente al trasplante (solución ante las largas listas de espera) y, actualmente cada vez más, como terapia de destino (para aquellos que no optan al trasplante cardiaco). Asimismo, se exponen sus posibles complicaciones, siendo la más frecuente a largo plazo la infección del cable conductor. En este tipo de terapia, los profesionales de enfermería cobran un papel fundamental en la educación tanto de los pacientes como de sus cuidadores, a fin de garantizar un adecuado conocimiento sobre el funcionamiento del DAVI y una correcta adaptación de ambos a la nueva situación. Discusión. El desarrollo tecnológico de estos dispositivos ha hecho que actualmente sean fundamentales en el tratamiento de la IC avanzada, y que el papel de enfermería resulte esencial, tanto en el aspecto asistencial como educacional, para asegurar el bienestar de los portadores.   ABSTRACT Introduction. Nowadays Heart Failure (HF) is considered as a major health problem. Heart transplantation is the best option of treatment for advanced or refractory HF, however, due to the progressive organ donor shortage, the development of left ventricular assist devices (LVADs) has increased. Aim. To identify the nursing role in the education and care of the patient with a long-term LVAD. Methodology. This study is a bibliographic review. Scientific articles in Spanish and English were consulted in databases as PubMed, Elsevier and SciELO.  Results. The different types of devices and its main indications are analyzed, such as a bridge to transplant (giving a solution to those on the long waiting lists), and, currently it is getting more usually seen, as a destination therapy (for those who do not opt for transplant). Likewise, long-term complications of LVADs are also explained, being the driveline infection the most frequent. In this therapy, nurses play an essential role in educating both patients and their caregivers, in order to ensure an adequate quality of life and their correct adaptation to the new situation.  Discussion. The technological improvements of this devices have made them fundamental in the treatment of advanced HF, and the role of nurses is essential, both in care and educational aspects, to ensure the patients well-being

Evolutionary Dynamics of Multigene Families in Triportheus (Characiformes, Triportheidae): A Transposon Mediated Mechanism?

Triportheus (Characiformes, Triportheidae) is a freshwater fish genus with 18 valid species. These fishes are widely distributed in the major river drainages of South America, having commercial importance in the fishing market, mainly in the Amazon basin. This genus has diverged recently in a complex process of speciation carried out in different river basins. The use of repetitive sequences is suitable to trace the genomic reorganizations occured along the speciation process. In this work, the 5S rDNA multigene family has been characterized at molecular and phylogenetic level. The results showed that other multigene family has been found within the non-transcribed spacer (NTS): the U1 snRNA gene. Double-FISH with 5S and U1 probes were also performed, confirming the close linkage between these two multigene families. Moreover, evidences of different transposable elements (TE) were detected within the spacer, thus suggesting a transposon-mediated mechanism of 5S-U1 evolutionary pathway in this genus. Phylogenetic analysis demonstrated a species-specific grouping, except for Triportheus pantanensis, Triportheus aff. rotundatus and Triportheus trifurcatus. The evolutionary model of the 5S rDNA in Triportheus species has been discussed. In addition, the results suggest new clues for the speciation and evolutionary trend in these species, which could be suitable to use in other Characiformes species

Novel hybrid organic/inorganic poly(thiourethane) covalent adaptable networks

Organic-inorganic hybrid materials combine the advantages of both phases: hardness and strength of inorganic phase and elasticity and toughness of the organic matrix. In the present study, we have prepared nanocomposites with a poly(thiourethane) polymeric matrix and silsesquioxane-type structures, with thiols as reactive groups (POSS-A or POSS-B, synthesized in different pressure conditions), looking for a covalent interaction between both phases, and good dispersion. Due to the click behavior of the reaction between the isocyanate and the thiol groups, highly homogeneous materials are obtained. Both monomers, catalyst (dibutyltin dilaurate, DBTDL), and the POSS precursor (3-mercaptopropyl trimethoxysilane, MPTMS), are commercially available, which present the advantage of being industrially scalable. The incorporation of POSS leads to an increase in glassy and rubbery storage moduli and the temperature of the maximum of tan delta curve. The vitrimeric behavior of the poly(thiourethanes) improved with the POSS incorporation, getting lower relaxation times. With a higher proportion of closed cages, POSS-B leads to the most significant improvements. All the materials prepared showed high transparency and the fracture of POSS modified materials indicates an improved toughness.This work is part of the R & D projects PID2020-115102RB-C21 and PID2020-115102RB-C22 funded by MCINAEI/10.13039/501100011033. We acknowledge these grants and the Generalitat de Catalunya (2017-SGR-77 and BASE3D) . The authors declare the following financial interests/personal re-lationships which may be considered as potential competing interests: Angels Serra reports financial support was provided by Spain Ministry of Science and Innovation

Desastres naturales y crecimiento económico: Evidencia para distritos de Argentina

Los desastres naturales representan una seria amenaza a nivel global. Este trabajo avanza en la estimación del impacto que los desastres naturales generan sobre el crecimiento económico. En particular, se analiza el caso de los distritos argentinos para el período 1992-2013. Debido a la falta de datos desagregados de PBI, se utilizan mapas de luminosidad nocturna -como proxy de la actividad económica y el crecimiento- según lo reportado por la Administración Nacional Oceánica y Atmosférica (NOAA). La información sobre desastres proviene de los registros del Sistema de Inventario de Desastres (DesInventar). Se implementa un análisis de regresión considerando un panel de 350 distritos durante más de dos décadas. Se encuentra que, un desastre natural adicional, ajustado por severidad, se asocia con una reducción del 0.53% en el crecimiento económico en el año de su ocurrencia. Los desastres geofísicos e hidrológicos son los responsables de este efecto negativo. No hay evidencia de efectos persistentes sobre el crecimiento. Los hallazgos son especialmente relevantes considerando que se espera un aumento en la frecuencia e intensidad de los desastres, a futuro, como resultado del cambio climático, y que los países en desarrollo son más vulnerables ante desastres.Fil: González, Fernando Antonio Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Económicas y Sociales del Sur. Universidad Nacional del Sur. Departamento de Economía. Instituto de Investigaciones Económicas y Sociales del Sur; ArgentinaFil: Santos, Maria Emma. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Económicas y Sociales del Sur. Universidad Nacional del Sur. Departamento de Economía. Instituto de Investigaciones Económicas y Sociales del Sur; ArgentinaFil: London, Silvia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Económicas y Sociales del Sur. Universidad Nacional del Sur. Departamento de Economía. Instituto de Investigaciones Económicas y Sociales del Sur; Argentin

Validation of a New Telenursing Questionnaire: Testing the Test

Abstract: Background: Existing surveys on telenursing refer to specific areas of nursing after the implementation of a programme, but telenursing in general has not been fully evaluated from a prospective approach. Aim: Design and statistical validation of a telenursing questionnaire. Methods: A new questionnaire was designed with 18 paired (to avoid leading) questions (Likert-5) plus three dichotomous questions (randomly ordered, inspired by existing validated tests) to analyse the dimensions of: acceptance, usefulness and appropriateness of telenursing from the nursing point of view (7 min test). The questionnaire was validated by classical tests and item response tests (Rasch) using six computer-generated databases with different response profiles (tendency to be positioned against, neutral and positioned in favour) with two degrees of agreement between each pair of responses for each option. Results: Classical testing: Cronbach’s alphas (from 0.8 to 0.95), Kaiser–Meyer–Olkin (KMO) (0.93 to 0.95) and a significant p < 0.0001 for Bartlett’s test of sphericity were obtained. Rasch analysis: Reliability coefficients (0.94). Warm’s mean weighted likelihood estimates (0.94). Extreme infit-t and outfit-t values (+1.61 to −1.98). Conclusions: Both the classical test and the Rasch approaches confirm the usefulness of the new test for assessing nurses’ positioning in relation to telenursing.info:eu-repo/semantics/publishedVersio

Effects of disease activity on lipoprotein levels in patients with early arthritis: can oxidized LDL cholesterol explain the lipid paradox theory?

Background An increased risk of cardiovascular (CV) complications has been described in patients with rheumatoid arthritis (RA). It is the result of the combined effect of classic CV risk factors and others that are specific to the disease. Methods We assessed data from 448 early arthritis (EA) patients: 79% women, age (median [p25-p75]) at onset: 55 [44?67] years and disease duration at study entry 5 [3?8] months; and 72% fulfilled the 1987 RA criteria at 2?years of follow-up. Rheumatoid factor was positive in 54% of patients and anti-citrullinated peptide antibodies in 50%. The follow-up of patients ranged from 2 to 5?years with more than 1400 visits with lipoprotein measurements available (mean 2.5 visits/patient). Demographic- and disease-related variables were systematically recorded. Total cholesterol (TC), high-density lipoprotein (HDL-C), and low-density lipoprotein (LDL-C) levels were obtained from routine laboratory tests. Oxidized-LDL (oxLDL-C) levels were assessed using a commercial ELISA kit. We fitted population-averaged models nested by patient and visit to determine the effect of independent variables on serum levels of TC, its fractions, and oxLDL-C. Results After adjustment for several confounders, high-disease activity was significantly associated with decreased TC, HDL-C, and LDL-C levels and increased oxLDL-C levels. Standardized coefficients showed that the effect of disease activity was greater on oxLDL-C and HDL-C. Interestingly, we observed that those patients with lower levels of LDL-C showed higher oxLDL-C/LDL-C ratios. Conclusions High-disease activity in EA patients results in changes in the HDL-C and oxLDL-C levels, which in turn may contribute to the increased risk of CV disease observed in these patients.Our manuscript was supported by grants RD16/0011/0012, RD16/0011/0009, RD16/0011/0004, PI05/2044, and PI18/0371 from the Ministerio de Economía y Competitividad (Instituto de Salud Carlos III) and co-funded by Fondo Europeo de Desarrollo Regional (FEDER)

Neocortical tissue recovery in severe congenital obstructive hydrocephalus after intraventricular administration of bone marrow-derived mesenchymal stem cells

BACKGROUND: In obstructive congenital hydrocephalus, cerebrospinal fluid accumulation is associated with high intracranial pressure and the presence of periventricular edema, ischemia/hypoxia, damage of the white matter, and glial reactions in the neocortex. The viability and short time effects of a therapy based on bone marrow-derived mesenchymal stem cells (BM-MSC) have been evaluated in such pathological conditions in the hyh mouse model. METHODS: BM-MSC obtained from mice expressing fluorescent mRFP1 protein were injected into the lateral ventricle of hydrocephalic hyh mice at the moment they present a very severe form of the disease. The effect of transplantation in the neocortex was compared with hydrocephalic hyh mice injected with the vehicle and non-hydrocephalic littermates. Neural cell populations and the possibility of transdifferentiation were analyzed. The possibility of a tissue recovering was investigated using 1H High-Resolution Magic Angle Spinning Nuclear Magnetic Resonance (1H HR-MAS NMR) spectroscopy, thus allowing the detection of metabolites/osmolytes related with hydrocephalus severity and outcome in the neocortex. An in vitro assay to simulate the periventricular astrocyte reaction conditions was performed using BM-MSC under high TNFα level condition. The secretome in the culture medium was analyzed in this assay. RESULTS: Four days after transplantation, BM-MSC were found undifferentiated and scattered into the astrocyte reaction present in the damaged neocortex white matter. Tissue rejection to the integrated BM-MSC was not detected 4 days after transplantation. Hyh mice transplanted with BM-MSC showed a reduction in the apoptosis in the periventricular neocortex walls, suggesting a neuroprotector effect of the BM-MSC in these conditions. A decrease in the levels of metabolites/osmolytes in the neocortex, such as taurine and neuroexcytotoxic glutamate, also indicated a tissue recovering. Under high TNFα level condition in vitro, BM-MSC showed an upregulation of cytokine and protein secretion that may explain homing, immunomodulation, and vascular permeability, and therefore the tissue recovering. CONCLUSIONS: BM-MSC treatment in severe congenital hydrocephalus is viable and leads to the recovery of the severe neurodegenerative conditions in the neocortex. NMR spectroscopy allows to follow-up the effects of stem cell therapy in hydrocephalus.España Instituto Carlos III , PI15/00619 (to AJJ), PI19/00778 (to AJJ and PPG), PI15/00796, and PI18/01557España Ministerio de Educación, Cultura y Deporte FPU13/02906España, Ministerio de Economía y Competitividad RYC-2014-16980España, FEDER Andalucía y Universidad de Málaga UMA18-FEDERJA-27

Trapping para-quinone methide intermediates with ferrocene: Synthesis and preliminary biological evaluation of new phenol-ferrocene conjugates

The reaction of para-hydroxybenzyl alcohols with ferrocene in the presence of a catalytic amount of InCl3 provided ferrocenyl phenol derivatives, an interesting class of organometallic compounds with potential applications in medicinal chemistry. This transformation exhibited a reasonable substrate scope delivering the desired products in synthetically useful yields. Evidence of involvement of a para-quinone methide intermediate in this coupling process was also provided. Preliminary biological evaluation demonstrated that some of the ferrocene derivatives available by this methodology exhibit significant cytotoxicity against several cancer cell lines with IC50 values within the range of 1.07&ndash;4.89 &mu;M