Valoración de la calidad de vida en los pacientes crónicos pluripatológicos

Actualmente, la sociedad se caracteriza por un aumento progresivo de la población envejecida, entre cuyas características sanitarias se encuentra la pluripatología. Por ello, en Castilla y León se implanta una estrategia de atención al paciente crónico pluripatológico en situación de complejidad, también llamado G3. Para tratarlos holísticamente se decide investigar sobre la percepción de su calidad de vida, específicamente en las zonas básicas de salud de La Victoria y de Magdalena de Valladolid Este. Objetivo: Valorar la calidad de vida de los pacientes pluripatológicos catalogados como G3 en la plataforma Medora en un momento aleatorio de su vida. Método: A través de un estudio transversal observacional se evalúan cuantitativamente distintas variables empleando el cuestionario de calidad de vida SF-36, la escala EVA, el índice de Barthel y el examen MiniMental. Resultado: Los pacientes G3 refieren peor estado en la esfera física que en la psíquica, existiendo diferencias entre las zonas básicas de salud analizadas. Discusión: El colectivo estudiado presenta mejor estado de salud mental que los valores de referencia normales de la población española y se encuentra dentro de los intervalos normales de salud física.Grado en Enfermerí

Automatic Interaction and Activity Recognition from Videos of Human Manual Demonstrations with Application to Anomaly Detection

This paper presents a new method to describe spatio-temporal relations between objects and hands, to recognize both interactions and activities within video demonstrations of manual tasks. The approach exploits Scene Graphs to extract key interaction features from image sequences, encoding at the same time motion patterns and context. Additionally, the method introduces an event-based automatic video segmentation and clustering, which allows to group similar events, detecting also on the fly if a monitored activity is executed correctly. The effectiveness of the approach was demonstrated in two multi-subject experiments, showing the ability to recognize and cluster hand-object and object-object interactions without prior knowledge of the activity, as well as matching the same activity performed by different subjects.Comment: 8 pages, 8 figures, submitted to IEEE RAS International Symposium on Robot and Human Interactive Communication (RO-MAN), for associated video see https://youtu.be/Ftu_EHAtH4

Automatic Interaction and Activity Recognition from Videos of Human Manual Demonstrations with Application to Anomaly Detection

This paper presents a new method to describe spatio-temporal relations between objects and hands, to recognize both interactions and activities within video demonstrations of manual tasks. The approach exploits Scene Graphs to extract key interaction features from image sequences, encoding at the same time motion patterns and context. Additionally, the method introduces an event-based automatic video segmentation and clustering, which allows to group similar events, detecting also on the fly if a monitored activity is executed correctly. The effectiveness of the approach was demonstrated in two multi-subject experiments, showing the ability to recognize and cluster hand-object and object-object interactions without prior knowledge of the activity, as well as matching the same activity performed by different subjects

Herpes simplex virus-type1 (HSV-1) impairs DNA repair in cortical neurons

Several findings suggest that Herpes simplex virus-1 (HSV-1) infection plays a role in the neurodegenerative processes that characterize Alzheimer's disease (AD), but the underlying mechanisms have yet to be fully elucidated. Here we show that HSV-1 productive infection in cortical neurons causes the accumulation of DNA lesions that include both single (SSBs) and double strand breaks (DSBs), which are reported to be implicated in the neuronal loss observed in neurodegenerative diseases. We demonstrate that HSV-1 downregulates the expression level of Ku80, one of the main components of non-homologous end joining (NHEJ), a major pathway for the repair of DSBs. We also provide data suggesting that HSV-1 drives Ku80 for proteasomal degradation and impairs NHEJ activity, leading to DSB accumulation. Since HSV-1 usually causes life-long recurrent infections, it is possible to speculate that cumulating damages, including those occurring on DNA, may contribute to virus induced neurotoxicity and neurodegeneration, further suggesting HSV-1 as a risk factor for neurodegenerative conditions

Exploiting the Interplay between Innate and Adaptive Immunity to Improve Immunotherapeutic Strategies for Epstein-Barr-Virus-Driven Disorders

The recent demonstration that immunotherapeutic approaches may be clinically effective for cancer patients has renewed the interest for this strategy of intervention. In particular, clinical trials using adoptive T-cell therapies disclosed encouraging results, particularly in the context of Epstein-Barr-virus- (EBV-) related tumors. Nevertheless, the rate of complete clinical responses is still limited, thus stimulating the development of more effective therapeutic protocols. Considering the relevance of innate immunity in controlling both infections and cancers, innovative immunotherapeutic approaches should take into account also this compartment to improve clinical efficacy. Evidence accumulated so far indicates that innate immunity effectors, particularly NK cells, can be exploited with therapeutic purposes and new targets have been recently identified. We herein review the complex interactions between EBV and innate immunity and summarize the therapeutic strategies involving both adaptive and innate immune system, in the light of a fruitful integration between these immunotherapeutic modalities for a better control of EBV-driven tumors

Array Comparative Genomic Hybridization Analysis Reveals Significantly Enriched Pathways in Canine Oral Melanoma

Human Mucosal Melanoma (hMM) is an aggressive neoplasm of neuroectodermal origin with distinctive features from the more common cutaneous form of malignant melanoma (cMM). At the molecular level, hMMs are characterized by large chromosomal aberrations rather than single-nucleotide mutations, typically observed in cMM. Given the scarcity of available cases, there have been many attempts to establish a reliable animal model. In pet dogs, Canine Oral Melanoma (COM) is the most common malignant tumor of the oral cavity, sharing clinical and histological aspects with hMM. To improve the knowledge about COM\u2019s genomic DNA alterations, in the present work, formalin-fixed, paraffin-embedded (FFPE) samples of COM from different European archives were collected to set up an array Comparative Genomic Hybridization (aCGH) analysis to estimate recurrent Copy Number Aberrations (CNAs). DNA was extracted in parallel from tumor and healthy fractions and 19 specimens were successfully submitted to labeling and competitive hybridization. Data were statistically analyzed through GISTIC2.0 and a pathway-enrichment analysis was performed with ClueGO. Recurrent gained regions were detected, affecting chromosomes CFA 10, 13 and 30, while lost regions involved chromosomes CFA 10, 11, 22, and 30. In particular, CFA 13 showed a whole-chromosome gain in 37% of the samples, while CFA 22 showed a whole-chromosome loss in 25%. A distinctive sigmoidal trend was observed in CFA 10 and 30 in 25 and 30% of the samples, respectively. Comparative analysis revealed that COM and hMM share common chromosomal changes in 32 regions. MAPK- and PI3K-related genes were the most frequently involved, while pathway analysis revealed statistically significant perturbation of cancer-related biological processes such as immune response, drug metabolism, melanocytes homeostasis, and neo-angiogenesis. The latter is a new evidence of a significant involvement of neovascularization-related pathways in COMs and can provide the rationale for future application in anti-cancer targeted therapies

Registro, clasificación y estudio de imágenes digitalizadas de resonancia magnética del cerebro humano (Cuarta parte): Obtención de valores de ángulos en imágenes de resonancia magnética de cerebros como complemento al estudio de modificaciones cerebrales

En reuniones de la Sociedad Argentina de Investigación Clínica mostramos en imágenes parasagitales de resonancia magnética (IPRM) que con el avance de la edad se reduce la superficie del lóbulo prefrontal (SLPF); la superficie del cuerpo calloso (SCC) también se reduce (Merlo et al Rev Chil Anat 2002, 20:131-138). El objetivo es cuantificar en imágenes de resonancia magnética de ambos sexos, la variación de la relación SLPF/SCC con el avance de la edad. En IPRM equidistantes 4 mm del plano sagital medio de 64 sujetos femeninos y 65 masculinos sin diagnóstico de enfermedad mental ni neurológica, se midieron con el programa Scion Image for Windows la SCC y, en la misma imagen, la SLPF comprendida entre el borde anterior del cerebro y la perpendicular a la línea que pasa por los puntos más distantes del borde ventral del cuerpo calloso en su intersección con el borde dorsal del genu. Para cada caso y hemisferio se calculó la relación SLPF/SCC. Las relaciones se agruparon por sexo, rangos de edad (21-40; 41-60 y 61-84 años) y hemisferio y se calcularon las medias +/- ES. Para el estudio estadístico se usó ANOVA. Se determinó para cada sexo el coeficiente de correlación de Pearson (r) entre edad (21-84 años) y valores de SLPF/SCC de cada hemisferio. Las relaciones SLPF/SCC (media +/- ES) derecha e izquierda en el grupo femenino y masculino son significativamente menores (p<0.01 ANOVA) al incrementarse los rangos de edad. Las r de Pearson (p<0.01) entre edad (21-84 años) y SLPF/SCC derecha e izquierda son en el grupo femenino -0.65 y -0.62 y el masculino -0.61 y -0.60, indicando correlación inversa entre las variables. La significativa disminución con el incremento de la edad en ambos sexos de la relación entre la superficie correspondiente al lóbulo prefrontal (medida entre reparos anatómicos confiables) y la superficie del cuerpo calloso en la misma imagen de cada hemisferio es indicativa de que la superficie del lóbulo prefrontal es la que sufre mayor deterioro relativo.In several meetings of the Sociedad Argentina de Investigación Clínica, we showed in parasagittalmagnetic resonance imaging (IPRM) that with increasing age the surface of the prefrontal lobe(SLPF) is reduced; the surface of the corpus callosum (SCC) is also reduced (Merlo et al Rev ChilAnat 2002; 20: 131-138).The objective is to quantify in magnetic resonance imaging of both sexes, the variation of SLPF/ SCC ratio with advancing age. In IPRM equidistant 4mm midsagittal plane of 64 male and 65female subjects without diagnosis of mental or neurological disease, were measured with the ScionImage program for Windows SCC and in the same picture, the SLPF between the leading edge ofbrain and perpendicular to the line passing through the most distant parts of the corpus callosumventral edge at its intersection with the dorsal edge of the genu. For each case hemisphere SLPF/ SCC ratio was calculated. Relations were grouped by gender, age ranges (21-40, 41-60 and 61-84 years) and hemisphere and means were calculated +/- ES. For statistical analysis ANOVA wasused. The Pearson correlation coefficient (r) between age (21-84 years) and values SLPF / SCCeach hemisphere was determined for each sex. The SLPF / SCC relationships (mean +/- ES) rightand left on the male and female group are significantly lower (p <0.01 ANOVA) with increasingage ranges. Pearson’s r (p <0.01) between age (21-84 years) and SLPF / SCC right and left in thefemale group are -0.65 and -0.62 and -0.61 and -0.60 male, indicating inverse correlation betweenvariables. The significant decrease with increasing age in both sexes of the relationship between thesurface corresponding to the prefrontal lobe (measured between reliable anatomic landmarks) andthe surface of the corpus callosum in the very image of each hemisphere is indicative of the lobesurface prefrontal is the most severely impaired relative

Evaluation of Factors Associated With Appropriate Drug Prescription and Effectiveness of Informative and Educational Interventions-The EDU.RE.DRUG Project

Background: EDU.RE.DRUG study is a prospective, multicentre, open-label, parallel-arm, controlled, pragmatic trial directed to general practitioners (GPs) and their patients. Methods: The study data were retrieved from health-related administrative databases of four local health units (LHUs) of Lombardy and four LHUs in Campania. According to the LHUs, the GPs/patients were assigned to (A) intervention on both GPs (feedback reports about appropriate prescribing among their patients and online courses) and patients (flyers and posters on proper drug use), (B) intervention on GPs, (C) intervention on patients, and (D) no intervention (control arm). A set of appropriate prescribing indicators (potential drug-drug interactions [pDDIs], potential and unnecessary therapeutic duplicates [pTDs], and inappropriate prescriptions in the elderly [ERD-list]) were measured at baseline and after the intervention phase. The effectiveness of the intervention was evaluated estimating the absolute difference in percentages of selected indicators carrying out linear random-intercept mixed-effect models. Results: A cohort of 3,586 GPs (2,567 in intervention groups and 1,019 in the control group) was evaluated. In Campania, the mean pre-intervention percentage of patients with at least one pDDI was always greater than 20% and always lower than 15% in Lombardy. The pre-post difference was quite heterogeneous among the LHUs, ranging from 1.9 to -1.4 percentage points. The mean pre-intervention percentage of patients with pTDs ranged from 0.59 to 2.1%, with slightly higher values characterizing Campania LHUs. The magnitude of the pre-post difference was very low, ranging from -0.11 to 0.20. In Campania, the mean pre-intervention percentage of patients with at least one ERD criterium was considerably higher than in Lombardy (approximately 30% in Lombardy and 50% in Campania). The pre-post difference was again quite heterogeneous. The results from the models accounting for GP geographical belonging suggested that none of the interventions resulted in a statistically significant effect, for all the three indicators considered. Conclusion: The proposed strategy was shown to be not effective in influencing the voluntary changes in GP prescription performance. However, the use of a set of explicit indicators proved to be useful in quantifying the inappropriateness. Further efforts are needed to find more efficient strategies and design more tailored interventions