Plan de cuidados en paciente con infarto agudo de miocardio

El infarto agudo de miocardio (IAM) es una patología con una gran incidencia sobre la población. En la actualidad, es una de las principales causas de muerte en España y en el mundo. Además, el envejecimiento de la población solo indica que seguirá aumentado. Para minimizar su incidencia, mortalidad y mejorar la calidad de vida tras el tratamiento, es imprescindible una rápida y buena identificación de la patología para su posterior tratamiento. Este trabajo expone los puntos principales para su sospecha según los factores de riesgo, sintomatología, herramientas de diagnóstico y tratamiento. A continuación, se realiza un proceso de atención de enfermería desarrollando un plan de cuidados basándonos en las 14 necesidades de Virginia Henderson. Por último, se termina con la importancia de la enfermería en el cuidado de los pacientes que han sufrido un IAM, así como la imprescindible formación para proporcionar unos cuidados adecuados y de calidad

Biotinylated Cell-penetrating Peptides to Study Intracellular Protein-protein Interactions

[EN] Here we present a protocol to study intracellular protein-protein interactions that is based on the widely used biotin-avidin pull-down system. The modification presented includes the combination of this technique with cell-penetrating sequences. We propose to design cell-penetrating baits that can be incubated with living cells instead of cell lysates and therefore the interactions found will reflect those that occur within the intracellular context. Connexin43 (Cx43), a protein that forms gap junction channels and hemichannels is down-regulated in high-grade gliomas. The Cx43 region comprising amino acids 266-283 is responsible for the inhibition of the oncogenic activity of c-Src in glioma cells. Here we use TAT as the cell-penetrating sequence, biotin as the pull-down tag and the region of Cx43 comprised between amino acids 266-283 as the target to find intracellular interactions in the hard-to-transfect human glioma stem cells. One of the limitations of the proposed method is that the molecule used as bait could fail to fold properly and, consequently, the interactions found could not be associated with the effect. However, this method can be especially interesting for the interactions involved in signal transduction pathways because they are usually carried out by intrinsically disordered regions and, therefore, they do not require an ordered folding. In addition, one of the advantages of the proposed method is that the relevance of each residue on the interaction can be easily studied. This is a modular system; therefore, other cell-penetrating sequences, other tags, and other intracellular targets can be employed. Finally, the scope of this protocol is far beyond protein-protein interaction because this system can be applied to other bioactive cargoes such as RNA sequences, nanoparticles, viruses or any molecule that can be transduced with cell-penetrating sequences and fused to pull-down tags to study their intracellular mechanism of action

Adsorption of azo-dye Orange II from aqueous solutions using a metal-organic framework material: Iron- benzenetricarboxylate

A Metal-Organic Framework (MOF), iron-benzenetricarboxylate (Fe(BTC)), has been studied for the adsorptive removal of azo-dye Orange II from aqueous solutions, where the effect of various parameters was tested and isotherm and kinetic models were suggested. The adsorption capacities of Fe(BTC) were much higher than those of an activated carbon. The experimental data can be best described by the Langmuir isotherm model (R2 > 0.997) and revealed the ability of Fe(BTC) to adsorb 435 mg of Orange II per gram of adsorbent at the optimal conditions. The kinetics of Orange II adsorption followed a pseudo-second-order kinetic model, indicating the coexistence of physisorption and chemisorption, with intra-particle diffusion being the rate controlling step. The thermodynamic study revealed that the adsorption of Orange II was feasible, spontaneous and exothermic process (-25.53 kJ·mol-1). The high recovery of the dye showed that Fe(BTC) can be employed as an effective and reusable adsorbent for the removal of Orange II from aqueous solutions and showed the economic interest of this adsorbent material for environmental purposes. © 2014 by the authors.The authors thank Autonomous Metropolitan University for its financial support to the project “Synthesis, modification and application of porous solid materials to sorption phenomena and catalysis”. Elizabeth Rojas-Garcia and Ricardo López-Medina thank CONACYT for their repatriation program fellowships. We acknowledge support by the CSIC Open Access Publication Initiative through its Unit of Information Resources for Research (URICI)Peer Reviewe

Associations for education and socialization of the heritage in rural area

El Grupo S.O.S. Patrimonio es un Grupo de Investigación y Desarrollo de la Universidad de Sevilla (HUM 673) dedica sus esfuerzos a la investigación en materia de Conservación y Restauración de los Bienes Culturales. Una de sus líneas de trabajo es el mejor conocimiento de los agentes que hacen posible la transmisión del legado patrimonial a las generaciones futuras. En este sentido se han realizado numerosos proyectos y publicaciones sobre los profesionales, fundamentalmente conservadores y restauradores. Con este póster, el Grupo S.O.S. Patrimonio avanza y plantea una nueva realidad, la acción participativa y activa de colectivos de ciudadanos que ligados a las asociaciones, transmiten a la sociedad sus preocupaciones y velan por el patrimonio natural y cultural, convirtiéndose en agentes culturales. Con este objetivo, el Grupo S.O.S. Patrimonio pone en marcha en colaboración con un grupo de asociaciones un Primer Encuentro de Asociaciones para la protección del patrimonio local que tiene lugar en Rota, el día 25 de mayo de 2013. El encuentro contó con la presencia de catorce asociaciones, el apoyo de instituciones (universidad, ayuntamiento), la participación de ciudadanos, estudiantes, e investigadores. El objetivo por tanto del póster es presentar imágenes que aportarán los miembros del Grupo de Investigación y que fueron mostradas en este primer encuentro, girando en torno a la labor que realizan. Las Asociaciones para la protección del patrimonio son instituciones sin ánimo de lucro que definen en sus estatutos como objetivos fundamentales la defensa del patrimonio natural y cultural de los pueblos. Con este fin, diseñan estrategias y actividades y todo tipo de programas (lúdicos, educativos, de restauración, etc.) que hagan posible, su transmisión a las generaciones futuras. Son organismos compuestos por ciudadanos y por tanto personas que configuran una red social o un proyecto de socialización. Su ámbito de acción se desarrolla tanto en el patrimonio rural como urbano, en el ámbito de lo tangible o lo intangible y sus preocupaciones se proyectan tanto en el patrimonio arqueológico, el patrimonio monumental, pero también en el patrimonio popular, entendiendo por popular, lo rural y cercano al ciudadano, ya que las asociaciones defienden y reconocen el patrimonio que relacionan con su propia identidad.The Group S.O.S. Heritage is a group of research and development of the University of Seville (Hum 673) that dedicates its efforts to the investigation as for Conservation and Restoration of cultural heritage. One of his lines of work is know better the agents who make possible the transmission of the patrimonial legacy to the future generations. In this respect we have realized numerous projects and publications on the professionals, fundamentally conservators and restaurators. With this poster, the group advances and raises a new reality, the participative and active action of the groups of citizens who, tied to the associations, transmit to the community his worries and guard over the natural and cultural heritage, turning into his cultural agents. With this motive, in collaboration with a group of associations, the group realizes the first Meeting of Associations for the protection of the local heritage, which takes place in Rota on May 25, 2013. In the meeting fourteen associations took part, and it had the institutional support (university, town hall) and the participation of citizens, students and investigators. The aim, therefore, of the poster is to present images that there will contribute the members of the group of investigation and that were showed in the first meeting, turning concerning the labor that they realize. The associations for the protection of the heritage are non-profit-making institutions that defend in his bylaws as fundamental aims the defense of the natural and cultural heritage of the peoples. With this end, they design strategies, activities and all kinds of programs (playful, educatives, of restoration, etc.) that make possible the transmission to the future generations. They are organisms composed by citizens and therefore persons who form a social network or a project of socialization. His area of action develops so much in the rural as urban heritage, in the area of the material thing as the immaterial thing. His worries are projected in the archaeological heritage or the monumental heritage, but also in the popular heritage, dealing for popularly, the rural and nearby thing to the citizen, since the associations defend and recognize the heritage that they relate to his own identity

Cómo minimizar los cambios radiológicos laterales en la osteotomía valguizante de adición medial de rodilla

Objetivo: estudiar la relación entre posición del injerto en Osteotomía Valguizante de Adición (OVA) en rodilla, los cambios radiológicos experimentados por la rótula y la pendiente tibial y su correlación clínica. Material y métodos: estudio retrospectivo de 10 pacientes operados de OVA. Medimos el cambio experimentado tras la osteotomía en Índice de Catón y la pendiente tibial y su relación con la ubicación del injerto. Valoración clínica mediante test de Lisholm y WOMAC. Resultados: edad media de 49.5 años, seguimiento medio de 32,2 meses. Se observa un cambio estadísticamente significativo de 1,45º en la pendiente tibial y de 0,15 unidades (Índice Catón) en la altura de la patela, pero sin correlación con la clínica. La ubicación del injerto en el cuadrante posterior se halló en el 80% de los casos. Conclusión : la osteotomía valguizante de adición medial tiene buenos resultados clínicos. Los cambios en la pendiente tibial y en la patela son menores cuanto más posterior es la ubicación del injerto.Objectives: we investigated changes in patellar height and tibial inclination angle after open-wedge high tibial osteotomy, the effect of these changes on patient satisfaction and the correlation with the graft position. Methods: retrospective study of 10 knees who underwent open-wedge proximal tibial osteotomy with allograft and medial plate for medial compartment. Were measured pre- and postoperatively tibial inclination angle, and patellar height (Caton Index), and we study the correlation of these changes with the location of the graft. Clinical evaluations were made using the Lysholm and WOMAC score. Results: the mean age was 49.5 years, the mean follow up was 32,2 months. The mean increase in the tibial inclination angle was 1,45 ° (p<0.05) and the mean of decrease in patellar height was 0.15 Units Caton Index (p<0.05). There weren’t correlation between radiological changes and patients satisfaction. The graft localization was posterior in 80% of patients. Conclusion: the open-wedge tibial osteotomy has good results and high clinical satisfaction. Changes in the tibial slope and the patellar height are lower if the graft position is posterior

Prediciendo reingresos hospitalarios no planificados antes de 15 días: una aplicación de la regresión logística

Hospital readmission is considered a key research area for improving care coordination and achieving potential savings. This is important because hospital readmissions can have negative consequences in terms of good health and recovery for patients. It is thus important to significantly reduce such readmissions. Unfortunately, there isn't a one-size-fits-all solution to preventing hospital readmissions. There are many variables outside of hospitals' direct control, such as social determinants and patient lifestyle factors, impacting readmissions. Although several studies have been undertaken to investigate 30-day readmissions, predicting revisits in shorter intervals (e.g., within 15 days after discharge) is highly needed to capture hospital-attributable returns better and develop more effective improvement plans. Hence, the aim of this paper is three-fold: i) to develop a comprehensive experimental study for identifying factors affecting 15-day readmission risk, ii) to classify patients according to the risk of 15-day readmission using logistic regression, and iii) provide general recommendations to reduce the 15-day readmission risk considering different predictors. To this end, the patients' characteristics were first described. Then, the significance of potential predictors, their interactions, and their effects were assessed. After this, a logistic regression model was derived to predict the likelihood of 15-day readmission in each patient. Finally, general recommendations were provided to reduce 15-day revisits. A real case study in Colombia was considered to validate the proposed methodology

Clinical factors associated with high glycemic variability defined by coefficient of variation in patients with type 2 diabetes

Antecedentes: La Variabilidad Glucémica Alta (VHG) ha convertirse en un predictor más fuerte de hipoglucemia. Sin embargo, aún se desconocen los factores clínicos asociados con el VHG. Objetivo:Determinar las variables clínicas que se asociaron con un coeficiente de variación (CV) superior al 36% evaluado mediante monitorización continua de glucosa (MCG) en un grupo de pacientes con diabetes mellitus. Métodos: Se evaluó una cohorte de pacientes con diabetes tipo 2 (T2D). Se evaluaron variables demográficas, HbA1c, tasa de filtración glomerular (TFG) y régimen de tratamiento. Se realizó un análisis bivariado, para evaluar la asociación entre la variable resultado (CV > 36%) y cada una de las variables independientes. Se construyó un modelo multivariado para evaluar las asociaciones después de controlar las variables de confusión. Resultados:Se analizaron los datos de MCG de 274 pacientes. CV> 36% estuvo presente en 56 pacientes (20,4%). En el análisis bivariado se incluyeron variables demográficas y clínicas, como tiempo desde el diagnóstico, antecedente de hipoglucemia, A1c, FG y tratamiento instaurado. En el análisis multivariante, FG 9% (OR 2,81; IC 1,05,7,51; p:0,04) y antecedentes de hipoglucemia (OR 2,09; IC 1,02, 4,32; p: 0,04) se asociaron con VHG. El tratamiento con iDPP4 (OR 0,39; IC 0,19, 0,82; p: 0,01) y AGLP1 (OR 0,08; IC 0,01, 0,68; p: 0,02) se asoció inversamente con la VG. Conclusión:Variables clínicas como FG 9% y antecedentes de hipoglucemia se asocian a un VG alto. Nuestros datos sugieren que el uso de tecnología y tratamientos capaces de reducir la variabilidad glucémica podría ser útil en esta población para reducir el riesgo de hipoglucemia y mejorar el control glucémico.Q3Background: High glycemic Variability (HGV) has become a stronger predictor of hypoglycemia. However, clinical factors associate with HGV still are unknown. Objective: To determine clinical variables that were associated with a coefficient of variation (CV) above 36% evaluated by continuous glucose monitoring (CGM) in a group of patients with diabetes mellitus. Methods: A cohort of patients with type 2 diabetes (T2D) was evaluated. Demographic variables, HbA1c, glomerular filtration rate (GFR) and treatment regimen were assessed. A bivariate analysis was performed, to evaluate the association between the outcome variable (CV> 36%) and each of the independent variables. A multivariate model was constructed to evaluate associations after controlling for confounding variables. Results: CGM data from 274 patients were analyzed. CV> 36% was present in 56 patients (20.4%). In the bivariate analysis, demographic and clinical variables were included, such as time since diagnosis, hypoglycemia history, A1c, GFR and treatment established. In the multivariate analysis, GFR 9% (OR 2.81; CI 1.05,7.51; p:0.04) and hypoglycemia history (OR 2.09; CI 1.02,4.32; p:0.04) were associated with HGV. Treatment with iDPP4 (OR 0.39; CI 0.19,0.82; p:0.01) and AGLP1 (OR 0.08; CI 0.01,0.68; p:0.02) was inversely associated with GV. Conclusion: Clinical variables such as GFR 9% and a history of hypoglycemia are associated with a high GV. Our data suggest that the use of technology and treatments able to reduce glycemic variability could be useful in this population to reduce the risk of hypoglycemia and to improve glycemic control.Revista Internacional - Indexad

Revista del Consejo Superior de Investigaciones Científicas

Actividad trófica de limícolas invernantes en salinas y cultivos piscícolas de la bahía de CádizUso de microhábitat del ratón de campo (Apodemus sylvatycus L.) en robledales y áreas ecotonales del Pirineo.Dieta de los pollos de tres especies simpátricas de alcaudones (Lanius spp.): variaciones con la edad, estacionales e interespecíficasOcupación de distintos modelos de nidal por el estornino negro (Sturnus unicolor)Estudio comparado sobre la biología de la reproducción de tres especies simpátricas de alcaudones (real Lanius excubitor, dorsirrojo L. collurio y común L. senatorFluctuación estacional del peso corporal de los machos adultos de Arvicola sapidus MILLER, 1908 (Rodentia, Arvicolidae)Acerca del significado de los ataques de alcaudones Lanius spp. sobre aves.Distribución de los emididos Mauremys leprosa, SCHW (1812) y Emys orbicularis, L. (1758) de la provincia de Badajoz. Factores que puedieran influir en sus áreas de ocupaciónDeterminación de la edad relativa en la rata de agua meridional, Arvicola sapidus MILLER, 1908 (Rodentia, Arvicolidae)Activity pattern, home range and habitat preference by coyotes (Canis latrans) in the Mapimi Biosphere Reserve of the Chihuahuan Desert, Mexico.Características de los refugios diarios y estacionales de Testudo graeca en DoñanaDieta del gato cimarrón (Felis catus L.) en el piso basal del Macízo de Teno (Noroeste de Tenerife)Peer reviewe

Functional Heterogeneity of Mouse and Human Brain OPCs: Relevance for Preclinical Studies in Multiple Sclerosis.

Besides giving rise to oligodendrocytes (the only myelin-forming cell in the Central Nervous System (CNS) in physiological conditions), Oligodendrocyte Precursor Cells (OPCs) are responsible for spontaneous remyelination after a demyelinating lesion. They are present along the mouse and human CNS, both during development and in adulthood, yet how OPC physiological behavior is modified throughout life is not fully understood. The activity of adult human OPCs is still particularly unexplored. Significantly, most of the molecules involved in OPC-mediated remyelination are also involved in their development, a phenomenon that may be clinically relevant. In the present article, we have compared the intrinsic properties of OPCs isolated from the cerebral cortex of neonatal, postnatal and adult mice, as well as those recovered from neurosurgical adult human cerebral cortex tissue. By analyzing intact OPCs for the first time with 1H High Resolution Magic Angle Spinning Nuclear Magnetic Resonance (1H HR-MAS NMR) spectroscopy, we show that these cells behave distinctly and that they have different metabolic patterns in function for their stage of maturity. Moreover, their response to Fibroblast Growth Gactor-2 (FGF-2) and anosmin-1 (two molecules that have known effects on OPC biology during development and that are overexpressed in individuals with Multiple Sclerosis (MS)) differs in relation to their developmental stage and in the function of the species. Our data reveal that the behavior of adult human and mouse OPCs differs in a very dynamic way that should be very relevant when testing drugs and for the proper design of effective pharmacological and/or cell therapies for MS.post-print753 K

Analysis of the information about Doctoral Degrees presented in the Spanish universities websites.

Globalization has intensified competition, as evidenced by the growing number of international classification systems (rankings) and the attention paid to them. Doctoral education has an international character in itself. It should promote opportunities for graduate students lo participate in these international studies. The quality and competitiveness are two of the most important issues for universities. To promote the interest of graduates to continue their education after the graduate level, it would be necessary to improve the published information of ihe doctoral programs. It should increase the visibility and provide high-quality, easily accessible and comparable information which includes all the relevant aspects of these programs. The authors analysed the website contents of doctoral programs, it was observed a lack of quality of them and very poor information about the contents, so that it was decided that any of them could constitute a model for creating new websites. The recommendations on the format and contents in the web were made by a discussion group. They recommended an attractive design; a page with easy access to contents and easy to find on Ihe net and with the information in more than one language. It should include complete program and academic staff information. It should also be included the study's results which should be easily accessible and includes quantitative data, such as number of students who completed scholars, publications, research projects, average duration of the studies, etc. It will facilitate the choice of progra