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BACKGROUND: Patients at the end-of-life may experience refractory symptoms of which pain, delirium, vomiting and dyspnea are the most frequent. Palliative sedation can be considered a last resort option to alleviate one or more refractory symptoms. There are only a limited number of (qualitative) studies exploring the experiences of relatives of sedated patients and their health care professionals (HCPs). The aims of this study protocol are: 1) to elicit the experiences of bereaved relatives and health care professionals of patients treated with palliative sedation and 2) to explore the understanding of the decision-making process to start palliative sedation across care settings in 5 European countries. METHODS: This study protocol is part of the larger HORIZON 2020 Palliative Sedation project. Organisational case study methodology will be used to guide the study design. In total, 50 cases will be conducted in five European countries (10 per country). A case involves a semi-structured interview with a relative and an HCP closely involved in the care of a deceased patient who received some type of palliative sedation at the end-of-life. Relatives and health care professionals of deceased patients participating in a linked observational cohort study of sedated patients cared for in hospital wards, palliative care units and hospices will be recruited. The data will be analyzed using a framework analysis approach. The first full case will be analyzed by all researchers after being translated into English using a pre-prepared code book. Afterwards, bimonthly meetings will be organized to coordinate the data analysis. DISCUSSION: The study aims to have a better understanding of the experiences of relatives and professional caregivers regarding palliative sedation and this within different settings and countries. Some limitations are: 1) the sensitivity of the topic may deter some relatives from participation, 2) since the data collection and analysis will be performed by at least 5 different researchers in 5 countries, some differences may occur which possibly makes it difficult to compare cases, but using a rigorous methodology will minimize this risk.
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Personal de Salud , Cuidados Paliativos , Humanos , Cuidados Paliativos/métodos , Dolor , Investigación Cualitativa , Muerte , Estudios Observacionales como Asunto , Estudios Multicéntricos como AsuntoRESUMEN
OBJECTIVE: To evaluate if the intraoperative human papillomavirus (IOP-HPV) test has the same prognostic value as the HPV test performed at 6 months after treatment of high-grade squamous intraepithelial lesion (HSIL) to predict treatment failure. DESIGN: Prospective cohort study. SETTING: Barcelona, Spain. POPULATION: A cohort of 216 women diagnosed with HSIL and treated with loop electrosurgical excision procedure (LEEP). METHODS: After LEEP, an HPV test was performed using the Hybrid Capture 2 system. If this was positive, genotyping was performed with the CLART HPV2 technique. The IOP-HPV test was compared with HPV test at 6 months and with surgical margins. MAIN OUTCOME MEASURE: Treatment failure. RESULTS: Recurrence rate of HSIL was 6%. There was a strong association between a positive IOP-HPV test, a positive 6-month HPV test, positive HPV 16 genotype, positive surgical margins and HSIL recurrence. Sensitivity, specificity, and positive and negative predictive values of the IOP-HPV test were 85.7, 80.8,24.0 and 98.8% and of the HPV test at 6 months were 76.9, 75.8, 17.2 and 98.0%. CONCLUSION: Intraoperative HPV test accurately predicts treatment failure in women with cervical intraepithelial neoplasia grade 2/3. This new approach may allow early identification of patients with recurrent disease, which will not delay the treatment. Genotyping could be useful in detecting high-risk patients. TWEETABLE ABSTRACT: IOP-HPV test accurately predicts treatment failure in women with CIN 2/3.
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Detección Precoz del Cáncer/métodos , Electrocirugia , Infecciones por Papillomavirus/diagnóstico , Lesiones Intraepiteliales Escamosas/cirugía , Displasia del Cuello del Útero/cirugía , Neoplasias del Cuello Uterino/cirugía , Adulto , Alphapapillomavirus , Biomarcadores de Tumor/metabolismo , Colposcopía/estadística & datos numéricos , Femenino , Genotipo , Pruebas de ADN del Papillomavirus Humano/métodos , Humanos , Biopsia Guiada por Imagen , Cuidados Intraoperatorios/métodos , Recurrencia Local de Neoplasia/virología , Estudios Prospectivos , Sensibilidad y Especificidad , Lesiones Intraepiteliales Escamosas/virología , Insuficiencia del Tratamiento , Neoplasias del Cuello Uterino/virología , Displasia del Cuello del Útero/virologíaRESUMEN
BACKGROUND: In breast cancer patients, the expression statuses of oestrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) are crucial in the choice of treatment. Receptor expression in metastatic lesions can differ from the primary tumour. The aim of our study was to analyse the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to obtain samples allowing the identification of ER, PR and HER2 expression in patients with mediastinal metastases of breast cancer. PATIENTS AND METHODS: The clinical files of all patients with a final diagnosis of breast cancer mediastinal metastases diagnosed by EBUS-TBNA in our institution were retrospectively analysed. The ability of EBUS-TBNA to obtain samples that allowed hormone receptor and HER2 expression analysis was calculated. RESULTS: Twenty-four patients were included. ER, PR and HER2 assessments could be performed in 22, 20 and 22 patients, respectively. In 20 of the 24 patients it was possible to investigate all three types of receptor expression. In the remaining four cases, where ER, PR or HER2 expression tests could not be performed, it was due to a lack of tissue. In cases with adequate results for EBUS-TBNA and the primary tumour agreement was greater for ER (16/19) and HER2 (12/14) than PR (8/17). Based on receptor status, there was a change in the choice of treatment for five patients. CONCLUSION: In patients with breast cancer mediastinal metastases, ER, PR and HER2 expression can be assessed in samples obtained by EBUS-TBNA whenever a sufficient tissue sample is collected.
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Biomarcadores de Tumor/análisis , Biopsia con Aguja Fina/métodos , Neoplasias de la Mama/patología , Neoplasias del Mediastino/secundario , Metástasis de la Neoplasia/patología , Femenino , Humanos , Neoplasias del Mediastino/patología , Receptor ErbB-2/análisis , Receptor ErbB-2/biosíntesis , Receptores de Estrógenos/análisis , Receptores de Estrógenos/biosíntesis , Receptores de Progesterona/análisis , Receptores de Progesterona/biosíntesis , Estudios Retrospectivos , Ultrasonografía Intervencional/métodosRESUMEN
BACKGROUND: Integrated Palliative Care (PC) strategies are often implemented following models, namely standardized designs that provide frameworks for the organization of care for people with a progressive life-threatening illness and/or for their (in)formal caregivers. The aim of this qualitative systematic review is to identify empirically-evaluated models of PC in cancer and chronic disease in Europe. Further, develop a generic framework that will consist of the basis for the design of future models for integrated PC in Europe. METHODS: Cochrane, PubMed, EMBASE, CINAHL, AMED, BNI, Web of Science, NHS Evidence. Five journals and references from included studies were hand-searched. Two reviewers screened the search results. Studies with adult patients with advanced cancer/chronic disease from 1995 to 2013 in Europe, in English, French, German, Dutch, Hungarian or Spanish were included. A narrative synthesis was used. RESULTS: 14 studies were included, 7 models for chronic disease, 4 for integrated care in oncology, 2 for both cancer and chronic disease and 2 for end-of-life pathways. The results show a strong agreement on the benefits of the involvement of a PC multidisciplinary team: better symptom control, less caregiver burden, improvement in continuity and coordination of care, fewer admissions, cost effectiveness and patients dying in their preferred place. CONCLUSION: Based on our findings, a generic framework for integrated PC in cancer and chronic disease is proposed. This framework fosters integration of PC in the disease trajectory concurrently with treatment and identifies the importance of employing a PC-trained multidisciplinary team with a threefold focus: treatment, consulting and training.
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Enfermedad Crónica/terapia , Neoplasias/terapia , Cuidados Paliativos/organización & administración , Adulto , Prestación Integrada de Atención de Salud/organización & administración , Europa (Continente) , Humanos , Relaciones Interprofesionales , Modelos Teóricos , Grupo de Atención al Paciente/organización & administraciónRESUMEN
INTRODUCTION: Spiritual pain and financial distress are two important dimensions of cancer care that are often overlooked. Both dimensions can have a significant impact on the quality of life of patients with cancer and their families. METHODS: This study conducted a cross-cultural adaptation, feasibility study, and psychometric properties of the Edmonton Symptom Assessment System-Financial and Spiritual (ESAS-FS) in a Spanish-speaking population with advanced cancer. The ESAS-FS is a patient-reported outcome measure that assesses 12 symptoms, including spiritual pain and financial distress. RESULTS: In the cross-cultural adaptation process, the terms "spiritual pain" and "financial distress" were refined to "sufrimiento espiritual" and "preocupación por asuntos económicos" respectively, with strong professional consensus and high patients' acceptancy (relevant questions 80%, appropriate terms 91%). A cohort of 100 onco-hematologic patients revealed that 70% experienced spiritual pain (mean 2.9/10), while 49% reported financial distress (mean 2.2/10). Symptomatic analyses illustrated significant associations of spiritual pain with various symptoms like fatigue, drowsiness, and depression. Similarly, financial distress correlated notably with drowsiness, depression, and anxiety. Moreover, a distinct correlation was observed between spiritual pain and financial distress. CONCLUSION: The findings of this study suggest that the ESAS-FS is a valuable tool for assessing spiritual pain and financial distress in Spanish-speaking patients with advanced cancer. The tool can be used to identify patients who are experiencing these dimensions of distress and to provide them with appropriate care.
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Neoplasias , Calidad de Vida , Humanos , Cuidados Paliativos , Estudios de Factibilidad , Comparación Transcultural , Dolor/diagnóstico , Neoplasias/terapia , Neoplasias/diagnósticoAsunto(s)
Delirio/terapia , Oncología Médica/normas , Neoplasias/complicaciones , Adulto , Anciano , Analgésicos Opioides/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Antipsicóticos/uso terapéutico , Dolor en Cáncer/tratamiento farmacológico , Dolor en Cáncer/etiología , Terapia Cognitivo-Conductual/métodos , Terapia Cognitivo-Conductual/normas , Delirio/diagnóstico , Delirio/epidemiología , Delirio/etiología , Deprescripciones , Sustitución de Medicamentos/métodos , Sustitución de Medicamentos/normas , Europa (Continente) , Familia , Humanos , Incidencia , Institucionalización/estadística & datos numéricos , Tamizaje Masivo/métodos , Tamizaje Masivo/normas , Oncología Médica/métodos , Estadificación de Neoplasias , Neoplasias/terapia , Educación del Paciente como Asunto/métodos , Educación del Paciente como Asunto/normas , Polifarmacia , Factores de Riesgo , Sociedades Médicas/normas , Cuidado Terminal/métodos , Cuidado Terminal/normasRESUMEN
Introduction: The case of combined drought and salinity stress is increasingly becoming a constraint to rice production, especially in coastal areas and river deltas where low rainfall not only reduces soil moisture levels but also reduces the flow of river water, resulting in intrusion of saline sea-water. A standardized screening method is needed in order to systematically evaluate rice cultivars under combined drought+salinity at the same time because sequential stress of salinity followed by drought or vice-versa is not similar to simultaneous stress effects. Therefore, we aimed to develop a screening protocol for combined drought+salinity stress applied to soil-grown plants at seedling stage. Methods: The study system used 30-L soil-filled boxes, which allowed a comparison of plant growth under control conditions, individual drought and salinity stress, as well as combined drought+salinity. A set of salinity tolerant and drought tolerant cultivars were tested, together with several popular but salinity and drought-susceptible varieties that are grown in regions prone to combined drought+salinity. A range of treatments were tested including different timings of the drought and salinity application, and different severities of stress, in order to determine the most effective that resulted in visible distinction among cultivars. The challenges related to determining a protocol with repeatable seedling stage stress treatment effects while achieving a uniform plant stand are described here. Results: The optimized protocol simultaneously applied both stresses by planting into saline soil at 75% of field capacity which was then allowed to undergo progressive drydown. Meanwhile, physiological characterization revealed that chlorophyll fluorescence at seedling stage correlated well with grain yield when drought stress was applied to vegetative stage only. Discussion: The drought+salinity protocol developed here can be used for screening rice breeding populations as part of a pipeline to develop new rice varieties with improved adaptation to combined stresses.
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INTRODUCTION: Cytological samples obtained by endobronchial ultrasound (EBUS) are capital for diagnosis, staging and molecular profile in non-small cell lung carcinoma (NSCLC). OBJECTIVE: To assess the success rate of complete, partial and individual of molecular analysis in samples obtained by EBUS-guided transbronchial needle aspiration (TBNA) and/or by oesophageal ultrasound-guided fine needle aspiration with an echobronchoscope (EUS-B-FNA) in patients with NSCLC. METHODS: Prospective study including 90 patients with non-squamous NSCLC, or non-smoking squamous. Cytological samples were classified into two groups. Group 1: PEN membrane slide and/or cell blocks for the determination of mutations of EGFR, KRAS, ERBB2 and BRAF. Group 2: silane coated slides or cell blocks for rearrangements of ALK, ROS1 and MET amplification. RESULTS: The success rate was 78.6% for 4 molecular alterations (EGFR, KRAS, ALK and ROS1), and 44% for 7 determinations. The individual success rate for EGFR was 97%, KRAS 96.3%, ALK 85%, ROS1 82.3%, ERBB2 71.4%, BRAF 67.7% and MET 81.1%. There were no significant differences (p=0.489) in the number of molecular analyses (1-3 vs. 4) in group 1, depending on the types of samples (cell block vs. PEN membrane slide vs. cell block and PEN membrane slide). CONCLUSIONS: In patients with NSCLC, the cytological material obtained by ultrasound-guided needle aspiration is sufficient for individual and partial molecular analysis in the vast majority of cases. Membrane slides such as cell blocks are valid samples for molecular analysis.
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Carcinoma de Pulmón de Células no Pequeñas/genética , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/métodos , Neoplasias Pulmonares/genética , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/patología , Análisis Mutacional de ADN/métodos , Receptores ErbB , Femenino , Amplificación de Genes , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Prevalencia , Estudios Prospectivos , Proteínas Tirosina Quinasas/genética , Proteínas Proto-Oncogénicas/genética , Proteínas Proto-Oncogénicas B-raf , Proteínas Proto-Oncogénicas p21(ras) , Proteínas Tirosina Quinasas ReceptorasRESUMEN
Grapes have high amounts of phenolic compounds, which can modulate the gut activity as well as modify the structure and function of the gastrointestinal tract. The microbiological activity of avoparcin, grape pomace concentrate, and grape seed extract was evaluated in an in vitro study. An in vivo experiment was also conducted to study the effect of the inclusion of grape pomace concentrate and grape seed extract in the diet of broiler chicks on performance, intestinal microflora (by cultured and terminal restriction fragment length polymorphism methodology), and gut morphology at 21 d of age. Dietary treatments included an antibiotic-free diet (CON), a positive control (AVP; 50 mg/kg of avoparcin), and antibiotic-free diets containing grape pomace concentrate (GPC; 60 g/kg) or grape seed extract (GSE; 7.2 g/kg). Performance was not affected by dietary treatment except in the case of birds fed the GSE diet, which showed decreased weight gain. In the ileal content, birds fed CON and GSE diets had the highest populations of Lactobacillus. Compared with the CON diet, the AVP, GPC, and GSE diets increased the populations of Enterococcus and decreased the counts of Clostridium in the ileal content. In the cecal digesta, birds fed GPC and GSE diets had higher populations of Escherichia coli, Lactobacillus, Enterococcus, and Clostridium than birds in any other treatment group. Animals fed GPC and GSE diets showed a higher biodiversity degree than those fed control diets. The frequency of detection of several potential phenol-degrading bacteria as well as unidentified and uncultured organisms was increased in animals fed GPC and GSE diets. Birds fed the CON diet had longer villi and deeper crypt depth than birds in any other treatment group. The highest villi height:crypt depth ratio corresponded to birds fed GPC and AVP diets and the lowest to those fed CON and GSE diets. In conclusion, dietary polyphenol-rich grape products modify the gut morphology and intestinal microflora and increase the biodiversity degree of intestinal bacteria in broiler chicks.
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Pollos , Dieta/veterinaria , Flavonoides/química , Flavonoides/farmacología , Intestinos/efectos de los fármacos , Fenoles/química , Fenoles/farmacología , Vitis/química , Alimentación Animal/análisis , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Bacterias/clasificación , Intestinos/anatomía & histología , Intestinos/microbiología , Masculino , PolifenolesRESUMEN
The magnetic properties of [Formula: see text], a paradigmatic hexaferrite for permanent magnet applications, have been addressed in detail combining density functional theory including spin-orbit coupling and a Hubbard U term with Monte Carlo simulations. This multiscale approach allows to estimate the Néel temperature of the material from ab initio exchange constants, and to determine the influence of different computational conditions on the magnetic properties by direct comparison versus available experimental data. It is found that the dominant influence arises from the choice of the Hubbard U term, with a value in the 2-3 eV range as the most adequate to quantitatively reproduce the two most relevant magnetic properties of this material, namely: its large perpendicular magnetocrystalline anisotropy and its elevated Néel temperature.
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UNLABELLED: The Eurobarometer Survey of the EAPC Task Force on the Development of Palliative Care in Europe is part of a programme of work to produce comprehensive information on the provision of palliative care across Europe. AIM: To identify barriers to the development of palliative care in Western Europe. METHOD: A qualitative survey was undertaken amongst boards of national associations, eliciting opinions on opportunities for, and barriers to, palliative care development. By July 2006, 44/52 (85%) European countries had responded to the survey; we report here on the results from 22/25 (88%) countries in Western Europe. ANALYSIS: Data from the Eurobarometer Survey were analysed thematically by geographical region and by the degree of development of palliative care in each country. RESULTS: From the data contained within the Eurobarometer, we identified six significant barriers to the development of palliative care in Western Europe: (i) lack of palliative care education and training programmes; (ii) lack of awareness and recognition of palliative care; (iii) limited availability of/knowledge about opioid analgesics; (iv) limited funding; (v) lack of coordination amongst services; and (vi) uneven palliative care coverage. CONCLUSION: Findings from the EAPC Eurobarometer Survey suggest that barriers to the development of palliative care in Western Europe may differ substantially from each other in both their scope and context and that some may be considered to be of greater significance than others. A number of common barriers to the development of the discipline do exist and much work still remains to be done in the identified areas. This paper provides a road map of which barriers need to be addressed.
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Atención a la Salud/organización & administración , Cuidados Paliativos/organización & administración , Analgésicos Opioides/provisión & distribución , Competencia Clínica , Educación Médica/estadística & datos numéricos , Europa (Continente) , Encuestas de Atención de la Salud , Accesibilidad a los Servicios de Salud , HumanosRESUMEN
Interferon (IFN)-γ release assays (IGRAs) are used to diagnose latent tuberculosis (TB) infection (LTBI). To improve the accuracy of these tests, different approaches, such as alternative cytokine detection and using different antigens, are considered. Following this purpose, this study aims to evaluate the addition of EspC, EspF and Rv2348-B to those present in the QuantiFERON-TB Gold In-Tube (QFN-G-IT). We included 115 subjects: 74 active TB patients, 17 LTBI individuals and 24 healthy controls. Whole blood samples were collected in QFN-G-IT and in-house tubes containing different combinations of EspC, EspF and Rv2348-B, together with ESAT-6, CFP-10, and TB7.7. After overnight incubation at 37 ºC, plasma was harvested and IFN-γ quantified. IFN-γ levels in the QFN-G-IT and in-house tubes correlated very good (Spearman Rho(r) > 0.86). In-house antigen combinations distinguished healthy individuals from those with active TB and LTBI (specificities and sensitivities higher than 87.5% and 96.3%, respectively [AUC > 0.938]). Adding EspC, EspF and Rv2348-B, increased the sensitivity of the test, being the addition of EspC and Rv2348-B the combination that yielded a higher sensitivity with no specificity loss. Addition of these antigens could improve diagnosis in patients with impaired or immature immune response who are at high risk of developing TB.
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Antígenos Bacterianos/inmunología , Tuberculosis Latente/diagnóstico , Mycobacterium tuberculosis/inmunología , Tuberculosis/diagnóstico , Adulto , Estudios de Casos y Controles , Diagnóstico Precoz , Femenino , Humanos , Ensayos de Liberación de Interferón gamma , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , España , Prueba de Tuberculina , Tuberculosis/inmunologíaRESUMEN
The effect of dietary fat sources (high-oleic-acid sunflower seeds, HOASS; palm oil, PO; and high-oleic-acid sunflower oil, HOASO) and high-oleic-acid sunflower hulls (HOAS hulls; 40 g/kg of diet) on performance, digestive organ size, fat digestibility, and fatty acid profile in abdominal fat and blood serum parameters was evaluated in chickens (from 1 to 21 d of age). Bird performance and digestive organ size were not affected by either dietary fat source or sunflower hull supplementation. Fat digestibility in birds fed diets enriched (HOASS and HOASO) in monounsaturated fatty acids (MUFA) was increased compared with those fed the PO diet. The addition of sunflower hulls did not modify fat digestibility. The fatty acids pattern of abdominal fat reflected the dietary fat profile. The greatest concentrations of C16:0 and C18:0 were found in birds fed PO diets. The C18:1n-9 content was increased in birds that received HOASS and HOASO diets compared with those fed PO diets. The greatest content of C18:2n-6 was observed in birds fed HOASS diets. The ratio of polyunsaturated fatty acid (PUFA) to MUFA was significantly increased in birds fed PO diets compared with those fed HOASS or HOASO diets. The addition of sunflower hulls to the diets resulted in a decrease of C18:2n-6 and PUFA concentrations and PUFA:MUFA ratio in abdominal fat. Dietary fat sources and sunflower hulls modify blood triglycerides and serum lipoproteins. A decrease in triglyceride concentrations was observed in birds fed HOASS diets compared with those fed PO and HOASO diets. The greatest concentrations of serum high density, very low density (VLDL), and low density lipoproteins were found in birds receiving HOASO, PO, and HOASS diets, respectively. The addition of sunflower hulls to the diets caused an increase of serum triglycerides and VLDL concentrations. The MUFA-enriched diets had lower triglyceride and VLDL concentrations than did diets rich in saturated fatty acids. However, the sunflower hull addition had the opposite effect.
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Alimentación Animal/análisis , Pollos , Grasas de la Dieta/farmacología , Ácido Oléico/análisis , Semillas/química , Grasa Abdominal/química , Fenómenos Fisiológicos Nutricionales de los Animales , Animales , Pollos/sangre , Dieta/veterinaria , Suplementos Dietéticos , Digestión/efectos de los fármacos , Interacciones Farmacológicas , Ácidos Grasos/análisis , Tracto Gastrointestinal/anatomía & histología , Tracto Gastrointestinal/efectos de los fármacos , Tracto Gastrointestinal/crecimiento & desarrollo , Helianthus/química , Masculino , Tamaño de los Órganos/efectos de los fármacosRESUMEN
OBJECTIVES: Platelet-rich plasma (PRP) is being used increasingly often in the clinical setting to treat tendon-related pathologies. Yet the optimal PRP preparations to promote tendon healing in different patient populations are poorly defined. Here, we sought to determine whether increasing the concentration of platelet-derived proteins within a derivative of PRP, platelet lysate (PL), enhances tenocyte proliferation and migration in vitro, and whether the mitogenic properties of PL change with donor age. METHODS: Concentrated PLs from both young (< 50 years) and aged (> 50 years) donors were prepared by exposing pooled PRP to a series of freeze-thaw cycles followed by dilution in plasma, and the levels of several platelet-derived proteins were measured using multiplex immunoassay technology. Human tenocytes were cultured with PLs to simulate a clinically relevant PRP treatment range, and cell growth and migration were assessed using DNA quantitation and gap closure assays, respectively. RESULTS: Platelet-derived protein levels increased alongside higher PL concentrations, and PLs from both age groups improved tenocyte proliferation relative to control conditions. However, PLs from aged donors yielded a dose-response relationship in tenocyte behaviour, with higher PL concentrations resulting in increased tenocyte proliferation and migration. Conversely, no significant differences in tenocyte behaviour were detected when increasing the concentration of PLs from younger donors. CONCLUSION: Higher PL concentrations, when prepared from the PRP of aged but not young donors, were more effective than lower PL concentrations at promoting tenocyte proliferation and migration in vitro.Cite this article: D. R. Berger, C. J. Centeno, N. J. Steinmetz. Platelet lysates from aged donors promote human tenocyte proliferation and migration in a concentration-dependent manner. Bone Joint Res 2019;8:32-40. DOI: 10.1302/2046-3758.81.BJR-2018-0164.R1.
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INTRODUCTION: It is recognized that mobile phones may play a role in microorganism transmission and that hand hygiene, is considered the most important action for preventing infections and the spread of pathogens. The objective of this study was to determine presence and circulation bacteria on hands and mobile phones capable of causing infections in people and also determine if disinfection with gel-alcohol is useful to reduce the bacterial colonization. METHODS: The bacterial evaluation included 596 hands of participants and 256 mobile phones. Isolated colonies were identified by biochemical test and confirmed by gene 16S rRNA sequencing. Antimicrobial susceptibility was performed using the automated instrument Vitek®2-Compact and disk-diffusionmethod. RESULTS: In total, 92.9% of mobile phones and 98.3% of participants in study demonstrated evidence of bacterial contamination with different types of bacteria. Surprisingly, we observed that 18.6% plaques inoculated with disinfected fingers showed bacterial growth. In general, Gram negative isolates showed resistance to a higher number of antibiotics tested than Gram positive isolates. CONCLUSIONS: Our results could help to raise awareness in our society about the importance of hand hygiene, as well as frequently used devices, reducing bacterial contamination and limiting the possibility of transmission of resistant multi-drug bacteria.
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Antibacterianos/farmacología , Teléfono Celular , Farmacorresistencia Bacteriana Múltiple , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/efectos de los fármacos , Desinfectantes para las Manos/farmacología , Mano/microbiología , Estudios Transversales , Bacterias Gramnegativas/genética , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Gramnegativas/fisiología , Bacterias Grampositivas/genética , Bacterias Grampositivas/aislamiento & purificación , Bacterias Grampositivas/fisiología , Desinfección de las Manos , Higiene de las Manos , Humanos , Pruebas de Sensibilidad Microbiana , ARN Bacteriano/análisis , ARN Ribosómico 16S/genéticaRESUMEN
INTRODUCTION: Given the high prevalence of erectile dysfunction in male population between 40-70 years old and the effect of radical prostatectomy on this domain, it is important to perform a baseline study. MATERIAL AND METHODS: Prior radical prostatectomy, erectile function has been assessed prospectively in 112 prostate cancer patients using the erectile function (EF) domain of the International Index of Erectile Function (EF-IIEF), Erectile Hardness Score (EHS) and a penile doppler ultrasound (PDUS). Comorbidities and Charlson index were collected. The EORTC QLQ C-30 and PR-25 tests were administered. RESULTS: According to EF-IIEF questionnaire, 50.9% of patients showed normal EF and EHS grade 3-4 erection was achieved in the 75.9%. PDUS was normal only in 28.6% of patients and 51.8% showed arterial insufficiency. We found a significant association (P<.0001) between categorized EF-IIEF (normal, mild/moderate/severe) and the EHS value. Between PDUS (normal vs. pathologic) and EHS (3-4 vs. 1-2) statistically significant association (P=.005) was found. Just 35.3% of patients with EHS 3-4 showed normal PDUS. Correlation between the PDUS and the EF-IIEF (≥26 vs.<26) was statistically significant (P=.043). Moreover, only 38.6% of patients with EF-IIEF≥26 had a normal PDUS. CONCLUSIONS: In order to predict EF recovery after surgery, global assessment is required. Solely self-administered tests are not enough. In this baseline study, PDUS can play an important role.
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Erección Peniana , Pene/diagnóstico por imagen , Pene/fisiología , Prostatectomía , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/cirugía , Ultrasonografía Doppler , Anciano , Humanos , Masculino , Persona de Mediana Edad , Periodo Preoperatorio , Estudios Prospectivos , Encuestas y CuestionariosRESUMEN
Platelets of strontium hexaferrite (SrFe12O19, SFO), up to several micrometers in width, and tens of nanometers thick have been synthesized by a hydrothermal method. They have been studied by a combination of structural and magnetic techniques, with emphasis on Mössbauer spectroscopy and X-ray absorption based-measurements including spectroscopy and microscopy on the iron-L edges and the oxygen-K edge, allowing us to establish the differences and similarities between our synthesized nanostructures and commercial powders. The Mössbauer spectra reveal a greater contribution of iron tetrahedral sites in platelets in comparison to pure bulk material. For reference, high-resolution absorption and dichroic spectra have also been measured both from the platelets and from pure bulk material. The O-K edge has been reproduced by density functional theory calculations. Out-of-plane domains were observed with 180° domain walls less than 20 nm width, in good agreement with micromagnetic simulations.
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Excitotoxic insults induce c-Jun N-terminal kinase (JNK) activation, which leads to neuronal death and contributes to many neurological conditions such as cerebral ischemia and neurodegenerative disorders. The action of JNK can be inhibited by the D-retro-inverso form of JNK inhibitor peptide (D-JNKI1), which totally prevents death induced by N-methyl-D-aspartate (NMDA) in vitro and strongly protects against different in vivo paradigms of excitotoxicity. To obtain optimal neuroprotection, it is imperative to elucidate the prosurvival action of D-JNKI1 and the death pathways that it inhibits. In cortical neuronal cultures, we first investigate the pathways by which NMDA induces JNK activation and show a rapid and selective phosphorylation of mitogen-activated protein kinase kinase 7 (MKK7), whereas the only other known JNK activator, mitogen-activated protein kinase kinase 4 (MKK4), was unaffected. We then analyze the action of D-JNKI1 on four JNK targets containing a JNK-binding domain: MAPK-activating death domain-containing protein/differentially expressed in normal and neoplastic cells (MADD/DENN), MKK7, MKK4 and JNK-interacting protein-1 (IB1/JIP-1).
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Corteza Cerebral/citología , Corteza Cerebral/efectos de los fármacos , Proteínas Quinasas JNK Activadas por Mitógenos/metabolismo , N-Metilaspartato/toxicidad , Neuronas/efectos de los fármacos , Neuronas/enzimología , Neurotoxinas/toxicidad , Proteínas Adaptadoras Transductoras de Señales/aislamiento & purificación , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Animales , Calcio/metabolismo , Corteza Cerebral/enzimología , Cicloheximida/farmacología , Proteínas Adaptadoras de Señalización del Receptor del Dominio de Muerte , Electroforesis en Gel Bidimensional , Activación Enzimática/efectos de los fármacos , Inhibidores Enzimáticos/farmacología , Técnica del Anticuerpo Fluorescente , Factores de Intercambio de Guanina Nucleótido/metabolismo , Proteínas Quinasas JNK Activadas por Mitógenos/antagonistas & inhibidores , MAP Quinasa Quinasa 4/metabolismo , MAP Quinasa Quinasa 7/metabolismo , Neuronas/citología , Neuronas/patología , Fosforilación/efectos de los fármacos , Proteómica , Ratas , Transducción de Señal/efectos de los fármacosRESUMEN
Constipation is one of the most common problems in patients receiving palliative care and can cause extreme suffering and discomfort. The aims of this study are to raise awareness of constipation in palliative care, provide clear, practical guidance on management and encourage further research in the area. A pan-European working group of physicians and nurses with significant experience in the management of constipation in palliative care met to evaluate the published evidence and produce these clinical practice recommendations. Four potentially relevant publications were identified, highlighting a lack of clear, practical guidance on the assessment, diagnosis and management of constipation in palliative care patients. Given the limited data available, our recommendations are based on expert clinical opinion, relevant research findings from other settings and best practice from the countries represented. Palliative care patients are at a high risk of constipation, and while general principles of prevention should be followed, pharmacological treatment is often necessary. The combination of a softener and stimulant laxative is generally recommended, and the choice of laxatives should be made on an individual basis. The current evidence base is poor and further research is required on many aspects of the assessment, diagnosis and management of constipation in palliative care.