Circulating Neutrophil Extracellular Trap (NET)-forming neutrophils in rheumatoid arthritis exacerbation are majority dual endothelin-1/signal peptide receptor (DEspR)+ subtype.

Neutrophil extracellular traps (NETs) are associated with rheumatoid arthritis pathogenesis and severity. Since homeostatic NET-forming neutrophils [NET+Ns] have beneficial roles in defense against pathogens, their distinction from pro-injury [NET+N] subtypes is important, especially if they are to be therapeutically-targeted. Having identified circulating, pro-injury DEspR+CD11b+ [NET+Ns] in patients with neutrophilic secondary tissue injury, we determined whether DEspR+ [NET+Ns] are present in RA-flares. Whole blood samples of patients with RA-flares on maintenance therapy (n=6), were analyzed by flow cytometry (FCM) and immunofluorescence cytology followed by semi-automated quantitative confocal microscopy (qIFC). We assessed clinical parameters, levels of neutrophils and [NET+Ns], and plasma S100A8/A9. qIFC detected circulating DEspR+CD11b+ neutrophils and [NET+Ns] in RA-flare patients but not healthy controls. DEspR+ [NET+Ns] were positive for citrullinated histone H3 (citH3+), extruded DNA, decondensed but recognizable polymorphic nuclei, and [NET+N] doublet-interactions in mostly non-ruptured NET-forming neutrophils. Circulating DNA+/DEspR+/CD11b+/citH3+ microvesicles (netMVs) were observed. FCM detected increased %DEspR+CD11b+ neutrophils and DEspR+ cell-cell doublets whose levels trended with DAS28 scores, as did plasma S100A8/A9 levels. This study identifies circulating DEspR+/CD11b+ neutrophils and [NET+Ns] in RA-flare patients on maintenance therapy. Detection of circulating DEspR+citH3+ [NET+Ns] and netMVs indicate a systemic neutrophilic source of citH3-antigen concordant with multi-joint RA pathogenesis. Increased S100A8/A9 alarmin levels are associated with cell injury and released upon NET-formation. As a ligand for TLR4, S100A8/A9 forms a positive feedback loop for TLR4-induced DEspR+ neutrophils. These data identify DEspR+ neutrophils and [NET+Ns] in RA pathogenesis as a potential biomarker and/or therapeutic target.

Communication Training within Partners in School: Feasibility, Acceptability, and Usability.

Partners in School is a consultation model adapted from Conjoint Behavioral Consultation where parents and teachers identify a mutual concern for children with Autism and then implement the same evidence-based practices (EBPs) across home and school. Adding parent-teacher communication training (School Talk) may bolster the effects of this consultation approach. The purpose of this study was to explore parents' and teachers' experiences with School Talk, as well as examine the clinical outcomes of Partners in School plus School Talk. Participants were 21 parents and 21 teachers (n=21 dyads, N=42 participants) of preschool to first-grade children with Autism. Results indicated that parents and teachers both rated School Talk as feasible and acceptable, but parents rated it as more usable. There was preliminary evidence that Partners in School with School Talk may be associated with improvements in parent-teacher communication, as well as reductions in the frequency of child concerns.

Implementation of a telerehabilitation program for children with neurodevelopmental disorders during the lockdown caused by COVID-19.

Introduction: Telerehabilitation is a tool for patients who, for different reasons, cannot participate in person with their physical presence. We aimed to identify the factors associated with satisfaction with telerehabilitation in families with children with neurodevelopmental disorders through a program that included physiotherapy, occupational therapy, and speech therapy. Methods: The program was developed during the COVID-19 lockdown period. Outcome measures: Child's age, the school stage to which they belonged, the person of reference in their daily care at home. The resources provided to the families, as well as the frequency of activities and difficulties detected, were evaluated through a survey. Findings: One hundred thirteen families responded to the survey. The general assessment resources were classified as very good. The average frequency of carrying out the activities was two times a week, with an average of 30 minutes per session. The ability to understand the information in the manual was not affected by the academic status of the caregivers (p = 0.286). Conclusions: This is the first study to quantify the multidisciplinary approach to children with neurodevelopmental disorders using telerehabilitation. The results show high levels of participation and satisfaction. The resources could be shared for their applicability in other countries whose families have similar needs conditioned by COVID-19.

Consenso Colombiano sobre el tratamiento de la leucemia linfoblástica aguda en adultos / Colombian consensus document for the treatment of adult acute lymphoblastic leukemia

Introducción: El Consenso Colombiano de Hematología Oncológica (CC CCHO) es un proyecto apoyado por el Instituto Nacional de Cancerología, E.S.E y por la Sociedad Colombiana de Hematología y Oncología. Su propósito es mejorar los resultados de las intervenciones realizadas en los pacientes con cáncer, ayudando a los profesionales en salud a suministrar la mejor evidencia disponible; a fin de optimizar las decisiones clínicas y promover el uso racional de los recursos. La actividad delCCHO permite desarrollar pautas para la práctica clínica, siguiendo la metodología del grupo nominal; los informes resultantes representan la síntesis de las recomendaciones extraídas de la información recolectada por medio de búsquedas sistemáticas de la literatura médica. La aprobación de las recomendaciones por parte de los miembros del CCHO no significa necesariamente que deba ser adoptada como política; depende del lector.Métodos: Se revisaron las bases Medline (1966-2005), Cochrane Library (Issue 2, 2005), Embase (1974-2005), Biosis (1992-2005), Lilacs (1989-2005) y otras bases de datos relevantes. Los artículos publicados fueron seleccionados y revisados por el comité central del CCHO. Este documento ha sido revisado y aprobada por todos los miembros del Consenso, que incluyó: hematólogos, oncólogos, epidemiólogos, hematopatólogos, un especialista en políticas de salud y un miembro dela comunidad. Tres hematólogos internacionales, de manera independiente, hicieron la revisión externa del documento de resumen. El documento final del consenso requirió un proceso formal de estandarización. Será obligatoria la revisión periódica y continua de la literatura científica y, cuando se considere apropiado, se integrará la nueva información relevante al consenso original. Población: El ámbito del consenso son los pacientes adultos con diagnóstico de leucemia linfoblástica aguda.