Meta-analysis to Implement Alpha-Synuclein in Extracellular Vesicles as a Potential Biomarker for Parkinson's Disease

ABSTRACT Background: In Parkinson's disease (PD), exosomes carry α-synuclein (α-syn), a fibrillar protein aggregates with potential value as a biomarker. Objective: Evidence on blood levels of exosomal α-syn in PD patients and controls was reviewed for their consistency. Methods: Thirty-six studies on exosomal α-syn concentrations in PD were identified in a systematic literature search and meta-analysis. Results: Both raw and ratio-adjusted blood exosomal α-syn levels were consistently higher in PD patients than in controls. The standardized mean difference (SMD) was 1.54 (0.18-2.90, CI95%, p < 0.01) and 1.53 (0.23-2.83, CI95%, p < 0.01), respectively. Conclusion: Our results suggest that exosomal α-syn concentrations could be a useful biomarker for PD.

Capacitación en reemplazo renal continuo, primera experiencia en el Sanatorio Allende. Relato de experiencia / Training in continuous renal replacement,first experience at the Allende Sanatorio. Experience report

La Insuficiencia Renal Aguda (IRA), es sin dudas una de las complicaciones más frecuentes que puede presentar el paciente crítico; la cual se define como la disminución en la capacidad que tienen los riñones para eliminar productos nitrogenados de desechos. En las unidades de cuidados críticos la causa de las mismas puede ser multifactorial y se relaciona con el fallo multiorgánico. El presente trabajo es un relato de experiencia, un trabajo descriptivo de experiencias de la terapia en reemplazo renal continuo, acompañado además de recolección bibliográfica, cuyo objetivo principal es la capacitación en el tratamiento de las insuficiencias renales en los pacientes críticos con la terapia de reemplazo renal continuo. Para abordar esta temática, se conformó un equipo multidisciplinario en el mes de Abril del año 2021, entre los servicios de Unidad de Cuidados Crítico y el Servicio de Nefrología, en donde se desarrolló un plan de capacitación de manera virtual para abordar el tratamiento a los pacientes con fallo renal, el cual contó además con la disertación y capacitación de personal altamente calificados en el tema, para posteriormente realizar un entrenamiento teórico-práctico en el servicio de Hemodiálisis del Sanatorio Allende de Nueva Córdoba, en la técnica de conexión y desconexión de catéteres de hemodiálisis, en el cual asistieron un total de 26 enfermeros del área de Terapia Intensiva de ambas sedes con el fin de aprender la técnica específica que se aplicará en los pacientes que serán sometidos a hemofiltración venovenosa continua[AU]

Acute Renal Insufficiency (AKI) is undoubtedly one of the most frequent complications that critical patients may present; which is defined as the decrease in the ability of the kidneys to eliminate nitrogenous waste products. In critical care units, their cause can be multifactorial and is related to multiorgan failure.The present work is a report of experiences, a descriptive work of experiences of continuous renal replacement therapy, accompanied by a bibliographic collection, whose main objective is training in the treatment of renal insufficiency in critical patients with replacement therapy. continuous kidney. To address this issue, a multidisciplinary team was formed in April 2021, between the services of the Critical Care Unit and the Nephrology Service, where a training plan was developed virtually to address the treatment of patients. patients with kidney failure, which also included the dissertation and training of highly qualified personnel on the subject, to subsequently carry out theoretical-practical training in the Hemodialysis service of the Allende Sanatorium in Nueva Córdoba, in the connection and disconnection technique of hemodialysis catheters, which was attended by a total of 26 nurses from the Intensive Care area of both sites in order to learn the specific technique that will be applied to patients who will undergo continuous venovenous hemofiltration[AU]

A Insuficiência Renal Aguda (LRA) é, semdúvida, uma das complicaçõesmaisfrequentes que os pacientes críticos podemapresentar; que é definida como a diminuição da capacidade dos rins de eliminar produtosresiduais nitrogenados. Em unidades de terapia intensiva, sua causa pode ser multifatorial e está relacionada à falência de múltiplos órgãos. O presente trabalho é um relato de experiências, umtrabalhodescritivo de experiências de terapia renal substitutiva contínua, acompanhado de umlevantamento bibliográfico, cujo objetivo principal é a capacitação no tratamento da insuficiência renal em pacientes críticos com terapia substitutiva renal. Para abordar essaquestão, uma equipe multidisciplinar foi formada em abril de 2021, entre os serviços da Unidade de Terapia Intensiva e o Serviço de Nefrologia, onde foi desenvolvido um plano de treinamento virtualmente para abordar o tratamento de pacientes com insuficiência renal, que incluiutambém o dissertação e treinamento de pessoal altamente qualificado no assunto, para posteriormente realizar treinamento teórico-prático no serviço de Hemodiálise do Sanatório Allende em Nueva Córdoba, na técnica de conexão e desconexão de cateteres de hemodiálise, que contoucom a participação de um total de 26 enfermeiros da área de Terapia Intensiva de ambos os locais para conhecer a técnica específica que será aplicada aos pacientes que ser ãosubmetidos à hemofiltração venovenosa contínua[AU]

Efectos de la interrelación arco-bracket, desde el microscopio electrónico de barrido / Effects of the arch-bracket interrelation, from the scanning electron microscope

Los alambres en ortodoncia son elementos activos que tienen la capacidad de almacenar energía y liberar fuerzas. Los brackets permiten la unión directa y selectiva entre el arco de alambre y las piezas dentarias, lo que optimiza el efecto de presiones específicas de forma precisa y controlada, transmitiendo el movimiento en los tres sentidos del espacio. Durante el tratamiento de ortodoncia, estos elementos podrían sufrir alteraciones estructurales impidiendo el movimiento dental óptimo. En el presente trabajo de investigación, se analizó la respuesta que tienen el arco de acero inoxidable 0.019" × 0.025" y el slot de brackets de zafiro, en el sector anterior del maxilar superior, cuando ejercen fricción entre sí, antes y después de ser utilizados clínicamente en un tratamiento de ortodoncia. Para esto, las muestras fueron lavadas con alcohol absoluto al 96 % y secadas para ser observadas en el microscopio electrónico de barrido ambiental (MEB) (ESEM - environmental scanning electron microscope), modelo FEI ESEM QuantaTM 200. Los arcos rectangulares fueron analizados por sus cuatro caras y cuatro aristas (superior, inferior, interna y externa; respectivamente) y los slots de brackets de zafiro fueron observados en un corte sagital y dividido en forma lineal en tres mediciones (interna, media y externa). Los datos obtenidos fueron volcados en una planilla de tabulación de datos para su análisis estadístico, mediante el test de normalidad de Shapiro-Wilk para medidas no paramétricas y el test de Fisher. En conclusión, las zonas más afectadas por el desgaste fueron las caras y aristas internas del arco de acero de 0.019" × 0.025", y la medición interna del slot de brackets de zafiro. Ambas presentaban una pérdida de la solución de continuidad en su estructura, evidenciando un área de mayor fricción(AU)

Orthodontic wires are active elements that have the ability to store energy and release forces. The brackets allow the direct and selective bonding between the wire arch and teeth, optimizing the effect of specific pressures in a precise and controlled way, transmitting movement in the three directions of space. During orthodontic treatment, these elements could undergo structural changes preventing optimal dental movement. In the current research work, the response that the 0.019" × 0.025" stainless steel archwire and the sapphire bracket slot have in the anterior sector of the upper jaw when they exert friction on each other, before and after being clinically used in an orthodontic treatment was analyzed. For this purpose, the samples were washed in 96% absolute alcohol and dried to be observed under the environmental scanning electron microscope ESEM (MEB - microscopio electrónico de barrido ambiental), model FEI ESEM QuantaTM 200. The rectangular archwires were analyzed on their 4 faces and 4 edges (upper, lower, internal and external) and the sapphire brackets slots were observed in a sagittal section and linearly divided into three measurements (internal, medium and external). The data obtained were put in a data tabulation spreadsheet for its statistical analysis by using the Shapiro-Wilk normality test for nonparametric measures, and the Fisher test. In conclusion, the areas most affected by wear were the internal face and edges of the 0.019" × 0.025" steel arch and the internal measurement of the sapphire brackets slot. They both presented loss of continuity in their structure, providing evidence of an area of greater friction(AU)

Estudio en el microscopio electrónico de barrido de los brackets zafiro / Scanning electron microscopic study of the sapphire brackets

El movimiento ortodóncico es el resultado de la aplicación de fuerzas a las piezas dentarias a través de dispositivos diseñados para almacenar energía y devolverla y, así, producir el efecto deseado. El profesional actuante puede confeccionar un diagnóstico e implementar una técnica para concretar un plan de tratamiento y cumplir las satisfacciones estéticas del paciente eligiendo el zafiro como material de innovación. Sin embargo, si el bracket de zafiro no mantiene su integridad estructural en el slot donde se encuentra la información para el movimiento de la pieza dentaria, el ortodoncista debe hacer maniobras compensatorias en busca del movimiento dental óptimo para alcanzar el éxito deseado. El objetivo de este trabajo fue comparar la angulación de las paredes del slot de los brackets de zafiro y el desgaste en la superficie estructural del material en brackets sin uso clínico y utilizados luego de concluir un tratamiento. Para esto, se eligieron brackets de zafiro de todas las piezas dentarias de la arcada del maxilar superior y del inferior con uso y sin uso clínico y fueron observados al microscopio electrónico de barrido ambiental (MEB) FEI ESEM Quanta 200. Las muestras fueron lavadas con alcohol absoluto de 96 % de volumen, cepilladas de manera mecánica y secadas antes de ser introducidas en la cámara del MEB. En la etapa de observación se procedió a la construcción de medidas lineales en la imagen de la ranura del bracket desde una vista sagital. Se obtuvieron una medida interna, una media y una externa, cuyos resultados se analizaron mediante el test de normalidad de Shapiro-Wilk. En conclusión, mediante este estudio se observó que algunos brackets mantuvieron su estructura al inicio y al final de su utilización clínica, y otros presentaron una diferenciación en la medida inicial del grupo de brackets no usados clínicamente, que lleva a determinar un desgaste del ángulo interno del slot producto del deslizamiento del alambre durante el uso clínico.

The orthodontic movement is the result of the application of forces to the dental pieces through devices designed to store energy and return it and so to produce the desired effect. The acting professional can make a diagnosis and implement a technique to carry out a treatment plan and meet the aesthetic satisfactions of the patient choosing sapphire as an innovation material. However, if the sapphire bracket does not maintain its structural integrity in the slot where the information for the movement of the tooth is located, the orthodontist must make compensatory maneuvers in search of optimal dental movement to achieve the wanted success. The objective of this work was to compare the angulation of the sapphire brackets slot walls and the wear on the structural surface of the brackets material without clinical use and used after completing a treatment. For this, sapphire brackets were selected from all teeth of the upper and lower jaw arches with use and without clinical use and were observed under the environmental scanning electron microscope (ESEM) FEI ESEM Quanta 200. Samples were washed with absolute alcohol at 96% vol, mechanically brushed and dried before being introduced into the MEB chamber. In the observation phase it was carried out the construction of linear measurements in the image of the bracket slot from a sagittal view. They were obtained an internal, an average and an external measurements which results were analyzed by the Shapiro-Wilk Normality Test. In conclusion, through this study it was observed that some brackets maintained their structure at the beginning and end of their clinical use and others presented a differentiation in the initial measurement of the group of not used clinically brackets that leads to determine a wear of the internal angle of the slot owing to the sliding of the wire during clinical use.

François Tosquelles, sua história no campo da Reforma Psiquiátrica / Desinstitucionalização e suas pistas para uma abordagem clínica do trabalho centrada na atividade / François Tosquelles, their history in the Psychiatric Reform - Deinstitutionalization and their clues to a clinical approach focused on the work activity

O artigo revisita aspectos da vida e da obra do psiquiatra catalão François Tosquelles, registrando a trajetória e o patrimônio de experimentações no campo da saúde mental, em especial em sua valorização da atividade. Para tanto, foi feito um levantamento bibliográfico dos textos por ele publicados, assim como das entrevistas que concedeu, além de materiais publicados por outros autores que se referem a ele ou à sua obra. Entende-se que aí se encontra uma riqueza ainda pouco explorada e que tal pesquisa permite avançar: seja na luta pela reforma psiquiátrica e desinstitucionalização; seja, enfim, explorando o ponto de vista da atividade na abordagem clínica do trabalho...

This paper raises some aspects of the life and work of the Catalan psychiatrist Francois Tosquelles, recording the history and heritage of his experiments in the mental health area, especially, in making the activity invaluable. It was pursued to a conduct a bibliographical survey on the texts published by him was sought after as well as on the interviews he gave, in addition to materials published by several other authors who refer to him or his work. We take it that there is still an unexplored richness in variousPsychology fields, whether in the struggle for deinstitutionalization andpsychiatric reform with new forms of psychosocial care whether in the pursuit of possibilities for intervention research and, finally, exploring theactivity viewpoint in relation to the clinic approach of work...

Saúde e segurança e a subjetividade no trabalho: os riscos psicossociais / Health and safety, and subjectivity at work: the psychosocial risks

Este ensaio apresenta reflexões sobre saúde e segurança no trabalho destacando as recentes propostas de inclusão dos aspectos psicossociais nas abordagens dos riscos ocupacionais que tradicionalmente valorizam apenas os aspectos objetivos (químicos, físicos e biológicos). Para subsidiar as colocações aqui mencionadas, foram utilizados referenciais teórico-metodológicos que, adotando uma perspectiva dinâmica, partem da atividade, do trabalho real, especialmente a psicodinâmica do trabalho e a perspectiva ergológica. Aponta-se para a necessidade de revisitar os atuais modelos de gestão de riscos ocupacionais centrados no controle e no cumprimento fiel das orientações, incorporando também as dimensões subjetivas, aquilo que é da ordem do não antecipável, que advém das situações reais com suas dramáticas, encontros, escolhas e ressingularizações. Nesse sentido, ressaltada a dimensão gestionária das atividades, seus protagonistas são convocados não apenas a cumprir prescrições elaboradas por especialistas, mas também a exercer, individual e coletivamente, a coautoria na gestão de sua saúde, segurança, trabalho e vida.

This paper presents reflections on health and safety at work, highlighting the recent proposals that are for the inclusion of psychosocial aspects in the management of occupational risks, which traditionally dealt only with objective (chemical, physical, and biological) aspects. To support the arguments presented, we worked within theoretical and methodological frameworks that, by adopting a dynamic perspective, focused on activity, on actual work, especially the psychodynamics of work and the ergological perspective. We pointed at the need to revisit the current occupational risk management models centered in control and compliance of the given orientations, by also incorporating those subjective dimensions that cannot be foreseen, but were generated in real situations and include dramas, encounters, choices, and re-singularizing. Therefore, after the managerial dimension of the activities was revealed, their protagonists are summoned not only to comply with experts' prescriptions, but also to act as co-authors, individually and collectively, of the management of their own health, safety, work, and life.