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1.
Soft Matter ; 12(25): 5501-14, 2016 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-27280176

RESUMEN

When a solute is dissolved in water, their mutual interactions determine the molecular properties of the solute on one hand, and the structure and dynamics of the surrounding water particles (the so-called hydration water) on the other. The very existence of soft matter and its peculiar properties are largely due to the wide variety of possible water-solute interactions. In this context, water is not an inert medium but rather an active component, and hydration water plays a crucial role in determining the structure, stability, dynamics, and function of matter. This review focuses on the collective dynamics of hydration water in terms of retardation with respect to the bulk, and of the number of molecules whose dynamics is perturbed. Since water environments are in a dynamic equilibrium, with molecules continuously exchanging from around the solute towards the bulk and vice versa, we examine the ability of different techniques to measure the water dynamics on the basis of the explored time scales and exchange rates. Special emphasis is given to the collective dynamics probed by extended depolarized light scattering and we discuss whether and to what extent the results obtained in aqueous solutions of small molecules can be extrapolated to the case of large biomacromolecules. In fact, recent experiments performed on solutions of increasing complexity clearly indicate that a reductionist approach is not adequate to describe their collective dynamics. We conclude this review by presenting current ideas that are being developed to describe the dynamics of water interacting with macromolecules.

2.
Phys Chem Chem Phys ; 18(13): 8881-9, 2016 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-26958663

RESUMEN

Hydrophilic and hydrophobic interactions strongly affect the solvation dynamics of biomolecules. To understand their role, small model systems are generally employed to simplify the investigations. In this study the amphiphile trimethylamine N-oxide (TMAO) is chosen as an exemplar, and studied by means of extended frequency range depolarized light scattering (EDLS) experiments as a function of solute concentration. This technique proves to be a suitable tool for investigating different aspects of aqueous solvation, being able at the same time to provide information about relaxation processes and vibrational modes of solvent and solute. In the case study of TMAO, we find that the relaxation dynamics of hydration water is moderately retarded compared to the bulk, and the perturbation induced by the solute on surrounding water is confined to the first hydration shell. The results highlight the hydrophobic character of TMAO in its interaction with water. The number of molecules taking part in the solvation process decreases as the solute concentration increases, following a trend consistent with the hydration water-sharing model, and suggesting that aggregation between solute molecules is negligible. Finally, the analysis of the resonant modes in the THz region and the comparison with the corresponding results obtained for the isosteric molecule tert-butyl alcohol (TBA) allow us to provide new insights into the different solvating properties of these two biologically relevant molecules.


Asunto(s)
Metilaminas/química , Agua/química , Luz , Dispersión de Radiación , Solubilidad
3.
J Phys Chem A ; 120(27): 5065-70, 2016 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-26859100

RESUMEN

We report on a study of protein aggregation induced on different cell samples by dimethyl sulfoxide (DMSO) addition. DMSO is the most commonly used cryoprotectant because it is supposed to readily diffuse across lipid bilayers, thus reducing water activity within cells; despite its large use, the mechanism of penetration and even the main interaction features with cell components are far from being understood. In the present work, infrared absorption spectroscopy is successfully applied to real time detection of chemical and structural changes occurring in cells during dehydration from water and water/DMSO suspensions. As a most interesting result, DMSO is observed to favor protein aggregation both in cellular model systems, as cultured lymphocytes and fibroblasts, and in human samples for clinic use, as hematopoietic stem cells from cord blood. This effect is evidenced at low water content, analogously to what is observed for protein solutions. Such tendency is not specific of the type of protein and suggests one possible origin of DMSO toxicity.


Asunto(s)
Dimetilsulfóxido/química , Fibroblastos/química , Células Madre Hematopoyéticas/química , Linfocitos/química , Animales , Células Cultivadas , Pollos , Humanos , Muramidasa/química , Agregado de Proteínas , Albúmina Sérica Bovina/química , Espectroscopía Infrarroja por Transformada de Fourier , Agua/química
4.
Phys Chem Chem Phys ; 17(17): 11423-31, 2015 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-25853990

RESUMEN

Protein low-frequency vibrational modes are an important portion of a proteins' dynamical repertoire. Yet, it is notoriously difficult to isolate specific vibrational features in the spectra of proteins. Given an appropriately chosen model peptide, and using different experimental conditions, we can simplify the system and gain useful insights into the protein vibrational properties. Combining neutron scattering, depolarized light scattering, and molecular dynamics simulations, we analyse the low frequency vibrations of biological molecules, comparing the results from a small globular protein, lysozyme, and an amphiphilic peptide, NALMA, both in solution and in powder states. Lysozyme and NALMA present similar spectral features in the frequency range between 1 and 10 THz. With the aid of MD simulations, we assign the spectral features to methyl groups' librations (1-5 THz) and hindered torsions (5-10 THz) in NALMA. Our data also show that, while proteins display boson peak vibrations in both powder and solution forms, NALMA exhibits boson peak vibrations in powder form only. This provides insight into the nature of this feature, suggesting a connection of BP collective motions to a characteristic length scale of heterogeneities present in the system. These results provide context for the use of model peptide systems to study protein dynamics; demonstrating both their utility, and the great care that has to be used in extrapolating results observed in powder to solutions.


Asunto(s)
Leucina/análogos & derivados , Muramidasa/química , Vibración , Leucina/química , Simulación de Dinámica Molecular , Muramidasa/metabolismo
5.
J Chem Phys ; 140(18): 184505, 2014 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-24832286

RESUMEN

Extended frequency range depolarized light scattering measurements of water-levoglucosan solutions are reported at different concentrations and temperatures to assess the effect of the presence and distribution of hydroxyl groups on the dynamics of hydration water. The anhydro bridge, reducing from five to three the number of hydroxyl groups with respect to glucose, considerably affects the hydration properties of levoglucosan with respect to those of mono and disaccharides. In particular, we find that the average retardation of water dynamics is ≈3-4, that is lower than ≈5-6 previously found in glucose, fructose, trehalose, and sucrose. Conversely, the average number of retarded water molecules around levoglucosan is 24, almost double that found in water-glucose mixtures. These results suggest that the ability of sugar molecules to form H-bonds through hydroxyl groups with surrounding water, while producing a more effective retardation, it drastically reduces the spatial extent of the perturbation on the H-bond network. In addition, the analysis of the concentration dependence of the hydration number reveals the aptitude of levoglucosan to produce large aggregates in solution. The analysis of shear viscosity and rotational diffusion time suggests a very short lifetime for these aggregates, typically faster than ≈20 ps.


Asunto(s)
Glucosa/análogos & derivados , Modelos Químicos , Modelos Moleculares , Agua/química , Simulación por Computador , Difusión , Glucosa/química , Enlace de Hidrógeno , Rotación , Resistencia al Corte , Soluciones
6.
J R Soc Interface ; 19(187): 20210642, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35104431

RESUMEN

Bone has a sophisticated architecture characterized by a hierarchical organization, starting at the sub-micrometre level. Thus, the analysis of the mechanical and structural properties of bone at this scale is essential to understand the relationship between its physiology, physical properties and chemical composition. Here, we unveil the potential of Brillouin-Raman microspectroscopy (BRaMS), an emerging correlative optical approach that can simultaneously assess bone mechanics and chemistry with micrometric resolution. Correlative hyperspectral imaging, performed on a human diaphyseal ring, reveals a complex microarchitecture that is reflected in extremely rich and informative spectra. An innovative method for mechanical properties analysis is proposed, mapping the intermixing of soft and hard tissue areas and revealing the coexistence of regions involved in remodelling processes, nutrient transportation and structural support. The mineralized regions appear elastically inhomogeneous, resembling the pattern of the osteons' lamellae, while Raman and energy-dispersive X-ray images through scanning electron microscopy show an overall uniform distribution of the mineral content, suggesting that other structural factors are responsible for lamellar micromechanical heterogeneity. These results, besides giving an important insight into cortical bone tissue properties, highlight the potential of BRaMS to access the origin of anisotropic mechanical properties, which are almost ubiquitous in other biological tissues.


Asunto(s)
Huesos , Osteón , Anisotropía , Huesos/diagnóstico por imagen , Hueso Cortical , Osteón/fisiología , Humanos , Microscopía Electrónica de Rastreo , Espectrometría Raman/métodos
7.
J Chem Phys ; 134(5): 055104, 2011 Feb 07.
Artículo en Inglés | MEDLINE | ID: mdl-21303164

RESUMEN

The longitudinal viscosity of diluted water-tert-butyl alcohol solutions in the 10 GHz frequency region has been measured by means of Brillouin light scattering and inelastic ultraviolet scattering. The main advantage of our hypersonic investigation compared to more traditional ultrasonic measurements is that in the gigahertz frequency range slow relaxation processes involving the alcohol dynamics are completely unrelaxed, so that the measured viscosity mainly originates from the hydrogen bond restructuring of water. In contrast with previous determinations, we estimate an activation energy which is independent from the alcohol mole fraction up to X = 0.1, and comparable to that of bulk water. A simple two-component model is used to describe the steep increase of viscosity with increasing alcohol mole fraction, and a retardation factor 1.7 ± 0.2 is found between the relaxation times of hydration and bulk water. These findings endorse a dynamic scenario where the slowing down of hydration water is mainly due to a reduction of configurational entropy and does not involve an arrested, icelike, dynamics.


Asunto(s)
Agua/química , Alcohol terc-Butílico/química , Interacciones Hidrofóbicas e Hidrofílicas , Luz , Dispersión de Radiación , Rayos Ultravioleta
8.
J Chem Phys ; 132(21): 214508, 2010 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-20528032

RESUMEN

High resolution depolarized light scattering spectra, extended from 0.5 to 2x10(4) GHz by the combined used of a dispersive and an interferometric setup, give evidence of separated solute and solvent dynamics in diluted trehalose aqueous solutions. The slow relaxation process, located in the gigahertz frequency region, is analyzed as a function of temperature and concentration and assigned to the rotational diffusion of the sugar molecule. The results are discussed in comparison with the data obtained on glucose solutions and they are used to clarify the molecular origin of some among the several relaxation processes reported in literature for oligosaccharides solutions. The concentration dependence of relaxation time and of shear viscosity are also discussed, suggesting that the main effect of carbohydrate molecules on the structural relaxation of diluted aqueous solutions is the perturbation induced on the dynamics of the first hydration shell of each solute molecule.


Asunto(s)
Luz , Rotación , Trehalosa/química , Glucosa/química , Oligosacáridos/química , Dispersión de Radiación , Soluciones , Temperatura , Agua/química
9.
Sci Rep ; 10(1): 17341, 2020 10 15.
Artículo en Inglés | MEDLINE | ID: mdl-33060731

RESUMEN

Brillouin-Raman microspectroscopy is presented as an innovative label-free all-optical investigation approachable to characterize the chemical composition and the mechanical properties of human tissues at micrometric resolution. Brillouin maps unveil mechanical heterogeneities in a human femoral diaphysis, showing a ubiquitous co-existence of hard and soft components, even in the most compact sections. The novel correlative analysis of Brillouin and Raman maps shows that the relative intensity of Brillouin peaks is a good proxy for the fraction of mineralized fibers and that the stiffness (longitudinal elastic modulus) of the hard component is linearly dependent on the hydroxyapatite concentration. For the soft component, a gradient of composition is found, ranging from an abundance of proteins in the more compact, external, bone to abundance of lipids, carotenoids, and heme groups approaching the trabecular, inner, part of the diaphysis. This work unveils the strong potential of correlative mechano-chemical characterization of human tissues at a micrometric resolution for both fundamental and translational research.


Asunto(s)
Diáfisis/química , Fémur/química , Espectrometría Raman/métodos , Fenómenos Biomecánicos , Módulo de Elasticidad , Humanos , Investigación Biomédica Traslacional
10.
Eur Rev Med Pharmacol Sci ; 24(8): 4558-4564, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32373995

RESUMEN

OBJECTIVE: SARS-CoV-2 is responsible for the present coronavirus pandemic and some suggestions were made about its possible artificial origin. We, therefore, compared SARS-CoV-2 with such known viruses that were prepared in the laboratory and other relevant natural strains to estimate their genetic relatedness. MATERIALS AND METHODS: BLAST and clustalW were used to identify and align viral sequences of SARS-CoV-2 to other animal coronaviruses (human, bat, mouse, pangolin) and related artificial constructs. Phylogenetics trees were then prepared using iTOL. RESULTS: Our study supports the notion that known artificial coronaviruses, including the chimeric SL-SHC014-MA15 synthesized in 2015, differ too much from SARS-CoV-2 to hypothesize an artificial origin of the latter. On the contrary, our data support the natural origin of the COVID-19 virus, likely derived from bats, possibly transferred to pangolins, before spreading to man. CONCLUSIONS: Speculations about the artificial origin of SARS-CoV-2 are most likely unfounded. On the contrary, when carefully handled, engineered organisms provide a unique opportunity to study biological systems in a controlled fashion. Biotechnology is a powerful tool to advance medical research and should not be abandoned because of irrational fears.


Asunto(s)
Betacoronavirus/clasificación , Biología Computacional , Filogenia , Secuenciación Completa del Genoma , Animales , COVID-19 , Quirópteros/virología , Infecciones por Coronavirus , Humanos , Ratones , Organismos Modificados Genéticamente , Pandemias , Neumonía Viral , ARN Viral/análisis , SARS-CoV-2 , Análisis de Secuencia de ARN
11.
J Phys Chem B ; 113(22): 7874-8, 2009 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-19422249

RESUMEN

Light scattering spectra on aqueous solutions of trehalose were recorded in a wide frequency range combining the use of a double monochromator and a multipass Fabry-Perot interferometer. Experimental results indicate the presence of a slow relaxation mode related to the solute dynamics, which is clearly separated from the solvent one. The spectral analysis reveals the existence of two separate solvent relaxation processes assigned to hydrating and bulk water molecules. The picosecond dynamics of water molecules directly interacting with the solute (proximal water) is consistently delayed with the corresponding relaxation time increase is about 5-6 times compared to the bulk. The slowing down induced by the sugar on the water dynamics mainly involves a restricted hydration layer constituted of 16-18 water molecules. These results improve our knowledge about the influence of carbohydrates on the fast rearrangement dynamics of water and may serve as a model to gain important insight on basic solvation properties of other biorelevant systems in aqueous media.


Asunto(s)
Interferometría/métodos , Trehalosa/química , Agua/química , Luz , Dispersión de Radiación , Soluciones/química , Solventes/química
12.
Ultrason Sonochem ; 16(1): 141-4, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18565782

RESUMEN

Mercury acetate (MA) can be obtained by metallic mercury immersed in a mixture of deionised, bidistillated water (dbw) and acetic acid. We show that MA crystallization time is drastically reduced if the previous mixtures are subjected to acoustic cavitation. The largest quantity of crystals is obtained by a concentration of acetic acid of about 7% in volume. NMR analysis of identical mixtures in the presence of mercury, performed as soon as possible after cavitation, showed the largest quantity of mercury acetate molecules, for the same concentration of acetic acid of 7% in volume.

13.
Biomed Opt Express ; 10(5): 2606-2611, 2019 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-31143505

RESUMEN

Brillouin micro-spectroscopy is applied for investigating the mechanical properties of bone and cartilage tissues of a human femoral head. Distinctive mechanical properties of the cartilage surface, subchondral and trabecular bone are reported, with marked heterogeneities at both micrometric and millimetric length scales. A ubiquitous soft component is reported for the first time, characterized by a longitudinal modulus of about 4.3 GPa, possibly related to the amorphous phase of the bone. This phase is mixed, at micrometric scales, with a harder component, ascribed to mineralized collagen fibrils, characterized by a longitudinal modulus ranging between 16 and 25 GPa.

14.
J Phys Chem Lett ; 9(1): 120-125, 2018 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-29243934

RESUMEN

Water is a strong self-associated liquid with peculiar properties that crucially depend on H-bonding. As regards its molecular dynamics, only recently has water reorientation been successfully described based on a jump mechanism, which is responsible for the overall H-bonding exchange. Here, using high-resolution broad-band depolarized light scattering, we have investigated the reorientational dynamics of formamide (FA) as a function of concentration from the neat liquid to diluted aqueous solutions. Our main findings indicate that in the diluted regime the water rearrangement can trigger the motion of FA solute molecules, which are forced to reorient at the same rate as water. This highlights an exceptional behavior of FA, which perfectly substitutes water within its network. Besides other fundamental implications connected with the relevance of FA, its water-like behavior provides rare experimental evidence of a solute whose dynamics is completely slaved to the solvent.

15.
Transplant Proc ; 49(4): 707-710, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28457377

RESUMEN

Since 2000, 13 uterine transplantations (UTxs) have been performed in women with absolute uterine infertility factor (AUIF), from both living and deceased donors, in different transplantation centers worldwide. At present the birth of 4 children following UTx is documented by the literature, and a woman was having a second pregnancy in October 2015. Following these successes it is likely that the procedure will become part of normal healthcare practice, even though at the moment it is still experimental and, as such, requires careful attention. Because the emotional aspects that are tied to UTx may foster the "therapeutic misconception" of participants, which consists in an overestimation of the benefits and an underestimation of the risks, careful attention should be paid also to informed consent (IC), which must include the following: describing techniques, pointing out risks and possibility of failure, and informing about the treatments required after the intervention. Because the final aim of UTx is the birth of a healthy child, the IC document must include details not only of the transplantation itself, but also of the very particular pregnancy deriving from it, and the need to remove the uterus following delivery(ies) to avoid these risks. Here we suggest that the IC process includes counselling techniques, possibly involving the psychologist that is part of the transplantation team, to target the information and decision-making process to the specific situation of each couple.


Asunto(s)
Consentimiento Informado/ética , Consentimiento Informado/psicología , Útero/trasplante , Niño , Femenino , Humanos , Infertilidad Femenina/cirugía , Embarazo
16.
Biophys Chem ; 208: 34-9, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26282883

RESUMEN

In the present study, FTIR spectroscopy was used to monitor the freeze-thaw cycle of two cellular lines (HuDe and Jurkat) suspended in three different media: phosphate buffer solution (PBS); dimethylsulfoxide (DMSO)/PBS solution at 0.1 DMSO molar fraction; and CryoSure (0.1 DMSO molar fraction PBS solution+dextran 5% w/v) solution. The Trypan Blue test was also applied before freezing and after thawing each cell sample to estimate the recovery of membrane integrity after thermal treatment, and correlate this datum with spectroscopic results. By following the temperature evolution of two different spectral components (the libration and bending combination mode νc(H2O) at 2000-2500 cm(-1), and the methylene symmetric stretching vibration νsym(CH2) at about 2850 cm(-1)) in the -120÷28°C range, we evidenced the main transition of lipid membrane in connection with cell dehydration, as induced by ice formation in the extracellular medium. In particular, in DMSO/PBS and CryoSure samples we observed a transition to a more rigid state of the lipid membrane together with an increased amount of non-freezable water in the extracellular medium; these results are connected to the role of DMSO as a cryoprotective agent irrespective of the nature of cell type.


Asunto(s)
Membrana Celular/química , Criopreservación , Crioprotectores/química , Fibroblastos/citología , Congelación , Lípidos de la Membrana/química , Tampones (Química) , Línea Celular , Dextranos/química , Dimetilsulfóxido/química , Humanos , Células Jurkat , Fosfatos/química , Espectroscopía Infrarroja por Transformada de Fourier , Temperatura
17.
Biophys Chem ; 208: 48-53, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26256426

RESUMEN

In this paper we test the ability of Raman micro-spectroscopy and Raman mapping to investigate the status of cells grown in adhesion on different substrates. The spectra of immortalized SH-SY5Y cells, grown on silicon and on metallic substrates are compared with those obtained for the same type of cells adhering on organic polyaniline (PANI), a memristive substrate chosen to achieve a living bio-hybrid system. Raman spectra give information on the status of the single cell, its local biochemical composition, and on the modifications induced by the substrate interaction. The good agreement between Raman spectra collected from cells adhering on different substrates confirms that the PANI, besides allowing the cell growth, doesn't strongly affect the general biochemical properties of the cell. The investigation of the cellular state in a label free condition is challenging and the obtained results confirm the Raman ability to achieve this information.


Asunto(s)
Compuestos de Anilina/química , Silicio/química , Adhesión Celular , Proliferación Celular , Supervivencia Celular , Humanos , Espectrometría Raman , Células Tumorales Cultivadas
18.
J Phys Chem B ; 119(29): 9236-43, 2015 Jul 23.
Artículo en Inglés | MEDLINE | ID: mdl-25436859

RESUMEN

Molecular dynamics and structural properties of water-tert-butyl alcohol (TBA) mixtures are studied as a function of concentration by extended depolarized light scattering (EDLS) experiments. The wide frequency range, going from fraction to several thousand GHz, explored by EDLS allows distinguishing TBA rotational dynamics from structural relaxation of water and intermolecular vibrational and librational modes of the solution. Contributions to the water relaxation originating from two distinct populations, i.e. hydration and bulk water, are clearly identified. The dynamic retardation factor of hydration water with respect to the bulk, ξ ≈ 4, almost concentration independent, is one of the smallest found by EDLS among a variety of systems of different nature and complexity. This result, together with the small number of water molecules perturbed by the presence of TBA, supports the idea that hydrophobic simple molecules are less effective than hydrophilic and more complex molecules in perturbing the H-bond network of liquid water. At increasing TBA concentrations the average number of perturbed water molecules shows a pronounced decrease and the characteristic frequency of librational motions reduces significantly, both of which are results consistent with the occurrence of self-aggregation of TBA molecules.


Asunto(s)
Luz , Simulación de Dinámica Molecular , Dispersión de Radiación , Agua/química , Alcohol terc-Butílico/química , Enlace de Hidrógeno , Interacciones Hidrofóbicas e Hidrofílicas , Rotación , Soluciones/química , Solventes/química , Espectrometría Raman , Vibración
19.
Pathol Res Pract ; 191(11): 1170-4, 1995 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-8822122

RESUMEN

A 47-year-old Caucasian female was admitted to the hospital with a suspicious lesion in the right lower lobe of the lung. At frozen tissue sections a malignant tumour was found which, after special stains and immunohistochemical investigations, was diagnosed as lymphoepithelioma-like carcinoma. Non-Hodgkin's lymphoma and metastasis of a nasopharygeal carcinoma could be excluded by immunohistochemical stains and clinical examination. The tumour cells and the infiltrating lymphocytes were negative for Epstein-Barr virus (EBV) as revealed by in situ hybridization (ISH) and polymerase chain reaction (PCR). A reevaluation of the literature showed an interesting and surprising fact: in all lung cases, so far reported, the tumour cells were positive for EBV in Asians and negative in Caucasians. Due to the high prevalence of EBV infections in the Asian population it might be speculated, that EBV positivity could be an epiphenomenon in Asian cases of lymphoepithelioma-like carcinoma of the lung.


Asunto(s)
Carcinoma de Células Escamosas/virología , Herpesvirus Humano 4/aislamiento & purificación , Neoplasias Pulmonares/virología , Secuencia de Bases , Carcinoma de Células Escamosas/química , Femenino , Humanos , Inmunohistoquímica , Neoplasias Pulmonares/química , Persona de Mediana Edad , Datos de Secuencia Molecular
20.
Tumori ; 79(5): 297-300, 1993 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-8116069

RESUMEN

In western countries the elderly are those who experience the major impact of cancer, as epidemiologic data clearly show. Thus, secondary prevention of cancer (SPC) in older persons deserves more attention than it has received until now. Target subjects, however, are often reluctant to enter SPC plans. The reasons range from the lack of knowledge about the importance of SPC to the underevaluation of the risk of cancer, or, even more often, to the anxiety and fear that may stem from such a clinical investigation. In this context, the intervention known as counseling finds its natural and essential role. In the paper some general considerations on the significance of medical counseling is given, with particular emphasis on its role in SPC in the elderly. The analysis herein reported points out the specific skills and methods that physicians can adopt to cope with the eventually adverse influences that may affect the participation of the elderly in SPC initiatives. However, such action should avoid any paternalistic approach and respect the patient's will and autonomy.


Asunto(s)
Consejo , Neoplasias/prevención & control , Factores de Edad , Anciano , Humanos
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