ABSTRACT
Galectins (Gals), a family of multifunctional glycan-binding proteins, have been traditionally defined as ß-galactoside binding lectins. However, certain members of this family have shown selective affinity toward specific glycan structures including human milk oligosaccharides (HMOs) and blood group antigens. In this work, we explored the affinity of human galectins (particularly Gal-1, -3, -4, -7, and -12) toward a panel of oligosaccharides including HMOs and blood group antigens using a complementary approach based on both experimental and computational techniques. While prototype Gal-1 and Gal-7 exhibited differential affinity for type I versus type II Lac/LacNAc residues and recognized fucosylated neutral glycans, chimera-type Gal-3 showed high binding affinity toward poly-LacNAc structures including LNnH and LNnO. Notably, the tandem-repeat human Gal-12 showed preferential recognition of 3-fucosylated glycans, a unique feature among members of the galectin family. Finally, Gal-4 presented a distinctive glycan-binding activity characterized by preferential recognition of specific blood group antigens, also validated by saturation transfer difference nuclear magnetic resonance experiments. Particularly, we identified oligosaccharide blood group A antigen tetraose 6 (BGA6) as a biologically relevant Gal-4 ligand, which specifically inhibited interleukin-6 secretion induced by this lectin on human peripheral blood mononuclear cells. These findings highlight unique determinants underlying specific recognition of HMOs and blood group antigens by human galectins, emphasizing the biological relevance of Gal-4-BGA6 interactions, with critical implications in the development and regulation of inflammatory responses.
ABSTRACT
The interactions of glycans with proteins modulate many events related to health and disease. In fact, the establishment of these recognition events and their biological consequences are intimately related to the three-dimensional structures of both partners, as well as to their dynamic features and their presentation on the corresponding cell compartments. NMR techniques are unique to disentangle these characteristics and, indeed, diverse NMR-based methodologies have been developed and applied to monitor the binding events of glycans with their associate receptors. This protocol outlines the procedures to acquire, process and analyze two of the most powerful NMR methodologies employed in the NMR-glycobiology field, 1H-Saturation transfer difference (STD) and 1H,15N-Heteronuclear single quantum coherence (HSQC) titration experiments, which complementarily offer information from the glycan and protein perspective, respectively. Indeed, when combined they offer a powerful toolkit for elucidating both the structural and dynamic aspects of molecular recognition processes. This comprehensive approach enhances our understanding of glycan-protein interactions and contributes to advancing research in the chemical glycobiology field.
Subject(s)
Polysaccharides , Polysaccharides/chemistry , Polysaccharides/metabolism , Nuclear Magnetic Resonance, Biomolecular/methods , Proteins/chemistry , Proteins/metabolismABSTRACT
Proteoglycans (PGs), consisting of glycosaminoglycans (GAGs) linked with the core protein through a tetrasaccharide linkage region, play roles in many important biological events. The chemical synthesis of PG glycopeptides is extremely challenging. In this work, the enzymes required for synthesis of chondroitin sulfate (CS) PG (CSPG) have been expressed and the suitable sequence of enzymatic reactions has been established. To expedite CSPG synthesis, the peptide acceptor was immobilized on solid phase and the glycan units were directly installed enzymatically onto the peptide. Subsequent enzymatic chain elongation and sulfation led to the successful synthesis of CSPG glycopeptides. The CS dodecasaccharide glycopeptide was the longest homogeneous CS glycopeptide synthesized to date. The enzymatic synthesis was much more efficient than the chemical synthesis of the corresponding CS glycopeptides, which could reduce the total number of synthetic steps by 80 %. The structures of the CS glycopeptides were confirmed by mass spectrometry analysis and NMR studies. In addition, the interactions between the CS glycopeptides and cathepsin G were studied. The sulfation of glycan chain was found to be important for binding with cathepsin G. This efficient chemoenzymatic strategy opens new avenues to investigate the structures and functions of PGs.
Subject(s)
Chondroitin Sulfates , Glycopeptides , Glycopeptides/chemistry , Glycopeptides/chemical synthesis , Glycopeptides/metabolism , Chondroitin Sulfates/chemistry , Chondroitin Sulfates/chemical synthesis , Solid-Phase Synthesis Techniques , Proteoglycans/chemistryABSTRACT
OBJECTIVE: To identify new parameters predicting fetal acidemia. METHODS: A retrospective case-control study in a cohort of deliveries from a tertiary referral hospital-based cohort deliveries in Zaragoza, Spain between 2018 and 2021 was performed. To predict fetal acidemia, the NICHD categorizations and non-NICHD parameters were analyzed in the electronic fetal monitoring (EFM). Those included total reperfusion time, total deceleration area and the slope of the descending limb of the fetal heart rate of the last deceleration curve. The accuracy of the parameters was evaluated using the specificity for (80%, 85%, 90%, 95%) sensitivity and the area under the receiver operating characteristic curve (AUC). RESULTS: A total of 10 362 deliveries were reviewed, with 224 cases and 278 controls included in the study. The NICHD categorizations showed reasonable discriminatory ability (AUC = 0.727). The non-NICHD parameters measured during the 30-min fetal monitoring, total deceleration area (AUC = 0.807, 95% CI: 0.770, 0.845) and total reperfusion time (AUC = 0.750, 95% CI: 0.707, 0.792), exhibited higher discriminatory ability. The slope of the descending limb of the fetal heart rate of the last deceleration curve had the best AUC value (0.853, 95% CI: 0.816, 0.889). The combination of total deceleration area or total reperfusion time with the slope demonstrated high discriminatory ability (AUC = 0.908, 95% CI: 0.882, 0.933; specificities of 71.6% and 72.7% for a sensitivity of 90%). CONCLUSIONS: The slope of the descending limb of the fetal heart rate of the last deceleration curve is the strongest predictor of fetal acidosis, but its combination with the total reperfusion time shows better clinical utility.
Subject(s)
Acidosis , Cardiotocography , Fetal Diseases , Heart Rate, Fetal , Humans , Female , Pregnancy , Heart Rate, Fetal/physiology , Acidosis/diagnosis , Retrospective Studies , Case-Control Studies , Cardiotocography/methods , Fetal Diseases/diagnosis , Adult , Deceleration , Spain , ROC Curve , Fetal Monitoring/methods , Sensitivity and SpecificityABSTRACT
Introducción: Las nuevas generaciones de alumnos (generación Z o nativa digital) en la actualidad han provocado la necesidad de implantar nuevas metodologías docentes en las que el alumnado sea un sujeto activo y participativo en su propio proceso de aprendizaje. Entre estas metodologías, el uso del aprendizaje basado en juegos puede considerarse una alternativa que refuerce a la clásica clase magistral y las clases prácticas en la docencia universitaria. Sujetos y métodos: Utilización del aprendizaje basado en juegos (juegos serios) en los alumnos matriculados de la asignatura de Anatomía Humana I (Aparato Locomotor), de primer curso del grado de Medicina en la Universidad de Zaragoza. Resultados: El uso de esta metodología ha sido valorado, mediante encuesta de evaluación de respuesta voluntaria, de manera muy positiva, haciendo hincapié en el efecto que tiene sobre la motivación, la participación y la integración de contenidos teóricos y prácticos. Conclusión: El aprendizaje basado en juegos debe considerarse como una potente alternativa que mejora la motivación, la participación y la integración de contenido en el aula de educación superior.(AU)
Introduction: The new generations of students, such as the current generation Z or digital natives, have provoked the need to implement new teaching methodologies where students are active and participative subjects in their own learning process. Among these methodologies, the use of game-based learning can be considered an alternative to reinforce the classic master class in university teaching. Subjects and methods: Use of game-based learning (serious games), in students enrolled in the subject of Human Anatomy I (Locomotor System), first year of the Degree of Medicine at the Universidad de Zaragoza. Results: The use of this methodology has been evaluated, by means of a voluntary evaluation survey, in a very positive way, emphasizing the effect on motivation, participation and integration of theoretical and practical contents. Conclusion: Game-based learning should be considered as a powerful alternative that improves motivation, participation and content integration in the higher education classroom.(AU)
Subject(s)
Humans , Male , Female , Anatomy/education , Education, Medical , Motivation , Learning/classification , Teaching/classification , MedicineABSTRACT
Introducción: La dehiscencia del canal semicircular posterior es una vestibulopatía rara, de baja prevalencia y cuya sintomatología se explica por el fenómeno de la tercera ventana. No fue hasta 2003 cuando Krombach describe los primeros casos. Objetivo: Evaluar mediante análisis bibliométrico y temático la producción científica sobre trabajos de dehiscencia del canal semicircular posterior (DCSP) y su incidencia a nivel de la comunidad científica mediante una revisión bibliográfica. Método: Se realiza búsqueda, revisión, selección y estudio a partir de ítems relacionados con DCSP indexados en la base de datos Pubmed, Web of Science, Alcorze y Scopus, desde el año 2003 hasta 2019, seleccionando 90 artículos. Resultados: Los 90 artículos han sido publicados en un total de 48 revistas, siendo 52% originales, 38% casos clínicos, 9% revisiones y 1% conferencias. La temática predominante fue la clínica (32%) y la etiología (27%). Los artículos estaban escritos en ocho idiomas diferentes, predominando el inglés (85%), y siendo Estados Unidos el país con más publicaciones (42%). Los índices de actividad institucional y autoría son bajos. La calidad de las revistas es alta, ya que el 70% de las publicaciones se encontraban en los cuartiles Q1-Q2. El área principal es Otorrinolaringología, con 66 trabajos, seguida por Radiología con 14. El número de descargas fue 6958, con una media de 77,31 por artículo, y las citaciones fueron 1193, equivalente a una media de 13,25. Conclusión: Los datos bibliométricos revelan cómo los trabajos sobre dehiscencia del canal semicircular posterior representan una pequeña producción científica, el tema está en fase de crecimiento sostenido, los índices de autoría, institucionalidad y colaboración son bajos y las publicaciones se concentran en pocas revistas, con una orientación claramente anglófona, pero de alta calidad e importante visualización. (AU)
Introduction: The dehiscence of the posterior semicircular canal is a rare vestibulopathy, of low prevalence and whose symptomatology is explained by the phenomenon of the third window. It was not until 2003 that Krombach described the first cases. Objective: Evaluate the scientific production about the dehiscence of the posterior semicircular canal (DCSP) by a bibliometric and thematic analysis and observes its incidence at the scientific community level. Method: A search with subsequent review, selection and study was carried out using items related to DCSP indexed in the Pubmed, Web of Science, Alcorze and Scopus databases, from 2003 to 2019, selecting a total of 90 articles. Results: The 90 articles have been published in a total of 48 magazines. 52% were originals, 38% clinical cases, 9% reviews and 1% conferences. Clinical (32%) and etiology (27%) were the main themes. The articles were written in eight different languages, predominantly English (85%), and the United States has been the country with the highest number of publications (42%). Institutional activity and authorship rates are low. The quality of the journals is high: 70% of the publications were in the Q1-Q2 quartiles. The main area corresponds to otorhinolaryngology, with a total of 66 works, followed by radiology (14). The total number of downloads was 6958, with an average of 77.31 per article and the total citations were 1193, 13.25 per article. Conclusions: The bibliometric results reveal how the works on dehiscence of the posterior semicircular canal present a small scientific production, the subject is in a phase of sustained growth, the authorship, institutional and collaboration index are low, the publications are concentrated in a few journals of high quality and important visualization, with a clearly anglophone orientation. (AU)
Subject(s)
Scientific and Technical Publications , Bibliometrics , Impact Factor , Scientific Publication IndicatorsABSTRACT
Introducción: Durante el curso 2019-2020, debido a la situación provocada por la COVID-19, Neuroanatomía humana (cuarto semestre, grado de Medicina, Universidad de Zaragoza), que en condiciones normales combina teoría y práctica presenciales, se planteó de manera telemática, mediante la aportación al alumnado de material didáctico a través de la intranet Anillo Digital Docente-Moodle© e Instagram©, así como por tutorías vía Google Meet©. Material y métodos: Con objeto de poder comprobar el grado de satisfacción de la docencia teórico-práctica presencial frente a la telemática, se realizaron con el alumnado dos cuestionarios (pre-COVID-19 y durante la COVID-19) de cuatro y seis preguntas cerradas, respectivamente, con cinco opciones de respuesta según una escala de Likert. Además, se plantearon dos preguntas abiertas en cada cuestionario. Por parte del profesorado, la valoración fue en una reunión de coordinación de la asignatura tras finalizar el período lectivo. Resultados: Las encuestas de satisfacción las respondió el 71% de los alumnos (68/95). La falta de asistencia no sufre variación significativa en ambas situaciones con respecto a la asistencia a las clases teóricas y prácticas, pero sí los motivos causantes de ausencia: los primeros fueron principalmente profesionales, y los segundos, de conectividad. El alumnado valora la docencia teórica presencial frente a la telemática de forma muy parecida, mientras que, a nivel práctico, sigue prefiriendo la presencialidad, lo que coincide con el profesorado. Conclusión: Esta evaluación permite constatar que la docencia teórica de la asignatura por vía telemática es viable, siempre y cuando el alumnado disponga de una buena conectividad, pero no así la parte práctica, donde la presencialidad es imprescindible actualmente.(AU)
Introduction: During the 2019-2020 academic year, and due to the situation caused by COVID-19, Human Neuroanatomy (4th semester- Degree of Medicine- University of Zaragoza) which under conditions of normality combines in-person theory and practice, had to consider itself in a telematic way by providing students with teaching materials through intranet ADD (Digital Teaching Ring)- Moodle©, Instagram©, as well as tutoring via Google Meet©. Material and methods: In order to be able to check the degree of satisfaction of the theoretical teaching- face-to-face versus telematic teaching, 2 questionnaires were carried out by the students (pre-COVID-19 and during COVID-19), of 4 and 6 closed questions respectively, with 5 answer options, according to Likert scale. In addition, 2 open questions were raised in each questionnaire. On the part of the teachers, was valued in a coordination meeting of the subject, after the end of the teaching period: Results: Satisfaction surveys were answered by 71% of students (68/95). The lack of attendance does not suffer a significant variation in both situations, but the reasons that have led to the absence, being the first being mainly professional, and the second reasons for connectivity. Students value in-person theoretical teaching versus telematics in a very similar way, while on a practical level, they continue to prefer face-to-face, coinciding with the teachers. Conclusion: This evaluation confirms that the theoretical teaching of the subject via telematics is viable, as long as the students have good connectivity, but not the practical part, where attendance is essential today.(AU)
Subject(s)
Humans , Severe acute respiratory syndrome-related coronavirus , Pandemics , Neuroanatomy/education , Personal Satisfaction , Education, Distance , 57945 , Surveys and Questionnaires , Spain , Education/methods , Telematics , Teaching/educationABSTRACT
BACKGROUND: The epidemiology of candidemia has changed over the last decades and varies widely among geographic areas. AIMS: We examined in children (aged 0-14) with candidemia the trends in the incidence rate of this infection, as well as the clinical characteristics of the patients, in order to optimize the prognosis and the control measures of this serious disease. METHODS: A retrospective cohort study of candidemia in the period 2011-2018 in the neonatal intensive care unit (NICU), pediatric ICU (PICU) and pediatric wards of a tertiary hospital, was conducted. The clinical course, Candida species isolated, antifungal susceptibility, outcome and incidence rates were analyzed and compared. RESULTS: We diagnosed 68 episodes of candidemia in 62 children, 48% occurred in the NICU, 31% in the PICU and 21% in pediatric wards. Candida albicans was the most frequent species isolated in NICU infants (53%), and Candida parapsilosis predominated among PICU patients (59%) and pediatric wards (50%). One third of NICU infants had invasive candidiasis (IC), most of them having extremely low birth weight (ELBW) (35%). All isolates were susceptible to the antifungal administered. Over time, the incidence of candidemia decreased in the PICU (from 2.2 to 0.3 episodes/1000 patient-days, OR=0.6; 95%CI 0.5-0.8), whereas in the NICU and in the wards remained stable. Mortality occurred mostly in NICU patients (26%), predominated in ELBW infants and did not change over time. CONCLUSIONS: The higher incidence and mortality of candidemia and IC observed in preterm infants requires a continuous evaluation of practices and diagnostic methods which will allow improving the prognosis of this most vulnerable population
ANTECEDENTES: La epidemiología de la candidemia varía con el tiempo y entre las áreas geográficas. OBJETIVOS: Se ha estudiado en niños (0-14 años) con candidemia la evolución de la tasa de incidencia y las características clínicas de los pacientes para optimizar el pronóstico y las medidas de control de esta grave enfermedad. MÉTODOS: Se llevó a cabo un estudio de cohorte retrospectivo de los casos de candidemia en la unidad de cuidados intensivos neonatales (UCIN), UCI pediátrica (UCIP) y salas pediátricas de un hospital terciario, entre los años 2011 y 2018. Se compara el curso clínico, las especies de Candida, la sensibilidad antifúngica y las tasas de incidencia. RESULTADOS: Se diagnosticaron 68 episodios de candidemia en 62 niños; el 48% de ellos tuvieron lugar en UCIN, el 31% en UCIP y el 21% en salas pediátricas. Candida albicans fue la especie más frecuente en UCIN (53%), y Candida parapsilosis predominó en UCIN (59%) y salas pediátricas (50%). Un tercio de los bebés de la UCIN tenía candidiasis invasora (CI) y la mayoría presentaba extremado bajo peso al nacimiento (EBPN) (35%). Con el tiempo, la incidencia de candidemia disminuyó en la UCIP (de 2,2 a 0,3 episodios/1.000 días/paciente, OR: 0,6; IC 95%: 0,5-0,8), mientras que en la UCIN y en las salas permaneció estable. La mortalidad se produjo principalmente en pacientes de UCIN (26%), predominó en lactantes EBPN y no cambió con el tiempo. CONCLUSIONES: La mayor incidencia y mortalidad de la candidemia y CI observadas en lactantes prematuros requiere una evaluación continua de prácticas y métodos de diagnóstico que permitan mejorar el pronóstico de esta población más vulnerable
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Candidemia/epidemiology , Candidemia/microbiology , Tertiary Care Centers , Antifungal Agents/therapeutic use , Retrospective Studies , Candidemia/drug therapy , Cohort Studies , Risk Factors , Spain/epidemiology , IncidenceABSTRACT
Resumen Objetivo Describir las anomalías asociadas y las repercusiones perinatales de la persistencia de la vena cava superior izquierda en el feto y revisar la bibliografía. Materiales y métodos Estudio descriptivo, transversal y retrospectivo efectuado de enero de 2009 a diciembre 2012 en la Unidad de Diagnóstico Prenatal del Departamento de Obstetricia y Ginecología del Hospital Universitario Miguel Servet de Zaragoza, España. El estudio incluyó a todos los fetos con diagnóstico prenatal de persistencia de la vena cava superior izquierda establecido durante los controles gestacionales ecográficos. Resultados Se diagnosticaron 21 casos de persistencia de la vena cava superior izquierda entre las 20 y 35 semanas de embarazo. El 29% de los casos se detectó en la ecografía de las 20 semanas; 9 casos (43%) tuvieron anomalías cardiacas o extracardiacas asociadas y en 2 casos (10%) se encontró, además, trisomía 21, ambos con anomalías cardiacas asociadas. En 4 casos (19%) no hubo vena cava superior derecha. En los casos aislados la evolución fue favorable. Conclusiones Puesto que la persistencia de la vena cava superior izquierda se asocia, frecuentemente, con anomalías cardiacas y extracardiacas está justificada la ecografía morfológica fetal detallada y una ecocardiografía con posterior seguimiento antenatal. Si es aislada, la evolución obstétrica y el pronóstico perinatal serán favorables, como ha sucedido en los casos de persistencia de la vena cava superior izquierda aislados, con ausencia de vena cava superior derecha.
Abstract Objective To describe the associated anomalies and perinatal results in fetuses diagnosed with persistence of the left superior vena cava and to conduct a review of the literature. Materials and methods A descriptive, cross-sectional, retrospective study conducted between January 2009 and December 2012 in the Prenatal Diagnostic Unit of the Obstetrics and Gynecology Department at the Miguel Servet University Hospital in Zaragoza, Spain. The study included all fetuses with prenatal diagnosis of persistence of the left superior vena cava performed during gestational ultrasound controls in that period. Results 21 cases of persistence of the left superior vena cava were diagnosed between 20 and 35 weeks. Only 29% of the cases were detected on ultrasound at 20 weeks. 9 cases (43%) had associated cardiac or extracardiac anomalies and two cases (10%) associated trisomy 21, both with associated cardiac anomalies. In 4 cases (19%) there was an absence of right superior vena cava. In isolated cases, the evolution was favorable. Conclusions The presence of persistence of the left superior vena cava is frequently associated with cardiac and extracardiac abnormalities, so in the case of diagnosis, detailed fetal morphological ultrasound and echocardiogram are justified with subsequent antenatal follow-up. In the case of being isolated, it has an obstetric evolution and a favorable perinatal prognosis, results that were also presented in isolated persistence of the left superior vena cava cases with absence of right superior vena cava.
ABSTRACT
La anomalía más frecuente de la vena cava inferior es su interrupción. En estos casos, el drenaje al corazón se realizará por la vena ácigos y menos frecuentemente por la vena hemiácigos. Se considera un marcador ecográfico prenatal de isomerismos y/o cardiopatías por lo que su hallazgo obliga a descartarlos realizando una ecografía detallada del corazón y del situs fetal. Además, probablemente sea de las anomalías venosas que más implicaciones clínicas pueden tener en la edad adulta por su asociación a trombosis venosa profunda y es útil conocer la anatomía para posibles futuros procedimientos quirúrgicos o cateterismos cardiacos. Por lo tanto, es interesante realizar el diagnóstico prenatal, aunque se presente de forma aislada, siendo su diagnóstico ecográfico sencillo si somos sistemáticos en la práctica de la ecografía morfológica. El signo característico ecográfico es el de «doble vaso¼ o «doble burbuja¼ en un corte axial abdominal o torácico. Presentamos los esquemas ecográficos de diagnóstico de los dos tipos de drenaje principales de la interrupción de la vena cava inferior para poder realizar el correcto diagnóstico prenatal. Para ello tomamos de referencia dos casos clínicos que no presentan cardiopatías ni isomerismos asociados.
The most frequent anomaly of the inferior vena cava is its interruption. In these cases, drains into the heart by the azygos vein and less frequently by the hemiazygos vein. It is considered a prenatal ultrasound marker of isomerisms and/or heart disease, therefore, its finding requires to discard them by performing a detailed ultrasound of the fetal heart and situs. Probably it is one of the venous anomalies with more clinical implications in adulthood due to their association with deep venous thrombosis, and it is useful to know the anatomy for possible future surgical or cardiac catheterization procedures. Therefore, it is interesting to perform the prenatal diagnosis, although isolated. In this sense, the ultrasound diagnosis of the interruption is simple if we are systematic in the practice of morphological ultrasound. The characteristic ultrasound sign of the aforementioned interruption is the "double vessel" or "double bubble" in an axial abdominal or thoracic section. We present the ultrasound diagnosis diagrams of the two main types of drainage of the inferior vena cava interruption in order to perform the correct prenatal diagnosis. For these purposes, we refer two cases with no heart diseases or isomerisms associated.
Subject(s)
Humans , Female , Pregnancy , Adult , Vena Cava, Inferior/abnormalities , Vena Cava, Inferior/diagnostic imaging , Ultrasonography, PrenatalABSTRACT
Este artículo plantea, desde el punto de vista de los Equipos de Orientación que intervienen en Educación Infantil y Primaria y en base a la experiencia de los autores, una manera de abordar los problemas de conducta que presentan algunos alumnos. El punto de partida tiene en cuenta las aportaciones de lapsicología evolutiva y laperspectiva conductal de sistemas. El centro escolar forma parte del conjunto de sistemas relacionados donde se presentan estos problemas y en muchas ocasiones se generan situaciones de estrés añadido y de reto para los profesionales implicados. Se plantean aquí una serie de actuaciones y procedimientos que los autores han denominado "buenas practicas" dirigidas a contar e implicar a las estructuras formales habituales de los centros con el fin de encauzar de manera adecuada la solución de estos problemas, colaborar con otros sistemas -familias, unidades de salud, servicios sociales- y tratar de minimizar los efectos colaterales que habitualmente se producen a la hora de intervenir. Se con cluye con la necesaria colaboración entre todos lso csitemas implicados para tratar de dar alternativas a las dificultades que se originan en estas situaciones y la formación de los profesionales de la educación en el conocimiento y aplicación de programas de intervención con base empírica(AU)
This article argues, from the standpoint of Guidance Teams involved in school and Primary Education and based on the authors' experience, a way to address behavior problems presented by some students. The starting point takes into account the contributions of lapsicología laperspectiva evolutionary behavioral systems. The school is part of the set of related systems where these problems occur and often generate added stress and challenge for the professionals involved. Raised here a series of actions and procedures that the authors have named "best practices" designed to count and to involve the usual formal structures of the centers in order to properly channel the solution of these problems, collaborate with other systems - families, health care, social services, and try to minimize side effects that often occur when to intervene. It concludes with the necessary cooperation between all csitemas lso involved in trying to provide alternatives to the difficulties that arise in these situations and the training of education professionals in the knowledge and implementation of empirically-based intervention (AU)
Subject(s)
Humans , Male , Female , School Health Services/ethics , School Health Services/legislation & jurisprudence , Cultural Characteristics , Child Behavior/psychology , Students/psychology , Antisocial Personality Disorder/psychology , Child Behavior Disorders/psychology , Clinical Protocols/standards , School Health Services/trends , School Health Services , Social Conditions/trends , Social Conditions/statistics & numerical data , Social Work/methods , Social Work/trendsABSTRACT
Objetivo: Estudiar el desarrollo de la articulación incudoestapedial en embriones y fetos humanos. Material y método: Se han estudiado 46 huesos temporale scon ejemplares comprendidos entre 9 mm y recién nacidos. Las preparaciones estaban cortadas en serie y teñidas con la técnica de tricrómico de Martins. Resultados: La articulación incudoestapedial adquiere las características de una articulación sinovial de tipo enartrosisa las 16 semanas de desarrollo. El cartílago que recubre las superficies articulares está formado por diferentes estratos que se desarrollan sucesivamente: el superficial, a las 19 semanas; el de transición, entre las 20 y las 23 semanas, y el radial, a partir de las 24 semanas. El hueso subcondral se desarrolla a partir de las 29 semanas por los mecanismos de aposición y extensión del periostal y el endostal, pero no es hasta la semana 34 cuando recubre por completo las superficies articulares, constituidos los fascículos óseos por los que se transmitirán las líneas de fuerza. La cápsula articularse forma a partir de la interzona, la zona superficial desarrolla el ligamento capsular y la interna, la sinovial. Conclusiones: En el momento del nacimiento la articulación incudoestapedial está completamente desarrollada (AU)
Objective: To study the development of the incudostapedial joint in human embryos and foetuses. Material and method: 46 temporal bones with specimens between 9 mm and new-borns were studied. The preparations were sliced serially and dyed using the Martins trichrome technique. Results: The incudostapedial joint takes on the characteristics of a spheroidal joint at 16 weeks of development. The cartilage covering the articular surfaces is formed by different strata that develop in succession: the superficial stratum at 19 weeks, the transitional between 20 and 23 weeks, and the radial from 24 weeks on. The subchondral bone develops after 29 weeks by the mechanisms of apposition and extension of the periosteal and endosteal bones, but it is not until week 34 that it completely covers the articular surfaces, following constitution of the bone fascicles transmitting the lines of force. The articular capsule is formed from the inter-zone, the surface zone develops the capsular ligament, and the internal surface develops the synovial membrane. Conclusions: At the time of birth, the incudostapedial joint is completely developed (AU)
Subject(s)
Humans , Reflex, Acoustic/genetics , Reflex, Acoustic/physiology , Embryonic and Fetal Development/genetics , Embryonic and Fetal Development/physiology , Temporal Bone/growth & development , Stapes/physiology , Cartilage, Articular , Incus/physiology , Origin of Life , Mesoderm/physiology , Epiphyses/growth & developmentABSTRACT
Objetivo: detectar los problemas que presentan los cuidadoresprincipales de personas con demencia en domicilio, el grado detolerancia a éstos y la frecuencia con que éstos supondrían unfactor de alivio si se solucionasen.Material y métodos: estudio analítico de 6 meses de duraciónque incluye a cuidadores de pacientes con demencia que ingresanen la unidad de agudos de geriatría. Las variables analizadasfueron: filiación del paciente, años de evolución de la enfermedad,filiación del cuidador y listado de problemas de Sanford. Elestudio se realizó con el programa SPSS 12.0.Resultados: se estudió a 82 cuidadores entrevistados, con unaedad media ± desviación estándar (DE) del paciente = 82,87 ±5,94 años; el 61% eran mujeres. Los años de evolución de la enfermedadfueron 3,47 ± 2,18 años, los cuidadores tenían unaedad de 65,71 ± 13,78 años, el 83% eran mujeres y el 51,2%eran hijas. Los problemas más frecuentes fueron: incontinenciade orina, imposibilidad para vestirse e imposibilidad para lavarse.Los factores de alivio más frecuentes fueron: imposibilidad de levantarsede la cama, imposibilidad de acostarse en la cama, faltade fuerzas e imposibilidad de dejar al paciente una hora solo.Los problemas peor tolerados eran: imposibilidad de dejar al pacienteuna hora solo, imposibilidad de acostarse en la cama, imposibilidadde levantarse de la cama, agitación nocturna, falta defuerzas y conducta peligrosa.Conclusiones: los problemas más frecuentes son los relacionadoscon la dependencia para las actividades básicas de la vidadiaria; son peor tolerados los trastornos de conducta y los querequieren esfuerzo físico(AU)
Objective: to detect the problems presented by the caregivers ofpeople with dementia living at home and their degree of toleranceto these problems and identify which problems, if solved,would lead to the greatest relief.Material and methods: we performed a 6-month analyticalstudy on the caregivers of patients with dementia admitted to ashort-term geriatric unit. The variables gathered were patientsand caregivers demographic data, time since onset of dementia,and Sanford´s list of problems. The data were analyzed using theSPSS 12.0 package.Results: eighty-two caregivers were interviewed. The mean ageof the patients was 82.87 years (SD 5.94) and 61% were women.Time since onset was 3.47 years (SD 2.18). Caregivers mean agewas 65.71 years (SD 13.78) and 83% were women (51.2%daughters). The most frequent problems were urinary incontinence,inability to get dressed, and inability to wash unaided. Themost frequent problems that, if solved, would lead to relief wereinability to get out bed unaided, inability to get into bed unaided,lack of strength, and impossibility of leaving the patient alone for1 hour. The most poorly tolerated problems were the impossibilityof leaving the patient alone for 1 hour, inability to get into bedunaided, inability to get out bed unaided, nocturnal agitation, lackof strength, and dangerous behavior.Conclusions: the most frequent problems were those related todependency for basic activities of daily living. The most poorly toleratedproblems were those requiring physical strength and behavioralproblems(AU)
Subject(s)
Humans , Caregivers/psychology , Permissiveness , Dementia/psychology , Frail Elderly/statistics & numerical data , Mental Disorders/psychology , Physical ExertionABSTRACT
Objetivo: Determinar si existen conexiones entre la médula ósea de los osículos timpánicos y el mesénquima que rellena la futura cavidad timpánica. Material y métodos: Se han examinado 90 huesos temporales pertenecientes a embriones y fetos, y se han seleccionado 15 de edades comprendidas entre las semanas 20 y 30 del desarrollo al presentar conexiones entre médula del osículo y el mesénquima. Resultados: Las conexiones son de tipo transitorio y aparecen en el martillo y el yunque entre las semanas 20 y 24 de desarrollo, mientras que en el estribo se manifiestan posteriormente, entre las semanas 24 y 28. Conclusiones: Estas conexiones pueden tener un papel importante en la fagocitosis de los restos mesenquimales y sumarse a los mecanismos de eliminación de los detritus producidos durante la regresión
Objective: To investigate the presence of connections between the bone marrow of the ossicles and the mesenchyme that fills the future tympanic cavity. Material and methods: Ninety temporal bones from embryos and foetuses were examined, selecting 15 aged between 20th to 30th weeks of development, to show connections between ossicle marrow and mesenchyme. Results: The connections are transitory and appear in the malleus and the incus between 20th to 24th weeks of development, while in the stapes appear later, being between 24th to 28th weeks. Conclusions: These connections may have an important role in the phagocytosis of the mesenchymal remains and join in the detritus elimination mechanisms produced during the regression