Factores pronósticos en el trasplante cardiopulmonar: experiencia a 30 años en un centro de referencia / Prognosis factors in heart–lung transplantation: Thirty years experience in a reference center

Introducción: El trasplante cardiopulmonar (TCP) ha presentado una disminución progresiva en el número de procedimientos. En nuestro país existe poca información al respecto, siendo el objetivo de este estudio analizar la experiencia de un hospital de referencia. Métodos: Estudio observacional unicéntrico de una cohorte histórica en el periodo entre 1990 y 2021. Las asociaciones entre categorías se evaluaron mediante la prueba de X2 o la f de Fisher. La supervivencia se analizó a través del método de Kaplan-Meier. Las diferencias se evaluaron con el estudio de log-rank y el análisis multivariante con el método de Cox. Resultados: Se observó una reducción del número de procedimientos realizados en el último decenio (2000-2009: 19 [44,2%]; 2010-2021: 15 [34,8%]). La mortalidad posoperatoria precoz fue de 23,3%, reduciéndose a 13,3% a partir del 2010. La intrahospitalaria fue de 41%, disminuyendo a 33% en 2010. Los factores asociados a la mortalidad fueron cirugía torácica previa, corticoterapia, circulación extracorpórea (CEC) mayor a 200 min, tiempo de isquemia mayor a 300 min y dehiscencia traqueal (p < 0,005). La supervivencia global a uno, cinco y 10 años fue de 58, 44,7 y 36,1%, respectivamente. Los factores asociados a menores tasas de supervivencia fueron cirugía torácica previa, donante masculino, CEC mayor 200 min, tiempo de isquemia mayor a 300 min, dehiscencia traqueal y diferencia de pesos (p < 0,005). Conclusiones: Existe una disminución en el número de procedimientos, siendo más evidente en la última década, pero evidenciando una mejora tanto de la mortalidad posoperatoria y supervivencia.(AU)

Introduction: Heart–lung transplantation has shown a progressive decrease in the number of procedures. There is a lack of information about this field in Spain. The main goal of this study is to analyze the experience of a national reference hospital. Methods: We performed a retrospective study of a historical cohort of heart–lung transplanted patients in a single center, during a 30 years period (from 1990 to 2021). The associations between variables were evaluated using the χ2 test or Fisher's exact test. Survival was analyzed using the Kaplan–Meier method. Differences were evaluated using the log-rank test and multivariate analysis with the Cox method. Results: A decrease in the number of procedures performed in the last decade was observed [2000–2009: 19 procedures (44.2%); 2010–2021: 15 procedures (34.8%)]. Early postoperative mortality was 23.3%, falling to 13.3% from 2010. In-hospital mortality was 41%, falling to 33% from 2010. Main factors related to higher mortality: previous thoracic surgery, corticosteroid therapy, extracorporeal circulation (ECLS) greater than 200 min, ischemia time greater than 300 min, and tracheal dehiscence (p < 0.005). Overall survival at one, five, and ten years was 58%, 44.7%, and 36.1%, respectively. Factors associated with lower survival rates: previous thoracic surgery, male donor, extracorporeal circulation greater than 200 min, ischemia time greater than 300 min, tracheal dehiscence and weight difference (p < 0.005). Conclusions: There has been a progressive decrease in the number of heart–lung transplantations, being more evident in the last decade, but showing an improvement in both mortality and survival.(AU)

Prognosis factors in heart-lung transplantation: 30 years experience in a reference center.

INTRODUCTION: Heart-lung transplantation has shown a progressive decrease in the number of procedures. There is a lack of information about this field in Spain. The main goal of this study is to analyze the experience of a national reference hospital. METHODS: We performed a retrospective study of a historical cohort of heart-lung transplanted patients in a single center, during a 30 years period (from 1990 to 2021). The associations between variables were evaluated using the χ2 test or Fisher's exact test. Survival was analyzed using the Kaplan-Meier method. Differences were evaluated using the log-rank test and multivariate analysis with the Cox method. RESULTS: A decrease in the number of procedures performed in the last decade was observed [2000-2009: 19 procedures (44.2%); 2010-2021: 15 procedures (34.8%)]. Early postoperative mortality was 23.3%, falling to 13.3% from 2010. In-hospital mortality was 41%, falling to 33% from 2010. Main factors related to higher mortality: previous thoracic surgery, corticosteroid therapy, extracorporeal circulation (ECLS) greater than 200 min, ischemia time greater than 300 min, and tracheal dehiscence (p < 0.005). Overall survival at one, five, and ten years was 58%, 44.7%, and 36.1%, respectively. Factors associated with lower survival rates: previous thoracic surgery, male donor, extracorporeal circulation greater than 200 min, ischemia time greater than 300 min, tracheal dehiscence and weight difference (p < 0.005). CONCLUSIONS: There has been a progressive decrease in the number of heart-lung transplantations, being more evident in the last decade, but showing an improvement in both mortality and survival.

Valoración de los patrones de consumo alimentario y actividad física en universitarios de tres carreras respecto a las guías alimentarias para la población argentina

RESUMEN Numerosos estudios coinciden en que el inicio de la vida universitaria se asocia a cambios poco saludables en prácticas alimentarias y estilos de vida que pueden consolidarse en la edad adulta. El objetivo fue valorar en qué medida estudiantes de tres carreras cumplen con las recomendaciones de las nuevas Guías Alimentarias para la Población Argentina de 2016. Se encuestaron 164 alumnos de Bioquímica (BQ), Licenciatura en Nutrición (LN) y Licenciatura en Biotecnología (LB) de la Universidad Nacional del Litoral. Los alumnos de LN se acercaron más a las recomendaciones que BQ y LB: mayor porcentaje realizaba cuatro comidas (45,0% vs 22,4% LB y 21,8% BQ, p= 0,009) y consumía diariamente leche/yogur (p= 0,042); los estudiantes de BQ presentaron el menor consumo de frutas (p= 0,000), mientras los de LB presentaron la menor ingesta de verduras (p= 0,023). El 79,3% del total realizaba actividad física y de ellos 59,8% alcanzó los 30 minutos diarios recomendados. La Universidad ofrece espacios de alimentación saludable (comedor universitario) y actividad física (predio de deportes) que no resultaban suficientemente aprovechados. Se concluye que resulta necesario planificar intervenciones para fomentar y/o mejorar patrones, consumo de alimentos y actividad física acordes a estilos más saludables en estos universitarios.

ABSTRACT Numerous studies agree that the beginning of university life is associated with unhealthy changes in eating practices and lifestyles that can be consolidated in adulthood. The aim of this study was to assess the extent to which the nutrition and physical activity of university students from three career programs comply with the recommendations of the new Dietary Guidelines for the Argentine Population (2016). One hundred and sixty-four (164) students of Biochemistry (BQ), Bachelor of Nutrition (LN) and Bachelor of Biotechnology (LB) of the Universidad Nacional del Litoral were surveyed. LN students approached the recommendations more than BQ and LB students: a higher percentage had four meals per day (45.0% LN vs. 22.4% LB and 21.8% BQ, p-value= 0.009) and consumed a daily portion of milk/yogurt (p-value= 0.042); the BQ students had the lowest fruit consumption (p-value= 0.000), while the LB students had the lowest vegetable intake (p-value= 0.023). All students presented patterns of intake and consumption of foods strongly influenced by the Argentine culture. Almost eighty percent (79.3%) of students did physical activity, but only 59.8% reached the recommended 30 minutes a day. The University offers healthy eating spaces (university canteen) and physical activity (sports grounds) that were not sufficiently exploited. It is concluded that it is necessary to plan interventions to promote and / or improve patterns of food consumption and physical activity, according to healthier lifestyles for university students.

Pharmacy and therapeutics committees strategy to address olmesartan safety issues at a primary care level.

Background Olmesartan, an antihypertensive drug, has been associated with a severe and potentially life-threatening sprue-like enteropathy, consisting of a serious, chronic diarrhoea and malabsorption syndrome. Treatment with this drug should be discontinued if patients develop such symptoms. Objective To retrospectively determine the reduction in olmesartan prescription following a strategy promoted by pharmacy and therapeutics committees within daily clinical practice to manage updated safety information on olmesartan. Setting Three primary healthcare centres. Method In May 2016, local pharmacy and therapeutics committees integrated by general practitioners, nursing staff and clinical pharmacists sent information about olmesartan safety issues to general practitioners, together with an individual list of their patients who were then being treated with olmesartan. Moreover, information about dose equivalents between angiotensin II receptor blockers and angiotensin II receptor blockers versus angiotensin-converting-enzyme inhibitors was also attached. The strategy aimed to promote individual benefit/risk assessment by general practitioners of the continuation of olmesartan treatment as a means to achieving a decrease in the risk of sprue-like enteropathy. The investigation team retrospectively reviewed the clinical records. Main outcome measure Reduction of olmesartan prescription. Results Olmesartan was discontinued in 44.4% of patients (197/444) in the year after the safety alert e-mail. In their medical records general practitioners registered that, after informing about olmesartan safety warnings, in four cases (0.9%), patients reported gastrointestinal symptoms. Conclusion A multidisciplinary strategy implemented to promote individual benefit/risk assessment regarding continuation of olmesartan treatment showed an important reduction in olmesartan prescriptions 1 year later.

CONOCIMIENTO Y PRÁCTICA DE RECOMENDACIONES SOBRE ALIMENTACIÓN SALUDABLE EN ESTUDIANTES UNIVERSITARIOS / KNOWLEDGE AND PRACTICE OF RECOMMENDATIONS ON HEALTHY FOOD IN UNIVERSITY STUDENTS

En la actualidad resulta evidente la relación que existe entre la alimentación y la salud. La etapa universitaria es un momento clave en la autonomía en la cual los jóvenes adquieren hábitos alimentarios propios, guiados en mayor o menor medida por gustos personales, influencias del entorno, factores económicos y la búsqueda de la salud, entre otros aspectos.

Solicitud de VIH en condiciones indicadoras en atención primaria: resultados de una colaboración / Indicator condition guided human immunodeficiency virus requesting in primary health care: results of a collaboration

INTRODUCCIÓN: La búsqueda de pacientes con VIH mediante condiciones indicadoras (CI) es una estrategia para aumentar la detección precoz de dicho virus. El objetivo es analizar si una colaboración en 3 centros de atención primaria para concienciar de su importancia influyó en la proporción de serologías VIH solicitadas. MÉTODOS: Estudio multicéntrico, retrospectivo, de comparación basal y poscolaborativa. La colaboración consistió en sesiones formativas y la participación en el estudio HIDES (años 2009-2010). Se incluyeron pacientes entre 18 y 64 años con nuevos diagnósticos de herpes zóster, eccema seborreico, síndrome mononucleósico y leucopenia/trombocitopenia en 3 centros de atención primaria en 2008 (situación basal) y 2012 (poscolaborativa). Se evaluaron variables sociodemográficas, condicionantes de riesgo para VIH, solicitud de serología de VIH y resultado. RESULTADOS: Se incluyeron 1.219 CI (558 en 2008 y 661 en 2012). En 2008, el número de solicitudes de pruebas de VIH en pacientes con una CI fue del 3,9% y aumentó al 11,8% en 2012 (p < 0,0001). La tasa de infección por VIH fue del 2,2% (IC95%: 0,4-7,3) (n = 2). Se estimó que se habrían diagnosticado 25 nuevos casos (12 en 2008 y 13 en 2012) si se hubiera hecho la prueba a todos los pacientes con CI. Los factores predictores de solicitud del VIH fueron tener una CI en el año 2012, una menor edad, tener un síndrome mononucleósico y no ser español. CONCLUSIONES: Tras la colaboración con atención primaria, se triplicó la petición de VIH. Sin embargo, no se solicitó en el 88%, implicando pérdidas diagnósticas. Son necesarias nuevas estrategias para mejorar la detección precoz de VIH

INTRODUCTION: The search of HIV infected patients guided by indicator conditions (IC) is a strategy used to increase the early detection of HIV. The objective is to analyze whether a collaboration to raise awareness of the importance of early detection of HIV in 3 primary care centers influenced the proportion of HIV serology requested. METHODS: Multicenter retrospective study was conducted comparing the baseline and a post-collaboration period. The collaboration consisted of training sessions and participation in the HIDES study (years 2009-2010). Patients between 18 and 64 years old with newly diagnosed herpes zoster, seborrheic eczema, mononucleosis syndrome, and leucopenia/thrombocytopenia in 3 primary care centers in 2008 (baseline period) and 2012 (post-collaboration period). The sociodemographic variables, HIV risk conditions, requests for HIV serology, and outcomes were evaluated. RESULTS: A total of 1,219 ICs were included (558 in 2008 and 661 in 2012). In 2008 the number of HIV tests in patients with an IC was 3.9%, and rose to 11.8% in 2012 (P < .0001). The HIV infection rate was 2.2% (95% CI: 0.4-7.3) (n = 2). It was estimated that 25 new cases (12 in 2008 and 13 in 2012) would have been diagnosed if they had performed the test on all patients with IC. Predictors of HIV request were, having an IC in 2012, a younger age, having an mononucleosis syndrome, and not being Spanish. CONCLUSIONS: The HIV request demand tripled, after the collaboration with primary care centers, however in 88% the test was not requested, resulting in diagnostic losses. New strategies are needed to raise awareness of the importance of early detection of HIV

[Indicator condition guided human immunodeficiency virus requesting in primary health care: results of a collaboration]. / Solicitud de VIH en condiciones indicadoras en atención primaria: resultados de una colaboración.

INTRODUCTION: The search of HIV infected patients guided by indicator conditions (IC) is a strategy used to increase the early detection of HIV. The objective is to analyze whether a collaboration to raise awareness of the importance of early detection of HIV in 3 primary care centers influenced the proportion of HIV serology requested. METHODS: Multicenter retrospective study was conducted comparing the baseline and a post-collaboration period. The collaboration consisted of training sessions and participation in the HIDES study (years 2009-2010). Patients between 18 and 64 years old with newly diagnosed herpes zoster, seborrheic eczema, mononucleosis syndrome, and leucopenia/thrombocytopenia in 3 primary care centers in 2008 (baseline period) and 2012 (post-collaboration period). The sociodemographic variables, HIV risk conditions, requests for HIV serology, and outcomes were evaluated. RESULTS: A total of 1,219 ICs were included (558 in 2008 and 661 in 2012). In 2008 the number of HIV tests in patients with an IC was 3.9%, and rose to 11.8% in 2012 (P<.0001). The HIV infection rate was 2.2% (95% CI: 0.4-7.3) (n=2). It was estimated that 25 new cases (12 in 2008 and 13 in 2012) would have been diagnosed if they had performed the test on all patients with IC. Predictors of HIV request were, having an IC in 2012, a younger age, having an mononucleosis syndrome, and not being Spanish. CONCLUSIONS: The HIV request demand tripled, after the collaboration with primary care centers, however in 88% the test was not requested, resulting in diagnostic losses. New strategies are needed to raise awareness of the importance of early detection of HIV.

The proteolytic processing of amelogenin by enamel matrix metalloproteinase (MMP-20) is controlled by mineral ions.

BACKGROUND: Enamel synthesis is a highly dynamic process characterized by simultaneity of matrix secretion, assembly and processing during apatite mineralization. MMP-20 is the first protease to hydrolyze amelogenin, resulting in specific cleavage products that self-assemble into nanostructures at specific mineral compositions and pH. In this investigation, enzyme kinetics of MMP-20 proteolysis of recombinant full-length human amelogenin (rH174) under different mineral compositions is elucidated. METHODS: Recombinant amelogenin was cleaved by MMP-20 under various physicochemical conditions and the products were analyzed by SDS-PAGE and MALDI-TOF MS. RESULTS: It was observed that mineral ions largely affect cleavage pattern, and enzyme kinetics of rH174 hydrolysis. Out of the five selected mineral ion compositions, MMP-20 was most efficient at high calcium concentration, whereas it was slowest at high phosphate, and at high calcium and phosphate concentrations. In most of the compositions, N- and C-termini were cleaved rapidly at several places but the central region of amelogenin was protected up to some extent in solutions with high calcium and phosphate contents. CONCLUSION: These in vitro studies showed that the chemistry of the protein solutions can significantly alter the processing of amelogenin by MMP-20, which may have significant effects in vivo matrix assembly and subsequent calcium phosphate mineralization. GENERAL SIGNIFICANCE: This study elaborates the possibilities of the processing of the organic matrix into mineralized tissue during enamel development.

Self-assembly of filamentous amelogenin requires calcium and phosphate: from dimers via nanoribbons to fibrils.

Enamel matrix self-assembly has long been suggested as the driving force behind aligned nanofibrous hydroxyapatite formation. We tested if amelogenin, the main enamel matrix protein, can self-assemble into ribbon-like structures in physiologic solutions. Ribbons 17 nm wide were observed to grow several micrometers in length, requiring calcium, phosphate, and pH 4.0-6.0. The pH range suggests that the formation of ion bridges through protonated histidine residues is essential to self-assembly, supported by a statistical analysis of 212 phosphate-binding proteins predicting 12 phosphate-binding histidines. Thermophoretic analysis verified the importance of calcium and phosphate in self-assembly. X-ray scattering characterized amelogenin dimers with dimensions fitting the cross-section of the amelogenin ribbon, leading to the hypothesis that antiparallel dimers are the building blocks of the ribbons. Over 5-7 days, ribbons self-organized into bundles composed of aligned ribbons mimicking the structure of enamel crystallites in enamel rods. These observations confirm reports of filamentous organic components in developing enamel and provide a new model for matrix-templated enamel mineralization.

Cellular uptake of gold nanoparticles bearing HIV gp120 oligomannosides.

Dendritic cells are the most potent of the professional antigen-presenting cells which display a pivotal role in the generation and regulation of adaptive immune responses against HIV-1. The migratory nature of dendritic cells is subverted by HIV-1 to gain access to lymph nodes where viral replication occurs. Dendritic cells express several calcium-dependent C-type lectin receptors including dendritic cell-specific ICAM-3 grabbing non-integrin (DC-SIGN), which constitute a major receptor for HIV-1. DC-SIGN recognizes N-linked high-mannose glycan clusters on HIV gp120 through multivalent and Ca(2+)-dependent protein-carbohydrate interactions. Therefore, mimicking the cluster presentation of oligomannosides from the virus surface is a strategic approach for carbohydrate-based microbicides. We have shown that gold nanoparticles (mannoGNPs) displaying multiple copies of structural motifs (di-, tri-, tetra-, penta-, or heptaoligomanosides) of the N-linked high-mannose glycan of viral gp120 are efficient inhibitors of DC-SIGN-mediated trans-infection of human T cells. We have now prepared the corresponding fluorescent-labeled glyconanoparticles (FITC-mannoGNPs) and studied their uptake by DC-SIGN expressing Burkitt lymphoma cells (Raji DC-SIGN cell line) and monocyte-derived immature dendritic cells (iDCs) by flow cytometry and confocal laser scanning microscopy. We demonstrate that the 1.8 nm oligomannoside coated nanoparticles are endocytosed following both DC-SIGN-dependent and -independent pathways and part of them colocalize with DC-SIGN in early endosomes. The blocking and sequestration of DC-SIGN receptors by mannoGNPs could explain their ability to inhibit HIV-1 trans-infection of human T cells in vitro.

Gold nanoparticles coated with oligomannosides of HIV-1 glycoprotein gp120 mimic the carbohydrate epitope of antibody 2G12.

After three decades of research, an effective vaccine against the pandemic AIDS caused by human immunodeficiency virus (HIV) is not still available, and a deeper understanding of HIV immunology, as well as new chemical tools that may contribute to improve the currently available arsenal against the virus, is highly wanted. Among the few broadly neutralizing human immunodeficiency virus type 1 (HIV-1) monoclonal antibodies, 2G12 is the only carbohydrate-directed one. 2G12 recognizes a cluster of high-mannose glycans on the viral envelope glycoprotein gp120. This type of glycan has thus been envisaged as a target to develop an HIV vaccine that is capable of eliciting 2G12-like antibodies. Herein we show that gold nanoparticles coated with self-assembled monolayers of synthetic oligomannosides [manno-gold glyconanoparticles (GNPs)], which are present in gp120, are able to bind 2G12 with high affinity and to interfere with 2G12/gp120 binding, as determined by surface plasmon resonance and saturation transfer difference NMR spectroscopy. Cellular neutralization assays demonstrated that GNPs coated with a linear tetramannoside could block the 2G12-mediated neutralization of a replication-competent virus under conditions that resemble the ones in which normal serum prevents infection of the target cell. Dispersibility in water and physiological media, absence of cytotoxicity, and the possibility of inserting more than one component into the same nanoparticle make manno-GNPs versatile, polyvalent, and multifunctional systems that may aid efforts to develop new multifaceted strategies against HIV.

Self-aligning amelogenin nanoribbons in oil-water system.

The highly organized microstructure of dental enamel is a result of protein-guided anisotropic growth of apatite nanofibers. It is established that amelogenin proteins, the main constituent of the developing enamel matrix, form nanospheres in vitro, but the amphiphilic nature of the full-length protein conveys the possibility of generating more complex structures as observed with other surfactant-like molecules. This study tested if the use of metastable oil-water emulsions can induce supramolecular assemblies of amelogenin. Recombinant full-length amelogenin, rH174, was mixed into octanol/ethyl acetate preparations of different ratios to form emulsions at pH 4.5 and 7.4. Atomic force and electron microscopy showed the formation of 16.7±1.0nm wide nanoribbons which grew to several micrometer length over a period of days. Nanoribbons formed from reverse micelles by enabling hydrophobic tails of the molecules to interact while preventing the formation of amelogenin nanospheres. Ribbon formation required the presence of calcium and phosphate ions and may be localized at a dark central line along the amelogenin ribbons. The ribbons have a strong tendency to align in parallel maintaining 5-20nm space between each other. The growth rates and number of ribbons were significantly higher at pH 4.5 and related to the metastability of the emulsion. A model for ribbon extension proposes the addition of short segments or amelogenin dimers to the ends of the ribbon. The formation of self-aligning and uniaxially elongating amelogenin structures triggered by the presence of calcium and phosphate may represent a suitable new model for protein controlled mineralization in enamel.

Self-assembly of amelogenin proteins at the water-oil interface.

Self-assembly of amelogenin plays a key role in controlling enamel biomineralization. Recently, we generated self-aligning nanoribbons of amelogenin in water-in-oil emulsions stabilized by the full-length protein (rH174). Here, we tested the hypothesis that the hydrophilic C-terminus is critical for self-assembly of amelogenin into nanoribbons. The self-assembled structures of two amelogenin cleavage products, rH163 and rH146, were compared with structures of rH174 at different pH values and degrees of saturation using atomic force microscopy, electron microscopy, and dynamic light scattering. We observed that the number density of rH174 nanoribbons increased significantly when the initial pH was raised from 4.5 to 5.6. Nanoribbons, as well as unique helical nanostructures, were also readily observed when amelogenin rH146 was used, but showed little tendency for parallel alignment and did not bundle into fibrils like rH174. In contrast, rH163 rarely formed nanoribbons but predominantly assembled into nanospheres under the same conditions. We conclude that the presence of a hydrophilic C-terminus may not be a prerequisite for nanoribbon formation but may be critical for ribbon alignment and subsequent fibril formation. These results highlight the contribution of the hydrophobic domain in the self-assembly of elongated structures of amelogenins. Molecular mechanisms governing these processes based on the formation of reverse micelles are discussed.

Gold nanoparticles capped with sulfate-ended ligands as anti-HIV agents.

Gold nanoparticles coated with multiple copies of an amphiphilic sulfate-ended ligand are able to bind the HIV envelope glycoprotein gp120 as measured by surface plasmon resonance (SPR) and inhibit in vitro the HIV infection of T-cells at nanomolar concentrations. A 50% density of sulfated ligands on approximately 2 nm nanoparticles (the other ligands being inert glucose derivatives) is enough to achieve high anti-HIV activities. This result opens up the possibility of tailoring both sulfated ligands and other anti-HIV molecules on the same gold cluster, thus contributing to the development of non-cocktail based multifunctional anti-HIV systems.

Gold manno-glyconanoparticles: multivalent systems to block HIV-1 gp120 binding to the lectin DC-SIGN.

The HIV envelope glycoprotein gp120 takes advantage of the high-mannose clusters on its surface to target the C-type lectin dendritic cell-specific intracellular adhesion molecule-3-grabbing non-integrin (DC-SIGN) on dendritic cells. Mimicking the cluster presentation of oligomannosides on the virus surface is a strategy for designing carbohydrate-based antiviral agents. Bio-inspired by the cluster presentation of gp120, we have designed and prepared a small library of multivalent water-soluble gold glyconanoparticles (manno-GNPs) presenting truncated (oligo)mannosides of the high-mannose undecasaccharide Man(9)GlcNAc(2) and have tested them as inhibitors of DC-SIGN binding to gp120. These glyconanoparticles are ligands for DC-SIGN, which also interacts in the early steps of infection with a large number of pathogens through specific recognition of associated glycans. (Oligo)mannosides endowed with different spacers ending in thiol groups, which enable attachment of the glycoconjugates to the gold surface, have been prepared. manno-GNPs with different spacers and variable density of mannose (oligo)saccharides have been obtained and characterized. Surface plasmon resonance (SPR) experiments with selected manno-GNPs have been performed to study their inhibition potency towards DC-SIGN binding to gp120. The tested manno-GNPs completely inhibit the binding from the micro- to the nanomolar range, while the corresponding monovalent mannosides require millimolar concentrations. manno-GNPs containing the disaccharide Manalpha1-2Manalpha are the best inhibitors, showing more than 20 000-fold increased activity (100 % inhibition at 115 nM) compared to the corresponding monomeric disaccharide (100 % inhibition at 2.2 mM). Furthermore, increasing the density of dimannoside on the gold platform from 50 to 100 % does not improve the level of inhibition.

El trabajo tutorial en la asignatura Medicina General Integral y su influencia en el proyecto educativo / Tutorial Work in Integral General Medicine and Its Influence for Educative Project

Dada la importancia que tienen las dimensiones del Proyecto Educativo para fortalecer los valores en la personalidad de nuestros estudiantes, durante su rotación por cinco semanas en la Atención Primaria de Salud y la posibilidad que nos brinda la asignatura Introducción a la Medicina General Integral, nos sentimos motivados a realizar esta investigación. En ella valoramos el trabajo tutorial (médico enfermera) en el cumplimiento de las dimensiones curricular, socio política y extensionista.Los resultados obtenidos evidencian lo que nos falta por hacer tanto con el personal de enfermería, como con los médicos, organizaciones políticas y estudiantiles para formar una personalidad profesional en correspondencia con las exigencias de nuestra sociedad, por lo antes expuesto proponemos un plan de acción para un mejor desarrollo del proceso docente...(AU)

The values of our students` personality should be supported during the primary health care through the teaching project due to its importance.These were the main reasons that motivated the authors to carry out this investigation The tutorial work (doctor-nurse) was assessed taking into account socio-political aspects. The results showed the need of developing the professional personality related with nursing and doctors according to our society requirements. The authors recommended to develop an action plan to improve the teaching process...(AU)

Ionisation density dependence of the optically stimulated luminescence dose-response of AL2O3:C to low-energy charged particles.

The optically stimulated luminescence (OSL) response of Al2O3:C to high doses of gamma or beta irradiation can be used to predict the response of this material to charged particles as a function of particle fluence, particle energy and/or linear energy transfer (LET). In particular, it is predicted that track interaction effects at high particle fluences should result in linear-sublinear growth of the OSL signal. Similar considerations also predict a dependence of the fluence at which sublinearity starts upon the energy of the particles. In this work the OSL response of Al2O3:C to low-energy charged particles was investigated using protons (1, 2 and 4 MeV), carbon ions (13 MeV) and oxygen ions (10 MeV). The sublinear growth predicted above was qualitatively confirmed, but the energy dependence prediction was not. Furthermore, the efficiency of OSL production in the material after charged particle irradiation, compared to that obtained for gamma irradiation, is determined from the dose-response curves by fitting to a simple saturating exponential function. The efficiency values so obtained using this method are compared with those obtained from a conventional single-point measurement in the linear portion of the curve and found to be in good agreement. In general, the efficiency decreases as the LET of the particle increases. The present data are compared with published data obtained using high-energy charged particles and the results show that the efficiency is not a unique function of LET.

Alteraciones en el autoconcepto ocasionadas por alteraciones en la imagen corporal de los usuarios del programa de lepra / Self-concept disorders due to body-image alterations in the leprae program users

La atencion de enfermeria hacia grupos de usuarios del programa de lepra a estado encaminada al manejo clinico exclusivamente sin tener encuenta los aspectos psicosociales implicitos en ella. Mediante la investigacion se logro investigar los cambios ocurridos en el autoconcepto de la persona teniendo encuenta para ello los juicios valorativos sobre aspectos afectivos emocionales, relaciones interpersonales, acciones y metas como consecuencia de las alteraciones en la imagen corporal ocurridas en el proceso evolutivo de la lepra en su estado inicial e intermedio en el Instituto Dermatologico Federico Lleras Acosta de Bogota en el periodo comprendido entre agosto y noviembre de 1987. Finalizando se pudo concluir que existen diferencias significativas en el autoconcepto de hombres y mujeres siendo mayor en hombres. Se presentan mas alteraciones en la imagen corporal en las fases intermedia y final, cuando se hace mas evidente la enfermedad; por lo tanto es necesario trabajar desde las primeras fases. Por ultimo se deja un manual de actividades para el trabajo de la imagen corporal de los usuarios del programa de lepra para que las personas e instituciones interesadas lo utilizen en sus programas a nivel nacional, regional o local