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1.
Astrobiology ; 23(10): 1056-1070, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37782210

RESUMO

Growing evidence of the potential habitability of Ocean Worlds across our solar system is motivating the advancement of technologies capable of detecting life as we know it-sharing a common ancestry or physicochemical origin with life on Earth-or don't know it, representing a distinct emergence of life different than our one known example. Here, we propose the Electronic Life-detection Instrument for Enceladus/Europa (ELIE), a solid-state single-molecule instrument payload that aims to search for life based on the detection of amino acids and informational polymers (IPs) at the parts per billion to trillion level. As a first proof-of-principle in a laboratory environment, we demonstrate the single-molecule detection of the amino acid L-proline at a 10 µM concentration in a compact system. Based on ELIE's solid-state quantum electronic tunneling sensing mechanism, we further propose the quantum property of the HOMO-LUMO gap (energy difference between a molecule's highest energy-occupied molecular orbital and lowest energy-unoccupied molecular orbital) as a novel metric to assess amino acid complexity. Finally, we assess the potential of ELIE to discriminate between abiotically and biotically derived α-amino acid abundance distributions to reduce the false positive risk for life detection. Nanogap technology can also be applied to the detection of nucleobases and short sequences of IPs such as, but not limited to, RNA and DNA. Future missions may utilize ELIE to target preserved biosignatures on the surface of Mars, extant life in its deep subsurface, or life or its biosignatures in a plume, surface, or subsurface of ice moons such as Enceladus or Europa. One-Sentence Summary: A solid-state nanogap can determine the abundance distribution of amino acids, detect nucleic acids, and shows potential for detecting life as we know it and life as we don't know it.


Assuntos
Júpiter , Ácidos Nucleicos , Exobiologia , Planeta Terra , Aminoácidos , Meio Ambiente Extraterreno/química
2.
J Membr Biol ; 256(3): 271-285, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37140614

RESUMO

The main objective of the present study was to find detergents that can maintain the functionality and stability of the Torpedo californica nicotinic acetylcholine receptor (Tc-nAChR). We examined the functionality, stability, and purity analysis of affinity-purified Tc-nAChR solubilized in detergents from the Cyclofos (CF) family [cyclofoscholine 4 (CF-4), cyclofoscholine 6 (CF-6), and cyclofloscholine 7 (CF-7)]. The functionality of the CF-Tc-nAChR-detergent complex (DC) was evaluated using the Two Electrode Voltage Clamp (TEVC) method. To assess stability, we used the florescence recovery after photobleaching (FRAP) in Lipidic Cubic Phase (LCP) methodology. We also performed a lipidomic analysis using Ultra-Performance Liquid Chromatography (UPLC) coupled to electrospray ionization mass spectrometry (ESI-MS/MS) to evaluate the lipid composition of the CF-Tc-nAChR-DCs. The CF-4-Tc-nAChR-DC displayed a robust macroscopic current (- 200 ± 60 nA); however, the CF-6-Tc-nAChR-DC and CF-7-Tc-nAChR-DC displayed significant reductions in the macroscopic currents. The CF-6-Tc-nAChR and CF-4-Tc-nAChR displayed higher fractional florescence recovery. Addition of cholesterol produced a mild enhancement of the mobile fraction on the CF-6-Tc-nAChR. The lipidomic analysis revealed that the CF-7-Tc-nAChR-DC displayed substantial delipidation, consistent with the lack of stability and functional response of this complex. Although the CF-6-nAChR-DC complex retained the largest amount of lipids, it showed a loss of six lipid species [SM(d16:1/18:0); PC(18:2/14:1); PC(14:0/18:1); PC(16:0/18:1); PC(20:5/20:4), and PC(20:4/20:5)] that are present in the CF-4-nAChR-DC. Overall, the CF-4-nAChR displayed robust functionality, significant stability, and the best purity among the three CF detergents; therefore, CF-4 is a suitable candidate to prepare Tc-nAChR crystals for structural studies.


Assuntos
Detergentes , Receptores Nicotínicos , Animais , Espectrometria de Massas em Tandem , Torpedo , Receptores Nicotínicos/química , Lipídeos/química , Eletrofisiologia
3.
Mol Cell ; 83(4): 574-588.e11, 2023 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-36731470

RESUMO

Most eukaryotic promoter regions are divergently transcribed. As the RNA polymerase II pre-initiation complex (PIC) is intrinsically asymmetric and responsible for transcription in a single direction, it is unknown how divergent transcription arises. Here, the Saccharomyces cerevisiae Mediator complexed with a PIC (Med-PIC) was assembled on a divergent promoter and analyzed by cryoelectron microscopy. The structure reveals two distinct Med-PICs forming a dimer through the Mediator tail module, induced by a homodimeric activator protein localized near the dimerization interface. The tail dimer is associated with ∼80-bp upstream DNA, such that two flanking core promoter regions are positioned and oriented in a suitable form for PIC assembly in opposite directions. Also, cryoelectron tomography visualized the progress of the PIC assembly on the two core promoter regions, providing direct evidence for the role of the Med-PIC dimer in divergent transcription.


Assuntos
RNA Polimerase II , Proteínas de Saccharomyces cerevisiae , RNA Polimerase II/metabolismo , Microscopia Crioeletrônica , Saccharomyces cerevisiae/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Regiões Promotoras Genéticas , Transcrição Gênica , Complexo Mediador/genética , Iniciação da Transcrição Genética
4.
ACS Omega ; 7(3): 2774-2785, 2022 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-35097274

RESUMO

Polyphenols are natural compounds with strong antioxidant properties synthesized by plants and widely distributed in plant tissues. They compose a broad class of compounds that are commonly employed for multiple applications such as food, pharmaceutical, adhesives, biomedical, agricultural, and industrial purposes. Runoffs from these sources result in the introduction of polyphenols into aquatic environments where they further transform into highly toxic pollutants that can negatively affect aquatic ecosystems and humans. Therefore, the development of extraction and remediation methods for such compounds must be addressed. This study describes the identification and operation of a method to recover polyphenolic compounds from water environments by utilizing membrane-based separation. Composite membranes derived from electrospun cellulose acetate (CA) fibers and diblock copolymer (DiBCP) PEO-b-P4VP were prepared to evaluate the adsorption of polyphenolic compounds from aqueous environments. The highly porous CA fibers were developed using the electrospinning technique, and the fabricated DiBCP/CA membranes were characterized using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), Fourier-transform infrared (FT-IR) spectroscopy, and tensile testing. Finally, the ability of the composite membranes to adsorb the soluble polyphenolic compounds catechol (CAT) and gallic acid (GA), from a wetland environment, was studied via batch adsorption experiments and by solid-phase extraction (SPE). Results revealed a successful recovery of both polyphenols, at concentrations within the parts per million (ppm) range, from the aqueous media. This suggests a novel approach to recover these compounds to prevent their transformation into toxic pollutants upon entrance to water environments.

5.
Mol Cell ; 82(3): 660-676.e9, 2022 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-35051353

RESUMO

Previous structural studies of the initiation-elongation transition of RNA polymerase II (pol II) transcription have relied on the use of synthetic oligonucleotides, often artificially discontinuous to capture pol II in the initiating state. Here, we report multiple structures of initiation complexes converted de novo from a 33-subunit yeast pre-initiation complex (PIC) through catalytic activities and subsequently stalled at different template positions. We determine that PICs in the initially transcribing complex (ITC) can synthesize a transcript of ∼26 nucleotides before transitioning to an elongation complex (EC) as determined by the loss of general transcription factors (GTFs). Unexpectedly, transition to an EC was greatly accelerated when an ITC encountered a downstream EC stalled at promoter proximal regions and resulted in a collided head-to-end dimeric EC complex. Our structural analysis reveals a dynamic state of TFIIH, the largest of GTFs, in PIC/ITC with distinct functional consequences at multiple steps on the pathway to elongation.


Assuntos
RNA Polimerase II/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/enzimologia , Iniciação da Transcrição Genética , Microscopia Crioeletrônica , Regulação Fúngica da Expressão Gênica , Modelos Moleculares , Regiões Promotoras Genéticas , Conformação Proteica , RNA Polimerase II/genética , RNA Polimerase II/ultraestrutura , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/ultraestrutura , Proteínas de Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/ultraestrutura , Relação Estrutura-Atividade , Fatores de Tempo , Elongação da Transcrição Genética , Fatores de Transcrição TFII/genética , Fatores de Transcrição TFII/metabolismo
6.
Nat Commun ; 12(1): 3487, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-34108468

RESUMO

Fusicoccadiene synthase from Phomopsis amygdali (PaFS) is a unique bifunctional terpenoid synthase that catalyzes the first two steps in the biosynthesis of the diterpene glycoside Fusicoccin A, a mediator of 14-3-3 protein interactions. The prenyltransferase domain of PaFS generates geranylgeranyl diphosphate, which the cyclase domain then utilizes to generate fusicoccadiene, the tricyclic hydrocarbon skeleton of Fusicoccin A. Here, we use cryo-electron microscopy to show that the structure of full-length PaFS consists of a central octameric core of prenyltransferase domains, with the eight cyclase domains radiating outward via flexible linker segments in variable splayed-out positions. Cryo-electron microscopy and chemical crosslinking experiments additionally show that compact conformations can be achieved in which cyclase domains are more closely associated with the prenyltransferase core. This structural analysis provides a framework for understanding substrate channeling, since most of the geranylgeranyl diphosphate generated by the prenyltransferase domains remains on the enzyme for cyclization to form fusicoccadiene.


Assuntos
Alquil e Aril Transferases/química , Diterpenos/metabolismo , Proteínas Fúngicas/química , Alquil e Aril Transferases/metabolismo , Ascomicetos/química , Ascomicetos/enzimologia , Catálise , Domínio Catalítico , Microscopia Crioeletrônica , Ciclização , Dimetilaliltranstransferase/química , Dimetilaliltranstransferase/metabolismo , Proteínas Fúngicas/metabolismo , Glicosídeos/biossíntese , Liases/química , Liases/metabolismo , Enzimas Multifuncionais , Fosfatos de Poli-Isoprenil/metabolismo , Conformação Proteica
7.
Sci Adv ; 7(15)2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33827808

RESUMO

During transcription initiation, the general transcription factor TFIIH marks RNA polymerase II by phosphorylating Ser5 of the carboxyl-terminal domain (CTD) of Rpb1, which is followed by extensive modifications coupled to transcription elongation, mRNA processing, and histone dynamics. We have determined a 3.5-Å resolution cryo-electron microscopy (cryo-EM) structure of the TFIIH kinase module (TFIIK in yeast), which is composed of Kin28, Ccl1, and Tfb3, yeast homologs of CDK7, cyclin H, and MAT1, respectively. The carboxyl-terminal region of Tfb3 was lying at the edge of catalytic cleft of Kin28, where a conserved Tfb3 helix served to stabilize the activation loop in its active conformation. By combining the structure of TFIIK with the previous cryo-EM structure of the preinitiation complex, we extend the previously proposed model of the CTD path to the active site of TFIIK.

8.
Clin J Am Soc Nephrol ; 15(1): 101-108, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31857376

RESUMO

BACKGROUND AND OBJECTIVES: In the United States mortality rates for patients treated with dialysis differ by racial and/or ethnic (racial/ethnic) group. Mortality outcomes for patients undergoing maintenance dialysis in the United States territories may differ from patients in the United States 50 states. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This retrospective cohort study of using US Renal Data System data included 1,547,438 adults with no prior transplantation and first dialysis treatment between April 1, 1995 and September 28, 2012. Cox proportional hazards regression was used to calculate hazard ratios (HRs) of death for the territories versus 50 states for each racial/ethnic group using the whole cohort and covariate-matched samples. Covariates included demographics, year of dialysis initiation, cause of kidney failure, comorbid conditions, dialysis modality, and many others. RESULTS: Of 22,828 patients treated in the territories (American Samoa, Guam, Puerto Rico, Virgin Islands), 321 were white, 666 were black, 20,299 were Hispanic, and 1542 were Asian. Of 1,524,610 patients in the 50 states, 838,736 were white, 444,066 were black, 182,994 were Hispanic, and 58,814 were Asian. The crude mortality rate (deaths per 100 patient-years) was lower for whites in the territories than the 50 states (14 and 29, respectively), similar for blacks (18 and 17, respectively), higher for Hispanics (27 and 16, respectively), and higher for Asians (22 and 15). In matched analyses, greater risks of death remained for Hispanics (HR, 1.65; 95% confidence interval, 1.60 to 1.70; P<0.001) and Asians (HR, 2.01; 95% confidence interval, 1.78 to 2.27; P<0.001) living in the territories versus their matched 50 states counterparts. There were no significant differences in mortality among white or black patients in the territories versus the 50 states. CONCLUSIONS: Mortality rates for patients undergoing dialysis in the United States territories differ substantially by race/ethnicity compared with the 50 states. After matched analyses for comparable age and risk factors, mortality risk no longer differed for whites or blacks, but remained much greater for territory-dwelling Hispanics and Asians.


Assuntos
Asiático , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/etnologia , Hispânico ou Latino , Nefropatias , Diálise Renal/mortalidade , Adulto , Negro ou Afro-Americano , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Nefropatias/diagnóstico , Nefropatias/etnologia , Nefropatias/mortalidade , Nefropatias/terapia , Masculino , Pessoa de Meia-Idade , Ilhas do Pacífico/epidemiologia , Porto Rico/epidemiologia , Fatores Raciais , Diálise Renal/efeitos adversos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Estados Unidos , População Branca
9.
Head Neck ; 41(5): 1153-1160, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30620438

RESUMO

Few protocols have been published for the dental management of patients with head and neck cancer to prevent complications from head and neck radiation therapy. Radiation therapy not only affects the tumor cells targeted, but also the dentition, bone, salivary gland, and oral soft tissue structures. A comprehensive dental evaluation prior to head and neck radiation therapy can help prevent many complications. The following clinical guidelines were established by a workgroup of oral health providers within the Department of Veterans Affairs. This workgroup focused on developing a set of recommendations regarding dental care prior to the initiation of head and neck radiation therapy based on the best clinical evidence and expert consensus. A systematic algorithm was developed for the evaluation including pre-exam data gathering, examination, education, and treatment, followed by maintenance and postradiation dental follow-up. This document is evidence-based, patient-centered, consistent with accepted practices of care and safety, and in accordance with applicable statutes and regulations.


Assuntos
Assistência Odontológica/normas , Neoplasias de Cabeça e Pescoço/radioterapia , Diagnóstico Bucal , Humanos , Higiene Bucal , Educação de Pacientes como Assunto/normas , Doenças Dentárias/prevenção & controle , Doenças Dentárias/terapia
10.
J Health Care Poor Underserved ; 28(4): 1245-1253, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29176092

RESUMO

Chronic kidney disease is a non-communicable disease that is now well recognized as a major source of premature morbidity and mortality. In general, racial/ethnic minorities in the United States are more likely than non-minority groups to develop end-stage renal disease (ESRD), but paradoxically most have a lower mortality risk. Unlike most minorities, dialysis patients in Puerto Rico have a mortality risk nearly 50% higher than the national average. Multiple factors such as medical conditions, socioeconomic, environmental, and health system factors can influence health outcomes for patients with ESRD. We describe one potential health system factor that may contribute to this finding, a unique interpretation and implementation of the ESRD Medicare Secondary Payer provision in the Commonwealth of Puerto Rico. We conducted a search of regulatory documents and key stakeholder interviews to help envision the potential implications of these differences for dialysis facilities, health care providers, and patients with ESRD.


Assuntos
Disparidades em Assistência à Saúde , Falência Renal Crônica/terapia , Medicare/economia , Mecanismo de Reembolso , Diálise Renal/economia , Etnicidade/estatística & dados numéricos , Política de Saúde , Disparidades nos Níveis de Saúde , Humanos , Falência Renal Crônica/economia , Falência Renal Crônica/etnologia , Falência Renal Crônica/mortalidade , Grupos Minoritários/estatística & dados numéricos , Porto Rico/epidemiologia , Diálise Renal/estatística & dados numéricos , Medição de Risco , Estados Unidos/epidemiologia
11.
An Real Acad Farm ; 83(5): 38-53, 2017. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-172267

RESUMO

Las aguas del balneario de San Nicolás, de Alhama de Almería, fueron declaradas de utilidad pública por Real Orden de 16 de mayo de 1877, bajo la denominación de aguas de Alhama la Seca; en 1928 fue confirmada la utilidad pública de las aguas mineromedicinales de Alhama de Almería. Existen diferentes estudios de las aguas de este balneario, especialmente en el siglo XIX, en los que se comenta el tipo de aguas y su clasificación, y la mayoría de autores hacen referencia a una temperatura de las mismas superior a 40ºC. Se analizaron las aguas correspondientes al origen del manantial, a una de las bañeras y a la fuente que se encuentra en uno de los patios. Las aguas surgen a una temperatura de 48ºC; su pH es cercano a 8. El residuo seco, a 180ºC, es superior a 600 mg/L. La dureza es cercana a 500 mg/L de CaCO3, y predomina el calcio, cuyo contenido es ligeramente superior a 100 mg/L. De los aniones, bicarbonatos y sulfatos son mayoritarios; el contenido de estos últimos, ligeramente superior a los 200 mg/L, permite considerar estas aguas como sulfatadas. Los fluoruros se encuentran en cantidad ligeramente superior a 1 mg/L, lo que indica que se pueden considerar fluoradas. Los análisis realizados nos indican que se trata de aguas hipertermales, de mineralización media, muy duras, sulfatadas y fluoradas (AU)


The waters of Balneario San Nicolás, in Alhama de Almería, were declared waters of public utility by Real Orden of 16th May 1877, under the name of Alhama la Seca. In 1928, the public utility of mineromedicinal waters of Alhama de Almería was confirmed. There are different studies of these waters, especially in the 19th century, in which the type of water and its classification are discussed, and most of authors refer to a water temperature higher than 40ºC. The water samples were taken in the spring, in one of the bathtubs and in a fountain. The waters emerge at 48ºC; its pH is close to 8. Dry residue, at 180ºC, is higher than 600 mg/L. Water hardness is close to 500 mg CaCO3/L, and calcium predominates, with a content slightly higher than 100 mg/L. In terms of anions content, bicarbonates and sulfates are the most abundant. The sulfates content is higher than 200 mg/L, so the waters can be considered sulfated. Fluorides are slightly higher than 1 mg/L, reason why these waters can be considered fluoridated. The analysis carried out indicate that these waters are hyperthermal, of medium mineralization, very hard, sulfated and fluoridated (AU)


Assuntos
Águas Termais/análise , Águas Termais/classificação , Águas Minerais/análise , Águas Minerais/uso terapêutico , 24961 , Águas Termais/etnologia , Águas Termais/história , Águas Minerais/administração & dosagem , Águas Minerais/história , Águas Minerais/provisão & distribuição , Química da Água/análise
12.
Gynecol Oncol ; 142(3): 496-500, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27423380

RESUMO

OBJECTIVES: To compare complete hydatidiform mole (CHM) clinical presentation and risk factors associated with GTN development between North American and South American adolescents. METHODS: This non-concurrent cohort study was undertaken including adolescents with CHM referred to centers in North America (New England Trophoblastic Disease Center, Harvard University, USA), and South America (Botucatu Trophoblastic Disease Center-São Paulo State University, Brazil; Trophoblastic Unit of Central University of Venezuela and Maternidad Concepcion Palacios of Caracas, Venezuela) between 1990 and 2012. Data were obtained from medical records and pathology reports. Study participants were allocated into 2 groups: North America (NA) and South America (SA). RESULTS: In NA and SA, 13.1% and 30.9% of patients with hydatidiform mole were adolescents, respectively. Of these, 77.6% in NA and 86.1% in SA had pathologic diagnosis of CHM (p=0.121). Vaginal bleeding (SA=69% vs NA=51%; p=0.020), anemia (SA=48% vs NA=18%; p<0.001), and elevated serum hCG (SA=232,860mIU/mL vs NA=136,412mIU/mL; p=0.039) were more frequent in SA than in NA. Median gestational age at diagnosis (SA=12weeks, NA=11weeks; p=0.030) differed whereas GTN development rate (SA=20%, NA=27%; p=0.282) showed no significant difference between groups. Compared to NA, medical complications and clinical factors associated with post-molar GTN were more frequent among SA adolescents. CONCLUSIONS: Medical complications and clinical factors associated with GTN development were more frequent in SA than in NA adolescents with CHM, suggesting that, in South America, awareness about the importance of diagnosing molar pregnancy early and considering CHM in the differential diagnosis in adolescents suspected to be pregnant should be raised.


Assuntos
Doença Trofoblástica Gestacional/epidemiologia , Mola Hidatiforme/epidemiologia , Adolescente , Adulto , Fatores Etários , Criança , Estudos de Coortes , Feminino , Humanos , América do Norte , Gravidez , Estudos Retrospectivos , América do Sul , Adulto Jovem
13.
Sci Total Environ ; 571: 164-71, 2016 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-27471981

RESUMO

BACKGROUND: Very few studies exist on urinary arsenic exposure in Spain. OBJECTIVE: To evaluate total and speciated urinary arsenic (As) levels in a Spanish population sample. METHODS: Demographic, lifestyle and dietary data was collected for 124 volunteers (aged 20-76years; 88 women and 36 men), who were tested for total arsenic and five arsenic species using high-performance liquid chromatography-inductively coupled plasma mass spectrometry. RESULTS: Arsenobetaine (AB) and dimethylarsinic acid (DMA) were detected in 96.8% of the study participants (limit of detection (LOD) 1.0µg/L for AB and 1.9µg/L for DMA). Monomethylarsonic acid (MMA) and arsenous acid (As(III)) were detected in 5.6% (LOD 1.8µg/L) and 1.6% (LOD 1.4µg/L) of the participants, respectively; arsenic acid (As(V)) was not detected (LOD 1.4µg/L). AB and DMA (geometric mean (GM) 29.1µg/L and 7.5µg/L, respectively) were the main contributors to total urinary arsenic levels. Urinary DMA was positively associated with AB. CONCLUSION: Total arsenic levels observed in the Spanish population sample were higher than those reported by other European studies. The most recurrent urinary arsenic species was AB, followed by DMA, probably attributable to the high Spanish consumption of seafood. We recommend using inorganic As+MMA as the two main urinary biomarkers for inorganic As exposure. Our results provide reference data for analysing arsenic speciation results and assessing human exposure.


Assuntos
Arsênio/urina , Exposição Ambiental , Poluentes Ambientais/urina , Adulto , Idoso , Arsênio/química , Monitoramento Ambiental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Adulto Jovem
14.
Dimens Crit Care Nurs ; 35(4): 175-80, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27258953

RESUMO

BACKGROUND: Although most organizations have comprehensive formal stress management programs, an approach that is most likely to be helpful is the one that is curtailed specifically to the needs of a particular nursing unit. With that aim in mind, a process of daily intensive care unit (ICU) multidisciplinary operational debriefings was developed. These operational debriefings use the same concepts as traditional debriefing, yet are offered on a daily basis, rather than being reserved only for major stressful events. Furthermore, they are informal, brief (15 minutes), and multidisciplinary (intensivists, ICU nurses, chaplain, ICU social worker, ICU nutritionist, and ICU pharmacist). The purpose of this descriptive study was to determine the perceptions of attendees in relation to the implementation of daily operational debriefings. METHODS: Six months into the process, the attendees were requested to fill out an anonymous voluntary survey. Questions were simple, straightforward, and close ended. RESULTS: Of 47 potential respondents (42 nurses, 2 nurse managers, 1 social worker, 1 pharmacist, and 1 nutritionist), 42 completed the survey. Results revealed that an overwhelming majority felt that daily operational debriefings provide an effective unit-based support system, a sense of connectedness, and a commitment to the well-being of others. Nearly 50% of the respondents felt that the overall stress level in the ICU decreased, and 98% indicated operational daily debriefings should continue. CONCLUSION: Daily Informal multidisciplinary ICU operational debriefing provides an effective support system for ICU nurses. A modified model could be replicated for non-ICU units as well.


Assuntos
Enfermagem de Cuidados Críticos , Tomada de Decisões Gerenciais , Unidades de Terapia Intensiva , Equipe de Assistência ao Paciente , Humanos , Disseminação de Informação , Inquéritos e Questionários
15.
Rev. obstet. ginecol. Venezuela ; 76(2): 76-84, jun. 2016. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-830669

RESUMO

Objetivo: Evaluar las características de la enfermedad trofoblástica gestacional, diagnosticada en restos ovulares obtenidos de pacientes con abortos espontáneos, atendidas en Sala de Partos de la Maternidad “Concepción Palacios” entre enero 2012 y enero 2014. Métodos: Estudio descriptivo, prospectivo, de corte transversal, que incluyó 325 pacientes con diagnóstico de aborto espontáneo. Previo consentimiento informado, se obtuvo información de la historia clínica, hallazgos del ultrasonido y de los resultados histopatológicos. Resultados: La frecuencia de mola parcial fue de 0,3 %. La edad promedio de las pacientes fue 27 años ± 7 años, la edad gestacional promedio fue 9 semanas + 3 días ± 4 semanas. La mediana de gestas obtenida fue 2, con un rango de 1 a 11. Un 89,84 % de las pacientes se encontraban sintomáticas al momento del ingreso, 55,4 % ingresó con cuello cerrado. Desde el punto de vista macroscópico 96,3 % eran de aspecto ovular, 3 % parcialmente hidrópicos, y 0,6 % hidrópicos y desde el punto de vista microscópico, 92,9 % correspondió a restos ovulares, 7 % a abortos con degeneración hidrópica y 0,3 % a mola parcial. No se encontró correlación estadística entre el ultrasonido y la histología para diagnóstico de enfermedad trofoblástica gestacional. Conclusión: La frecuencia de mola parcial fue baja.


Objective: To evaluate the characteristics of gestational trophoblastic disease, diagnosed in POC from patients with spontaneous abortions, attending Birthplace of “Concepcion Palacios Maternity” between January 2012 and January 2014. Method: A descriptive, prospective, cutting cross, which included 325 patients with a diagnosis of spontaneous abortion. Prior informed consent information from the clinical history, ultrasound findings and histopathological results were obtained. Results: The frequency of partial mole was 0.3 %, the average age of the patients was 27 years ± 7 years, mean gestational age was 9 weeks + 3 days ± 4 weeks. Median deeds obtained was 2 with a range of 1 to 11 A 89.84 % of patients were symptomatic at the time of admission, 55.4 % were admitted with high collar. From the macroscopic viewpoint aspect 96.3 % were ovulating, 3 % partially hydropic and hydropic and 0.6 % from the microscopic, 92.9.% are POC, 7% to abortions with hydropic degeneration and 0, 3 % a partial mole. We did not find that there is statistical correlation between ultrasound and histology for the diagnosis of gestational trophoblastic disease. Conclusion: the frequency of partial mole was low.

16.
Cir Cir ; 84(1): 58-64, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-26238591

RESUMO

BACKGROUND: Aneurysm of the splenic artery is diagnosed when the diameter of the splenic artery is greater than 1cm. It occupies third place among abdominal aneurysms. It is more frequent in women (4:1). It is associated with trauma, haemodynamics and local hormonal effects during pregnancy, portal hypertension (including the Caroli syndrome), arterial degeneration, atherosclerosis, and liver transplantation. It is difficult to diagnose, and it generally presents as ruptured, thus once the diagnosis is made, the surgical approach is indicated due to its high mortality. CLINICAL CASE: Female of 66 years of age with a diagnosis of splenic artery aneurysm, with pulsing sensation at epigastric level of 8 months onset. On physical examination there is a palpable throbbing mass of 9 cm of diameter approximately, for which she was admitted. The computed tomography angiography with reconstruction showed three splenic aneurysms. Two were tied and the larger one was repaired by endo-aneurysmorrhaphy. DISCUSSION: Visceral aneurysms are extremely rare. They are currently increasing and are the third leading cause of cardiovascular death, as morbidity/mortality is high. The surgical treatment must be done selectively according to their size. Selection of the surgical techniques depends on the anatomic location and the need for revascularisation, the aetiology and the experience of the surgeon. CONCLUSION: A review has been presented on the advances in diagnostic, and management, concluding that the best is to preserve the spleen, and whatever the technique it must be performed by trained surgeons.


Assuntos
Aneurisma/cirurgia , Tratamentos com Preservação do Órgão/métodos , Baço/cirurgia , Artéria Esplênica/cirurgia , Idoso , Aneurisma/diagnóstico por imagem , Angiografia , Embolectomia com Balão , Feminino , Humanos , Ligadura , Circulação Esplâncnica , Baço/irrigação sanguínea , Artéria Esplênica/diagnóstico por imagem , Tomografia Computadorizada por Raios X
17.
An. R. Acad. Farm ; 82(5): 38-66, 2016. tab, ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-159387

RESUMO

Las aguas de Villavieja (Castellón) han sido motivo de numerosos estudios, especialmente en el siglo XIX. Las características de sus aguas se determinaron mediante análisis realizados por distintos profesionales farmacéuticos o médicos, y se clasificaron en función de las costumbres de la época. Las del Balneario de Villavieja, Pozo Monlleó, son hipertermales ya que surgen a una temperatura de 40ºC; tienen un pH de 7,5. Se caracterizan por su mineralización fuerte, con un residuo seco a 180ºC superior a 1500 mg/l. Por su contenido salino, estas aguas se clasifican como cálcicas, magnésicas, muy duras y sulfatadas (AU)


The Waters of the have been studied widely, specialy in the 19th century. Their characteristics were analyzed by different professionals, and they were classified according to the customs of the time. The waters of Pozo Monlleó Villavieja (Castellón) Spa are hypertermic (> 40ºC), have a pH of 7.5. They have a high mineralization, with a residue content above 1500 mg/l. The waters are rich in calcium, magnesium and sulphates and can be considered as very hard water (AU)


Assuntos
24961 , Águas Termais/análise , Águas Minerais/análise , Características Físico-Químicas da Água/análise , Balneologia/história , Fontes Termais
18.
Rev. obstet. ginecol. Venezuela ; 75(4): 280-283, dic. 2015.
Artigo em Espanhol | LILACS | ID: lil-783110

RESUMO

Presentamos el caso de una paciente de 35 años de edad, VII gestas, VI molas I aborto, portadora de la mutación en la proteína NLRP7, evaluada en el servicio de patología del primer trimestre del embarazo de la Maternidad “Concepción Palacios” entre los años 1998- 2010. Ambos padres tenían cariotipos normales y se detectó un antecedente familiar de embarazo molar. Este caso forma parte de un raro subconjunto de molas cuyo origen es biparental, generalmente recurrente y a menudo familiar y se asocia a imposibilidad de obtener un embarazo exitoso.


We report the case of a 35 years old patient, with 7 pregnancies, 6 molas, 1 abortion, carrier of a mutation in the protein NLRP7, evaluated in the pathology service of the Maternidad “Concepcion Palacios” between 1998-2010. Both parents had normal karyotypes and a family history of molar pregnancy was detected. This case is part of a rare subset of molas with biparental origin, usually recurrent and often family and associated with failure to obtain a successful pregnancy.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Complicações na Gravidez , Mola Hidatiforme , Incidência , Doença Trofoblástica Gestacional , Hiperplasia , Fatores de Risco , Genes
19.
J Trace Elem Med Biol ; 31: 113-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26004901

RESUMO

This study analyzed the variation and relationship of several trace elements, metabolic substrates and stress hormones activated by exercise during incremental exercise. Seventeen well-trained endurance athletes performed a cycle ergometer test: after a warm-up of 10 min at 2.0 W kg(-1), the workload was increased by 0.5 W kg(-1) every 10 min until exhaustion. Prior diet, activity patterns, and levels of exercise training were controlled, and tests timed to minimize variations due to the circadian rhythm. Oxygen uptake, blood lactate concentration, plasma ions (Zn, Se, Mn and Co), serum glucose, non-esterified fatty acids (NEFAs) and several hormones were measured at rest, at the end of each stage and 3, 5 and 7 min post-exercise. Urine specific gravity was measured before and after the test, and participants drank water ad libitum. Significant differences were found in plasma Zn and Se levels as a function of exercise intensity. Zn was significantly correlated with epinephrine, norepinephrine and cortisol (r = 0.884, P < 0.01; r = 0.871, P < 0.01; and r = 0.808, P = 0.05); and Se showed significant positive correlations whit epinephrine and cortisol (r = 0.743, P < 0.05; and r = 0.776, P < 0.05). Neither Zn nor Se levels were associated with insulin or glucagon, and neither Mn nor Co levels were associated with any of the hormones or substrate metabolites studied. Further, while Zn levels were found to be associated only with lactate, plasma Se was significantly correlated with lactate and glucose (respectively for Zn: r = 0.891, P < 0.01; and for Se: r = 0.743, P < 0.05; r = 0.831, P < 0.05). In conclusion, our data suggest that there is a positive correlation between the increases in plasma Zn or Se and stress hormones variations induced by exercise along different submaximal intensities in well-hydrated well-trained endurance athletes.


Assuntos
Cobalto/sangue , Fadiga/sangue , Manganês/sangue , Esforço Físico , Selênio/sangue , Estresse Fisiológico , Zinco/sangue , Adulto , Atletas , Epinefrina/sangue , Teste de Esforço , Glucagon/sangue , Humanos , Hidrocortisona/sangue , Insulina/sangue , Ácido Láctico/sangue , Masculino , Norepinefrina/sangue , Resistência Física , Espanha
20.
An. R. Acad. Farm ; 81(5): 33-44, 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-146982

RESUMO

Las aguas del balneario de La Villa de Olmedo (Valladolid) tienen características especiales; son aguas de alta salinidad que fueron declaradas como agua "Termal y Mineromedicinal" en junio de 2005 en la Comunidad de Castilla-León. Se trata de aguas hipotermales, con un pH en torno a 8, de alta mineralización, con un elevado residuo superior a los cinco gramos por litro. Destaca el elevado contenido de sodio que, junto a un alto contenido de cloruros, da origen a aguas clorurado-sódicas. El contenido de sulfatos es elevado y presentan concentraciones bajas de calcio y magnesio, por lo que no destacan por su dureza, considerándolas blandas


The waters of the Spa La Villa de Olmedo (Valladolid) have special characteristics; are high salinity waters declared as water "Thermal and Minero-medicinal water" in June 2005 by the Community of Castilla-León. These hypothermic waters have a pH around 8.0 and are characterized by high mineralization, with a high residue content of five grams per liter. Sodium content stand out among the elements that form the salts, which along with high chloride content gives rise to sodium-chloride waters. In addition, the sulphate content is high and the concentrations of calcium and magnesium are low, which these waters are not noted for heir hardness, so they are considered as soft waters


Assuntos
Águas Minerais/normas , Águas Minerais , Cloreto de Sódio/análise , Cloreto de Sódio/química , Água/análise , Água/química , Ânions/química , Ânions/síntese química , Águas Minerais/análise , Nascentes Naturais/análise , Nascentes Naturais/química , Mineração , Permanganato de Potássio/análise
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