Impacto del momento de medición y de la sintomatología acontecida durante la hemodiálisis en la Calidad de Vida percibida por el paciente / Impact of measurement timing and symptomatology during hemodialysis on perceived quality of life by the patient

Objetivo: Determinar la relación entre calidad de vida percibida por el paciente en hemodiálisis, el momento de medición de esta y el número de síntomas/complicaciones acontecidos durante la sesión.Material y Método: Estudio observacional longitudinal en pacientes en hemodiálisis con capacidad cognitiva conservada. Se recogieron variables sociodemográficas y clínicas, así como calidad de vida mediante instrumento Coop-Wonka.El estudio se desarrolló en 2 fases:Primera fase: evaluación calidad de vida preHD, cuestionario autoadministrado (en las 12 h previas a 1ª sesión semanal).Segunda fase: 4 semanas más tarde, cumplimentación del mismo cuestionario de calidad de vida, administrado por enfermería (al finalizar 1ª sesión semanal).Durante cuatro semanas se recogieron todos los síntomas, complicaciones mecánicas y situaciones de estrés experimentadas por el paciente durante las sesiones.Resultados: Se estudiaron 61 pacientes, 39 hombres (64%). Edad 67,7±13 años. Tiempo en hemodiálisis 68,7±79 meses. Las puntuaciones globales de calidad de vida relacionada con la salud fueron 25,6±6,9 puntos (1ª fase) y 24,2±7 puntos (2ª fase), con diferencias significativas entre ambos periodos. Se registraron 328 síntomas (0,44±0,54/paciente y sesión).El tiempo en hemodiálisis se relacionó con sintomatología y calidad de vida, presesión y post-sesión.Y la sintomatología se relacionó con calidad de vida relacionada con la salud pre y post-sesión.Conclusiones: A mayor tiempo en hemodiálisis los pacientes presentan peor calidad de vida y más sintomatología durante las sesiones. La percepción sobre su estado de salud, es mejor post-sesión en comparación con la percibida antes de la sesión de diálisis. (AU)

Objective: To determine the relationship between patients’ perceived quality of life on hemodialysis, the timing of its measurement, and the number of symptoms/complications occurring during the session.Material and Method: Longitudinal observational study in hemodialysis patients with preserved cognitive capacity. Sociodemographic and clinical variables and quality of life were collected using the Coop-Wonka instrument. The study was conducted in 2 phases:First phase: pre-HD quality of life evaluation, self-administered questionnaire (12 hours before the 1st weekly session).Second phase: 4 weeks later, completion of the same quality of life questionnaire, administered by nursing staff at the end of the 1st weekly session. All symptoms, mechanical complications, and stress situations experienced by the patient during the sessions were recorded for four weeks.Results: Sixty-one patients were studied, 39 men (64%). The mean age was 67.7±13 years. Time on hemodialysis was 68.7±79 months. Overall scores for health-related quality of life were 25.6±6.9 points (1st phase) and 24.2±7 points (2nd phase), with significant differences between both periods. 328 symptoms were recorded (0.44±0.54/patient and session). Time on hemodialysis was related to symptomatology and quality of life, pre-session and post-session. Symptoma-tology was related to health-related quality of life pre and post-session.Conclusions: Patients who have been on hemodialysis for more extended periods have worse quality of life and more symptoms during the sessions. Their perception of their health status is better post-session compared to pre-dialysis sessions. (AU)

Gold nanoparticle-coated apoferritin conductive nanowires.

Gold-metallic nanofibrils were prepared from three different iso-apoferritin (APO) proteins with different Light/Heavy (L/H) subunit ratios (from 0% up to 100% L-subunits). We show that APO protein fibrils have the ability to in situ nucleate and grow gold nanoparticles (AuNPs) simultaneously assembled on opposite strands of the fibrils, forming hybrid inorganic-organic metallic nanowires. The AuNPs are arranged following the pitch of the helical APO protein fiber. The mean size of the AuNPs was similar in the three different APO protein fibrils studied in this work. The AuNPs retained their optical properties in these hybrid systems. Conductivity measurements showed ohmic behavior like that of a continuous metallic structure.

Folliculin: A Regulator of Transcription Through AMPK and mTOR Signaling Pathways.

Folliculin (FLCN) is a tumor suppressor gene responsible for the inherited Birt-Hogg-Dubé (BHD) syndrome, which affects kidneys, skin and lungs. FLCN is a highly conserved protein that forms a complex with folliculin interacting proteins 1 and 2 (FNIP1/2). Although its sequence does not show homology to known functional domains, structural studies have determined a role of FLCN as a GTPase activating protein (GAP) for small GTPases such as Rag GTPases. FLCN GAP activity on the Rags is required for the recruitment of mTORC1 and the transcriptional factors TFEB and TFE3 on the lysosome, where mTORC1 phosphorylates and inactivates these factors. TFEB/TFE3 are master regulators of lysosomal biogenesis and function, and autophagy. By this mechanism, FLCN/FNIP complex participates in the control of metabolic processes. AMPK, a key regulator of catabolism, interacts with FLCN/FNIP complex. FLCN loss results in constitutive activation of AMPK, which suggests an additional mechanism by which FLCN/FNIP may control metabolism. AMPK regulates the expression and activity of the transcriptional cofactors PGC1α/ß, implicated in the control of mitochondrial biogenesis and oxidative metabolism. In this review, we summarize our current knowledge of the interplay between mTORC1, FLCN/FNIP, and AMPK and their implications in the control of cellular homeostasis through the transcriptional activity of TFEB/TFE3 and PGC1α/ß. Other pathways and cellular processes regulated by FLCN will be briefly discussed.

A New Heterogeneous Catalyst Obtained via Supramolecular Decoration of Graphene with a Pd2+ Azamacrocyclic Complex.

A new G-(H2L)-Pd heterogeneous catalyst has been prepared via a self-assembly process consisting in the spontaneous adsorption, in water at room temperature, of a macrocyclic H2L ligand on graphene (G) (G + H2L = G-(H2L)), followed by decoration of the macrocycle with Pd2+ ions (G-(H2L) + Pd2+ = G-(H2L)-Pd) under the same mild conditions. This supramolecular approach is a sustainable (green) procedure that preserves the special characteristics of graphene and furnishes an efficient catalyst for the Cu-free Sonogashira cross coupling reaction between iodobenzene and phenylacetylene. Indeed, G-(H2L)-Pd shows an excellent conversion (90%) of reactants into diphenylacetylene under mild conditions (50 °C, water, aerobic atmosphere, 14 h). The catalyst proved to be reusable for at least four cycles, although decreasing yields down to 50% were observed.

Phosphoproteome Analysis Reveals Estrogen-ER Pathway as a Modulator of mTOR Activity Via DEPTOR.

ER-positive breast tumors represent ∼70% of all breast cancer cases. Although their treatment with endocrine therapies is effective in the adjuvant or recurrent settings, the development of resistance compromises their effectiveness. The binding of estrogen to ERα, a transcription factor, triggers the regulation of the target genes (genomic pathway). Additionally, a cytoplasmic fraction of estrogen-bound ERα activates oncogenic signaling pathways such as PI3K/AKT/mTOR (nongenomic pathway). The upregulation of the estrogenic and the PI3K/AKT/mTOR signaling pathways are frequently associated with a poor outcome. To better characterize the connection between these two pathways, we performed a phosphoproteome analysis of ER-positive MCF7 breast cancer cells treated with estrogen or estrogen and the mTORC1 inhibitor rapamycin. Many proteins were identified as estrogen-regulated mTORC1 targets and among them, DEPTOR was selected for further characterization. DEPTOR binds to mTOR and inhibits the kinase activity of both mTOR complexes mTORC1 and mTORC2, but mitogen-activated mTOR promotes phosphorylation-mediated DEPTOR degradation. Although estrogen enhances the phosphorylation of DEPTOR by mTORC1, DEPTOR levels increase in estrogen-stimulated cells. We demonstrated that DEPTOR accumulation is the result of estrogen-ERα-mediated transcriptional upregulation of DEPTOR expression. Consequently, the elevated levels of DEPTOR partially counterbalance the estrogen-induced activation of mTORC1 and mTORC2. These results underscore the critical role of estrogen-ERα as a modulator of the PI3K/AKT/mTOR signaling pathway in ER-positive breast cancer cells. Additionally, these studies provide evidence supporting the use of dual PI3K/mTOR or dual mTORC1/2 inhibitors in combination with endocrine therapies as a first-line treatment option for the patients with ER-positive advanced breast cancer.

Estrogen receptor α promotes protein synthesis by fine-tuning the expression of the eukaryotic translation initiation factor 3 subunit f (eIF3f).

Approximately two thirds of all breast cancer cases are estrogen receptor (ER)-positive. The treatment of this breast cancer subtype with endocrine therapies is effective in the adjuvant and recurrent settings. However, their effectiveness is compromised by the emergence of intrinsic or acquired resistance. Thus, identification of new molecular targets can significantly contribute to the development of novel therapeutic strategies. In recent years, many studies have implicated aberrant levels of translation initiation factors in cancer etiology and provided evidence that identifies these factors as promising therapeutic targets. Accordingly, we observed reduced levels of the eIF3 subunit eIF3f in ER-positive breast cancer cells compared with ER-negative cells, and determined that low eIF3f levels are required for proper proliferation and survival of ER-positive MCF7 cells. The expression of eIF3f is tightly controlled by ERα at the transcriptional (genomic pathway) and translational (nongenomic pathway) level. Specifically, estrogen-bound ERα represses transcription of the EIF3F gene, while promoting eIF3f mRNA translation. To regulate translation, estrogen activates the mTORC1 pathway, which enhances the binding of eIF3 to the eIF4F complex and, consequently, the assembly of the 48S preinitiation complexes and protein synthesis. We observed preferential translation of mRNAs with highly structured 5'-UTRs that usually encode factors involved in cell proliferation and survival (e.g. cyclin D1 and survivin). Our results underscore the importance of estrogen-ERα-mediated control of eIF3f expression for the proliferation and survival of ER-positive breast cancer cells. These findings may provide rationale for the development of new therapies to treat ER-positive breast cancer.

Apoferritin Protein Amyloid Fibrils with Tunable Chirality and Polymorphism.

Ferritin, a soluble and highly robust protein with subunits packed into well-defined helices, is a key component of the iron regulatory system in the brain and thus is widely recognized as a crucial protein for iron metabolism, but may also bear possible implications in some neurodegenerative disorders. Here, we present evidence of how human recombinant apoferritin can convert into an unusual structure from its folded native state; that is, amyloid fibrils analogue to those found in pathological disorders such as Alzheimer's and Parkinson's diseases. An extensive combination of advanced microscopy, spectroscopy and scattering techniques concur to reveal that apoferritin fibrils possess a common double stranded twisted ribbon structure which can result in a mesoscopic right-handed chirality. We highlight a direct connection between the chirality and morphology of the resulting amyloid fibrils, and the initial protein subunits composition, advancing our understanding on the possible role of misfolding in some ferritin-related pathologies and posing new bases for the design of chiral 1D functional nanostructures.

Análisis del impacto de la producción científica de la revista Enfermería Nefrológica entre 1998 y 2017 / Analysis of the impact of the scientific production of the journal Enfermería Nefrológica between 1998 and 2017

Introducción: Enfermería Nefrológica es la publicación oficial de la Sociedad Española de Enfermería Nefrológica, que cumple su 20 aniversario. El análisis de los artículos de una revista permite determinar la evolución de una publicación. Objetivo: Analizar la producción científica publicada en la revista Enfermería Nefrológica durante el periodo 1998-2017. Material y Método: Estudio bibliométrico descriptivo transversal de la revista Enfermería Nefrológica, del volumen 1 al 20, mediante el software "Publish or Perish" V6. Se analizaron las siguientes variables: número total de artículos y de citas; citas por artículo, por autor, por año; artículos por autor y autores por artículo; AWCR, índice g e índice h. Se realizaron análisis por periodos de 5 años (Periodo-1 1998-2002, Periodo-2 2003-2007, Periodo-3 2008-2011, Periodo-4 2012-2017). Resultados: Se analizaron 1198 artículos: Periodo-1 n=81 (6,76%), Periodo-2 n=160 (13,35%), Periodo-3 n=164 (13,68%), Periodo-4 n=793 (66,19%); y 2167 citaciones: Periodo-1 n=47 (2,17%), Periodo-2 n=759 (35%), Periodo-3 n=782 (36%), Periodo-4 n=579 (26,7%). Media de autores por artículo: Periodo-1: 1,96, Periodo-2: 2,66, Periodo-3: 2,82, Periodo-4: 3. AWCR: Periodo-1: 2,80 (sqrt=1,67) 1,58/autor, Periodo-2: 60,33 (sqrt=7,77) 26,58/autor, Periodo-3: 93,93 (sqrt=9,69), 35,21/autor, Periodo-4: 147,12 (sqrt=12,13), 57,31/autor. Índice h: Periodo-1: 4 (a=2,94, m=0,20, 35 citas=74,5% cobertura), Periodo-2: 16 (a=2,96, m=1,07, 433 citas=57,0% cobertura), Periodo-3: 9 (a=7,15, m=1,50, 116 citas=20,0% cobertura), Periodo-4: 11 (g/h=1,22, 133 citas=23,0% cobertura). Conclusiones: La revista Enfermería Nefrológica ha crecido de forma exponencial en los últimos 20 años, tanto en volumen de producción como en calidad y visibilidad, convirtiéndose en la publicación de referencia del cuidado renal en el ámbito hispano-hablante

Introduction: The Journal Enfermería Nefrológica (EN) is the official publication of the Spanish Nephrology Nursing Association (SEDEN), and in 2018, EN celebrates its 20th anniversary. Analysis of journal articles allows to determine the publication's evolution. Aim: To analyze the scientific production published in the journal EN during the period 1998-2017. Material and Method: Bibliometric cross-sectional descriptive study of the journal EN from volume 1 to 20, using the software "Publish or Perish" 6th version. The following variables were analyzed: total number of articles and citations; citations per article, per author, per year; articles by author and authors by article; AWCR, g-index and h-index. Five-year periods analyzes were carried out (Period-1 1998-2002, Period-2 2003-2007, Period-3 2008-2011, Period-4 2012-2017). Results: 1198 articles were analyzed: Period-1 n=81 (6.76%), Period-2 n=160 (13.35%), Period-3 n=164 (13.68%), Period-4 n=793 (66.19%); and 2167 citations: Period-1 n=47 (2.17%), Period-2 n= 759 (35%), Period-3 n=782 (36%), Period-4 n=579 (26.7%). Average number of authors per article: Period-1 1.96, Period-2 2.66, Period-3 2.82, Period-4 3. AWCR: Period-1 2.80 (sqrt=1.67) 1.58/author, Period-2 60.33 (sqrt=7.77) 26.58/author, Period-3 93.93 (sqrt=9.69), 35.21/author, Period-4 147.12 (sqrt=12.13), 57.31/author. H index: Period-1 4 (a=2.94, m=0.20, 35 cites=74.5% coverage), Period-2 16 (a=2.96, m=1.07, 433 cites=57.0% coverage), Period-3 9 (a=7.15, m=1.50, 116 cites=20.0% coverage), Period-4 11 (g/h=1.22, 133 cites=23.0% coverage). Conclusions: The journal EN has grown exponentially in the last 20 years, both in production volume and in quality and visibility, becoming the reference publication of renal care in the Spanish-speaking world

Análisis de la punción de prótesis intravasculares recubiertas tras el rescate de la fístula arteriovenosa después de 12 meses de experiencia / Analysis of puncture of coated intravascular prostheses after salvage of arteriovenous fistula, after 12 months of experience

Objetivos: Evaluar la eficacia a medio plazo de una nueva prótesis intravascular (VIABAHN(R)), y su seguridad, analizando la incidencia de eventos adversos asociados a su punción. Pacientes y Método: Se estudiaron 20 pacientes, a los que se les implantó VIABAHN(R), por pseudoaneurismas con trombosis, úlceras en las zonas de punción, fracaso de angioplastia o reestenosis en menos de 6 meses. Se estudió: Parámetros de la FAV, permeabilidad primaria y secundaria (6 y 12 meses), presencia de complicaciones y control del deterioro de la prótesis mediante flebografía a los 3 y 6 meses. Para la punción se esperó un periodo de 4 semanas. Resultados: Se analizó un periodo de 15±9.4 meses. La media de los parámetros funcionales de la FAV durante la hemodiálisis fue: Fs: 362.5±43.3 ml/min, PA: -209.5±35.6 mmHg, PV: 215.8±34.5 mmHg, Kt 55±5.4 l y Recirculación 12.7±3.7%. A los 6 meses el 66% (IC 95% 54-77) de los pacientes tenía permeabilidad primaria y el 77% (IC 95% 67-87) tenía permeabilidad secundaria. A los 12 meses el 38% (IC 95% 24-52) permeabilidad primaria y el 76% (IC 95% 66-87) permeabilidad secundaria. No se observaron eventos adversos relacionados con la punción, ni se objetivó radiológicamente deterioro en las prótesis. Hubo un episodio de infección que requirió la retirada de la prótesis. Conclusiones: La prótesis vascular recubierta VIABAHN(R) es eficaz y segura en el rescate de las FAVs nativas estenosadas y/o trombosadas, ya que proporciona excelentes parámetros de diálisis y alta permeabilidad primaria y secundaria, sin que su punción repetida se asocie a complicaciones (AU)

Aim: To evaluate the medium-term efficacy of a new intravascular prosthesis (VIABAHN(R)), and its safety, by analyzing the incidence of adverse events associated with its puncture. Patients and method: Twenty patients, with VIABAHN(R) implanted, were studied for pseudoaneurysms with thrombosis, ulcers in the puncture sites, failure of angioplasty or restenosis in less than 6 months. Parameters of AVF, primary and secondary patency (6 and 12 months), presence of complications and control of prosthesis deterioration by phlebography at 3 and 6 months were studied. For the puncture, a period of 4 weeks was expected. Results: A period of 15 ± 9.4 months was analyzed. The mean of the functional parameters of the AVF during hemodialysis was: blood flow rate: 362.5 ± 43.3 ml / min, Arterial Pressure: -209.5 ± 35.6 mmHg, Venous Pressure: 215.8 ± 34.5 mmHg, Kt 55 ± 5.4 l and recirculation 12.7 ± 3.7%. At 6 months, 66% (95% CI: 54-77) of the patients had primary permeability and 77% (95% CI 67-87) had secondary permeability. At 12 months 38% (IC 95% 24-52) primary permeability and 76% (IC 95% 66-87) secondary permeability. No adverse events related to the puncture, nor radiologically objectified deterioration in prostheses were observed. There was an episode of infection requiring removal of the prosthesis. Conclusión: The VIABAHN(R) coated vascular prosthesis is effective and safe in the rescue of stented and / or thrombosed native AVFs, as it provides excellent dialysis parameters and high primary and secondary permeability, without repeated puncture associated with complications (AU)

Varying iron release from transferrin and lactoferrin proteins. A laboratory experiment.

Iron metabolism is an important subject of study for undergraduate students of chemistry and biochemistry. Relevant laboratory exercises are scarce in the literature but would be very helpful in assisting students grasp key concepts. The experiment described here deals with different iron release mechanisms of two protagonists in iron metabolism: serum transferrin (Tf) and lactoferrin (Lf). Despite having very similar structures and iron-binding sites, Tf releases practically all its iron at pH 5.5 while Lf requires a significantly lower pH of 3. This difference in behavior is directly related to their respective biological functions as Tf blood-borne iron into the cell, while Lf competes with pathogens to sequester iron in biological fluids at more acidic pHs. During this experiment, the students will carry out iron loading and unloading on both human Lf and Tf and monitor the iron release at different pHs using UV-Vis spectroscopy. With this simple approach, the students will discover the different patterns of iron release of Tf and Lf and how this variance in behavior relates to their biological functions. Furthermore, this laboratory practice can be expanded to allow students to investigate a variety of iron proteins. © 2017 by The International Union of Biochemistry and Molecular Biology, 45(6):521-527, 2017.

La satisfacción del paciente como componente de la calidad en las unidades de diálisis / Patient satisfaction as a component of quality in dialysis units

Introducción. En la calidad de cualquier servicio, intervienen elementos objetivos como las características de los materiales e instalaciones que se emplean, y elementos subjetivos como la satisfacción del usuario del servicio, entendida esta como la obtención de una respuesta satisfactoria a las expectativas que se había planteado. La relación paciente-sistema sanitario ha evolucionado hasta situar al paciente como eje del sistema, y su satisfacción se ha consolidado como un importante componente de calidad, al considerarse en sí misma una medida de resultado; y determinar los índices de satisfacción de forma periódica, se está consolidando como una herramienta imprescindible para valorar la evolución de la calidad del servicio. Objetivos. -Estado de instalaciones. -Tiempo de espera para ser atendido por un médico. Respecto a la pregunta abierta del cuestionario, 22 pacientes han sugerido alguna área de mejora. Al comparar los resultados entre los tres centros de la UGC, destaca que los pacientes en DP son los que muestran el mayor grado de satisfacción, encontrándose una ligera diferencia entre los pacientes de las dos unidades de HD, mostrándose más satisfechos los de la UH que los del CPD. Conclusiones. Con este estudio hemos constatado que los pacientes que reciben tratamiento de diálisis en nuestra UGC, se reconocen muy satisfechos con el servicio, con ligeras diferencias según la unidad en la reciben tratamiento, y además nos ha permitido conocer aspectos mejorables, que se están abordando para aumentar la satisfacción del paciente y por consiguiente la calidad asistencial. General: n Conocer el grado de satisfacción global de los pacientes con el servicio de Nefrología. Secundarios: n Determinar eventuales diferencias en la satisfacción entre las diferentes unidades que integran la unidad de gestión clínica (UGC). n Detectar aspectos mejorables en la atención a nuestros pacientes. Pacientes/Método. Estudio observacional descriptivo transversal sobre todos los pacientes atendidos en las tres unidades de diálisis de nuestra UGC. Utilizamos para la recogida de datos el cuestionario autoadministrado SERVQHOS, que fue distribuido a los pacientes por enfermeras ajenas a las unidades donde se estaban dializando, las cuales explicaron los objetivos del estudio, solicitaron el consentimiento verbal para su participación, y pidieron que una vez cumplimentado lo depositaran de forma anónima en un buzón colocado en cada unidad. Resultados. La muestra fue de 89 pacientes, con una edad media de 65,1±14.9 años (22-93), de los cuales (30%) mujeres y (70%) hombres. 29 pacientes (32%) se dializaban en la Unidad Hospitalaria (UH), 45 (49%) en el Centro Periférico de Diálisis (CPD) y 17 (19%) estaban en Diálisis Peritoneal (DP). Al comparar las variables sociodemográficas por centros, solo se observan ligeras diferencias en el nivel de estudios y en la situación laboral de los pacientes...(AU)

Introduction. The quality of any service involving objective factors such as the characteristics of the materials and facilities used, and subjective elements such as user satisfaction about the service, understood as obtaining a satisfactory response to the expectations that had been raised. The patient-health system relationship has evolved to place the patient at the heart of the system, and their satisfaction has become an important component of quality, considering itself an outcome; and determine satisfaction rates periodically, it is consolidating as an essential tool to assess the evolution of the quality of service. Objectives. General: n Know the overall satisfaction of patients in the nephrology unit. Secondary: n Determine any differences in satisfaction between different units within the clinical management unit (CMU). n Identify areas for improvement in the care of our patients. Patients / Method. Cross-sectional, observational study of all patients seen in the three dialysis units in our CMU. We used to collect data a self-administered questionnaire, SERVQHOS, which was distributed to patients by nurses not employees of the units where these patients were dialyzing. They explained the objectives of the study, requested verbal consent for participation, and asked that once completed, this must be deposited anonymously in a letterbox placed in each unit. Results. The sample was of 89 patients, with a mean age of 65.1 ± 14.9 years (22-93), of which 30% were women and 70% men. 29 patients (32%) were dialyzed in the Hospital Unit (HU), 45 (49%) at a non-Hospital Unit and 17 (19%) were on peritoneal dialysis (PD). When comparing the sociodemographic variables per centers were observed only slight differences in educational level and employment status of patients. Overall assessment of the questionnaires: - 98.8% of patients were satisfied or very satisfied with the service. - 97.7% say they would recommend the service without hesitation. Best rated aspects: -Transmitting -Security personnel. -Friendliness. -Interest In Patients. -Personalized. Worst rated aspects: -Punctuality of medical consultations. - State of facilities. - Time waiting to be seen by a doctor Regarding the open question of the questionnaire, 22 patients have suggested some area of improvement. When comparing the results between the three centers of the UGC, it emphasizes that PD patients are those that show the greatest degree of satisfaction, being a slight difference between patients in the two units of HD, showing more satisfied whose at the HU than those at the non-HU. Conclusions. With this study we have found that patients receiving dialysis treatment in our CMU, they are recognized very satisfied with the service, with slight differences depending on the unit where they receive treatment, and has also allowed us to know improvable aspects that are addressing to increase patient satisfaction and therefore the quality of care (AU)

Apoferritin fibers: a new template for 1D fluorescent hybrid nanostructures.

Recently, research in the field of protein amyloid fibers has gained great attention due to the use of these materials as nanoscale templates for the construction of functional hybrid materials. The formation of apoferritin amyloid-like protein fibers is demonstrated herein for the first time. The morphology, size and stiffness of these one-dimensional structures are comparable to the fibers formed by ß-lactoglobulin, a protein frequently used as a model in the study of amyloid-like fibrillar proteins. Nanometer-sized globular apoferritin is capable of self-assembling to form 1D micrometer-sized structures after being subjected to a heating process. Depending on the experimental conditions, fibers with different morphologies and sizes are obtained. The wire-like protein structure is rich in functional groups and allows chemical functionalization with diverse quantum dots (QD), as well as with different Alexa Fluor (AF) dyes, leading to hybrid fluorescent fibers with variable emission wavelengths, from green to near infrared, depending on the QD and AFs coupled. For fibers containing the pair AF488 and AF647, efficient fluorescence energy transfer from the covalently coupled donor (AF488) to acceptor tags (AF647) takes place. Apoferritin fibers are proposed here as a new promising template for obtaining hybrid functional materials.

RSK-mediated down-regulation of PDCD4 is required for proliferation, survival, and migration in a model of triple-negative breast cancer.

The p90 ribosomal S6 kinase (RSK) is a family of MAPK-activated serine/threonine kinases (RSK1-4) whose expression and/or activity are deregulated in several cancers, including breast cancer. Up-regulation of RSKs promotes cellular processes that drive tumorigenesis in Triple Negative Breast Cancer (TNBC) cells. Although RSKs regulate protein synthesis in certain cell types, the role of RSK-mediated translational control in oncogenic progression has yet to be evaluated. We demonstrate that proliferation and migration of TNBC MDA-MB-231 cells, unlike ER/PR-positive MCF7 cells, rely on RSK activity. We show that RSKs regulate the activities of the translation initiation factor eIF4B and the translational repressor PDCD4 in TNBC cells with up-regulated MAPK pathway, but not in breast cancer cells with hyperactivated PI3K/Akt/mTORC1 pathway. These results identify PDCD4 as a novel RSK substrate. We demonstrate that RSK-mediated phosphorylation of PDCD4 at S76 promotes PDCD4 degradation. Low PDCD4 levels reduce PDCD4 inhibitory effect on the translation initiation factor eIF4A, which increases translation of "eIF4A sensitive" mRNAs encoding factors involved in cell cycle progression, survival, and migration. Consequently, low levels of PDCD4 favor proliferation and migration of MDA-MB-231 cells. These results support the therapeutic use of RSK inhibitors for treatment of TNBC with deregulated MAPK/RSK pathway.

Valoración de las necesidades de cuidados del paciente durante la hemodiálisis y su relación con el grado de dependencia / Assessment of patient care needs during hemodialysis and its relationship with the level of dependence

Introducción: En la actualidad, el paciente en hemodiálisis tiene más edad, comorbilidad añadida y algún grado de dependencia. Esta situación ha hecho que su atención en las unidades de diálisis sea cada más compleja, relacionándose a menudo grado de dependencia con mayor necesidad de cuidados de enfermería. Sin embargo, no existen estudios donde se evidencie este hecho de forma concreta. Objetivo: El objetivo del presente estudio fue evaluar el grado de dependencia de los pacientes en hemodiálisis y su relación con las necesidades de cuidados de enfermería durante la sesión. Pacientes y Métodos: Se estudiaron 88 pacientes en hemodiálisis, del Servicio de Nefrología del HURS de Córdoba, mediante un diseño observacional analítico. Para evaluar el grado de dependencia se utilizó el "Test Delta", y el "Índice de Katz". Para analizar la demanda de cuidados se usó una parrilla de actividades de enfermería durante la sesión, de elaboración propia. Resultados: La edad media fue 64,87 años y en el índice de comorbilidad se encontró una mediana de 7 (rango 0-12). Cuando se analizaron los resultados del Test Delta, comprobamos que el 69,3% presentaban algún tipo de dependencia, mientras que con el Índice de Katz la presentaban el 72,7%, encontrándose entre ambos una buena correlación (r=0,866 p<0,01). Se encontró correlación entre la edad y las actividades de enfermería (r=0,331, p<0,01), el índice de comorbilidad (r=0,726, p<0,01) y el Test Delta (r= 0,244, p<0,05). También se encontró correlación entre las actividades de enfermería y el Delta, (r=0,483, p<0,05), el Katz (r=0,405 p<0,01) y el índice de comorbilidad (r=0,380 p< 0,01). A su vez el índice de comorbilidad se correlacionó con el Delta (r=0,320 p<0,05) y el índice de Katz (r= 0,276 p<0,01). Conclusiones: Nuestros resultados sugieren que a mayor grado de dependencia, indistintamente del instrumento utilizado, mayor necesidad de cuidados. De igual manera, a más edad y mayor índice de comorbilidad, más necesidad de cuidados de enfermería durante la sesión de hemodiálisis. Sería necesario profundizar en el estudio de la parrilla de cuidados durante la sesión (AU)

Introduction: Currently, haemodialysis patients are older, higher comorbidity added and a certain greater degree of dependence. This situation causes that the attention in dialysis units become increasingly complex, often related to the degree of dependence with higher patient care needs. However, there are no studies where this fact is evidenced concretely. Objective: The aim of this study was to evaluate the dependence of haemodialysis patients and their relationship to the needs of nursing care during the session. Patients and Methods: 88 haemodialysis patients were studied in the Nephrology Unit of the HURS of Córdoba, through an analytical observational design. To assess the degree of dependence, we used the "Delta Test" and the "Katz index". To analyse the demand for care, we used during the session, a homemade table of nursing activities. Results: The mean age was 64.87 years, with a mean comorbidity index of 7 (range 0-12. When Delta Test results were analyzed, we found that 69.3% had some type of dependency, while the Katz index showed 72.7%, finding a good correlation between the two measures (r= 0.866; p<0.01). Correlations between age and nursing activities (r= 0.331; p <0.01), comorbidity index (r= 0.726; p<0.01) and the Delta Test (r = 0.244; p<0.05) were found. Conclusions: Our results suggest that the greater the degree of dependence, regardless of the instrument used, the greater care needs. Similarly, the higher age and comorbidity, higher need for nursing care during haemodialysis. It would be necessary deepen on the study of the table care during the session (AU)

Evaluación de la hemodiafiltración con reinfusión endógena en el tratamiento del riñón del mieloma / Evaluation of hemodiafiltration with endogenous reinfusion in the treatment of myeloma kidney

Introducción: El mieloma múltiple (MM) es una enfermedad hematológica que produce un fracaso renal agudo (FRA) subsidiario de hemodiálisis en el 10 % de casos. Este fracaso renal, denominado riñón del mieloma, está producido por una nefropatía por cilindros, formados fundamentalmente por cadenas ligeras libres (CLL), que originan una obstrucción tubular que si no remite precozmente, produce daños glomerulares e insuficiencia renal crónica. El tratamiento del riñón del mieloma se centra en reducir la formación de CLL con quimioterapia, y en eliminar las cadenas existentes reduciendo su concentración en plasma. Las técnicas empleadas tradicionalmente en la depuración de CLL, utilizan membranas de muy alta permeabilidad, y presentan el inconveniente de la elevada pérdida de albúmina. Recientemente ha aparecido la hemodiafiltración con reinfusión endógena (HFR), técnica que combina difusión, convección y adsorción. Con esta técnica se utiliza una membrana de muy alta permeabilidad para la extracción de ultrafiltrado, y podría ser utilizada para la eliminación de CLL, salvando el inconveniente de la pérdida de albúmina que tienen otras técnicas. Objetivo: Analizar la eliminación de CLL con esta técnica y su relación con la recuperación de la función renal, y el comportamiento de la albúmina sérica en tres pacientes tratados por FRA por MM. Pacientes y método: Estudiamos tres pacientes con edad media de 64 años tratados con HFR por FRA por MM. Los tres fueron tratados con quimioterapia y HFR para la eliminación de CLL utilizando monitores fórmulaTM 2000, y Kit Supra 17 de Bellco®. El tratamiento fue personalizado en función de los niveles de CLL, manteniéndose mientras el paciente requirió hemodiálisis...(AU)

Introduction: Multiple myeloma (MM) is a hematologic disease that causes acute renal failure (ARF), requiring hemodialysis 10% of cases. This renal failure, called myeloma kidney, is caused by the formation of urinary casts in the renal tubules from free light chains (FLCs). The tubular obstruction if not treated early, causes glomerular damage and chronic kidney disease. Treatment of myeloma kidney focuses on reducing the formation of FLCs with chemotherapy and the elimination of existing chains reducing its concentration in plasma. Techniques traditionally used in the clearance of FLCs, using very high permeability membranes, and have the disadvantage of the high albumin loss. Recently hemodiafiltration with endogenous reinfusion (HFR) has emerged, a technique that combines diffusion, convection and adsorption. This technique uses a high permeability membrane to extract ultrafiltrate, and could be used for eliminating FLCs, overcoming the albumin loss. Aim. To analyze the elimination of FLCs with this technique and its relationship to the recovery of renal function, and monitoring of serum albumin in three patients treated by ARF due to MM. Material and methods: Three patients with ARF by MM, with a mean age of 64 years and treated with HFR were studied. All patients were treated with chemotherapy and HFR for the elimination of FLCs using formulaTM 2000 monitors and Kit Supra 17 from Bellco®. The treatment is personalized according to the levels of FLCs, maintained during hemodialysis. To evaluate the elimination of FLCs, blood samples and ultrafiltrates of the week were analyzed. Pre- and post- session FLCs and serum albumin concentrations were determined, calculating the reduction ratio. In ultrafiltrates, FLCs and albumin concentrations before and after passing through the adsorptive resin, at the beginning and end of the session were determined...(AU)

Monitoring lactoferrin iron levels by fluorescence resonance energy transfer: a combined chemical and computational study.

Three forms of lactoferrin (Lf) that differed in their levels of iron loading (Lf, LfFe, and LfFe2) were simultaneously labeled with the fluorophores AF350 and AF430. All three resulting fluorescent lactoferrins exhibited fluorescence resonance energy transfer (FRET), but they all presented different FRET patterns. Whereas only partial FRET was observed for Lf and LfFe, practically complete FRET was seen for the holo form (LfFe2). For each form of metal-loaded lactoferrin, the AF350-AF430 distance varied depending on the protein conformation, which in turn depended on the level of iron loading. Thus, the FRET patterns of these lactoferrins were found to correlate with their iron loading levels. In order to gain greater insight into the number of fluorophores and the different FRET patterns observed (i.e., their iron levels), a computational analysis was performed. The results highlighted a number of lysines that have the greatest influence on the FRET profile. Moreover, despite the lack of an X-ray structure for any LfFe species, our study also showed that this species presents modified subdomain organization of the N-lobe, which narrows its iron-binding site. Complete domain rearrangement occurs during the LfFe to LfFe2 transition. Finally, as an example of the possible applications of the results of this study, we made use of the FRET fingerprints of these fluorescent lactoferrins to monitor the interaction of lactoferrin with a healthy bacterium, namely Bifidobacterium breve. This latter study demonstrated that lactoferrin supplies iron to this bacterium, and suggested that this process occurs with no protein internalization.

A method to quantify infection and colonization of holm oak (Quercus ilex) roots by Phytophthora cinnamomi.

Phytophthora cinnamomi Rands. is an important root rot pathogen widely distributed in the north hemisphere, with a large host range. Among others diseases, it is known to be a principal factor in the decline of holm oak and cork oak, the most important tree species in the "dehesa" ecosystem of south-western Spain. Previously, the focus of studies on P. cinnamomi and holm oak have been on molecular tools for identification, functional responses of the host, together with other physiological and morphological host variables. However, a microscopic index to describe the degree of infection and colonization in the plant tissues has not yet been developed. A colonization or infection index would be a useful tool for studies that examine differences between individuals subjected to different treatments or to individuals belonging to different breeding accessions, together with their specific responses to the pathogen. This work presents a methodology based on the capture and digital treatment of microscopic images, using simple and accessible software, together with a range of variables that quantify the infection and colonization process.

A new approach to the ferritin iron core growth: influence of the H/L ratio on the core shape.

An electron microscopy study, in combination with modeling and image simulation, of four different reconstituted ferritin samples: recombinant human H and L homopolymers, and H and L heteropolymers of native L-subunit-rich horse spleen and H-subunit-rich human heart ferritins, points out the existence of a correlation between iron core shape and protein shell.

Magnetic nanoparticles--templated assembly of protein subunits: a new platform for carbohydrate-based MRI nanoprobes.

A new approach for the preparation of carbohydrate-coated magnetic nanoparticles is reported. In a first step, we show that the pH-driven assembly-disassembly natural process that occurs in apoferritin protein is effective for the encapsulation of maghemite nanoparticles of different sizes: 4 and 6 nm. In a second step, we demonstrate that the presence of functional amine groups in the outer shell of apoferritin allows functionalization with two carbohydrates, N-acetyl-D-glucosamine and d-mannose. High-resolution electron microscopy (HREM), high angle annular dark field scanning electron microscopy (HAADF-STEM), electron energy loss spectroscopy (EELS), X-ray diffraction (XRD), and SQUID technique have been used to characterize the magnetic samples, termed herein Apomaghemites. The in vivo magnetic resonance imaging (MRI) studies showed the efficiency in contrasting images for these samples; that is, the r(2) NMR relaxivities are comparable with Endorem (a commercial superparamagnetic MRI contrast agent). The r(2) relaxivity values as well as the pre-contrast and post-contrast T(2)*-weighted images suggested that our systems could be used as perspective superparamagnetic contrast agents for magnetic resonance imaging (MRI). The carbohydrate-functionalized Apomaghemite nanoparticles retained their recognition abilities, as demonstrated by the strong affinity with their corresponding carbohydrate-binding lectins.

Estudio retrospectivo de las complicaciones de los catéteres temporales para hemodiálisis / Retrospective study of the complications of temporary catheters for haemodialysis

Los objetivos de este estudio fueron analizar la duración y las causas de retirada de los catéteres temporales para hemodiálisis Hemos estudiado 1409 catéteres que fueron implantados en 608 pacientes en hemodiálisis periódicas (60.9 ± 15.5 años, 341 mujeres (56%) y 267 hombres (44%). 280 (46%) pacientes recibieron 1 catéter y 144 (24%) 2 catéteres. Posteriormente se analizaron 546 catéteres retirados exclusivamente por complicaciones. La duración media de todos los catéteres (n=546) fue de 21±36 días. Las causas más frecuentes de retirada de catéteres por complicaciones fueron: 75% por déficit de flujo sanguíneo, 11% por infección, 6% por pérdida de sutura, 3% por oclusión, 3% por acodamiento. El déficit de flujo apareció a los 18 ± 34 días y la infección 29±50 días. La duración media de los catéteres implantados en el lado izquierdo fue 16±32 días y para el lado derecho 23±38 días (p<0.0001). Cuando analizamos la duración de los catéteres entre las distintas venas utilizadas, la duración media fue de 2 5.3±43 días para la yugular, 17.5±23 para la subclavia, y 11.9±10 días para la femoral, siendo las diferencias estadísticamente entre la yugularsubclavia y la vena femoral (p<0.05). Cuando comparamos la duración entre los de una sola luz frente a los de doble luz, en los catéteres retirados por complicaciones no se encuentran diferencias significativas (análisis multivariante). Podemos concluir, que la duración de los catéteres temporales colocados en vena yugular o subclavia y en el lado derecho, es significativamente superior a los colocados en vena femoral o lado izquierdo. No encontramos diferencias en la duración entre los catéteres de una o doble luz, al menos en nuestro estudio (AU)

The aim of this study was to analyze the duration and causes of removing complications for temporary catheters for haemodialysis. We studied 1409 catheters which were implanted on 608 patients in haemodialysis chronic (60.9 ± 15.5 years, 341 females (56%) and 267 males (44%). 280 (46%) patients received 1 catheter and 144 (24%) 2 catheters. We analyzed 546 catheters retired exclusively by complications. Mean duration of the catheters (n=546) of was 21±36 days. The main catheters complications that forced their retreat were: 75% for deficit blood flow rate, 11% infection, 6%, for loss of surgical suture, 3% for occlusion, 3% for elbowed. The deficit blood flow rate appeared to the 18 ± 34 days and the la infection to the 29±50 days. Mean duration of the catheters was of the 16±32 days for the left side and 23±38 for right side (p<0.0001). When we compared the different blood vessel, mean duration of the catheters was of the 25.3±43 days for the jugular, 17.5±23 for the subclavia, and 11.9±10 days for the femoral, being significant differences among jugular-subclavia and femoral vein (p<0.05). When comparing the duration, among a single lumen vs dual lumen, in catheters retired by complications, they were not significant differences (multivariate analysis). We can conclude that the duration, of the catheters placed in jugular or subclavia veins and right side is superior to the placed in femoral vein or left side, being recommended its use therefore as temporary access in HD, also facilitating the patient’s mobility and ambulatory dialysis. We have not found, at least in our study, differs in the duration among the single lumen versus dual lumen catheters (AU)