Altered apoptosis and proliferation in milk cells and PBMc from BLV-infected bovines with different proviral loads: Possible role of the BCL-2 family proteins, TNF-alpha, and receptors.

Bovines infected by bovine leukemia virus (BLV) are characterized by presenting low proviral load (LPL) or high proviral load (HPL). It is reported that animals with HPL in peripheral blood mononuclear cells (PBMCs) present a decrease in apoptosis, an increase in viability and the proliferation rate, while animals that maintain an LPL have an intrinsic ability to control the infection, presenting an increased apoptosis rate of their PBMCs. However, there is little information on the effect of BLV on these mechanisms when the virus infects somatic milk cells (SC). This study investigates the mechanisms underlying apoptosis in milk and blood from BLV-infected animals with HPL and LPL. Relative levels of mRNA of tumor necrosis factor-α (TNF-α), TNF receptor 1 (TNF-RI), TNF receptor 2 (TNF-RII), anti-apoptotic B-cell lymphoma 2 protein (Bcl-2), and pro-apoptotic Bcl-2-like protein 4 (Bax) were measured in SC and PBMCs using quantitative reverse transcription-polymerase chain reaction (RT-qPCR) assay. A significant decrease in the expression of TNF-α in SC from HPL animals vs non-infected bovines was observed, but the infection in SC with BLV did not show a modulation on the expression of TNF receptors. A significant increase in TNF-RI expression in PBMCs from HPL bovines compared to LPL bovines was observed. No significant differences in PBMCs between HPL and LPL compared to non-infected animals concerning TNF-α, TNF-RI, and TNF-RII expression were found. There was a significant increase of both Bcl-2 and Bax in SC from LPL compared to non-infected bovines, but the Bcl-2/Bax ratio showed an anti-apoptotic profile in LPL and HPL bovines compared to non-infected ones. Reduced mRNA expression levels of Bax were determined in the PBMCs from HPL compared to LPL subjects. In contrast, BLV-infected bovines did not differ significantly in the mRNA expression of Bax compared to non-infected bovines. Our data suggest that the increased mRNA expression of Bax corresponds to the late lactation state of bovine evaluated and the exacerbated increase of mRNA expression of Bcl-2 may be one of the mechanisms for the negative apoptosis regulation in the mammary gland induced by BLV infection. These results provide new insights into the mechanism of mammary cell death in HPL and LPL BLV-infected bovine mammary gland cells during lactation.

Derivación desde el Servicio de Indicación Farmacéutica al de Revisión del uso de medicamentos / Referral from the Pharmaceutical Indication Service to the Medicines Use Review Service

Paciente acude a la farmacia comunitaria por un trastorno del sueño solicitando tratamiento. Se indica Melatonina tras presentar insomnio clínico moderado en el Insomnia Severity Index. Pese a que 2 semanas después del principio del tratamiento refirió estar mejor, 2 meses después deja de ser así. Al realizar un seguimiento se sospecha de la existencia de problemas relacionados con los medicamentos por lo que se le deriva al servicio de Revisión de Uso de los Medicamentos. En dicho servicio se detectan varios problemas con su medicación habitual. Entre ellos, se detecta una confusión entre cápsulas de cafeína pertenecientes a su nieto con el que convive y el producto indicado en el servicio de indicación farmacéutica. Gracias al seguimiento del servicio de indicación farmacéutica se ha producido una derivación que ha solventado varios problemas relacionados con los medicamentos. (AU)

Factores psicosociales, estrés psicológico y burnout en enfermería: un modelo de trayectorias / Psychosocial factors, psychological stress, and burnout in nursing: a model of trajectories / Fatores psicossociais, estresse psicológico e burnout em enfermagem: um modelo de trajetórias

Resumen Introducción: El personal de enfermería se enfrenta cotidianamente a diferentes eventos asociados al estrés, factores psicosociales y otros mecanismos que afectan su salud mental. Objetivo: Evaluar la correlación entre la demanda psicológica, el control laboral, el apoyo social, el estrés psicológico, y las dimensiones del Síndrome de Burnout (ilusión por el trabajo, desgaste psíquico, indolencia y culpa), en un modelo de trayectorias en enfermeras mexicanas. Metodología: Estudio transversal, observacional, analítico, conducido en 357 profesionales de enfermería de Morelos, México, seleccionados por conveniencia. Los datos fueron colectados empleando tres cuestionarios, la Escala de Estrés Percibido, el Cuestionario del Contenido del Trabajo y el Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo. Los programas SPSS 19 y LISREL 8.3 fueron empleados para el procesamiento y modelaje de los datos. Resultados: En el modelo de trayectorias, se especificó como variable mediadora de los factores psicosociales y de las dimensiones del Síndrome de Quemarse por el Trabajo (SQT), al estrés psicológico. Los índices de ajuste fueron aceptables. Se encontraron altos niveles de apoyo social, control laboral e ilusión por el trabajo; grados moderados de demanda psicológica y estrés psicológico; y bajos niveles de desgaste psíquico, indolencia y culpa. Conclusión: Implicaciones para la disciplina, se propone implementar estrategias de intervención efectivas para mantener en el personal de enfermería bajos niveles de demandas psicológicas, altos niveles de control laboral, altos niveles de apoyo social, y niveles moderados de estrés, para prevenir, el SQT.

Abstract Introduction: Nurses frequently face different events associated with stress, psychosocial factors, and other issues which have impacts on their mental health. Objective: To assess the correlation between psychological demand, work control, social support, psychological stress, and burnout dimensions (illusion for the activity, psychic wear, indolence, guilt), within a model of trajectories among Mexican nurses. Methodology: This is a transversal, observational, and analytical study conducted on a convenience sample of 357 nursing professionals from the state of Morelos, Mexico. Data were gathered using three questionnaires, the Perceived Stress Scale, the Job Content Questionnaire, y el Maslach Burnout Inventory. SPSS 19 and LISREL 8.3 were used to process and model the data. Results: Psychological Stress was specified as the mediating variable of the psychosocial factors and dimensions of burnout within the model of trajectories. Adjustment indexes were acceptable. High levels of social support, work control, and illusion for the activity were found. Moderate degrees of psychological demand and psychological stress were found. Low levels of psychic wear, indolence, and guilt were found. Conclusion: It is recommended to implement effective intervention strategies to maintain nursing personnel within low levels of psychological demand, high levels of work control, high levels of social support, and moderate levels of stress, all these in order to prevent the Syndrome of Burnout.

Resumo Introdução: O pessoal de enfermagem se enfrenta cotidianamente a diferentes eventos associados ao estresse, fatores psicossociais e outros mecanismos que afetam sua saúde mental. Objetivo: Avaliar a correlação entre a demanda psicológica, o controle laboral, o apoio social, o estresse psicológico, e as dimensões e da Síndrome de Burnout (ilusão pelo trabalho, desgaste psíquico, indolência e culpa), em um modelo de trajetórias em enfermeiras mexicanas. Metodologia: Estudo transversal, observacional, analítico, conduzido em 357 profissionais de enfermagem de Morelos, México, selecionados por conveniência. Os dados foram coletados empregando três questionários, a Escala de Estresse Percebido, o Questionário do Conteúdo do Trabalho e o Questionário para a Avaliação da Síndrome de Burnout no Trabalho. Os programas SPSS 19 e LISREL 8.3 foram empregados para o processamento e modelagem dos dados. Resultados: No modelo de trajetórias, especificou-se como variável mediadora dos fatores psicossociais e das dimensões da Síndrome de Burnout no Trabalho (SQT), ao estresse psicológico. Os índices de ajuste foram aceitáveis. Encontraram-se altos níveis de apoio social, controle laboral e ilusão pelo trabalho; graus moderados de demanda psicológica e estresse psicológico; e baixos níveis de desgaste psíquico, indolência e culpa. Conclusão: Implicações para a disciplina, propõe-se implementar estratégias de intervenção efetivas para manter no pessoal de enfermagem baixos níveis de demandas psicológicas, altos níveis de controle laboral, altos níveis de apoio social, e níveis moderados de estresse, para prevenir, o SQT.

Reproducibilidad de la Escala Motriz del Infante de Alberta (Alberta Infant Motor Scale) aplicada por fisioterapeutas en formación / Reliability of the Alberta Infant Motor Scale applied by physiotherapists in training

Objetivo Evaluar la reproducibilidad intra e interevaluador de la Escala Motriz del Infante de Alberta (AIMS), Canadá, aplicada por fisioterapeutas en formación de último nivel. Materiales y métodos Se realizó un estudio de evaluación de pruebas diagnósticas en 21 infantes clínicamente sanos de ambos géneros, entre 0 y 18 meses residentes de la ciudad de Bucaramanga, Colombia. La evaluación fue realizada por 12 evaluadores, 11 fisioterapeutas en formación de último nivel y un fisioterapeuta con experiencia en el área pediátrica, con un intervalo de una semana y mediante vídeo. El análisis de reproducibilidad intra y entre evaluadores se estableció con el coeficiente de correlación intraclase (CCI) y adicionalmente se calculó el error estándar de la medición (EEM), considerando un α=0,05.ResultadosSe encontró una muy buena reproducibilidad interevaluadores para el puntaje total de la escala (CCI>0,98) y para la subescala en sedente (CCI>0,97). El análisis para las otras subescalas mostró CCI moderados entre 0,54 y 0,64. La reproducibilidad intraevaluador registró coeficientes entre bajos y excelentes. El EEM fue bajo para las subescalas de pie, en prono y el puntaje total (0,20-0,77).Conclusiones La AIMS es un instrumento reproducible, que puede ser utilizado en nuestro contexto por fisioterapeutas en formación para la evaluación del desarrollo motor en niños clínicamente sanos (AU)

Objective To evaluate the intra- and inter-rater reliability of the Alberta Infant Motor Scale (AIMS) applied by final level undergraduate physiotherapy students. Materials and methods An assessment of evaluation of diagnostic tests was done in 21 clinically healthy infants of both genders, aged 0 to 18 months, residents at Bucaramanga, Colombia. The evaluation was conducted by 12 raters, 11 physiotherapy students in final level and a physiotherapist with experience in pediatrics. The assessments were performed with an interval of one week and by video. An Intraclass Correlation Coefficient (ICC) was applied for the reliability analysis and Standard Error of Measurement (SEM) was obtained, considering an α=0.05.ResultsA very good inter-rater reliability for the total score (ICC>0.98) and the sitting subscale (ICC>0.97) were registered. The other subscales showed moderate reliability, ICC between 0.54 and 0.64. Intra-rater reliability showed low to excellent ICC. The SEM was low for the standing, prone subscales and total score (0.20 to 0.77).Conclusions The AIMS is a reliable tool that can be used in our context by undergraduate physical therapy students in their year of study in order to assess motor development in clinically healthy children (AU)

Cirugía radioguiada de las lesiones no palpables de mama (ROLL): ¿cómo lo hacemos? / No disponible

El objetivo de este trabajo es describir la técnica ROLL tal como nosotros la venimos aplicando, aprendida durante estancias realizadas en el Instituto Europeo de Oncología de Milán. S e describen los aspectos más importantes que tenemos en cuenta en las distintas fases: diagnóstica, pre-quirúrgica, quirúrgica y de cuidados postoperatorios. El procedimiento ROLL es una técnica multidisciplinar sencilla y reproducible que permite conseguir resultados óptimos y una tasa baja de reintervenciones, así como un buen resultado estético cuando se adquiere la suficiente experiencia(AU)

The aim of this paper is to describe the ROLL technique as we perform after having it learned during stays at the European Institute of Oncology in Milan. We describe the most important aspects that we consider in the different phases such as diagnostic, pre-surgical, surgical and postoperative care. The ROLL procedure is a multidisciplinary technique, simple and reproducible, that allows optimum results with a low rate of reintervention and a good cosmetic result when sufficient experience is gained(AU)

Episodio de glaucoma agudo de ángulo cerrado tras cirugía ginecológica con anestesia general / No disponible

No disponible

Lean adolescents with increased risk for metabolic syndrome

The aim of the present study was to determine in adolescents the relationship between insulin levels and body mass index (BMI), body fat distribution, diet, life style and lipid profile. We studied 167 adolescents (68 boys and 99 girls) whose ages ranged from 14 to 17 years. A detailed medical (including pubertal stage) and nutritional record was obtained from each subject. Biochemical measurements included fasting serum insulin, glucose, total cholesterol (TC), triglycerides (Tg), HDL-C, LDL-C and VLDL-C. HOMA insulin resistance (IR) and HOMA beta-cell function (beta-cell) were calculated. Insulin levels were over 84 pmol/L (cut off normal value in our lab) in 56 per cent of the boys and 43 per cent of the girls. Thirty-seven percent of lean adolescents whose BMI was 21.5 +/- 1.9 kg/m2 presented higher fasting insulin levels. HOMA IR, Tg, systolic (SBP) and diastolic blood pressure (DBP) values when compared to a lean normoinsulinemic group. Insulin levels were correlated (p < 0.01) with body mass index. Both boys and girls in the highest BMI quartile (BMI > 24 kg/m2) had significantly higher serum insulin, HOMA beta-cell, and Tg levels, and the lowest HDL-C levels. A high-energy intake rich in saturated fat and low physical activity were found in this lean but metabolically altered adolescents. We conclude that even with a BMI as low as 21 kg/m2 an inappropriate diet and low physical activity might be responsible for the high insulin levels and dislipidemias in adolescents.

Efectos electrocardiograficos del Cavinton. / Electrocardiographic effects of Cavinton

En una muestra de diez pacientes se investigo los efectos de una nueva droga vasodilatadora sobre la presion arterial, frecuencia cardiaca, asi como su efecto sobre los intervalos PR, QTc y el complejo QRS.Esta droga redujo la presion arterial, la frecuencia cardiaca y prolongo los intervalos RR y QTc del electrocardiograma