Radiofrequency at 2.45 GHz increases toxicity, pro-inflammatory and pre-apoptotic activity caused by black carbon in the RAW 264.7 macrophage cell line.

Environmental factors such as air pollution by particles and/or electromagnetic fields (EMFs) are studied as harmful agents for human health. We analyzed whether the combined action of EMF with fine and coarse black carbon (BC) particles induced cell damage and inflammatory response in RAW 264.7 cell line macrophages exposed to 2.45 GHz in a gigahertz transverse electromagnetic (GTEM) chamber at sub-thermal specific absorption rate (SAR) levels. Radiofrequency (RF) dramatically increased BC-induced toxicity at high doses in the first 24 h and toxicity levels remained high 72 h later for all doses. The increase in macrophage phagocytosis induced after 24 h of RF and the high nitrite levels obtained by stimulation with lipopolysaccharide (LPS) endotoxin 24 and 72 h after radiation exposure suggests a prolongation of the innate and inflammatory immune response. The increase of proinflammatory cytokines tumor necrosis factor-α, after 24 h, and of interleukin-1ß and caspase-3, after 72 h, indicated activation of the pro-inflammatory response and the apoptosis pathways through the combined effect of radiation and BC. Our results indicate that the interaction of BC and RF modifies macrophage immune response, activates apoptosis, and accelerates cell toxicity, by which it can activate the induction of hypersensitivity reactions and autoimmune disorders.

La atención al paciente con patología linfática y lipedema en la pandemia COVID-19. Recomendaciones del Grupo Español de Linfología (GEL) / Management of patients with lymphatic diseases and lipoedema during the COVID-19 pandemic. Recommendations of the Spanish Group of Lymphology

La pandemia de COVID-19 es un desafío para el manejo de las patologías no COVID como la enfermedad linfática y el lipedema. La telemedicina puede evitar la propagación del coronavirus. Se necesita un sistema que nos ayude a determinar la prioridad clínica y la selección de la asistencia presencial o telemática para cada paciente y la forma de realizarlas durante la pandemia. El Grupo Español de Linfología ha realizado un documento de consenso con recomendaciones basadas en la bibliografía y experiencia clínica, como guía de práctica clínica en el manejo de anomalías linfáticas y lipedema durante la pandemia de COVID-19. Estas recomendaciones deben adaptarse a las características del paciente, las condiciones locales de los centros y las decisiones de los profesionales de la salud. Es un documento de criterios mínimos, sujeto a modificaciones según evolucione la pandemia, los conocimientos científicos y las instrucciones de las autoridades sanitarias

The COVID-19 pandemic poses a challenge to the management of non-COVID pathologies such as lymphatic diseases and lipoedema. The use of telemedicine can prevent the spread of the disease. A system is needed to help determine the clinical priority and selection of face-to-face or telemedicine options for each patient and how to carry them out during the pandemic. The Spanish Lymphology Group has drafted a consensus document with recommendations based on the literature and clinical experience, as clinical practice guidelines for the management of lymphatic abnormalities and lipoedema during the COVID-19 pandemic. These recommendations must be adapted to the characteristics of each patient, the local conditions of the centres, and the decisions of health care professionals. The document contains minimum criteria, subject to modifications according to the evolution of the pandemic, scientific knowledge and instructions from health authorities

[Management of patients with lymphatic diseases and lipoedema during the COVID-19 pandemic. Recommendations of the Spanish Group of Lymphology]. / La atención al paciente con patología linfática y lipedema en la pandemia COVID-19. Recomendaciones del Grupo Español de Linfología (GEL).

The COVID-19 pandemic poses a challenge to the management of non-COVID pathologies such as lymphatic diseases and lipoedema. The use of telemedicine can prevent the spread of the disease. A system is needed to help determine the clinical priority and selection of face-to-face or telemedicine options for each patient and how to carry them out during the pandemic. The Spanish Lymphology Group has drafted a consensus document with recommendations based on the literature and clinical experience, as clinical practice guidelines for the management of lymphatic abnormalities and lipoedema during the COVID-19 pandemic. These recommendations must be adapted to the characteristics of each patient, the local conditions of the centres, and the decisions of health care professionals. The document contains minimum criteria, subject to modifications according to the evolution of the pandemic, scientific knowledge and instructions from health authorities.

Feasibility Study on Measuring the Particulate Matter Level in the Atmosphere by Means of Yagi-Uda-Like Antennas.

In this work, the application of a technique for monitoring changes of the dielectric constant of the atmosphere caused by the presence of pollution is discussed. The method is based on changes in the reflection coefficient of the device induced by these dielectric constant variations of the surrounding medium. To that end, several Yagi-Uda-like antenna designs with different size limitations were simulated by using a Method-of-Moments software and optimized by means of a simulated annealing strategy. It has been found that the larger the optimal elements of the array are allowed to be, the higher the sensitivity reached. Thus, in a trade-off between sensitivity and moderate length (regarding flexibility purposes), the most promising solution has been built. This prototype has been experimentally tested in presence of an artificial aerosol made of PAO (polyalphaolefin) oil and black carbon inclusions of a size of 0.2 µm. As a result, potentials for developing a measurement procedure by means of changes in the characteristic parameters of the antenna led by different concentration levels of suspended particles in the surrounding medium are shown. In this manner, a local mapping of polluted levels could be developed in an easy, real-time, and flexible procedure.

Alopecia frontal fibrosante: a propósito de un caso / Frontal fibrosing alopecia: A case report

No disponible

Estudio comparativo sobre la higiene de manos prequirúrgica con solución hidroalcohólica frente a la higiene prequirúrgica tradicional / Comparative study of presurgical hand hygiene with hydroalcoholic solution versus traditional presurgical hand hygiene

Objetivo: Comparar la higiene de manos prequirúrgica con solución hidroalcohólica siguiendo el protocolo de la OMS con la higiene de manos prequirúrgica tradicional. Método: Se realizaron cultivos de las manos de cirujanos y enfermeros quirúrgicos antes y después de la higiene de manos prequirúrgica y tras la retirada de los guantes al acabar la cirugía. Los cultivos se hicieron en 2 días diferentes: el primero tras la higiene de manos prequirúrgica tradicional y el segundo tras la higiene de manos prequirúrgica con solución hidroalcohólica siguiendo el protocolo de la OMS. Se cronometró el tiempo de realización de la higiene de manos tradicional y se comparó con los 3 min del protocolo de la OMS. El coste de los productos usados para la técnica tradicional se comparó con el coste de la solución hidroalcohólica utilizada. La variabilidad de la técnica tradicional se obtuvo observando a cada participante en el estudio durante su realización. Resultados: Tras la higiene prequirúrgica con solución hidroalcohólica se detectaron unidades formadoras de colonias (UFC) en 5 sujetos (7,3%) mientras que tras la higiene prequirúrgica tradicional, se detectaron UFC en 14 sujetos (20,5%) (p<0,05). Tras la retirada de los guantes, el recuento de UFC fue similar (p<0,7). El tiempo de realización de la higiene con solución hidroalcohólica (3 min) fue inferior al de la higiene tradicional (p<0,05), su coste fue la mitad y se eliminó la variabilidad. Conclusiones: Comparada con otras técnicas, la higiene de manos prequirúrgica con solución hidroalcohólica disminuye de forma significativa las UFC, se acompaña de un tiempo de latencia similar, tiene menor coste y ahorra tiempo (AU)

Objective: To compare presurgical hand hygiene with hydroalcoholic solution following the WHO protocol with traditional presurgical hand hygiene. Methods: Cultures of the hands of surgeons and surgical nurses were performed before and after presurgical hand hygiene and after removing gloves at the end of surgery. Cultures were done in 2different days: the first day after traditional presurgical hand hygiene, and the second day after presurgical hand hygiene with hydroalcoholic solution following the WHO protocol. The duration of the traditional hand hygiene was measured and compared with the duration (3min) of the WHO protocol. The cost of the products used in the traditional technique was compared with the cost of the hydroalcoholic solution used. The variability of the traditional technique was determined by observation. Results: Following presurgical hand hygiene with hydroalcoholic solution, colony-forming units (CFU) were detected in 5 (7.3%) subjects, whereas after traditional presurgical hand hygiene CFU were detected in 14 subjects (20.5%) (p < 0.05). After glove removal, the numbers of CFU were similar. The time employed in hand hygiene with hydroalcoholic solution (3min) was inferior to the time employed in the traditional technique (p < 0.05), its cost was less than half, and there was no variability. Conclusions: Compared with other techniques, presurgical hand hygiene with hydroalcoholic solution significantly decreases CFU, has similar latency time, a lower cost, and saves time (AU)

Comparative study of presurgical hand hygiene with hydroalcoholic solution versus traditional presurgical hand hygiene. / Estudio comparativo sobre la higiene de manos prequirúrgica con solución hidroalcohólica frente a la higiene prequirúrgica tradicional.

OBJECTIVE: To compare presurgical hand hygiene with hydroalcoholic solution following the WHO protocol with traditional presurgical hand hygiene. METHODS: Cultures of the hands of surgeons and surgical nurses were performed before and after presurgical hand hygiene and after removing gloves at the end of surgery. Cultures were done in 2different days: the first day after traditional presurgical hand hygiene, and the second day after presurgical hand hygiene with hydroalcoholic solution following the WHO protocol. The duration of the traditional hand hygiene was measured and compared with the duration (3min) of the WHO protocol. The cost of the products used in the traditional technique was compared with the cost of the hydroalcoholic solution used. The variability of the traditional technique was determined by observation. RESULTS: Following presurgical hand hygiene with hydroalcoholic solution, colony-forming units (CFU) were detected in 5 (7.3%) subjects, whereas after traditional presurgical hand hygiene CFU were detected in 14 subjects (20.5%) (p < 0.05). After glove removal, the numbers of CFU were similar. The time employed in hand hygiene with hydroalcoholic solution (3min) was inferior to the time employed in the traditional technique (p < 0.05), its cost was less than half, and there was no variability. CONCLUSIONS: Compared with other techniques, presurgical hand hygiene with hydroalcoholic solution significantly decreases CFU, has similar latency time, a lower cost, and saves time.

Validación de herramienta informática para el cálculo de linfedema en pacientes con afectación unilateral de extremidad superior / Validation of computer tool for the calculation of lymphedema in patients with unilateral involvement of upper limb

Introducción. El linfedema secundario a linfadenectomía axilar es una secuela grave que afecta a la calidad de vida de las pacientes con cáncer de mama. Hay diversas técnicas para la valoración del linfedema. Nuestro objetivo es presentar y validar una herramienta informática para el cálculo del volumen de linfedema a partir de la circometría y mostrar los resultados de su análisis de fiabilidad. El diseño de la herramienta se ha realizado en el seno de un ensayo clínico aleatorizado con grupo control. Material y métodos. Se seleccionó a 29 pacientes al azar, de la consulta de rehabilitación de dos centros de Madrid, con linfedema unilateral tras mastectomía. Dos rehabilitadores calcularon el volumen de los brazos de cada paciente mediante circometría tomando como referencia estructuras anatómicas y a partir de la fórmula de los conos truncados, utilizando una macro de Excel. Se obtuvo el tamaño medio de las cuatro determinaciones, su desviación estándar (DE) y su coeficiente de variación (CV). El grado de acuerdo intraobservador y entre observadores se cuantificó mediante la estimación del coeficiente de correlación intraclase (CCI) y su intervalo de confianza (IC). Resultados. La media±DE de los volúmenes del brazo afecto y el sano fue 3.155,82±877ml y 2.748,76±667,1ml, respectivamente (p=0,001). No hubo diferencias significativas en cuanto a la dispersión. El CCI intraobservador para el brazo afecto fue 0,991 y 0,979, y para el brazo sano, 0,967 y 0,961. El CCI interobservador del brazo afecto fue 0,952, y el brazo sano, 0,976. Conclusiones. La calculadora de linfedema es una herramienta fiable, reproducible, de manejo sencillo y bajo coste, que permite cuantificar el volumen del linfedema(AU)

Background. Lymphedema following breast cancer surgery is a serious sequel that affects the quality of life of breast cancer patients. There are several methods to evaluate lymphedema. We have aimed to present and validate a computer tool that calculates the lymphedema volume based on perimeter measurements and to show the results of its reliability analysis. This tool design was developed without a randomized clinical trial with a control group. Material and methods. A total of 29 patients were randomly selected from the Rehabilitation consultations of two centers in Madrid suffering unilateral lymphedema after mastectomy. Two rehabilitation doctors measured the arm perimeters of each patient using anatomic structures and with the frustum formula, using an Excel macro. Mean volume, standard deviation (SD) and variation coefficient (VC) were obtained for each measurement. Intra-and inter-rater reliability were calculated by estimation of the intra-class correlation coefficient (ICC) and its confidence interval (CI). Results. Mean volume of affected arm was 3155.82mL (877 SD) and for the healthy arm 2748.76mL (667.1 SD). There were no significant differences in the SD and CV dispersion. Intra-rater ICC for the affected arm was 0.991 and 0.979, and for healthy arm 0.967 and 0.961 for each observer. Inter-rater ICC for the affected arm was 0.952 and for the healthy arm 0.976. Conclusions. The «lymphedema calculator» is a reliable, reproducible, easy to use and low cost computer tool that helps the clinician to evaluate lymphedema volume as well as to objectify its distribution(AU)

Conocimientos y actitudes de la población ante la gripe A (H1N1) / Knowledge and attitudes of population on influenza A (H1N1)

Introducción. La pandemia de gripe A ha supuesto un reto para los sistemas sanitarios mundiales, conllevando una considerable alarma social. No tenemos la seguridad de que los mensajes de las autoridades sanitarias hayan llegado adecuadamente a la población. Objetivo: describir el grado de conocimiento y las actitudes de la población sobre prevención y tratamiento de la gripe A. Métodos. Estudio descriptivo transversal por reclutamiento de usuarios mayores de edad que acuden al Centro de Salud mediante encuesta autocumplimentada elaborada ad hoc. Resultados. Doscientas seis encuestas (60% mujeres), edad media 49,8±17,4 años. El 33,5% se consideraban pertenecientes a grupos de riesgo frente a la gripe A. El 29,13% se había vacunado el año anterior frente a la gripe, por 27,8% el año actual (7,14% frente a gripe A). Los conocimientos correctos sobre síntomas, tratamiento y necesidad de receta para conseguir antivirales fueron del 61%, 32,7% y 70,3%, respectivamente. El 40,1% se consideraba poco o nada informado, obteniendo la información fundamentalmente de la televisión (75,7%). El 37,81% se consideraba bastante o muy preocupado ante la enfermedad, y el 37,24% consideraba que esta era bastante o muy grave. Las actitudes ante el padecimiento de un cuadro catarral no cambiaron respecto a la pauta habitual. Conclusiones. La cobertura vacunal es baja, especialmente ante la gripe A. La población se considera poco informada sobre síntomas y tratamiento de la gripe A. La mayor parte de la información se obtiene de medios no oficiales (televisión). El grado de preocupación y la percepción de gravedad se encuentran en niveles medios. La pandemia no ha alterado las costumbres de la población (AU)

Introduction. The influenza A (H1N1) outbreak has been a challenge for world health systems; it has provoked significant social alarm. We do not know if the health authorities advertisements have been understood by the population. Objective. To describe the knowledge and attitudes of the population on the prevention and treatment of influenza A (H1N1). Methods. Descriptive, cross-sectional study of a population who attended their Health Centre. A self-completed questionnaire was given. Results. There were 206 responses (60% women), with a mean age 49.8±17.4 years old, of which 33.5% thought they belonged to a risk group for A (H1N1)-flu. A total of 29.13% had been immunized against usual flu last season, and 27.8% this season (7.14% against A-flu). Proper knowledge about symptoms, treatment and the need of a prescription for antivirals were 61%, 32.7% and 70.3%, respectively. There was 40.1% who said they had little or no information, getting their information mainly from television (75.7%). A total of 37.81% were quite worried or very worried about the illness, and 37.24% thought it was severe or very severe. The attitudes relating to suffering the illness were similar to seasonal flu. Conclusions. Flu vaccination coverage (especially A-flu) is low. Knowledge of A (H1N1) flu symptoms and treatment was low, and a significant percentage of the population said they had little or no information. The information is mostly taken from unofficial channels (television). Concern about the illness is not great, but there is a perception of the severity. A-flu pandemic has not changed the attitudes of the population (AU)

El papel de la escuela de linfedema y la cinesiterapia en la prevención y el tratamiento del linfedema / The role of the school of lymphedema and kinesitherapy in the prevention and treatment of lymphedema

La elevada prevalencia de linfedema con su impacto en la calidad de vida y la eficacia incompleta de las terapias actuales hace aconsejable la instauración de programas de prevención que hagan posible una detección y un tratamiento precoz. La escuela de linfedema tiene como objetivo el de instruir a los pacientes de riesgo y a pacientes afectados en las medidas de prevención, autocuidado y en la identificación precoz del linfedema o sus complicaciones. Los ejercicios activos forman parte de los programas de prevención del linfedema y del tratamiento del mismo en la denominada terapia física compleja. Estudios recientes muestran que además de los ejercicios habituales recomendados la elaboración personalizada de protocolos que engloben actividad aeróbica, de resistencia y de flexibilización están indicados ya que ni desencadenan ni exacerban el linfedema, pero contribuyen a aumentar la calidad de vida de estos pacientes (AU)

The high prevalence of lymphedema along with its impact on quality of life and incomplete efficacy of current therapies makes the establishment of prevention programs that enable detection and early treatment recommendable. The School of Lymphedema aims to educate the at-risk and affected patients regarding preventive measures, self-care and early identification of lymphedema and its complications. Active exercises are part of lymphedema prevention programs and its treatment in the so-called complex physical therapy. Recent studies show that in addition to the recommended regular exercises, development of personalized protocols including aerobic, resistance and flexibility exercises is indicated since they neither trigger nor exacerbate lymphedema but contribute to improving the quality of life of these patients (AU)

Impact of sulfur starvation on cysteine biosynthesis in T-DNA mutants deficient for compartment-specific serine-acetyltransferase.

Sulfur plays a pivotal role in the cellular metabolism of many organisms. In plants, the uptake and assimilation of sulfate is strongly regulated at the transcriptional level. Regulatory factors are the demand of reduced sulfur in organic or non-organic form and the level of O-acetylserine (OAS), the carbon precursor for cysteine biosynthesis. In plants, cysteine is synthesized by action of the cysteine-synthase complex (CSC) containing serine acetyltransferase (SAT) and O-acetylserine-(thiol)-lyase (OASTL). Both enzymes are located in plastids, mitochondria and the cytosol. The function of the compartmentation of the CSC to regulate sulfate uptake and assimilation is still not clearly resolved. To address this question, we analyzed Arabidopsis thaliana mutants for the plastidic and cytosolic SAT isoenzymes under sulfur starvation conditions. In addition, subcellular metabolite analysis by non-aqueous fractionation revealed distinct changes in subcellular metabolite distribution upon short-term sulfur starvation. Metabolite and transcript analyses of SERAT1.1 and SERAT2.1 mutants [previously analyzed in Krueger et al. (Plant Cell Environ 32:349-367, 2009)] grown under sulfur starvation conditions indicate that both isoenzymes do not contribute directly to the transcriptional regulation of genes involved in sulfate uptake and assimilation. Here, we summarize the current knowledge about the regulation of cysteine biosynthesis and the contribution of the different compartments to this metabolic process. We relate hypotheses and views of the regulation of cysteine biosynthesis with our results of applying sulfur starvation to mutants impaired in compartment-specific cysteine biosynthetic enzymes.

Analysis of cytosolic and plastidic serine acetyltransferase mutants and subcellular metabolite distributions suggests interplay of the cellular compartments for cysteine biosynthesis in Arabidopsis.

In plants, the enzymes for cysteine synthesis serine acetyltransferase (SAT) and O-acetylserine-(thiol)-lyase (OASTL) are present in the cytosol, plastids and mitochondria. However, it is still not clearly resolved to what extent the different compartments are involved in cysteine biosynthesis and how compartmentation influences the regulation of this biosynthetic pathway. To address these questions, we analysed Arabidopsis thaliana T-DNA insertion mutants for cytosolic and plastidic SAT isoforms. In addition, the subcellular distribution of enzyme activities and metabolite concentrations implicated in cysteine and glutathione biosynthesis were revealed by non-aqueous fractionation (NAF). We demonstrate that cytosolic SERAT1.1 and plastidic SERAT2.1 do not contribute to cysteine biosynthesis to a major extent, but may function to overcome transport limitations of O-acetylserine (OAS) from mitochondria. Substantiated by predominantly cytosolic cysteine pools, considerable amounts of sulphide and presence of OAS in the cytosol, our results suggest that the cytosol is the principal site for cysteine biosynthesis. Subcellular metabolite analysis further indicated efficient transport of cysteine, gamma-glutamylcysteine and glutathione between the compartments. With respect to regulation of cysteine biosynthesis, estimation of subcellular OAS and sulphide concentrations established that OAS is limiting for cysteine biosynthesis and that SAT is mainly present bound in the cysteine-synthase complex.

Knocking out cytosolic cysteine synthesis compromises the antioxidant capacity of the cytosol to maintain discrete concentrations of hydrogen peroxide in Arabidopsis.

Plant cells contain different O-acetylserine(thiol)lyase (OASTL) enzymes involved in cysteine (Cys) biosynthesis and located in different subcellular compartments. These enzymes are made up of a complex variety of isoforms resulting in different subcellular Cys pools. To unravel the contribution of cytosolic Cys to plant metabolism, we characterized the knockout oas-a1.1 and osa-a1.2 mutants, deficient in the most abundant cytosolic OASTL isoform in Arabidopsis (Arabidopsis thaliana). Total intracellular Cys and glutathione concentrations were reduced, and the glutathione redox state was shifted in favor of its oxidized form. Interestingly, the capability of the mutants to chelate heavy metals did not differ from that of the wild type, but the mutants have an enhanced sensitivity to cadmium. With the aim of establishing the metabolic network most influenced by the cytosolic Cys pool, we used the ATH1 GeneChip for evaluation of differentially expressed genes in the oas-a1.1 mutant grown under nonstress conditions. The transcriptomic footprints of mutant plants had predicted functions associated with various physiological responses that are dependent on reactive oxygen species and suggested that the mutant was oxidatively stressed. Evidences that the mutation caused a perturbation in H2O2 homeostasis are that, in the knockout, H2O2 production was localized in shoots and roots; spontaneous cell death lesions occurred in the leaves; and lignification and guaiacol peroxidase activity were significantly increased. All these findings indicate that a deficiency of OAS-A1 in the cytosol promotes a perturbation in H2O2 homeostasis and that Cys is an important determinant of the antioxidative capacity of the cytosol in Arabidopsis.

Cytosolic cysteine in redox signaling.

CYSTEINE BIOSYNTHESIS IN PLANTS TAKES PLACE IN THE THREE CELLULAR COMPARTMENTS WITH AUTONOMOUS PROTEIN BIOSYNTHESIS MACHINERY: cytosol, plastids and mitochondria. This sulfur-containing molecule is synthesized sequentially in these compartments by two enzymatic families, the serine acetyltransferases and the O-acetylserine(thiol) lyases. Each family consists of several isoforms that differ in subcellular localization and abundance. Why so many isoforms are required in plant cell for cysteine biosynthesis has remained unknown to date. The characterization of gene-specific knockout mutants has started to address this question. In our recent work, we have performed a detailed analysis of the Arabidopsis oas-a1 null mutant and showed that the antioxidant capacity of the cytosol is compromised, highlighting the contribution of cytosolic Cys in redox signaling.

Cuidados perioperatorios de Enfermería a paciente sometido a fijación externa / Peri-operative nursing care for the patient undergoing external fixation

La fijación externa es una técnica cada vez más utilizada en nuestros hospitales, dado que se puede emplear como técnica definitiva en la estabilización de fracturas cerradas, o provisional en fracturas abiertas o en las que existen una alteración cutánea. Además su indicación en muy versátil pudiéndose utilizar en el caso de fracturas en las vértebras cervicales, de la mandíbula, en la articulación de la muñeca, de las falanges, del codo, en fracturas de pelvis, de fémur, de la tibia, articulación de la rodilla y tobillo, entre otras. Además proporciona comodidad al paciente, disminuye el dolor, facilita los cuidados de enfermería y el transporte y movilización del mismo. Con todo ello se hace necesaria la realización de un plan de cuidados estandarizado en el perioperatorio de estos pacientes, que facilite el trabajo de las enfermeras, y permita la aplicación y registro de los mismos siguiendo una metodología científica (AU)

El object of this article is to establish the standardized nursing plan in the peri-operative care of patients with external fixation, the purpose of which is to facilitate the work of peri-operative nurses (AU)

Las taxonomías enfermeras NANDA, NOC y NIC en la práctica asistencial hospitalaria / The nursing taxonomies, NANDA, NIC and NOC in hospital practice

Introducción. El uso de taxonomías obtenidas en contextos ajenos al nuestro obliga a una validación preliminar que posibilite la adecuación de éstas a nuestra realidad asistencial. Objetivos. Mejorar la organización de los cuidados en las unidades de hospitalización y desarrollar e implementar un método de trabajo para enfermería, con unos registros coherentes y eficientes. Material y método. En una primera fase se forman los profesionales que actuarán como dinamizadores del proyecto, y posteriormente se realiza la elaboración e implementación de planes de cuidados estandarizados mediante grupos de discusión y consenso compuesto por 4-7 profesionales expertos en el cuidado de las enfermedades de mayor prevalencia en las unidades de hospitalización de nuestro ámbito de estudio. Conclusiones. La elaboración de planes de cuidados estandarizados mediante la técnica del consenso y el uso de las taxonomías enfermeras son herramientas válidas para la homogeneización de cuidados y el desarrollo de la disciplina enfermera

Introduction. The use of taxonomies originally developed in contexts other than our own means that a preliminary validation is required to adjust them to our healthcare system. Objectives. To improve the management of nursing care in hospitalization units and to develop working systems for nursing staff with coherent and efficient records. Material and method. The project will be performed in two phases: 1) Instruction of staff members who will act as project leaders. 2) Design and implementation of standardized care plans by discussion groups composed of 4 to 7 experts in the care of the most prevalent diseases in the units collaborating in the study. Conclusions. The design of standardized care plans by the consensus technique and the use of nursing taxonomies are valid tools for the homogenization of nursing care and the development of the discipline of nursing

Increased cysteine availability is essential for cadmium tolerance and accumulation in Arabidopsis thaliana.

Employing genetic transformation using an Atcys-3A cDNA construct expressing the cytosolic O-acetylserine(thiol)lyase (OASTL), we obtained two Arabidopsis lines with different capabilities for supplying cysteine under metal stress conditions. Lines 1-2 and 10-10, grown under standard conditions, showed similar levels of cysteine and glutathione (GSH) to those of the wild-type. However, in the presence of cadmium, line 10-10 showed significantly higher levels. The increased thiol content allowed line 10-10 to survive under severe heavy metal stress conditions (up to 400 microm of cadmium in the growth medium), and resulted in an accumulation of cadmium in the leaves to a level similar to that of metal hyperaccumulator plants. Investigation of the epidermal leaf surface clearly showed that most of the cadmium had accumulated in the trichomes. Furthermore, line 10-10 was able to accumulate more cadmium in its trichomes than the wild-type, whereas line 1-2 showed a reduced capacity for cadmium accumulation. Our results suggest that an increased rate of cysteine biosynthesis is responsible for the enhanced cadmium tolerance and accumulation in trichome leaves. Thus, molecular engineering of the cysteine biosynthesis pathway, together with modification of the number of leaf trichomes, may have considerable potential in increasing heavy metal accumulation for phytoremediation purposes.