Human Neutrophils Couple Nitric Oxide Production and Extracellular Traps Formation in Allergic Asthma.

RATIONALE: Nitric oxide (NO) is elevated in the airways and serum of allergic asthmatic patients, suggesting an important role in asthma. NO production has been widely attributed to the canonical inducible nitric oxide synthase (iNOS). Much effort has been made to inhibit this enzyme with two outcomes: no asthma improvement; and partial NO reduction, suggesting the involvement of an iNOS-independent source. OBJECTIVES: Neutrophils produce NO under inflammatory conditions and their role in asthma has been overlooked. The present study analyzes their possible role as source of NO. METHODS: Our hypothesis was tested in 99 allergic patients with intermittent bronchial asthma and 26 healthy donors. NO production by blood and sputum neutrophils in response to allergens, anti-IgE, and anti-IgE receptors Abs was assessed by Griess, flow cytometry and confocal microscopy. Extracellular traps (ETs) formation, as a possible consequence of NO production, was quantified by western blot and confocal microscopy, and reactive oxygen species by luminol-enhanced chemiluminescence. RESULTS: Among blood and sputum granulocytes from allergic asthmatic patients, only neutrophils, produce NO by an IgE-dependent mechanism. This production is independent of NOS, but dependent on a reaction between L-arginine and reactive oxygen species from NOX2. NO and ETosis are induced in parallel, and NO amplifies ETs formation, which is a key mediator in asthma. CONCLUSIONS: Our findings reveal a novel role of neutrophils as the unique allergen/IgE-dependent NO source in allergic asthma enhancing ETs formation. These results suggest that NO produced by neutrophils needs further consideration in the treatment of allergic asthma.

Riesgos psicosociales considerados por jueces de familia en decisiones sobre pérdida de patria potestad: Estudio exploratorio / Psychosocial risks considered by family judges in decisions on loss of parental authority: An exploratory study

La investigación realizada tuvo como objetivo identificar riesgos psicosociales considerados por jueces en decisiones sobre pérdida de la patria potestad. El tipo y diseño de la investigación fue cualitativo. Las fuentes de información eran dos: (1) se preseleccionaron 50 documentos judiciales en las siguientes ciudades de Colombia: Bogotá, Tunja y Duitama y (2) se hizo una entrevista grupal con ocho jueces. Los documentos fueron analizados con un protocolo y para diseñarlo, se determinaron categorías orientadas por los objetivos y sustento teórico. La entrevista consistió en un grupo focal. El audio de la entrevista se transcribió literalmente y se realizó un análisis categorial inductivo. Los hallazgos indican que en la mayor parte de casos, la causal más común corresponde al abandono. Allí se identifica más un interés por viajar con el niño fuera del país sin tener que pedir permiso al progenitor demandado. Igualmente se observa que poco se tiene en cuenta la interdisciplinariedad y el interés superior del menor dentro de las decisiones. En el momento de tomar la decisión los jueces utilizan más la lógica silogística que la realista. Empero, en la discusión generada dentro del contexto de la entrevista grupal, anteponen la experiencia profesional y posiblemente vivencias propias para describir las situaciones evaluadas (lógica realista). De la misma manera, reconocen riesgos psicosociales que no quedan expuestos en el documento judicial. Finalmente, se encuentra la necesidad de evaluar más detalladamente la historia relacional de la pareja parental, ya que suelen existir secuelas psicológicas que afectan las competencias parentales.

Suspension of custody as a right of the child may lead to psychosocial risks considered as potential dangers to the well-being of the child, his family or his community in various dimensions. It is therefore important to consider the possibility of these psychosocial risks when making these judicial decisions about the loss of parental rights. The phenomenon of psychosocial risk has been more studied in working environments and also linked to health problems. This fact assigns a new connotation to this study, since it opens the door to the interdisciplinarity from Psychology and Law, when investigating if the psychosocial risks in the judicial decisions on loss of parental authority are taken into account. The research aims to identify psychosocial risks considered by family judges in decisions about loss of custody. The type and design research is qualitative, since one of its general pretensions is the understanding. The sources of information are two. The first corresponds to 50 pre-selected court documents in the Colombian cities of Bogota, Tunja and Duitama. The other is a group interview with 8 family judges. The documents were analyzed by means of a protocol. For the design and implementation of the protocol, categories oriented by interdisciplinary research team objectives, theoretical support and expectations were made. The interview consisted of a focus group interview with family judges (four men and four women). The audio of the interview was transcribed literally and an inductive categorical analysis was made. Results of the analysis of the interview and documents were contrasted. Judicial documents reviewed show that judges use syllogistic logic when seeking to accommodate situations to the causal. Within the judicial decisions it is observed that the best interest of the minor is not privileged. The analysis of the interview in which the use of experience and intuition is observed following a realistic logic, invites us to reflect on aspects such as: the subjectivity of udges in the evaluation, the pressure they face on the number of lawsuits and the speed of judgment, and the need to revise the causal deprivation of liberty superior to one year. The judges manifest a deficit in the interdisciplinary work and the lack of more training in aspects of mental health that would make possible the use of psychological reports and the greater understanding of causes such as disability. It was possible to identify a pattern that leads to the decision of loss of custody power by abandonment (most common causal): (1) Search for legal advice. (2) To promote the notoriety of the physical and emotional distance between the defendant and the child. (3) Establish the claim. (4) Accumulate evidential evidence on the causal. (5) Obtain witnesses. In the discussion generated in the group interview, judges recognize psychosocial risks that are not exposed in the court document or sentence. Finally there is the need to assess in more detail the relational history of the parental couple, as they tend to be psychological consequences that affect parenting skills. The discussion between the researchers of Family Psychology and those of Family Law appear questions that build an interdisciplinary bridge. One limitation of the study was that it was not possible to have sufficient time and resources to conduct group and individual interviews with a greater number of family judges in other cities of the country and achieve more generalizable results. The research question on whether judges take into account the risks to make the decisions is answered that it attends to the grounds provided in the law taking the decision guided by the syllogistic logic. Causals can be equated with psychosocial risks.

Necesidades de la familia de los pacientes ingresados en una Unidad de Cuidados Intensivos / Needs of the relatives of patients admitted to an intensive care unit

OBJETIVO: describir las diferentes necesidades de los familiares de los pacientes ingresados en una Unidad de Cuidados Intensivos (UCI), así como sus prioridades y los sentimientos que presentan durante el ingreso. MÉTODO: se realizó un estudio piloto con metodología cualitativa descriptiva de las necesidades, mediante entrevistas individuales a las familias de los pacientes ingresados en la UCI del Hospital de Sant Pau I Santa Tecla de Tarragona. La muestra obtenida es de carácter no probabilístico por bola de nieve. Su análisis posterior, previa transcripción literal de las entrevistas, se desarrolló desde una visión fenomenológica desarrollando categorías sobre el tema a estudio. RESULTADOS: las necesidades detectadas en las familias son las de información, proximidad, seguridad, estar tranquilo, esperanza y las prácticas o de recursos. También describieron sentimientos y emociones que presentan durante el ingreso de su familiar, de los que destacan el llanto y el miedo a la muerte del ser querido.La UCI donde se realizó el estudio tiene como particularidad un horario de visitas en régimen de puertas abiertas, por lo que la escala de prioridades de las necesidades de estos familiares ha variado respecto a lo encontrado en estudios previos, evidenciándose como más prioritarias las necesidades consideradas prácticas, ya que la necesidad de proximidad, una de las más destacadas descritas en la literatura, está bien cubierta al disponer de flexibilidad en el horario de visitas. Dentro de las necesidades prácticas, lo que los familiares más demandan es ayuda psicológica en el momento del ingreso de su familiar. CONCLUSIONES: se ha demostrado que las familias sí que tienen necesidades durante el ingreso de su familiar y que estas necesidades son iguales que las descritas en la literatura encontrada sobre el tema, con la diferencia que si estas están bien cubiertas surgen en importancia otras que antes no lo eran

OBJECTIVE: to describe the different needs of the relatives of patients admitted to an Intensive Care Unit (ICU), as well as their priorities and the feelings experienced during hospitalization. METHOD: a pilot study was conducted with qualitative methodology describing the needs, through individual interviews with the families of patients admitted to the ICU of the Hospital de Sant Pau I Santa Tecla in Tarragona. The sample was obtained through a non-probability snowball sampling technique. Its subsequent analysis, based on the verbatim transcription of interviews, was conducted from a phenomenological view, developing categories about the matter to be studied. RESULTS: the needs detected in families included: information, closeness, safety, being calm, hope, and practical needs or in terms of resources. They also described feelings and emotions experienced during the hospitalization of their relative; among these, the main ones were crying and fear of death of their love done. The ICU where the study was conducted had the distinctive feature of an open-door regimen of visiting hours, therefore the priority scale of needs in these relatives was different from what was found in previous studies. In this case, those needs of a practical nature were considered the priority, because the need for closeness, one of the most prominent described in literature, was well covered by flexibility in visiting hours. Within practical needs, the most demanded by families was psychological help at the time of the admission of their relative CONCLUSIONS: it has been demonstrated that families do have needs during the hospitalization of their relative, and that those needs are equal to those described in the literature on the subject; with the difference that, if these needs are well covered, the importance of other needs will now increase

El abuso verbal dentro de la violencia doméstica / Verbal abuse in domestic violence

En este ensayo se analizan las legislaciones vigentes y los tipos de violencia intra familiar, haciendo énfasis en la agresión verbal y el daño que provoca el callar este tipo de agresión. La violencia intra familiar es un mal que históricamente ha aquejado a nuestra sociedad, de modo que a través de la transmisión intergeneracional se ha arraigado como una lamentable costumbre de dificil, pero no imposible, erradicación. Los funcionarios encargados del procedimiento que regula la violencia doméstica en general, deben ser funcionarios, no solo con conocimiento de la ley, sino personas con cogniciones médicas, sociales, culturales e históricas, pues deben ser hábiles para localizar y diagnosticar el problema, sus posibles soluciones y velar por los derechos de las partes. Estos conocimientos especiales deben ser introducidos o bien alimentados por el mismo Estado. Así que el poder Judicial, estaría en la obligación de realizar una serie de actividades académicas, que profundicen sobre el tema, capaciten y actualicen al personal señalado. La educación también debe ser para la población, ya que es el método específico, para evitar la reiteración de conductas que una sociedad considera lesivas, dado que no son las penas, ni las leyes, las que evitan la comisión de estos actos hostiles. Palabras clave: Bloquear, desviar, acusar, culpar, juzgar, criticar, trivializar, socavar, amenazar, insultar, olvidar, ordenar,, negar, actuar con ira, abuso verbal, violencia doméstica.