Mesenchymal Stromal Cell (MSC) Functional Analysis-Macrophage Activation and Polarization Assays.

Stem cell-based therapies have evolved to become a key component of regenerative medicine approaches to human pathologies. Exogenous stem cell transplantation takes advantage of the potential of stem cells to self-renew, differentiate, home to sites of injury, and sufficiently evade the immune system to remain viable for the release of anti-inflammatory cytokines, chemokines, and growth factors. Common to many pathologies is the exacerbation of inflammation at the injury site by proinflammatory macrophages. An increasing body of evidence has demonstrated that mesenchymal stromal cells (MSCs) can influence the immunophenotype and function of myeloid lineage cells to promote therapeutic effects. Understanding the degree to which MSCs can modulate the phenotype of macrophages within an inflammatory environment is of interest when considering strategies for targeted cell therapies. There is a critical need for potency assays to elucidate these intercellular interactions in vitro and provide insight into potential mechanisms of action attributable to the immunomodulatory and polarizing capacities of MSCs, as well as other cells with immunomodulatory potential. However, the complexity of the responses, in terms of cell phenotypes and characteristics, timing of these interactions, and the degree to which cell contact is involved, have made the study of these interactions challenging. To provide a research tool to study the direct interactions between MSCs and macrophages, we developed a potency assay that directly co-cultures MSCs with naïve macrophages under proinflammatory conditions. Using this assay, we demonstrated changes in the macrophage secretome and phenotype, which can be used to evaluate the abilities of the cell samples to influence the cell microenvironment. These results suggest the immunomodulatory effects of MSCs on macrophages while revealing key cytokines and phenotypic changes that may inform their efficacy as potential cellular therapies. Key features • The protocol uses monocytes differentiated into naïve macrophages, which are loosely adherent, have a relatively homogeneous genetic background, and resemble peripheral blood mononuclear cells-derived macrophages. • The protocol requires a plate reader and a flow cytometer with the ability to detect six fluorophores. • The protocol provides a quantitative measurement of co-culture conditions by the addition of a fixed number of freshly thawed or culture-rescued MSCs to macrophages. • This protocol uses assessment of the secretome and cell harvest to independently verify the nature of the interactions between macrophages and MSCs.

The application of electrosprayed minocycline-loaded PLGA microparticles for the treatment of glioblastoma.

The survival of patients with glioblastoma multiforme (GBM), the most common and invasive form of malignant brain tumors, remains poor despite advances in current treatment methods including surgery, radiotherapy, and chemotherapy. Minocycline is a semi-synthetic tetracycline derivative that has been widely used as an antibiotic and more recently, it has been utilized as an antiangiogenic factor to inhibit tumorigenesis. The objective of this study was to investigate the utilization of electrospraying process to fabricate minocycline-loaded poly(lactic-co-glycolic acid) (PLGA) microparticles with high drug loading and loading efficiency and to evaluate their ability to induce cell toxicity in human glioblastoma (i.e., U87-MG) cells. The results from this study demonstrated that solvent mixture of dicholoromethane (DCM) and methanol is the optimal solvent combination for minocycline and larger amount of methanol (i.e., 70:30) resulted in a higher drug loading. All three solvent ratios of DCM:methanol tested produced microparticles that were both spherical and smooth, all in the micron size range. The electrosprayed microparticles were able to elicit a cytotoxic response in U87-MG glioblastoma cells at a lower concentration of drug compared to the free drug. This work provides proof of concept to the hypothesis that electrosprayed minocycline-loaded PLGA microparticles can be a promising agent for the treatment of GBM and could have potential application for cancer therapies.

Mesenchymal stromal cells for bone trauma, defects, and disease: Considerations for manufacturing, clinical translation, and effective treatments.

Bone is a complex tissue capable of natural repair to injury, however, the healing process is often impaired by the untoward effects of trauma, defects, and disease. Thus, therapeutic modalities, including the use of cells involved in the body's natural healing processes, are investigated to promote or complement natural bone repair. Herein, several modalities and innovative approaches for using mesenchymal stromal cells (MSCs) to treat bone trauma, defects, and diseases are discussed. Given the evidence that supports the promising potential of MSCs, we highlight important considerations for advancing the clinical use of MSCs including the standardization of procedures from the harvest to delivery to patients and realized solutions to manufacturing. A better understanding of the current approaches implemented to address the challenges of using therapeutic MSCs will help improve study designs and, ultimately, achieve effective outcomes for restoring bone health.

A multiadjuvant polysaccharide-amino acid-lipid (PAL) subunit nanovaccine generates robust systemic and lung-specific mucosal immune responses against SARS-CoV-2 in mice.

Existing parenteral SARS-CoV-2 vaccines produce only limited mucosal responses, which are essential for reducing transmission and achieving sterilizing immunity. Appropriately designed mucosal boosters could overcome the shortcomings of parenteral vaccines and enhance pre- existing systemic immunity. Here we present a new protein subunit nanovaccine using multiadjuvanted (e.g. RIG-I: PUUC, TLR9: CpG) polysaccharide-amino acid-lipid nanoparticles (PAL-NPs) that can be delivered both intramuscularly (IM) and intranasally (IN) to generate balanced mucosal-systemic SARS-CoV-2 immunity. Mice receiving IM-Prime PUUC+CpG PAL- NPs, followed by an IN-Boost, developed high levels of IgA, IgG, and cellular immunity in the lung, and showed robust systemic humoral immunity. Interestingly, as a purely intranasal vaccine (IN-Prime/IN-Boost), PUUC+CpG PAL-NPs induced stronger lung-specific T cell immunity than IM-Prime/IN-Boost, and a comparable IgA and neutralizing antibodies, although with a lower systemic antibody response, indicating that a fully mucosal delivery route for SARS-CoV-2 vaccination may also be feasible. Our data suggest that PUUC+CpG PAL-NP subunit vaccine is a promising candidate for generating SARS-CoV-2 specific mucosal immunity.

Early detection and metabolic pathway identification of T cell activation by in-process intracellular mass spectrometry.

BACKGROUND AIMS: In-process monitoring and control of biomanufacturing workflows remains a significant challenge in the development, production, and application of cell therapies. New process analytical technologies must be developed to identify and control the critical process parameters that govern ex vivo cell growth and differentiation to ensure consistent and predictable safety, efficacy, and potency of clinical products. METHODS: This study demonstrates a new platform for at-line intracellular analysis of T-cells. Untargeted mass spectrometry analyses via the platform are correlated to conventional methods of T-cell assessment. RESULTS: Spectral markers and metabolic pathways correlated with T-cell activation and differentiation are detected at early time points via rapid, label-free metabolic measurements from a minimal number of cells as enabled by the platform. This is achieved while reducing the analytical time and resources as compared to conventional methods of T-cell assessment. CONCLUSIONS: In addition to opportunities for fundamental insight into the dynamics of T-cell processes, this work highlights the potential of in-process monitoring and dynamic feedback control strategies via metabolic modulation to drive T-cell activation, proliferation, and differentiation throughout biomanufacturing.

Single-cell epitope-transcriptomics reveal lung stromal and immune cell response kinetics to nanoparticle-delivered RIG-I and TLR4 agonists.

Lung-resident and circulatory lymphoid, myeloid, and stromal cells, expressing various pattern recognition receptors (PRRs), detect pathogen- and danger-associated molecular patterns (PAMPs/DAMPs), and defend against respiratory pathogens and injuries. Here, we report the early responses of murine lungs to nanoparticle-delivered PAMPs, specifically the retinoic acid-inducible gene I (RIG-I) agonist poly-U/UC (PUUC), with or without the TLR4 agonist monophosphoryl lipid A (MPLA). Using cellular indexing of transcriptomes and epitopes by sequencing (CITE-seq), we characterized the responses at 4 and 24 h after intranasal administration. Within 4 h, ribosome-associated transcripts decreased in both stromal and immune cells, followed by widespread interferon-stimulated gene (ISG) expression. Using RNA velocity, we show that lung-neutrophils dynamically regulate the synthesis of cytokines like CXCL-10, IL-1α, and IL-1ß. Co-delivery of MPLA and PUUC increased chemokine synthesis and upregulated antimicrobial binding proteins targeting iron, manganese, and zinc in many cell types, including fibroblasts, endothelial cells, and epithelial cells. Overall, our results elucidate the early PAMP-induced cellular responses in the lung and demonstrate that stimulation of the RIG-I pathway, with or without TLR4 agonists, induces a ubiquitous microbial defense state in lung stromal and immune cells. Nanoparticle-delivered combination PAMPs may have applications in intranasal antiviral and antimicrobial therapies and prophylaxis.

The use of complementary and traditional medicine for the treatment of patients with COVID-19: A systematic review.

OBJECTIVE: The aim of this study was to evaluate the use and effectiveness of non-pharmacological therapies as part of the treatment of COVID-19 and its complications, either combined or not with the usual treatment. METHODS: A systematic review was conducted between August and October 2021 using PubMed, Scopus, CINAHL and Web of Science databases. From a total of 204 articles identified, 33 were included in the final sample (15 clinical trials and 18 quasi-experimental studies). The methodological evaluation was carried out using STROBE and CONSORT guidelines. RESULTS: There is a growing literature on the use of CAM for COVID-19. Most studies have shown positive findings, particularly for the use of TCM, other herbal therapies and acupuncture. Nevertheless, most studies were carried out in Asia and relied on quasi-experimental designs. The current evidence is available for physical outcomes (mortality rate, pneumonia resolution and other symptoms, negative PCR test, and hospitalization and ICU admissions) and for mental health outcomes. CONCLUSION: Despite a positive role of CAM on COVID-19 outcomes, the evidence is still mostly based on quasi-experimental studies. More robust clinical trials are needed in order to generate better evidence in this area.

Longitudinal two-dimensional gas chromatography mass spectrometry as a non-destructive at-line monitoring tool during cell manufacturing identifies volatile features correlative to cell product quality.

BACKGROUND AIMS: Cell therapies have emerged as a potentially transformative therapeutic modality in many chronic and incurable diseases. However, inherent donor and patient variabilities, complex manufacturing processes, lack of well-defined critical quality attributes and unavailability of in-line or at-line process or product analytical technologies result in significant variance in cell product quality and clinical trial outcomes. New approaches for overcoming these challenges are needed to realize the potential of cell therapies. METHODS: Here the authors developed an untargeted two-dimensional gas chromatography mass spectrometry (GC×GC-MS)-based method for non-destructive longitudinal at-line monitoring of cells during manufacturing to discover correlative volatile biomarkers of cell proliferation and end product potency. RESULTS: Specifically, using mesenchymal stromal cell cultures as a model, the authors demonstrated that GC×GC-MS of the culture medium headspace can effectively discriminate between media types and tissue sources. Headspace GC×GC-MS identified specific volatile compounds that showed a strong correlation with cell expansion and product functionality quantified by indoleamine-2,3-dioxygenase and T-cell proliferation/suppression assays. Additionally, the authors discovered increases in specific volatile metabolites when cells were treated with inflammatory stimulation. CONCLUSIONS: This work establishes GC×GC-MS as an at-line process analytical technology for cell manufacturing that could improve culture robustness and may be used to non-destructively monitor culture state and correlate with end product function.

Nanoparticle-delivered TLR4 and RIG-I agonists enhance immune response to SARS-CoV-2 subunit vaccine.

Despite success in vaccinating populations against SARS-CoV-2, concerns about immunity duration, continued efficacy against emerging variants, protection from infection and transmission, and worldwide vaccine availability remain. Molecular adjuvants targeting pattern recognition receptors (PRRs) on antigen-presenting cells (APCs) could improve and broaden the efficacy and durability of vaccine responses. Native SARS-CoV-2 infection stimulates various PRRs, including toll-like receptors (TLRs) and retinoic acid-inducible gene I (RIG-I)-like receptors. We hypothesized that targeting PRRs using molecular adjuvants on nanoparticles (NPs) along with a stabilized spike protein antigen could stimulate broad and efficient immune responses. Adjuvants targeting TLR4 (MPLA), TLR7/8 (R848), TLR9 (CpG), and RIG-I (PUUC) delivered on degradable polymer NPs were combined with the S1 subunit of spike protein and assessed in vitro with isogeneic mixed lymphocyte reactions (isoMLRs). For in vivo studies, the adjuvant-NPs were combined with stabilized spike protein or spike-conjugated NPs and assessed using a two-dose intranasal or intramuscular vaccination model in mice. Combination adjuvant-NPs simultaneously targeting TLR and RIG-I receptors (MPLA+PUUC, CpG+PUUC, and R848+PUUC) differentially induced T cell proliferation and increased proinflammatory cytokine secretion by APCs in vitro. When delivered intranasally, MPLA+PUUC NPs enhanced CD4+CD44+ activated memory T cell responses against spike protein in the lungs while MPLA NPs increased anti-spike IgA in the bronchoalveolar (BAL) fluid and IgG in the blood. Following intramuscular delivery, PUUC NPs induced strong humoral immune responses, characterized by increases in anti-spike IgG in the blood and germinal center B cell populations (GL7+ and BCL6+ B cells) in the draining lymph nodes (dLNs). MPLA+PUUC NPs further boosted spike protein-neutralizing antibody titers and T follicular helper cell populations in the dLNs. These results suggest that protein subunit vaccines with particle-delivered molecular adjuvants targeting TLR4 and RIG-I could lead to robust and unique route-specific adaptive immune responses against SARS-CoV-2.

Nursing Education during the SARS-CoV-2 Pandemic: Assessment of Students' Satisfaction with e-Learning Environment.

The disease caused by the SARS-CoV-2 coronavirus led to the disruption of normality with respect to education, public healthcare and new technologies. Education is a fundamental pillar to increase the knowledge and morale of people. However, due to the lockdown implemented to protect the population from an infection of unknown aetiology, the education system decided to switch from face-to-face education to virtual education. This modality has affected the teaching-learning process in the Degree of Nursing, since its competencies and knowledge demand in-presence learning. The aim of this study was to evaluate the impact that telematic education had on students of the Degree of Nursing who were studying in the final year of said degree, which involves their imminent entry into the labour market. We used the client satisfaction questionnaire of Bob Hayes to gather data and analyse the satisfaction level of the nursing students. As a result, a considerable amount of information was obtained about teaching, which shows the absence of practical activities and the lack of information about safety and protection measures related to the pandemic. Most educators themselves were struggling to understand the implications of the virus and implement appropriate safety measures, since there was quite a bit of conflicting information relating to the effectiveness of personal protective safety equipment and the lifespan of the virus on various media outside of the host. It is, therefore, not surprising that education for students in this regard was lacking. In general, most of the students showed dissatisfaction with the virtual education they received.

Nanoparticle-delivered TLR4 and RIG-I agonists enhance immune response to SARS-CoV-2 subunit vaccine.

Despite recent success in vaccinating populations against SARS-CoV-2, concerns about immunity duration, continued efficacy against emerging variants, protection from infection and transmission, and worldwide vaccine availability, remain. Although mRNA, pDNA, and viral-vector based vaccines are being administered, no protein subunit-based SARS-CoV-2 vaccine is approved. Molecular adjuvants targeting pathogen-recognition receptors (PRRs) on antigen-presenting cells (APCs) could improve and broaden the efficacy and durability of vaccine responses. Native SARS-CoV-2 infection stimulate various PRRs, including toll-like receptors (TLRs) and retinoic-acid-inducible gene I-like receptors (RIG-I). We hypothesized that targeting the same PRRs using adjuvants on nanoparticles along with a stabilized spike (S) protein antigen could provide broad and efficient immune responses. Formulations targeting TLR4 (MPLA), TLR7/8 (R848), TLR9 (CpG), and RIG-I (PUUC) delivered on degradable polymer-nanoparticles (NPs) were combined with the S1 subunit of S protein and assessed in vitro with isogeneic mixed lymphocyte reactions (iso-MLRs). For in vivo studies, the adjuvanted nanoparticles were combined with stabilized S protein and assessed using intranasal and intramuscular prime-boost vaccination models in mice. Combination NP-adjuvants targeting both TLR and RIG-I (MPLA+PUUC, CpG+PUUC, or R848+PUUC) differentially increased proinflammatory cytokine secretion (IL-1ß, IL-12p70, IL-27, IFN-ß) by APCs cultured in vitro, and induced differential T cell proliferation. When delivered intranasally, MPLA+PUUC NPs enhanced local CD4+CD44+ activated memory T cell responses while MPLA NPs increased anti-S-protein-specific IgG and IgA in the lung. Following intramuscular delivery, PUUC-carrying NPs induced strong humoral immune responses, characterized by increases in anti-S-protein IgG and neutralizing antibody titers and germinal center B cell populations (GL7+ and BCL6+ B cells). MPLA+PUUC NPs further boosted S-protein-neutralizing antibody titers and T follicular helper cell populations in draining lymph nodes. These results suggest that SARS-CoV-2-mimicking adjuvants and subunit vaccines could lead to robust and unique route-specific adaptive immune responses and may provide additional tools against the pandemic.

Theranostic nanocarriers combining high drug loading and magnetic particle imaging.

We report preparation of theranostic nanocarriers loaded with up to 50 wt% of the anticancer drug doxorubicin that contain magnetic nanoparticles which enable Magnetic Particle Imaging (MPI), an emerging technology for quantitative and unambiguous imaging of the nanocarriers. The nanocarriers, coated with poly(ethylene glycol)-block-poly(lactic acid) (PEG4.9kD-b-PLA6kD) block copolymer for colloidal stability, are composed of a hydrophobic core of precipitated hydrolysable doxorubicin prodrug (proDox) and magnetic nanoparticles. Transmission electron microscopy (TEM) shows evidence of precipitated proDox for nanocarriers with high drug loading of up to 50 wt%. MPI measurements show that the nanocarriers can be quantitatively imaged. The nanocarriers are internalized by MDA-MB-231 cells and their IC50 value via metabolic assay is 1.1 µM, compared to 0.21 µM for free doxorubicin. The release rate from the nanocarriers was dependent on environmental pH. These nanocarriers with high drug loading and quantitative imaging are promising candidates for future applications.

Cáncer de laringe y sinunasal en Cali, Colombia 1962 ­ 2015 / Sinonasal and laryngeal carcinoma in Cali, Colombia 1962 ­ 2015

Introducción: El cáncer es una enfermedad de alta incidencia, con múltiples factores etiológicos y diferentes características evolutivas. Objetivo: Describir la supervivencia y la tendencia de las tasas de incidencia y mortalidad por cáncer de laringe y senos paranasales en Cali (Colombia) durante el periodo 1962 a 2015. Diseño: Estudio observacional descriptivo. Métodos: La información de incidencia, durante el periodo 1962 a 2012, se obtuvo en el RPCC y la mortalidad entre 1984-2015 de la SSPM. El comportamiento de la tendencia se evaluó con el porcentaje de cambio anual (APC) y la supervivencia relativa se estimó con el método de Ederer II. La estadificación se realizó con la AJCC. Resultados: Durante 1962 a 2012, se diagnosticaron 1623 casos nuevos de cáncer, 85.2% (1383 casos) fueron de laringe y 14.8% (240 casos) sinunasal 76% fueron hombres y el CCE fue el tipo histológico más frecuente 84.1% y 59.6% en laringe y sinunasal respectivamente. Se observó una disminución significativa del riesgo de cáncer de laringe en ambos sexos, siendo mayor la disminución en hombres (APC=-1,1*(ICD95%: -1,6; -0,7)). La disminución en la tasa de incidencia de cáncer de laringe CEC fue mayor en hombres (APC=-1,1*(ICD95%: -1,6; -0,6)) durante 1962-2012. Las tasas de mortalidad disminuyeron significativamente (APC=- 2,5*(ICD95%:-3,6 -1,5)). La supervivencia relativa a 5 años durante el periodo 2008- 2012, 43,5%; 93 pacientes se estadificaron con supervivencia: T3-T4 (41,5%) y T1- T2 (55,0%). Conclusiones: El riesgo del cáncer de laringe y sinunasal escamocelular asociado al tabaquismo disminuyó de manera significativa en hombres y mujeres de Cali durante los últimos 53 años.

Introduction: Cancer is disease with high incidence, multiple etiological factors and different characteristics. Objective: To describe the survival and trend of the incidence and mortality rates for cancer of the larynx and paranasal sinuses in Cali (Colombia) during the period 1962 to 2015. Design: Descriptive observational study. Methods: Incidence information, during the period 1962 to 2012, was obtained in the RPCC and mortality between 1984-2015 of the SSPM. The behavior of the trend was evaluated with the percentage of annual change (APC) and the relative survival was estimated with the method of Ederer II. The arrangement was made with the AJCC. Results: During 1962 to 2012, 1623 new cases of cancer were diagnosed, 85.2% (1383 cases) were laryngeal and 14.8% (240 cases) sinunasal 76% were men and the CCE was the most frequent histological type 84.1% and 59.6% in larynx and sinunasal respectively. A significant decrease in the risk of laryngeal cancer was observed in both sexes, with a greater decrease in men (APC = -1.1 * (ICD95%: -1.6, -0.7)). The decrease in the incidence rate of laryngeal cancer CEC was higher in men (APC = -1.1 * (ICD95%: -1.6, -0.6)) during 1962-2012. Mortality rates decreased significantly (APC = -2.5 * (ICD95%: - 3.6 -1.5)). The 5-year relative survival rate during the period 2008-2012 was 43.5%; 93 patients were stratified with survival: T3-T4 (41.5%) and T1-T2 (55.0%). Conclusions: The risk of laryngeal and squamous cell sinonasal cancer associated to smoking decreased significantly in men and women of Cali during the last 53 years.

Hispanic health in the USA: a scoping review of the literature.

Hispanics are the largest minority group in the USA. They contribute to the economy, cultural diversity, and health of the nation. Assessing their health status and health needs is key to inform health policy formulation and program implementation. To this end, we conducted a scoping review of the literature and national statistics on Hispanic health in the USA using a modified social-ecological framework that includes social determinants of health, health disparities, risk factors, and health services, as they shape the leading causes of morbidity and mortality. These social, environmental, and biological forces have modified the epidemiologic profile of Hispanics in the USA, with cancer being the leading cause of mortality, followed by cardiovascular diseases and unintentional injuries. Implementation of the Affordable Care Act has resulted in improved access to health services for Hispanics, but challenges remain due to limited cultural sensitivity, health literacy, and a shortage of Hispanic health care providers. Acculturation barriers and underinsured or uninsured status remain as major obstacles to health care access. Advantageous health outcomes from the "Hispanic Mortality Paradox" and the "Latina Birth Outcomes Paradox" persist, but health gains may be offset in the future by increasing rates of obesity and diabetes. Recommendations focus on the adoption of the Health in All Policies framework, expanding access to health care, developing cultural sensitivity in the health care workforce, and generating and disseminating research findings on Hispanic health.

Local 3D matrix confinement determines division axis through cell shape.

How the division axis is determined in mammalian cells embedded in three-dimensional (3D) matrices remains elusive, despite that many types of cells divide in 3D environments. Cells on two-dimensional (2D) substrates typically round up completely to divide. Here, we show that in 3D collagen matrices, mammalian cells such as HT1080 human fibrosarcoma and MDA-MB-231 breast cancer cells exhibit division modes distinct from their Counterparts on 2D substrates, with a markedly higher fraction of cells remaining highly elongated through mitosis in 3D matrices. The long axis of elongated mitotic cells accurately predicts the division axis, independently of matrix density and cell-matrix interactions. This 3D-specific elongated division mode is determined by the local confinement produced by the matrix and the ability of cells to protrude and locally remodel the matrix via ß1 integrin. Elongated division is readily recapitulated using collagen-coated microfabricated channels. Cells depleted of ß1 integrin still divide in the elongated mode in microchannels, suggesting that 3D confinement is sufficient to induce the elongated cell-division phenotype.

La recepción, acogida y clasificación en urgencias: clave en la comunicación con familiares y pacientes / Reception, attendance and classification in the emergency unit: key for communication with relatives and patients

La recepción, acogida y clasificación de pacientes en urgencias(RAC) implica una correcta comprensión del problema de salud delos pacientes desde la óptica asistencial por niveles de gravedad ysu correspondiente clasificación y adecuación a la estructura del medio asistencial. Uno de sus principales objetivos es optimizar la calidad y la eficacia de los servicios de urgencias y emergencias, para la mejor respuesta a las necesidades de los usuarios, estableciendo criterios homogéneos, científicos y coherentes sobre la necesidad de atención que un paciente presenta con respecto a su demanda de asistencia y, sobre la base de ello, aplicar las intervenciones enfermeras pertinentes para garantizar su seguridad. De ahí que el cometido de la enfermera/o de RAC no solo sea la ordenación eficaz de la demanda mediante una entrevista rápida y la valoración clínica del paciente, sino que también, y no menos importante, será la de ofertar a los pacientes y a sus familiares o acompañantes una aproximación humana y profesional al problema planteado como demanda asistencial en todo su contexto, facilitando su estabilidad y confort mediante la prestación de apoyo emocional y ayuda psicológica, para disponer al paciente en una actitud terapéutica positiva, obteniendo así el mejor índice de calidad posible en el conjunto de las prestaciones sanitarias. El objetivo del presente artículo consiste en reflexionar sobre la trascendencia de la comunicación para el establecimiento de una adecuada relación terapéutica entre profesionales y pacientes en la consulta de RAC, procurando la máxima seguridad de los mismos

The reception, attendance and classification of patients in the Emergency Unit (RAC) involves an adequate understanding by levels of severity of the health problem of patients from a care point of view, and their relevant classification and adaptation to the structure of the setting of care. One of its main objectives is to optimize the quality and efficacy of the Emergency department, in order to offer a better response to the needs of users, determining homogeneous and consistent scientific criteria about the need for care presented by a patient regarding their demand for care, and based on this, to implement the appropriate nursing interventions to ensure their safety. Therefore, the task of the RAC nurse is not only an efficient organization of demand through a fast interview and clinical assessment of the patient, but also, and not least important, to offer patients and their relatives or carers a human and professional approximation to the problem put forward as demand for care in all its context, ensuring their stability and comfort by providing emotional support and psychological help, to place patients in a positive therapeutic attitude, thus obtaining the best quality index possible within the set of healthcare services. The objective of this article is to reflect onthe importance of communication in order to establish an adequate therapeutic relationship between professionals and patients at the RAC unit, trying to achieve their maximum safety

Edad, escolarización y tareas de Fluencia Verbal para el screening de pacientes con Enfermedad de Alzheimer / Age, schooling and Verbal Fluency tasks for the screening of Alzheimer´s disease patients

Introducción. Las pruebas de Fluencia Verbal (FV) Semántica (FVS) y Fonológica (FVF) son muy empleadas en la práctica clínica. Disponer de diferentes pruebas alternativas que además tengan en cuenta el efecto de variables sociodemográficas mejorarían su uso como tests de cribado, permitiendo diferenciar a personas con y sin Enfermedad de Alzheimer (EA). Objetivos. Comparar la capacidad discriminativa de las tareas de FVS 'cosas en una casa' y 'alimentos' frente a la tarea 'animales' entre pacientes con EA (n = 50) y sujetos sanos (n = 50); comparar el uso de los fonemas 'P'-'M'-'R' como tarea alternativa y/o paralela a los fonemas 'F'-'A'-'S'; y valorar el uso combinado de ambos tipos de tareas junto con el de variables sociodemográficas para la discriminación de pacientes con EA y sujetos sanos. Resultados. Tanto la categoría semántica como fonológica muestran resultados semejantes, una alta correlación, mantienen la validez de criterio y permiten su utilización de forma paralela. El modelo de predicción que logra discriminar correctamente al 91% de los sujetos evaluados es el que incluye las tareas 'cosas en una casa', los fonemas 'A' - 'S' y las variables edad y años de escolarización. Conclusiones. La utilización paralela de pruebas de FVS y FVF, junto con variables sociodemográficas mejora la capacidad discriminativa de las pruebas de FV

Introduction. The Verbal (VF), Semantic (SF) and Phonemic Fluency (PF) tests are commonly used in clinical practice. Having different alternative tests, that could also allow for the effect of demographic variables, would improve their use as screening tests, making it possible to differentiate patients with or without Alzheimer´s disease (AD). Aims. (1) To compare the discriminatory ability of the SF tasks 'things in a house' and 'food' versus the task 'animals' among patients with the AD (n = 50) and healthy subjects (n = 50). (2) To compare the use of the phonemes such as 'P', 'M' and 'R' as an alternative and/or parallel task to the phonemes 'F', 'A' and 'S'. (3) To assess the combined use of both tasks with the demographic variables for the screening of AD patients and the healthy ones. Results. Both semantic and phonemic categories indicate similar results, high correlation, support the criteria validity and allow for their use in a parallel way. Among all the different roles assessed, the most successful in screening correctly 91% of the evaluated subjects is the one that includes tasks such as 'things in a house', the phonemes 'A' and 'S' and the age and schooling time variables. Conclusion. The parallel use of VF and PF, plus the demographic variables improve the discriminatory ability of the VF tests

Correlación de variables antropométricas como predictor de salud, en una población de niños y adolescentes con síndrome de Down de Temuco, Chile / Correlating anthropometric variables as health predictors in a group of children and adolescents suffering Down's syndrome in Temuco, Chile

Antecedentes. En los últimos años se ha evidenciado la importancia de investigar sobre la obesidad, incluyendo a grupos de sujetos que presentan necesidades educativas especiales permanentes, como es el caso del Síndrome de Down. Objetivo. Determinar la correlación entre el Índice de Masa Corporal (IMC) con la circunferencia de cintura (CCi) y el IMC con la circunferencia de cadera (CCa) de los niños y adolescentes con síndrome de Down. Materiales y métodos. Se realizó un estudio de corte transversal, donde se evaluaron 42 niños y adolescentes, 23 hombres (54,7%) y 19 mujeres (35,3%), entre 3 y 16 años de edad, alumnos de escuelas especiales de Temuco, Chile. Para obtener el IMC y la CCa se utilizó el método descrito por la OMS. Resultados. Se evidencia un alto grado de correlación entre IMC y CCi (0,776) y entre IMC y CCa (0,771). Además el 61,9% del total presentan sobrepeso u obesidad. El 52,1% de los hombres y el 73,6% de las mujeres presentan obesidad o sobrepeso. Discusión. A partir de los resultados, es recomendable la utilización de la circunferencia de cintura y cadera, además del IMC para la detección temprana de problemas asociados a la obesidad. Además de focalizar el trabajo a realizar con esta población especial, generando estrategias que involucren a distintos profesionales del ámbito de la salud y del ejercicio físico, permitiendo abordar sistémicamente desde los primeros años la prevención de la obesidad y las patologías asociadas.

Background. The importance of investigating obesity has grown during recent years, especially regarding groups of people involving long-term special education needs, such as Down's syndrome. Objective. Determining the correlation between body mass index (BMI) and waist circumference and BMI and hip circumference in children and teenagers suffering Down's syndrome. Materials and methods. This cross-sectional study involved evaluating 42 children and adolescents aged 3 to 16 years old; 23 of them were male (54.7%) and 19 female (35.3%) and all were studying in specialised schools in Temuco, Chile. The method described by the WHO was used for obtaining BMI, waist and hip circumference measurements. Results. A high correlation was seen for both BMI and waist circumference (0.776) and BMI and hip circumference (0.771). It was also seen that 61.9% of the population studied were overweight or obese; 52.1% of the males and 73.6% of the females were either obese or overweight. Discussion. It is thus recommended that waist and hip circumference and BMI should be used for the early detection of obesity-related problems. Efforts should be specifically focused on this special population of people, leading to strategies involving healthcare workers in different areas as well as physical exercise. This would lead to the systematic prevention of obesity and associated pathologies from an early age.

Three-dimensional self-assembling of gold nanorods with controlled macroscopic shape and local smectic B order.

We describe a method of controlled evaporation on a textured substrate for self-assembling and shaping gold-nanorod-based materials. Tridimensional wall features are formed over areas as large as several square millimeters. Furthermore, analyses by small-angle X-ray scattering and scanning electron microscopy techniques demonstrate that colloids are locally ordered as a smectic B phase. Such crystallization is in fact possible because we could finely adjust the nanoparticle charge, knowledge that additionally enables tuning the lattice parameters. In the future, the type of ordered self-assemblies of gold nanorods we have prepared could be used for amplifying optical signals.