ABSTRACT
BACKGROUND: Education is a social tipping intervention necessary for stabilising the earth's climate by 2050. Integrating sustainable healthcare into healthcare professions curricula is a key action to raise awareness. OBJECTIVES: This study aimed to: i) investigate nursing students' attitudes towards and awareness of climate change and sustainability issues and its inclusion in nurse education, ii) explore differences across a range of countries, and iii) compare attitudes in 2019 with those of a similar sample in 2014. DESIGN: A cross-sectional multicentre study. Data were collected through the Sustainability Attitudes in Nursing Survey (SANS_2) questionnaire. SETTINGS: Seven different universities and schools of nursing in five countries (UK, Spain, Germany, Sweden, and Australia). PARTICIPANTS: A convenience sample of first-year undergraduate nursing students. METHODS: The SANS_2 questionnaire was self-administered by nursing students at the seven participating universities at the start of their undergraduate degree, between September 2019 and February 2020. RESULTS: Participants from all seven universities (N = 846) consistently showed awareness and held positive attitudes towards the inclusion of climate change and sustainability issues in the nursing curriculum (M = 5.472; SD: 1.05; min-max 1-6). The relevance of climate change and sustainability to nursing were the highest scored items. Esslingen-Tübingen students scored the highest in the 'inclusion of climate change and sustainability in the nursing curricula'. Students at all universities applied the principles of sustainability to a significant extent at home. Nursing students' attitudes towards climate change and sustainability showed significantly higher values in 2019 (Universities of Plymouth, Brighton, Esslingen-Tübingen, Jaen, Murcia, Dalarna, and Queensland) than in 2014 (universities of Plymouth, Jaen, Esslingen, and Switzerland). CONCLUSIONS: Nursing students have increasingly positive attitudes towards the inclusion of sustainability and climate change in their nursing curriculum. They also recognise the importance of education regarding sustainability and the impact of climate change on health, supporting formal preparation for environmental literacy. It is time to act on this positive trend in nursing students' attitudes by integrating these competencies into nursing curricula.
Subject(s)
Education, Nursing, Baccalaureate , Students, Nursing , Attitude , Attitude of Health Personnel , Climate Change , Cross-Sectional Studies , Humans , Surveys and QuestionnairesABSTRACT
BACKGROUND: An increasing body of evidence has revealed that SARS-CoV-2 infection in pregnant women could increase the risk of adverse maternal and fetal outcomes. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted. Therefore, rapid antibody tests have been suggested as an efficient screening tool during pregnancy. CASES: We analysed the clinical performance during pregnancy of a rapid, lateral-flow immunochromatographic assay for qualitative detection of SARS-CoV-2 IgG/IgM antibodies. We performed a universal screening including 169 patients during their last trimester of pregnancy. We present a series of 14 patients with positive SARS-CoV-2 immunochromatographic assay rapid test result. Immunochromatographic assay results were always confirmed by chemiluminescent microparticle immunoassays for quantitative detection of SARS-CoV-2 IgG and IgM+IgA antibodies as the gold standard. We observed a positive predictive value of 50% and a false positive rate of 50% in pregnant women, involving a significantly lower diagnostic performance than reported in non-pregnant patients. DISCUSSION: Our data suggest that although immunochromatographic assay rapid tests may be a fast and profitable screening tool for SARS-CoV-2 infection, they may have a high false positive rate and low positive predictive value in pregnant women. Therefore, immunochromatographic assay for qualitative detection of SARS-CoV-2 IgG/IgM antibodies must be verified by other test in pregnant patients.
Subject(s)
Antibodies, Viral/immunology , COVID-19 Serological Testing , COVID-19 , Immunoglobulin G/immunology , Immunoglobulin M/immunology , Pregnancy Complications, Infectious , SARS-CoV-2/immunology , Adult , COVID-19/diagnosis , COVID-19/immunology , Female , Humans , Immunoassay , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/immunologyABSTRACT
Desde el punto de vista de la hierofanía de lo sagrado, presente en la obra "Arte de Enfermería para la Asistencia teórico-práctica de los Pobres Enfermos que se acogen a la de los Hospitales de la Sagrada Religión de N.P.S Juan de Dios" (1833), se desvela la conciencia mítico-religiosa del espacio sagrado destinado a la formación de los hermanos enfermeros de la Orden de San Juan de Dios. Para ello se parte de un análisis historiográfico del contexto sociocultural del texto, para adentrarse a continuación en aproximaciones gnoseológicas que nos acercan al paradigma asistencial y educativo que emana de éste. El objetivo es hacer «conciencia histórica» desde la hermenéutica de lo fáctico, analizar la «palabrea» abordando las relaciones inmanentes entre concepto y palabra, entre pensamiento y lenguaje, considerando las conexiones conceptuales como espacios significativos de explicación. En conclusión, se pretende escudriñar la influencia de la Orden a través de sus escritos, contrastando la influencia del desarrollo de un arquetipo de instrucción-profesionalización en la popularización-democratización del arte de cuidar
The hierophany of the sacred, present in the work "Art of Nursing for the Theoretical-Practical Assistance of the Poor Sick who take refuge in the Hospitals of the Sacred Religion of NPS Juan de Dios" (1833), reveals the mythical-religious consciousness of the sacred space destined for the formation of the nursing brothersof the Order of San Juan de Dios. To do this, we start with a historiographic analysis of the sociocultural context of the text, to go further into gnoseological approaches that bring us closer to the welfare and educational paradigm that emanates from it. The objective is to make "historical awareness" from the hermeneutics of the factual, to analyze the "palabrea" by addressing the immanent relations between concept and word, between thought and language, considering the conceptual connections as meaningful spaces of explanation. In conclusion, it is intended to scrutinize the influence of the Order through his writings, contrasting the influence of the development of an archetype of instruction-professionalization in the popularization-democratization of the art of caring
Do ponto de vista do hierophany do sagrado, presente na obra "Arte de Enfermagem para a assistência teórico e prático dos Pobres doente beneficiando dos Hospitais da religião sagrada do NPS Juan de Dios" (1833), revela a consciência mítico-religiosa do espaço sagrado destinado à formação dos irmãos de enfermagem da Ordem de São João de Deus. Para tanto, partimos de uma análise historiográfica do contexto sociocultural do texto, para aprofundar as abordagens gnosiológicas que nos aproximam do paradigma de bem-estar e educação que emana dele. O objetivo é fazer da "consciência histórica" a partir da hermenêutica do factual, analisar a "palabrea", abordando as relações imanentes entre conceito e palavra, entre pensamento e linguagem, considerando as conexões conceituais como espaços significativos de explicação. Em conclusão, pretende-se escrutinar a influência da Ordem através de seus escritos, contrastando a influência do desenvolvimento de um arquétipo de profissionalização-instrução na popularização-democratização da arte de cuidar
Subject(s)
History, 19th Century , History of Nursing , Nursing Care , Hermeneutics , Religion , Hospitals/history , Nurse-Patient RelationsABSTRACT
IMPACT STATEMENT: 3D bioprinting represents a novel advance in the area of regenerative biomedicine and tissue engineering for the treatment of different pathologies, among which are those related to cartilage. Currently, the use of different thermoplastic polymers, such as PLA or PCL, for bioprinting processes presents an important limitation: the high temperatures that are required for extrusion affect the cell viability and the final characteristics of the construct. In this work, we present a novel bioprinting process called volume-by-volume (VbV) that allows us to preserve cell viability after bioprinting. This procedure allows cell injection at a safe thermoplastic temperature, and also allows the cells to be deposited in the desired areas of the construct, without the limitations caused by high temperatures. The VbV process could make it easier to bring 3D bioprinting into the clinic, allowing the generation of tissue constructs with polymers that are currently approved for clinical use.
Subject(s)
Bioprinting/methods , Cartilage/cytology , Chondrocytes/cytology , Bioprinting/instrumentation , Biotechnology/instrumentation , Biotechnology/methods , Cartilage/physiology , Cell Culture Techniques , Cell Proliferation , Cell Survival , Chondrocytes/physiology , Hot Temperature , Humans , Printing, Three-Dimensional/instrumentation , Regeneration , Tissue Engineering/methods , Tissue ScaffoldsABSTRACT
Regenerative medicine and tissue engineering (TE) have experienced significant advances in the development of in vitro engineered skin substitutes, either for replacement of lost tissue in skin injuries or for the generation of in vitro human skin models to research. However, currently available skin substitutes present different limitations such as expensive costs, abnormal skin microstructure and engraftment failure. Given these limitations, new technologies, based on advanced therapies and regenerative medicine, have been applied to develop skin substitutes with several pharmaceutical applications that include injectable cell suspensions, cell-spray devices, sheets or 3Dscaffolds for skin tissue regeneration and others. Clinical practice for skin injuries has evolved to incorporate these innovative applications to facilitate wound healing, improve the barrier function of the skin, prevent infections, manage pain and even to ameliorate long-term aesthetic results. In this article, we review current commercially available skin substitutes for clinical use, as well as the latest advances in biomedical and pharmaceutical applications used to design advanced therapies and medical products for wound healing and skin regeneration. We highlight the current progress in clinical trials for wound healing as well as the new technologies that are being developed and hold the potential to generate skin substitutes such as 3D bioprinting-based strategies.
Subject(s)
Acellular Dermis , Regeneration , Skin Physiological Phenomena , Skin, Artificial , Wound Healing , Biocompatible Materials , Humans , Skin Transplantation , Tissue EngineeringABSTRACT
The success of cell-based approaches for the treatment of cartilage defects requires an optimal autologous cell source with chondrogenic differentiation ability that maintains its differentiated properties and stability following implantation. The objective of this study was to compare the chondrogenic capacity of mesenchymal stem cells (MSCs) isolated from lipoaspirates (ASCs) and the infrapatellar fat pad (IFPSCs) of osteoarthritic patients and treated with transforming growth factor (TGF)-ß family-related growth factors. Cells were cultured for 6 weeks in a 3D pellet culture system with the chimeric activin A/bone morphogenic protein (BMP)-2 ligand (AB235), the chimeric nodal/BMP-2 ligand (NB260) or BMP-2. To investigate the stability of the new cartilage, ASCs-treated pellets were transplanted subcutaneously into severe combined immunodeficiency (SCID) mice. Histological and immunohistochemical assessment confirmed that the growth factors induced cartilage differentiation in both isolated cell types. However, reverse transcription-quantitative PCR results showed that ASCs presented a higher chondrogenic potential than IFPSCs. In vivo results revealed that AB235-treated ASCs pellets were larger in size and could form stable cartilage-like tissue as compared to NB260-treated pellets, while BMP-2-treated pellets underwent calcification. The chondrogenic induction of ASCs by AB235 treatment was mediated by SMAD2/3 activation, as proved by immunofluorescence analysis. The results of this study indicated that the combination of ASCs and AB235 might lead to a cell-based cartilage regeneration treatment.
Subject(s)
Adipose Tissue/pathology , Cell Differentiation/drug effects , Cell Separation , Chondrogenesis/drug effects , Lipectomy , Osteoarthritis/pathology , Stem Cells/pathology , Transforming Growth Factor beta/pharmacology , Aged , Animals , Female , Humans , Male , Mice, SCID , Middle Aged , Phenotype , Smad Proteins/metabolism , Stem Cell TransplantationABSTRACT
The treatment and regeneration of bone defects caused by traumatism or diseases have not been completely addressed by current therapies. Lately, advanced tools and technologies have been successfully developed for bone tissue regeneration. Functional scaffolding materials such as biopolymers and bioresorbable fillers have gained particular attention, owing to their ability to promote cell adhesion, proliferation, and extracellular matrix production, which promote new bone growth. Here, we present novel biofunctional scaffolds for bone regeneration composed of silk fibroin (SF) and ß-tricalcium phosphate (ß-TCP) and incorporating Sr, Zn, and Mn, which were successfully developed using salt-leaching followed by a freeze-drying technique. The scaffolds presented a suitable pore size, porosity, and high interconnectivity, adequate for promoting cell attachment and proliferation. The degradation behavior and compressive mechanical strengths showed that SF/ionic-doped TCP scaffolds exhibit improved characteristics for bone tissue engineering when compared with SF scaffolds alone. The in vitro bioactivity assays using a simulated body fluid showed the growth of an apatite layer. Furthermore, in vitro assays using human adipose-derived stem cells presented different effects on cell proliferation/differentiation when varying the doping agents in the biofunctional scaffolds. The incorporation of Zn into the scaffolds led to improved proliferation, while the Sr- and Mn-doped scaffolds presented higher osteogenic potential as demonstrated by DNA quantification and alkaline phosphatase activity. The combination of Sr with Zn led to an influence on cell proliferation and osteogenesis when compared with single ions. Our results indicate that biofunctional ionic-doped composite scaffolds are good candidates for further in vivo studies on bone tissue regeneration.
Subject(s)
Biocompatible Materials/chemistry , Bone and Bones/drug effects , Calcium Phosphates/chemistry , Fibroins/chemistry , Biocompatible Materials/pharmacology , Biomechanical Phenomena , Bone and Bones/cytology , Bone and Bones/physiology , Cell Differentiation , Fibroins/pharmacology , Humans , Tissue Engineering , Tissue ScaffoldsABSTRACT
The protein kinase R (PKR, also called EIF2AK2) is an interferon-inducible double-stranded RNA protein kinase with multiple effects on cells that plays an active part in the cellular response to numerous types of stress. PKR has been extensively studied and documented for its relevance as an antiviral agent and a cell growth regulator. Recently, the role of PKR related to metabolism, inflammatory processes, cancer and neurodegenerative diseases has gained interest. In this review, we summarise and discuss the involvement of PKR in several cancer signalling pathways and the dual role that this kinase plays in cancer disease. We emphasise the importance of PKR as a molecular target for both conventional chemotherapeutics and emerging treatments based on novel drugs, and its potential as a biomarker and therapeutic target for several pathologies. Finally, we discuss the impact that the recent knowledge regarding PKR involvement in metabolism has in our understanding of the complex processes of cancer and metabolism pathologies, highlighting the translational research establishing the clinical and therapeutic potential of this pleiotropic kinase.
Subject(s)
Energy Metabolism , Neoplasms/metabolism , eIF-2 Kinase/metabolism , Animals , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Apoptosis/genetics , Biomarkers , Energy Metabolism/drug effects , Humans , Neoplasms/drug therapy , Neoplasms/genetics , Protein Kinase Inhibitors/pharmacology , Protein Kinase Inhibitors/therapeutic use , Signal Transduction/drug effects , eIF-2 Kinase/antagonists & inhibitors , eIF-2 Kinase/geneticsABSTRACT
Oncogenic microRNAs (miRs) have emerged as diagnostic biomarkers and novel molecular targets for anti-cancer drug therapies. Real-time quantitative PCR (qPCR) is one of the most powerful techniques for analyzing miRs; however, the use of unsuitable normalizers might bias the results. Tumour heterogeneity makes even more difficult the selection of an adequate endogenous normalizer control. Here, we have evaluated five potential referenced small RNAs (U6, rRNA5s, SNORD44, SNORD24 and hsa-miR-24c-3p) using RedFinder algorisms to perform a stability expression analysis in i) normal colon cells, ii) colon and breast cancer cell lines and iii) cancer stem-like cell subpopulations. We identified SNORD44 as a suitable housekeeping gene for qPCR analysis comparing normal and cancer cells. However, this small nucleolar RNA was not a useful normalizer for cancer stem-like cell subpopulations versus subpopulations without stemness properties. In addition, we show for the first time that hsa-miR-24c-3p is the most stable normalizer for comparing these two subpopulations. Also, we have identified by bioinformatic and qPCR analysis, different miR expression patterns in colon cancer versus non tumour cells using the previously selected suitable normalizers. Our results emphasize the importance of select suitable normalizers to ensure the robustness and reliability of qPCR data for analyzing miR expression.
Subject(s)
MicroRNAs/metabolism , Neoplasms/pathology , Biomarkers, Tumor/genetics , Biomarkers, Tumor/metabolism , Cell Line, Tumor , Computational Biology , Gene Expression Regulation, Neoplastic , Humans , Neoplasms/metabolism , Real-Time Polymerase Chain ReactionABSTRACT
Autologous chondrocyte implantation (ACI) depends on the quality and quantity of implanted cells and is hindered by the fact that chondrocytes cultured for long periods of time undergo dedifferentiation. Here we have developed a reproducible and efficient chondrogenic protocol to redifferentiate chondrocytes isolated from osteoarthritis (OA) patients. We used morphological, histological and immunological analysis together with a RT-PCR detection of collagen I and collagen II gene expression to show that chondrocytes isolated from articular cartilage biopsies of patients and subjected to long-term culture undergo dedifferentiation and that these cells can be redifferentiated following treatment with the chimeric Activin A/BMP2 ligand AB235. Examination of AB235-treated cell pellets in both in vitro and in vivo experiments revealed that redifferentiated chondrocytes synthesized a cartilage-specific extracellular matrix (ECM), primarily consisting of vertically-orientated collagen fibres and cartilage-specific proteoglycans. AB235-treated cell pellets also integrated into the surrounding subcutaneous tissue following transplantation in mice as demonstrated by their dramatic increase in size while non-treated control pellets disintegrated upon transplantation. Thus, our findings describe an effective protocol for the promotion of redifferentiation of autologous chondrocytes obtained from OA patients and the formation of a cartilage-like ECM that can integrate into the surrounding tissue in vivo.
Subject(s)
Activins/metabolism , Bone Morphogenetic Protein 2/metabolism , Cell Differentiation , Chondrocytes/pathology , Activins/genetics , Aged , Animals , Bone Morphogenetic Protein 2/genetics , Cartilage, Articular/metabolism , Cartilage, Articular/pathology , Chondrocytes/transplantation , Collagen/genetics , Collagen/metabolism , Extracellular Matrix/metabolism , Female , Gene Expression , Humans , Immunohistochemistry , Ligands , Male , Mice , Mice, Inbred NOD , Mice, SCID , Middle Aged , Osteoarthritis/pathology , Osteoarthritis/therapy , Proteoglycans/metabolism , Reverse Transcriptase Polymerase Chain Reaction , Time Factors , Transplantation, Autologous , Transplantation, HeterologousABSTRACT
Las diversas series publicadas sobre la prevalencia de las alteraciones tiroideas en las personas con síndrome de Down (SD) muestran una gran dispersión de resultados, aunque todas coinciden en señalar una frecuencia mayor que en la población general. La causa de estas diferencias puede que dependa del método de selección de la muestra. En este trabajo se estudia una población sana de adolescentes con SD, perteneciente a la Asociación de Málaga, seleccionada aleatoriamente, al margen del circuito asistencial. Al valorar la tirotropina (TSH) como parámetro bioquímico para definir la función tiroidea, resulta que la media de la distribución de la población con SD estudiada se sitúa 2 desviaciones estándar por encima de la población general. Estos datos muestran que son dos poblaciones diferentes, por lo que sería necesario definir los criterios de normalidad e hipotiroidismo subclínico, dudoso o patológico, y proponer nuevas pautas para iniciar el tratamiento (AU)
Studies on the prevalence of thyroid disorders in people with Down syndrome (DS) show a wide dispersion of results. However, most of these studies agree in indicating a greater frequency than in the general population. The cause of these differences may depend on the method of sample selection. In this work we studied a healthy population of adolescents with DS of the Association of Málaga, selected randomly and regardless of the medical care. Mean TSH distribution, used here as a tool to define the biochemical thyroid function of the studied DS population, was two standard deviation higher than the mean for the general population. These data show that in terms of TSH the DS population is a distinct population with respect to the general population. This clearly indicates that it would be necessary to identify and define new criteria to establish what is normal, subclinical hypothyroidism, borderline or pathological, and to propose new treatment guide (AU)
Subject(s)
Humans , Male , Female , Adolescent , Thyroid Diseases/metabolism , Thyroid Diseases/pathology , Thyroid Diseases/chemically induced , Thyroid Diseases/diagnosisABSTRACT
OBJECTIVE: Infrapatellar fat pad of patients with osteoarthritis (OA) contains multipotent and highly clonogenic adipose-derived stem cells that can be isolated by low invasive methods. Moreover, nuclear and cytoplasmic cellular extracts have been showed to be effective in induction of cell differentiation and reprogramming. The aim of this study was to induce chondrogenic differentiation of autologous mesenchymal stem cells (MSCs) obtained from infrapatellar fat pad (IFPSCs) of patients with OA using cellular extracts-based transdifferentiation method. DESIGN: IFPSCs and chondrocytes were isolated and characterized by flow cytometry. IFPSCs were permeabilized with Streptolysin O and then exposed to a cell extract obtained from chondrocytes. Then, IFPSCs were cultured for 2 weeks and chondrogenesis was evaluated by morphologic and ultrastructural observations, immunologic detection, gene expression analysis and growth on 3-D poly (dl-lactic-co-glycolic acid) (PLGA) scaffolds. RESULTS: After isolation, both chondrocytes and IFPSCs displayed similar expression of MSCs surface makers. Collagen II was highly expressed in chondrocytes and showed a basal expression in IFPSCs. Cells exposed to chondrocyte extracts acquired a characteristic morphological and ultrastructural chondrocyte phenotype that was confirmed by the increased proteoglycan formation and enhanced collagen II immunostaining. Moreover, chondrocyte extracts induced an increase in mRNA expression of chondrogenic genes such as Sox9, L-Sox5, Sox6 and Col2a1. Interestingly, chondrocytes, IFPSCs and transdifferentiated IFPSCs were able to grow, expand and produce extracellular matrix (ECM) on 3D PLGA scaffolds. CONCLUSIONS: We demonstrate for the first time that extracts obtained from chondrocytes of osteoarthritic knees promote chondrogenic differentiation of autologous IFPSCs. Moreover, combination of transdifferentiated IFPSCs with biodegradable PLGA 3D scaffolds can serve as an efficient system for the maintenance and maturation of cartilage tissue. These findings suggest its usefulness to repair articular surface in OA.
Subject(s)
Chondrocytes/metabolism , Chondrogenesis/physiology , Mesenchymal Stem Cells/metabolism , Osteoarthritis, Knee/metabolism , Cell Transdifferentiation/genetics , Cell Transdifferentiation/physiology , Chondrogenesis/genetics , Collagen Type II/metabolism , Extracellular Matrix/metabolism , Flow Cytometry , Humans , Patella/metabolism , Proteoglycans/metabolism , Tissue ScaffoldsABSTRACT
Objetivos: Presentar nuestros resultados en suprarrenalectomía laparoscópica transperitoneal tras haber realizado 70 procedimientos. Material y métodos: Entre julio de 2002 y diciembre de 2010, 70 pacientes fueron sometidos a suprarrenalectomía laparoscópica transperitoneal con los siguientes diagnósticos: 22 de síndrome de Conn, 18 adenomas no funcionantes, 10 casos de síndrome de Cushing, 7 feocromocitomas, 4 mielolipomas, 6 casos de metástasis tras tratamiento de neoplasia primaria no adrenal, un ganglioneuroma, un hematoma de glándula suprarrenal y un carcinoma suprarrenal. Describimos el tamaño, el tiempo quirúrgico y de hospitalización, la pérdida sanguínea y la necesidad de transfusión, las complicaciones quirúrgicas y la tasa de conversión a cirugía abierta. Resultados: De los 70 pacientes 35 fueron hombres y otras 35 mujeres (1:1) con una edad media de 58,2 años (82,2 - 29,1). La localización predominante fue la izquierda (58%) frente a la derecha (42%). Con un tamaño medio de la pieza quirúrgica de 5,11cm, el tiempo quirúrgico promedio fue de 119,2 minutos (50 - 240) y el sangrado operatorio medio de 140,6 cc (30 - 800), precisando tan sólo en tres pacientes transfusión sanguínea. El período promedio para alimentación oral fue de 17 horas y la estancia media hospitalaria fue de 4,3 días (15 - 2). Como complicaciones observamos dos casos de infecciones quirúrgicas, un íleo paralítico prolongado, un caso de laceración esplénica y otro de perforación intestinal; ambos precisaron reconversión a cirugía abierta (4,28%). Conclusiones: La suprarrenalectomía por vía laparoscópica es una técnica quirúrgica segura, con un bajo porcentaje de complicaciones y que precisa breve estancia hospitalaria. La elección de esta vía de acceso dependerá de la experiencia individual del cirujano, teniendo en cuenta tanto la etiología como el tamaño de la lesión en cada caso (AU)
Objectives: To present our results with transperitoneal laparoscopic adrenalectomy after completion of 70 procedures. Material and Methods: Between July 2002 and December 2010, transperitoneal laparoscopic adrenalectomy was performed in 70 patients with the following diagnoses: Conn syndrome (22 cases), nonfunctioning adenomas (18), Cushing syndrome (10), pheochromocytomas (7), myelolipomas (4), metastasis after treatment of primary nonadrenal tumors (6), ganglioneuroma (1), adrenal gland hematoma (1) and adrenal carcinoma (1). We describe the size, surgical and hospitalization times, blood loss, need for transfusion, surgical complications and rate of conversion to open surgery. Results: Of 70 patients, 35 were men and 35 women (1:1) with a mean age of 58.2 years (range, 82.2- 29.1). The most common site was left (58%) compared to right (42%). The mean size of the surgical specimen was 5.11cm, mean surgical time was 119.2minutes (50-240) and mean operative bleeding was 140.6 (30-800) cc. Only 3 patients required blood transfusion. The mean time until oral feeding was 17hours, and the mean hospital stay was 4.3 (2-15) days. Complications included 2 cases of surgical infections, 1 of prolonged paralytic ileus, and 1 of splenic laceration and 1 of intestinal perforation which both which required reconversion to open surgery (4.28%). Conclusions: Laparoscopic adrenalectomy is a safe procedure, with a low percentage of complications and a short hospital stay. The choice of this approach will depend on the surgeon's experience with the lesion etiology and size in each case (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Adrenalectomy/methods , Adrenalectomy , Laparoscopy/methods , /statistics & numerical data , Cushing Syndrome/complications , Myelolipoma/complications , Ganglioneuroma/complications , Carcinoma/complications , Adrenalectomy/instrumentation , Adrenocortical Adenoma/complications , Adrenocortical Adenoma/surgery , Postoperative Complications/diagnosis , Postoperative Complications/therapyABSTRACT
OBJECTIVES: To present our results with transperitoneal laparoscopic adrenalectomy after completion of 70 procedures. MATERIAL AND METHODS: Between July 2002 and December 2010, transperitoneal laparoscopic adrenalectomy was performed in 70 patients with the following diagnoses: Conn syndrome (22 cases), nonfunctioning adenomas (18), Cushing syndrome (10), pheochromocytomas (7), myelolipomas (4), metastasis after treatment of primary nonadrenal tumors (6), ganglioneuroma (1), adrenal gland hematoma (1) and adrenal carcinoma (1). We describe the size, surgical and hospitalization times, blood loss, need for transfusion, surgical complications and rate of conversion to open surgery. RESULTS: Of 70 patients, 35 were men and 35 women (1:1) with a mean age of 58.2 years (range, 82.2- 29.1). The most common site was left (58%) compared to right (42%). The mean size of the surgical specimen was 5.11 cm, mean surgical time was 119.2 minutes (50-240) and mean operative bleeding was 140.6 (30-800) cc. Only 3 patients required blood transfusion. The mean time until oral feeding was 17 hours, and the mean hospital stay was 4.3 (2-15) days. Complications included 2 cases of surgical infections, 1 of prolonged paralytic ileus, and 1 of splenic laceration and 1 of intestinal perforation which both which required reconversion to open surgery (4.28%). CONCLUSIONS: Laparoscopic adrenalectomy is a safe procedure, with a low percentage of complications and a short hospital stay. The choice of this approach will depend on the surgeon's experience with the lesion etiology and size in each case.
Subject(s)
Adrenalectomy/methods , Laparoscopy/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Peritoneum , Retrospective StudiesABSTRACT
BACKGROUND: Gene therapy is a new method used to induce cancer cell differentiation. Our group previously showed that transfection of the gef gene from Escherichia coli, related to cell-killing functions, may be a novel candidate for cancer gene therapy. Its expression leads to cell cycle arrest unrelated to the triggering of apoptosis in MS-36 melanoma cells. OBJECTIVES: To determine the basis of the antiproliferative effect of the gef gene in this cell line. METHODS: Transmission electron microscopy, apoptosis analysis by confocal microscopy, flow cytometry and immunocytochemical analysis were used. RESULTS: Ultrastructural analysis showed a strikingly different morphology after treatment with dexamethasone and expression of the gef gene, with large accumulations of pigment throughout the cell cytoplasm and presence of melanosomes in different stages of development. High mitochondrial turnover and myeloid bodies, characteristics of neurone cells, were also observed. In addition, both immunocytochemical and indirect immunofluorescence analysis demonstrated a significant decrease in HMB-45, Ki-67 and CD44 antigen expression and an increase in S100 and p53 expression in gef gene-transfected MS-36 melanoma cells that were correlated with the duration of dexamethasone treatment. In the present work, we report that gef gene not only reduces cell proliferation in transfected melanoma MS-36TG cell line but also induces morphological changes clearly indicative of melanoma cell differentiation and a reduction in tumour malignancy. CONCLUSIONS: These findings support the hypothesis that the gef gene offers a new approach to differentiation therapy in melanoma.
Subject(s)
DNA-Binding Proteins/genetics , Melanoma/genetics , Skin Neoplasms/genetics , Transcription Factors/genetics , Apoptosis , Cell Differentiation/genetics , Cell Proliferation , Dexamethasone/pharmacology , Humans , Hyaluronan Receptors/metabolism , Melanoma/pathology , Melanoma/ultrastructure , Microscopy, Confocal , Microscopy, Electron , Neoplasm Proteins/genetics , Skin Neoplasms/pathology , Skin Neoplasms/ultrastructure , Transfection , Tumor Cells, CulturedABSTRACT
Development of the European Higher Education Area is linked to the adoption of a new educational model. Thus, in the Health Sciences, basic science knowledge must be integrated with the clinical skills that students will require in their professional activity. The Anatomy and Embryology Teaching Investigation Group at our university (UGR-N-40-UCUA) designed a specific questionnaire to analyse specific items that affect Anatomy learning. It also developed a teaching methodology for the acquisition of anatomic knowledge, integrating theory and practice, including individual and collective tasks for students and leading to future self-learning. Analyses were performed in different groups of first-year students at the School of Medicine of Granada University, School of Nursing of Almería University and School of Physiotherapy of Jaén University. It was found that application of this teaching methodology achieved an improvement in two areas considered essential by these students, i.e. a better understanding of several aspects of the study subject, and greater satisfaction with their acquisition of anatomic and embryologic knowledge (AU)
No disponible
Subject(s)
Female , Humans , Male , Education, Medical/methods , Education, Medical/trends , Health Sciences/education , Anatomy/education , Anatomy/trends , Curriculum/trends , Cardiology/education , Cardiology/methods , Cardiology/trendsABSTRACT
Within the three-year nursing degree course in Spain, the way in which anatomy teaching is organised shows distinct differences between different universities. At the University of Jaén, first-year students have human anatomy (HA) as a separate subject, whereas at the University of Almeria, anatomy is included within a larger module called the structure and function of the human body (SFHB). The aim of this study was to analyze the reaction of students to the organization of their anatomy courses, the resources used in their teaching, their contents, and the tutoring and evaluation system. For this purpose, a 35-item questionnaire was designed to address aspects related to these objectives and administered at the end of the 2005-6 academic year to 82 students of taking human anatomy at the University of Jaén and 52 students taking structure and function of human body at the University of Almeria. Results obtained showed differences in the evaluation of the educational organization of these subjects at the two universities. The approval rating of Jaen students for the relationship between their theoretical and practical education/training was 25% lower than that of Almeria students. This difference appears to be related to the different distributions of credits between the two subjects in the courses surveyed. Students appeared more highly to value the resources that were most frequently used during the course, suggesting that students may value most highly those resources employed most frequently within a course. There were some similarities between the students at the different universities in the importance they assigned to the different thematic units of the respective subjects. Finally, both groups revealed a preference for face-to-face tutorial sessions and for evaluation by written examinations (AU)
No disponible
Subject(s)
Female , Humans , Male , Anatomy/education , Anatomy/methods , Teaching/methods , Teaching/trends , Digestive System/anatomy & histology , Students/classificationABSTRACT
The integration of the Spanish university system within the European Higher Education Area implies a change in the current educational model towards a more flexible system that establishes the equivalence of degrees and encourages greater competition among courses. In this system, students will be expected to make a greater contribution to real learning in order for it to be more useful in their future professional activity. These changes will involve new student-teacher relationships, new methodologies, new teaching strategies and different evaluation systems. The success of this project will depend on a thorough knowledge of the present state of the courses that we teach. This is the first study to address the current state of human anatomy and embryology learning in the physiotherapy degree course. The analysis was performed in first-year students and focussed on the subject designated the structure and function of the human body, skeletal and muscle system anatomy at the Universities of Almería and Jaén. Student opinions were sought on the appropriateness of these subjects to their degree, on the methods used in practice and theory classes and on the evaluation and tutorial systems. Results obtained were similar between the two universities included in this study and indicated that: 1) students have a good opinion of the usefulness of the subject contents in human anatomy and embryology, 2) students prefer the new technologies to traditional educational systems, and 3) students have a positive appreciation of written examination versus oral examination or continuous continuous assessment. These findings will assist teachers of anatomy and embryology to establish approaches to improve the quality of learning in the setting of the European Higher Education Area (AU)
No disponible
Subject(s)
Female , Humans , Male , /methods , Physical Therapy Specialty/education , Anatomy/education , Anatomy/methods , Embryology/education , Muscles/anatomy & histologyABSTRACT
Anatomy has been classically considered as a basic foundation for the teaching of medicine, developing a decisive role in medical education and for future professional activity. But, in common with other scientific disciplines, it has grown simultaneously with technology and communication sciences and in a much prescribed manner. The purpose of our study was to estimate different parameters related to the quality of the anatomical teaching at the University of Granada. In trying to achieve this, we have focused on the Human Anatomy I and II courses (given in the first and second years of the medical degree respectively). Once the examinations in these courses were completed, a questionnaire was filled by the students in which they had to estimate, in a one to five range, the adaptation and the adjustment of different aspects related to the development of the course. The results indicated that the students were in favour of practical classes compared to theoretical tuition. On the other hand, the pedagogical organisation of the courses was highly valued by the students, particularly in relation to the adaptation of programme objectives and to the recommended bibliography (both for textbooks and atlases). The best estimated didactic resource for the practical aspect of the subject was the use of human anatomical specimens, and the most favoured procedure in the theoretical classes was the use of the blackboard. For the examinations and assessments, no special preference for any evaluation method was found, but the use of complementary papers (e.g. use of monographs, oral expositions) was considered by the students to be of very little importance (AU)
No disponible
Subject(s)
Female , Humans , Male , Learning/ethics , Anatomy/education , Anatomy/ethics , Societies/ethics , Societies/methods , Spain/ethnology , Learning/classification , Anatomy/instrumentation , Anatomy/methods , Societies/legislation & jurisprudence , Societies/policiesABSTRACT
The clustering of type A gamma-aminobutyric acid receptors (GABA(A)R) at discrete and functionally significant domains on the nerve cell surface is an important determinant in the integration of synaptic inputs. To discern the role that the subunits of the GABA(A)R play in determining the receptor's cell surface topography and mobility, the alpha1, beta1, beta3, and gamma2s subunits were transfected into COS7, HEK293, and PC12 cells and the distribution and cell surface mobility of these recombinant receptors were examined. Our results show that alpha1 subunits are retained in the endoplasmic reticulum while beta1 and beta3 subunits are sorted to the plasma membrane where they form clusters. Co-expression and co-assembly of alpha1 and beta3 subunits result in the rescue of intracellular alpha1 subunits, which are transported as alphabeta subunit complexes to the cell surface where they formed clusters. Fluorescence photobleach recovery and single particle tracking of recombinant receptors show that, despite clustering, beta3 subunit homooligomers are mobile within a cell surface domain. Inclusion of alpha1 in beta3 or beta3gamma2s complexes, however, dramatically reduces the receptor's lateral mobility in COS 7 and PC12 cells and anchors GABA(A)Rs on the cell surface, suggesting the formation of a direct link to a component of the cytoskeleton. The mobility of recombinant receptors that include the alpha1 subunit mirrors the mobility of GABA(A)Rs on cell bodies and dendrites of cortical and spinal cord neurons. The results suggest that incorporation of alpha1 subunits give rise to a population of GABA(A)Rs that are immobilized on the cell surface.
