[Quality of healthcare in oncological patients from health personnel's perspective]. / Calidad de la atención en pacientes oncológicos desde la perspectiva del personal de salud.

INTRODUCTION: The quality of care in health institutions is a constant challenge, mainly in oncology. The literature shows it has partially evaluated in contrast to it proposed by Donabedian; in addition, health personnel's perspective, who has direct contact with the patient, knows and executes the care process, has not been considered. The objective of the present study was to establish a framework to evaluate the quality of healthcare provided to patients with colorectal or ovarian cancer from health personnel's perspective. MATERIAL AND METHODS: Cross-sectional study that included health personnel belonging to nine services of a cancer hospital. A questionnaire was applied to evaluate the quality of healthcare through amenities, the interpersonal and scientific-technical dimension (Donabedian's model). The variables were standardized, compliance with them among services was compared using non-parametric tests (Kruskal-Wallis test and Mann-Whitney U test), and 40 indicators were evaluated. RESULTS: Health personnel's 181 members participated, the evaluated oncology hospital presented regular compliance to the quality of healthcare (bad ≤82, regular 83-109, good ≥110). When comparing this in the nine services, differences were detected between surgery and radiotherapy (higher compliance scores, 132 and 126 respectively) versus the other services P<.05. Both services had more than 25 indicators with compliance ≥80%. CONCLUSIONS: It is shown that the established framework is useful for evaluating the quality of healthcare from health personnel's perspective (an approach not used so far for this type of evaluation), by detecting differences in its compliance, specific problems and its causes by service.

Chronic atrazine exposure increases the expression of genes associated with GABAergic and glutamatergic systems in the brain of male albino rat.

The herbicide atrazine (ATR; 2-chloro-4-ethylamino-6-isopropylamino-s-triazine) is widely used to destroy grasses and broadleaf weeds in crops and some fruits. Studies in rodents have shown that acute, repeated or chronic exposure to ATR is associated with alterations in the nigrostriatal dopaminergic pathway, whereas its effects on GABAergic and glutamatergic pathways have only recently been reported. Sprague-Dawley male rats were exposed daily to 1 or 10 mg ATR/kg of BW for 13 months to evaluate the ATR effects on GABAergic and glutamatergic systems. At the end of the ATR treatment, the levels of mRNA of several genes involved in the production, vesiculation, reuptake, and receptors of GABA and Glu in the striatum (STR), nucleus accumbens (NAcc), prefrontal cortex (PFC), ventral midbrain (vMID) and hippocampus (HIPP) were evaluated by absolute qPCR. For the GABAergic genes, increased expression of GAD67 and Slc32a1 in STR and/or vMID in rats exposed to 1 and/or 10 mg ATR were detected. With regard to the expression of genes involved in the glutamatergic system, Slc17a6 and Grin1 in HIPP of rats exposed to 1 and/or 10 mg ATR, increased as was Gria1 in STR and PFC in the group exposed to 1 mg ATR. In the same fashion, Slc1a3 expression and MGLUR1 increased in STR of rats exposed to 1 and 10 mg ATR groups. The expression of the glutaminases gls (variants 1 and 2) was greater in STR, NAcc, HIPP, and PFC of rats exposed to 1 and/or 10 mg ATR. These findings show that the GABAergic and, especially glutamatergic systems are targets of ATR exposure.

Potencia muscular y cinética de lactato en sangre entre genotipos de ACTN3 / Muscle Power and Blood Lactate Kinetics Among ACTN3

En este trabajo se estudiaron las diferencias en la potencia muscular y la cinética de las concentraciones de lactato en sangre ([LA-]b) entre genotipos de ACTN3 durante la prueba anaeróbica de Wingate, (PAnW). Participaron 35 voluntarios (18-35 años) masculinos, sanos y físicamente activos. Se analizaron la potencia muscular, las concentraciones de [LA-]b y la actividad de la Lactato Deshidrogenasa (LDH). El gen ACTN3 se determinó a partir de ADN de glóbulos blancos en sangre periférica. Independientemente del peso y masa muscular de los participantes, los portadores del genotipo RR vs. RX y XX desarrollaron mayor potencia muscular durante la PAnW (p<0.05), lo cual sugiere una mayor capacidad en este genotipo para utilizar el sistema ATP-PC durante un ejercicio supramáximo. La cinética en la potencia muscular y en las concentraciones de [LA-]b fueron semejantes entre genotipos. La PAnW no fue suficiente para causar daño muscular observado por la concentración de LDH. (AU)

In this work, the differences in the muscle power and the kinetics of blood lactate concentrations ([LA-]b) between ACTN3 genotypes were studied during the Wingate anaerobic test (PAnW). Thirty-five healthy and physically active male volunteers (18-35 years old) participated. Muscle power, [LA-] b concentrations, and Lactate Dehydrogenase (LDH) activity were analyzed. The ACTN3 gene was determined from the DNA of white blood cells in peripheral blood. Regardless of the participants' weight and muscle mass, carriers of the RR genotype vs. RX and XX developed greater muscle power during PAnW (p <0.05), suggesting a greater capacity in this genotype to use the ATP-PC system during supramaximal exercise. The kinetics in muscle power and in [LA-]b concentrations were similar between genotypes. PAnW was not enough to cause muscle damage seen by LDH concentration. (AU)

[Adverse events and essential actions for patient safety]. / Eventos adversos y acciones esenciales para la seguridad del paciente.

INTRODUCTION: The adverse events (AE) in hospitalized patients occur with increasing frequency due to the increase in complexity of medical care, which implies a greater risk of committing a human error inherent to the care, constituting a serious threat to the safety of the patient. MATERIAL AND METHODS: Cross-sectional study, including patients older than 16years, with hospital stay longer than 24h and discharge from the general surgery service, patients treated in emergency observation units or other hospital services were not considered. AE were identified, classified by cause according to the essential actions for patient safety (EAPS), and compliance with the EAPS was verified. RESULTS: 352 clinical records were reviewed, 61 (17%) were positive on screening. Of the positives, 66% resulted in AE (47 cases). The prevalence of AE was 13%. The AE were: 40% related to procedures; 39% with infections; 17% with medication; 4% with patient identification. The EAPS with the best rating was EAPS5 and the lowest rating was EAPS4. The night shifts with the greatest opportunity area, only with 40% and 44% correct procedures. CONCLUSIONS: The study shows that the two methodologies used, one to identify AE and the other to establish its causes and classification according to the EAPS, demonstrated usefulness and synergy for patient safety, when detecting AE, as well as determining their causes and evaluate compliance with the EAPS.

Percepción de Enfermería de equipos movilizables sobre los cuidados críticos y urgencias del paciente pediátrico / Perception by the Mobile Team Nurses about Critical and Emergency Care for paediatric patients

Objetivo: explorar la vivencia en relación con la atención de avisos pediátricos de los profesionales de Enfermería de los equipos movilizables de los Servicios de Cuidados Críticos y Urgencias de Sevilla, así como describir la formación y dificultades que perciben.Método: estudio cualitativo fenomenológico realizado entre enero y junio de 2020. Se incluyó a enfermeros/as de los equipos movilizables con al menos seis meses de experiencia. Fueron seleccionados por conveniencia y contactados a través de la coordinadora del servicio. Se hicieron entrevistas individuales semiestructuradas por videoconferencia que se grabaron y transcribieron junto a las notas de campo. Se llevó a cabo un análisis de contenido en función de las categorías preestablecidas con ayuda del software NVivo 12.Resultados: participaron nueve enfermeras (cinco mujeres y cuatro hombres; la mitad de ellos con experiencia superior a cinco años). Las categorías finales fueron: características del niño, frecuencia de la atención pediátrica e inseguridad en la atención pediátrica, estrés; dificultades y preparación previa a la asistencia.Conclusión: los participantes percibieron la asistencia urgente en la edad pediátrica como infrecuente, compleja y estresante debido a las características infantiles. El estrés se relacionó con las competencias profesionales, adquiridas mediante la formación y la experiencia, la presencia de familiares, el equipo de trabajo y la condición de madre o padre. Las dificultades se relacionaron con cuestiones técnicas, el componente emocional y la comunicación.(AU)

Objective: to explore the experiences regarding paediatric alerts by Nursing professionals in the Critical and Emergency Care Unit of Seville mobile teams, as well as to describe their training and the challenges perceived.Method: a qualitative phenomenological study conducted between January and June, 2020, which included mobile team nurses with at least 6-month experience. They were selected by convenience, and contacted through the unit coordinator. Individual semi-structured interviews were conducted through videoconference, which were recorded and transcribed together with fieldwork notes. Content analysis was made based on the pre-established categories, aided by the NVivo 12 software.Results: the study involved nine nurses (five women and four men; half of them with over five years of experience). The final categories were: child characteristics, frequency of paediatric care and insecurity in paediatric care, stress; difficulties and preparation before care.Conclusion: the participants perceived emergency care in paediatric ages as infrequent, complex, and stressful, due to the characteristics of children. Stress was associated with professional skills, acquired through training and experience, the presence of relatives, the work team, and the status of being a parent. Challenges were associated with technical issues, the emotional component, and communication.(AU)

Paciente afectado de psoriasis, quien desarrolla una enfermedad ampollar intercurrente: a propósito de un caso

RESUMEN La asociación y coexistencia de psoriasis en placas y penfigoide ampollar (Psoriasis-PA) es una variante clínica poco frecuente. Predomina en el sexo masculino, después de los 60 años de edad. En general, los pacientes ya cuentan con el antecedente de psoriasis y posteriormente se agrega la enfermedad ampollar, con un intervalo promedio de 20 años. Aunque la etiopatogenia aún no se encuentra del todo establecida, se identifican factores desencadenantes tales comoPUVA, fármacos e infecciones. Las opciones terapéuticas consisten en esquemas de monoterapia obiterapia con asociación de corticoesteroides orales e inmunosupresores como el metotrexato (MTX) con evolución favorable en la mayoría de los casos. Se presenta el caso de un paciente masculino, de 52 años de edad con psoriasis vulgar de tres años de evolución y lareciente aparición de penfigoide ampollar.

ABSTRACT The association and coexistence of plaque psoriasis and bullous pemphigoid is a rare clinical variant. It predominates in the male sex, after 60 years old. In general, patients already have a history of psoriasis and then bullous disease is added, with an average interval of 20 years. Although the pathogenesis is not yet fully established, it identifies triggers such as PUVA, drugs, and infections. Therapeutic options consist of monotherapy or combination regimens of systemic corticosteroids and other immunosuppressants such as methotrexate, with favorable evolution in most cases. We present the case of a 52-year-old male patient with 3-year history of vulgar psoriasis and recent appearance of bullous pemphigoid.

Physicochemical characterization of protein isolates of amaranth and common bean and a study of their compatibility with xanthan gum.

Vegetables are considered to be a sustainable source of promising biomaterials such as proteins and polysaccharides. In this study, four protein isolates (amaranth protein isolate API, amaranth globulin-rich protein isolate AGR, bean protein isolate BPI, and bean phaseolin-rich protein isolate BPR) were structurally characterized under different pH conditions (2-12) and their compatibility behavior with xanthan gum (XG) in aqueous medium was described. All protein isolates showed ß turn and ß sheet (78.24-81.11%), as the major secondary structures without statistically significant difference under the pH conditions surveyed. Protein isolates show solubility at pH ≤ 3 (40.4-85.1%) and pH ≥ 8 (57.6-99.9%) and surface hydrophobicity results suggest protein denaturation at pH ≤ 3. In the compatibility study, API/XG ratios between 1:1 and 5:1 at pH from 7 to 9 and the BPI/XG ratios from 1:1 to 20:1 at pH 7 form gels that do not require heating nor crosslinking agent addition. Zeta potential results, on the other hand, evidenced that formation of gels is driven by attractive electrostatic interaction of the charged regions of both biopolymers and intermolecular interactions such as hydrogen bonds.

Electrical Cochlear Response as an Objective Measure of Hearing Threshold and Hearing Performance Evaluation in Pediatric Cochlear Implant Users / Respuesta Coclear Eléctrica como Medida Objetiva del Umbral Auditivo y la Evaluación del Rendimiento Auditivo en Usuarios Pediátricos de Implante Coclear

ABSTRACT The difficulties of applying the audiometry in pediatric populations and its methodological limitations in implanted patients have spurred the development of new alternative auditory evaluation methods. This study aimed to show an objective method to estimate hearing thresholds in pediatric cochlear implanted patients through Electrical Cochlear Response (ECR) and to quantify the hearing performance by using an Auditory Skills Questionnaire (ASQ) and a Calibrated Sounds Test (CST) designed on purpose. Eighteen implanted patients, 1-6 years old underwent standard audiometry, ECR, and ASQ in two evaluation sessions T1 and T2. At T2, in addition, patients underwent CST. For patients ≤3 years old (G1), Pure Tone Averages (PTA and PTAECR)showed a statistically significant difference between them at T1 and T2. At T2 improvements in audiometric and ECR thresholds were observed (p<0.05), regarding T1. Patients older than 3 years (G2) had significantly better ASQ and CST scores. CST detection scores at 40 dBHL for groups G1 and G2, 36% and 70% respectively, showed a better relationship to ECR thresholds. The relationship observed between ECR thresholds and CST detection scores seems to confirm that ECR brings the feasibility of objective hearing threshold estimation and provides a better frequency resolution than audiometry.

RESUMEN Las dificultades para la aplicación de la audiometría en la población pediátrica además de sus limitaciones metodológicas en pacientes usuarios de implante coclear, señalan la necesidad de métodos audiométricos alternos. En el presente trabajo se utiliza el potencial eléctrico, denominado Respuesta Coclear Eléctrica (ECR) observado solamente en usuarios de implante coclear, para la estimación de umbrales auditivos prescindiendo de la participación consiente del paciente, además de evaluar el desempeño auditivo mediante un Cuestionario de Habilidades Auditivas (ASQ) y la Prueba de Sonidos Calibrados (CST). A dieciocho participantes de 1 a 6 años, se les practicó Audiometría, ECR y ASQ en dos sesiones, T1 y T2; adicionalmente, en T2 se aplicó CST. En T1 y T2 los promedios de tonos puros, PTA y PTAECR, de pacientes ≤ 3 años (G1), mostraron una diferencia estadísticamente significativa entre ellos. En T2 los umbrales audiométricos y ECR (p <0.05), mejoraron respecto de T1. Pacientes > 3 años (G2) lograron puntuaciones ASQ y CST significativamente mejores. Los puntajes de detección CST a 40 dBHL, G1(36%) y G2(70%), mostraron mejor relación con los umbrales ECR. Esta relación entre los umbrales ECR y los puntajes de detección CST indican que la ECR permite estimar el umbral de audición, logrando adicionalmente mayor resolución en frecuencia que la audiometría.

Brain alterations in GABA, glutamate and glutamine markers after chronic atrazine exposure in the male albino rat.

Atrazine (ATR; 2-chloro-4-ethylamino-6-isopropylamino-s-triazine) is an herbicide widely used to kill annual grasses and broadleaf weeds in crops such as corn, sorghum, and sugarcane. Studies in rodents have shown that chronic ATR exposure is associated with alterations in the nigrostriatal dopaminergic pathway such as hyperactivity, decreased striatal dopamine levels, and diminished numbers of tyrosine hydroxylase positive cells in substantia nigra pars compacta. However, the effects of ATR on neurotransmitters such as GABA and glutamate have been scarcely studied. To evaluate the impact of ATR on motor and anxiety tasks, tissue levels of GABA, glutamate, glutamine, and extracellular and potassium-evoked release of glutamate in the striatum, we daily exposed Sprague-Dawley male rats to 1 or 10 mg ATR/kg of body weight for 12-14 months. As previously reported, chronic ATR exposure causes hyperactivity in the group exposed to 10 mg ATR/kg and increased anxiety in both groups exposed to ATR. GABA, glutamate, and glutamine levels were differentially altered in brain regions related to nigrostriatal and mesolimbic systems, the amygdala, and the prefrontal cortex. The groups exposed to 10 mg ATR/kg showed increased extracellular levels and release of glutamate in the striatum. These neurochemical alterations could underlie the behavioral changes observed in rats. These results indicate that chronic exposure to the herbicide ATR disrupts the neurochemistry of several brain structures and could be a risk factor for the development of neurodegenerative diseases.

Efecto del ejercicio agudo sobre la filtración glomerular de adultos mayores / Acute Exercise Effect on Glomerular Filtration in the Elderly

INTRODUCCIÓN: Existe una disminución de la Filtración Glomerular (FG) en adultos mayores y la práctica del ejercicio puede causar cambios en la función renal. OBJETIVO: Evaluar el efecto de diferentes intensidades de ejercicio agudo sobre la filtración glomerular en adultos mayores. MÉTODO: 20 adultos mayores aparentemente sanos de 69,8 ± 4 años realizaron 3 pruebas de ejercicio físico: máxima y 2 sub-máximas (80% y 60%). Se colectaron muestras de sangre venosa para estimar la filtración glomerular por creatinina, antes y después del ejercicio. RESULTADOS: Se observó una disminución significativa post-ejercicio en la filtración glomerular, estimada a partir de creatinina sérica en las pruebas máxima y sub-máxima a 80% (p < 0,05). CONCLUSIÓN: El ejercicio físico agudo máximo y sub-máximo al 80% de intensidad en adultos mayores aparentemente sanos, provoca una disminución de la filtración glomerular

INTRODUCTION: There is a decrease in Glomerular Filtration Rate (GFR) in older adults and the exercise practice may lead to changes in renal function. Purpose: To evaluate the effect of different intensities of acute exercise on elderly population GFR. METHODS: 20 apparently healthy older adults (69,8 ± 4 years) performed 3 exercise tests a week apart: one maximal and 2 submaximal (80% and 60%). Blood samples were collected to determine serum creatinine and to estimate GFR, before and after each exercise test. RESULTS: A significant post-exercise decline in GFR, estimated from serum creatinine values, was observed in the maximal and submaximal 80% tests (p <0,05). CONCLUSION: Maximum and sub-maximum acute physical exercise at 80% intensity causes a decrease in glomerular filtration in apparently healthy older adults

Molecular analysis of three Clostridium difficile strain genomes isolated from pig farm-related samples.

Clostridium difficile is an anaerobic spore-forming bacillus that usually causes gastrointestinal disorders in man and other animal species. Most of the strains isolated from animals are toxigenic being the virulent ribotype (RT) 078 predominant in several animal species. Although C. difficile is pathogenic to both humans and animals, there is no direct evidence of zoonosis. Deep genome sequencing provides sufficient resolution to analyse which strains found in animals might be related to human pathogens. So far, there are only a few fully sequenced genomes of C. difficile strains isolated from domestic and wild animals. Using Illumina technology, we have sequenced the genome of three isolates; a strain isolated from the vagina of a sow (5754), one from rat (Rattus spp) intestinal content (RC10) and a third one isolated from environmental rat faeces (RF17). Both, rat and rat faeces were sampled in fattening pig farms. Our study reveals a close genetic relationship of two of these isolates with the virulent strain M120 (RT078) isolated from a human patient. The analysis of the sequences has revealed the presence of antibiotic resistance genes, mobile elements, including the transposon linked with virulence Tn6164, and the similarity of virulence factors between these isolates and human strains. This is the first study focused on the sequencing of C. difficile genomes obtained from wild animals like rats, which can be considered as potential reservoirs for humans and other animal species. This study can help to understand the genome composition and epidemiology of this bacterium species.

Presence of Clostridium difficile in pig faecal samples and wild animal species associated with pig farms.

AIMS: To determine the presence of Clostridium difficile on fattening pig farms in north-eastern Spain. METHODS AND RESULTS: Twenty-seven farms were sampled. Pools of pig faecal samples (n = 210), samples of intestinal content from common farm pest species (n = 95) and environment-related samples (n = 93) were collected. Isolates were tested for toxin genes of C. difficile, and typed by PCR-ribotyping and toxinotyping. The minimal inhibitory concentrations of six antimicrobial agents were determined using Etest. Thirty-four isolates were obtained from 12 farms, and 30 (88·2%) had toxin genes. Seven ribotypes were identified. Ribotype 078 and its variant 126 were predominant (52·9%). The same ribotypes were isolated from different animal species on the same farm. None of the isolates were resistant to metronidazole or vancomycin. CONCLUSIONS: Clostridium difficile was common within the pig farm environment. Most of the positive samples came from pest species or were pest-related environmental samples. SIGNIFICANCE AND IMPACT OF THE STUDY: Pest species were colonized with toxigenic and antimicrobial-resistant C. difficile strains of the same ribotypes that are found in humans and pigs. Rodents and pigeons may transmit toxigenic and antimicrobial-resistant C. difficile strains that are of the same ribotypes as those occuring in humans.

Behavioral effects and neuroanatomical targets of acute atrazine exposure in the male Sprague-Dawley rat.

Atrazine (ATR) is an herbicide broadly used in the world to control weeds in corn and sorghum fields, and it is potentially toxic for the dopaminergic system. Alterations in dopaminergic markers after ATR administration in rats and C57BL/6 mice have been reported. Behaviorally, it has been observed that ATR exposure causes hypoactivity shortly after its administration. To understand how acute ATR administration induces hypoactivity, we set out to map the brain areas responsive to ATR using c-Fos as a marker of neuronal activity, and tyrosine hydroxylase (TH) as a marker of dopaminergic neurons. The levels of glutamate and gamma-aminobutyric acid (GABA) were measured using high performance liquid chromatography, and spontaneous locomotor activity was evaluated as well. Male Sprague-Dawley rats received a systemic injection of 1% methyl cellulose (vehicle) or 100mg ATR/kg body weight to evaluate locomotor activity immediately after injection, c-Fos and TH immunohistochemistry in forebrain, midbrain and hindbrain, or glutamate and GABA content in various brain areas 90min after injection. To assess the possible involvement of the GABAergic system on ATR effects we tested the effects of a GABA-B antagonist. We found statistically significant decreases in locomotor activity, which were partially reversed by the GABA-B antagonist, and increases in the number of c-Fos-positive cells in thalamus, central amygdala, subthalamic nucleus, superior colliculus, and substantia nigra, TH positive cells were not selectively activated by ATR. The acute administration of ATR did not affect GABA or glutamate tissue levels but significantly decreased locomotor activity. These results corroborate the hypoactivity-inducing effect of ATR, and show that non-dopaminergic cells respond to the acute administration of ATR. The activation of cell populations in the basal ganglia and their target nuclei may contribute to the acute behavioral effects of ATR.

Systemic Amyloid A Amyloidosis in Island Foxes (Urocyon littoralis): Severity and Risk Factors.

Systemic amyloid A (AA) amyloidosis is highly prevalent (34%) in endangered island foxes (Urocyon littoralis) and poses a risk to species recovery. Although elevated serum AA (SAA) from prolonged or recurrent inflammation predisposes to AA amyloidosis, additional risk factors are poorly understood. Here we define the severity of glomerular and medullary renal amyloid and identify risk factors for AA amyloidosis in 321 island foxes necropsied from 1987 through 2010. In affected kidneys, amyloid more commonly accumulated in the medullary interstitium than in the glomeruli (98% [n= 78 of 80] vs 56% [n= 45], respectively;P< .0001), and medullary deposition was more commonly severe (19% [n= 20 of 105]) as compared with glomeruli (7% [n= 7];P= .01). Univariate odds ratios (ORs) of severe renal AA amyloidosis were greater for short- and long-term captive foxes as compared with free-ranging foxes (ORs = 3.2, 3.7, respectively; overall P= .05) and for females as compared with males (OR = 2.9;P= .05). Multivariable logistic regression revealed that independent risk factors for amyloid development were increasing age class (OR = 3.8;P< .0001), San Clemente Island subspecies versus San Nicolas Island subspecies (OR = 5.3;P= .0003), captivity (OR = 5.1;P= .0001), and nephritis (OR = 2.3;P= .01). The increased risk associated with the San Clemente subspecies or captivity suggests roles for genetic as well as exogenous risk factors in the development of AA amyloidosis.

El viejo y su tiempo: hacia una ética de la razón cordial / The old man and his era: towards a friendly and rational ethics

Cada época vive su vida “en el horizonte que le ha correspondido”. Los problemas e inquietudes de los hombres han sido semejantes y su estilo y respuesta dependen de su circunstancia histórico-cultural. Lo que ha trascendido en el tiempo es que nadie ama la vejez, prueba de ello son los antiguos escritos que datan del 3000 – 2500 A C.,en los cuales se denota una visión negativa del efecto del paso del tiempo, como una merma en las aptitudes físicas e intelectuales que se producen en la ancianidad. Aún más, en todo tiempo se ha buscado la forma de enlentecer la llegada de esta etapa, buscando “la fuente de la juventud”. La línea de pensamiento que guiará este artículo, va en relación con la descripción "comarca que nos cobija", teniendo presente que estará limitada a la llamada cultura occidental. Por lo tanto la forma, de interpretar la realidades, en gran medida, compartida por la sociedad que concurre en ese momento histórico y que establece el horizonte. Actualmente, la ética referida a la ancianidad está fuertemente reducida a la etiqueta, al modo de trato o a la consideración para con ellos. Por todo lo anterior se hace necesario e imprescindible mejorar la autoestima que los ancianos tengan de sí, proporcionándoles la oportunidad de participación en la sociedad, con una cuota de responsabilidad con ellos mismos, procurando llegar a la edad del adulto mayor en buenas condiciones físicas y psicológicas. El adulto mayor debe vivir su vida dentro de sus capacidades y esta es una tarea personal y social. La vinculación ética con los ancianos es un compromiso de afecto. En otras palabras, el motor de las actitudes son los afectos, la verdad por sí misma carece de poder suficiente para superar los afectos a no ser que sea asumida como afecto. Las sociedades se motivan más por las emociones que por las razones. En síntesis, demográficamente el grupo de la tercera edad se hace más...

Each era lives its life “in the horizon that has been agreed to”. Men´s problems and worries have been similar, and their style and replies depend on their historical and cultural circumstances. Something that has transcended time, is the fact that nobody likes to be old . There is evidence from old manuscripts dated 3000-2500 AC , where there was a negative view towards the passing of time, seen as the depletion of physical and intellectual skills due to this age. Moreover, in every time there has stated the purpose of slowing this inevitable stage, always looking for “life´s fountain of youth”. The line of thought guiding this article is related with the description “the land that shelter us”, restricting the meaning to the occidental culture. Therefore, the way life is interpreted, to a large degree, shared by the society of that historical moment setting also its horizon. Nowadays, ethics referred to oldness is strongly narrowed to formality, the way of treating or considering these type of people. As a result, it is necessary and vital to enhance their self-esteem, giving them the opportunity to be members of society with responsibilities, keeping the idea that people can reach oldness in good physical and psychological conditions. Elderly people should live their life according to their capacities, a personal and social task. Ethics´ link to elderly is an emotional compromise. In other words, emotions move elder people, truth is not enough to surpass emotions, unless it is considered as such. Societies are more moved by affections rather than reasons. To sum up, demographically speaking, old people are extremely relevant, in this way, is urgent that the society resolves a fruitful, active and ennoble relation with them.

Biochemical and physiological weaknesses associated with the pathogenesis of femoral bone degeneration in broiler chickens.

Femoral bone degeneration has been recognized as an important cause of lameness in broiler chickens for many years, but the pathogenesis of this condition has not been completely elucidated. The current work presents comprehensive analyses of changes associated with femoral bone degeneration based on findings from gross pathology, histopathology, biochemistry, and synchrotron-based imaging techniques. Gross lesions were predominantly seen in epiphysis and metaphysis of the proximal femur, and infrequently in distal femur, but we did not observe gross lesions in the diaphysis. Bone fractures were observed occasionally, but the most common lesions involved separation of articular cartilage of the femoral bone head, with progressive erosions of the subchondral bone. In advanced cases, on histopathological examination, changes in femoral bone were indicative of chondronecrosis and osteonecrosis. Computed tomography revealed that the degenerative process involves loss of trabecular bone. The course of the lesion development in the mineralized matrix appears to be coupled with increased bone resorption associated with excessive proliferation of pathologically altered osteoclasts. Light microscopy, Fourier transform infrared spectroscopy, and biochemical analysis provided consistent evidence that lowered protein content of the bone organic matrix is an integral component of femoral bone pathology, but these changes do not appear to be associated with excessive activity of matrix metalloproteinases. Taken together, our findings indicate that femoral bone degeneration is associated with structural changes occurring in both inorganic and organic matrix of the bone, but insufficiency in protein metabolism is most probably a primary aetiological factor in the natural history of femoral bone degeneration. However, it is important to stress that our findings do not negate the importance of bacterial infection in the evolution of this condition. Pathogens play a critical role in the progressive pathogenesis of this condition, which ultimately is manifested, in most instances, as femoral head necrosis.

Retinoic acid reduces chemotherapy-induced neuropathy in an animal model and patients with lung cancer.

OBJECTIVE: To evaluate the effect of all-trans retinoic acid (ATRA) as treatment for chemotherapy-induced peripheral neuropathy in an experimental animal model and in a randomized, double-blinded, controlled trial in patients with non-small-cell lung cancer (NSCLC). METHODS: Forty male Wistar rats were randomized in 5 groups: group A, control; groups B and C, treated with cisplatin; and groups D and E, treated with paclitaxel. ATRA (20 mg/kg PO) was administered for 15 days in groups C and E. We evaluated neuropathy and nerve regeneration-related morphologic changes in sciatic nerve, the concentration of nerve growth factor (NGF), and retinoic acid receptor (RAR)-α and RAR-ß expression. In addition, 95 patients with NSCLC under chemotherapy treatment were randomized to either ATRA (20 mg/m(2)/d) or placebo. Serum NGF, neurophysiologic tests, and clinical neurotoxicity were assessed. RESULTS: The experimental animals developed neuropathy and axonal degeneration, associated with decreased NGF levels in peripheral nerves. Treatment with ATRA reversed sensorial changes and nerve morphology; this was associated with increased NGF levels and RAR-ß expression. Patients treated with chemotherapy had clinical neuropathy and axonal loss assessed by neurophysiology, which was related to decreased NGF levels. ATRA reduced axonal degeneration demonstrated by nerve conduction velocity and clinical manifestations of neuropathy grades ≥2. CONCLUSIONS: ATRA reduced chemotherapy-induced experimental neuropathy, increased NGF levels, and induced RAR-ß expression in nerve. In patients, reduction of NGF in serum was associated with the severity of neuropathy; ATRA treatment reduced the electrophysiologic alterations. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that ATRA improves nerve conduction in patients with chemotherapy-induced peripheral neuropathy.

Antimicrobial susceptibility of canine and human Staphylococcus aureus collected in Saskatoon, Canada.

Staphylococcus aureus is one of the most common causes of infection in people and is increasingly recognized in dogs. The increasing prevalence of methicillin resistant S. aureus (MRSA) is complicating the treatment of these infections. Panton Valentine leukocidin (PVL), a toxin involved in the pathogenesis of necrotic syndromes in people may be partially responsible for the rise of MRSA. Canine and human S. aureus from the same geographic area are genetically similar, indicating a common population and likely transmission. The implications of increasing antimicrobial resistance complicated by interspecies transmission, necessitates including both dogs and humans in S. aureus resistance surveillance studies. A collection of 126 S. aureus isolates from people (n = 99) and dogs (n = 27) were included, minimum inhibitor concentrations to a panel of 33 antimicrobials used in human and veterinary medicine were determined. No resistance to vancomycin, linezolid, daptomycin, quinupristin/dalfopristin or nitrofurantoin was found. A wide range of antibiograms were found; including resistance to 0-12 drugs (0-6 drug classes). Outstanding antibiograms included a canine MRSA resistant to rifampin and a human MRSA resistant to chloramphenicol. Inducible clindamycin resistance was found among 78% and 4% of canine and human MRSA and 17% and 25% of canine colonizing and human methicillin susceptible S. aureus (MSSA), respectively. Resistance to mupirocin was only found among human isolates including 20% of MRSA and 4% of MSSA. While no canine isolates were PVL positive, 39% of human MRSA and 2% of MSSA carried the gene. The bidirectional transmission of S. aureus between people and dogs necessitates the inclusion of isolates from both species in future studies.

Effective line tension and contact angles between membrane domains in biphasic vesicles.

Inhomogeneities in membranes give rise to localized interactions at the interface between domains in two-component vesicles. The corresponding energy is expressed as a line tension between the two phases. In this paper we study the implications of the thickness mismatch between domains which has been experimentally reported to be of order 20-30% and the conditions under which the induced line tension can destabilize the domains in inhomogeneous vesicles. For asymmetric lipidic membranes we prove an increase of the line tension and the existence of a contact angle. Adsorption of impurities is also examined, our scope being the extension of the Canham-Helfrich model to describe elastic deformations and chemical interactions arising at microscopic scales. This mismatch effect may have important consequences for the stability of very small domains.

Engineering the Escherichia coli fermentative metabolism.

Fermentative metabolism constitutes a fundamental cellular capacity for industrial biocatalysis. Escherichia coli is an important microorganism in the field of metabolic engineering for its well-known molecular characteristics and its rapid growth. It can adapt to different growth conditions and is able to grow in the presence or absence of oxygen. Through the use of metabolic pathway engineering and bioprocessing techniques, it is possible to explore the fundamental cellular properties and to exploit its capacity to be applied as industrial biocatalysts to produce a wide array of chemicals. The objective of this chapter is to review the metabolic engineering efforts carried out with E. coli by manipulating the central carbon metabolism and fermentative pathways to obtain strains that produce metabolites with high titers, such as ethanol, alanine, lactate and succinate.