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Molecular Profile of Subungual Melanoma: a MelaNostrum Consortium Study of 68 Cases Reporting BRAF, NRAS, KIT, and TERT promoter status
Get PDFBackground: Subungual melanoma (SM) is an unusual type of melanocytic tumor affecting the nail apparatus. The mutational prevalence of the most prominently mutated genes in melanoma has been reported in small cohorts of SM, with unclear conclusions on whether SM is different from the rest of melanomas arising in acral locations or not. Hence, the molecular profile of a large series of SM is yet to be described. Objectives: The aim of this study was to describe the molecular characteristics of a large series of SM and their association with demographic and histopathological features. Methods: Patients diagnosed with SM between 2001 and 2021 were identified from six Spanish and Italian healthcare centers. The mutational status for BRAF, NRAS, KIT, and the promoter region of TERT (TERTp) were determined either by Sanger sequencing or Next-Generation Sequencing. Clinical data were retrieved from the hospital databases to elucidate potential associations. Results: A total of 68 SM cases were included. Mutations were most common in BRAF (10.3%) and KIT (10%), followed by NRAS (7.6%), and TERTp (3.8%). Their prevalence was similar to that of non-subungual acral melanoma, but higher in SM located on the hand than on the foot. Conclusions: To date, this study represents the largest cohort of SM patients with data on the known driver gene mutations. The low mutation rate supports a different etiopathogenic mechanism for SM in comparison of non-acral cutaneous melanoma, particularly for SM of the foot.Submitted VersionMedicin
Reference ranges for SpO2, respiratory rate, and tidal volume in term newborn infants after birth: a narrative review
Get PDFBackground and Objective: Post-natal adaptation implies respiratory and hemodynamic changes
that contribute to the successful switching from transplacental to lung-based respiration and from serial to
parallel circulation after cord clamping. Initial respiratory efforts extrude lung fluid to the interstitial space,
facilitate alveolar aeration, and alveolar-capillary gas exchange contributing to an increase in the arterial
partial pressure of oxygen (paO2). Consequently, there is a decrease in pulmonary vascular resistance and the
closure of the intra-and-extracardiac shunts. The establishment of a functional residual capacity contributes
to the stabilization of the respiratory rate (RR) and the arterial paO2. This study sought to update the
reference ranges for respiratory function, oxygen saturation, and heart rate (HR) to guide neonatologists in
the stabilization and/or resuscitation of newborn infants in the delivery room (DR).
Methods: Data on the respiratory function and oxygenation pattern of normal term infants in the
stabilization period during the first minutes after birth were retrieved and stored by employing continuous
pre-ductal pulse oximetry and respiratory function monitoring. The electronic databases searched included
MEDLINE, Embase, CINAHL, and Scopus. Statistical methods were employed to establish the percentile
curves for each parameter.
Key Content and Findings: We provide data of HR and oxygen saturation measured by pulse oximetry
and RR and tidal volume (VT) measured by a respiratory function monitor and recorded during the first
10 minutes after birth in healthy term infants. Post-natal respiratory and cardiorespiratory adaptation in
healthy term babies is enhanced by delayed cord clamping. HR and oxygen saturation achieved values of
140–160 bpm and 90–95% in the first 2–3 minutes after birth, respectively, and a VT and RR between
5–10 minutes.
Conclusions: Updated reference ranges for clinical parameters in the DR constitute a useful tool for
guiding neonatologists in the stabilization of newborn infants.M Vento received PI20/00964 and RD16/0022/0001 grants, and the ILC CM20/00187 grant from the Health Research Institute Carlos III (Ministry of Science and Innovation; Kingdom of Spain).Medicin
Improvements in gait and balance in patients with multiple sclerosis after treatment with coconut oil and epigallocatechin gallate. A pilot study
Get PDFMultiple sclerosis (MS) is a neurodegenerative disease that progressively decreases the muscular and functional capacity. Thus, there is an alteration in the ability to walk that affects balance, speed and resistance. Since MS pathology involves neuroinflammation, cellular oxidation and mitochondrial alterations, the objective of the study was to assess the impact of a nutritional intervention with coconut oil and epigallocatechin gallate (EGCG) on gait and balance. In order to do this, 51 patients with MS were enrolled and randomly distributed into an intervention group and a control group, which received either a daily dose of 800 mg of EGCG and 60 ml of coconut oil, or a placebo, all during a period of 4 months and which followed a Mediterranean isocaloric diet. Initial and final assessments consisted of the evaluation of quantitative balance (Berg scale), perceived balance (ABC scale), gait speed (10MWT) and resistance (2MWT). Besides, muscle strength was measured using a dynamometer and levels of β-hydroxybutyrate (BHB) were measured in serum samples. In the intervention group, there was a significant improvement in the gait speed, quantitative balance and muscle strength of the right quadriceps; an improvement in gait resistance was observed in both groups. There were also significant and positive correlations between balance and gait scales. In conclusion, the administration of EGCG and coconut oil seems to improve gait speed and balance in MS patients, although the latter was not perceived by them. Furthermore, these variables appear to be related and contribute to functionality.The present research was funded by the Catholic University Foundation “San Vicente Mártir”, for the research project “The Impact of Triglycerides on Multiple Sclerosis” (promotion code 2018-203-001).Nutrición humana y dietétic
Biocompatible Ti3Au–Ag/Cu thin film coatings with enhanced mechanical and antimicrobial functionality
Get PDFBackground Bioflm formation on medical device surfaces is a persistent problem that shelters bacteria and encour‑
ages infections and implant rejection. One promising approach to tackle this problem is to coat the medical device
with an antimicrobial material. In this work, for the frst time, we impart antimicrobial functionality to Ti3Au intermetal‑
lic alloy thin flm coatings, while maintaining their superior mechanical hardness and biocompatibility.
Methods A mosaic Ti sputtering target is developed to dope controlled amounts of antimicrobial elements of Ag
and Cu into a Ti3Au coating matrix by precise control of individual target power levels. The resulting Ti3Au-Ag/Cu thin
flm coatings are then systematically characterised for their structural, chemical, morphological, mechanical, corrosion,
biocompatibility-cytotoxicity and antimicrobial properties.
Results X-ray difraction patterns reveal the formation of a super hard β-Ti3Au phase, but the thin flms undergo
a transition in crystal orientation from (200) to (211) with increasing Ag concentration, whereas introduction of Cu
brings no observable changes in crystal orientation. Scanning and transmission electron microscopy analysis show
the polyhedral shape of the Ti3Au crystal but agglomeration of Ag particles between crystal grains begins at 1.2 at%
Ag and develops into large granules with increasing Ag concentration up to 4.1 at%. The smallest doping concen‑
tration of 0.2 at% Ag raises the hardness of the thin flm to 14.7 GPa, a 360% improvement compared to the ∼4 GPa
hardness of the standard Ti6Al4V base alloy. On the other hand, addition of Cu brings a 315—330% improvement
in mechanical hardness of flms throughout the entire concentration range of 0.5—7.1 at%. The thin flms also show
good electrochemical corrosion resistance and a>tenfold reduction in wear rate compared to Ti6Al4V alloy. All thin
flm samples exhibit very safe cytotoxic profles towards L929 mouse fbroblast cells when analysed with Alamar blue
assay, with ion leaching concentrations lower than 0.2 ppm for Ag and 0.08 ppm for Cu and conductivity tests reveal
the positive efect of increased conductivity on myogenic diferentiation. Antimicrobial tests show a drastic reduction
in microbial survival over a short test period of<20 min for Ti3Au flms doped with Ag or Cu concentrations as low
as 0.2—0.5 at%.
Conclusion Therefore, according to these results, this work presents a new antimicrobial Ti3Au-Ag/Cu coating mate‑
rial with excellent mechanical performance with the potential to develop wear resistant medical implant devices
with resistance to bioflm formation and bacterial infection.This work was funded by a Leverhulme Trust Research Project Grant (RPG2018–344) to develop super hard biocompatible coatings of a Ti based thin flm material system.Biotecnologí
Biochemical and Hematological Indexes of Liver Dysfunction in Horses
Get PDFIn the present review, the authors, based on the multiple functions performed by the liver, analyze the
multiple biochemical and hematological changes as an expression of altered liver function in the horse.
The liver performs important metabolic functions related to the synthesis, degradation, and excretion of
various substances. Modification of these functions can be evaluated and diagnosed by determining serum
concentrations of several serum analytes, including enzymes and other endogenous substances. Hepatocellular enzymes, such as sorbitol dehydrogenase-SDH and glutamate dehydrogenase-GLDH, are released
following hepatocellular necrosis. Hepatobiliary enzymes, such as γ -glutamyl transferase-GGT, increase in
response to necrosis, cholestasis, and other alterations in bile conducts. Serum concentrations of mainly
endogenous and exogenous substances that the liver should synthesize or eliminate, such as proteins
(albumin and globulins), bile acids, urea, glucose, total and direct bilirubin, and coagulation factors, and
fibrinogen should be included in the liver function test profile. The interpretation of laboratory tests of
liver function will allow the diagnosis of functional loss of the organ. Some of the analytes considered
provide information on the prognosis of liver disease. This review will provide an accurate and objective interpretation of the common biochemical and hematological tests in use in the diagnosis of equine
hepatic disease patients, aiding still further the veterinary activity on the applied equine clinical cases.Veterinari
Diacrónicos episódicos: la cuestión de la identidad personal
No full textLección magistral leída en el solemne acto de apertura de curos académico 2023-2024Esta primera lección inaugural del curso 23-24 quere ser una defensa del carácter narrativo de la identidad personal a través del reconocimiento del papel central que tiene un elemento de nuestra psicologia moral (área de confluencia de la antrolopogía filosófica y ética) (Arpaly, 2004). Es un modo de avanzar, la reflexión que sobre el tema de la identidad personal encuentra uno en una parte sustantiva de la bibliografía filosófica contemporáneaFilosofí
Diseño de un programa psicoeducativo dirigido a cuidadores informales de personas con dolor crónico no oncológico
Get PDFComo consecuencia del aumento de enfermedades crónicas, y
dentro de ellas, el dolor crónico, se ha producido un incremento de las necesidades de
cuidado. Un cuidado que en entornos no formales es llevado a cabo por cuidadores
informales. Existen potentes evidencias sobre la angustia del cuidador informal en el
desempeño de su rol porque dicen no sentirse preparados. Surge así, la necesidad de
desarrollar programas de intervención dirigidos a la capacitación de este colectivo. Y, a
la vez, los resultados señalan la importancia de analizar la eficacia de los programas, junto
a la necesidad de explorar si sus diseños facilitan el trabajo de los investigadores a la hora
de poder concluir que son eficaces. El objetivo consiste en formar a familiares, amigos o
acompañantes de personas que viven en situación de dolor crónico no oncológico, para el
desarrollo de un modelo adecuado de apoyo social (de cuidado) y de una dinámica de
comunicación afectiva.As a consequence of the increase in chronic illnesses, including
chronic pain, there has been an increase in the need for care. Care in non-formal settings
is carried out by informal carers. There is strong evidence of informal carers' distress in
carrying out their role because they say they feel unprepared. Thus, there is a need to
develop intervention programmes aimed at training this group. And, at the same time, the
results point to the importance of analysing the effectiveness of the programmes, together
with the need to explore whether their designs facilitate the work of researchers when it
comes to concluding that they are effective. The main objective is to train family members, friends
or companions of people living with chronic non-cancer pain to develop an appropriate
model of social support (care) and affective communication dynamics.Psicologí
Déficit de vitamina D en la escoliosis idiopática del adolescente: meta-análisis
Get PDFRecientemente se ha estudiado la asociación entre la vitamina D y la
escoliosis idiopática del adolescente (EIA). Se cree que la vitamina D podría influir en
la etiopatogenia de la EIA. El objetivo es determinar la incidencia de déficit de vitamina D en pacientes con EIA a
través de un meta-análisis, así como analizar tendencias y factores de riesgo.The relationship between vitamin D and adolescent idiopathic scoliosis
(AIS) has been the subject of recent research. There is a belief that vitamin D may
significantly impact the development and causes of AIS. The aim is to determine the incidence of vitamin D deficiency in patients with AIS
through a meta-analysis and analyzing trends and risk factors.Medicin
La alianza terapéutica desde la teoría del apego y la figura del terapeuta
Get PDFLa teoría del apego explica de qué manera los seres humanos se vinculan afectivamente
y expone las consecuencias de los diferentes estilos de vinculación en el desarrollo
emocional, cognitivo y social de toda persona a lo largo de su vida. Se considera que la
alianza es el principal vínculo que se crea entre terapeuta y paciente dentro del encuadre
terapéutico. Diversos estudios proponen que a través de una adecuada alianza el
paciente puede traer al presente y reparar sus primeras experiencias relacionales
dolorosas, creando nuevos patrones de funcionamiento interpersonal. El objetivo del
presente trabajo es realizar una revisión sistemática acerca de los hallazgos de los
últimos años sobre la relación que existe entre los estilos de apego del terapeuta y el
establecimiento de la alianza terapéutica en terapia individual. La metodología utilizada
para la revisión de los documentos seleccionados a partir de las bases de datos Scopus,
EBSCOhost y Web Of Science (WoS) corresponde a la última edición del método
PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Se
presenta las principales características de 9 publicaciones y sus resultados. La mayoría
de las investigaciones indican que no hay relación directa entre el tipo de apego del
terapeuta y el desarrollo de la alianza. Sin embargo, presentan las influencias de
diversas variables moduladoras que intervienen en el vínculo entre paciente y terapeuta.
Los últimos hallazgos parecen señalar que el tipo de apego del terapeuta es un factor
relevante en la alianza teniendo en cuenta su dimensión temporal.Attachment theory defines the way that human beings are affectionately bound and
exposes the consequences of the different attachment styles for the emotional, cognitive,
and social development of every person during its life. It is perceived that the alliance is
the main bond that is created between the therapist and the patient within the therapeutic
frame. Several studies propose that, using an adequate therapeutic alliance, the patient
can bring to the present its first painful relational experiences and repair them, creating
new interpersonal operating patterns. The aim of this work is to perform a systematic
review of the findings of the last few years regarding the relationship between the
attachment styles of the therapist and the setting of the therapeutic alliance in individual
therapies. The documents’ assortment for the review were executed using the following
databases: Scopus, EBSCOhost and Web of Science (WoS), applying for this the last
version of the PRISMA procedure (Preferred Reporting Items for Systematic reviews and
Meta-Analyses). The main features of 9 publications and their results are presented.
Most of the studies point that there is no direct relationship between the therapist’s type
of attachment and the development of the bond. Nevertheless, they present the influence
of several modulating factors that have an impact on the therapist-patient alliance. Last
findings would suggest that, considering the time dimension, the therapist’s type of
attachment is a key element for alliance.Psicologí
Retinosquisis ligada al cromosoma X. Revisión bibliográfica a propósito de un caso
Get PDFEl objetivo principal de este trabajo es describir un caso
clínico diagnosticado de Retinosquisis ligada al cromosoma X. El objetivo
secundario es realizar una revisión bibliográfica sobre la Retinosquisis ligada al
cromosoma X analizando casos publicados en los últimos 20 años.The main objective of this paper is to describe a
clinical case diagnosed with X-linked retinoschisis. The secondary objective is to
perform a literature review on X-linked retinoschisis in general by analysing
published cases.Medicin