Objetivo: Describir cómo viven y afrontan los profesionales de enfermería la experiencia de cuidar personas con cáncer. Materiales y métodos: cualitativo fenomenológico. El tamaño de la muestra se ...definió por la saturación teórica, conformada por seis profesionales de enfermería que laboraban en oncología. El instrumento fue la entrevista a profundidad. Se mantuvo la reflexibilidad, también la credibilidad a través de una segunda entrevista para corroborar los datos interpretados, notas de campo y relectura con investigadores asesores. Para el análisis de la información se utilizó el método de Taylor y Bogdan, se plasmaron en matrices de análisis y gráficos. Fue avalado por el Comité de Ética y se utilizó el consentimiento informado. Resultados: se develaron dos temas centrales, el primero fue titulado “Que tengo que vivir, que tengo que hacer, con quien debo compartir” mecanismos de afrontamiento desde el interior y el segundo “Hay otras formas para descargarnos” mecanismos de afrontamiento desde afuera. Adicionalmente se generaron los siguientes subtemas: transformar el concepto de muerte, tener características especiales, cambiar la forma de ver la vida, ser espiritual, la seguridad que ofrece el conocimiento científico, la seguridad que ofrece la experiencia laboral, el apoyo institucional para el bienestar del trabajador y la formación universitaria en el cuidado oncológico. Conclusiones: la experiencia de cuidar a pacientes con cáncer develó mecanismos de afrontamiento que le permiten al enfermero adaptarse y resolver diversas situaciones en su quehacer profesional en los servicios de oncología
Background: mobilized peripheral hematopoietic stem cells (PHSC) are the main cell source for autologous bone marrow transplantation. Failure to mobilize an appropriate number of PHSC can jeopardize ...autologous bone marrow transplantation procedure. Objective: our aim was to describe the clinical and demographics characteristics, the incidence of mobilization failure and the prevalence of risks factors for poor mobilization in patients in whom PHSC mobilization were attempted for autologous bone marrow transplantation between January 1st 2017 and 31 December 2022. A univariate and multivariate analysis (binary logistic regression) were done to determinate the association between risk factors and mobilization failure. Results: 129 patients were included , the patients median age was 54 years. Indications for autologous bone marrow transplantation were multiple myeloma in 50,4 %, lymphoma in 46,5 % and systemic sclerosis in 2,3 % of patients respectively. Mobilization was attempted with Filgrastim in 71,1 %, Filgrastim plus Plerixafor in 26,6 % and chemotherapy (Cyclophosphamide) plus Filgrastim in 2,3 % of patients respectively. Mobilization failure occurred in 9,3 % of patients (12 patients) occurring in 11 % of patients who received Filgrastim, in 5,6 % who received Filgrastim plus Plerixafor and in none of patients who received chemotherapy plus Filgrastim. No difference in mobilization failure was found between patients who received Filgrastim monotherapy versus those who received Filgrastim plus Plerixafor ( χ 2 p=0,388, relative risk: 1,8, confidence interval 95% 0,43 - 8,1). Patients who received Filgrastim plus Plerixafor had been treated more frequently (four of more cycles of Lenalidomide) compared with patients who received Filgrastim alone (63,3 % versus 18,7 %, χ 2 p < 0,001, RR=4,01, CI 95 %; 2,32-6,87).The median age of patients was superior in patients who received Filgrastim plus Plerixafor compared with those who received Filgrastim (58 vs 51 years, U Mann Whitney p = 0,02). The median number of treatment lines tended to be superior in patients receiving Filgrastim plus Plerixafor compared to those receiving Filgrastim (2 lines versus 1 line of therapy, U Mann Withney p= 0,054). Patients who had been treated with intensive chemotherapy regimens like DHAP, ESHAP or Hyper CVAD (p=0,004, RR: 4,3, CI 1,5-12,3)) and patients older than 60 years (p=0,018, RR: 3,4 (1,2-9,85)) were significant more prone to mobilization failure in bivariate and multivariate analysis. Conclusion: mobilization failure occurred in 9,3 % of patients , Filgrastim monotherapy was more frequently used, no difference in mobilization failure was found between those who received Filgrastim versus Filgrastim plus Plerixafor, history of treatment with more than 4 cycles of lenalidomide and older age were more frequently in patients who received Filgrastim plus Plerixafor. History of a treatment intensive chemotherapy regimen and being older than 60 years were consistently associated with mobilization failure in univariate and multivariate analysis.
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IJS, IMTLJ, KILJ, NLZOH, NUK, SAZU, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Interstitial lung disease (ILD) usually has a poor therapeutic response and prognosis. One of the methods that could help in the diagnosis and optimize the management of these patients is ...capillaroscopy. The study aimed to determine the clinical and capillaroscopic characteristics of patients with ILD and the frequency of findings suggestive of autoimmune disease.
A descriptive observational study that evaluated patients with ILD treated between 2010 and 2019 without a previous diagnosis of autoimmune disease. An interview, capillaroscopy, and laboratory tests were performed.
28 patients were evaluated, 16 (57.1%) were women and 17 (60.7%) had hypertension. Three patients (10.7%) reported morning stiffness for more than 60 minutes and there was one unexplained digital edema. There were no telangiectasias, Raynaud’s phenomenon, mechanic’s hands, sclerodactyly or Gottron’s sign, or ANAS titres greater than 1:80. The rest of the laboratory tests were negative in 100% of the patients. In the capillaroscopies, 13 (46.4%) patients had a normal capillaroscopic pattern, and 15 (53.6%) had capillaroscopic abnormalities of undetermined significance. There were none with a pattern of systemic sclerosis or similar.
No laboratory or capillaroscopy findings were found that suggested interstitial disease with autoimmune features, possibly due to the low prevalence of the disease, its high mortality, and underdiagnosis. These findings reinforce the concept of capillaroscopic normality in patients with non-autoimmune ILD and call for an active search for ILD with autoimmune features for prognostic purposes.
La enfermedad pulmonar intersticial (EPI) suele tener una pobre respuesta terapéutica y un mal pronóstico. Uno de los métodos que podrían ayudar a su diagnóstico y optimizar el manejo de estos pacientes es la capilaroscopia. El objetivo del estudio fue determinar las características clínicas y capilaroscópicas de pacientes con EPI y la frecuencia de hallazgos que sugieran enfermedad autoinmune.
Estudio observacional descriptivo que evaluó pacientes con EPI, sin diagnóstico previo de enfermedad autoinmune, atendidos entre el 2010 y el 2019, a quienes se les realizó entrevista, capilaroscopia y se tomó laboratorio.
Se evaluaron 28 pacientes, 16 (57,1%) de los cuales fueron mujeres y 17 (60,7%) tenían HTA. Tres pacientes (10,7%) refirieron rigidez matinal mayor de 60 min y uno edema digital inexplicable. No se encontraron telangiectasias, fenómeno de Raynaud, manos de mecánico, esclerodactilia o signo de Gottron, ni ANAS con títulos superiores a 1:80. El resto de paraclínicos fueron negativos en el 100% de los pacientes. En las capilaroscopias, 13 (46,4%) pacientes tenían un patrón capilaroscópico normal y 15 (53,6%) tenían anormalidades capilaroscópicas con significado indeterminado. No hubo ninguno con patrón de esclerosis sistémica o similar.
No se hicieron hallazgos de laboratorio o capilaroscópicos que sugirieran enfermedad intersticial con características autoinmunes, posiblemente debido a la baja prevalencia de la enfermedad, su alta mortalidad y subdiagnóstico. Estos hallazgos refuerzan el concepto de la normalidad capilaroscópica en pacientes con EPI no autoinmune y constituyen un llamado a la búsqueda activa de la EPI con características autoinmunes para fines pronósticos.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
La enfermedad pulmonar intersticial (EPI) suele tener una pobre respuesta terapéutica y un mal pronóstico. Uno de los métodos que podrían ayudar a su diagnóstico y optimizar el manejo de estos ...pacientes es la capilaroscopia. El objetivo del estudio fue determinar las características clínicas y capilaroscópicas de pacientes con EPI y la frecuencia de los hallazgos que sugieran enfermedad autoinmune.
Estudio observacional descriptivo que evaluó pacientes con EPI, sin diagnóstico previo de enfermedad autoinmune, atendidos entre los años 2010 y 2019, a quienes se les realizó entrevista, capilaroscopia y se tomó laboratorio.
Se evaluaron 28 pacientes, 16 (57,1%) de los cuales fueron mujeres y 17 (60,7%) tenían HTA. Tres pacientes (10,7%) refirieron rigidez matinal mayor de 60min y uno edema digital inexplicable. No se encontraron telangiectasias, fenómeno de Raynaud, manos de mecánico, esclerodactilia o signo de Gottron, ni ANA con títulos superiores a 1:80. El resto de los paraclínicos fueron negativos en el 100% de los pacientes. En las capilaroscopias, 13 (46,4%) pacientes tenían un patrón capilaroscópico normal y 15 (53,6%) tenían anormalidades capilaroscópicas con significado indeterminado. No hubo ninguno con patrón de esclerosis sistémica o similar.
No se hicieron hallazgos de laboratorio o capilaroscópicos que sugirieran enfermedad intersticial con características autoinmunes, posiblemente debido a la baja prevalencia de la enfermedad, su alta mortalidad y subdiagnóstico. Estos hallazgos refuerzan el concepto de la normalidad capilaroscópica en pacientes con EPI no autoinmune y constituyen un llamado a la búsqueda activa de la EPI con características autoinmunes para fines pronósticos.
Interstitial lung disease (ILD) usually has a poor therapeutic response and prognosis. One of the methods that could help in the diagnosis and optimize the management of these patients is capillaroscopy. The study aimed to determine the clinical and capillaroscopic characteristics of patients with ILD and the frequency of findings suggestive of autoimmune disease.
A descriptive observational study that evaluated patients with ILD treated between 2010 and 2019 without a previous diagnosis of autoimmune disease. An interview, capillaroscopy, and a laboratory tests were performed.
28 patients were evaluated, 16 (57.1%) were women and 17 (60.7%) had hypertension. Three patients (10.7%) reported morning stiffness for more than 60minutes and there was one unexplained digital oedema. There were no telangiectasias, Raynaud's phenomenon, mechanic's hands, sclerodactyly or Gottron's sign, or ANAs titres greater than 1:80. The rest of the laboratory tests were negative in 100% of the patients. In the capillaroscopies, 13 (46.4%) patients had a normal capillaroscopic pattern and 15 (53.6%) had capillaroscopic abnormalities of undetermined significance. There were none with a pattern of systemic sclerosis or similar.
No laboratory or capillaroscopy findings were found that suggested interstitial disease with autoimmune features, possibly due to the low prevalence of the disease, its high mortality, and underdiagnosis. These findings reinforce the concept of capillaroscopic normality in patients with non-autoimmune ILD and call for an active search for ILD with autoimmune features for prognostic purposes.
This study tackles limitations of Silk Fibroin (SF), including availability of sites for modification. This is achieved by Direct Plasma Nanosynthesis (DPNS), an Ar+ bombardment method, to generate ...and modify nanostructures and nanoscale properties on the SF surface. SF samples were treated with DPNS at incidence angles of 45o and 60o, with specific ion dose and energy parameters (1 × 1018 ions/cm2 and 500 eV, respectively) maintained throughout the process. Fourier-transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) primarily underscored transformations in SF's nitrogenous components. Specifically, treatment produced a boost in C-NH2, particularly pronounced in the 45o-treated samples, suggesting changes were more superficial than alterations to the secondary structure.
The DPNS treatment gave rise to periodic nanocone structures on the SF surface, with a scale increase correlated to a higher angle of incidence. This resulted in a decrease in surface stiffness and significant changes in the motility of J774 macrophages interacting with the transformed SF. Furthermore, the SF samples treated at a 60o incidence showcased a confinement effect, moderating the macrophages' motility, morphology, and inflammatory response. The DPNS-induced alterations not only mitigate SF's limitations but also affect cellular behavior, expanding potential for SF in biomaterials.
•Ar+ ion modifications of silk fibroin's chemistry and nanotopography are dependent on incidence angle.•Ar+-induced atom motility alters silk fibroin superficial structure, reduces stiffness, and boosts amine groups exposure.•Nanocones on silk fibroin surface show ∼33 nm roughness and scale up with incidence angle from 45° to 60°.•60° Ar+ plasma-treated silk fibroin shows confinement and limits TNF-α, CCR7 in J774 cells.•DPNS overcomes traditional limits by increasing binding sites and nanotopography on silk fibroin surfaces.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Resumen: Este trabajo examina la internacionalizacion de las multilatinas colombianas en la ultima decada y propone un modelo de estudio cualitativo de este fenomeno a partir de tres aspectos ...importantes: patrones de expansion, beneficios alcanzados y riesgos e incertidumbre derivados de la inversion en el exterior de las companias colombianas. Utilizando una muestra de 14 estudios de caso correspondientes a multilatinas de diferentes sectores productivos, contrastamos con los directivos de estas companias, la percepcion que tienen frente a estos tres asuntos en particular. En general, los hallazgos sugieren un perfil de expansion influenciado por la oportunidad del entorno, el aprendizaje exportador y las mejoras en la productividad. Igualmente, como beneficios importantes se destacan las transformaciones organizativas en las empresas, la rentabilidad del negocio y el conocimiento de los mercados. Adicionalmente, a nivel de los riesgos, las ventajas competitivas que enfrentan las empresas de economias en desarrollo cuando actuan en entornos complejos y con alto riesgo. Estas particularidades permiten sugerir un modelo de estudio que comprende la expansion, los aprendizajes y la gestion de riesgo, con algunos elementos comunes de las teorias clasicas de la internacionalizacion, donde la adaptacion, extension e incluso combinacion de teorias y modelos proporcionan bases para explicar, interpretar y analizar la expansion internacional de las multilatinas colombianas observadas. Abstract : This paper examines the colombian multilatinas internationalization in the last decade and proposes a qualitative study model of this phenomenon, based on three important aspects: Expansion patterns, Achieved benefits and Risk as uncertainty derived from investment abroad by colombian companies. Using a sample of 14 case studies, corresponding to multilatinas from different productive sectors, we contrasted with the managers of these companies, the perception they have regarding thes
Background
The COVID-19 pandemic remains a global health problem. As in other viral infections, the humoral immune response against SARS-CoV-2 is thought to be crucial for controlling the infection. ...However, the dynamic of B cells in the clinical spectrum of this disease is still controversial. This study aimed to characterize B cell subsets and neutralizing responses in COVID-19 patients according to disease severity through a one-month follow-up.
Methods
A cohort of 71 individuals with SARS-CoV-2 infection confirmed by RT-PCR were recruited and classified into four groups: i) asymptomatic; ii) symptomatic outpatients; iii) hospitalized in ward, and iv) intensive care unit patients (ICU). Samples were taken at days 0 (inclusion to the study), 7 and 30. B cell subsets and neutralizing antibodies were assessed using multiparametric flow cytometry and plaque reduction neutralization, respectively.
Results
Older age, male gender and body mass index over 25 were common factors among hospitalized and ICU patients, compared to those with milder clinical presentations. In addition, those requiring hospitalization had more comorbidities. A significant increase in the frequencies of CD19
+
cells at day 0 was observed in hospitalized and ICU patients compared to asymptomatic and symptomatic groups. Likewise, the frequency of plasmablasts was significantly increased at the first sample in the ICU group compared to the asymptomatic group, but then waned over time. The frequency of naïve B cells decreased at days 7 and 30 compared to day 0 in hospitalized and ICU patients. The neutralizing antibody titers were higher as the severity of COVID-19 increased; in asymptomatic individuals, it was strongly correlated with the percentage of IgM
+
switched memory B cells, and a moderate correlation was found with plasmablasts.
Conclusion
The humoral immune response is variable among SARS-CoV-2 infected people depending on the severity and time of clinical evolution. In severe COVID-19 patients, a higher plasmablast frequency and neutralizing antibody response were observed, suggesting that, despite having a robust humoral immunity, this response could be late, having a low impact on disease outcome.
Background and Aims
Acute respiratory failure (ARF) is the most frequent cause of cardiorespiratory arrest and subsequent death in children worldwide. There have been limited studies regarding ARF in ...high altitude settings. The aim of this study was to calculate mortality and describe associated factors for severity and mortality in children with ARF.
Methods
The study was conducted within a prospective multicentric cohort that evaluated the natural history of pediatric ARF. For this analysis three primary outcomes were studied: mortality, invasive mechanical ventilation, and pediatric intensive care unit (PICU) length of stay. Eligible patients were children older than 1 month and younger than 18 years of age with respiratory difficulty at the time of admission. Patients who developed ARF were followed at the time of ARF, 48 h later, at the time of discharge, and at 30 and 60 days after discharge. It was conducted in the pediatric emergency, in‐hospital, and critical‐care services in three hospitals in Bogotá, Colombia, from April 2020 to June 2021.
Results
Out of a total of 685 eligible patients, 296 developed ARF for a calculated incidence of ARF of 43.2%. Of the ARF group, 90 patients (30.4%) needed orotracheal intubation, for a mean of 9.57 days of ventilation (interquartile range = 3.00–11.5). Incidence of mortality was 6.1% (n = 18). The associated factors for mortality in ARF were a history of a neurologic comorbidity and a higher fraction of inspired oxygen at ARF diagnosis. For PICU length of stay, the associated factors were age between 2 and 5 years of age, exposure to smokers, and respiratory comorbidity. Finally, for mechanical ventilation, the risk factors were obesity and being unstable at admission.
Conclusions
ARF is a common cause of morbidity and mortality in children. Understanding the factors associated with greater mortality and severity of ARF might allow earlier recognition and initiation of prompt treatment strategies.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Semen quality in sheep Cardona Cadavid, Henry; Cardona Maya, Walter D.; Mejia, Andrés Felipe ...
Veterinarska stanica,
06/2022, Volume:
54, Issue:
1
Journal Article
Peer reviewed
Open access
Reproductive evaluation, the selection of individual breeders, and reproductive biotechnologies are important tools in developing productive and reproductive rates. When choosing a male as a breeding ...future, determining its general health status and genotypic and phenotypic superiority are necessary. This study evaluated the conventional and functional seminal quality in ovine males. The semen of eleven ovines of different pure races was collected by electroejaculation. The following average values were observed for each conventional parameter: scrotal circumference (CE, 34.3 cm), seminal volume (vol, 1.63 mL), concentration (C, 768.4 x 106/mL), individual motility (MI, 80%), masal motility (MM, 4) and vigor (Vi, 3.7). On the other hand, functional analysis showed plasma membrane integrity (PMI) of 45.7%, mitochondrial membrane potential (MMP) of 38.5%, DNA fragmentation index (DFI) of 17.0%, lipoperoxidation of the membrane (LPO) of 32.7%, and the production of reactive oxygen species (ROS) of 28.56%. Additionally, a high and positive correlation was found for variables concerning seminal quality: Vi and MM, Vi and MI, MMP and MM, MMP and MI, PMI and MMP, as well as ROS and MMP. In contrast, two strongly negative correlations were obtained (C vs. Vol and LPO vs. CE). These are the first estimates of functional seminal quality evaluation of sheep in Colombia. In addition, this study provides a baseline for conventional and functional seminal parameters in the region.
Reproduktivna procjena, odabir pojedinačnih rasplodnih mužjaka i reproduktivne biotehnologije važni su alati u unaprjeđenju produktivnih i reproduktivnih stopa. Pri odabiru mužjaka za rasplod, potrebno je određivanje općeg zdravstvenog statusa te genotipske i fenotipske superiornosti. Ovaj rad procjenjuje konvencionalnu i funkcionalnu kvalitetu sjemena u ovnova. Sjeme jedanaest ovnova različitih čistokrvnih pasmina prikupljeno je elektroejakulacijom. Zamijećene su sljedeće prosječne vrijednosti za svaki konvencionalni parametar: opseg skrotuma (CE, 34,3 cm), volumen sjemena (vol, 1,63 mL), koncentracija (C, 768,4 x 106/mL), pojedinačna pokretljivost (MI, 80 %), ukupna pokretljivost (MM, 4) i vitalnost (Vi, 3,7). S druge strane, funkcionalna analiza pokazala je integritet stanične membrane (PMI) od 45,7 %, potencijal mitohondrijske membrane (MMP) od 38,5 %, indeks fragmentacije DNK (DFI) od 17,0%, lipoperoksidaciju membrane (LPO) od 32,7 % i proizvodnju reaktivnih kisikovih spojeva (ROS) od 28,56 %. Uz to je otkrivena i visoka i pozitivna korelacija za varijable o kvaliteti sjemena: Vi i MM, Vi i MI, MMP i MM, MMP i MI, PMI i MMP, kao i ROS i MMP. Suprotno tome, dobivene su dvije vrlo negativne korelacije (C nasuprot Vol i LPO nasuprot CE). To su prve procjene ocjenjivanja funkcionalne kvalitete sjemena ovaca u Kolumbiji. Uz to, ova studija osigurava početnu vrijednost za sve konvencionalne i funkcionalne parametre sjemena u regiji.
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