Resumen Introducción y objetivos Los pacientes con melanoma parecen llevar al extremo las medidas de protección, lo que puede influir en los niveles de 25-hidroxivitamina D —25(OH)D—. El objetivo del ...estudio fue evaluar los niveles de 25(OH)D en pacientes con melanoma cutáneo e identificar factores relacionados con niveles inadecuados. Material y métodos Se midieron prospectivamente los niveles séricos de 25(OH)D en pacientes diagnosticados de melanoma cutáneo durante un periodo de seguimiento de un año. Se evaluaron qué factores ambientales, fenotípicos y genotípicos se relacionaban con niveles insuficientes y deficientes mediante regresión logística. Resultados De un total de 215 pacientes solo un 24,7% tenían valores normales de 25(OH)D y un 8,8% tenían valores deficientes (< 10 ng/ml). La obesidad (OR: 4,2; IC 95% OR: 1,3-13,3) y la extracción de sangre realizada en otoño/invierno (OR: 2,1; IC 95% OR: 1,1-4) se asociaron a niveles insuficientes (< 30 ng/ml). Los niveles deficitarios (< 10 ng/m) se asociaron a la obesidad (OR: 7,1; IC 95% OR: 1,1-46,9), la extracción de sangre realizada en otoño/invierno (OR: 9,0; IC 95% OR: 1,7-47,0), la ausencia de efélides (OR: 5,4; IC 95% OR: 1,2-23,4) y, marginalmente, a la presencia de tener < 2 polimorfismos no sinónimos en el receptor 1 de la melanocortina ( MC1R ) (OR: 5,0; IC 95% OR: 0,9-28,9). Limitaciones No se han incluido en el análisis algunos factores, como la alimentación, relacionados con los niveles de 25(OH)D. Conclusiones Se deberían monitorizar los niveles de 25(OH)D en los pacientes con melanoma y valorar dar suplementos orales en los casos que lo precisen.
La pandemia por SARS-CoV-2 está condicionando los abordajes diagnósticos, terapéuticos y asistenciales establecidos en esclerosis múltiple (EM). Durante las fases inicial y pico de la epidemia, los ...fármacos modificadores del curso de la EM caracterizados por ser inmunosupresores administrados en pulsos (TIP), vieron pospuesta su administración debido a la incertidumbre sobre su influencia en la infección, principalmente en contagiados/contagiosos asintomáticos/presintomáticos. El objetivo de este trabajo es presentar un algoritmo basado en criterios de seguridad que permita reanudar los TIP durante la fase de desescalado.
Se elabora un algoritmo, cuya estructura se sustenta en la experiencia clínica en EM de los autores y en una revisión bibliográfica del conocimiento acumulado, que facilita la detección de contagiosos asintomáticos, presintomáticos o con síntomas leves de SARS-CoV-2, con el objetivo de evitar la administración de TIP y contagios por contacto prolongado en hospital de día (HdD).
Algoritmo con doble filtro clínico-microbiológico consistente en la aplicación telemática de un listado de comprobación de síntomas y después realización de PCR para SARS-CoV-2 en exudado nasofaríngeo, a las 48 y 24h antes del TIP programado respectivamente.
Considerando el balance beneficio-riesgo, la aplicación del algoritmo resultaría ventajosa pese a que no se conoce la proporción real de asintomáticos/presintomáticos contagiosos. La realización sistemática de PCR, como test con mayor sensibilidad en la fase presintomática de la infección, en combinación con un sistema de detección precoz de síntomas, reduciría contagios y favorecería la identificación de pacientes con riesgo antes de su exposición a TIP.
The COVID-19 pandemic is changing approaches to diagnosis, treatment, and care provision in multiple sclerosis (MS). During both the initial and peak phases of the epidemic, the administration of disease-modifying drugs, typically immunosuppressants administered in pulses, was suspended due to the uncertainty about their impact on SARS-CoV-2 infection, mainly in contagious asymptomatic/presymptomatic patients. The purpose of this study is to present a safety algorithm enabling patients to resume pulse immunosuppressive therapy (PIT) during the easing of lockdown measures.
We developed a safety algorithm based on our clinical experience with MS and the available published evidence; the algorithm assists in the detection of contagious asymptomatic/presymptomatic cases and of patients with mild symptoms of SARS-CoV-2 infection with a view to withdrawing PIT in these patients and preventing new infections at day hospitals.
We developed a clinical/microbiological screening algorithm consisting of a symptom checklist, applied during a teleconsultation 48hours before the scheduled session of PIT, and PCR testing for SARS-CoV-2 in nasopharyngeal exudate 24hours before the procedure.
The application of our safety algorithm presents a favourable risk-benefit ratio despite the fact that the actual proportion of asymptomatic and presymptomatic individuals is unknown. Systematic PCR testing, which provides the highest sensitivity for detecting presymptomatic cases, combined with early detection of symptoms of SARS-CoV-2 infection may reduce infections and improve detection of high-risk patients before they receive PIT.
Although Snail factors promote cell survival in development and cancer, the tumor-suppressor p53 promotes apoptosis in response to stress. p53 and Snail2 act antagonistically to regulate p53 ...upregulated modulator of apoptosis (Puma) and cell death in hematopoietic progenitors following DNA damage. Here, we show that this relationship is conserved in the developing nervous system in which Snail genes are excluded from vertebrate neurons and they are substituted by Scratch, a related but independent neural-specific factor. The transcription of scratch2 is induced directly by p53 after DNA damage to repress puma, thereby antagonizing p53-mediated apoptosis. In addition, we show that scratch2 is required for newly differentiated neurons to survive by maintaining Puma levels low during normal embryonic development in the absence of damage. scratch2 knockdown in zebrafish embryos leads to neuronal death through the activation of the intrinsic and extrinsic apoptotic pathways. To compensate for neuronal loss, the proliferation of neuronal precursors increases in scratch2-deficient embryos, reminiscent of the activation of progenitor/stem cell proliferation after damage-induced apoptosis. Our data indicate that the regulatory loop linking p53/Puma with Scratch is active in the vertebrate nervous system, not only controlling cell death in response to damage but also during normal embryonic development.
A two‐channel switchable nanoscopic hybrid system, able to modulate mass transport by photoresponsive appended organic groups and the presence of G1.5 PAMAM dendrimers as molecular caps, is reported. ...This new functional gatelike ensemble is chemically (by pH changes) and photochemically (using visible light) controlled in pure aqueous solution, as demonstrated by an experiment involving the controlled release of a dye (see figure).
Purpose: Taking a literature review as a point of departure, the main aim of this paper was the identification of the behavioural indicators of innovators at the workplace, and their classification. ...Design/methodology/approach: A literature review was addressed by means of a search in Elsevier’s Scopus, Web of Science and Google Scholar. By applying inclusive and exclusive criteria, references were obtained with the search protocol. After filtering and scanning, there was a selection of references plus other articles added by the snowball effect. The final phase undertaken was the classification of the main indicators raised in the publications selected. Findings: Our main contribution was the identification of the behavioural indicators of innovators at the workplace and their classification in five dimensions. Practical implications: This research may yield some light on the assessment of innovative workplace performance of individuals in organisations, as well as on the development of the innovative competence of students in academic institutions as a challenge to meet the needs of both professionals and Higher Education institutions. Originality/value: Some authors have studied the characteristics of innovative people mainly focusing on cognitive abilities, personality, motivation and knowledge. We have sought to offer a better understanding of the phenomenon of individual innovation in organisations, through the analysis of behavioural indicators, an issue that has not been studied from this perspective previously.
Purpose: The purpose of our research is to show the point of view of the members of the Board concerning advantages, disadvantages and effectiveness of open ended questions used as a complement to ...closed response questionnaires.Design/methodology/approach: In this paper, we will describe a pilot experience carried out at a Spanish public university where a short questionnaire with open ended questions was launched, and students were invited to comment on their perception of the teaching received.Findings: The response return rate (about 35%) was relatively high compared to other online closed response questionnaires delivered. Moreover, the students’ comments provided valuable information which made the members of the Board of the Engineering Degree chosen reflect. Their reflection was evidence based and led to initiatives and actions to improve the quality of teaching, as well as to get an extensive view of the Degree.Practical implications: Findings reveal that the information retrieved can also be used in multiple ways such as formative feedback or even for improvement of courses and instruction. Originality/value: Student evaluation of teaching is a powerful tool for continuous teaching improvement but the information provided by conventional closed response questionnaires may not be sufficient.
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