The detection and analysis of circulating tumor cells (CTCs) may enable a broad range of cancer-related applications, including the identification of acquired drug resistance during treatments. ...However, the non-scalable fabrication, prolonged sample processing times, and the lack of automation, associated with most of the technologies developed to isolate these rare cells, have impeded their transition into the clinical practice. This work describes a novel membrane-based microfiltration device comprised of a fully automated sample processing unit and a machine-vision-enabled imaging system that allows the efficient isolation and rapid analysis of CTCs from blood. The device performance was characterized using four prostate cancer cell lines, including PC-3, VCaP, DU-145, and LNCaP, obtaining high assay reproducibility and capture efficiencies greater than 93% after processing 7.5 mL blood samples spiked with 100 cancer cells. Cancer cells remained viable after filtration due to the minimal shear stress exerted over cells during the procedure, while the identification of cancer cells by immunostaining was not affected by the number of non-specific events captured on the membrane. We were also able to identify the androgen receptor (AR) point mutation T878A from 7.5 mL blood samples spiked with 50 LNCaP cells using RT-PCR and Sanger sequencing. Finally, CTCs were detected in 8 out of 8 samples from patients diagnosed with metastatic prostate cancer (mean ± SEM = 21 ± 2.957 CTCs/mL, median = 21 CTCs/mL), demonstrating the potential clinical utility of this device.
Introduction: Nowadays, it is increasingly urgent to regulate the use of the natural resources of our planet. From the field of physiotherapy, it is necessary to address this issue to ensure that our ...centers comply as much as possible with the Sustainable Development Goals (SDGs). Objective: To analyze the current situation in physiotherapy clinics in the Community of Madrid so as to identify whether their managers are aware of the concept of sustainability and its levels of application. Material and Methods: A survey study was carried out with the collaboration of 52 physiotherapy clinics in the Community of Madrid (Spain) to collect relevant data on sustainability. The questions were designed by experts in physiotherapy and sustainability with the aim of obtaining as much information as possible, analyzing the knowledge of sustainability and part of the goals established in the 2030 agenda. The procedures were conducted following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and checklist, in addition to following the Declaration of Helsinki. The study was approved by the Local Ethics Committee of the European University of Madrid, Madrid, Spain (CIPI/22.016). Results: A total of 35 questions were answered by 52 physiotherapy clinics in the Autonomous Community of Madrid (Spain) that completed the survey. In addition to the results of each question related to the concept of sustainability, significant differences were observed in the proportion of emotions detected with the NRC dictionary in the question about how waste is removed from the center (p = 0.002 and 0.008, respectively) with a higher proportion of positive feelings with emotions of joy, anticipation, confidence and surprise expressed by participants from clinics of less than 90 m2, while in those from clinics of more than 90 m2, negative feelings predominated with emotions of disgust, fear or sadness; in both cases, the effect of size was large and significant. Conclusions: Most of the physiotherapy clinics in the Community of Madrid that participated in the study are aware of the concept of sustainability. However, in practice, they do not sufficiently apply sustainability protocols in their clinics.
Las actividades extraescolares se engloban dentro de la educación no formal. Diversos autores destacan su impacto positivo en el desarrollo de las competencias interpersonales, el pensamiento crítico ...y la madurez de los escolares. En 2007, cerca del 92.0% del alumnado de Educación Primaria participaba en alguna actividad extraescolar. En este trabajo se presenta: una revisión sistemática de los artículos publicados entre 2000 y 2020 sobre las actividades extraescolares realizadas en España, y un estudio para profundizar en la naturaleza de las mismas, desarrollado con una encuesta referida al curso 2018/2019 y analizada siguiendo técnicas de estadística descriptiva e inferencial. De la revisión sistemática cabe destacar que más del 62.0% del alumnado viene participando en actividades extraescolares, preferentemente de carácter recreativo. En cuanto a la encuesta, no se aprecian preferencias marcadas entre las actividades cognitivas y las recreativas (50.2% vs. 49.8%). Entre las últimas, los niños participan 1.9 veces más que las niñas en las deportivas (Fútbol, Baloncesto, Tenis, etc.), mientras que las niñas realizan 7.6 veces más las relacionadas con las artes escénicas (Danza, Ballet, Flamenco, etc.). Un 76.7% de los escolares dedican de 2 a 4 días a la semana a estas actividades y el 26.7% las desarrollan en su propio colegio. Por otra parte, el 45.0% de sus tutores declaran un gasto mensual por escolar de 70€ o más para estas actividades. Se observa un cambio de tendencia hacia las actividades extraescolares cognitivas, con la aparición de nuevas como la Robótica, la Programación y las Científicas. La elección la realizan los propios escolares, manteniendo el sesgo de género en la decisión. Por último, su elevado coste, podría suponer un elemento más de exclusión social en las familias con menos recursos y no contribuir a la conciliación familiar y laboral.
INTRODUCTIONOutpatient laparoscopic cholecystectomy is a safe procedure and provides a better use of health resources and perceived satisfaction without affecting quality of care. Preoperative ...education has shown less postoperative stress, pain and nausea in some interventions. The principal objective of this study is to assess the impact of preoperative education on postoperative pain in patients undergoing ambulatory laparoscopic cholecystectomy. Secondary objectives were: to evaluate presence of nausea, morbidity, hospital admissions, readmissions rate, quality of life and satisfaction. METHODSProspective, randomized, and double blind study. Between April 2014 and May 2016, 62 patients underwent outpatient laparoscopic cholecystectomy. INCLUSION CRITERIAASA I-II, age 18-75, outpatient surgery criteria, abdominal ultrasonography with cholelithiasis. Patient randomization in two groups, group A: intensified preoperative education and group B: control. RESULTSSixty-two patients included, 44 women (71%), 18 men (29%), mean age 46,8 years (20-69). Mean BMI 27,5. Outpatient rate 92%. Five cases required admission, two due to nausea. Pain scores obtained using a VAS was at 24-hour, 2,9 in group A and 2,7 in group B. There were no severe complications or readmissions. Results of satisfaction and quality of life scores were similar for both groups. CONCLUSIONSWe did not find differences due to intensive preoperative education. However, we think that a correct information protocol should be integrated into the patient's preoperative preparation. Registered in ISRCTN number ISRCTN83787412.
The purpose of this study was to assess the effectiveness of the application of kinesio taping in reducing induced pain after dry needling of active trigger points (TrPs) to the upper trapezius ...muscle.
Consecutive patients had mechanical neck pain (n = 34, 44% female) with active TrPs in the upper trapezius muscle. All participants received dry needling into upper trapezius active TrPs. Then, they were randomly divided into a kinesio taping group, which received an adhesive tape (Kinesio Tex), and a control group, which did not receive the taping. The numeric pain rating scale was assessed (0-10) at post-needling; immediately after; and 24 hours, 48 hours, and 72 hours after needling. Neck- and shoulder-related disability was assessed before and 72 hours after needling with the Neck Disability Index (NDI) and the Shoulder Pain and Disability Index, respectively. The pressure pain threshold (PPT) over the TrP was also assessed post-needling, immediately post-intervention, and 72 hours after needling.
The analysis of covariance did not find a significant group × time interaction (P = .26) for post-needling soreness: both groups exhibited similar changes in post-needling induced pain (P < .001). No significant group × time interactions were observed for changes in NDI (P = .62), SPADI (P = .41), or PPTs (P = .52): similar improvements were found after the needling procedure for the NDI (P < .001), Shoulder Pain and Disability Index (P < .001), and PPT (P < .001). The number of local twitch responses and sex (all, P > .30) did not influence the effect for any outcome.
The application of kinesio taping after dry needling of active TrPs in the upper trapezius muscle was not effective for reducing post-needling induced pain in people with mechanical neck pain. Further, the application of kinesio taping as a post-needling intervention did not influence short-term changes in disability.
Circulating tumor cells (CTCs) have the potential of becoming the gold standard marker for cancer diagnosis, prognosis and monitoring. However, current methods for its isolation and characterization ...suffer from equipment variability and human operator error that hinder its widespread use. Here we report the design and construction of a fully automated high-throughput fluorescence microscope that enables the imaging and classification of cancer cells that were labeled by immunostaining procedures. An excellent agreement between our machine vision-based approach and a state-of-the-art microscopy equipment was achieved. Our integral approach provides a path for operator-free and robust analysis of cancer cells as a standard clinical practice.
Outpatient laparoscopic cholecystectomy is a safe procedure and provides a better use of health resources and perceived satisfaction without affecting quality of care. Preoperative education has ...shown less postoperative stress, pain and nausea in some interventions. The principal objective of this study is to assess the impact of preoperative education on postoperative pain in patients undergoing ambulatory laparoscopic cholecystectomy. Secondary objectives were: to evaluate presence of nausea, morbidity, hospital admissions, readmissions rate, quality of life and satisfaction.
Prospective, randomized, and double blind study. Between April 2014 and May 2016, 62 patients underwent outpatient laparoscopic cholecystectomy.
ASA I-II, age 18–75, outpatient surgery criteria, abdominal ultrasonography with cholelithiasis. Patient randomization in two groups, group A: intensified preoperative education and group B: control.
Sixty-two patients included, 44 women (71%), 18 men (29%), mean age 46.8 years (20–69). Mean BMI 27.5. Outpatient rate 92%. Five cases required admission, two due to nausea. Pain scores obtained using a VAS was at 24-hour, 2.9 in group A and 2.7 in group B. There were no severe complications or readmissions. Results of satisfaction and quality of life scores were similar for both groups.
We did not find differences due to intensive preoperative education. However, we think that a correct information protocol should be integrated into the patient's preoperative preparation.
Registered in ISRCTN number ISRCTN83787412.
La colecistectomía laparoscópica ambulatoria es segura y proporciona mejor aprovechamiento de recursos sanitarios y satisfacción percibida, sin repercutir en la calidad asistencial. La educación preoperatoria ha demostrado disminución del estrés, del dolor y náuseas postoperatorios en algunas intervenciones. El objetivo principal del estudio es valorar el impacto de la educación preoperatoria sobre el dolor postoperatorio en la colecistectomía laparoscópica ambulatoria. Los objetivos secundarios fueron evaluar las náuseas postoperatorias, morbilidad, ingresos no esperados, readmisiones, calidad de vida y grado de satisfacción.
Estudio prospectivo, aleatorizado, doble ciego. Entre abril de 2014 y mayo de 2016 fueron intervenidos 62 pacientes de colecistectomía laparoscópica ambulatoria.
ASA I-II, edad 18-75 años, criterios de ambulatorización, ecografía abdominal con colelitiasis. Aleatorización de pacientes en grupo A: educación preoperatoria intensificada, y grupo B: control.
Sesenta y dos pacientes incluidos, 44 mujeres (71%), 18 hombres (29%), edad media 46,8 años (20-69). Media IMC de 27,5. Tasa de ambulatorización del 92%, 5 casos requirieron ingreso, 2 fueron por náuseas. La media del grado de dolor según EVA fue a las 24h de 2,9 en el grupo A y de 2,7 en el grupo B. No complicaciones graves ni reingresos. La encuesta de satisfacción y el test de calidad de vida no mostraron diferencias entre grupos.
Las bajas cifras de dolor y complicaciones impiden evidenciar diferencias atribuibles a la educación preoperatoria. Sin embargo, un correcto protocolo de información se debería integrar en la preparación preoperatoria de los pacientes.
Registro ISRCTN con número de referencia ISRCTN83787412.
With an unprecedented mergers and acquisitions boom taking place in a pharmaceutical industry suffering rocketing development cost and a stagnation in the number of new medicines reaching the market, ...this dissertation provides insight on the extent to which this deal-making trend has consequences on R&D productivity. This analysis is focused on 2009 Roche’s acquisition of Genentech and shows the evolution of 6 key R&D metrics in a time frame that includes the years preceding and following the transaction. It identifies the signals given in terms of trends, which are instrumental to understand the transaction consequences on R&D activity. Evidence has been found that suggests an overall positive impact. Nevertheless, it is still necessary to continue tracking this particular case to assess if there is consistency in the trends and identify which might be the key success factors. Moreover, the relationship between the two companies involved and their R&D strategic direction is discussed.
Objetivo Establecer la correlación entre los métodos de Wintrobe y de micro-hematocritoMétodos Se tomaron 407 pacientes asistentes a un laboratorio de tercer nivel a quienes en forma simultánea se ...les realizó las dos pruebas en estudio.Resultados Mediante el un método estadístico de regresión lineal se encontró un coeficiente de correlación de 0,99.Conclusión Ambos métodos pueden contribuir al análisis clínico de los pacientes a quienes se les solicitó la prueba con fines de diagnóstico, control y seguimiento de diferentes patologías.
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