Learning ethics through everyday problems: informed consent

The teaching of bioethics and its importance in clinical relationships is to a certain extent complicated when we address students of medicine, young people who are more used to dealing with and solving strictly clinical problems. Informed Consent is one of the aspects of professional practice that is generally and widely accepted in Western societies, although difficulties are still encountered in explaining it from a purely theoretical model. This situation led us to design an educational strategy to make the Informed Consent concept more understandable.     

Thermo-Mechanical Behavior of Textile Heating Fabric Based on Silver Coated Polymeric Yarn

This paper presents a study conducted on the thermo-mechanical properties of knitted structures, the methods of manufacture, effect of contact pressure at the structural binding points, on the degree of heating. The test results also present the level of heating produced as a function of the separation between the supply terminals. The study further investigates the rate of heating and cooling of the knitted structures. The work also presents the decay of heating properties of the yarn due to overheating. Thermal images were taken to study the heat distribution over the surface of the knitted fabric. A tensile tester having constant rate of extension was used to stretch the fabric. The behavior of temperature profile of stretched fabric was observed. A comparison of heat generation by plain, rib and interlock structures was studied. It was observed from the series of experiments that there is a minimum threshold force of contact at binding points of a knitted structure is required to pass the electricity. Once this force is achieved, stretching the fabric does not affect the amount of heat produced.     

Molecular characterisation and recent evolution of myxoma virus in Spain

Myxoma virus and the European rabbit are one of the best-studied examples of coevolution of pathogen virulence and host resistance. Since the introduction of the virus in Spain in 1953, a decrease in its virulence has been observed; however, most strains are still considered highly virulent. To determine whether this attenuation is due to molecular differences, and to characterise the field strains in Spain and the genetic changes that have occurred since the introduction of the virus, we analysed 7,741 bp in 97 virus samples from 12 localities. We found an extremely low genetic variability and an absence of a geographic structure. We defined 35 haplotypes, none of which were identical to the original Lausanne strain. Three genetic groups were determined and were found to occur at different frequencies in different locations. Overall, virus evolution deviated from neutrality and did not conform to a strict molecular clock, probably due to the existence of a strong selective pressure that acts differently across the viral genome.     

Comparative analysis of the expression of proliferating cell nuclear antigen, p53, bax, and bcl-2 in oral lichen planus and oral squamous cell carcinoma

Several epidemiologic studies have shown the malignant transformation potential of oral lichen planus; however, this potential is subject of much controversy. To evaluate the expression of proteins related to the cell proliferation and apoptosis processes in oral lichen planus, we compared oral lichen planus with oral squamous cell carcinoma. Twenty-four cases of each lesion were submitted according to streptavidin-biotin technique to evaluate the immunohistochemical expression of proliferating cell nuclear antigen, p53, bax, and bcl-2 proteins. χ² test showed no statistically significant differences between the expression of p53, bax, and bcl-2 in oral lichen planus and oral squamous cell carcinoma (P > .05). However, the expression of proliferating cell nuclear antigen was significantly lower in oral lichen planus than in oral squamous cell carcinoma (P < .05). No statistically significant differences between the expression of p53, bax, and bcl-2 in oral lichen planus and oral squamous cell carcinoma were observed, which may be an evidence of the potential of malignant transformation of oral lichen planus.     

Conjunctivitis with Regional Lymphadenopathy in a Trainee Microbiologist

We report a case of conjunctival tuberculosis in a trainee microbiologist caused by direct inoculation. The resident strain was analyzed by DNA fingerprinting, and an identical pattern was found in an isolate from sputum handled by the resident. After 6 months of treatment, the patient was cured.     

Non-invasive atrial fibrillation organization follow-up under successive attempts of electrical cardioversion

The development of non-invasive tools able to provide valuable information about the effectiveness of a shock in external electrical cardioversion (ECV) is clinically relevant to enhance these protocols in the treatment of atrial fibrillation (AF). The present contribution analyzes the ability of a non-linear regularity index, such as sample entropy (SampEn), to follow-up non-invasively AF organization under successive attempts of ECV and to predict the effectiveness of every single shock. To this respect, the atrial activity (AA) preceding each delivered shock was extracted by using a QRST cancellation method. Next, the main atrial wave (MAW), which can be considered as the fundamental waveform associated to the AA, was obtained by applying a selective filtering centered on the dominant atrial frequency (DAF). Finally, the MAW organization was estimated with SampEn and two thresholds (Th1 = 0.1223 and Th2 = 0.0832) were established to predict the ECV outcome. Results indicated that, prior to the first attempt, all the patients who needed only one shock to restore NSR were below Th1. In addition, most of them were above Th2 in case of AF relapsing during the first month. Regarding several shocks, all the patients who maintained NSR more than one month were below Th2 after the first shock. Moreover, all the patients who relapsed to AF during the first month were between Th1 and Th2 and, finally, all the patients with ineffective ECV were above Th1. After each unsuccessful shock, a SampEn relative decrease was observed for the patients who finally reverted to NSR, but the largest variation took place after the first attempt, thus indicating that this shock plays the most important role in the procedure. Indeed, by considering jointly the patients who needed only one shock and the patients who needed several shocks, 91.67% (22 out of 24) of ECVs resulting in NSR, 93.55% (29 out of 31) of ECVs relapsing to AF during the first month and 100% (10 out of 10) of ECVs in which NSR was not restored were correctly classified. As conclusion, the MAW organization analysis via SampEn can provide useful information that could improve the effectiveness of conventional external ECV protocols used in AF treatment.     

Reciprocal modulation of eye-blink and pinna-flexion components of startle during reward anticipation

Because expectancies play a central role in current theories of dopaminergic neuron function, it is important to develop measures of reward anticipation processes. In the present study, reflexogenic bursts of white noise were presented to 39 healthy young adults as they awaited rewards and punishments in a gambling-like task. The rewards were small pieces of chocolate; the punishments, segments of bitter-tasting banana peel. Consistent with prior research on affective valence, postauricular reflexes were larger prior to rewards than punishments, whereas the reverse was true for acoustic blink reflexes. We theorized that potentiation of the postauricular reflex prior to consuming appetizing food is related to the priming of ear-retraction musculature during nursing in our remote ancestors.     

Increased plasma levels of brain-derived neurotrophic factor in patients with long-term bipolar disorder

Recent data indicate that neurotrophins may play a role in the physiopathology of bipolar disorder (BD) and may be useful as biomarkers of the disease. The aim of this study was to evaluate the plasma concentrations of brain-derived neurotrophic factor (BDNF) in BD patients, and to correlate their levels with clinical parameters. BDNF was measured in plasma from 53 BD type I subjects (34 during mania and 19 during euthymia) and 38 healthy controls by enzyme-linked immuno-sorbent assay (ELISA). Patients were assessed by a structured clinical interview (Mini-plus), Young mania and Hamilton depression rating scales. Plasma BDNF levels were significantly increased in patients with mania (P ≤ 0.001) and euthymia (P ≤ 0.001) when compared with controls, but did not correlate with any clinical parameters. BDNF concentration was higher in BD patients with 10 or more years of disease. BDNF plasma levels were increased in BD patients, mainly in those with a longer course of disease. In line with previous studies, it is conceivable that BDNF may play a role in the pathophysiology of BD.