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Jara Rascon J.,Francisco de Vitoria University
Cuadernos de bioetica : revista oficial de la Asociacion Espanola de Bioetica y Etica Medica | Year: 2014

Introduction. The concept of person-based medicine may be transmitted to undergraduate studies and the subject of History of Medicine can be a good chance for it, if we engage the students to confront them with the characters, values and actions of those personalities who achieved the principal scientific advances in biomedicine area. Material and Method. In this work, it is described a methodological experience in the transmission of knowledge of History of Medicine following a teaching model which was lead on 130 students who performed analysis on circumstances, actions and ethical values of physicians and scientists that led to significant advances in the field of biomedicine through history. Thus, each student was assigned the subject of one character for study and every one was asked to make an oral presentation with a brief written work including a personal reflection. Results. Oral presentations and written works showed how students were able to do a balance of ethical implications in 77% of the cases. Only 23% of students were not able to see ethical perspectives of the studied characters. The most frequently refered values were the attitudes of perseverance in the study, the selfless dedication to patients and the passionate effort on continuous learning. Conclussions. Undergraduate training in Health Sciences and Medicine offers an excellent training opportunities in ethics and transmission of values through humanistic subjects such as the History of Medicine. The self-reflection by students on the main characters of scientific advances seems to be a good education proposal to promote ethical awareness.


Ruiz Moral R.,Francisco de Vitoria University | Alvarez Montero S.,Francisco de Vitoria University
Educacion Medica | Year: 2017

This study initially seeks to clarify features and components of a "person-patient centred" physician-patient communication, and define the ethical values of this kind of practice. The study addresses the inextricable interface between communication (relationship) and ethics, and it also highlights how this communication-ethics link is reflected in usual physician practice, in their actions, through their attitudes and habits (the character). This will reveal the inescapable need to educate our medical students in values and skills, in order to be able to perform a genuine and effective "patient-centered care." This, in turn, will show how this type of medical education reverberates on the person-doctor by moulding their character. © 2017 Elsevier España, S.L.U.


Piedras M.J.,Francisco de Vitoria University | Saura M.,University of Alcalá | Zaragoza C.,Francisco de Vitoria University
Arteriosclerosis, Thrombosis, and Vascular Biology | Year: 2014

Objective - Nitric oxide synthase 3 (NOS3) prevents neointima hyperplasia by still unknown mechanisms. To demonstrate the significance of endothelial nitric oxide in the polarization of infiltrated macrophages through the expression of matrix metalloproteinase (MMP)-13 in neointima formation. Approach And Results - After aortic endothelial denudation, NOS3 null mice show elevated neointima formation, detecting increased mobilization of LSK (lineage-negative [Lin]-stem-cell antigen 1 [SCA1]+KIT+) progenitor cells, and high ratios of M1 (proinflammatory) to M2 (resolving) macrophages, accompanied by high expression of interleukin-5, interleukin-6, MCP-1 (monocyte chemoattractant protein), VEGF (vascular endothelial growth factor), GM-CSF (granulocyte-macrophage colony stimulating factor), interleukin-1β, and interferon-γ. In conditional c-Myc knockout mice, in which M2 polarization is defective, denuded aortas showed extensive wall thickening as well. Conditioned medium from NOS3-deficient endothelium induced extensive repolarization of M2 macrophages to an M1 phenotype, and vascular smooth muscle cells proliferated and migrated faster in conditioned medium from M1 macrophages. Among the different proteins participating in cell migration, MMP-13 was preferentially expressed by M1 macrophages. M1-mediated vascular smooth muscle cell migration was inhibited when macrophages were isolated from MMP-13-deficient mice, whereas exogenous administration of MMP-13 to vascular smooth muscle cell fully restored migration. Excess vessel wall thickening in mice lacking NOS3 was partially reversed by simultaneous deletion of MMP-13, indicating that NOS3 prevents neointimal hyperplasia by preventing MMP-13 activity. An excess of M1-polarized macrophages that coexpress MMP-13 was also detected in human carotid samples from endarterectomized patients. Conclusions - These findings indicate that at least M1 macrophage-mediated expression of MMP-13 in NOS3 null mice induces neointima formation after vascular injury, suggesting that MMP-13 may represent a new promising target in vascular disease. © 2014 American Heart Association, Inc.


Alvarez-Diaz S.,Autonomous University of Madrid | Alvarez-Diaz S.,Walter and Eliza Hall Institute of Medical Research | Valle N.,Autonomous University of Madrid | Valle N.,Francisco de Vitoria University | And 6 more authors.
Human Molecular Genetics | Year: 2012

Vitamin D deficiency is associated with the high risk of colon cancer and a variety of other diseases. The active vitamin D metabolite 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3) regulates gene transcription via its nuclear receptor (VDR), and posttranscriptional regulatory mechanisms of gene expression have also been proposed. We have identified microRNA-22 (miR-22) and several other miRNA species as 1,25(OH)2D3 targets in human colon cancer cells. Remarkably, miR-22 is induced by 1,25(OH)2D3 in a time-, dose- and VDR-dependent manner. In SW480-ADH and HCT116 cells, miR-22 loss-of-function by transfection of a miR-22 inhibitor suppresses the antiproliferative effect of 1,25(OH)2D3. Additionally, miR-22 inhibition increases cell migration per se and decreases the antimigratory effect of 1,25(OH)2D3 in both cell types. In silico analysis shows a significant overlap between genes suppressed by 1,25(OH)2D3 and miR-22 putative target genes. Consistently, miR-22 inhibition abrogates the 1,25(OH)2D3-mediated suppression of NELL2, OGN, HNRPH1, RERE and NFAT5 genes. In 39 out of 50 (78%) human colon cancer patients, miR-22 expression was found lower in the tumour than in the matched normal tissue and correlated directly with that of VDR. Our results indicate that miR-22 is induced by 1,25(OH)2D3 in human colon cancer cells and it may contribute to its antitumour action against this neoplasia. © The Author 2012. Published by Oxford University Press. All rights reserved.


Herruzo R.,Autonomous University of Madrid | Vizcaino M.J.,Autonomous University of Madrid | Herruzo I.,Francisco de Vitoria University
Journal of Hospital Infection | Year: 2014

Microbial contamination of hospital surfaces may be a source of infection for hospitalized patients. We evaluated the efficacy of Glosair™ 400 against two American Type Culture Collection strains and 18 clinical isolates, placed on glass germ-carriers. Carriers were left to air-dry for 60min and then exposed to a cycle before detection of any surviving micro-organisms. Antibiotic-susceptible Gram-negative bacilli were less susceptible (although not significantly) to this technique than resistant Gram-negative bacilli or Gram-positive cocci and yeasts (3, 3.4 and 4.6 log10 reduction, respectively). In conclusion, in areas that had not been cleaned, aerosolized hydrogen peroxide obtained >3 log10 mean destruction of patients' micro-organisms. © 2014 The Healthcare Infection Society.


Ruiz-Garcia J.,Francisco de Vitoria University | Alegria-Barrero E.,Francisco de Vitoria University
Journal of Cardiovascular Pharmacology and Therapeutics | Year: 2016

As drug development becomes a long and demanding process, it might also become a barrier to medical progress. Drug safety concerns are responsible for many of the resources consumed in launching a new drug. Despite the money and time expended on it, a significant number of drugs are withdrawn years or decades after being in the market. Cardiovascular toxicity is one of the major reasons for those late withdrawals, meaning that many patients are exposed to unexpected serious cardiovascular risks. It seems that current methods to assess cardiovascular safety are imperfect, so new approaches to avoid the exposure to those undesirable effects are quite necessary. Endothelial dysfunction is the earliest detectable pathophysiological abnormality, which leads to the development of atherosclerosis, and it is also an independent predictor for major cardiovascular events. Endothelial toxicity might be the culprit of the cardiovascular adverse effects observed with a significant number of drugs. In this article, we suggest the regular inclusion of the best validated and less invasive endothelial function tests in the clinical phases of drug development in order to facilitate the development of drugs with safer cardiovascular profiles. © SAGE Publications.


Clinical communication is nowadays one of the core competencies of a clinician and so is being introduced into medical educational programs. Both, the strategy for introducing Communication Skills in health sciences curricula as how to teach and evaluate them is at present a topic for debate. In this process, an important drawback is lack of clarity about the theoretical constructs underlying the patient-centered communication model, as well as the still limited and sometimes contradictory scientific evidence about its relationship with relevant health outcomes. This article highlights two key dimensions of clinical communication: its own communicative nature and the person-centered orientation. In this paper some general principles and theories of human communication and a pragmatic approach to biopsychosocial model are used for presenting graphically a rational framework proposal that highlights the most relevant communicational components of clinical care. These components can be considered as an open and revisable framework to guide educators and clinicians in the selection, organization and structuring the specific competencies and communication skills to be taught in undergraduate and postgraduate medical education. © 2015.


Echavarren A.U.,Francisco de Vitoria University
International Journal of Human Capital and Information Technology Professionals | Year: 2011

Although a wide consensus exists about potential business benefits derived from Competency based HR management practices, reality shows that in practice, Competency Management deployment cases are scarce and difficult to implement. This HR business related problem directly affects IT Software industries, both in HRMS applications development and consultancy related services. Market indicators reflect 'unbalance' between potential organizational benefits and actual applications deployment. In this context, defining useful, business-oriented Competency Frameworks has become an important challenge for many organizations willing to progress along through continuous HRMimprovement processes. This paper addresses the major issues underlying this Competency Management unbalance. A new business-oriented approach proposing an alternative, scope extended methodology is outlined in this publication, after field validation and wide acceptance from experts in functional HR management and IT Systems professionals from various large size organizations. Therefore, the findings resulting from this research work have both theoretical and practical implications in helping IT management in defining efficient HRMS Competency based applications and deployment strategies. Copyright © 2011, IGI Global.


Garcia-Urena M.A.,Francisco de Vitoria University | Lopez-Monclus J.,Francisco de Vitoria University | Hernando L.A.B.,Francisco de Vitoria University | Montes D.M.,Francisco de Vitoria University | And 4 more authors.
Annals of Surgery | Year: 2015

Objective: To reduce the incidence of incisional hernia (IH) in colorectal surgery by implanting a mesh on the overlay position. Background: The incidence of IH in colorectal surgery may be as high as 40%. IH causes severe health and cosmetic problems, and its repair increases health care costs. Material and Methods: Randomized, controlled, prospective trial. Patients undergoing any colorectal procedure (both elective and emergency) through a midline laparotomy were divided into 2 groups. The abdomen was closed with an identical technique in both groups, except for the implantation of an overlay large-pore polypropylene mesh in the study group. Patients were followed up clinically and radiologically for 24 months. Results: A total of 107 patients were included: 53 in the study group and 54 in the control group. Both groups were homogeneous, except for a higher incidence of diabetes in the mesh group. There were 20 emergency procedures in the study group and 17 in the control group. There were no statistical differences in surgical site infections, seromas, or mortality between the groups (33.3%, 13.8%, and 3.7% in the control group and 18.9%, 13.2%, and 3.8% in the study group). No mesh rejection was reported. The incidence of IH was 17 of 54 (31.5%) in the control group and 6 of 53 (11.3%) in the study group (P = 0.011). Conclusions: The incidence of IH is high in patients undergoing elective or emergency surgery for colorectal diseases. The addition of a prophylactic large-pore polypropylene mesh on the overlay position decreases the incidence of IH without adding morbidity. © 2014 Wolters Kluwer Health, Inc. All rights reserved.


Iglesias M.T.,Francisco de Vitoria University
Lazaroa | Year: 2010

Fire is a dominant factor in the evolution and ecology of Mediterranean-type ecosystems. The effects of wildfires on the chemical properties of soils beneath the Aleppo pine forest, after recurrent and individual fires, have been studied. The burned area was located near Montpellier (south-eastern France) where the climate is Mediterrancan. In the burned area 30 plots of soils (10 burned in July 1981; 10 burned in September 1996; and 10 burned in July 1981 and reburned in September 1996) were selected and sampled. Ten soils were also sampled in an unburned part of the forest as control. All soils (burned and unburned) were sampled at 0-5 (layer 1 ) and 5-10 (layer 2) cm depth. The greatest differences were observed in soils burned in 1996 in comparison with the others; there were also increases of organic matter in the burned soils, as well as in total N and available P, particularly in layer 2. Levels of Ca were slightly higher in burned than in control soils, but exchangeable Mg and K did not differ significantly. The pH values did not change after wildfires; but electrical conductivity decreased slightly in layer 1 of the burned soils. Values for exchangeable cations of burned soils were always similar to mose in control soils.

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