816 resultados para soy isoflavones
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Colorectal cancer (CRC) is the third most common cancer worldwide. Various factors such as age, lifestyle and dietary patterns affect the risk of having CRC. Epidemiological studies showed a chemopreventive effect of soy consumption against CRC. However, which component(s) of soybean is associated with this reduced risk is not yet fully delineated. The objective of this research was to evaluate the anti-colon cancer potential of lunasin isolated from defatted soybean flour using in vitro and in vivo models of CRC. Lunasin was isolated from defatted soybean flour by a combination of different chromatographic and ultrafiltration techniques. The anti-colon cancer potential of lunasin was determined using different human colon cancer cell lines in vitro and a CRC liver metastasis model in vivo. Lunasin caused cytotoxicity to different human colon cancer cells with an IC50 value of 13.0, 21.6, 26.3 and 61.7 µM for KM12L4, RKO, HCT-116 and HT-29 human colon cancer cells, respectively. This cytotoxicity correlated with the expression of the α5 integrin on human colon cancer cells with a correlation coefficient of 0.78. The mechanism involved in the cytotoxic effect of lunasin was through cell cycle arrest and induction of the mitochondrial pathway of apoptosis. In KM12L4 human colon cancer cells, lunasin caused a G2/M phase arrest increasing the percentage of cells at G2/M phase from 12% (PBS-treated) to 24% (treated with 10 µM lunasin). This arrest was attributed to the capability of lunasin to increase the expression of cyclin dependent kinase inhibitors p21 and p27. At 10 µM, lunasin increased the expression of p21 and p27 in KM12L4 colon cancer cells by 2.2- and 2.3-fold, respectively. Flow cytometric analysis showed that lunasin at 10 µM increased the percentage of cells undergoing apoptosis from 13.6% to 24.7%. This is further supported by fluorescence microscopic analysis of KM12L4 cells treated with 10 µM lunasin showing chromatin condensation and DNA fragmentation. The mechanism involved is through modification of proteins involved in the mitochondrial pathway of apoptosis in KM12L4 cells as 10 µM lunasin reduced the expression of the anti-apoptotic Bcl-2 protein by 2-fold and increased the expression of the pro-apoptotic proteins Bax, cytochrome c and nuclear clusterin by 2.2-, 2.1- and 2.3- fold, respectively. This led to increased expression and activity of the executioner of apoptosis, caspase-3 by 1.8- and 2.3-fold, respectively. This pro-apoptotic property of lunasin can be attributed to its capability to internalize into the cytoplasm and nucleus of colon cancer cells 24 h and 72 h after treatment, respectively. In addition, lunasin mediated metastasis of colon cancer cells in vitro by inhibiting the focal adhesion kinase activation thereby reducing expression of extracellular regulated kinase and nuclear factor kappa B and finally inhibiting migration of colon cancer cells. In KM12L4 colon cancer cells, 10 µM lunasin resulted in the reduction of phosphorylation of focal adhesion kinase and extracellular regulated kinase by 2.5-fold, resulting in the reduced nuclear translocation of p50 and p65 NF-κB subunits by 3.8- and 1.4-fold, respectively. In an in vivo model of CRC liver metastasis, daily intraperitoneal administration of lunasin at 4 mg/kg body weight resulted in the inhibition of KM12L4 liver metastasis as shown by the reduction of the number of liver metastases from 28 (PBS-treated) to 14 (lunasin-treated, P = 0.047) and reduction in tumor burden as measured by liver weight/body weight from 0.13 (PBS-treated) to 0.10 (lunasin-treated, P = 0.039). Moreover, lunasin potentiated the anti-metastatic effect of the chemotherapeutic drug oxaliplatin given at 5 mg/kg body weight twice per week. Lunasin and oxaliplatin combination resulted in a more potent inhibition of outgrowth of KM12L4 cell metastases to the liver reducing the number of liver metastases by 6-fold and reducing the tumor burden in the liver by 3-fold when compared to PBS-treated group. This can be attributed by the capability of lunasin and oxaliplatin to reduce expression of proliferating cell nuclear antigen in liver-tumor tissue as measured by immunohistochemical staining. The results of this research for the first time demonstrated the anti-colon cancer potential of lunasin isolated from defatted soybean flour which might contribute to the chemopreventive effect of soybean in CRC as seen in different epidemiological studies. In conclusion, lunasin isolated from defatted soybean flour mediated colon carcinogenesis by inducing apoptosis and preventing outgrowth of metastasis. We suggest that the results of this research serve as a basis for further study on the chemopreventive effect of lunasin against CRC and a possible adjuvant role for lunasin in therapy of patients with metastatic CRC.
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In this study, four hundred freshwater Crayfish (A. leptodactylus) with average weight of 25-40g were purchased from Aras dam reservoirs in west Azerbayjan province and transported to Iranian Artemia Research Center of Uromya province in September 2010. (One hundred crayfish extra purchased for probably mortality). Before implement of experiment the Crayfish were acclimated for ten days. These experiments was designed in four group treatments (Number, 1,2,3,4) and one control group (Number 5) in triplicate with 20 Crayfish in each repetition prepared of glass aquarium with size (50x40x30cm). Many of infected Crayfish were used for isolation of bacteria. Haemolymph sample had been gathered from infected Crayfish with cutting their antennules and transferred to TSA medium (tryptic soy agar) and then A. hydrophila were determined in order to biochemical test. The treatments and repetitions has exposed to A. hydrophila. The concentrations of the bacteria in 4 treatments were respectively 3 x 108 (T=10-15°C), 3x106 (T=25°C), 3 x 106 and 3 x 104 Cfu mL-1 (T=10- i5oc) (4, 2, 3 and 1) that were prepared in individual containers for exposure of treatments. The control (5) prepared without any bacteria and disinfected by oxytetracycline antibiotic with concentration 100 ppm for 24 hours. The hemolymph samples were withdrawn from abdominal second segments of Crayfish for measuring of THC and TPC in interval hours (2, 6, 12, 24, 48, 96, 144, 240 and 336). For histopatological studies the crayfish samples fixed in Davidson fixative. The results indicated that interval 2 hours after experiment the difference of THC value between treatment 4 with control and treatments 1,2, and 3 was significant (P< 0.05). After 48 hours of experiment the difference of THC value between control group with treatment 1 ,2 and 3 was significant (P< 0.05). The interval 336 hours after experiment also the difference of THC value between treatment 2 with treatments 1, 3 and 4 was significant (P< 0.05). The finding of TPP value showed that the last time after challenge (336 h) there was significant difference between treatment 2 with treatment 4 and control group (P< 0.05). In histopathology studying, in hepatopancreas observed hemocyte aggregated and necrosis withof peknosis nucleus that with increased concentration of bacteria and temperature, The value of hemocyte has increased. Gill revealed necrosis and cell death especially with increased concentration of bacteria and temperature. In lower concentration of bacteria in heart no difference observed, but with increased concentration of bacteria (3 x 108) the low aggregation of hemocyte observed in heart. In treatment 3 x 106 with high temperature also distributed of high hemocyte in heart was observed. In digestive system didn't appear any difference in treatments land 3 but in concentration of 3 x 108 Cfu m1-1 and 3 x 106 (T=25°C) in digestive system was revealed the low aggregation of hemocyte.
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Seeds from legumes including the Glycine max are known to be a rich source of protease inhibitors. The soybean Kunitz trypsin inhibitor (SKTI) has been well characterised and has been found to exhibit many biological activities. However its effects on inflammatory diseases have not been studied to date. In this study, SKTI was purified from a commercial soy fraction, enriched with this inhibitor, using anion exchange chromatography Resource Q column. The purified protein was able to inhibit human neutrophil elastase (HNE) and bovine trypsin. . Purified SKTI inhibited HNE with an IC50 value of 8 µg (0.3 nM). At this concentration SKTI showed neither cytotoxic nor haemolytic effects on human blood cell populations. SKTI showed no deleterious effects on organs, blood cells or the hepatic enzymes alanine amine transferase (ALT) and aspartate amino transferase (AST) in mice model of acute systemic toxicity. Human neutrophils incubated with SKTI released less HNE than control neutrophils when stimulated with PAF or fMLP (83.1% and 70% respectively). These results showed that SKTI affected both pathways of elastase release by PAF and fMLP stimuli, suggesting that SKTI is an antagonist of PAF/fMLP receptors. In an in vivo mouse model of acute lung injury, induced by LPS from E. coli, SKTI significantly suppressed the inflammatory effects caused by elastase in a dose dependent manner. Histological sections stained by hematoxylin/eosin confirmed this reduction in inflammation process. These results showed that SKTI could be used as a potential pharmacological agent for the therapy of many inflammatory diseases
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Una presentación de la actual educación de bibliotecarios en Suecia y de su historia durante el siglo XX.Mi nombre es Kerstin Rydbeck y soy profesora de biblioteconomía y ciencias de la información en la universidad de Uppsala en Suecia. El objetivo de mi conferencia es presentarles a ustedes a grandes rasgos la situación y características de la carrera de biblioteconomía en Suecia, las oportunidades del mercado de trabajo para nuestros egresados y también una visión de futuro desde la perspectiva del profesorado. Yo usaré el termino biblioteconomía que es el usado en España. Aquí quizá ustedes usan bibliotecología.
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Dissertação (mestrado)—Universidade de Brasília, Faculdade UnB Planaltina, Programa de Pós-Graduação em Meio Ambiente e Desenvolvimento Rural, 2015.
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O escoamento sanguíneo é um dos temas de grande interesse para a comunidade científica. Assim, a busca de fluidos que sejam análogos ao sangue bem como o estudo do seu escoamento em microcanais, tal como acontece com o sangue nos capilares, continua a ser alvo de investigação. Numa primeira fase deste trabalho, procedeu-se ao desenvolvimento de um modelo inovador para produzir glóbulos vermelhos artificiais, constituído por Vesículas Unilamelares Gigantes, vulgarmente designadas Giant Unilamellar Vesicles (GUVs), com três concentrações diferentes. Pretende-se que estas vesículas tenham um comportamento reológico idêntico ao escoamento dos glóbulos vermelhos (GVs) em microcanais, permitindo assim proceder a vários estudos hemodinâmicos. No desenvolvimento destas vesículas, foi verificado que as mais adequadas são constituídas por uma mistura natural de lípidos e lecitina de soja. Foi realizado um estudo relativamente à sua concentração, onde se verificou que, com o aumento da quantidade da lecitina de soja nas soluções, a concentração de GUVs tende a aumentar. Foi também realizado um estudo relativo aos diâmetros dos GUVs para verificar se estes se aproximavam em termos de tamanho dos GVs, onde foi verificado que a maioria dos GUVs possuem diâmetros com dimensões entre os 5 e 7 μm, tal como os GVs. Foi ainda verificado que a solução com a menor concentração de lecitina de soja possui uma maior quantidade de GUVs com diâmetros entre os 5 e 7 μm. Na segunda fase, foi estudado experimentalmente o escoamento das três soluções de GUVs em microcanais hiperbólicos, com três caudais diferentes, com o objetivo de visualizar a Camada Livre de Células (CLC), determinar a deformação e estudar as velocidades destes. Foi verificado que existe a formação de CLC em todas as concentrações e que aumenta com o aumento do caudal. Relativamente à deformação, esta é bastante mais evidente na contração do microcanal onde a taxa deformação é máxima. Para o caso da velocidade, foi observado um aumento bastante significativo e linear da velocidade na região da contração do microcanal hiperbólico e uma velocidade baixa e aproximadamente constante a montante e jusante da contração. vi Por fim, foi também realizado o estudo reológico dos GUVs, de forma a investigar se estes têm uma viscosidade próxima do sangue. Foi verificado que os GUVs apresentam uma viscosidade inferior à do sangue total e que existe um ligeiro aumento da viscosidade dos GUVs com o aumento da sua concentração. Por último, também foi efetuada uma comparação da viscosidade da solução de GUVs com uma solução de 5% de Hematócrito (Hct) em soro fisiológico, onde foi verificado que ambas as viscosidades são muito próximas.
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he present model of agriculture is based on intensive use of industrial inputs, due to its rapid response, but it brings harmful consequences to the environment, and it is necessary the use of modern inputs. And an alternative is the use of rock biofertilizers in agriculture, a product easy to use, with higher residual effect and does not harm the environment. The objective of study was to evaluate the inoculation and co-inoculation of different microorganisms in the solubilization of rock phosphate and potash ground microbial evaluating the best performance in the production of biofertilizers comparing with rocks pure in soil chemical properties and, verify effect of inoculation of the bacterium Paenibacillus polymyxa in the absorption of minerals dissolved in the development of cowpea (Vigna unguiculata [L.] Walp.). The first bioassay was conducted in Laboratory (UFRN) for 72 days in Petri dishes, where the rock powder was increased by 10% and sulfur co-inoculated and inoculated with bacterial suspension of Paenibacillus polymyxa grown in medium tryptone soy broth, Ralstonia solanacearum in medium Kelman, Cromobacterium violaceum in medium Luria-Bertani and Acidithiobacillus thiooxidans in medium Tuovinen and Kelly,and fungi Trichoderma humatum and Penicillium fellutanum in malt extract. Every 12 days, samples were removed in order to build up the release curve of minerals. The second bioassay was conducted in a greenhouse of the Agricultural Research Corporation of Rio Grande do Norte in experimental delineation in randomized block designs, was used 10 kg of an Yellow Argissolo Dystrophic per pot with the addition of treatments super phosphate simple (SS), potassium chloride (KCl), pure rock, biofertilizers in doses 40, 70, 100 and 200% of the recommendation for SS and KCl, and a control, or not inoculated with bacteria P. polymyxa. Were used seeds of cowpea BRS Potiguar and co-inoculated with the bacterial suspension of Bradyrhizobium japonicum and P. polymyxa. The first crop was harvested 45 days after planting, were evaluated in the dry matter (ADM), macronutrients (N, P, K, Ca, Mg) and micronutrients (Zn, Fe, Mn) in ADM. And the second at 75 days assessing levels of macro end micronutrients in plants and soil, and the maximum adsorption capacity of P in soil. The results showed synergism in co-inoculations with P. polymyxa+R. solanacearum and, P. polymyxa+C. violaceum solubilizations providing higher P and K, respectively, and better solubilization time at 36 days. The pH was lower in biofertilizers higher doses, but there was better with their addition to P at the highest dose. Significant reduction of maximum adsorption capacity of phosphorus with increasing dose of biofertilizer. For K and Ca was better with SS+KCl, and Mg to pure rock. There was an effect of fertilization on the absorption, with better results for P, K and ADM with SS+KCL, and N, Ca and Mg for biofertilizers. Generally, the P. polymyxa not influence the absorption of the elements in the plant. In treatments with the uninoculated P. polymyxa chemical fertilizer had an average significantly higher for weight and number of grains. And in the presence of the bacteria, biofertilizers and chemical fertilizers had positive values in relation to rock and control. The data show that the rocks and biofertilizers could meet the need of nutrients the plants revealed as potential for sustainable agriculture
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Optimization of Carnobacterium divergens V41 growth and bacteriocin activity in a culture medium deprived of animal protein, needs for food bioprotection, was performed by using a statistical approach. In a screening experiment, twelve factors (pH, temperature, carbohydrates, NaCl, yeast extract, soy peptone, sodium acetate, ammonium citrate, magnesium sulphate, manganese sulphate, ascorbic acid and thiamine) were tested for their influence on the maximal growth and bacteriocin activity using a two-level incomplete factorial design with 192 experiments performed in microtiter plate wells. Based on results, a basic medium was developed and three variables (pH, temperature and carbohydrates concentration) were selected for a scale-up study in bioreactor. A 23 complete factorial design was performed, allowing the estimation of linear effects of factors and all the first order interactions. The best conditions for the cell production were obtained with a temperature of 15°C and a carbohydrates concentration of 20 g/l whatever the pH (in the range 6.5-8), and the best conditions for bacteriocin activity were obtained at 15°C and pH 6.5 whatever the carbohydrates concentration (in the range 2-20 g/l). The predicted final count of C. divergens V41 and the bacteriocin activity under the optimized conditions (15°C, pH 6.5, 20 g/l carbohydrates) were 2.4 x 1010 CFU/ml and 819200 AU/ml respectively. C. divergens V41 cells cultivated in the optimized conditions were able to grow in cold-smoked salmon and totally inhibited the growth of Listeria monocytogenes (< 50 CFU g-1) during five weeks of vacuum storage at 4° and 8°C.
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Biodiesel is a fuel obtained from vegetable oils, such as soy, castorbean, among others. The monoester of fatty acid of these oils have chains with mono, di and tri double connections. The presence of these insaturations are susceptible to oxidization. Antioxidants are substances able to prevent oxidization from oils, fats, fat foods, as well as esters of Alquila( biodiesel). The objective of this work is to summarize a new antioxidant from the Cashew Nut Shell Liquid (CNSL) using the electrolysis technique. A current of 2 amperes was used in a single cell of only one group and two eletrodos of stainless steel 304 in a solution of methanol, together with the eletrolits: acetic acid, sodium chloride and sodium hydroxide, for two hours of agitation. The electrolysis products are characterized by the techniques of cromatography in a thin layer, spectroscopy of infrared and gravimetric analysis. The material was submitted to tests of oxidative stability made by the techniques of spectropy of impendancy and Rancimat (EN 14112). The analyses of characterization suggest that the polimerization of the electrolytic material ocurred. The application results of these materials as antioxidants of soy biodiesel showed that the order of the oxidative stability was obtained by both techniques used
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Stable isotope analyses were applied to explore the relative dietary nitrogen contributions from fish meal and pea meal (Pisum sativum) to muscle tissue of Pacific white shrimp postlarvae (141 ± 31 mg) fed low protein diets having different proportions of both ingredients as the sole dietary protein sources. A negative control diet was formulated to contain 100% pea meal and six more isoproteic diets to have decreasing levels of pea meal-derived nitrogen: 95%, 85%, 70%, 55%, 40% and 0% of the initial level. Growth rates were negatively correlated to dietary pea protein inclusion due to progressive essential amino acid deficiencies (sulphur amino acids, threonine, lysine, histidine). The nitrogen turnover rate significantly increased in muscle tissue of shrimps fed diets having high levels of pea meal; however, contrary to observations from a previous study using soy protein, the relative contributions of dietary nitrogen from pea meal to shrimp muscle tissue were equal or higher than expected contributions established by the dietary formulations. Results highlight the effectiveness of stable isotope analysis in assessing the nutritional contributions of alternative ingredients for aquaculture feeds and the potential suitability of pea as a source of protein (provided the diets are nutritionally balanced)
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En este modesto intento de hacer un esquema de la historia de Cuenca hay lagunas y fallas que soy el primero en reconocer; sin embargo, lo ofrezco a la consideración pública porque estoy convencido de que en sus páginas no dejarán de encontrarse datos que sirvan para el mejor conocimiento de una comarca que, si vale mucho como parte integrante de la Patria, también significa bastante si se la juzga en forma aislada, pues cuando la región Cañari se incorpora en 1534 al dominio de España no adviene como pueblo oscuro y sin raigambre, • sino trayendo consigo un rico acervo de cualidades que le dan aspecto propio, peculiar, enteramente suyo, que lo conserva hasta ahora con la recia vitalidad de su cepa milenaria. Si «el pasado es la fuerza viva y actuante que sostiene nuestro hoy», como declara insigne pensador contemporáneo, que Cuenca reafirme la fe en sus destinos, pues lo glorioso de su historia de ayer es símbolo claro de la que hoy escribe (son lustre y decoro que no habrán de desmayar en el porvenir.
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RESUMO: O objetivo deste estudo foi verificar a influência de Apis mellifera na produção de grãos e qualidade de sementes da soja transgênica Glycine max (L.) Merrill Roundup ReadyTM e convencional. A soja transgênica foi plantada intercalada com a convencional, em 18 parcelas, em três tratamentos: gaiolas com abelhas A. mellifera, gaiolas sem abelhas e áreas descobertas, com livre visitação de insetos. Na soja transgênica, em três parcelas de cada tratamento, foi aplicado glifosato, 30 dias após a emergência. Os parâmetros analisados foram: produção de grãos; número de vagens por planta; peso de 100 sementes e porcentagem de germinação das sementes. Não houve diferença entre as cultivares, entretanto a produção de 2.757,40 kg ha-1 obtida na área coberta por gaiola com abelhas, e 2.828,47 kg ha-1 na área livre para visitação de insetos foram superiores a 2.000,53 kg ha-1 da área coberta por gaiola sem abelhas. O número de vagens por planta foi maior na área coberta por gaiola com abelhas (38,28) e área livre (32,65), quando comparado com o da área coberta por gaiola sem abelhas (21,19). O peso médio de 100 sementes e a germinação das sementes não foram diferentes entre as cultivares e nem entre os tratamentos. Conclui-se que, para as cultivares estudadas, houve benefício na produção de grãos de 37,84%, quando foi permitida a visita de abelhas. ABSTRACT. Pollination by Apis mellifera in transgenic soy (Glycine max (L.) Merrill) Roundup Ready? cv. BRS 245 RR and conventional cv. BRS 133. This research was carried out to evaluate the influence of Africanized honeybees in grain production and seed quality of Glycine max (L.) Merrill Roundup Ready? transgenic soy, as well as of conventional soy. Transgenic soy was interposed with conventional soybean, in 18 plots and three treatments: covered area with Africanized honeybees, covered area without honeybees, and uncovered area with free insect visitation. The herbicide Glyphosate was applied on three plots of each treatment of transgenic soy, 30 days after emergence. Grain production, number of pods/plant, weight per 100 seeds, and seed germination percentage were evaluated. There was no difference among cultivars; however, the production in the covered area with honeybees (2757.4 kg ha-1) and in the uncovered area (2828.47 kg ha-1) were higher than in the covered area without honeybees (2000.53 kg ha-1). The number of pods/plant was greater than in the covered area with honeybees (38.28) and in the uncovered area (32.65) as compared to the covered area without honeybees (21.19). The weight per 100 seeds seed germination did not differ among cultivars or treatments. It can be concluded that, for these cultivars, there was a rise in grain production of 37.84% when honeybee visits were allowed.
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In a hospital environment, these bacteria can be spread by insects such as ants, which are characterized by high adaptability to the urban environment. Staphylococcus is a leading cause of hospital infection. In Europe, Latin America, USA and Canada, the group of coagulase negative staphylococci (CoNS) is the second leading cause of these infections, according to SENTRY (antimicrobial surveillance program- EUA). In this study, we investigated the potential of ants (Hymenoptera: Formicidae) as vehicle mechanics of Staphylococcus bacteria in a public hospital, in Natal-RN. The ants were collected, day and night, from June 2007 to may 2008, in the following sectors: hospitals, laundry, kitchen, blood bank. The ants were identified according to the identification key of Bolton, 1997. For the analysis of staphylococci, the ants were incubated in broth Tryptic Soy Broth (TSB) for 24 hours at 35 º C and then incubated on Mannitol Salt Agar. The typical colonies of staphylococci incubated for 24 hours at 35 ° C in Tryptic Soy Agar for the characterization tests (Gram stain, catalase, susceptibility to bacitracin and free coagulase). The identification of CoNS was performed through biochemical tests: susceptibility to novobiocin, growth under anaerobic conditions, presence of urease, the ornithine decarboxylation and acid production from the sugars mannose, maltose, trehalose, mannitol and xylose. The antimicrobial susceptibility examined by disk-diffusion technique. The technique of Polymerase Chain Reaction was used to confirm the presence of mecA gene and the ability to produce biofilm was verified by testing in vitro using polystyrene inert surface, in samples of resistant staphylococci. Among 440 ants, 85 (19.1%) were carrying coagulase-negative staphylococci (CoNS) of the species Staphylococcus saprophyticus (17), Staphylococcus epidermidis (15), Staphylococcus xylosus (13), Staphylococcus hominis hominis (10), Staphylococcus lugdunensis (10), Staphylococcus warneri (6), Staphylococcus cohnii urealyticum (5), Staphylococcus haemolyticus (3), Staphylococcus simulans (3), Staphylococcus cohnii cohnii (2), and Staphylococcus capitis (1). No Staphylococcus aureus was found. Among the isolates, 30.58% showed resistance to erythromycin. Two samples of CoNS (2.35%), obtained from the ant Tapinoma melanocephalum collected in the post-surgical female ward, S. Hominis hominis and S. lugdunensis harbored the mecA gene and were resistant to multiple antibiotics, and the specie S. hominis hominis even showed to be a biofilm producer. This study proves that ants act as carriers of multidrug-resistant coagulase-negative Staphylococci and biofilm producers and points to the risk of the spreading of pathogenic microorganisms by this insect in the hospital environment
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El análisis de la situación de salud del nuevo mileno, muestra un perfil epidemiológico con un incremento de población adulta mayor, patologías crónicas complejas y procesos degenerativos. Esta situación incrementa el nivel de dependencia del paciente y promueve la necesidad de articular fórmulas alternativas a la hospitalización convencional. La ambulatorización de procesos asistenciales, desarrolla el concepto de hospital hacia un modelo institucional más abierto y dinámico con un mejor conocimiento de las consultas de atención especializada. La coordinación socio sanitaria de los servicios de salud impulsa la intervención de equipos multidisciplinarios y el rol de la enfermera en la gestión del cuidado. Las consultas externas de atención especializada son el principal punto de contacto del hospital con la población de su área de influencia y tienen como objetivo asegurar de la forma más ágil el abordaje de los problemas de salud del paciente sano o enfermo con su entorno de convivencia. No obstante, el desempeño del rol enfermero está influido por una serie de factores de riesgo que pueden interferir en el proceso asistencial y en los resultados de salud...