Notch controls the cell cycle to define leader versus follower identities during collective cell migration.

Coordination of cell proliferation and migration is fundamental for life, and its dysregulation has catastrophic consequences, such as cancer. How cell cycle progression affects migration, and vice versa, remains largely unknown. We address these questions by combining in silico modelling and in vivo experimentation in the zebrafish trunk neural crest (TNC). TNC migrate collectively, forming chains with a leader cell directing the movement of trailing followers. We show that the acquisition of migratory identity is autonomously controlled by Notch signalling in TNC. High Notch activity defines leaders, while low Notch determines followers. Moreover, cell cycle progression is required for TNC migration and is regulated by Notch. Cells with low Notch activity stay longer in G1 and become followers, while leaders with high Notch activity quickly undergo G1/S transition and remain in S-phase longer. In conclusion, TNC migratory identities are defined through the interaction of Notch signalling and cell cycle progression.

O princípio da partilha de saberes científicos vs. propriedade intelectual: a propósito das patentes farmacêuticas no contexto da pandemia de COVID-19 / The principle of sharing scientific knowledge vs. intellectual property: Regarding pharmaceutical patents in the context of the COVID-19 pandemic / El principio de compartir conocimiento científico vs. propiedad intelectual: Respecto a las patentes farmacéuticas en el contexto de la pandemia COVID-19

O direito de propriedade intelectual tem as suas exceções e os seus limites internos, previstos na lei. Nos últimos tempos, vem crescendo a discussão da sua compressão à luz de princípios gerais, como o interesse público, a liberdade de expressão ou a saúde pública. Dir-se-ia, pois, que estes direitos têm, também, uma função social, para além da proteção das prerrogativas dos seus titulares, o que é verdadeiro, sobretudo, para as patentes farmacêuticas. Grande parte desta discussão sempre passou, na verdade, pelas patentes farmacêuticas, sua concessão e exploração, em especial no que tange às patentes biotecnológicas. Esta discussão mais e mais se exacerbou quanto às patentes das vacinas destinadas ao tratamento contra a COVID-19. Não falta quem queira lançar mão dos meios previstos nas leis nacionais e internacionais para compelir às licenças obrigatórias das patentes e, até, à sua expropriação. Em causa, podem estar, no entanto, outros aspetos, como contratos mal negociados pela Comissão da União Europeia com algumas empresas farmacêuticas e os problemas logísticos na produção de vacinas. Por outro lado, centrar a discussão nas patentes poderá ser redutor, uma vez que há outros aspetos da propriedade intelectual a considerar. Contudo, a resposta estará, muito provavelmente, no equilíbrio entre os direitos dos titulares de patentes e o interesse público.

Intellectual property law has its exceptions and internal limits, as provided by law. In recent times, there has been a growing discussion of its compression in the light of general principles, such as public interest, freedom of expression or public health. It would be said, therefore, that these rights also have a social function, in addition to protecting the rights of their holders, which is especially true for pharmaceutical patents. Much of this discussion has always, in fact, passed through pharmaceutical patents, their granting and exploitation, especially regardingbiotechnological patents. This discussion has become increasinglyexacerbated regardingthe patents on vaccines intended for treatment against COVID-19. There is no shortage of people who want to use the means provided by national and international laws to compel mandatory patent licenses and even their expropriation. At issue, however, may be other aspects, such as contracts poorly negotiated by the European Union Commission with pharmaceutical companies and logistical problems in the production of vaccines. On the other hand, focusing the discussion on patents, can be reduced, there are other aspects of intellectual property to consider. However, the answer will most likely lie in the balance between the rights ofpatent holders and the public interest.

La ley de propiedad intelectual tiene sus excepciones y límites internos, según lo establece la ley. En los últimos tiempos, ha habido un creciente debate sobre su compresión a la luz de principios generales, como el interés público, la libertad de expresión o la salud pública. Se diría,por tanto, que estos derechos también tienen una función social, además de proteger los derechos de sus titulares, lo que es especialmente cierto para las patentes farmacéuticas. Gran parte de esta discusión siempre ha pasado, de hecho, por las patentes farmacéuticas, su concesión y explotación, especialmente en lo que respecta a las patentes biotecnológicas. Esta discusión se ha exacerbado cada vez más con respecto a las patentes de vacunas destinadas al tratamiento contra COVID-19. No hay escasez de personas que quieran utilizar los medios que brindan las leyes nacionales e internacionales para imponer licencias de patentes obligatorias e incluso su expropiación. Sin embargo, pueden estar en juego otros aspectos, como los contratos mal negociados por la Comisión de la Unión Europea con algunas empresas farmacéuticas y los problemas logísticos en la producción de vacunas. Por otro lado, centrar la discusión en las patentes, se puede reducir, hay otros aspectos de la propiedad intelectual a considerar. Sin embargo, lo más probable es que la respuesta esté en el equilibrio entre los derechos de los titulares de patentes y el interés público.

Zebrafish Cdx4 regulates neural crest cell specification and migratory behaviors in the posterior body.

The neural crest (NC) is a transient multipotent cell population that migrates extensively to produce a remarkable array of vertebrate cell types. NC cell specification progresses in an anterior to posterior fashion, resulting in distinct, axial-restricted subpopulations. The anterior-most, cranial, population of NC is specified as gastrulation concludes and neurulation begins, while more posterior populations become specified as the body elongates. The mechanisms that govern development of the more posterior NC cells remain incompletely understood. Here, we report a key role for zebrafish Cdx4, a homeodomain transcription factor, in the development of posterior NC cells. We demonstrate that cdx4 is expressed in trunk NC cell progenitors, directly binds NC cell-specific enhancers in the NC GRN, and regulates expression of the key NC development gene foxd3 in the posterior body. Moreover, cdx4 mutants show disruptions to the segmental pattern of trunk NC cell migration due to loss of normal leader/follower cell dynamics. Finally, using cell transplantation to generate chimeric specimens, we show that Cdx4 does not function in the paraxial mesoderm-the environment adjacent to which crest migrates-to influence migratory behaviors. We conclude that cdx4 plays a critical, and likely tissue autonomous, role in the establishment of trunk NC migratory behaviors. Together, our results indicate that cdx4 functions as an early NC specifier gene in the posterior body of zebrafish embryos.

Fibrolamellar Carcinoma: A Multimodal Approach.

Fibrolamellar carcinoma is a rare variant of hepatocellular carcinoma not associated with cirrhosis or viral hepatitis. Serum alpha-fetoprotein levels are usually normal; the histology is of a well-differentiated tumor, and the staging is the same as for hepatocellular carcinoma. We describe the case of a female patient in her 4th decade of life with a diagnosis of fibrolamellar hepatocellular carcinoma with a multimodal approach. The rare incidence of this cancer and its unusual clinical presentation justifies reporting this case and highlights the importance of multidisciplinary teams in the treatment of cancer patients.

O Carcinoma fibrolamelar é uma variante rara de hepatocarcinoma, não associado a cirrose ou hepatites virais. Os níveis séricos de alfafetoproteína são geralmente normais; A histologia é de um tumor bem diferenciado e o estadiamento é o mesmo do hepatocarcinoma. Descrevese o caso clínico de um doente do sexo feminino, na sua 4a década de vida com diagnóstico de Hepatocarcinoma fibrolamelar com abordagem multimodal. A rara incidência desta neoplasia e a sua apresentação clínica incomum justificam a notificação deste caso e destacam a importância de equipas multidisciplinares no tratamento dos doentes oncológicos.

From head to tail: regionalization of the neural crest.

The neural crest is regionalized along the anteroposterior axis, as demonstrated by foundational lineage-tracing experiments that showed the restricted developmental potential of neural crest cells originating in the head. Here, we explore how recent studies of experimental embryology, genetic circuits and stem cell differentiation have shaped our understanding of the mechanisms that establish axial-specific populations of neural crest cells. Additionally, we evaluate how comparative, anatomical and genomic approaches have informed our current understanding of the evolution of the neural crest and its contribution to the vertebrate body.

Cytomegalovirus Colitis Mimicking Rectal Tumour in an Undiagnosed HIV Patient.

INTRODUCTION: Cytomegalovirus (CMV) is the most common opportunistic agent in HIV-infected patients. It can affect the entire gastrointestinal tract, but frequently involves the oesophagus and the colon. CASE REPORT: We report the case of a 70-year-old female, ultimately diagnosed with HIV infection, whose inaugural clinical manifestation was CMV colitis with endoscopic findings resembling a rectal tumour in which initial histological evaluation was not able to provide a proper diagnosis. DISCUSSION/CONCLUSION: Since clinical presentation is variable and histopathological yield without immunohistochemical analysis is poor, recognizing CMV infection in the absence of known risk factors may be difficult. It is crucial to consider this entity with suspicious lesions or when initial evaluation, either clinical or histopathological, is inconclusive, thus avoiding potentially debilitating and superfluous treatment or life-threatening complications.

INTRODUÇÃO: O citomegalovírus (CMV) é o agente oportunista mais comum nos doentes com infeção pelo virus da imunodeficiência humana (VIH). Pode afetar todo o trato gastrointestinal, mas frequentemente envolve o esófago e o cólon. CASO CLÍNICO: Os autores apresentam o caso de uma doente do sexo feminino com 70 anos, com diagnóstico final de infeção por VIH, cuja manifestação clínica inaugural foi colite a CMV, com achados endoscópicos iniciais mimetizando um tumor rectal. DISCUSSÃO/CONCLUSÃO: Uma vez que a apresentação clínica é variável e a rentabilidade da análise histopatológica sem imunohistoquímica é baixa, o reconhecimento da infeção por CMV na ausência de fatores de risco pode ser difícil. É crucial considerar esta entidade perante lesões suspeitas ou quando a avaliação inicial, clínica ou histopatológica, for inconclusiva, de forma a evitar potenciais terapêuticas debilitantes e/ou supérfluas bem como complicações graves.

Endoscopic Management of Sigmoid Volvulus in a Debilitated Population: What Relevance?

BACKGROUND: Colonic volvulus, mainly from the sigmoid, is a relatively common cause of intestinal obstruction, particularly in the elderly and in patients with debilitating conditions. The high morbi-mortality of emergency surgery places the endoscopic approach as the first-line treatment for the resolution of this acute obstructive condition. OBJECTIVES: To assess the importance of endoscopic treatment for the resolution of colonic volvulus in a debilitated population. METHOD: This is a retrospective analysis of emergency lower gastrointestinal endoscopies in patients with colonic volvulus as diagnosis, performed over a 9-year period (2009-2018), as well as population characterization and follow-up after the first exam. RESULTS: We performed 88 procedures in 52 patients (56.4% males, median age 83 years, range 33-94). Endoscopic resolution was effective in 86.4% (76/88) of the exams, without procedure complications. Eighty-one percent of patients presented with volvulus recurrence, 50% of which occurred during the 3 months after the initial procedure. Twenty-one were submitted to surgery, 12 of which were emergency procedures after endoscopic failure as the primary treatment (5 of which had mucosal necrosis at endoscopy). There was no mortality in elective surgery. In the emergency plus necrosis group, mortality was 60% (3/5) and 14.3% (1/7) in the emergency without necrosis group. CONCLUSIONS: Despite the high recurrence of volvulus after endoscopic treatment, it seems to be an adequate and low-risk first-line therapy for sigmoid volvulus in debilitated patients, allowing improvement of surgical conditions.

INTRODUÇÃO: O volvo cólico, particularmente da sigmoideia, é uma causa relativamente comum de obstrução intestinal, sobretudo em idosos ou doentes com condições debilitantes. A elevada morbi-mortalidade do procedimento cirúrgico de urgência coloca a abordagem endoscópica como primeira linha na tentativa de resolução do quadro obstrutivo agudo. OBJETIVOS: Avaliar a importância da terapêutica endoscópica na resolução do volvo sigmoideu (inaugural ou de repetição) numa população debilitada. MÉTODOS: Análise retrospetiva dos procedimentos endoscópicos realizados em contexto de urgência e com diagnóstico de volvo cólico, durante um período de 9 anos (2009-2018) num Serviço de Urgência de um Hospital Central, bem como caracterização demográfica da população e curso clínico após procedimento endoscópico inicial. RESULTADOS: Realizados 88 procedimentos em 52 doentes (56.4% do sexo masculino, idade mediana 83 anos, intervalo 33-94). A resolução endoscópica foi conseguida em 86.4% dos procedimentos (76/88), não se registando complicaçõs associadas ao procedimento. Um total de 81% dos doentes apresentaram recidiva de volvo após procedimento endoscópico, 50% dos quais nos 3 meses após procedimento inicial. Vinte e um doentes foram operados, 12 de urgência por não ter havido resolução endoscópica (5 destes com necrose da mucosa na endoscopia). Não se registou mortalidade nos doentes operados eletivamente. No grupo de doentes operados em urgência com necrose da mucosa cólica a mortalidade foi de 60% (3/5), e de 14.3% (1/7) no grupo de urgência sem necrose da mucosa. CONCLUSÃO: Apesar da elevada taxa de recorrência, a terapêutica endoscópica parece apresentar-se como uma opção de primeira linha adequada e de baixo risco na resolução de volvo cólico em doentes debilitados, permitindo melhorar condições clínicas para a realização de intervendo cirúrgica eletiva.

Prevalence, risk factors and global impact of musculoskeletal injuries among endoscopists: a nationwide European study.

Background and study aims Previous studies have suggested a high prevalence of musculoskeletal injuries (MI) in endoscopists. Little evidence has come from European countries. Our main aim was to evaluate the prevalence, type, and impact of MI among Portuguese endoscopists. We also sought to identify risk factors for the development, severity and number of endoscopy-related MI. Material and methods A 48-question electronic survey was developed by a multidisciplinary group. The electronic survey was sent to all members of Portuguese Society of Gastroenterology (n = 705) during May 2019. Study data were collected and managed using REDCap electronic data capture tools hosted at SPG - CEREGA. Results The survey was completed by 171 endoscopists (response rate of 24.3 %), 55.0 % female with a median age of 36 years (range 26-78). The prevalence of at least one MI related to endoscopy was 69.6 % (n = 119), the most frequent being neck pain (30.4 %) and thumb pain (29.2 %). The median time for MI development was 6 years (range 2 months-30 years). Severe pain was reported by 19.3 %. Change in endoscopic technique was undertaken by 61.3 % and reduction in endoscopic caseload was undertaken by 22.7 %. Missing work was reported by 10.1 %, with the median time off from work being 30 days (range 1-90). Female gender and ≥ 15 years in practice were independently associated with MI and severe pain. Years in practice, weekly-time performing endoscopy, and gender were significant predictors of the number of MI. Conclusions Prevalence of MI was significant among Portuguese endoscopists and had a relevant impact on regular and professional activities.

Neural crest development: insights from the zebrafish.

Our understanding of the neural crest, a key vertebrate innovation, is built upon studies of multiple model organisms. Early research on neural crest cells (NCCs) was dominated by analyses of accessible amphibian and avian embryos, with mouse genetics providing complementary insights in more recent years. The zebrafish model is a relative newcomer to the field, yet it offers unparalleled advantages for the study of NCCs. Specifically, zebrafish provide powerful genetic and transgenic tools, coupled with rapidly developing transparent embryos that are ideal for high-resolution real-time imaging of the dynamic process of neural crest development. While the broad principles of neural crest development are largely conserved across vertebrate species, there are critical differences in anatomy, morphogenesis, and genetics that must be considered before information from one model is extrapolated to another. Here, our goal is to provide the reader with a helpful primer specific to neural crest development in the zebrafish model. We focus largely on the earliest events-specification, delamination, and migration-discussing what is known about zebrafish NCC development and how it differs from NCC development in non-teleost species, as well as highlighting current gaps in knowledge.

Prickle1 is required for EMT and migration of zebrafish cranial neural crest.

The neural crest-a key innovation of the vertebrates-gives rise to diverse cell types including melanocytes, neurons and glia of the peripheral nervous system, and chondrocytes of the jaw and skull. Proper development of the cephalic region is dependent on the tightly-regulated specification and migration of cranial neural crest cells (NCCs). The core PCP proteins Frizzled and Disheveled have previously been implicated in NCC migration. Here we investigate the functions of the core PCP proteins Prickle1a and Prickle1b in zebrafish cranial NCC development. Using analysis of pk1a and pk1b mutant embryos, we uncover similar roles for both genes in facilitating cranial NCC migration. Disruption of either gene causes pre-migratory NCCs to cluster together at the dorsal aspect of the neural tube, where they adopt aberrant polarity and movement. Critically, in investigating Pk1-deficient cells that fail to migrate ventrolaterally, we have also uncovered roles for pk1a and pk1b in the epithelial-to-mesenchymal transition (EMT) of pre-migratory NCCs that precedes their collective migration to the periphery. Normally, during EMT, pre-migratory NCCs transition from a neuroepithelial to a bleb-based and subsequently, mesenchymal morphology capable of directed migration. When either Pk1a or Pk1b is disrupted, NCCs continue to perform blebbing behaviors characteristic of pre-migratory cells over extended time periods, indicating a block in a key transition during EMT. Although some Pk1-deficient NCCs transition successfully to mesenchymal, migratory morphologies, they fail to separate from neighboring NCCs. Additionally, Pk1b-deficient NCCs show elevated levels of E-Cadherin and reduced levels of N-Cadherin, suggesting that Prickle1 molecules regulate Cadherin levels to ensure the completion of EMT and the commencement of cranial NCC migration. We conclude that Pk1 plays crucial roles in cranial NCCs both during EMT and migration. These roles are dependent on the regulation of E-Cad and N-Cad.

Mortality Associated with Hepatobiliary Disease in Portugal between 2006 and 2012.

INTRODUCTION: Hepatobiliary disease is becoming a major public health problem, and recent data suggest that the burden of liver disease is higher than previously thought. Our aim was to quantify the mortality from hepatobiliary disease in Portugal and to compare this with the mortality related o other causes over a 7-year period (2006-2012). MATERIALS AND METHODS: A statistical analysis of mortality data according to cause, sex, age, and region from the National Statistics Institute in Portugal was carried out. The data related to 14 causes of death, the most frequent of which were alcoholic liver disease (ALD) (International Classification of Diseases code K70), unspecified cirrhosis of liver (UCL) (K74.6), hepatocellular carcinoma (HCC) (C22.0), unspecified malignant neoplasm of liver (C22.9), and cholangiocarcinoma (C22.1). RESULTS: Between 2006 and 2012, 18,279 deaths (24.5/100,000) from hepatobiliary disease were registered in Portugal, constituting the 8th leading cause of death. The main causes of death from hepatobiliary disease were ALD (7.1/100,000), UCL (5.5/100,000), and HCC (4.3/100,000), with a male predominance (72%). ALD was the main aetiology in younger age groups (40-65 years), while primary neoplasms of the liver and the intrahepatic bile ducts were predominant in the elderly (>80 years). The mortality related to HCC increased by 66% between 2006 and 2012. CONCLUSION: These data outline the burden of hepatobiliary disease in Portugal (8th cause of death) and highlight a potential impact on economic productivity.

INTRODUÇÃO: A doença hepatobiliar representa um importante problema para a saúde pública e dados recentes sugerem que o seu impacto é superior ao que se pensava. O nosso objetivo foi quantificar a mortalidade por doença hepatobiliar em Portugal e compará-la com a mortalidade por outras causas, durante um período de sete anos (2006­2012). MATERIAIS E MÉTODOS: Foi feita uma análise estatística da mortalidade por doença hepatobiliar em Portugal, de acordo com a causa de morte, sexo, idade e região geográfica, com dados fornecidos pelo Instituto Nacional de Estatística. Foram estudadas 14 causas de morte, sendo as principais a doença hepatica alcoólica (código da Classificação Internacional de Doenças, 10a versão: K70), cirrose hepatica não especificada (K74.6), carcinoma hepatocelular (C22.0), neoplasia maligna do fígado não especificada (C22.9) e colangiocarcinoma (C22.1). RESULTADOS: Entre 2006 e 2012 foram registadas 18,279 mortes (24.5/100,000) por doença hepatobiliar em Portugal, sendo a 8a causa de morte no país. As principais causas de morte por doença hepatobiliar foram a doença hepatica alcoólica (7.1/100,000), cirrose hepática não especificada (5.5/100,000) e carcinoma hepatocelular (4.3/ 100,000), com predominância no sexo masculino (72%). A doença hepática alcoólica foi a principal causa de morte nos grupos etários mais jovens (40­65 anos), enquanto que a neoplasia do fígado e vias biliares intra-hepáticas foi a principal causa nos idosos (>80 anos). A mortalidade por carcinoma hepatocelular aumentou 66% de 2006 a 2012. CONCLUSÕES: Este estudo salienta o impacto que a doença hepatobiliar tem em Portugal (8a causa de morte), o que representa um potencial impacto para a produtividade do país.

Neural crest and cancer: Divergent travelers on similar paths.

Neural crest cells are multipotent progenitors that dynamically interpret diverse microenvironments to migrate significant distances as a loosely associated collective and contribute to many tissues in the developing vertebrate embryo. Uncovering details of neural crest migration has helped to inform a general understanding of collective cell migration, including that which occurs during cancer metastasis. Here, we discuss several commonalities and differences of neural crest and cancer cell migration and behavior. First, we focus on some of the molecular pathways required for the initial specification and potency of neural crest cells and the roles of many of these pathways in cancer progression. We also describe epithelial-to-mesenchymal transition, which plays a critical role in initiating both neural crest migration and cancer metastasis. Finally, we evaluate studies that demonstrate myriad forms of cell-cell and cell-environment communication during neural crest and cancer collective migration to highlight the remarkable similarities in their molecular and cell biological regulation.

Demodicosis Treatment with Systemic Ivermectin.

A 23-year-old white man presented to our dermatology department complaining of pruriginous and erythematous papulopustules on the right cheek that had developed 6 months previously. He had a history of chronic blepharitis, complicated by a recurrent hordeolum that had been treated with warm compresses and topical antibiotic ointment (chloramphenicol) for approximately 2 years. The patient had oily skin and atopy (allergic rhinitis) and did not experience photosensitivity or flushing or have previous exposure to immunosuppressants or topical/systemic corticosteroids.

Anthropogenic noise, but not artificial light levels predicts song behaviour in an equatorial bird.

Birds in cities start singing earlier in the morning than in rural areas; commonly this shift is attributed to light pollution. Some studies have suggested that traffic noise has a stronger influence on singing activity than artificial light does. Changes in the timing of singing behaviour in relation to noise and light pollution have only been investigated in the temperate zones. Tropical birds, however, experience little seasonal variation in day length and may be less dependent on light intensity as a modifier for reproductive behaviours such as song. To test whether noise or light pollution has a stronger impact on the dawn chorus of a tropical bird, we investigated the singing behaviour of rufous-collared sparrows (Zonotrichia capensis) in Bogota, Colombia at two times during the year. We found that birds in places with high noise levels started to sing earlier. Light pollution did not have a significant effect. Birds may begin to sing earlier in noisy areas to avoid acoustic masking by traffic later in the morning. Our results also suggest that some tropical birds may be less sensitive to variations in day length and thus less sensitive to light pollution.

Non-anesthesiologist administration of propofol sedation for colonoscopy is safe in low risk patients: results of a noninferiority randomized controlled trial.

BACKGROUND AND STUDY AIMS: Propofol provides the best sedation in colonoscopy. The safety of non-anesthesiologist administration of propofol (NAAP) is still a matter of debate. The aim of the current study was to evaluate sedation safety, colonoscopy quality, and patient satisfaction with NAAP. PATIENTS AND METHODS: The study was a single-blinded, noninferiority, randomized controlled trial comparing NAAP (Group A) with anesthesiologist-administered sedation (Group B) performed at a single academic institution. Patients (18 - 80 years) who underwent colonoscopy and were at low anesthetic risk (American Society of Anesthesiologists class I - II) were included. The primary end point was the incidence of adverse events. Secondary end points were propofol dose, patient satisfaction and pain, colonoscopy quality indicators, and procedure and recovery times. RESULTS: A total of 277 patients were included in the analysis. The incidence of adverse events was 39.3 % in Group A and 39.0 % in Group B (absolute difference - 0.3 %, 95 % confidence interval [CI] - 12.0 % to 11.4 %; P = 0.959). There were no sentinel adverse events. The following interventions (Group A vs. Group B) were necessary: atropine administration (0 % vs. 5.5 %; P = 0.004); airway repositioning (8.7 % vs. 4.7 %; P = 0.196); increased oxygen administration (6.7 % vs. 3.9 %; P = 0.317), and increased fluid rate (2.7 % vs. 0.8 %; P = 0.379). There were no differences in cecal intubation and adenoma detection rates. Recovery times were longer in Group B (58 ±â€Š33 vs. 67 ±â€Š29 minutes; P = 0.032). There were no differences in mean propofol dose, withdrawal time, painless colonoscopy, satisfaction, and amnesia. All but two patients (Group B) were willing to repeat the colonoscopy. CONCLUSIONS: NAAP is equivalent to anesthesiologist-administered sedation in the rate of adverse events in a low risk population. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02067065).

Expression and light-triggered movement of rhodopsins in the larval visual system of mosquitoes.

During the larval stages, the visual system of the mosquito Aedes aegypti contains five stemmata, often referred to as larval ocelli, positioned laterally on each side of the larval head. Here we show that stemmata contain two photoreceptor types, distinguished by the expression of different rhodopsins. The rhodopsin Aaop3 (GPROP3) is expressed in the majority of the larval photoreceptors. There are two small clusters of photoreceptors located within the satellite and central stemmata that express the rhodopsin Aaop7 (GPROP7) instead of Aaop3. Electroretinogram analysis of transgenic Aaop7 Drosophila indicates that Aaop3 and Aaop7, both classified as long-wavelength rhodopsins, possess similar but not identical spectral properties. Light triggers an extensive translocation of Aaop3 from the photosensitive rhabdoms to the cytoplasmic compartment, whereas light-driven translocation of Aaop7 is limited. The results suggest that these photoreceptor cell types play distinct roles in larval vision. An additional component of the larval visual system is the adult compound eye, which starts to develop at the anterior face of the larval stemmata during the 1st instar stage. The photoreceptors of the developing compound eye show rhodopsin expression during the 4th larval instar stage, consistent with indications from previous reports that the adult compound eye contributes to larval and pupal visual capabilities.

El servicio de escolaridad en la atención del niño hospitalizado / Shooling service in the attention of hospitalized child

En los últimos años, los hospitales pediátricos han comenzado a desplegar un enfoque novedoso en la atención de las enfermedades que afectan el desarrollo integral de nuestros niños, porque los aspectos emocionales y afectivos han cobrado tanta importancia en su recuperación y tratamiento como la tiene el aspecto médico. El Instituto Nacional de Pediatría ha contado con dicho enfoque desde su creación, ya que el Servicio de Escolaridad ha llevado a cabo terapias educativas ocupacionales y recreativas que tienen como finalidad apoyar y fomentar todas las áreas de desarrollo de los pacientes durante su hospitalización, así como brindarles una estancia más agradable y benéfica.

Tomografia computadorizada nos processos infecciosos renais inespecíficos / Computed tomography in inspecified infections renal processes

Os processos infecciosos renais inespecíficos apresentam diversas etapas evolutivas. Os autores relatam os aspectos encontrados em exames de tomografia computadorizada nestas diversas etapas e revisam os dados clínicos e laboratoriais descritos na literatura