The contribution of dogs and other animals to social inclusion programmes. / Contribución de los perros y otros animales en programas destinados a la inclusión social.

Animal-assisted interventions refer to any intervention that intentionally includes or incorporates animals as part of a therapeutic, palliative, educational, psychoeducational or recreational process or milieu. The Faculty of Veterinary Science of the University of Buenos Aires began work on this issue in 1996 and gradually incorporated outreach, research and teaching projects, undertaking several stages of institutionalisation and reconceptionalisation that led, in 2014, to the creation of an open chair in animal-assisted interventions. This article aims to introduce the discipline, with special emphasis on its potential as a means of promoting inclusion, and to present a specific case of work with dogs, which began in 2009 with the non-profit organisation Senderos del Sembrador (Trails of the Sower) for people with an intellectual disability who are in great need of support. This article describes how the contact with dogs was systematised, along with outcomes, challenges and difficulties, and how leisure came to be used as a means of promoting inclusion and altering the preconceptions of people without disabilities. Finally, in reflecting on practices, the project evolved from a treatment plan for rehabilitating people with disabilities into a space for effective social inclusion that gradually changed the perceptions and practices of all participants.

Les interventions assistées par des animaux désignent toute intervention intégrant de manière intentionnelle des animaux en tant qu'acteurs au sein d'un processus thérapeutique, palliatif, pédagogique, psycho-éducatif, ludique ou environnemental. La faculté des Sciences vétérinaires de l'université de Buenos Aires a commencé à explorer ce domaine dès 1996, en y ajoutant progressivement des projets d'application locale, de recherche et d'enseignement qui ont connu plusieurs phases successives d'institutionnalisation et de conceptualisation avant d'aboutir en 2014 à la création d'une chaire autonome d'interventions assistées par l'animal. Après avoir introduit cette discipline en mettant un accent particulier sur ses perspectives en tant que facteur d'inclusion, les auteurs décrivent une expérience concrète d'interventions menées depuis 2009 avec des chiens auprès d'une association de la société civile (« Senderos del Sembrador ¼) qui s'occupe de personnes ayant des déficiences intellectuelles et qui ont un grand besoin d'aide. Les auteurs expliquent le recours systématique à ce contact, ainsi que ses résultats, ses enjeux et ses difficultés, et l'utilisation des loisirs comme facteur d'inclusion parallèlement à la lutte contre les préjugés chez les personnes non handicapées. Enfin, à travers les ateliers proposés, ce projet a constitué une authentique proposition thérapeutique qui a donné aux personnes handicapées les outils nécessaires pour constituer un espace d'inclusion sociale efficace, qui a progressivement transformé les conceptions et les pratiques de tous les participants.

Las intervenciones asistidas con animales son cualquier intervención que intencionalmente incluya o incorpore animales como parte de un proceso terapéutico, paliativo, pedagógico, psicoeducativo, lúdico o ambiental. La Facultad de Ciencias Veterinarias de la Universidad de Buenos Aires comenzó a trabajar en este tema en 1996, e incorporó paulatinamente proyectos de extensión, investigación y docencia atravesando diversas etapas de institucionalización y reconceptualización, hasta que en 2014 se creó la Cátedra Libre de Intervenciones Asistidas con Animales. El objetivo de este trabajo es introducir esta disciplina, con especial énfasis en sus posibilidades como factor de inclusión, y presentar una experiencia concreta de trabajo con perros que se realiza desde 2009 con la Asociación Civil Senderos del Sembrador, a la que concurren personas con discapacidad intelectual y una gran necesidad de apoyo. Relatamos cómo hemos sistematizado este contacto, sus resultados, desafíos y dificultades, y cómo hemos podido trabajar el ocio como factor de inclusión además de actuar sobre los prejuicios de las personas sin discapacidad. Finalmente, en cuanto a las prácticas, este proyecto pasó de ser una propuesta terapéutica para rehabilitar a las personas con discapacidad a constituir un espacio de inclusión social efectiva que fue modificando las concepciones y prácticas de todos los participantes.

Eyebrow anomalies as a diagnostic sign of genomic disorders.

Microdeletions and microduplications in the human genome, termed genomic disorders, contribute to a high proportion of human multisystemic neurodevelopmental diseases and are detected by array-based comparative genomic hybridization (aCGH). In general, most genomic disorders are associated with craniofacial and skeletal features and behavioural abnormalities, in addition to learning disability and developmental delay (LD/DD). Specifically, recognition of a characteristic 'facial gestalt' has been the key to distinguish one genomic disorder from the other. Here, we report our experience concerning the relevance of abnormal eyebrow pattern as a diagnostic indicator of specific genomic disorders.

Atm-deficient mice Purkinje cells show age-dependent defects in calcium spike bursts and calcium currents.

Ataxia telangiectasia in humans results from homozygous loss-of-function mutations in ATM. Neurological deterioration is the major cause of death in ataxia telangiectasia patients: in the cerebellum, mainly Purkinje cells are affected. We have generated Atm-deficient mice which display neurological abnormalities by several tests of motor function consistent with an abnormality of cerebellar function, but without histological evidence of neuronal degeneration. Here we performed a more detailed morphological analysis and an electrophysiological study on Purkinje cells from Atm-deficient mice of different ages. We found no histological or immunohistochemical abnormalities. Electrophysiology revealed no abnormalities in resting membrane potential, input resistance or anomalous rectification. In contrast, there was a significant decrease in the duration of calcium and sodium firing. The calcium deficit became significant between six to eight and 12-20 weeks of age, and appeared to be progressive. By voltage-clamp recording, we found that the firing deficits were due to a significant decrease in calcium currents, while inactivating potassium currents seem unaffected. In other mutant mice, calcium current deficits have been shown to be related to cell death.Our experiments suggest that the electrophysiological defects displayed by Atm-deficient mice are early predegenerative lesions and may be a precursor of Purkinje cell degeneration displayed by ataxia telangiectasia patients.

A novel role for HERG K+ channels: spike-frequency adaptation.

1. The regular firing of a Hodgkin-Huxley neurone endowed with fast Na+ and delayed K+ channels can be converted into adapting firing by appending HERG (human eag-related gene) channels. 2. The computer model predictions were verified by studying the firing properties of F-11 DRG neurone x neuroblastoma hybrid cells induced to differentiate by long-term exposure to retinoic acid. These cells, which express HERG currents (IHERG), show clear spike-frequency adaptation of their firing when current clamped with long depolarizations. 3. In agreement with the prediction, the selective blocking of IHERG by class III antiarrhythmic drugs always led to the disappearance of the spike-frequency adaptation, and the conversion of adapting firing to regular firing. 4. It is proposed that, in addition to their role in the repolarization of the heart action potential, HERG channels may sustain a process of spike-frequency adaptation, and hence contribute to the control of burst duration in a way that is similar to that of the K+ currents, IAHP, IC and IM. In addition to the known cardiac arrhythmia syndrome (LQT2), genetic mutations or an altered HERG expression could lead to continuous hyperexcitable states sustained by the inability of nerve or endocrine cells to accommodate to repetitive stimuli. This might help in clarifying the pathogenesis of still undefined idiopathic familial epilepsies.

Radiofrequency catheter ablation in the treatment of supraventricular tachycardia in the elderly.

OBJECTIVES: The purpose of this study was to evaluate the efficacy and safety of radiofrequency catheter ablation for the treatment of supraventricular tachycardias in an elderly (> or = 70 years of age) group of patients. BACKGROUND: Supraventricular tachycardias are the most common form of cardiac arrhythmia and affect all age groups. Although usually well tolerated in youth, supraventricular tachycardias may be associated with disabling symptoms and have life-threatening potential in the elderly. In addition, antiarrhythmic agents are less well tolerated and may be associated with a higher incidence of toxicity in the elderly. METHODS: From May 1989 to March 1993, 454 patients underwent a radiofrequency catheter ablation procedure at the University of California, San Francisco, for the treatment of symptomatic supraventricular tachycardia. Sixty-seven of these patients were > or = 70 years of age and constituted the study group. Patients underwent one of the following catheter ablation procedures: complete atrioventricular (AV) junctional ablation for ventricular rate control in patients with atrial fibrillation (37 patients), AV node modification for the treatment of AV node reentrant tachycardia (17 patients), accessory pathway ablation (9 patients), ablation of the "slow zone" to cure atrial flutter (4 patients) and atrial tachycardia ablation (1 patient). One patient underwent ablation for both AV node reentrant tachycardia and atrial flutter. RESULTS: Success was achieved in 67 (98.5%) of 68 ablation procedures. There were no procedural or early deaths. The overall complication rate was 7.4%, and only one patient (1.5%) had long-term sequelae (permanent cardiac pacing for complete heart block). At a mean (+/- SD) follow-up of 22.1 +/- 12.9 months, 63 (94%) of 67 patients were alive, with no antiarrhythmic agents for the treatment of their presenting arrhythmia. CONCLUSIONS: In this series radiofrequency catheter ablation appears to be an effective and safe treatment option for elderly patients (> or = 70 years of age) with a variety of symptomatic, drug-resistant supraventricular tachycardias. Because of the high incidence of severe symptoms associated with tachycardic episodes, the expense and the possible severe proarrhythmic problems associated with antiarrhythmic medications in this age group, catheter ablation may be considered an early rather than a "last resort" treatment option.

Emergency intracardiac defibrillation for refractory ventricular fibrillation during routine electrophysiologic study.

Ventricular fibrillation refractory to cardiopulmonary resuscitation including multiple transthoracic defibrillations occurred in four patients during 1,215 consecutive ventricular tachycardia induction studies. A technique of emergency intracardiac defibrillation for management of refractory ventricular fibrillation is described. In four patients, stable monomorphic ventricular tachycardia (320 to 570 ms cycle length) was induced during the study and overdrive ventricular pacing resulted in ventricular fibrillation. These patients did not respond to prompt transthoracic defibrillations (5 to 15 attempts/patient) and cardiopulmonary resuscitation, including antiarrhythmic therapy. As a last resort, intracardiac defibrillation was performed with use of a previously inserted standard right ventricular quadripolar catheter as cathode and a posterior skin patch as anode. High energy intracardiac defibrillation pulses (100 to 500 J) delivered from a standard defibrillator successfully terminated each arrhythmia. Intracardiac defibrillation is technically simple and appears effective in terminating refractory ventricular fibrillation in the electrophysiology laboratory. However, further research is necessary to determine the safety and efficacy of this technique, as well as potential applications in other emergency settings.