K+ontrol rapidly and efficiently reduces potassium in donor blood during ex vivo circulation.

BACKGROUND: Patients with kidney failure are at risk for lethal complications from hyperkalemia. Resuscitation, medications, and hemodialysis are used to mitigate increased potassium (K+) levels in circulating blood; however, these approaches may not always be readily available or effective, especially in a resource limited environment. We tested a sorbent cartridge (KC, K+ontrol CytoSorbents Medical Inc., Monmouth Junction, New Jersey) which contains a resin adsorber for K+. The objective of this study was to test the utility of KC in an ex vivo circulation system. We hypothesized that KC reduces K+ levels in extracorporeal circulation of donor swine whole blood infused with KCl. METHODS: A six-hour circulation study was carried out using KC, a NxStage (NxStage Medical, Inc., Lawrence, MA) membrane, blood bag containing heparinized whole blood with KCl infusion, 3/16-inch ID tubing, a peristaltic pump, and flow sensors. The NxStage permeate line was connected back to the main circuit in the Control group (n = 6), creating a recirculation loop. For KC group (n = 6), KC was added to the recirculation loop, and a continuous infusion of KCl at 10 mEq/hour was administered for two hours. Blood samples were acquired at baseline and every hour for 6 h. RESULTS: In the control group, K+ levels remained at ∼9 mmol/L; 9.1 ± 0.4 mmol/L at 6 h. In the KC group, significant decreases in K+ at hour 1 (4.3 ± 0.3 mmol/L) and were sustained for the experiment duration equilibrating at 4.6 ± 0.4 mmol/L after 6 h (p = 0.042). Main loop blood flow was maintained under 400 mL/min; recirculation loop flow varied between 60 and 70 mL/min in the control group and 45-55 mL/min in the KC group. Decreases in recirculation loop flow in KC group required 7% increase of pump RPM. CONCLUSIONS: During ex-vivo extracorporeal circulation using donor swine blood, KC removed approximately 50% of K+, normalizing circulating levels.

The Role of Exosomal Epigenetic Modifiers in Cell Communication and Fertility of Dairy Cows.

Abnormal uterine function affects conception rate and embryo development, thereby leading to poor fertility and reproduction failure. Exosomes are a nanosized subclass of extracellular vesicles (EV) that have important functions as intercellular communicators. They contain and carry transferable bioactive substances including micro RNA (miRNA) for target cells. Elements of the cargo can provide epigenetic modifications of the recipient cells and may have crucial roles in mechanisms of reproduction. The dairy industry accounts for a substantial portion of the economy of many agricultural countries. Exosomes can enhance the expression of inflammatory mediators in the endometrium, which contribute to various inflammatory diseases in transition dairy cows. This results in reduced fertility which leads to reduced milk production and increased cow maintenance costs. Thus, gaining a clear knowledge of exosomal epigenetic modifiers is critical to improving the breeding success and profitability of dairy farms. This review provides a brief overview of how exosomal miRNA contributes to inflammatory diseases and hence to poor fertility, particularly in dairy cows.

Task Learning Promotes Plasticity of Interneuron Connectivity Maps in the Olfactory Bulb.

UNLABELLED: Elucidating patterns of functional synaptic connectivity and deciphering mechanisms of how plasticity influences such connectivity is essential toward understanding brain function. In the mouse olfactory bulb (OB), principal neurons (mitral/tufted cells) make reciprocal connections with local inhibitory interneurons, including granule cells (GCs) and external plexiform layer (EPL) interneurons. Our current understanding of the functional connectivity between these cell types, as well as their experience-dependent plasticity, remains incomplete. By combining acousto-optic deflector-based scanning microscopy and genetically targeted expression of Channelrhodopsin-2, we mapped connections in a cell-type-specific manner between mitral cells (MCs) and GCs or between MCs and EPL interneurons. We found that EPL interneurons form broad patterns of connectivity with MCs, whereas GCs make more restricted connections with MCs. Using an olfactory associative learning paradigm, we found that these circuits displayed differential features of experience-dependent plasticity. Whereas reciprocal connectivity between MCs and EPL interneurons was nonplastic, the connections between GCs and MCs were dynamic and adaptive. Interestingly, experience-dependent plasticity of GCs occurred only in certain stages of neuronal maturation. We show that different interneuron subtypes form distinct connectivity maps and modes of experience-dependent plasticity in the OB, which may reflect their unique functional roles in information processing. SIGNIFICANCE STATEMENT: Deducing how specific interneuron subtypes contribute to normal circuit function requires understanding the dynamics of their connections. In the olfactory bulb (OB), diverse interneuron subtypes vastly outnumber principal excitatory cells. By combining acousto-optic deflector-based scanning microscopy, electrophysiology, and genetically targeted expression of Channelrhodopsin-2, we mapped the functional connectivity between mitral cells (MCs) and OB interneurons in a cell-type-specific manner. We found that, whereas external plexiform layer (EPL) interneurons show broadly distributed patterns of stable connectivity with MCs, adult-born granule cells show dynamic and plastic patterns of synaptic connectivity with task learning. Together, these findings reveal the diverse roles for interneuons within sensory circuits toward information learning and processing.

Using reflective practice to support PhD students in the biosciences.

Postgraduate study can be mentally, physically and emotionally challenging. The levels of anxiety and depression in postgraduate students are much higher than those in the general population, and isolation can also be a problem, especially for students who are marginalised due to gender, race, sexuality, disability or being a first-generation and/or international student. These challenges are not new, but awareness of them has increased over the past decade, as have efforts by institutions to make students feel supported. Under the umbrella of a Doctoral Training Partnership, we developed a programme in which reflective practice is employed to help postgraduate students navigate work environments, deal with difficult supervisory or professional relationships, and improve their work-life balance. Additionally, this reflective practice is allowing the training partnership to tailor support to its students, enabling them to effectively nurture our next generation of bioscientists.

Microplastics in dermatology: Potential effects on skin homeostasis.

BACKGROUND: Microplastics (MPs) and nanoplastics (NPs) have become a growing concern in dermatology due to their widespread presence in cosmetic formulations and the environment. These minuscule synthetic polymer particles prompt an essential exploration of their potential impact on dermatological homeostasis. AIMS: This study aims to investigate the effects of MPs and NPs on the integumentary system. Specifically, it seeks to understand the potential cutaneous alterations, inflammatory responses, and disruptions to the skin's physiological functions caused by these synthetic particles. PATIENTS/METHODS: The investigation involves a comprehensive analysis of emerging research on MPs and NPs. This includes their presence in cosmetic formulations and environmental pervasiveness. The study delves into their capacity to breach the cutaneous barrier, raising concerns about the implications of prolonged exposure. RESULTS: Evidence suggests that MPs and NPs may indeed incite cutaneous alterations, provoke inflammatory responses, and disturb the homeostasis of the skin's physiological functions. Their small dimensions enhance their capability to breach the cutaneous barrier, further emphasizing the apprehensions associated with prolonged exposure. CONCLUSIONS: While a precise understanding of the implications of MPs and NPs on dermatological health remains an ongoing scientific endeavor, this study underscores the growing significance of these synthetic particles. The findings emphasize the need for proactive measures to safeguard both individual well-being and environmental preservation in the context of dermatological health.

Tracing synaptic connectivity onto embryonic stem cell-derived neurons.

Transsynaptic circuit tracing using genetically modified rabies virus (RV) is an emerging technology for identifying synaptic connections between neurons. Complementing this methodology, it is now possible to assay the basic molecular and cellular properties of neuronal lineages derived from embryonic stem cells (ESCs) in vitro, and these properties are under intense investigation toward devising cell replacement therapies. Here, we report the generation of a novel mouse ESC (mESC) line that harbors the genetic elements to allow RV-mediated transsynaptic circuit tracing in ESC-derived neurons and their synaptic networks. To facilitate transsynaptic tracing, we have engineered a new reporter allele by introducing cDNA encoding tdTomato, the Rabies-G glycoprotein, and the avian TVA receptor into the ROSA26 locus by gene targeting. We demonstrate high-efficiency differentiation of these novel mESCs into functional neurons, show their capacity to synaptically connect with primary neuronal cultures as evidenced by immunohistochemistry and electrophysiological recordings, and show their ability to act as source cells for presynaptic tracing of neuronal networks in vitro and in vivo. Together, our data highlight the potential for using genetically engineered stem cells to investigate fundamental mechanisms of synapse and circuit formation with unambiguous identification of presynaptic inputs onto neuronal populations of interest.

Laparoscopic single port surgery in children using Triport: our early experience.

Laparoscopy has become the gold standard technique for appendectomy and cholecystectomy. With the emergence of newer laparoscopic instruments which are roticulating and provide 7 degrees of freedom it is now possible to perform these operations through a single umbilical incision rather than the standard 3-4 incisions and thus lead to more desirable cosmetic results and less postoperative pain. The newer reticulating telescopes provide excellent exposure of the operating field and allow the operations to proceed routinely. Recently, ports [Triports (Olympus surgery)/SILS ports] especially designed for single incision laparoscopic surgery (SILS) have been developed. We herein describe our experience with laparoscopic single port appendectomies and cholecystectomies in children using the Triport. This is a retrospective cohort study of children who underwent single incision laparoscopic surgery between May 2009 and August 2010 at Texas Children's Hospital and Ben Taub General Hospital in Houston Texas by a single surgeon. Charts were reviewed for demographics, type of procedure, operative time, early or late complications, outcome and cosmetic results. Fifty-four patients underwent SILS. A total of 50 appendectomies (early or perforated) and 4 cholecystectomies were performed using this new minimally invasive approach. The average operative time for SILS/LESS appendectomy was 54 min with a range between 25 and 205 min, while operative time for SILS cholecystectomy was 156 min with a range of 75-196 min. Only small percentage (4%) of appendectomies (mostly complicated) were converted to standard laparoscopy, but none were converted to open procedure. All patients were followed up in the clinic after 3-4 weeks. No complications were noted and all patients had excellent cosmetic results. Parents were extremely satisfied with the cosmetic results. SILS/LESS is a safe, minimally invasive approach for appendectomy and cholecystectomy in children. This new approach is performed in an acceptable operative time with good outcomes and great cosmetic result.

Molecular Characterization of KPC-2-Producing Enterobacter cloacae Complex Isolates from Cali, Colombia.

The Enterobacter cloacae complex is an emerging opportunistic pathogen whose increased resistance to carbapenems is considered a public health problem. This is due to the loss of efficacy of beta-lactam antibiotics, which are used as the first treatment option in the management of infections caused by Gram-negative bacteria. The objective of this study was to perform the molecular characterization of 28 isolates of the E. cloacae complex resistant to cephalosporins and carbapenems isolated between 2011 and 2018 from five hospitals located in the municipality of Santiago de Cali, Colombia. Molecular detection of blaKPC, blaVIM, blaNDM and blaOXA-48-like genes was performed on these isolates and the genetic relationship between the isolates was assessed using multilocus sequence typing (MLST). Forty-three percent of the isolates carried the blaKPC-2 gene variant. MLST showed high genetic diversity among isolates, the most frequent being the sequence type ST510 with a frequency of 50%. The identification of the genes involved in carbapenem resistance and dispersing genotypes is an important step toward the development of effective prevention and epidemiological surveillance strategies in Colombian hospitals.

The Role(s) of Eicosanoids and Exosomes in Human Parturition.

The roles that eicosanoids play during pregnancy and parturition are crucial to a successful outcome. A better understanding of the regulation of eicosanoid production and the roles played by the various end products during pregnancy and parturition has led to our view that accurate measurements of a panel of those end products has exciting potential as diagnostics and prognostics of preterm labor and delivery. Exosomes and their contents represent an exciting new area for research of movement of key biological factors circulating between tissues and organs akin to a parallel endocrine system but involving key intracellular mediators. Eicosanoids and enzymes regulating their biosynthesis and metabolism as well as regulatory microRNAs have been identified within exosomes. In this review, the regulation of eicosanoid production, abundance and actions during pregnancy will be explored. Additionally, the functional significance of placental exosomes will be discussed.

Local corticotropin releasing hormone (CRH) signals to its receptor CRHR1 during postnatal development of the mouse olfactory bulb.

Neuropeptides play important physiological functions during distinct behaviors such as arousal, learning, memory, and reproduction. However, the role of local, extrahypothalamic neuropeptide signaling in shaping synapse formation and neuronal plasticity in the brain is not well understood. Here, we characterize the spatiotemporal expression profile of the neuropeptide corticotropin-releasing hormone (CRH) and its receptor CRHR1 in the mouse OB throughout development. We found that CRH-expressing interneurons are present in the external plexiform layer, that its cognate receptor is expressed by granule cells, and show that both CRH and CRHR1 expression enriches in the postnatal period when olfaction becomes important towards olfactory-related behaviors. Further, we provide electrophysiological evidence that CRHR1-expressing granule cells functionally respond to CRH ligand, and that the physiological circuitry of CRHR1 knockout mice is abnormal, leading to impaired olfactory behaviors. Together, these data suggest a physiologically relevant role for local CRH signaling towards shaping the neuronal circuitry within the mouse OB.

Dopamine Regulates Aversive Contextual Learning and Associated In Vivo Synaptic Plasticity in the Hippocampus.

Dopamine release during reward-driven behaviors influences synaptic plasticity. However, dopamine innervation and release in the hippocampus and its role during aversive behaviors are controversial. Here, we show that in vivo hippocampal synaptic plasticity in the CA3-CA1 circuit underlies contextual learning during inhibitory avoidance (IA) training. Immunohistochemistry and molecular techniques verified sparse dopaminergic innervation of the hippocampus from the midbrain. The long-term synaptic potentiation (LTP) underlying the learning of IA was assessed with a D1-like dopamine receptor agonist or antagonist in ex vivo hippocampal slices and in vivo in freely moving mice. Inhibition of D1-like dopamine receptors impaired memory of the IA task and prevented the training-induced enhancement of both ex vivo and in vivo LTP induction. The results indicate that dopamine-receptor signaling during an aversive contextual task regulates aversive memory retention and regulates associated synaptic mechanisms in the hippocampus that likely underlie learning.

Cell type-specific and time-dependent light exposure contribute to silencing in neurons expressing Channelrhodopsin-2.

Channelrhodopsin-2 (ChR2) has quickly gained popularity as a powerful tool for eliciting genetically targeted neuronal activation. However, little has been reported on the response kinetics of optogenetic stimulation across different neuronal subtypes. With excess stimulation, neurons can be driven into depolarization block, a state where they cease to fire action potentials. Herein, we demonstrate that light-induced depolarization block in neurons expressing ChR2 poses experimental challenges for stable activation of specific cell types and may confound interpretation of experiments when 'activated' neurons are in fact being functionally silenced. We show both ex vivo and in vivo that certain neuronal subtypes targeted for ChR2 expression become increasingly susceptible to depolarization block as the duration of light pulses are increased. We find that interneuron populations have a greater susceptibility to this effect than principal excitatory neurons, which are more resistant to light-induced depolarization block. Our results highlight the need to empirically determine the photo-response properties of targeted neurons when using ChR2, particularly in studies designed to elicit complex circuit responses in vivo where neuronal activity will not be recorded simultaneous to light stimulation. DOI: http://dx.doi.org/10.7554/eLife.01481.001.

Enucleation of Odontogenic Cyst with Bone Graft / Enucleación de Quiste Odontogénico con Injerto Óseo

ABSTRACT: Periapical cyst originates from an inflammatory reaction in the body that occurs due to a long-term endodontic aggression. It is more prevalent in caucasian male, during the third decade of life, in the anterior portion of the maxilla. They are commonly radiographic findings, due to their asymptomatic aspect. This study reports a Periapical Cyst in the portion corresponding to teeth 21, 22 and 23, which was treated by enucleation of the cyst, apicoectomy and retrograde root filling with Mineral trioxide aggregate (M.T.A) of teeth 21 and 22, filling of the cyst cavity with xenogeneic bone graft GenOx and a collagen membrane Gen-Derm. Observations after three months show good and rapid bone regeneration, periodontal and periapical health of the teeth involved.

RESUMEN: El quiste periapical se origina de una reacción inflamatoria que ocurre debido a una agresión endodóntica a largo plazo. Es más frecuente en el varón caucásico, durante la tercera década de la vida, en la porción anterior del maxilar. Son comúnmente hallazgos radiográficos, debido a su aspecto asintomático. En este estudio informamos acerca de un quiste periapical, en la porción correspondiente a los dientes 21, 22 y 23, que se trató mediante enucleación, apicectomía y relleno de raíz retrógrada con agregado de trióxido mineral (MTA) de los dientes 21 y 22, relleno de la cavidad del quiste con injerto óseo xenogénico Gen-Ox y una membrana de colágeno GenDerm. Las observaciones después de tres meses mostraron una buena y rápida regeneración ósea, con conservación de la salud periodontal y periapical de los dientes involucrados.

Local CRH signaling promotes synaptogenesis and circuit integration of adult-born neurons.

Neural activity either enhances or impairs de novo synaptogenesis and circuit integration of neurons, but how this activity is mechanistically relayed in the adult brain is largely unknown. Neuropeptide-expressing interneurons are widespread throughout the brain and are key candidates for conveying neural activity downstream via neuromodulatory pathways that are distinct from classical neurotransmission. With the goal of identifying signaling mechanisms that underlie neuronal circuit integration in the adult brain, we have virally traced local corticotropin-releasing hormone (CRH)-expressing inhibitory interneurons with extensive presynaptic inputs onto new neurons that are continuously integrated into the adult rodent olfactory bulb. Local CRH signaling onto adult-born neurons promotes and/or stabilizes chemical synapses in the olfactory bulb, revealing a neuromodulatory mechanism for continued circuit plasticity, synapse formation, and integration of new neurons in the adult brain.

Revealing neuronal circuitry using stem cell-derived neurons.

Mouse embryonic stem cell (mESC)-derived neurons are a renewable cell source for investigation of neuronal circuits. Engineering circuit-tracing components into stem cells facilitates studies on mechanisms of synaptic coupling and circuitogenesis. This unit details methods for the generation of mESC-derived neurons harboring trans-synaptic viral tracing elements, which are used for investigation of synaptic connections within circuits in vitro, ex vivo, and in vivo. The first protocol describes procedures for feeder-free passaging of mESCs, modified to carry reporter and rabies virus tracing elements. The second protocol describes in vitro generation of neurons from these ESCs. The last protocols describe the use of ESC-derived neurons as "source cells" for rabies virus circuit-tracing to identify inputs onto synaptically connected neurons. Given the broad applicability, these protocols can be applied to investigate the ability of in vitro-derived neurons to establish/maintain synaptic connections in disease models, and/or with human-induced pluripotent stem cells.

Reciprocal connectivity between mitral cells and external plexiform layer interneurons in the mouse olfactory bulb.

Proper brain function relies on exquisite balance between excitation and inhibition, where inhibitory circuits play fundamental roles toward sculpting principle neuron output and information processing. In prominent models of olfactory bulb circuitry, inhibition of mitral cells by local interneurons sharpens odor tuning and provides contrast enhancement. Mitral cell inhibition occurs at both mitral cell apical dendrites and deep-layer dendrodendritic synapses between granule cells, the most abundant population of inhibitory interneurons in the olfactory bulb. However, it remains unclear whether other local interneurons make inhibitory connections onto mitral cells. Here, we report a novel circuitry with strong and reciprocal connectivity between a subpopulation of previously uncharacterized Corticotropin-Releasing Hormone (CRH)-expressing interneurons located in the external plexiform layer (EPL), and mitral cells. Using cell type-specific genetic manipulations, imaging, optogenetic stimulation, and electrophysiological recordings, we reveal that CRH-expressing EPL interneurons strongly inhibit mitral cell firing, and that they are reciprocally excited by fast glutamatergic mitral cell input. These findings functionally identify a novel subpopulation of olfactory bulb interneurons that show reciprocal connectivity with mitral cells, uncovering a previously unknown, and potentially critical player in olfactory bulb circuitry that may influence lateral interactions and/or facilitate odor processing.

Genetic strategies to investigate neuronal circuit properties using stem cell-derived neurons.

The mammalian brain is anatomically and functionally complex, and prone to diverse forms of injury and neuropathology. Scientists have long strived to develop cell replacement therapies to repair damaged and diseased nervous tissue. However, this goal has remained unrealized for various reasons, including nascent knowledge of neuronal development, the inability to track and manipulate transplanted cells within complex neuronal networks, and host graft rejection. Recent advances in embryonic stem cell (ESC) and induced pluripotent stem cell (iPSC) technology, alongside novel genetic strategies to mark and manipulate stem cell-derived neurons, now provide unprecedented opportunities to investigate complex neuronal circuits in both healthy and diseased brains. Here, we review current technologies aimed at generating and manipulating neurons derived from ESCs and iPSCs toward investigation and manipulation of complex neuronal circuits, ultimately leading to the design and development of novel cell-based therapeutic approaches.

Efeito da massagem e do kinesio taping na dismenorreia primária / Effect of massage and kinesio taping on primary dysmenorrhea

Introdução: A dismenorreia é caracterizada por dores na região lombar e abdominal inferior e está associada ao ciclo menstrual sendo frequente em jovens mulheres e afetando suas atividades de vida diária e a qualidade de sono. Objetivo: Verificar o efeito da massagem do tecido conjuntivo (MTC) e do Kinesio Taping na dismenorreia primária nas variáveis dor, influência da dor nas atividades de vida diária e qualidade do sono. Métodos: Participaram do estudo 63 mulheres entre 18-26 anos e que referiam dor igual ou superior a 5 na Escala Visual Analógica (EVA). Destas, apenas 21 participaram efetivamente do estudo, e foram divididas em 3 grupos: Grupo Controle (7) que não recebeu intervenção, Grupo MTC (6) tratado com massagem terapêutica e grupo Kinesio Taping (8) que recebeu aplicação do recurso em baixo ventre e lombar. Para avaliação foi utilizada a EVA para dor; questionário para influência da dor nas AVDs, e as Escalas Visuais Análogas do Sono para qualidade de sono. Resultados: Os grupos que receberam intervenção apresentaram melhora significativa da dor em relação ao grupo controle em todos os momentos avaliados (p < 0,05) e melhora da influência da dor nas AVDs em todos os dias do ciclo quando comparado o mês controle e o mês da intervenção (p < 0,05). A avaliação do sono não demonstrou diferença estatística entre o mês controle e tratamento, mas na análise entre grupos, o Kinesio Taping demonstrou-se superior (p = 0,03). Conclusão: Houve redução do quadro álgico nos grupos que receberam intervenção, e o Kinesio Taping demonstrou-se mais efetivo na melhora da qualidade do sono.

Effect of caffeine and alcohol on the toxicity and metabolism of methacrylonitrile in male Sprague-Dawley rats.

This study reports the toxicity and metabolism of methacrylonitrile (MeAN) in normal male Sprague-Dawley rats and those pre-treated with caffeine, alcohol or both. Rats were divided into groups often. One group received an oral dose by gavage of 6 % MeAN solution in corn oil (equivalent to 0.5 LD50). Other three groups of rats were pre-treated with alcohol (2 ml of 50% solution in water), caffeine (1 ml of 2% solution in water) or both alcohol and caffeine 12 hr before receiving MeAN dose by gavage. The rats were observed for mortality, cholinomimetic and central nervous system (CNS) effects and urinary dysfunction for 6 hr. The concentrations of cyanide, thiocyanate and glutathione (GSH) were determined in blood, liver, kidney and brain. Alcohol and alcohol + caffeine pre-treatment caused significant increase in cholinomimetic, CNS and urinary dysfunction effects of MeAN and mortality. However, caffeine alone pre-treatment protected rats from these effects. In the rats treated with MeAN alone and those pre-treated with alcohol and alcohol + caffeine the GSH concentrations significantly decreased in liver, brain and kidney. In the rats pre-treated with caffeine alone the concentrations of GSH were not significantly different from controls. In the rats treated with MeAN alone and those pretreated with alcohol and alcohol + caffeine the cyanide and thiocyanate concentrations increased in the blood and other organs up to 2-4 folds whereas in rats pre-treated with caffeine alone the concentrations of cyanide and thiocyanate were not significantly different from controls. Western Blot experiment showed CYP2E1 induction in rats pretreated with alcohol and MeAN. These results suggest that caffeine inhibited and alcohol enhanced toxicity and metabolism of MeAN.

El modelo situacional en la interconsulta psiquiátrica / The situational model in the psychiatric interconsult

Por ser la interconsulta el quehacer fundamental de la Unidad de Psiquiatría del Hospital Miguel Pérez Carreño, dirigida a la atención del paciente hospitalizado, los autores presentan el siguiente trabajo destinado a investigar las características del abordaje de la interconsulta en dicho Hospital durante el período Enero-Diciembre de 1992, a partir de cuyos resultados proponen un modelo alternativo, el modelo situacional. Se basa la investigación en la realización de un estudio descriptivo-exploratorio a partir de un instrumento de recolección de la información (Hoja de Registro), a través de la cual se recabó lo siguiente: datos de identificación, motivo de consulta verbal y escrita, actitud del tratante ante el paciente, actitud del tratante ante la consulta, diagnóstico e intervención terapéutica. A los fines del análisis se categorizó la información en relación al motivo de consulta en tanto claro, confuso, contradictorio o discordante, en virtud de la receptividad o no del médico tratrante hacia la interconsulta y en cuanto a la posición del interconsultante de Psiquiatría atinente a la orientación de su intervención: hacia el paciente, el médico o la relación médico paciente. Se realizó así un diagnóstico transversal de lo ocurrido en la Interconsulta de Psiquiatría en el lapso señalado. Los resultados mostraron centramiento de la atención hacia la figura del paciente, dificultades en la relación médico tratante-interconsultante psiquiatra y visión parcial de la problemática planteada. Se discuten los resultados y se propone como modelo alternativo de intervención, el modelo situacional que permite ampliar la visualización del problema, estrechar las relaciones tratante-interconsultante, privilegiar el trabajo en equipo y que redunda en beneficio de una intervención terapéutica más pertinente y por tanto más eficaz