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Fluorescence imitating brightfield imaging (FIBI) is a novel microscopy method that allows for real-time, nondestructive, slide-free tissue imaging of fresh, formalin-fixed, or paraffin-embedded tissue. The nondestructive nature of the technology permits tissue preservation for downstream analyses. The objective of this observational study was to assess the utility of FIBI compared with conventional hematoxylin and eosin (H&E)-stained histology slides in feline gastrointestinal histopathology. Formalin-fixed paraffin-embedded full-thickness small intestinal tissue specimens from 50 cases of feline chronic enteropathy were evaluated. The ability of FIBI to evaluate predetermined morphological features (epithelium, villi, crypts, lacteals, fibrosis, submucosa, and muscularis propria) and inflammatory cells was assessed on a 3-point scale (0 = FIBI cannot identify the feature; 1 = FIBI can identify the feature; 2 = FIBI can identify the feature with more certainty than H&E). H&E and FIBI images were also scored according to World Small Animal Veterinary Association (WSAVA) Gastrointestinal Standardization Group guidelines. FIBI identified morphological features with similar or, in some cases, higher confidence compared with H&E images. The identification of inflammatory cells was less consistent. FIBI and H&E images showed an overall poor agreement with regard to the assigned WSAVA scores. While FIBI showed an equal or better ability to identify morphological features in intestinal biopsies, its ability to identify inflammatory cells is currently inferior compared with H&E-based imaging. Future studies on the utility of FIBI as a diagnostic tool for noninflammatory histopathologic lesions are warranted.
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Doenças do Gato , Doenças Inflamatórias Intestinais , Gatos , Animais , Microscopia/veterinária , Doenças Inflamatórias Intestinais/patologia , Doenças Inflamatórias Intestinais/veterinária , Intestino Delgado/patologia , Duodeno/patologia , Biópsia/veterinária , Doenças do Gato/diagnóstico por imagem , Doenças do Gato/patologiaRESUMO
BACKGROUND: Fecal microbiota transplantation (FMT) is increasingly used for gastrointestinal and extra-gastrointestinal diseases in veterinary medicine. However, its effects on immune responses and possible adverse events have not been systematically investigated. HYPOTHESIS/OBJECTIVES: Determine the short-term safety profile and changes in the peripheral immune system after a single FMT administration in healthy dogs. ANIMALS: Ten client-owned, clinically healthy dogs as FMT recipients, and 2 client-owned clinically healthy dogs as FMT donors. METHODS: Prospective non-randomized clinical trial. A single rectal enema of 5 g/kg was given to clinically healthy canine recipients. During the 28 days after FMT administration, owners self-reported adverse events and fecal scores. On Days 0 (baseline), 1, 4, 10, and 28 after FMT, fecal and blood samples were collected. The canine fecal dysbiosis index (DI) was calculated using qPCR. RESULTS: No significant changes were found in the following variables: CBC, serum biochemistry, C-reactive protein, serum cytokines (interleukins [IL]-2, -6, -8, tumor necrosis factor [TNF]-α), peripheral leukocytes (B cells, T cells, cluster of differentiation [CD]4+ T cells, CD8+ T cells, T regulatory cells), and the canine DI. Mild vomiting (n = 3), diarrhea (n = 4), decreased activity (n = 2), and inappetence (n = 1) were reported, and resolved without intervention. CONCLUSIONS AND CLINICAL IMPORTANCE: Fecal microbiota transplantation did not significantly alter the evaluated variables and recipients experienced minimal adverse events associated with FMT administration. Fecal microbiota transplantation was not associated with serious adverse events, changes in peripheral immunologic variables, or the canine DI in the short-term.
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Transplante de Microbiota Fecal , Animais , Cães , Transplante de Microbiota Fecal/veterinária , Transplante de Microbiota Fecal/efeitos adversos , Feminino , Masculino , Fezes/microbiologia , Estudos Prospectivos , Citocinas/sangue , Citocinas/metabolismo , Disbiose/veterinária , Disbiose/terapia , Microbioma GastrointestinalRESUMO
Chronic enteropathies (CE) are common disorders in cats and the differentiation between the two main underlying diseases, inflammatory bowel disease (IBD) and low-grade intestinal T-cell lymphoma (LGITL), can be challenging. Characterization of the serum metabolome could provide further information on alterations of disease-associated metabolic pathways and may identify diagnostic or therapeutic targets. Unbiased metabolomics analysis of serum from 28 cats with CE (14 cats with IBD, 14 cats with LGITL) and 14 healthy controls identified 1,007 named metabolites, of which 129 were significantly different in cats with CE compared to healthy controls at baseline. Random Forest analysis revealed a predictive accuracy of 90% for differentiating controls from cats with chronic enteropathy. Metabolic pathways found to be significantly altered included phospholipids, amino acids, thiamine, and tryptophan metabolism. Several metabolites were found to be significantly different between cats with IBD versus LGITL, including several sphingolipids, phosphatidylcholine 40:7, uridine, pinitol, 3,4-dihydroxybenzoic acid, and glucuronic acid. However, random forest analysis revealed a poor group predictive accuracy of 60% for the differentiation of IBD from LGITL. Of 129 compounds found to be significantly different between healthy cats and cats with CE at baseline, 58 remained different following treatment.
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Doenças do Gato , Doenças Inflamatórias Intestinais , Gatos , Animais , Metabolômica , Metaboloma , Doenças do Gato/diagnósticoRESUMO
BACKGROUND: Cytosine arabinoside (Ara-C) is a nucleoside analog prodrug utilized for immunomodulatory effects mediated by its active metabolite Ara-CTP. Optimal dosing protocols for immunomodulation in dogs have not been defined. Cytarabine ocfosfate (CO) is a lipophilic prodrug of Ara-C that can be administered PO and provides prolonged serum concentrations of Ara-C. OBJECTIVES: Provide pharmacokinetic data for orally administered CO and determine accumulation and functional consequences of Ara-CTP within peripheral blood leukocytes. ANIMALS: Three healthy female hound dogs and 1 healthy male Beagle. METHODS: Prospective study. Dogs received 200 mg/m2 of CO PO q24h for 7 doses. Serum and cerebrospinal fluid (CSF) CO and Ara-C concentrations were measured by liquid chromatography-tandem mass spectroscopy (LC-MS/MS). Complete blood counts, flow cytometry, and leukocyte activation assays were done up to 21 days. Incorporation of Ara-CTP within leukocyte DNA was determined by LC-MS/MS. RESULTS: Maximum serum concentration (Cmax ) for Ara-C was 456.1-724.0 ng/mL (1.88-2.98 µM) and terminal half-life was 23.3 to 29.4 hours. Cerebrospinal fluid: serum Ara-C ratios ranged from 0.54 to 1.2. Peripheral blood lymphocyte concentrations remained within the reference range, but proliferation rates poststimulation were decreased at 6 days. Incorporation of Ara-CTP was not saturated and remained >25% of peak concentration at 13 days. CONCLUSIONS AND CLINICAL IMPORTANCE: Oral CO may produce prolonged serum Ara-C half-lives at concentrations sufficient to induce functional changes in peripheral leukocytes and is associated with prolonged retention of DNA-incorporated Ara-CTP. Application of functional and active metabolite assessment is feasible and may provide more relevant data to determine optimal dosing regimens for Ara-C-based treatments.
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Arabinofuranosilcitosina Trifosfato , Pró-Fármacos , Feminino , Masculino , Cães , Animais , Cromatografia Líquida/veterinária , Estudos Prospectivos , Espectrometria de Massas em Tandem/veterinária , Leucócitos , Biomarcadores , Citarabina , DNARESUMO
Human embryonic stem cells (hESCs) are self-renewing pluripotent cells that can differentiate to a wide range of specialized cells and hold great promise as models for human development and disease, as well as for drug discovery and cell-replacement therapies. Group B Coxsackie viruses (CVBs) produce acute myocarditis, pancreatitis, non-septic meningitis and encephalitis in neonates, children and young adults. Moreover, CVBs can produce spontaneous miscarriage after early embryo infection. It was reported that hESCs express CVBs receptors and are susceptible to CVB3 infection. Apoptosis is one of the hallmarks of CVBs infection although details regarding CVB3 involvement in the apoptotic processes remain elusive. In order to evaluate the mechanisms of cell death induced by CVB3 in these pluripotent cells, we infected HUES-5 (H5) and WA01 (H1) hESC lines with CVB3. After validating the maintenance of stemness in these hESC lines when grown as confluent monolayers in feeder-free conditions, we analysed several aspects of programmed cell death triggered by CVB3. In all cases, we detected chromatin condensation, DNA fragmentation and caspase-9 and 3 cleavages. Moreover, we observed the presence of cleaved PARP product which was preceded by the appearance of p17, the catalytically active fragment of caspase-3. Mitochondrial function assays revealed a MOI dependent decrease in cell viability at 24 h post-infection (pi). No appreciable modifications in Bcl-2, Bcl-X(L) and Bax protein levels were observed upon CVB3 infection during 5-24 h observation period. However, a marked decrease in pro-apoptotic Bad abundance was detected without changes in its mRNA levels. In this study we found that the hESCs are highly susceptible to CVB3 infection and display elevated apoptosis rates, thus emerging as suitable human non-transformed in vitro models to study CVB3-induced apoptosis and resulting relevant to understand CVBs pathogenesis.
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Apoptose , Infecções por Coxsackievirus/metabolismo , Células-Tronco Embrionárias/metabolismo , Enterovirus/metabolismo , Caspases/genética , Caspases/metabolismo , Linhagem Celular , Sobrevivência Celular , Cromatina/metabolismo , Infecções por Coxsackievirus/virologia , Fragmentação do DNA , Células-Tronco Embrionárias/citologia , Células-Tronco Embrionárias/virologia , Enterovirus/patogenicidade , Expressão Gênica , Células HeLa , Humanos , Transdução de Sinais , Proteína de Morte Celular Associada a bcl/genética , Proteína de Morte Celular Associada a bcl/metabolismoRESUMO
The small intestinal mucosa constitutes a physical barrier separating the gut lumen from sterile internal tissues. Junctional complexes between cells regulate transport across the barrier, preventing water loss and the entry of noxious molecules or pathogens. Inflammatory diseases in cattle disrupt this barrier; nonetheless, mechanisms of barrier disruption in cattle are poorly understood. We investigated the direct effects of three inflammatory cytokines, TNFα, IFNγ, and IL-18, on the bovine intestinal barrier utilizing intestinal organoids. Flux of fluorescein isothiocyanate (FITC)-labeled dextran was used to investigate barrier permeability. Immunocytochemistry and transmission electron microscopy were used to investigate junctional morphology, specifically tortuosity and length/width, respectively. Immunocytochemistry and flow cytometry was used to investigate cellular turnover via proliferation and apoptosis. Our study shows that 24-h cytokine treatment with TNFα or IFNγ significantly increased dextran permeability and tight junctional tortuosity, and reduced cellular proliferation. TNFα reduced the percentage of G2/M phase cells, and IFNγ treatment increased cell apoptotic rate. IL-18 did not directly induce significant changes to barrier permeability or cellular turnover. Our study concludes that the inflammatory cytokines, TNFα and IFNγ, directly induce intestinal epithelial barrier dysfunction and alter the tight junctional morphology and rate of cellular turnover in bovine intestinal epithelial cells.
Assuntos
Citocinas , Enteropatias , Animais , Bovinos , Dextranos , Células Epiteliais , Interleucina-18 , Mucosa Intestinal , Permeabilidade , Junções Íntimas , Fator de Necrose Tumoral alfaRESUMO
Induced pluripotent stem cells (iPSCs) are a promising type of stem cells, comparable to embryonic stem cells (ESCs) in terms of self-renew and pluripotency, generated by reprogramming somatic cells. These cells are an attractive approach to supply patient-specific pluripotent cells, for producing in vitro models of disease, drug discovery, toxicology and potentially treating degenerative disease circumventing immune rejection. In spite of the great advance since iPSCs' establishment, their obtention and propagation is an increasing area of great interest. In a recent work, we have shown that the conditioned medium from a bovine granulosa cell line (BGC-CM) is able to preserve the basic properties of mESCs. Therefore, based on our previous results and the reported resemblance between iPSCs and ESCs, we hypothesized that BGC-CM could provide a favorable context to culturing iPSCs. In this work, we have reprogrammed mouse embryonic fibroblasts obtaining iPSC lines, and showed that they can be propagated in BGC-CM while maintaining self-renewal and pluripotency, evidenced by expression of specific gene markers and capability of in vitro and in vivo differentiation to cell types from the three germ layers. We believe that these findings may provide a novel context to propagate iPSCs to study the molecular mechanisms involved in self-renewal and pluripotency.
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Meios de Cultivo Condicionados/farmacologia , Células-Tronco Pluripotentes Induzidas/efeitos dos fármacos , Células-Tronco Pluripotentes Induzidas/fisiologia , Regeneração , Animais , Bovinos , Técnicas de Cultura de Células , Linhagem Celular , Meios de Cultivo Condicionados/metabolismo , Feminino , Células da Granulosa/metabolismo , Células da Granulosa/fisiologia , Células-Tronco Pluripotentes Induzidas/metabolismo , Camundongos , Fator 3 de Transcrição de Octâmero/metabolismoRESUMO
Robust and reproducible protocols to efficiently reprogram adult canine cells to induced pluripotent stem cells are still elusive. Somatic cell reprogramming requires global chromatin remodeling that is finely orchestrated spatially and temporally. Histone acetylation and deacetylation are key regulators of chromatin condensation, mediated by histone acetyltransferases and histone deacetylases (HDACs), respectively. HDAC inhibitors have been used to increase histone acetylation, chromatin accessibility, and somatic cell reprogramming in human and mice cells. We hypothesized that inhibition of HDACs in canine fibroblasts would increase their reprogramming efficiency by altering the epigenomic landscape and enabling greater chromatin accessibility. We report that a combined treatment of panobinostat (LBH589) and vitamin C effectively inhibits HDAC function and increases histone acetylation in canine embryonic fibroblasts in vitro, with no significant cytotoxic effects. We further determined the effect of this treatment on global chromatin accessibility via Assay for Transposase-Accessible Chromatin using sequencing. Finally, the treatment did not induce any significant increase in cellular reprogramming efficiency. Although our data demonstrate that the unique epigenetic landscape of canine cells does not make them amenable to cellular reprogramming through the proposed treatment, it provides a rationale for a targeted, canine-specific, reprogramming approach by enhancing the expression of transcription factors such as CEBP.
RESUMO
Naturally occurring disease in pet dogs is an untapped and unique resource for stem cell-based regenerative medicine translational research, given the many similarities and complexity such disease shares with their human counterparts. Canine-specific regulators of somatic cell reprogramming and pluripotency maintenance are poorly understood. While retroviral delivery of the four Yamanaka factors successfully reprogrammed canine embryonic fibroblasts, adult stromal cells remained resistant to reprogramming in spite of effective viral transduction and transgene expression. We hypothesized that adult stromal cells fail to reprogram due to an epigenetic barrier. Here, we performed assay for transposase-accessible chromatin using sequencing (ATAC-seq) on canine stromal and pluripotent stem cells, analyzing 51 samples in total, and establishing the global landscape of chromatin accessibility before and after reprogramming to induced pluripotent stem cells (iPSC). We also studied adult stromal cells that do not yield iPSC colonies to identify potential reprogramming barriers. ATAC-seq analysis identified distinct cell type clustering patterns and chromatin remodeling during embryonic fibroblast reprogramming. Compared with embryonic fibroblasts, adult stromal cells had a chromatin accessibility landscape that reflects phenotypic differentiation and somatic cell-fate stability. We ultimately identified 76 candidate genes and several transcription factor binding motifs that may be impeding somatic cell reprogramming to iPSC, and could be targeted for inhibition or activation, in order to improve the process in canines. These results provide a vast resource for better understanding of pluripotency regulators in dogs and provide an unbiased rationale for novel canine-specific reprogramming approaches.
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Human foreskin fibroblasts were used to generate the iPSC line iPSC-FH2.1 using the EF1a-hSTEMCCA-loxP vector expressing OCT4, SOX2, c-MYC and KLF4, in 5% O2 culture conditions. Stemness was confirmed, as was pluripotency both in vivo and in vitro, in normoxia and hypoxia. Human Embryonic Stem Cell (hESC) line WA-09 and reprogrammed fibroblast primary culture HFF-FM were used as controls.
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Fibroblastos/citologia , Prepúcio do Pênis/citologia , Células-Tronco Pluripotentes Induzidas/citologia , Diferenciação Celular , Células Cultivadas , Reprogramação Celular , Hibridização Genômica Comparativa , Metilação de DNA , Humanos , Células-Tronco Pluripotentes Induzidas/metabolismo , Cariótipo , Fator 4 Semelhante a Kruppel , Masculino , Microscopia de Fluorescência , Fator 3 de Transcrição de Octâmero/genética , Regiões Promotoras Genéticas , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismoRESUMO
INTRODUCTION: Mesenchymal stem cells (MSCs) are a promising source of cells for regenerative therapies. Although they can be isolated easily from several tissues, cell expansion is limited since their properties are lost with successive passages. Hence, pluripotent derived MSCs (PD-MSCs) arise as a suitable alternative for MSC production. Nevertheless, at present, PD-MSC derivation protocols are either expensive or not suitable for clinical purposes. METHODS: In this work we present a therapy-grade, inexpensive and simple protocol to derive MSCs from pluripotent stem cells (PSCs) based on the use of platelet lysate (PL) as medium supplement. RESULTS: We showed that the PD-MSCPL expressed multiple MSC markers, including CD90, CD73, CD105, CD166, and CD271, among others. These cells also show multilineage differentiation ability and immunomodulatory effects on pre-stimulated lymphocytes. Thorough characterization of these cells showed that a PD-MSCPL resembles an umbilical cord (UC) MSC and differs from a PSC in surface marker and extracellular matrix proteins and integrin expression. Moreover, the OCT-4 promoter is re-methylated with mesenchymal differentiation comparable with the methylation levels of UC-MSCs and fibroblasts. Lastly, the use of PL-supplemented medium generates significantly more MSCs than the use of fetal bovine serum. CONCLUSIONS: This protocol can be used to generate a large amount of PD-MSCs with low cost and is compatible with clinical therapies.
Assuntos
Plaquetas/metabolismo , Células-Tronco Mesenquimais/citologia , Células-Tronco Pluripotentes/citologia , Antígenos de Superfície/metabolismo , Diferenciação Celular/efeitos dos fármacos , Células Cultivadas , Metilação de DNA , Células-Tronco Embrionárias Humanas/citologia , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Células-Tronco Mesenquimais/metabolismo , Microscopia de Fluorescência , Fenótipo , Células-Tronco Pluripotentes/efeitos dos fármacos , Células-Tronco Pluripotentes/metabolismo , Regiões Promotoras GenéticasRESUMO
We studied the susceptibility of human embryonic stem cells and derived contractile embryoid bodies from WAO9, HUES-5 and HUES-16 cell lines to Coxsackievirus B infection. After validating stem cell-like properties and cardiac phenotype, Coxsackievirus B receptors CAR and DAF, as well as type I interferon receptors were detected in all cell lines and differentiation stages studied. Real-time PCR analysis showed that CAR mRNA levels were 3.4-fold higher in undifferentiated cells, while DAF transcript levels were 2.78-fold more abundant in differentiated cultures (P<0.05). All cell lines were susceptible to Coxsackievirus serotypes B1-5 infection as shown by RT-PCR detection of viral RNA, immunofluorescence detection of viral protein and infectivity titration of cell culture supernatants resulting in cell death. Supernatants infectivity titers 24-48 h post-infection ranged from 105-106 plaque forming units (PFU)/ml, the highest titers were detected in undifferentiated cells. Cell viability detected by a colorimetric assay, showed inverse correlation with infectivity titers of cell culture supernatants. Treatment with 100 U of interferon Iß significantly reduced viral replication and associated cell death during a 24-48 h observation period, as detected by reduced infectivity titers in the supernatants and increased cell viability by a colorimetric assay, respectively. We propose human embryonic stem cell and derived contractile embryoid bodies as a valid model to study cardiac Coxsackievirus B infection.
Assuntos
Infecções por Coxsackievirus/virologia , Corpos Embrioides/virologia , Células-Tronco Embrionárias/virologia , Enterovirus Humano B/fisiologia , Interferon beta/farmacologia , Linhagem Celular , Infecções por Coxsackievirus/genética , Infecções por Coxsackievirus/metabolismo , Corpos Embrioides/efeitos dos fármacos , Células-Tronco Embrionárias/efeitos dos fármacos , Enterovirus Humano B/efeitos dos fármacos , Humanos , Receptores Virais/genética , Receptores Virais/metabolismo , Replicação Viral/efeitos dos fármacosRESUMO
Introducción Las células madre son motivo de intensa investigación debido a la posibilidad de su utilización en el tratamiento de numerosas enfermedades, en particular las cardiovasculares. La diferenciación de células madre embrionarias humanas en cardiomiocitos se ha realizado exitosamente in vitro. Se han establecido métodos de cultivo y diferenciación, señales involucradas en la cardiogénesis y los cardiomiocitos generados se han utilizado en modelos de regeneración miocárdica. Sin embargo, aún quedan muchos interrogantes que se están investigando activamente. Objetivo Desarrollar una metodología que permita el cultivo de células embrionarias y su diferenciación en cardiomiocitos. Material y métodos Se utilizaron cuatro líneas de células madre embrionarias humanas. Se cultivaron y diferenciaron a través de los métodos publicados previamente en la bibliografía. El estado indiferenciado y la diferenciación en cardiomiocitos se verificaron por medio de inmunomarcación fluorescente y RT-PCR. Resultados La metodología utilizada permitió cultivar las células y mantenerlas en estado indiferenciado. Aunque con eficacia dispar, se logró la diferenciación en cardiomiocitos de las cuatro líneas celulares utilizadas. La confirmación se realizó por medio de la expresión de factores de transcripción miocárdicos y proteínas estructurales cardíacas. Conclusiones El cultivo y la diferenciación de células madre embrionarias humanas fue posible en nuestro sistema. Estos resultados preliminares nos impulsan a continuar y a desarrollar nuestros métodos con células pluripotentes inducidas.
Background The role of stem cells in the treatment of several conditions, especially heart diseases, is under permanent investigation. Human embryonic stem cells have been successfully differentiated in vitro into cardiomyocytes. Methods of cell culture and cardiomyocyte differentiation are well established; signals regulating cardiogenesis have been identified and the cardiomyocytes generated have been used in models of myocardial regeneration. However, several questions still remain and are currently under active investigation. Objective To develop a culture system that is suitable for the induction of embryonic stem cells to cardiomyocyte differentiation. Material and Methods Four human embryonic stem cell lines were used. The cells were cultured and differentiation was induced using methods previously described. The presence of cells in an undifferentiated state and cardiomyocyte differentiation was detected by immunohistochemical studies (fluorescent staining) and RT-PCR. Results The methodology used allowed stem cells growth in the culture, and maintained them in an undifferentiated state. Cardiomyocyte differentiation was achieved in the four cell lines used, yet with uneven efficacy. This was confirmed by the expression of myocardial transcription factors and heart structural proteins. Conclusions Our system allowed human embryonic stem cell growth and differentiation in the culture. These preliminary results encourage us to continue developing our methods with induced pluripotent stem cells.
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El presente trabajo de investigacion de tipo descriptivo, de corte longitudinal y retrospectivo, tuvo comno objetivo primordial detectar alteraciones de incumbencia fonoaudiologica relacionadas con el lenguaje expresivo, lenguaje comprensivo, audicion y las alteraciones que pueden traer posibles dificultades en el proceso de adquisicion de la lectoescritura. Se trata de un trabajo llevado a cabo en la escuela privada, Nuestra Señora del Calvario, de la ciudad de Galvez (provincia de Santa Fe), en la seccion "A" turno mañana, jardin de cinco. Para obtener estos datos fue necesario recolectar las fichas de entrevista inicial y de seguimiento individual, de cada niño/a y seleccionar los indicadoes que brindaban informacion sobre las area involucradas. Entre los 22 niños estudiados, que asistieron a jardin entre 1998 y el año 2000, los resultados a los que se arribo fueron: 7 ninos (31,8 por ciento) presentaron alteraciones fonoaudiologicas; de audicion, de lenguaje expresivo, de lenguaje cmprensivo y/o en el proceso de adquisicion de lectoescritura solas o combinadas. Algunos de ellos (4) contaban con antecedentes de riesgo prenatal, natal o postnatal. A lo largo de este trabajo se intento demostrar la importancia que tienen los datos aportados por los padres, los resultados y observaciones obtenidos por los docentes, en el analisis que podra hacer el fonoaudiologo para descartar alteraciones fonoaudiologica que interfieran el desarrollo pedagogico, ya que con solo revisar las fichas de los ninos el profesional podra visualizar si existen problemas. En caso de que los hubiere, de que tipo, permitiendo facilitar con rapidez la derivacion y consulta al profesional adecuado y el posterior tratamiento y recuperacion