Sweet corn cob as a functional ingredient in bakery products.

Gluten free (GF) products are often inferior in quality attributes, nutritional content and consumer acceptability. The use of GF by-products is a novel strategy to improve the structure and nutritional profile of these products. Sweet corn cob (SCC) is a by-product of sweet corn processing containing a considerable amount of fibre and ferulic acid. The effect of baking on ferulic acid content, colour, texture and physical characteristics on muffins incorporated with SCC flour (SCCF) as a value-added food ingredient was investigated using a GF model system. The freeze-dried SCCF, containing ferulic acid (6.02 mg g-1) was used to replace the rice flour at varying levels of 10, 20, and 30%. In general, SCCF increased dietary fibre and free ferulic acid content of muffins. Inclusion of 20% SCCF showed an increase in terms of the height of the muffin and number of air cells in the crumb, along with a decrease in the hardness of muffins. Muffins with SCCF showed higher mean overall liking scores than rice flour muffin.

Diseño y fabricación de modelos impresos en 3D como complemento para las clases prácticas de histología médica / Design and manufacturing of 3D printed models as a complement for medical histology practical classes

RESUMEN: Tradicionalmente, la Histología se ha apoyado del análisis de preparaciones histológicas a través del microscopio para su enseñanza. En este sentido, uno de los principales obstáculos que enfrentan los estudiantes al analizar los tejidos, es extrapolar una imagen bidimensional a una estructura tridimensional (3D). La impresión 3D permite subsanar esta limitación, haciendo posible fabricar material docente, con las características requeridas con un alto grado de detalle y bajo costo. El objetivo de este trabajo fue diseñar y fabricar modelos impresos en 3D como complemento para las clases prácticas de Histología Médica. Se fabricaron modelos impresos en 3D de la ultraestructura de la barrera de filtración glomerular (BFG) en su estado normal y síndrome nefrótico. Además, se fabricó un modelo de la capa muscular del esófago humano dando énfasis a la disposición helicoidal de sus fibras musculares. Los modelos de epidermis permitieron identificar sus distintos estratos: estrato córneo, estrato granuloso, estrato espinoso, y estrato basal. Dentro los beneficios derivados de la impresión de modelos en 3D podemos destacar el bajo costo económico de su fabricación, alta reproducibilidad, bioseguridad, y potencial para favorecer el aprendizaje y la enseñanza de la Histología. No obstante, es necesario analizar la percepción y beneficio sobre el aprendizaje de los estudiantes derivados de la aplicación de los modelos mediante técnicas de evaluación cuantitativas y cualitativas.

SUMMARY: Traditionally, Histology has relied on the analysis of histological slides through the microscope for its teaching. In this sense, one of the main obstacles faced by students when analyzing tissues is to extrapolate a two-dimensional image to a three-dimensional (3D) structure. 3D printing makes it possible to overcome this limitation, making it possible to manufacture teaching material with the required characteristics with a high degree of detail and low cost. The objective of this work was to design and manufacture 3D printed models as a complement for the practical classes of Medical Histology. 3D printed models of the ultrastructure of the glomerular filtration barrier (GFB) in its normal state and nephrotic syndrome were fabricated. In addition, a model of the muscular layer of the human esophagus was fabricated emphasizing the helical arrangement of its muscle fibers. The epidermis models allowed the identification of its different layers: stratum corneum, stratum granulosum, stratum spinosum, and stratum basale. Among the benefits derived from 3D printing of models, we can highlight the low economic cost of manufacturing, biosafety and potential to favor the learning and teaching of Histology. However, it is necessary to analyze the perception and benefit on student learning derived from the application of the models by means of quantitative and qualitative evaluation techniques.

Urgencia pediátrica: la primera línea de atención hospitalaria del paciente pediátrico con virus SARS-COV-2: el desafío que tenemos / Emergency room: the first line in the hospital medical attention of the pediatric patient with SARS-COV-2 virus: the challenge we have

The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed great challenges for both public health and medical clinical practice since the first cases reported in Wuhan, China. Coronavirus disease (CoVID-19) is a zoonotic disease caused by an RNA virus. SARS-CoV-2 is transmitted through respiratory droplets and fomites, and it has a lethality estimated at 4%. In the pediatric population it mainly produces mild cases, but it also can cause severe cases with hypoxemia, respiratory distress, and multiple organ failure. Children have been recognized as an important disease vector than can spread disease to higher risk groups. It is fundamental to rearrange emergency department functioning, in order to achieve an adequate patient flow that reduces the risk of disease transmission. In the following, we lay out the recommendations for patient care in the emergency room.

La emergencia mundial del virus SARS-CoV-2 (CoV2) ha producido grandes desafíos para la salud pública y para la atención clínica, desde la aparición de los primeros casos en Wuhan, China. La enfermedad, CoVID-19, es una infección zoonótica producida por un virus RNA (1). Se transmite a través de gotitas y fómites con una letalidad estimada en 4%. En pediatría, provoca cuadros respiratorios en su mayoría leves, pero también cuadros severos con hipoxemia y distrés respiratorio (2). Se ha reconocido al niño como un vector importante que aumenta los contagios en personas que tendrán probablemente cuadros de gravedad. La organización adecuada de los servicios de urgencias es fundamental para lograr un flujo y áreas especiales para los pacientes sospechosos de CoVID-19 y así evitar nuevos contagios. A continuación, se detallan las principales recomendaciones para la atención de estos pacientes en un servicio de urgencias.

Optimising adjacent membrane segmentation and parameterisation in multicellular aggregates by piecewise active contours.

In fluorescence microscopy imaging, the segmentation of adjacent cell membranes within cell aggregates, multicellular samples, tissue, organs, or whole organisms remains a challenging task. The lipid bilayer is a very thin membrane when compared to the wavelength of photons in the visual spectra. Fluorescent molecules or proteins used for labelling membranes provide a limited signal intensity, and light scattering in combination with sample dynamics during in vivo imaging lead to poor or ambivalent signal patterns that hinder precise localisation of the membrane sheets. In the proximity of cells, membranes approach and distance each other. Here, the presence of membrane protrusions such as blebs; filopodia and lamellipodia; microvilli; or membrane vesicle trafficking, lead to a plurality of signal patterns, and the accurate localisation of two adjacent membranes becomes difficult. Several computational methods for membrane segmentation have been introduced. However, few of them specifically consider the accurate detection of adjacent membranes. In this article we present ALPACA (ALgorithm for Piecewise Adjacent Contour Adjustment), a novel method based on 2D piecewise parametric active contours that allows: (i) a definition of proximity for adjacent contours, (ii) a precise detection of adjacent, nonadjacent, and overlapping contour sections, (iii) the definition of a polyline for an optimised shared contour within adjacent sections and (iv) a solution for connecting adjacent and nonadjacent sections under the constraint of preserving the inherent cell morphology. We show that ALPACA leads to a precise quantification of adjacent and nonadjacent membrane zones in regular hexagons and live image sequences of cells of the parapineal organ during zebrafish embryo development. The algorithm detects and corrects adjacent, nonadjacent, and overlapping contour sections within a selected adjacency distance d, calculates shared contour sections for neighbouring cells with minimum alterations of the contour characteristics, and presents piecewise active contour solutions, preserving the contour shape and the overall cell morphology. ALPACA quantifies adjacent contours and can improve the meshing of 3D surfaces, the determination of forces, or tracking of contours in combination with previously published algorithms. We discuss pitfalls, strengths, and limits of our approach, and present a guideline to take the best decision for varying experimental conditions for in vivo microscopy.

Proteomic and peptidomic UHPLC-ESI MS/MS analysis of cocoa beans fermented using the Styrofoam-box method.

This work characterises the peptide and protein profiles of Theobroma cacao beans of the genotype IMC 67 at different fermentation stages, using the Styrofoam-box fermentation method and employing UHPLC-ESI MS/MS for the analysis of peptides and proteins extracted from the beans. A total of 1058 endogenous peptides were identified and quantified over four fermentation time points. The majority of these peptides were formed after 2 and 4 days of fermentation, and originated predominantly from the proteolysis of two storage proteins - vicilin and a 21 kDa albumin. The changes in the peptide profile over fermentation were subsequently evaluated, and potential markers for assessing the degree of fermentation were identified. In particular, changes of the relative abundance of the major cocoa proteins detected can be proposed as potential markers for the fermentation stage. Furthermore, PCA of both the peptidomic and proteomic data has allowed differentiation of beans at different fermentation stages.

UHPLC-MS/MS analysis of cocoa bean proteomes from four different genotypes.

In this study the proteomic profiles of cocoa beans from four genotypes with different flavour profiles were analysed by bottom-up label-free UHPLC-MS/MS. From a total of 430 identified proteins, 61 proteins were found significantly differentially expressed among the four cocoa genotypes analysed with a fold change of ≥2. PCA analysis allowed clear separation of the genotypes based on their proteomic profiles. Genotype-specific abundances were recorded for proteases involved in the degradation of storage proteins and release of flavour precursors. Different genotype-specific levels of other enzymes, which generate volatiles compounds that could potentially lead to flavour-inducing compounds, were also detected. Overall, this study shows that UHPLC-MS/MS data can differentiate cocoa bean varieties.

[Foundations for the classification of medical specialist programs in a national qualifications framework]. / Fundamentos para la clasificación de los programas de médico especialista en un marco de cualificaciones nacional.

Qualification of learning outcomes in terms of knowledge, skills, responsibility and autonomy provided by medical specialist programs is of interest to State authorities, educational service providers, employers, and specialists. Countries that are signatories to the Bologna Process and others outside Europe, established that the guaranteed primary degree for medical studies is the Master in Medicine (second cycle). There is agreement that medical specialist programs are more advanced than a Master of Medicine but are different from the Doctor of Medicine (third cycle) in their clinical orientation. These programs usually do not have research components and occasionally they are not carried out in the higher education system. However, the level of qualification of medical specialist programs has not been established due to lack of consensus. In Chile, this decision becomes even more complicated due to the certification of "licenciatura" (first cycle) that medical schools provide. There are also gaps in the educational classification procedure employed by the country. However, the review of national qualification frameworks and government acts shows that some countries have validated these certifications as third cycle. Medical specialties certainly do not correspond to PhD programs and the eligibility of the qualification level must be guaranteed to all stakeholders, who require an agreement on the specific national framework of learning outcomes and competencies.

Fundamentos para la clasificación de los programas de médico especialista en un marco de cualificaciones nacional / Foundations for the classification of medical specialist programs in a national qualifications framework

Qualification of learning outcomes in terms of knowledge, skills, responsibility and autonomy provided by medical specialist programs is of interest to State authorities, educational service providers, employers, and specialists. Countries that are signatories to the Bologna Process and others outside Europe, established that the guaranteed primary degree for medical studies is the Master in Medicine (second cycle). There is agreement that medical specialist programs are more advanced than a Master of Medicine but are different from the Doctor of Medicine (third cycle) in their clinical orientation. These programs usually do not have research components and occasionally they are not carried out in the higher education system. However, the level of qualification of medical specialist programs has not been established due to lack of consensus. In Chile, this decision becomes even more complicated due to the certification of "licenciatura" (first cycle) that medical schools provide. There are also gaps in the educational classification procedure employed by the country. However, the review of national qualification frameworks and government acts shows that some countries have validated these certifications as third cycle. Medical specialties certainly do not correspond to PhD programs and the eligibility of the qualification level must be guaranteed to all stakeholders, who require an agreement on the specific national framework of learning outcomes and competencies.

Characterization of the Proteome of Theobroma cacao Beans by Nano-UHPLC-ESI MS/MS.

Cocoa seed storage proteins play an important role in flavour development as aroma precursors are formed from their degradation during fermentation. Major proteins in the beans of Theobroma cacao are the storage proteins belonging to the vicilin and albumin classes. Although both these classes of proteins have been extensively characterized, there is still limited information on the expression and abundance of other proteins present in cocoa beans. This work is the first attempt to characterize the whole cocoa bean proteome by nano-UHPLC-ESI MS/MS analysis using tryptic digests of cocoa bean protein extracts. The results of this analysis show that >1000 proteins could be identified using a species-specific Theobroma cacao database. The majority of the identified proteins were involved with metabolism and energy. Additionally, a significant number of the identified proteins were linked to protein synthesis and processing. Several proteins were also involved with plant response to stress conditions and defence. Albumin and vicilin storage proteins showed the highest intensity values among all detected proteins, although only seven entries were identified as storage proteins. A comparison of MS/MS data searches carried out against larger non-specific databases confirmed that using a species-specific database can increase the number of identified proteins, and at the same time reduce the number of false positives. The results of this work will be useful in developing tools that can allow the comparison of the proteomic profile of cocoa beans from different genotypes and geographic origins. Data are available via ProteomeXchange with identifier PXD005586.

¿Es tiempo de modificar la vinculación pregrado postgrado en la educación médica chilena? Reflexiones sobre una vía de doble titulación Médico cirujano/Doctor en ciencias médicas / Time to change the graduate-postgraduate liaison in Chilean medical education? Reflections about a double certification as Physician and Doctor in medical sciences

In the last 150 years, scientific research has produced extraordinary discoveries in Medicine and there is no doubt that research will continue contributing substantially in the future but there is no the same conviction regarding how to provision such capacities in medical graduates. In Chile, the Faculties of Medicine created several doctorate programs in Medical Sciences (Ph.D.) to strengthen medical research. However, the low number of physicians who apply to these programs is a caveat. These programs provide the advanced third-cycle competencies expected by students aspiring for an excellence research certification and their incorporation into academia. Universities stand out in their capacity to adapt themselves to educational needs, developing programs designed to fill specific gaps. Ph.D. programs intercalated to the medical career show that this is the correct approach. The development of specific doctorate programs for the small number of physicians interested in research and for medical students with a strong interest in research could be an innovative solution to motivate and encourage them to develop a career in clinical investigation. Using this approach, Medical Schools and Doctorate in Medical Sciences programs would jointly stimulate the training of medical scientists.

Prion Function and Pathophysiology in Non-Mammalian Models.

More than thirty years have passed since the discovery of the prion protein (PrP) and its causative role in transmissible spongiform encephalopathy. Since a combination of both gain- and loss-of-function mechanisms may underlay prion pathogenesis, understanding the physiological role of PrP may give important clues about disease mechanisms. Historically, the primary strategy for prion research has involved the use of human tissue, cell cultures and mammalian animal models. Nevertheless, experimental difficulties of in vivo studies and controversial observations obtained in these systems have stimulated the search for alternative animal models. PrPC is highly conserved in mammals, and PrPC-related orthologs are expressed in zebrafish, a vertebrate model organism suitable to study the mechanisms associated with human diseases. Invertebrate models, as they do not express PrPC have served to investigate the neurotoxic mechanisms of mammalian PrP. Here we overview most recent advances in the study of PrP function in normal and pathogenic conditions based on non-mammalian studies, highlighting the contribution of zebrafish, fly and worms to our current understanding of PrP biology.

[Time to change the graduate-postgraduate liaison in Chilean medical education? Reflections about a double certification as Physician and Doctor in medical sciences]. / ¿Es tiempo de modificar la vinculación pregrado postgrado en la educación médica chilena? Reflexiones sobre una vía de doble titulación Médico cirujano/Doctor en ciencias médicas.

In the last 150 years, scientific research has produced extraordinary discoveries in Medicine and there is no doubt that research will continue contributing substantially in the future but there is no the same conviction regarding how to provision such capacities in medical graduates. In Chile, the Faculties of Medicine created several doctorate programs in Medical Sciences (Ph.D.) to strengthen medical research. However, the low number of physicians who apply to these programs is a caveat. These programs provide the advanced third-cycle competencies expected by students aspiring for an excellence research certification and their incorporation into academia. Universities stand out in their capacity to adapt themselves to educational needs, developing programs designed to fill specific gaps. Ph.D. programs intercalated to the medical career show that this is the correct approach. The development of specific doctorate programs for the small number of physicians interested in research and for medical students with a strong interest in research could be an innovative solution to motivate and encourage them to develop a career in clinical investigation. Using this approach, Medical Schools and Doctorate in Medical Sciences programs would jointly stimulate the training of medical scientists.

Vólvulo del colon transverso espontáneo: reporte de dos casos / Two Case Reports of Spontaneous Transverse Colon Volvulus

Los vólvulos del colon transverso son una presentación poco frecuente del vólvulo del colon debido a la fijación anatómica que impide su torsión. En la literatura mundial se han presentado menos de 100 casos documentados. A continuación se presentan 2 casos de vólvulo del colon transverso que se sospechan mediante cuadro clínico e imagenológico, son llevados a colonoscopia para devolvulación y se confirman en el intraoperatorio.

Transverse colon volvulus is rare due to the anatomic location which impedes twisting. In the literature of the world, there have been fewer than 100 documented cases. This article presents two cases of transverse colon volvulus. They were suspected because of clinical evidence, images were obtained, colonoscopic reduction was performed and the disorders were confirmed intraoperatively.

Guía de práctica clínica para el diagnóstico y tratamiento del estreñimiento crónico funcional en población adulta / Clinical Practice Guideline for the Diagnosis and Management of Adult Patients with Functional Chronic Constipation

Objetivo: diseñar una guía de práctica clínica para orientar el diagnóstico, y establecer la clasificación y el tratamiento farmacológico y no farmacológico en los pacientes adultos con estreñimiento crónico funcional en Colombia. Materiales y métodos: el grupo desarrollador de la presente guía estuvo conformado por un equipo multidisciplinario con apoyo de la Asociación Colombiana de Gastroenterología, el Grupo Cochrane ITS y el Instituto de Investigaciones Clínicas de la Universidad Nacional de Colombia. Se desarrollaron preguntas clínicas relevantes y se realizó la búsqueda de guías nacionales e internacionales en bases de datos especializadas. Las guías existentes fueron evaluadas en términos de calidad y aplicabilidad; ninguna de ellas cumplió criterios de adaptación, por lo que se decidió desarrollar una guía de novo. El Grupo Cochrane realizó la búsqueda sistemática de la literatura. Las tablas de evidencia y recomendaciones fueron realizadas usando la metodología GRADE. Resultados: se desarrolló una guía de práctica clínica basada en la evidencia para el diagnóstico, clasificación y tratamiento farmacológico y no farmacológico de los pacientes con estreñimiento crónico funcional en Colombia. Conclusiones: se establecieron los criterios clínicos y signos de alarma, las pruebas diagnósticas y los esquemas terapéuticos que se recomiendan en la atención de los pacientes con estreñimiento crónico funcional en Colombia.

Objective: Design a clinical practice guideline to orient the diagnosis and establishing the classification and pharmacological and non-pharmacological treatment in adult patients with chronic functional constipation in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. None of the guidelines met the criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. Results: A clinical practice based on evidence was developed for the diagnosis, classification and pharmacological and non-pharmacological treatment of patients with chronic functional constipation in Colombia. Conclusions: The clinical criteria and warning signs, diagnostic tests and therapeutic regimens that are recommended in the care of patients with chronic functional constipation were established in Colombia.

Reduction of serum advanced glycation end-products with a low calorie Mediterranean diet.

UNLABELLED: Dietary intake of advanced glycation end-products (AGEs) increases circulating and tissue levels of these substances, contributing to a state of increased oxidative stress and inflammation. A low dietary AGE intervention has been shown to reduce body AGE content. Mediterranean diets (MD) are theoretically considered low in AGEs, but the specific effects of a MD on AGEs serum levels has not been tested. METHODOLOGY: Forty-seven overweight and obese premenopausal women underwent a three-month calorie restriction treatment (20 kcal/kg initial weight) with a Mediterranean-type diet that excluded wine intake. The adherence to the MD was assessed before and at the end of treatment using an on-line questionnaire, which scores from 0 to 14 (minimal to maximal adherence). Body composition, insulin resistance, lipoproteins and carboxymethyl-lisine (CML) serum levels were measured at both time periods. Serum CML was assessed through ELISA (enzyme-linked immunosorbent assay). Compliance to calorie restriction was assessed according to weight loss (< or > 5% initial weight). RESULTS: Mean body weight, body fat, waist circumference, total cholesterol, triglycerides and serum CML fell significantly, together with an increase in the Mediterranean score, although none of the patients reached the highest score. Significant changes in CML and insulin resistance were observed in 17 women classified as compliant to caloric restriction, but not in the 27 participants who were considered adherent to the MD (according to improvement of the Mediterranean Score). CONCLUSIONS: CML serum levels can be reduced through calorie restricted-Mediterranean-type diet. We could not reach a high enough MD score, so we cannot conclude whether the MD itself has an additive effect to caloric restriction.

La ingesta dietaria de productos finales de glicación avanzada (AGEs) aumenta los niveles séricos y tisulares de estas sustancias, lo que contribuye a un estado de mayor estrés oxidativo e inflamación. Una intervención dietaria con bajo contenido de AGEs ha demostrado reducir el contenido de AGEs en el cuerpo. La dieta mediterránea (DM) se considera teóricamente baja en AGEs, pero los efectos específicos de este tipo de intervención en los niveles séricos de AGEs no ha sido probado. Metodología: cuarenta y siete mujeres premenopáusicas con sobrepeso u obesidad se sometieron a tres meses de restricción calórica (20 kcal por kg de peso corporal inicial) con una dieta de tipo mediterráneo que excluía la ingesta de vino. La adherencia a la DM se evaluó al comienzo y al final del tratamiento utilizando una encuesta on-line, con puntuaciones de 0 a 14 (mínima a máxima adherencia a la DM). La composición corporal, la resistencia a la insulina, los niveles séricos de lipoproteínas y carboximetil-lisina (CML) se midieron en ambos períodos. El CML sérico se evaluó mediante ELISA (ensayo inmunoenzimático). La adherencia a la restricción calórica se evaluó de acuerdo con la pérdida de peso (< o > 5% del peso inicial). Resultados: la media de peso corporal, grasa corporal, circunferencia de la cintura, colesterol total, triglicéridos y CML sérica disminuyeron significativamente, junto con un aumento en el puntaje de adherencia a la DM, aunque ninguno de los pacientes alcanzó la máxima puntuación. Hubo cambios significativos en los niveles de CML y de resistencia a la insulina en 17 mujeres clasificadas como adherentes a la restricción calórica, pero no en las 27 participantes que fueron consideradas adherentes a la DM (de acuerdo con la mejoría en el puntaje de la encuesta). Conclusiones: los niveles séricos de CML disminuyeron tras la restricción calórica con una dieta tipo mediterránea. Dado que no se pudo alcanzar la puntuación máxima en la encuesta de DM, no podemos concluir si la propia DM tiene un efecto aditivo a la restricción calórica.

Pseudohiperkalemia por trombocitosis esencial: una entidad pobremente reconocida / Pseudohyperkalaemia in essential thrombocytosis: a poorly recognized

INTRODUCCIÓN: La hiperkalemia representa una emergencia médica frecuentemente manejada en servicios de urgencia. Identificar una pseudohiperkalemia en pacientes que presentan recuentos plaquetarios elevados permite evitar terapias innecesarias e iatrogenia que pueden tener consecuencias potencialmente fatales. PRESENTACIÓN DEL CASO: Mujer de 73 años, con enfermedad renal crónica (ERC) etapa-3a (etiología no precisada). En consulta neurológica por crisis isquémica transitoria (abril 2011), se demostró hiperkalemia de 6,0 mEq/L (suero), tasa de filtración glomerular(TFG) de 51 mL/min y trombocitosis de 1.113.000 plaquetas/mm3. Se trata la hiperkalemia con furosemida y dieta pobre en potasio. Inició hidroxiurea indicada por hematología. En control nefrológico (diciembre 2012) presenta hiperkalemia de 7,5 mEq/L (suero), TFG de 37 ml/min y trombocitosis de 1.052.000 plaquetas/mm3. Electrocardiograma (ECG), sin signos de cardiotoxicidad acordes al nivel de kalemia. Se sospechó pseudohiperkalemia secundaria a trombocitosis esencial (PSTE), se suspendió atenolol, furosemida y se continuó hidroxiurea. En febrero de 2013 presentó kalemia de 6,1 mEq/L (suero), trombocitosis de 713.000 plaquetas/mm3 y TFG de 31 mL/min. En mayo de 2014 la kalemia en suero fue de 5,5 mEq/L y en plasma de 5,2 mEq/L; trombocitosis de 503.000plaquetas/mm3 y TFG de 23 ml/min, confirmándose la PSTE. DISCUSIÓN: Hiperkalemia asociada a trombocitosis exige descartar PSTE. La regresión de la kalemia junto con la trombocitosis y ECG sin alteraciones en hiperkalemia, apoyan este diagnóstico. Su confirmación exige demostrar una hiperpotasemia mayor en suero que en plasma (0,36 +/-0,18 meq/L). Tratar una pseudohiperkalemia, puede generar iatrogenia (hipokalemia y/o hemoconcentración que aumenta riesgo de trombosis). Se descarta hiperkalemia secundaria a ERC con TFG>15ml/min

INTRODUCTION: Hyperkalemia is a medical emergency often managed in emergency services. Identifying a pseudohiperkalemia in patients with high platelet counts will avoid unnecessary iatrogenic therapies, which can have potentially fatal consequences. CASE REPORT: 73 year old woman, with chronic kidney disease (CKD) stage-3a (unknown etiology). In neurological consultation by transient ischemic attack (april 2011) it was evidenced a hyperkalemia of 6.0 mEq/L (serum), glomerular filtration rate (GFR) of 51 mL/min and thrombocytosis of 1,113,000 platelets/mm3. Hyperkalemia is treated with furosemide and potassium poor diet. Started on hydroxyurea indicated by hematology. Nephrology consultant (december 2012) realized hyperkalemia of 7.5 mEq/L (serum), GFR of 37mL/min and thrombocytosis of 1,052,000 platelets/mm3. EKG with no sign of cardiotoxicity was found in relation to potassium serum level. A pseudohyperkalemia secondary to essential thrombocytosis (PSET) was suspected. Atenolol and furosemide were discontinued and hidroxiurea was continued. In February 2013 potassium serum level was 6.1 mEq/L, platelet count: 713,000/ mm3 and GFR: 31 mL/min. In may 2014 serum potassium was 5.5 mEq/L and plasma potassium was 5.2 mEq/L; platelet count: 503,000//mm3 and GFR: 23 mL/min, confirming PSET. DISCUSSION: Hiperkalemia associated with thrombocytosis requires to rule out PSET. Regression of serum potassium with platelet count and the abscense of EKG changes with simultaneous hyperkalemia, support this diagnosis. Confirmation of PSTE diagnosis needs to demonstrate a potassium serum level greater than in plasma (0.36 +/- 0.18 mEq/L). Treating a pseudohiperkalemia can generate iatrogenia (hypokalemia and/or hemoconcentration, increasing the risk of thrombosis). A hyperkalemia secondary to CKD is ruled out with GFR >15mL/min

Computational methods for analysis of dynamic events in cell migration.

Cell migration is a complex biological process that involves changes in shape and organization at the sub-cellular, cellular, and supra-cellular levels. Individual and collective cell migration can be assessed in vitro and in vivo starting from the flagellar driven movement of single sperm cells or bacteria, bacterial gliding and swarming, and amoeboid movement to the orchestrated movement of collective cell migration. One key technology to access migration phenomena is the combination of optical microscopy with image processing algorithms. This approach resolves simple motion estimation (e.g. preferred direction of migrating cells or path characteristics), but can also reveal more complex descriptors (e.g. protrusions or cellular deformations). In order to ensure an accurate quantification, the phenomena under study, their complexity, and the required level of description need to be addressed by an adequate experimental setup and processing pipeline. Here, we review typical workflows for processing starting with image acquisition, restoration (noise and artifact removal, signal enhancement), registration, analysis (object detection, segmentation and characterization) and interpretation (high level understanding). Image processing approaches for quantitative description of cell migration in 2- and 3-dimensional image series, including registration, segmentation, shape and topology description, tracking and motion fields are presented. We discuss advantages, limitations and suitability for different approaches and levels of description.

Células Troncales en el Desarrollo y las Perspectivas de Reprogramación Celular para la Regeneración / Stem Cells in Development and the Perspectives of Cellular Reprogramming for Regeneration

Los organismos multicelulares se desarrollan a partir de una sola célula: el cigoto. A lo largo de su ontogenia, las células que derivan del cigoto despliegan distintos programas celulares, los cuales son estabilizados por mecanismos epigenéticos. Los programas de las células troncales son más inclusivos, siendo mayor el silenciamiento que la activación de genes durante el proceso de diferenciación celular. Experimentalmente, se ha logrado que células en estado de diferenciación terminal reactiven el programa de células troncales y recuperen su pluripotencialidad, proceso llamado reprogramación. Esto despierta esperanzas en el avance de una medicina regenerativa con nuevas capacidades para el tratamiento de enfermedades crónicas, sin las restricciones éticas del uso de células embrionarias.

Multicellular organisms develop from one cell: the zygote. During ontogeny, cells derived from the zygote display different cellular programs that are stabilized through epigenetic mechanisms. The programs of stem cells seem more inclusive, and during the process of differentiation a larger number of genes are silenced than activated. The reactivation of pluripotency recovers of the stem cell program in terminally differentiated cells has been achieved experimentally. This process, called reprogramming, brings new hope for the development of a regenerative medicine with new capabilities for the treatment of chronic diseases, without the ethic restrains imposed by the use of embryonic cells.