Purinergic signaling modulates human visceral adipose inflammatory responses: implications in metabolically unhealthy obesity.

Obesity is accompanied by chronic inflammation of VAT, which promotes metabolic changes, and purinergic signaling has a key role in a wide range of inflammatory diseases. Therefore, we addressed whether fat inflammation could be differentially modulated by this signaling pathway in the MUO and in individuals who remain MHO. Our results show that the necrotized VAT of both groups released greater levels of ATP compared with lean donors. Interestingly, MUO tissue SVCs showed up-regulation and engagement of the purinergic P2X7R. The extracellular ATP concentration is regulated by an enzymatic process, in which CD39 converts ATP and ADP into AMP, and CD73 converts AMP into adenosine. In VAT, the CD73 ectoenzyme was widely distributed in immune and nonimmune cells, whereas CD39 expression was restricted to immune CD45PAN+ SVCs. Although the MUO group expressed the highest levels of both ectoenzymes, no difference in ATP hydrolysis capacity was found between the groups. As expected, MUO exhibited the highest NLRP3 inflammasome expression and IL-1ß production. MUO SVCs also displayed up-regulation of the A2AR, allowing extracellular adenosine to increase IL-1ß local secretion. Additionally, we demonstrate that metabolic parameters and BMI are positively correlated with purinergic components in VAT. These findings indicate that purinergic signaling is a novel mechanism involved in the chronic inflammation of VAT underlying the metabolic changes in obesity. Finally, our study reveals a proinflammatory role for adenosine in sustaining IL-1ß production in this tissue.

Reservorio urinario contyinente ortotópico cecoileal con anastomosis uretro-apendicular término-terminal (Técnica original) / Orthotopic continent ceco-ileal urinary diversion with end-to-end urethro-apendicular anastomosis (Original technique)

Introducción: La búsqueda de un reservorio urinario continente ortotópico de fácil realización y con una continencia satisfactoria, nos llevó a desarrollar esta variante técnica. Material y métodos: Se presenta la experiencia en 10 enfermos, estudiados en el período 1997-2000, con diagnóstico de Carcinoma Transicional Infiltrante de vejiga a los que se les realizó cistoprostatectomía radical y se confeccionó reservorio urinario con colon derecho e íleon terminal efectuando la anastomosis entre apéndice y uretra en forma término-terminal. Resultados: Las complicaciones postoperatorias fueron mínimas, incluyendo pérdida transitoria de orina peritalla vesical en un enfermo, y absceso de herida quirúrgica en otro. El volumen promedio obtenido fue de 500 cc., con una continencia efectiva principalmente diurna. El seguimiento de los pacientes no muestra progresión de la enfermedad ni alteraciones del árbol urinario superior. Conclusiones: Esta variante técnica resulta una alternativa interesante para la confección de un reservorio urinario seguro y efectivo. Creemos que con el aumento de la casuística estaremos en condiciones de demostrar los beneficios de nuestra variante técnica y compararla con otras técnicas de difusión universal.(AU)

Reservorio urinario contyinente ortotópico cecoileal con anastomosis uretro-apendicular término-terminal (Técnica original) / Orthotopic continent ceco-ileal urinary diversion with end-to-end urethro-apendicular anastomosis (Original technique)

Introducción: La búsqueda de un reservorio urinario continente ortotópico de fácil realización y con una continencia satisfactoria, nos llevó a desarrollar esta variante técnica. Material y métodos: Se presenta la experiencia en 10 enfermos, estudiados en el período 1997-2000, con diagnóstico de Carcinoma Transicional Infiltrante de vejiga a los que se les realizó cistoprostatectomía radical y se confeccionó reservorio urinario con colon derecho e íleon terminal efectuando la anastomosis entre apéndice y uretra en forma término-terminal. Resultados: Las complicaciones postoperatorias fueron mínimas, incluyendo pérdida transitoria de orina peritalla vesical en un enfermo, y absceso de herida quirúrgica en otro. El volumen promedio obtenido fue de 500 cc., con una continencia efectiva principalmente diurna. El seguimiento de los pacientes no muestra progresión de la enfermedad ni alteraciones del árbol urinario superior. Conclusiones: Esta variante técnica resulta una alternativa interesante para la confección de un reservorio urinario seguro y efectivo. Creemos que con el aumento de la casuística estaremos en condiciones de demostrar los beneficios de nuestra variante técnica y compararla con otras técnicas de difusión universal.

Sindrome de Larsen.Comunicacion de un caso. / Larsen's syndrome. Report of a case

Se informa la observacion de un caso de sindrome de Larsen, siendo el segundo caso de la literatura nacional. Este cuadro fue descripto por primera vez por Larsen y col en 1950. Es de rara observacion y han sido descriptos una treintena de casos en la literatura mundial. Esta cantidad no se menciona en los tratados de Pediatria, Ortopedia y Radiologia, siendo posible su publicacion con otras denominaciones. El recien nacido presenta luxaciones multiples de las grandes articulaciones: codos, caderas y rodillas, que se acompanan de malformaciones mediofaciales: paladar ojival, nariz achatada y depresible, frente prominente o hipertelorismo ocular. Se estudia la historia natural de la enfermedad describiendose mejoria articular sin recuperacion total y cociente intelectual normal. El estudio radiologico revela gran compromiso articular. El patron de herencia es discutido y se realizan consideraciones etiopatogenicas. Nuestro caso se interpreta como un mutacion "de novo"

Sindrome de Larsen.Comunicacion de un caso. / Larsens syndrome. Report of a case

Se informa la observacion de un caso de sindrome de Larsen, siendo el segundo caso de la literatura nacional. Este cuadro fue descripto por primera vez por Larsen y col en 1950. Es de rara observacion y han sido descriptos una treintena de casos en la literatura mundial. Esta cantidad no se menciona en los tratados de Pediatria, Ortopedia y Radiologia, siendo posible su publicacion con otras denominaciones. El recien nacido presenta luxaciones multiples de las grandes articulaciones: codos, caderas y rodillas, que se acompanan de malformaciones mediofaciales: paladar ojival, nariz achatada y depresible, frente prominente o hipertelorismo ocular. Se estudia la historia natural de la enfermedad describiendose mejoria articular sin recuperacion total y cociente intelectual normal. El estudio radiologico revela gran compromiso articular. El patron de herencia es discutido y se realizan consideraciones etiopatogenicas. Nuestro caso se interpreta como un mutacion "de novo"

An analysis of observed attention and activity patterns in preschool children.

An activity-attention scale was incorporated into the Pediatric Examination of Educational Readiness to determine whether performance of age-appropriate tasks would elicit or provoke attentional weakness or activity level modulation in a sample of prekindergarten children. Thirty-three (9.8%) of the 338 children met the criteria of weak attention and/or increased activity at one time during the assessment, and 18 (5.3%) met the criteria at two or more times. The "flagged" children were more likely to be boys and to have other developmental findings, lower McCarthy scores, and teacher concerns. Significant fluctuation of attention was noted commonly during the sessions. Furthermore, difficulty in interrater scoring of severity was demonstrated. This study underscores the variability and complexity of attention and activity findings, and confirms the need for direct observation as well as integration of information from all available sources.

[Recent medical research on yoga and states of concentration]. / Recientes investigaciones médicas sobre yoga y estados concentrativos

Traditional oriental thinking attracts the growing scientific interest of occidental practitioners. Dr. Pierre Etévenon, head of the Department of Neuro-Psycho-Pharmacology at the French Institute for Health and Medical Research (INSERM), held several conversations and scientific exchanges with the author, and kindly provided copies of some of his works. They are at the basis of the present paper. M. A. Descamps (Paris) found that asanas--yoga postures-- are generators of dynamic action when there is an extension of the spinal column, whilst they lead to quiet states when there is a flexion of it. Claeys and Gones (Belgium) proved that overall global relaxation, as well as differential relaxation were far more effective and deep when obtained by yogis than those attempted by University students majoring in Physical Education. Lonsdorfer and Nussbaum (France) studied several parameters concerning hatha-yoga and concluded that it provides a regular functioning of the main bodily functions fostering thus a psycho-physical balance. Wallace and Benson (U.S.A.) proved that transcendental meditation increases aerobic metabolism, counteracting anaerobic metabolism which is related to mental distress. Etévenon (Paris) investigated neurophysiological effects of yoga in connection to ancient Indian concepts (Upanishads) on sleeping, meditation and degree of consciousness. Dr. Etévenon has studied the phylogenetic evolution of waking-sleeping cycles, focusing on phylogenetic and ontongenetic appearances of REM cycles (activated sleep). A correlation has been made with EEG studies during states of concentration (yoga, transcendental meditation, Zen). These states have been found to be specific brain activities, and different from deep sleep, in spite of certain similarities in the EEG. Several hypothesis are set forth to explain brain activities underlying sites of concentration. The possibilities of developing a conscious mastering of dreams are also under research, and special attention is paid to the works of Saint Denys (1867), and hindu tradition. This paper discusses also the psychological, therapeutic and anthropological implications of recent discoveries in the field.

Recientes investigaciones médicas sobre yoga y estados concentrativos / [Recent medical research on yoga and states of concentration]

Traditional oriental thinking attracts the growing scientific interest of occidental practitioners. Dr. Pierre Etévenon, head of the Department of Neuro-Psycho-Pharmacology at the French Institute for Health and Medical Research (INSERM), held several conversations and scientific exchanges with the author, and kindly provided copies of some of his works. They are at the basis of the present paper. M. A. Descamps (Paris) found that asanas--yoga postures-- are generators of dynamic action when there is an extension of the spinal column, whilst they lead to quiet states when there is a flexion of it. Claeys and Gones (Belgium) proved that overall global relaxation, as well as differential relaxation were far more effective and deep when obtained by yogis than those attempted by University students majoring in Physical Education. Lonsdorfer and Nussbaum (France) studied several parameters concerning hatha-yoga and concluded that it provides a regular functioning of the main bodily functions fostering thus a psycho-physical balance. Wallace and Benson (U.S.A.) proved that transcendental meditation increases aerobic metabolism, counteracting anaerobic metabolism which is related to mental distress. Etévenon (Paris) investigated neurophysiological effects of yoga in connection to ancient Indian concepts (Upanishads) on sleeping, meditation and degree of consciousness. Dr. Etévenon has studied the phylogenetic evolution of waking-sleeping cycles, focusing on phylogenetic and ontongenetic appearances of REM cycles (activated sleep). A correlation has been made with EEG studies during states of concentration (yoga, transcendental meditation, Zen). These states have been found to be specific brain activities, and different from deep sleep, in spite of certain similarities in the EEG. Several hypothesis are set forth to explain brain activities underlying sites of concentration. The possibilities of developing a conscious mastering of dreams are also under research, and special attention is paid to the works of Saint Denys (1867), and hindu tradition. This paper discusses also the psychological, therapeutic and anthropological implications of recent discoveries in the field.

Recientes investigaciones médicas sobre yoga y estados concentrativos / [Recent medical research on yoga and states of concentration]

Traditional oriental thinking attracts the growing scientific interest of occidental practitioners. Dr. Pierre Etévenon, head of the Department of Neuro-Psycho-Pharmacology at the French Institute for Health and Medical Research (INSERM), held several conversations and scientific exchanges with the author, and kindly provided copies of some of his works. They are at the basis of the present paper. M. A. Descamps (Paris) found that asanas--yoga postures-- are generators of dynamic action when there is an extension of the spinal column, whilst they lead to quiet states when there is a flexion of it. Claeys and Gones (Belgium) proved that overall global relaxation, as well as differential relaxation were far more effective and deep when obtained by yogis than those attempted by University students majoring in Physical Education. Lonsdorfer and Nussbaum (France) studied several parameters concerning hatha-yoga and concluded that it provides a regular functioning of the main bodily functions fostering thus a psycho-physical balance. Wallace and Benson (U.S.A.) proved that transcendental meditation increases aerobic metabolism, counteracting anaerobic metabolism which is related to mental distress. Etévenon (Paris) investigated neurophysiological effects of yoga in connection to ancient Indian concepts (Upanishads) on sleeping, meditation and degree of consciousness. Dr. Etévenon has studied the phylogenetic evolution of waking-sleeping cycles, focusing on phylogenetic and ontongenetic appearances of REM cycles (activated sleep). A correlation has been made with EEG studies during states of concentration (yoga, transcendental meditation, Zen). These states have been found to be specific brain activities, and different from deep sleep, in spite of certain similarities in the EEG. Several hypothesis are set forth to explain brain activities underlying sites of concentration. The possibilities of developing a conscious mastering of dreams are also under research, and special attention is paid to the works of Saint Denys (1867), and hindu tradition. This paper discusses also the psychological, therapeutic and anthropological implications of recent discoveries in the field.