Development of a model for fibroblast-led collective migration from breast cancer cell spheroids to study radiation effects on invasiveness.

BACKGROUND: Invasiveness is a major factor contributing to metastasis of tumour cells. Given the broad variety and plasticity of invasion mechanisms, assessing potential metastasis-promoting effects of irradiation for specific mechanisms is important for further understanding of potential adverse effects of radiotherapy. In fibroblast-led invasion mechanisms, fibroblasts produce tracks in the extracellular matrix in which cancer cells with epithelial traits can follow. So far, the influence of irradiation on this type of invasion mechanisms has not been assessed. METHODS: By matrix-embedding coculture spheroids consisting of breast cancer cells (MCF-7, BT474) and normal fibroblasts, we established a model for fibroblast-led invasion. To demonstrate applicability of this model, spheroid growth and invasion behaviour after irradiation with 5 Gy were investigated by microscopy and image analysis. RESULTS: When not embedded, irradiation caused a significant growth delay in the spheroids. When irradiating the spheroids with 5 Gy before embedding, we find comparable maximum migration distance in fibroblast monoculture and in coculture samples as seen in unirradiated samples. Depending on the fibroblast strain, the number of invading cells remained constant or was reduced. CONCLUSION: In this spheroid model and with the cell lines and fibroblast strains used, irradiation does not have a major invasion-promoting effect. 3D analysis of invasiveness allows to uncouple effects on invading cell number and maximum invasion distance when assessing radiation effects.

Lung regeneration: implications of the diseased niche and ageing.

Most chronic and acute lung diseases have no cure, leaving lung transplantation as the only option. Recent work has improved our understanding of the endogenous regenerative capacity of the lung and has helped identification of different progenitor cell populations, as well as exploration into inducing endogenous regeneration through pharmaceutical or biological therapies. Additionally, alternative approaches that aim at replacing lung progenitor cells and their progeny through cell therapy, or whole lung tissue through bioengineering approaches, have gained increasing attention. Although impressive progress has been made, efforts at regenerating functional lung tissue are still ineffective. Chronic and acute lung diseases are most prevalent in the elderly and alterations in progenitor cells with ageing, along with an increased inflammatory milieu, present major roadblocks for regeneration. Multiple cellular mechanisms, such as cellular senescence and mitochondrial dysfunction, are aberrantly regulated in the aged and diseased lung, which impairs regeneration. Existing as well as new human in vitro models are being developed, improved and adapted in order to study potential mechanisms of lung regeneration in different contexts. This review summarises recent advances in understanding endogenous as well as exogenous regeneration and the development of in vitro models for studying regenerative mechanisms.

Inducible transgene expression in PDX models in vivo identifies KLF4 as a therapeutic target for B-ALL.

BACKGROUND: Clinically relevant methods are not available that prioritize and validate potential therapeutic targets for individual tumors, from the vast amount of tumor descriptive expression data. METHODS: We established inducible transgene expression in clinically relevant patient-derived xenograft (PDX) models in vivo to fill this gap. RESULTS: With this technique at hand, we analyzed the role of the transcription factor Krüppel-like factor 4 (KLF4) in B-cell acute lymphoblastic leukemia (B-ALL) PDX models at different disease stages. In competitive preclinical in vivo trials, we found that re-expression of wild type KLF4 reduced the leukemia load in PDX models of B-ALL, with the strongest effects being observed after conventional chemotherapy in minimal residual disease (MRD). A nonfunctional KLF4 mutant had no effect on this model. The re-expression of KLF4 sensitized tumor cells in the PDX model towards systemic chemotherapy in vivo. It is of major translational relevance that azacitidine upregulated KLF4 levels in the PDX model and a KLF4 knockout reduced azacitidine-induced cell death, suggesting that azacitidine can regulate KLF4 re-expression. These results support the application of azacitidine in patients with B-ALL as a therapeutic option to regulate KLF4. CONCLUSION: Genetic engineering of PDX models allows the examination of the function of dysregulated genes like KLF4 in a highly clinically relevant translational context, and it also enables the selection of therapeutic targets in individual tumors and links their functions to clinically available drugs, which will facilitate personalized treatment in the future.

Haplaxius crudus (Hemiptera: Cixiidae) Transmits the Lethal Yellowing Phytoplasmas, 16SrIV, to Pritchardia pacifica Seem. & H.Wendl (Arecaceae) in Yucatan, Mexico.

Lethal yellowing (LY) affects several palm species in the Americas. It is caused by 16SrIV group phytoplasmas. In Florida (USA), LY was shown to be transmitted by the planthopper Haplaxius crudus ( Van Duzee ) (Hemiptera, Cixiidae) to different palm species, including Pritchardia pacifica Seem . & H. Wendl . (Arecaceae) in insect-proof cage experiments in the 1980s, a result that had never been reproduced later. LY has destroyed many coconut plantations as well as other palm species in the Caribbean and Mexico. In order to evaluate if H. crudus is a vector of LY phytoplasmas in Mexico, experiments were carried out in Yucatan (Mexico). Several H. crudus from palms infected by LY in the field were introduced into cages containing young P. pacifica palms. These insects were able to transmit 16SrIV group phytoplasmas to P. pacifica palms. According to DNA sequences comparative analysis, virtual restriction fragment length polymorphism, and phylogenetic analysis, the phytoplasmas detected in these infected P. pacifica were of subgroups A and D. All of ten P. pacifica palms infected with the subgroup D phytoplasmas developed symptoms of LY and died, whereas only one of two palms infected with subgroup A developed LY symptoms and died. This is the first time, more than 30 years later, that the role of H. crudus as a vector of LY is confirmed.

Efecto genotóxico del material particulado PM2.5 recolectado en la zona urbana de Cuenca - Ecuador sobre la línea celular de ovario de hámster chino CHO-K1 / Genotoxic effect of PM2.5 particulate material collected in the urban area of the city of Cuenca - Ecuador in the Chinese hamster ovary cells line CHO-K1

Estudios toxicológicos y epidemiológicos ponen de manifiesto que el material particulado (PM) específicamente el PM2.5 tiene efectos negativos significativos en la salud humana, asociado con mortalidad, insuficiencia cardíaca, trastornos respiratorios, enfermedades pulmonares y cáncer. La toxicidad y el efecto inflamatorio de estas partículas están relacionados con su tamaño y características químicas. En este estudio se determinaron las características químicas de las fracciones acuosas y orgánicas solubles del PM2.5 recolectado en tres sitios de monitoreo del área urbana de la ciudad de Cuenca-Ecuador y se evaluó su actividad genotóxica mediante el ensayo del cometa en la línea celular de ovario de hámster chino, CHO-K1. El análisis gravimétrico de las muestras reveló que dos de los sitios de estudio superaron el límite de 25 mig/m3 establecido por la Organización Mundial de la Salud. En la caracterización de las fracciones acuosas y orgánicas se determinó la presencia de metales como el hierro y zinc e hidrocarburos aromáticos tales como el benzo(a) antraceno respectivamente. Las células fueron expuestas a 3,26 m3 de aire /mL de los extractos acuosos y 1,63 m3 de aire/mL de los extractos orgánicos. Finalmente se observó que los extractos obtenidos de PM2.5 inducen daño genotóxico en la longitud del largo de cola medido mediante el ensayo del cometa; este tipo de daño pueden atribuirse a la combinación de las especies químicas detectadas

Toxicological and epidemiological studies have a manifesto that particulate matter (PM), specifically PM2.5 has negative effects on human health, associated with mortality, heart failure, respiratory disorders, lung diseases, and cancer. The toxicity and inflammatory effect of these particles are related to their size and chemical characteristics. The objective of this study was to determine the characteristics of the soluble aqueous and organic fractions of the particulate material PM 2.5 collected in the monitoring sites of the urban area of ​​the city of Cuenca-Ecuador and to evaluate its genotoxic activity by means of the test of the comet of in the Chinese hamster ovary cells line CHO-K1. The gravimetric analysis of the samples revealed that two of the study sites exceeded the limit of 25 ug / m3 established by the WHO. In the characterization of water and organic fractions, the presence of metals such as Fe and Zn and aromatic hydrocarbons such as benzo(a) anthracene determined, respectively. Cells were exposed to 3,26 m3 of air /mL of aqueous extracts and 1,63 m3 of air/ mL of organic extracts. Finally, it was observed that the extracts obtained from PM2.5 induce genotoxic in the length of tail length measured by the comet assay; this type of damage can be attributed to the combination of the detected chemical species

[Analysis of polymorphism rs1051730 of CHRNA3 in patients with dual pathology in a Mexican population]. / Analisis del polimorfismo rs1051730 de CHRNA3 en pacientes con patologia dual en poblacion mexicana.

INTRODUCTION: Epidemiological studies have described a high comorbidity of substance use disorders with another psychiatric disorder, which has been called dual pathology. However, the aetiological mechanisms underlying this association are still not fully understood. AIM: To carry out a preliminary study of the effect of polymorphism rs1051730 of the gene group CHRNA5-CHRNA3-CHRNB4 through a case-control study. SUBJECTS AND METHODS: A total of 225 subjects were selected and divided into three groups: those diagnosed with bipolar disorder, those with nicotine dependence, and subjects without nicotine dependence or any other psychiatric disorder. Genotyping was performed by real-time polymerase chain reaction. Genetic association analysis was performed using chi-square tests and multivariate logistic regressions. RESULTS: On comparing allelic frequencies with the control group, we found that polymorphism rs1051730 was associated with nicotine dependence (p = 0.03), but not with bipolar disorder (p = 0.94). CONCLUSION: Variant rs1051730 was associated with nicotine dependence in the Mexican population and showed the same effect in dual pathology. However, further studies are recommended to obtain conclusive results.

TITLE: Analisis del polimorfismo rs1051730 de CHRNA3 en pacientes con patologia dual en poblacion mexicana.Introduccion. Estudios epidemiologicos han descrito una alta comorbilidad de los trastornos de uso de sustancias con otro trastorno psiquiatrico, al cual se le ha llamado patologia dual. Sin embargo, los mecanismos etiologicos de esta asociacion continuan siendo dificiles de entender. Objetivo. Realizar un estudio preliminar del efecto del polimorfismo rs1051730 del grupo de genes CHRNA5-CHRNA3-CHRNB4 a traves de un estudio de casos y controles. Sujetos y metodos. Se selecciono a un total de 225 sujetos, divididos en tres grupos: con diagnostico de trastorno bipolar, con dependencia a la nicotina y sujetos sin dependencia a la nicotina o cualquier otro trastorno psiquiatrico. La genotipificacion se realizo mediante reaccion en cadena de la polimerasa en tiempo real. El analisis de asociacion genetica se realizo mediante pruebas de chi cuadrado y regresiones logisticas multivariables. Resultados. Al comparar las frecuencias alelicas con el grupo control, encontramos que el polimorfismo rs1051730 se asocio con el grupo de dependencia a la nicotina (p = 0,03), pero no con el de trastorno bipolar (p = 0,94). Conclusion. La variante rs1051730 se asocio con dependencia a la nicotina en la poblacion mexicana y mostro el mismo efecto en la patologia dual. Sin embargo, se recomiendan estudios adicionales para tener resultados concluyentes.

[Efficacy of Ozone Infiltrations in the Treatment of Knee Osteoarthritis Vs Other Interventional Treatments: A Systematic Review of Clinical Trials]. / Eficacia de las infiltraciones con ozono en el tratamiento de la osteoartritis de rodilla vs. otros tratamientos intervencionistas: revisión sistemática de ensayos clínicos.

INTRODUCTION: Intra-articular ozone infiltrations have been used as a therapeutic intervention in osteoarthritis of the knee with reports of favourable effects. However, this therapeutic procedure is still controversial due to the lack of scientific evidence to justify its use. OBJECTIVE: To evaluate the safety and efficacy of intra-articular ozone infiltrations in patients with knee osteoarthritis. MATERIAL AND METHODS: A systematic search was performed in electronic databases such as Pubmed, Dialnet, Scielo, Medigraphic and other electronic sources from January 1990 to January 2018. We included controlled clinical trials that used intra-articular ozone infiltrations as a therapeutic intervention in patients with knee osteoarthritis. The variables analysed were the study design, risk of bias, clinical configuration, characteristics of the participants, characteristics of the interventions, results, length of follow-up and adverse events. RESULTS: Ten studies with a total of 400 patients treated with ozone vs 381 controls were included in the systematic review. Most studies had a high risk of bias. Intra-articular ozone infiltrations were more effective than placebo and were as effective as other interventional treatments in short-term follow-up. No adverse effects or serious adverse reactions were reported in the treated patients. CONCLUSION: Intra-articular ozone infiltration appears to be an effective therapeutic intervention in the short term. However studies with better methodological quality are needed to confirm its efficacy and to analyze long-term safety.

Conditions associated with REM sleep behaviour disorder: Description of a hospital series. / Patologías asociadas al trastorno de conducta de sueño REM. Descripción de una serie hospitalaria.

INTRODUCTION: REM sleep behaviour disorder (RBD) is characterised by violent behaviours (screaming, kicking, vivid dreams) during REM sleep. It has a prevalence of 1% to 2% of the general population and is especially frequent in men and the population older than 60. In the last decade, RBD has been suggested to be a prodrome of neurodegenerative disease. We analysed associated neurological diseases and responses to drug treatment in 33 patients with RBD treated in the multidisciplinary sleep disorders unit at Hospital Infanta Sofía. PATIENTS AND METHODS: We conducted an observational descriptive retrospective analysis of patients diagnosed with RBD and treated in our multidisciplinary sleep disorders unit between October 2012 and December 2015. We recorded age, sex, associated diseases, and treatments administered to these patients. RESULTS: A total of 365 patients were attended at our unit, including 33 with RBD: 13 women (40%) and 20 men (60%). Mean age was 62.72 years. An associated disorder was identified in 48%, with the most common being mild cognitive impairment (69%). The percentage of patients with RBD and an associated disorder among patients older than 60 was 68%. Eighty-two percent of the patients required treatment. The most commonly used drug was clonazepam (76%), followed by melatonin (9%), gabapentin (6%), and trazodone (3%). DISCUSSION: In our series, 48% of the patients had an associated disorder. The likelihood of detecting an associated disorder increases with patients' age. The vast majority of patients required drug treatment due to symptom severity; the most frequently administered drug was clonazepam (76%).

[Transcultural adaptation to the Spanish language of the Balance Evaluation Systems Test (BESTest) in older adults]. / Adaptacion transcultural al castellano del sistema de evaluacion del equilibrio (BESTest) en adultos mayores.

INTRODUCTION: The risk of falls in older adults increases because of the decrease in strength, flexibility, balance and sensory changes affecting functionality and quality of life. For this reason, an integral system of evaluation of equilibrium is necessary, for preventive purposes or for early therapeutic interventions. AIM: To present the results of the transcultural translation and adaptation process of the Balance Evaluation Systems Test (BESTest) to Spanish language. SUBJECTS AND METHODS: The original version of the BESTest was translated into Spanish, following the process of retro-traduction and cultural adaptation considering the semantic, idiomatic, conceptual and experiential equivalences. Subsequently the version was reviewed by a panel of experts qualifying clarity, coherence, relevance and sufficiency. The pilot test included 32 adults between 50 and 80 years old. RESULTS: It was possible to carry out the complete translation of the instrument, the instructions for the subject and for the evaluator. Most items of the test reached the maximum score of 4.0 (100%), nine items achieved an average score of 3.9 (99%), one item got an average score of 3.8 (95%) and two items achieved an average score of 3.7 (92.5%). CONCLUSIONS: With this study the Spanish speakers community has a pertinent sufficient, coherent and clear instrument in order to identify the control postural system altered to focus treatment and to get better functional outcomes from balance evaluation in older adults.

TITLE: Adaptacion transcultural al castellano del sistema de evaluacion del equilibrio (BESTest) en adultos mayores.Introduccion. El riesgo de caidas en adultos mayores se incrementa a consecuencia de la disminucion de la fuerza, la flexibilidad, el equilibrio y los cambios sensoriales, que afectan a la funcionalidad y la calidad de vida. Por tal razon se hace necesario un sistema integral de evaluacion del equilibrio con fines preventivos o para intervenciones terapeuticas tempranas. Objetivo. Presentar los resultados del proceso de traduccion y adaptacion transcultural del sistema de evaluacion del equilibrio (BESTest) al castellano. Sujetos y metodos. Se tradujo al castellano la version original del BESTest, siguiendo el proceso de retrotraduccion y adaptacion cultural y teniendo en cuenta las equivalencias semanticas, idiomaticas, conceptual y experiencial. Posteriormente, la version fue revisada por un panel de expertos que califico la claridad, la coherencia, la pertinencia y la suficiencia. En la prueba piloto participaron 32 adultos de 50-80 años. Resultados. Se realizo la traduccion completa del instrumento y de las instrucciones para el sujeto y para el evaluador. La mayoria de items de la prueba alcanzaron la puntuacion maxima de 4 (100%), nueve items lograron una calificacion media de 3,9 (99%); un item, una calificacion media de 3,8 (95%), y dos items, una calificacion media de 3,7 (92,5%). Conclusiones. Con este estudio, la comunidad de habla hispana cuenta con un instrumento pertinente, suficiente, coherente y claro para identificar el sistema del equilibrio afectado, enfocar el tratamiento y obtener mejores resultados funcionales a partir de la evaluacion del equilibrio en adultos mayores.

Genotipificación de cagA y de la región intermedia de vacA en cepas de Helicobacter pylori aisladas de pacientes adultos colombianos y su asociación con enfermedades gástricas / Genotyping of cagA and the intermediate region of vacA in strains of Helicobacter pylori isolated from Colombian adult patients and associations with gastric diseases

Resumen Objetivo: este estudio caracteriza la diversidad de los genes de virulencia cagA (gen asociado con la citotoxina A) y vacA (citotoxina vacuolizante) en pacientes colombianos para determinar posibles asociaciones entre estos 2 genes y la severidad de los hallazgos endoscópicos teniendo en cuenta todos los genotipos reportados para el gen vacA (s, m e i). Materiales y métodos: Helicobacter pylori fue detectado por cultivo y por métodos moleculares en biopsias de 62 pacientes. Los genotipos de cagA y vacA (m/i/s) se determinaron por reacción en cadena de la polimerasa (PCR) y secuenciación. Resultados: se aislaron 124 cepas de 62 pacientes; de estas, el 48,5% (n = 48) fueron vacA s2/m2/i2-cagA (-) presente en su mayoría en pacientes con gastritis folicular; mientras el 32,3% (n = 32) fueron vacA s1/m1/i1-cagA (+) presentes mayormente en pacientes con gastritis folicular, gastritis crónica y posible metaplasia. Se encontró una asociación significativa entre la presencia de cagA y el genotipo vacA s1/m1/i1 y la ausencia de cagA y el genotipo vacA s2/m2/i2 (p <0,001). No se encontró una asociación significativa entre la severidad de los hallazgos endoscópicos y el estatus cagA-vacA de las cepas. Conclusión: se encontró una baja prevalencia de cepas cagA (+), el estatus cagA-vacA no es un predictor de riesgo en la población estudiada y la presencia de infecciones heterogéneas sin tropismo sugieren la necesidad de tomar biopsias tanto del cuerpo como del antro del estómago en la práctica clínica rutinaria.

Abstract Objective: This study characterizes the diversity of cagA and vacA virulence genes in Colombian patients to determine possible associations between them and the severity of endoscopic findings. It considers all four genotypes reported for the vacA gene (s, m and i). Materials and methods: Helicobacter pylori was detected in biopsies of 62 patients through culturing and by molecular methods. Genotypes of cagA and vacA (m/i/s) were determined by PCR and sequencing. Results: One hundred twenty four strains from 62 patients were isolated. Of these, 48.5% (n = 48) were vacA s2/m2/i2 - cagA (-) which were mostly found in patients with follicular gastritis; 32.3% (n = 32) were vacA s1/m1/i1-cagA (+) which were mostly found in patients with follicular gastritis, chronic gastritis and possible metaplasia. Significant associations were found between the presence of cagA and the vacA s1/m1/i1 genotype and the absence of cagA and the vacA s2/m2/i2 genotype (p <0.001). No significant association was found between the severity of endoscopic findings and the cagA-vacA status of the strains. Conclusion: We found a low prevalence of cagA (+) strains, the cagA-vacA status is not a predictor of risk in this population. Moreover, the presence of heterogenous infections without tropism suggests a need for biopsies from both the corpus and the antrum of the stomach in routine clinical practice.

Analysis of uni and bi-parental markers in mixture samples: Lessons from the 22nd GHEP-ISFG Intercomparison Exercise.

Since 1992, the Spanish and Portuguese-Speaking Working Group of the ISFG (GHEP-ISFG) has been organizing annual Intercomparison Exercises (IEs) coordinated by the Quality Service at the National Institute of Toxicology and Forensic Sciences (INTCF) from Madrid, aiming to provide proficiency tests for forensic DNA laboratories. Each annual exercise comprises a Basic (recently accredited under ISO/IEC 17043: 2010) and an Advanced Level, both including a kinship and a forensic module. Here, we show the results for both autosomal and sex-chromosomal STRs, and for mitochondrial DNA (mtDNA) in two samples included in the forensic modules, namely a mixture 2:1 (v/v) saliva/blood (M4) and a mixture 4:1 (v/v) saliva/semen (M8) out of the five items provided in the 2014 GHEP-ISFG IE. Discrepancies, other than typos or nomenclature errors (over the total allele calls), represented 6.5% (M4) and 4.7% (M8) for autosomal STRs, 15.4% (M4) and 7.8% (M8) for X-STRs, and 1.2% (M4) and 0.0% (M8) for Y-STRs. Drop-out and drop-in alleles were the main cause of errors, with laboratories using different criteria regarding inclusion of minor peaks and stutter bands. Commonly used commercial kits yielded different results for a micro-variant detected at locus D12S391. In addition, the analysis of electropherograms revealed that the proportions of the contributors detected in the mixtures varied among the participants. In regards to mtDNA analysis, besides important discrepancies in reporting heteroplasmies, there was no agreement for the results of sample M4. Thus, while some laboratories documented a single control region haplotype, a few reported unexpected profiles (suggesting contamination problems). For M8, most laboratories detected only the haplotype corresponding to the saliva. Although the GHEP-ISFG has already a large experience in IEs, the present multi-centric study revealed challenges that still exist related to DNA mixtures interpretation. Overall, the results emphasize the need for further research and training actions in order to improve the analysis of mixtures among the forensic practitioners.

Sistema de Apoyo Experimental para el Reconocimiento Visual y el Nombrado de Objetos / Experimental support system for visual recognition and object nomination

Resumen: En la práctica clínica relacionada con la rehabilitación cognitiva, perceptual y del lenguaje, es habitual emplear como estímulos representaciones de objetos en dos dimensiones como dibujos o fotografías para que sean identificados por los pacientes. Ello supone una limitación, puesto que la presentación de objetos en tres dimensiones, dada su mayor riqueza visual, facilita su identificación y podría apoyar procesos de rehabilitación. Objetivo: Diseñar una configuración experimental para conocer el grado en que las modalidades de presentación de estímulos afectan el reconocimiento visual de objetos. Materiales y Métodos: Se diseñó un sistema de bajo costo para mostrar estímulos en tres modalidades: imágenes, videos y objetos reales. Fueron seleccionados 80 objetos, controlando las variables de manipulabilidad, edad de adquisición, familiaridad, complejidad visual y frecuencia léxica. Se realizó una prueba piloto utilizando el sistema con cinco personas sanas y se midieron los tiempos de reacción en la nominación de los objetos. Resultados: Las diferencias en los tiempos de reacción entre las modalidades observadas apoyan la influencia de la modalidad de presentación en el reconocimiento de objetos. Conclusiones: Las propiedades de volumen de los objetos permitirían la exploración de características que las fotografías no tendrían; razón por la cual, los tiempos de reacción para los objetos reales y los videos fueron menores. Son valiosos los aportes que ofrecen una alternativa de bajo costo para la visualización y el reconocimiento de objetos.

Abstract: A wide variety of stimuli or objects such as drawings or photographs are used in cognitive perceptual and language rehabilitation. However, the presentation of objects in three dimensions, due to the visual richness, facilitates the identification and could support the rehabilitation process. Objective: Design an experimental setup to determine the extent to which the modality of presentation of objects affects the visual recognition of objects. Materials and methods: A low-cost experimental system was designed in order to show the stimulus in three ways: images, videos and real objects. Eighty objects were selected and variables as manipulability, age of acquisition, familiarity, visual complexity, agreement on the label and lexical frequency were controlled. A pilot study was conducted using the system in five healthy participants and the reaction time to identify objects was measured. Results: The findings reveal that the differences in reaction times between the modalities of presentation support the influence of the mode of presentation in object recognition. Conclusions: The volume object properties could allow the exploration of characteristics that the photographs would not have. This may be why the reaction time to identify real objects or videos was lower. Low-cost alternatives for the visualization and object recognition are valuable in cognitive perceptual and language rehabilitation.

Dopamine D1 and D2 receptor immunoreactivities in the arcuate-median eminence complex and their link to the tubero-infundibular dopamine neurons.

Dopamine D1 and D2 receptor immunohistochemistry and Golgi techniques were used to study the structure of the adult rat arcuate-median eminence complex, and determine the distribution of the dopamine D1 and D2 receptor immunoreactivities therein, particularly in relation to the tubero-infundibular dopamine neurons. Punctate dopamine D1 and D2 receptor immunoreactivities, likely located on nerve terminals, were enriched in the lateral palisade zone built up of nerve terminals, while the densities were low to modest in the medial palisade zone. A codistribution of dopamine D1 receptor or dopamine D2 receptor immunoreactive puncta with tyrosine hydroxylase immunoreactive nerve terminals was demonstrated in the external layer. Dopamine D1 receptor but not dopamine D2 receptor immnunoreactivites nerve cell bodies were found in the ventromedial part of the arcuate nucleus and in the lateral part of the internal layer of the median eminence forming a continuous cell mass presumably representing neuropeptide Y immunoreactive nerve cell bodies. The major arcuate dopamine/ tyrosine hydroxylase nerve cell group was found in the dorsomedial part. A large number of tyrosine hydroxylase immunoreactive nerve cell bodies in this region demonstrated punctate dopamine D1 receptor immunoreactivity but only a few presented dopamine D2 receptor immunoreactivity which were mainly found in a substantial number of tyrosine hydroxylase cell bodies of the ventral periventricular hypothalamic nucleus, also belonging to the tubero-infundibular dopamine neurons. Structural evidence for projections of the arcuate nerve cells into the median eminence was also obtained. Distal axons formed horizontal axons in the internal layer issuing a variable number of collaterals classified into single or multiple strands located in the external layer increasing our understanding of the dopamine nerve terminal networks in this region.  Dopamine D1 and D2 receptors may therefore directly and differentially modulate the activity and /or Dopamine synthesis of substantial numbers of tubero-infundibular dopamine neurons at the somatic and terminal level. The immunohistochemical work also gives support to the view that dopamine D1 receptors and/or dopamine D2 receptors in the lateral palisade zone by mediating dopamine volume transmission may contribute to the inhibition of luteinizing hormone releasing hormone release from nerve terminals in this region.

Resultados en cirugía mayor ambulatoria en otorrinolaringología realizada en un hospital de baja complejidad / Results in major ambulatory surgery in otorhinolaryngology performed in a hospital of low complexity

Introducción: La cirugía mayor ambulatoria confiere al sistema sanitario un modelo de gestión eficiente y de alta calidad. Objetivo: Conocer los resultados de la cirugía mayor ambulatoria en otorrinolaringología (ORL) en un hospital de baja complejidad. Material y método: Estudio descriptivo retrospectivo realizado en el Hospital Santo Tomás de Limache entre los años 2004 y 2009. La inclusión de pacientes sometidos a cirugía otorrinolaringológica bajo la modalidad de cirugía mayor ambulatoria. Se realizó análisis descriptivo en base a promedios, desviación estándary proporciones. En análisis bivariado, se emplearon las pruebas de chi cuadrado y t-student. Resultados: Se incorporó 815 pacientes. El 58% fue de sexo masculino, con edad promedio de 8,4 ±6,2 años. La adenoamigdalectomía sola o asociada a otras cirugías se efectuó en 54,2(0)% de los casos. La tasa de complicaciones posoperatorias fue de 1,22 %, la mitad de ella, la hemorragia. No hubo mortalidad. No se encontró asociación estadística entre la presencia de complicaciones y alguna variable en particular. Conclusiones: En pacientes de otorrinolaringología seleccionados, la cirugía mayor ambulatoria efectuada en un hospital de baja complejidad tiene buenos resultados, con una baja tasa de complicaciones.

Background: Major ambulatroy surgery provide to public health and efficient and high quality model. Aim: To know teh results in patient underwent Otorrinolaringologic surgery in a low complexity hospital. Material and method: Date from 815 who underwent Otorrinolaringologic surgery carried on a major ambulatory surgery basis in Hospital Santo Tomás de Limache, between 2004 and 2009 where retrospectively reviewed. Analysed date included sex, age, type of conducted surgery, type of complications and the period of time in which patients were discharged. Averages, standard deviation and proportions were used. In bivariate analysis, chi square and t-student were used. Results: 58% of enrolled patients were males with age average of 8.4 ±6.2 years. Adenotonsillectomy single or associated to other surgeries took place in 54,2% of the cases. The rate ofpostoperation side effects was 1.22%%, And half of these patient presented postoperatory bleeding. There was no mortality. There was not statistical association between the presence of complications and some variable in particular. Conclusions: Major ambulatory surgery In selected patients who need otorrinolaringologic surgery in a low complexity hospital is safe whith low rate of complication.

Calidad subjetiva de sueño en pacientes con Trastornos de la Conducta Alimentaria / Subjective quality of sleep in eating disorders patients

El presente estudio se centra en analizar la calidad de sueño de pacientes con trastornos de la conducta alimentaria (TCA). Para ello se compararon las puntuaciones de 13 pacientes con dichos diagnósticos y 15 controles en el Inventario de Calidad de Sueño de Pittsburg (PSQI), la Escala de Somnolencia de Epworth (ESS), la Escala de Creencias y Actitudes Disfuncionales sobre el Sueño (DBAS-18) y un diario de sueño. Se encontraron diferencias significativas con respecto a calidad subjetiva de sueño, consumo de medicación hipnótica y problemas durante el sueño, en los niveles de somnolencia diurna en la ESS y con respecto a creencias disfuncionales sobre el sueño. En conclusión, los pacientes con TCA manifiestan peor calidad de sueño y más problemas de sueño que los controles sanos. Estos resultados ponen de manifiesto la conveniencia de atender a los problemas de sueño en los programas terapéuticos con este tipo de pacientes (AU)

The present research focuses on the analysis of the quality of sleep in eating disorder patients (EDs). For this purpose, scores of 13 EDs patients and 15 controls on the Pittsburg Sleep Quality Inventory (PSQI), the Epworth Somnolence Scale (ESS), the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-18) and a sleep diary were compared. Significant differences were found with regard to subjective quality of sleep, hypnotic medication use, and sleep problems in the PSQI; in addition significant differences were shown on daytime sleepiness levels in the ESS, and in relation to several dysfunctional beliefs about the sleep. In conclusion, EDs patients show less quality of sleep and more sleep problems than controls. These results show the need to be aware into to sleep problems in ED therapeutic interventions (AU)

Nuevo accesorio para la disección submucosal endoscopica (erbe hybrid knife): reporte de 2 casos / New accessory for endoscopic submucosal dissection (erbe hybrid knife): reporte of 2 cases

Introducción: Recientemente se ha desarrollado un accesorio para la disección submucosal endoscópica (DSE) que combina un jet de agua ultrafino de alta presión para la hidrodisección submucosal con un electrocauterio. Objetivo: Mostrar la experiencia inicial con el uso del ERBE Hybrid Knife para la DSE. Materiales y pacientes: Se incluyen 2 pacientes con adenomas planos extendidos lateralmente de colon y recto, a quienes se les realizó DSE con el ERBE Hybrid Knife como instrumento único y la fuente electroquirúrgica ERBE VIO-200 D. Se marcó el área utilizando coagulación (FORCED COAG). El jet de agua de alta presión se usó en forma intermitente para elevar la submucosa durante el proceso de disección a una presión entre 45 y 60 bar. Luego se hizo una incisión circunferencial en la mucosa y se realizó la disección submucosal usando los modos FORCED COAG Y ENDOCUT D del mismo accesorio. Resultados: Las lesiones estaban localizadas en sigmoides y recto bajo, de 1,5 y 3 cm de diámetro respectivamente, las cuales fueron resecadas en su totalidad en un solo segmento. El tiempo promedio utilizado fue de 65 minutos. Los procedimientos fueron realizados con sedación profunda asistida por anestesiólogo. No hubo complicaciones mayores. La histología de las lesiones fue adenoma tubulovelloso de colon con displasia leve y adenoma plano de recto. Conclusión: El ERBE Hybrid Knife es una alternativa para realizar la DSE, simplificando la técnica al usar un solo instrumento. Se deben hacer estudios prospectivos para medir el impacto en la estandarización de la técnica.

Introduction: Recently there has been developed an accessory for endoscopic submucosal dissection (ESD) that combines an ultra-thin water jet high pressure for a submucosal hydrodissection with an electrocautery. Aim: initial experience with the use of ERBE Hybrid Knife for the DSE. Materials and patients: The study included 2 patients with laterally spreading flat adenomas of the colon and rectum, who underwent ESD with ERBE Hybrid Knife as a single instrument and ERBE VIO electrosurgical source-200 D. It was marked the area using coagulation (FORCED COAG). The jet of high pressure water was used intermittently to raise the submucosa during the dissection at a pressure between 45 and 60 bar. Then, a circumferential incision in the mucosa and the submucosal dissection were performed with modes ENDOCUT D and FORCED COAG of the same accessory. Results: The lesions were located in lower rectum and sigmoid colon, 1.5 and 3 cm in diameter respectively, which were resected in its entirety as a single segment. The mean time spent was 65 minutes. The procedures were performed with deep sedation assisted by an anesthesiologist. There were no major complications. The histology of the lesions was tubulovillous adenoma with mild dysplasia colon and rectal adenoma plane. Conclusion: The ERBE Hybrid Knife is an alternative for the ESD, simplifying the technique of using a single instrument. Prospective studies should be made to measure the impact on the standardization of the technique.

Capsula endoscópica y enteroscopia asistida por balones en pacientes con sospecha de enfermedad de intestino delgado métodos complementarios / Capsule endoscopy and balloon enteroscopy in patients with suspected small bowel disease complementary methods

El desarrollo reciente de la cápsula endoscópica (CE) y la enteroscopia asistida por balones (EAPB) ha cambiado el algoritmo diagnóstico de la patología del intestino delgado. La combinación de ambos métodos parece ser una herramienta útil. Mostrar la experiencia con el uso combinado de CE y EAPB en pacientes con sospecha de enfermedades del intestino delgado. 34 pacientes a quienes se les realizó CE y EAPB. El endoscopista conocía el resultado de la CE. Equipos: CE M2A, PillCam SB (Given Imaging), videoenteroscopios doble balón Fujinon EN-450P5, EN-450T5, enteroscopio balón único Olympus SIG Q-180. Se registraron datos demográficos, indicaciones, segmentos evaluados, hallazgos y complicaciones. 34 pacientes (19 mujeres, 15 hombres), edad promedio: 57,67 años. Principales indicaciones: sangrado digestivo oscuro evidente 67,64 %, anemia 11,76%, enfermedad de Crohn 5,88%. La EAPB se realizó por vía anterógrada en 25 pacientes, retrógrada en 4 y combinada en 5. Se detectaron lesiones con CE en 85,29% pacientes, con EAEAPB en 67,64% y con ambos métodos en 52,9%. En 11 pacientes se detectaron lesiones por CE y la EAPB fue normal. En 2 pacientes hubo hallazgos en la EAPB no vistos por la cápsula. Hallazgos mas frecuentes: CE: angioectasias 11, tumor subepitelial ulcerado 2, presencia de sangre 4, úlceras 3. EAPB: angioectasias 9, tumor subepitelial ulcerado 1, ulceras 3, divertículo de Meckel, 1. Terapéutica endoscópica en 13 pacientes y cirugía en 4 con sangrado digestivo. CE y EBU combinadas permiten mejorar el diagnóstico y orientar la conducta terapéutica en pacientes con sospecha de patología del intestino delgado...

The recent development of capsule endoscopy (CE) and balloon-assisted enteroscopy (BAE) has changed the diagnostic algorithm of small bowel pathology. The combination of both methods seems to be a useful tool. To show the experience with the combined use of CE and BAE in patients with suspected small bowel diseases. 34 patients who underwent CE and BAE. The endoscopist knew the outcome of the CE. We used the CE M2A, Pillcam (Given Imaging), double balloon videoenteroscopy Fujinon EN-450P5, EN-450T5, single balloon enteroscopy GIS Olympus Q-180. Demographic data, indications, segments evaluated, findings and complications were recorded. 34 patients (19 women, 15 men), average age: 57.67 years. Main indications: evident obscure gastrointestinal bleeding 67.64%, anemia 11, 76%, Crohn’s disease 5.88%. Anterograde BAE was performed in 25 patients, retrograde in 4 and combined in 5 patients. CE lesions were detected in 85.29% patients with BAE in 67.64% and 52.9% in both methods. In 11 patients lesions were detected by CE and the BAE was normal. In 2 patients there were findings in the BAE, not seen by the capsule. Most common finding: CE: 11 angiodysplasia, 2 subepithelial ulcerated tumor, 4 blood presence, 3 ulcers. BAE: 9 angiodysplasia, 1 subepithelial ulcerated tumor, 3 ulcers, 1 Meckel diverticulum. Therapeutic endoscopy was performed in 13 patients and surgery in 4 patients with digestive bleeding. Combined CE and BAE allow improving the diagnostic and orientate the therapeutic behavior in patients with suspected small bowel pathology...

Involvement of oxytocin in the nucleus tractus solitarii on central cardiovascular control: interactions with glutamate.

Oxytocin (OT) is a peptide involved in several physiological functions in the central nervous system including central cardiovascular regulation. To clarify the role of endogenous OT in cardiovascular control, one group of anesthetized rats received unilateral microinjections of the OT receptor antagonist [d(CH(2))(5),Tyr(Me)(2),Orn(8)]-vasotocin (OTA) in the nucleus tractus solitarii (NTS) and a second group was injected with specific OT antiserum (Anti-OT). Moreover, the modulation of the cardiovascular effect of L-glutamate (GLU) by OT was also evaluated by cardiovascular analysis using effective and threshold doses of GLU. Mean arterial pressure (MAP) and heart rate (HR) were measured from a femoral catheter. OTA significantly (p<0.01) decreased the vasopressor and tachycardiac long-lasting response elicited by an effective dose of OT. Microinjections of Anti-OT antibody did not modify the values of MAP and HR compared with the control group. With regard to the OT/GLU coinjections, a subthreshold dose of OT significantly (p<0.001) counteracted the vasodepressor and bradycardiac responses induced by GLU. The coinjection of subthreshold doses of OT and GLU did not produce a change in MAP or in HR. These findings seem to exclude an endogenous tonic action of OT on central regulation of MAP and HR, although they confirm the significant role of OT on central cardiovascular control within the NTS. In fact, the modulation of GLU responses by OT supports the importance of OT on the central cardiovascular adjustments likely acting on the baroreceptor reflex sensitivity.

Colangiopancreatografía retrógrada endoscópica: prácticas en un centro hospitalario privado / Endoscopic retrograde cholangiopancreatography: practices in a private hospital

Colangiopancreatografía Retrógrada Endoscópica (CPRE), es un método endoscópico avanzado que posibilita el estudio y tratamiento de la vía biliar y pancreática. Este procedimiento requiere alto nivel de conocimientos y destrezas técnicas para garantizar mínimas complicaciones en el paciente. En nuestro país, existen pocos centros para la formación de gastroenterólogos para desarrollar habilidad en la realización de CPRE. Determinar la casuística en procedimientos de CPRE en un centro privado para proveer los estándares más altos en la capacitación teórica y práctica en las técnicas avanzadas de este procedimiento. Estudio retrospectivo, descriptivo, que incluyó pacientes con patologías bilio-pancreáticas que acudieron a la Policlínica Metropolitana y se les realizó CPRE. Durante el período de estudio se realizaron 815 procedimientos, 486 (59,6%) y 329 (40,36%) eran del sexo femenino y masculino respectivamente. La edad promedio de los pacientes fue 53,34 años, con edades comprendidas entre 2 y 98 años, con 18 menores de 12 años. Las indicaciones más frecuentes: colestasis, litiasis biliar, pancreatitis aguda y crónica. Otras indicaciones: fístula biliar, recambio de prótesis, colangitis y pacientes con tumor bilio-pancreático. Los procedimientos terapéuticos abarcaron desde esfinterotomía hasta ampulectomía, toma de biopsia, colocación de prótesis tanto en vía biliar como pancreática, con resolución del problema en la mayoría de los pacientes. Hubo complicaciones en 36 pacientes (4,17%), las más frecuentes fueron hemorragia (16) y pancreatitis post-CPRE (7), de los cuales 3 fueron severas. No se reportaron muertes debido al procedimiento. En nuestro estudio demostramos que estamos dentro de lo que realiza cualquier centro de entrenamiento reportado en la literatura mundial (número de procedimientos, indicaciones, hallazgos, procedimientos terapéuticos y tasa de éxito...

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an advanced endoscopic procedure that allows the study and treatment of biliary and pancreatic ducts. This procedure requires a higher level of knowledge and technical skills, to ensure a minimal complications outcome of the patient. In our country there are few training centers for gastrointestinal specialists for developing the necessary skills for performing ERCP. To asses the statistics of ERCP procedures that were performed in our private hospital between January 2005 until January 2009, to demonstrate that we possessed the high standars on capacitation, both theorical and practical on performing ERCP. ItÊs a descriptive and retrospective study, including all patients that came to our center with pancreatic or billiary pathology and underwent the procedure. 815 ERCP were performed during the time of the study, 486 (59.6%) were female and 329 (40, 36%) were male. The mean age was 53, 34 years, with range between 2 and 98 years, and 18 patients were younger than 12 years. The main indications for the procedure were cholestasis, billiary litiasis, acute and chronic pancreatitis. Also other indications were billiary fistulae, billiary prothesis placement and replacement, cholangitis and tumors of the pancreas and billiary ducts. The therapeutics procedures performed were sphinctectomy, ampullectomy, biopsy, billiary and pancreatic prothesis placement. In most of the cases the problem was solved. There were complications in 36 patients (4, 17%), the most common being bleeding 16 and post ERCP acute pancreatitis 7 there were no deaths attributed to the procedure. In our study we show that our statistics are well placed among the standards of any reported trainning center in the world, regarding number of procedures, indications for the procedure, findings, therapeutic procedures and a very low morbility/mortality rate...