En contextos sociales vulnerados se observan condiciones que interfieren el desarrollo de habilidades y destrezas académicas, relacionales y emocionales. Esto, ligado a una respuesta inadecuada a los ...estímulos ambientales o necesidades individuales, puede convertir el proceso de adaptación del niño al contexto escolar en una tarea que requiere coordinación y gestión en red. Esta sistematización tiene como objetivo presentar un tipo de intervención que facilita los procesos de autonomía de niños en situación de vulnerabilidad escolar en escuelas municipales de la comuna de Huechuraba, entre los años 2006 y 2009. La estrategia central consiste en fomentar las interacciones de todos los sistemas a través de intervenciones ya sea individuales y/o grupales a niños, familiares, profesores, comunidad educativa, centros de salud y especialistas de salud y educación. Con ello se promueve el respeto por los derechos del niño y por las particularidades individuales del desarrollo, incorporando acciones relevantes en la convivencia diaria. Esto permite reconstruir y resignificar relaciones y símbolos vinculares desde la cotidianeidad, abarcando los contextos ocupacionales y el campo relacional del niño, permitiendo así el surgimiento de la autonomía del niño.
Two strategies for same-admission cholecystectomy in mild gallstone pancreatitis (MGP) exist: early surgery (within 48–72 h from admission) and delayed surgery until resolution of symptoms and ...normalization of pancreatic tests.
This was a single-center, open-label RCT. Patients with MGP according to revised Atlanta classification-2012 and SIRS criteria were randomly assigned to early laparoscopic cholecystectomy (E-LC) within 72 h from admission or delayed laparoscopic cholecystectomy (D-LC). Laparoscopic-endoscopic rendezvous was performed when common bile duct stones were found at systematic intraoperative cholangiography. The primary outcome was length of stay (LOS), and the secondary outcomes were complications at 90 days, need for ERCP/choledocolithiasis, conversion, and re-admission. One year of follow-up was carried-on.
At interim analysis, 52 patients were randomized (26 E-LC, 26 D-LC). E-LC versus D-LC was associated with a significantly shorter LOS (median 58 versus 167 h; P = 0.001). There were no differences in ERCP necessity for choledocolithiasis between the two approaches (E-LC 26.9% versus D-LC 23.1%, P = 1.00). No differences in postoperative complications were found.
E-LC approach in patients with MGP significantly reduced LOS and was not associated with clinically relevant postoperative complications.
clinicaltrials.gov (NCT02590978).
Atopic asthma is a chronic allergic disease that involves T-helper type 2 (Th2)-inflammation and airway remodeling. Bronchiolar club cells (CC) and alveolar macrophages (AM) are sentinel cells of ...airway barrier against inhaled injuries, where allergy induces mucous metaplasia of CC and the alternative activation of AM, which compromise host defense mechanisms and amplify Th2-inflammation. As there is evidence that high levels of environmental endotoxin modulates asthma, the goal of this study was to evaluate if the activation of local host defenses by Lipopolysaccharide (LPS) previous to allergy development can contribute to preserving CC and AM protective phenotypes. Endotoxin stimulus before allergen exposition reduced hallmarks of allergic inflammation including eosinophil influx, Interleukin-4 and airway hyperreactivity, while the T-helper type 1 related cytokines IL-12 and Interferon-γ were enhanced. This response was accompanied by the preservation of the normal CC phenotype and the anti-allergic proteins Club Cell Secretory Protein (CCSP) and Surfactant-D, thereby leading to lower levels of CC metaplasia and preventing the increase of the pro-Th2 cytokine Thymic stromal lymphopoietin. In addition, classically activated alveolar macrophages expressing nitric oxide were promoted over the alternatively activated ones that expressed arginase-1. We verified that LPS induced a long-term overexpression of CCSP and the innate immune markers Toll-like receptor 4, and Tumor Necrosis Factor-α, changes that were preserved in spite of the allergen challenge. These results demonstrate that LPS pre-exposition modifies the local bronchioalveolar microenvironment by inducing natural anti-allergic mechanisms while reducing local factors that drive Th2 type responses, thus modulating allergic inflammation.
Summary
Bronchiolar Clara cells play a critical role in lung homoeostasis. The main goal of this study was to evaluate the effects of chronic allergy on these cells and the efficacy of budesonide ...(BUD) and montelukast (MK) in restoring their typical phenotypes after ovalbumin‐induced chronic allergy in mice. Chronic allergy induced extensive bronchiolar Alcian blue‐periodic acid‐Schiff (AB/PAS)‐positive metaplasia. In addition, cells accumulated numerous big electron‐lucent granules negative for Clara cell main secretory protein (CC16), and consequently, CC16 was significantly reduced in bronchoalveolar lavage. A concomitant reduction in SP‐D and CYP2E1 content was observed. The phenotypic changes induced by allergy were pharmacologically reversed by both treatments; MK was more efficient than BUD in doing so. MK decreased AB/PAS reactivity to control levels whereas they remained persistently elevated after BUD. Moreover, most non‐ciliated cells recovered their normal morphology after MK, whereas for BUD normal cells coexisted with ‘transitional’ cells that contained remnant mucous granules and stained strongly for CC16 and SP‐D. Glucocorticoids were also less able to reduce inflammatory infiltration and maintained higher percentage of neutrophils, which may have contributed to prolonged mucin expression. These results show that chronic allergy‐induced mucous metaplasia of Clara cells affects their defensive mechanisms. However, anti‐inflammatory treatments were able to re‐establish the normal phenotype of Clara cell, with MK being more efficient at restoring a normal profile than BUD. This study highlights the role of epithelial cells in lung injuries and their contribution to anti‐inflammatory therapies.
Recently, we reported that oxidative stress due to 3,3′,5‐triiodothyronine (T3)‐induced calorigenesis up‐regulates the hepatic expression of mediators promoting cell protection. In this study, T3 ...administration in rats (single dose of 0.1 mg/kg intraperitoneally) induced significant depletion of reduced liver glutathione (GSH), with higher protein oxidation, O2 consumption, and Kupffer cell function (carbon phagocytosis and carbon‐induced O2 uptake). These changes occurred within a period of 36 hours of T3 treatment in animals showing normal liver histology and lack of alteration in serum AST and ALT levels. Partial hepatic ischemia‐reperfusion (IR) (1 h of ischemia via vascular clamping and 20 h reperfusion) led to 11‐fold and 42‐fold increases in serum AST and ALT levels, respectively, and significant changes in liver histology, with a 36% decrease in liver GSH content and a 133% increase in that of protein carbonyls. T3 administration in a time window of 48 hours was substantially protective against hepatic IR injury, with a net 60% and 90% reduction in liver GSH depletion and protein oxidation induced by IR, respectively. Liver IR led to decreased DNA binding of nuclear factor‐κB (NF‐κB) (54%) and signal transducer and activator of transcription 3 (STAT3) (53%) (electromobility shift assay), with 50% diminution in the protein expression of haptoglobin (Western blot), changes that were normalized by T3 preconditioning. Conclusion: T3 administration involving transient oxidative stress in the liver exerts significant protection against IR injury, a novel preconditioning maneuver that is associated with NF‐κB and STAT3 activation and acute‐phase response. (HEPATOLOGY 2007;45:170–177.)
INTRODUCCIÓN: Los premolares inferiores son conocidos por la naturaleza compleja de la configuraciónde sus conductos. Generalmente cuando presentan uno solo es estrecho y acintado. En la ...actualidadcontamos con herramientas de diagnóstico más precisas como las Tomografías Computadas de Haz Cónicopara evaluar la morfología de los conductos en los tres planos del espacio.OBJETIVO: Es estudiar la sección transversal de los conductos de premolares inferiores humanos, con unsolo conducto radicular.MATERIAL Y MÉTODO: Fueron estudiados 120 premolares inferiores humanos extraídos. Losespecímenes fueron estudiados por medio de CBCT, con un tomógrafo Carestream 8200. Del total de lamuestra, se seleccionaron a través de las CBCT, sólo los premolares con un conducto. Los mismos fueronanalizados en cortes perpendiculares al eje largo del diente (axiales) En cada pieza dentaria se midió eldiámetro en sentido bucolingual y mesiodistal del conducto (expresado en milímetros) en los tres tercios:cervical, medio y apical. Posteriormente, se analizó la morfología del conducto en los cortes axiales, en lostres tercios antes mencionados, clasificándolos en: circulares, ovales, ovalesalargados y acintados. Lasvariables cuantitativas fueron representadas en tablas mediante promedio y desvío, mientras que lascualitativas con frecuencias y porcentajes. Se realizaron pruebas de Friedman y prueba de uniformidad chicuadrado. Se utilizaron los soft RMedic e Infostat. En todos los casos el nivel de significación fue del 5%.RESULTADOS: El 1,22% de los casos presentaron un conducto circular y 4,88 % ovalado en todo surecorrido. El 93,9% de la muestra presentó diferentes morfologías en los 3 tercios del conducto: LCC en21.95%, seguida por ACC con un 20.73% y OCC con un 10,98%. Se observó un predominio de conductoscirculares en el 84% en el tercio apical y 56% en el medio; ovalados en tercio medio en un 31,71% yaplanados en el tercio cervical en un 37.8%. El diámetro promedio del conducto circular a 3 mm del ápicefue de 0,55 mm2. En cervical el promedio de diámetro mayor fue de 2.58 mm en BL y 0.83 mm en MD yen tercio medio 1,29 mm en BL y 0.82 mm en MD.CONCLUSIONES: Los premolares inferiores con un solo conducto presentaron diferentes morfologías enlos tres tercios del conducto. El predominio de la anatomía fue Alargada o Aplanada en el tercio Cervical(37.80%) y predominio de Circulares en Medio (56.10%) y Apical (84.15%). Este tipo de conductos, quevarían su morfología longitudinalmente, pueden ser un verdadero desafío para su instrumentación,irrigación y obturación.
ALPPS procedure has been introduced to increase the volume of future liver remnant. The mechanisms underlying the accelerated regeneration observed with ALPPS are unknown. It was hypothesized that ...AMPK/mTOR is activated as an integrating pathway for metabolic signals leading to proliferation and cell growth. Our aim was to analyze increase in liver volume, proliferation parameters and expression of AMPK/mTOR pathway-related molecules in patients undergoing ALPPS.
A single center prospective study of patients undergoing ALPPS was performed from 2013 to 2015. Liver and serum samples, clinical laboratory results and CT-scan data were obtained. ELISA, Ki-67 immunostaining and qRT-PCR were performed in deportalized and remnant liver tissue in both stages of the procedure.
11 patients were enrolled. Remnant liver volume increased 112 ± 63% (p < 0.05) in 9.1 ± 1.6 days. Proliferation-related cytokines IL-6, TNF-α, HGF and EGF significantly increased, while higher Ki-67 immunostaining and cyclin D expression were observed in remnant livers after ALPPS. mTOR, S6K1, 4E-BP1, TSC1 and TSC2 expression were significantly increased in remnant livers at second stage, while AMPK and Akt increased only in deportalized liver samples.
Rapid liver regeneration with ALPPS might be associated with hepatocyte proliferation induced by mTOR pathway activation.
Functionalization of multi-walled carbon nanotubes (MWCNTs) is a growing area in the field of materials with biological applications; due that their surface characteristics could determine their ...biocompatibility and therapeutic uses. This research is focused on the evaluation of the effect of oxidized MWCNTs on the cell cultures of a hepatic carcinoma cell line (HepG2). Pristine MWCNTs (p-MWCNT) with an external diameter of 8–15 nm and a length in the range of 10–50 μm were oxidized with (a) nitric acid/hydrogen peroxide, (b) nitric acid, and (c) nitric acid/sulfuric acid solutions, and their physicochemical properties and biological effects were examined. The findings demonstrated that MWCNT oxidation produced different surface moieties and structural changes depending on the oxidation process, in particular, the oxidation with nitric acid/sulfuric acid generates a high grade of cell toxicity compared to the other types of oxidized MWCNTs. Interestingly, the p-MWCNTs exhibited slight cytotoxic and genotoxic effects but without affecting cell viability, which requires further analysis. The results open the possibility of using oxidized MWCNT with nitric acid/sulfuric acid to promote cytotoxic effects on cancer cells, as well as to explore different oxidative methods in medical applications.
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