Este artículo realiza un análisis normativo y jurisprudencial en torno a la protección de la libertad religiosa y el derecho de los padres a elegir la educación para sus hijos conforme a sus ...convicciones religiosas y morales en el sistema educativo de Estados Unidos, ante la posibilidad de que en los centros educativos públicos, los alumnos menores de edad practiquen clases de yoga y de meditación o mindfulness, al formar tales actividades parte de la programación escolar, lo que, según el modo de impartición, podría suponer algún tipo de adoctrinamiento y, en consecuencia, ser contrarias al principio de neutralidad estatal o separación Iglesia- Estado, dispuesto en la Primera Enmienda de la Constitución norteamericana.
Uveitis is an inflammatory process that initially starts in the uvea, but can also affect other adjacent eye structures, and is currently the fourth cause of blindness in developed countries. ...Corticoids are probably the most widespread treatment, but resorting to other immunosuppressive treatments is a frequent practice. Since the implication of different cytokines in uveitis has been well demonstrated, the majority of recent treatments for this disease include inhibitors or antibodies against these. Nevertheless, adequate treatment for each uveitis type entails a difficult therapeutic decision as no clear recommendations are found in the literature, despite the few protocolized clinical assays and many case-control studies done. This review aims to present, in order, the mechanisms and main indications of the most modern immunosuppressive drugs against cytokines.
SUMMARY
The seasonal and interannual proximate and sterol composition were assessed in two red (Gelidium robustum, Gelidiaceae and Gracilariopsis sjoestedtii, Gracilariaceae), two brown (Ecklonia ...arborea, Lessoniaceae and Macrocystis pyrifera, Laminariaceae), and two green (Ulva lactuca and Ulva clathrata, Ulvaceae) macroalgae species and the seagrass Phyllospadix torreyi (Zosteraceae) sampled over 3 years in a subtropical climate in Baja California Sur, Mexico. Each macroalga had a particular sterol composition that was typical of their taxonomic group. The red algae had cholesterol as the major sterol; 92% on average in G. robustum and 90% in G. sjoestedtii, followed by t‐dehydrosterol and brassicasterol. In the brown algae the major sterol was fucosterol, which accounted for approx. 90% and 92% of total sterols for M. pyrifera and E. arborea, respectively, followed by campesterol (7% and 5%) and isofucosterol (1.5% and 1.3%). The green algae had isofucosterol as the major sterol, with 92% on average for U. lactuca and 87% for U. clathrata, followed by cholesterol, fucosterol, and brassicasterol or norcholesterol. The seagrass P. torreyi had β‐sitosterol as the major sterol (39 to 89%, depending on the season), followed by campesterol (4 to 7%), stigmasterol (3 to 6%), and isofucosterol (1.7 to 3.5%). Four (cholesterol, campesterol, fucosterol, and isofucosterol) of the 14 sterols identified in macroalgae and the seagrass could be used to differentiate between classes (Florideophyceae – red, Phaeophyceae – brown, Ulvophyceae – green, and Monocots – seagrass) both seasonally and interannually. The seasonal and interannual sterol composition of macroalgae and seagrass was quite stable, with the exception of red G. sjoestedtii sampled in August and green macroalga U. lactuca and seagrass P. torreyi both sampled in May 2002. Seasonal and interannual variations of proximate and sterol composition are discussed in relation to their reproductive state and environmental parameters.
Background: The prognosis of patients with stage II and stage III colon cancer is heterogeneous. Clinical and pathological characteristics, such as tumor budding, may help to further refine the ...recurrence risk. Methods: We included all the patients with localized colon cancer at Hospital Universitario La Paz from October 2016 to October 2021. We built a prognostic score for recurrence in the training cohort based on multivariate cox regression analysis and categorized the patients into two risk groups. Results: A total of 440 patients were included in the training cohort. After a median follow-up of 45 months, 81 (18%) patients had a first tumor recurrence. T4, N2, and high tumor budding remained with a p value <0.05 at the last step of the multivariate cox regression model for time to recurrence (TTR). We assigned 2 points to T4 and 1 point to N2 and high tumor budding. Forty-five percent of the patients were assigned to the low-risk group (score = 0). Compared to the high-risk group (score 1−4), patients in the low-risk group had a significantly longer TTR (hazard ratio for disease recurrence of 0.14 (95%CI: 0.00 to 0.90; p < 0.045)). The results were confirmed in the validation cohort. Conclusions: In our study, we built a simple score to predict tumor recurrence based on T4, N2, and high tumor budding. Patients in the low-risk group, that comprised 44% of the cohort, had an excellent prognosis.
Background
The use of topically applied hemostatic substances during surgery has become a common practice. In some cases, the material is not absorbed or induces a granulomatous reaction resulting in ...a pseudotumoral lesion. With imaging studies, it is not possible to differentiate this from a tumor recurrence or abscess. This study describes the authors' cytologic experience with a large series of pseudotumoral lesions induced by oxidized cellulose, one of the most commonly used hemostatic agents. Almost no cytologic descriptions are available in the medical literature.
Methods
Sixteen patients were evaluated, and the most common sites of fine‐needle aspiration (FNA) were the mediastinum and thyroid surgical bed. Other locations were the axilla, neck, vulva, liver, and retroperitoneum. All these lesions appeared after surgical procedures in which oxidized cellulose was used as a topical hemostatic agent. The interval time between surgery and FNA varied from 4 to 46 months with a mean of 15 months.
Results
Cytology samples showed very similar findings. In all cases, foreign‐body material with a variable granulomatous reaction was present. Oxidized cellulose was seen as laminated inorganic fragments and most often showed an elongated, quadrangular appearance. Amorphous, ill‐defined fragments as well as a dense proteinaceous background with phagocytic cells were also present.
Conclusions
The current study demonstrates that FNA cytology is a very useful method for the detection of pseudotumoral lesions induced by hemostatic agents. Pathologists must be familiarized with this finding because cytology permits easy differentiation from tumor recurrence.
Complications such as delayed absorption and foreign‐body granulomatous reactions associated with the use of oxidized cellulose hemostatic agents are easily recognized via fine‐needle aspiration cytology. Cytologic findings are characteristic and permit easy differentiation from tumor recurrence.
Resident and infiltrated macrophages play relevant roles in uveitis as effectors of innate immunity and inductors of acquired immunity. They are major effectors of tissue damage in uveitis and are ...also considered to be potent antigen-presenting cells. In the last few years, experimental animal models of uveitis have enabled us to enhance our understanding of the leading role of macrophages in eye inflammation processes, including macrophage polarization in experimental autoimmune uveoretinitis and the major role of Toll-like receptor 4 in endotoxin-induced uveitis. This improved knowledge should guide advantageous iterative research to establish mechanisms and possible therapeutic targets for human uveitis resolution.
Only 10% of pancreatic ductal adenocarcinoma (PDAC) patients survive longer than five years. Factors underlining long-term survivorship in PDAC are not well understood. Therefore, we aimed to ...identify the key players in the tumor immune microenvironment (TIME) associated with long-term survivorship in PDAC patients.
The immune-related gene expression profiles of resected PDAC tumors of patients who survived and remained recurrence-free of disease for ≥36 months (long-term survivors, n=10) were compared to patients who had survived ≤6 months (short-term survivors, n=10) due to tumor recurrence. Validation was performed by the spatial protein expression profile of immune cells using the GeoMx™ Digital Spatial Profiler. An independent cohort of samples consisting of 12 long-term survivors and 10 short-term survivors, was used for additional validation. The independent validation was performed by combining qualitative immunohistochemistry and quantitative protein expression profiling.
B cells were found to be significantly increased in the TIME of long-term survivors by gene expression profiling (
=0.018). The high tumor infiltration of B cells was confirmed by spatial protein profiling in the discovery and the validation cohorts (
=0.002 and
=0.01, respectively). The higher number of infiltrated B cells was found mainly in the stromal compartments of PDAC samples and was exclusively found within tumor cells in long-term survivors.
This is the first comprehensive study that connects the immune landscape of gene expression profiles and protein spatial infiltration with the survivorship of PDAC patients. We found a higher number and a specific location of B cells in TIME of long-term survivors which emphasizes the importance of B cells and B cell-based therapy for future personalized immunotherapy in PDAC patients.
Changes in lipid reserves as a result of supplementing 3.4%
Ulva clathrata
meal in the diet (based on dry weight of all ingredienta) for
Litopenaeus vannamei
broodstock were evaluated in a commercial ...larval laboratory. The profile of fatty acids, sterols, carotenoids, and phenolic compounds in the gonad, hepatopancreas, and muscle of females with unilateral ablation was analyzed. Shrimp fed the
Ulva
supplemented diet had significantly higher proportions of arachidonic acid (20:4n-6) in the acylglycerides of mature gonads (84% increase) compared with mature controls. In the phospholipids of mature gonads, there was a 30% increase of 18:3n-3, 13% increase of 20:4n-6, and 10% of docosahexaenoic acid (22:6n-3) in
Ulva
-fed shrimp compared with controls. 22:6n-3 also increased 51% in the lipid reserves of hepatopancreas of
Ulva
-fed shrimp compared with controls. Carotenoids increased by 43% in the gonads and fivefold in the hepatopancreas of mature females fed
Ulva
. The proportion of fucosterol and isofucosterol went from undetectable in controls to 0.3 and 0.2%, respectively, in shrimp fed the algae. No significant differences were found in muscle. Phenolic compounds in the gonad were higher in mature gonads compared with immature, but no significant differences were found in relation to
Ulva
consumption. Carotenoids and phenolic compounds present in
Ulva
might be acting as antioxidants of highly unsaturated fatty acids (HUFAs), increasing the proportion of 20:4n-6 and 22:6n-3, but other mechanisms associated to these compounds and to fucosterol can be synchronizing oocyte maturation and increasing transport of HUFA during vitellogenesis, and together, they are further impacting the reproductive performance of shrimp.
To evaluate the relationship between the displacement of the lamina cribrosa (LC) and prelaminar tissue with corneal hysteresis (CH) using spectral-domain coherence tomography (SD-OCT) after reducing ...intraocular pressure (IOP) with medical treatment.
Sixty-one eyes of 61 patients with ocular hypertension or primary open-angle glaucoma who were going to start with treatment were imaged by means of 12 cross-sectional scans of the optic nerve using enhanced depth imaging SD-OCT before and after 1 week of treatment. We used the 'follow-up' mode to make sure that all the measurements were performed in the same location. We also measured the CH using an Ocular Response Analyzer, and we related it to the magnitude of displacement of LC and prelaminar tissue and the thickness of both structures.
There was a significant variation of LC thickness from 132.66±37.40 to 160.09±41.13 µm (p<0001). LC distance was significantly reduced from 258.53±145 µm before treatment to 239.86±135 µm after it. No significant changes were found in the thickness and movement of prelaminar tissue before and after treatment. The only factors related with LC displacement were CH (R
=0.48) and age (R
=0.42).
A significant increase in LC thickness and a reduction in the posterior displacement of LC but not in the prelaminar tissue were demonstrated after IOP reduction with medical treatment. The factors most related with LC displacement were age and CH.
Enteric duplication cysts (EDCs) are rare congenital malformations formed during the embryonic development of the digestive tract. They are usually detected prenatally or in the first years of life. ...The size, location, type, mucosal pattern and presence of complications produce a varied clinical presentation and different imaging findings. Ultrasonography (US) is the most used imaging method for diagnosis. Magnetic resonance (MR) and computed tomography (CT) are less frequently used, but can be helpful in cases of difficult surgical approach. Conservative surgery is the treatment of choice. Pathology confirms the intestinal origin of the cyst, showing a layer of smooth muscle in the wall and an epithelial lining inside, resembling some part of the gastrointestinal tract (GT). We review the different forms of presentation of the EDCs, showing both the typical and atypical imaging findings with the different imaging techniques. We correlate the imaging findings with the surgical results and the final pathological features.
Teaching Points
•
EDCs are rare congenital anomalies from the digestive tract with uncertain pathogenesis.
•
More frequently, diagnosis is antenatal, with most EDCs occurring in the distal ileum.
•
Ultrasonography is the method of choice for diagnosis of EDCs.
•
Complicated EDCs can show atypical imaging findings.
•
Surgery is necessary to avoid complications.
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