Drug-Induced Reorganisation of Lipid Metabolism Limits the Therapeutic Efficacy of Ponatinib in Glioma Stem Cells.

The standard of care for glioblastoma (GBM) involves surgery followed by adjuvant radio- and chemotherapy, but often within months, patients relapse, and this has been linked to glioma stem cells (GSCs), self-renewing cells with increased therapy resistance. The identification of the epidermal growth factor receptor (EGFR) and platelet-derived growth factor receptor (PDGFR) as key players in gliomagenesis inspired the development of inhibitors targeting these tyrosine kinases (TKIs). However, results from clinical trials testing TKIs have been disappointing, and while the role of GSCs in conventional therapy resistance has been extensively studied, less is known about resistance of GSCs to TKIs. In this study, we have used compartmentalised proteomics to analyse the adaptive response of GSCs to ponatinib, a TKI with activity against PDGFR. The analysis of differentially expressed proteins revealed that GSCs respond to ponatinib by broadly rewiring lipid metabolism, involving fatty acid beta-oxidation, cholesterol synthesis, and sphingolipid degradation. Inhibiting each of these metabolic pathways overcame ponatinib adaptation of GSCs, but interrogation of patient data revealed sphingolipid degradation as the most relevant pathway in GBM. Our data highlight that targeting lipid metabolism, and particularly sphingolipid degradation in combinatorial therapies, could improve the outcome of TKI therapies using ponatinib in GBM.

Metabolic rewiring induced by ranolazine improves melanoma responses to targeted therapy and immunotherapy.

Resistance of melanoma to targeted therapy and immunotherapy is linked to metabolic rewiring. Here, we show that increased fatty acid oxidation (FAO) during prolonged BRAF inhibitor (BRAFi) treatment contributes to acquired therapy resistance in mice. Targeting FAO using the US Food and Drug Administration-approved and European Medicines Agency-approved anti-anginal drug ranolazine (RANO) delays tumour recurrence with acquired BRAFi resistance. Single-cell RNA-sequencing analysis reveals that RANO diminishes the abundance of the therapy-resistant NGFRhi neural crest stem cell subpopulation. Moreover, by rewiring the methionine salvage pathway, RANO enhances melanoma immunogenicity through increased antigen presentation and interferon signalling. Combination of RANO with anti-PD-L1 antibodies strongly improves survival by increasing antitumour immune responses. Altogether, we show that RANO increases the efficacy of targeted melanoma therapy through its effects on FAO and the methionine salvage pathway. Importantly, our study suggests that RANO could sensitize BRAFi-resistant tumours to immunotherapy. Since RANO has very mild side-effects, it might constitute a therapeutic option to improve the two main strategies currently used to treat metastatic melanoma.

The Regulators of Peroxisomal Acyl-Carnitine Shuttle CROT and CRAT Promote Metastasis in Melanoma.

Circulating tumor cells are the key link between a primary tumor and distant metastases, but once in the bloodstream, loss of adhesion induces cell death. To identify the mechanisms relevant for melanoma circulating tumor cell survival, we performed RNA sequencing and discovered that detached melanoma cells and isolated melanoma circulating tumor cells rewire lipid metabolism by upregulating fatty acid (FA) transport and FA beta-oxidation‒related genes. In patients with melanoma, high expression of FA transporters and FA beta-oxidation enzymes significantly correlates with reduced progression-free and overall survival. Among the highest expressed regulators in melanoma circulating tumor cells were the carnitine transferases carnitine O-octanoyltransferase and carnitine acetyltransferase, which control the shuttle of peroxisome-derived medium-chain FAs toward mitochondria to fuel mitochondrial FA beta-oxidation. Knockdown of carnitine O-octanoyltransferase or carnitine acetyltransferase and short-term treatment with peroxisomal or mitochondrial FA beta-oxidation inhibitors thioridazine or ranolazine suppressed melanoma metastasis in mice. Carnitine O-octanoyltransferase and carnitine acetyltransferase depletion could be rescued by medium-chain FA supplementation, indicating that the peroxisomal supply of FAs is crucial for the survival of nonadherent melanoma cells. Our study identifies targeting the FA-based cross-talk between peroxisomes and mitochondria as a potential therapeutic opportunity to challenge melanoma progression. Moreover, the discovery of the antimetastatic activity of the Food and Drug Administration‒approved drug ranolazine carries translational potential.

Desensibilización con Ketocal® en lactante con dieta cetogénica y alergia a proteínas de leche de vaca / Oral desensitization with Ketocal® in an infant with ketogenic diet and cow's milk protein allergy

Introducción: la dieta cetogénica es un tratamiento con eficacia demostrada en la epilepsia infantil refractaria a fármacos. La alergia a la proteína de leche de vaca puede ser una limitación para tratar a lactantes con dieta cetogénica, ya que necesitan un producto que contiene proteínas de leche de vaca (Ketocal®). Caso clínico: presentamos el caso de un lactante con una encefalopatía epiléptica refractaria a fármacos y alergia a las proteínas de leche de vaca IgE mediada al que se quiere instaurar una dieta cetogénica clásica. Se consigue la desensibilización con Ketocal 3:1®, pudiendo utilizarlo en la dieta y logrando una mejoría clínica con el control de las crisis. Discusión: un paciente con epilepsia y alergia a las proteínas de leche de vaca puede beneficiarse de la dieta cetogénica, ya que es posible realizar una inmunoterapia oral con Ketocal® y conseguir, además, una probable resolución de su alergia. (AU)

Introduction: ketogenic diet is a treatment with proven efficacy in drug-refractory childhood epilepsy. Cow's milk protein allergy may be a limitation for treating infants with ketogenic diet, as they need a product that contains cow's milk protein (Ketocal®). Case report: we report the case of an infant with a drug-refractory epileptic encephalopathy and IgE-mediated cow's milk protein allergy, who started a classic ketogenic diet. Oral desensitization was achieved with Ketocal 3:1®, allowing its use in the diet and achieving a clinical improvement with seizure control. Discussion: a patient with epilepsy and cow's milk protein allergy can benefit from the ketogenic diet, since it is possible to perform an oral immunotherapy with Ketocal®, also achieving a probable resolution of his/her allergy. (AU)

[Oral desensitization with Ketocal® in an infant with ketogenic diet and cow's milk protein allergy]. / Desensibilización con Ketocal® en lactante con dieta cetogénica y alergia a proteínas de leche de vaca.

Introduction: Introduction: ketogenic diet is a treatment with proven efficacy in drug-refractory childhood epilepsy. Cow's milk protein allergy may be a limitation for treating infants with ketogenic diet, as they need a product that contains cow's milk protein (Ketocal®). Case report: we report the case of an infant with a drug-refractory epileptic encephalopathy and IgE-mediated cow's milk protein allergy, who started a classic ketogenic diet. Oral desensitization was achieved with Ketocal 3:1®, allowing its use in the diet and achieving a clinical improvement with seizure control. Discussion: a patient with epilepsy and cow's milk protein allergy can benefit from the ketogenic diet, since it is possible to perform an oral immunotherapy with Ketocal®, also achieving a probable resolution of his/her allergy.

Introducción: Introducción: la dieta cetogénica es un tratamiento con eficacia demostrada en la epilepsia infantil refractaria a fármacos. La alergia a la proteína de leche de vaca puede ser una limitación para tratar a lactantes con dieta cetogénica, ya que necesitan un producto que contiene proteínas de leche de vaca (Ketocal®). Caso clínico: presentamos el caso de un lactante con una encefalopatía epiléptica refractaria a fármacos y alergia a las proteínas de leche de vaca IgE mediada al que se quiere instaurar una dieta cetogénica clásica. Se consigue la desensibilización con Ketocal 3:1®, pudiendo utilizarlo en la dieta y logrando una mejoría clínica con el control de las crisis. Discusión: un paciente con epilepsia y alergia a las proteínas de leche de vaca puede beneficiarse de la dieta cetogénica, ya que es posible realizar una inmunoterapia oral con Ketocal® y conseguir, además, una probable resolución de su alergia.

Contribution of allergy in the acquisition of uncontrolled severe asthma.

Asthma is a multifactorial, heterogeneous disease that has a challenging management. It can be divided in non-allergic and allergic (usually associated with house dust mites (HDM) sensitization). There are several treatments options for asthma (corticosteroids, bronchodilators, antileukotrienes, anticholinergics,…); however, there is a subset of patients that do not respond to any of the treatments, who can display either a T2 or a non-T2 phenotype. A deeper understanding of the differential mechanisms underlying each phenotype will help to decipher the contribution of allergy to the acquisition of this uncontrolled severe phenotype. Here, we aim to elucidate the biological pathways associated to allergy in the uncontrolled severe asthmatic phenotype. To do so, twenty-three severe uncontrolled asthmatic patients both with and without HDM-allergy were recruited from Hospital Universitario de Gran Canaria Dr. Negrin. A metabolomic fingerprint was obtained through liquid chromatography coupled to mass spectrometry, and identified metabolites were associated with their pathways. 9/23 patients had uncontrolled HDM-allergic asthma (UCA), whereas 14 had uncontrolled, non-allergic asthma (UCNA). 7/14 (50%) of the UCNA patients had Aspirin Exacerbated Respiratory Disease. There were no significant differences regarding gender or body mass index; but there were significant differences in age and onset age, which were higher in UCNA patients; and in total IgE, which was higher in UCA. The metabolic fingerprint revealed that 103 features were significantly different between UCNA and UCA (p < 0.05), with 97 being increased in UCA and 6 being decreased. We identified lysophosphocholines (LPC) 18:2, 18:3 and 20:4 (increased in UCA patients); and deoxycholic acid and palmitoleoylcarnitine (decreased in UCA). These metabolites were related with a higher activation of phospholipase A2 (PLA2) and other phospholipid metabolism pathways. Our results show that allergy induces the activation of specific inflammatory pathways, such as the PLA2 pathway, which supports its role in the development of an uncontrolled asthma phenotype. There are also clinical differences, such as higher levels of IgE and earlier onset ages for the allergic asthmatic group, as expected. These results provide evidences to better understand the contribution of allergy to the establishment of a severe uncontrolled phenotype.

Identification of a Dexamethasone Mediated Radioprotection Mechanism Reveals New Therapeutic Vulnerabilities in Glioblastoma.

(1) Background: Despite the indisputable effectiveness of dexamethasone (DEXA) to reduce inflammation in glioblastoma (GBM) patients, its influence on tumour progression and radiotherapy response remains controversial. (2) Methods: We analysed patient data and used expression and cell biological analyses to assess effects of DEXA on GBM cells. We tested the efficacy of tyrosine kinase inhibitors in vitro and in vivo. (3) Results: We confirm in our patient cohort that administration of DEXA correlates with worse overall survival and shorter time to relapse. In GBM cells and glioma stem-like cells (GSCs) DEXA down-regulates genes controlling G2/M and mitotic-spindle checkpoints, and it enables cells to override the spindle assembly checkpoint (SAC). Concurrently, DEXA up-regulates Platelet Derived Growth Factor Receptor (PDGFR) signalling, which stimulates expression of anti-apoptotic regulators BCL2L1 and MCL1, required for survival during extended mitosis. Importantly, the protective potential of DEXA is dependent on intact tyrosine kinase signalling and ponatinib, sunitinib and dasatinib, all effectively overcome the radio-protective and pro-proliferative activity of DEXA. Moreover, we discovered that DEXA-induced signalling creates a therapeutic vulnerability for sunitinib in GSCs and GBM cells in vitro and in vivo. (4) Conclusions: Our results reveal a novel DEXA-induced mechanism in GBM cells and provide a rationale for revisiting the use of tyrosine kinase inhibitors for the treatment of GBM.

Targeting PFKFB3 alleviates cerebral ischemia-reperfusion injury in mice.

The glycolytic rate in neurons is low in order to allow glucose to be metabolized through the pentose-phosphate pathway (PPP), which regenerates NADPH to preserve the glutathione redox status and survival. This is controlled by 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase-3 (PFKFB3), the pro-glycolytic enzyme that forms fructose-2,6-bisphosphate, a powerful allosteric activator of 6-phosphofructo-1-kinase. In neurons, PFKFB3 protein is physiologically inactive due to its proteasomal degradation. However, upon an excitotoxic stimuli, PFKFB3 becomes stabilized to activate glycolysis, thus hampering PPP mediated protection of redox status leading to neurodegeneration. Here, we show that selective inhibition of PFKFB3 activity by the small molecule AZ67 prevents the NADPH oxidation, redox stress and apoptotic cell death caused by the activation of glycolysis triggered upon excitotoxic and oxygen-glucose deprivation/reoxygenation models in mouse primary neurons. Furthermore, in vivo administration of AZ67 to mice significantly alleviated the motor discoordination and brain infarct injury in the middle carotid artery occlusion ischemia/reperfusion model. These results show that pharmacological inhibition of PFKFB3 is a suitable neuroprotective therapeutic strategy in excitotoxic-related disorders such as stroke.

[Severe rhabdomyolysis secondary to severe hypernatraemic dehydration]. / Rabdomiólisis grave secundaria a deshidratación hipernatrémica.

INTRODUCTION: Rhabdomyolysis is a rare paediatric condition. The case is presented of a patient in whom this developed secondary to severe hypernatraemic dehydration following acute diarrhoea. CASE REPORT: Infant 11 months of age who presented with vomiting, fever, diarrhoea and anuria for 15 hours. Parents reported adequate preparation of artificial formula and oral rehydration solution. He was admitted with malaise, severe dehydration signs and symptoms, cyanosis, and low reactivity. The laboratory tests highlighted severe metabolic acidosis, hypernatraemia and pre-renal kidney failure (Sodium [Na] plasma 181 mEq/L, urine density> 1030). He was managed in Intensive Care Unit with gradual clinical and renal function improvement. On the third day, slight axial hypotonia and elevated cell lysis enzymes (creatine phosphokinase 75,076 IU/L) were observed, interpreted as rhabdomyolysis. He was treated with intravenous rehydration up to 1.5 times the basal requirements, and he showed a good clinical and biochemical response, being discharged 12 days after admission without motor sequelae. CONCLUSIONS: Severe hypernatraemia is described as a rare cause of rhabdomyolysis and renal failure. In critically ill patients, it is important to have a high index of suspicion for rhabdomyolysis and performing serial determinations of creatine phosphokinase for early detection and treatment.

Rabdomiólisis grave secundaria a deshidratación hipernatrémica / Severe rhabdomyolysis secondary to severe hypernatraemic dehydration

Introducción: La rabdomiólisis es una enfermedad poco frecuente en pediatría. El objetivo es presentar un paciente en el que se desarrolló secundario a una deshidratación hipernatrémica grave tras una diarrea aguda. Caso clínico: Lactante de 11 meses que consultó por fiebre, vómitos, diarrea y anuria. Presentó convulsión tónico-clónica autolimitada. Ingresó en mal estado general, severamente deshidratado, con escasa reactividad. En las pruebas complementarias destacó acidosis metabólica grave, hipernatremia e insuficiencia renal prerrenal. Al tercer día apreció leve hipotonía axial y elevación de creatín fosfokinasa 75.076 UI/l, interpretado como rabdomiólisis. Se inició hiperhidratación y alcalinización sistémica, con buena respuesta clínica y bioquímica, siendo dado de alta sin secuelas motoras. Conclusiones: La hipernatremia grave está descrita como causa rara de rabdomiólisis e insuficiencia renal. En pacientes críticos es importante un alto índice de sospecha de rabdomiólisis y determinación seriada de la creatín fosfokinasa para su detección y tratamiento precoz.

Introduction: Rhabdomyolysis is a rare paediatric condition. The case is presented of a patient in whom this developed secondary to severe hypernatraemic dehydration following acute diarrhoea. Case report: Infant 11 months of age who presented with vomiting, fever, diarrhoea and anuria for 15 hours. Parents reported adequate preparation of artificial formula and oral rehydration solution. He was admitted with malaise, severe dehydration signs and symptoms, cyanosis, and low reactivity. The laboratory tests highlighted severe metabolic acidosis, hypernatraemia and pre-renal kidney failure (Sodium [Na] plasma 181 mEq/L, urine density> 1030). He was managed in Intensive Care Unit with gradual clinical and renal function improvement. On the third day, slight axial hypotonia and elevated cell lysis enzymes (creatine phosphokinase 75,076 IU/L) were observed, interpreted as rhabdomyolysis. He was treated with intravenous rehydration up to 1.5 times the basal requirements, and he showed a good clinical and biochemical response, being discharged 12 days after admission without motor sequelae. Conclusions: Severe hypernatraemia is described as a rare cause of rhabdomyolysis and renal failure. In critically ill patients, it is important to have a high index of suspicion for rhabdomyolysis and performing serial determinations of creatine phosphokinase for early detection and treatment.

Intervención educativa sobre obesidad como riesgo para enfermedades crónicas no transmisibles en mujeres / Educative intervention about obesity like a risk for non-transmitted chronic diseases

Introducción: La obesidad ha creado un impacto negativo debido a su alta prevalencia y asociación con la frecuente aparición de enfermedades crónicas.Objetivo: Elevar el nivel de conocimiento sobre obesidad como factor de riesgo de enfermedades crónicas no transmisibles.Métodos: Intervención educativa, a mujeres de 20 años o más de un consultorio tipo I del reparto Antonio Guiteras, Bayamo, Granma. La muestra quedó conformada por 154 mujeres. Se utilizaron como medidas de resumen, los números absolutos, y la prueba de antes y después de Friedman, se usó el programa estadístico Statistics versión 8.0 para Windows, con un nivel de significación de 0.05.Resultados: Ciento cuarenta y seis mujeres tenían un nivel bajo y 8 un nivel medio de conocimientos antes de aplicada la intervención, después de aplicada, 122 lograron un nivel alto. Al relacionar a la obesidad con la hipertensión arterial, 123 mujeres tenían un nivel bajo de conocimientos y 31 un nivel medio antes de aplicada la intervención, después de aplicada 97 obtuvieron un nivel alto. Para la diabetes mellitus 2, 137 tenían un nivel bajo de conocimientos antes de aplicada la intervención, después de aplicada 109 alcanzaron un nivel alto. En las enfermedades cardiovasculares, antes de aplicada la intervención 137 mujeres tenían un nivel bajo de conocimientos, de estas 116 alcanzaron un nivel alto. Al valorar el nivel de conocimientos de la obesidad como factor de riesgo de enfermedades crónicas, de las 119 mujeres con un nivel bajo antes de aplicada la intervención, todas alcanzaron un nivel alto.Conclusiones: La prueba ANOVA de Friedman arrojó un resultado de 118,35 con coeficiente de concordancia de 0,77, probabilidad igual a 0, demostrando la existencia de diferencias significativas respecto al nivel de conocimiento antes y después de la intervención, evidenciándose su efectividad(AU)

Caracterización clínico-epidemiológica de las malformaciones congénitas del sistema nervioso central, provincia Granma / Clinical- epidemiological characterization of the congenital malformations of the central nervous system, Granma province

Introducción: el sistema nervioso central permite integrar y controlar las diferentes funciones del organismo. La falta de cierre de una parte del tubo neural o la reapertura de una región de este tras su cierre adecuado, puede dar lugar a diversas malformaciones. Objetivo: caracterizar clínico y epidemiológicamente las malformaciones del sistema nervioso central. Métodos se realizó un estudio descriptivo y retrospectivo en el centro provincial de Genética en Bayamo, Granma en el período del 2009-2011. Resultados: la hidrocefalia fue la más frecuente con 41 casos (48.23 por ciento), 82 casos (96.47 por ciento) se diagnosticaron entre las 14 a las 26 semanas, 55 casos (64.70 por ciento), se diagnosticaron en el grupo de edades comprendido entre 20 a 35 años de edad, en la hidrocefalia hubo una tendencia mayor al sexo masculino con 24 casos (28.23 por ciento) y en el sexo femenino 17 casos (20 por ciento), se diagnosticaron prenatalmente por ecografía 39 casos (45,88 por ciento) de hidrocefalia y en el estudio anatomopatológico se detectó en 41 casos (48,23 por ciento). Conclusiones: la hidrocefalia fue la malformación congénita del sistema nervioso central de mayor frecuencia, seguida de la anencefalia, con una discreta tendencia a la aparición en el sexo masculino, donde la edad gestacional al diagnóstico más frecuente estuvo entre las 14 y 26 semanas, y la edad materna entre 20 y 35 años, existiendo una alta correspondencia entre el diagnóstico positivo ecográfico y anatomopatológico(AU)

Introduction: the central nervous system allows integrating and controlling the different functions of the organism. The lack of closure of a part of the neural tube or the reopening of one of its region after its suitable closing can bring about several malformations. Objective: to characterize, clinically and epidemiologically the malformations of the central nervous system. Methods: it was performed a descriptive and retrospective research at the Genetics Province Center during the period of 2009-2011. Results: the hydrocephalia was the most frequent condition with 41 cases, (48.23 percent). 82 cases (96.47 percent) were diagnosed between the 14 and the 26 weeks, according to the gestational age. 55 cases (64.70 percent) were diagnosed in the group of ages between 20 to 35 years old, in the hydrocephalia there was a greatest tendency to the male sex with 24 cases, (28.23 percent) and there were 17 female cases (20 percent). There were prenatally diagnosed 39 cases (45.88 percent) through the echography and in the anatomopathological study it was detected in 41 cases (48.23 percent).Conclusions: the hydrocephalia was the most frequent congenital malformation of the central nervous system, followed by the anencephalia, with a slight tendenncy in the male sex, where the gestational age to the most frequent diagnosis was between the 14 and 26 weeks, and the maternal age was between the 20 and 35 years, existing a correspondence between the positive echographic and anatomopathological diagnosis(EU)

El desarrollo embrionario visto a través de modelos tridimensionales / The embryonic development through tridimensional patterns

El trabajo titulado El desarrollo embrionario visto a través de modelos tridimensionales se desarrolló para probar la efectividad de nuevos modelos macroscópicos como medios de enseñanza de la asignatura Embriología Humana, determinando la influencia del uso de los mismos en los resultados de calidad de los estudiantes y la satisfacción de estos al trabajar con ellos en clases prácticas. En cada una de las actividades prácticas de un semestre se aplicaron los medios de enseñanza en dos grupos de estudio definidos como A y B, formados por 31 estudiantes de segundo año cada uno. De forma alternativa, un grupo hacía de experimental usando los medios mientras que el otro era el de control. En cada clase se intercambiaba el rol. Se demostró que los resultados de calidad (4-5 puntos) del grupo experimental (ya fuera A o B) siempre estuvieron por encima del 85 por ciento y superaban los resultados de calidad del grupo de control, en el que se mantuvieron por debajo del 65 por ciento. Al culminar el semestre se aplicó una encuesta para conocer la valoración de los estudiantes y 60 de ellos (98.4 por ciento) valoraron como positiva su aplicación en clases prácticas. Con esto se demostró que los nuevos medios de enseñanza eran efectivos y aplicables, al mejorar los resultados docentes y al aumentar la satisfacción e inclinación de los estudiantes por la asignatura(AU)

The work entitled the Embryonic Development through tridimensional patterns was fulfilled to prove the effectiveness of new macroscopic patterns as teaching aids of human Embryology subject, determining their influence upon the results of the students quality and their satisfaction at the time of applying them in the practical lessons. In each of these practical activities of one semester there were applied the teaching aids into two research groups, defined as A and B made by 31 students of second year. Alternatively; one group was the experimental using the teaching aids while the other was the control one. In each lesson, they changed the role. It was shown that quality results (4-5points) of the experimental group (either A or B) were always over 85 per cent and they surpassed the quality results of the control group in which they were under 65 per cent. At the end of the semester, it was applied a survey to know the students valuation and 60 of then (98.4 per cent) valued their application in practical lessons as positive. By means of that, it has beer shown that the now teaching aids were effective and could be applied to improve the teaching results and to enlarge the satisfaction and motivation of students towards this subject(AU)

Características morfométricas de los pulmones fetales humanos durante el segundo y tercer trimestre de gestación / Morphometric characteristics of human fetal lung during the second and third trimester of gestation

Se realizó un estudio descriptivo longitudinal prospectivo para evaluar las características morfométricas de los pulmones de 60 fetos humanos nacidos muertos procedentes de abortos o partos distócicos de madres clínicamente sanas, atendidas en el Hospital Carlos Manuel de Céspedes de Bayamo, provincia Granma, en el periodo de Septiembre 2004-Mayo 2005. En el estudio morfométrico de los pulmones fetales en las diferentes semanas de gestación, se consideró los ejes pulmonares (longitudinal, latero-medial y antero-posterior) y el volumen pulmonar. Se relevó una alta relación entre los ejes, y el volumen de ambos pulmones; además el comportamiento de los parámetros morfológicos y biométricos de los pulmones durante la etapa estudiada es de un elevado grado de interdependencia(AU)

It was performed a descriptive longitudinal and prospective study to evaluate the morphometrics characteristics of 60 human fetus lung dead births, coming from abortions or dystocic labour of clinically healthy mothers, assisted in Carlos Manuel de Cespedes Hospital, Bayamo, Granma, since September 2004 to May 2005. In the morphometric study of the fetals lungs in the different gestation weeks, there were considered the lungs axes (longitudinal, medical and antero-posterior) and the pulmonary volume. It was relieved a high relation among the axis and the volume of both lungs, besides the behaviour of the morphological and biometric parameters of the lungs during the studied stage was of a high level of interdependence(AU)

Guía para facilitadores/as en prevención del VIH/SIDA / Pilas con el SIDA / HIV/AIDS prevention: trainers guide

Es un material de apoyo para educadores, facilitadores o personas responsables de la educación sexual, que deseen desarrollar talleres de sensibilización sobre SIDA, dirigido especialmente a jóvenes...