YABBY transcription factor family in the octoploid Fragaria × ananassa and five diploid Fragaria species.

YABBY genes encode specific TFs of seed plants involved in development and formation of leaves, flowers, and fruit. In the present work, genome-wide and expression analyses of the YABBY gene family were performed in six species of the Fragaria genus: Fragaria × ananassa, F. daltoniana, F. nilgerrensis, F. pentaphylla, F. viridis, and F. vesca. The chromosomal location, synteny pattern, gene structure, and phylogenetic analyses were carried out. By combining RNA-seq data and RT-qPCR analysis we explored specific expression of YABBYs in F. × ananassa and F. vesca. We also analysed the promoter regions of FaYABBYs and performed MeJA application to F. × ananassa fruit to observe effects on gene expression. We identified and characterized 25 YABBY genes in F. × ananassa and six in each of the other five species, which belong to FIL/YAB3 (YABBY1), YAB2 (YABBY2), YAB5 (YABBY5), CRC, and INO clades previously described. Division of the YABBY1 clade into YABBY1.1 and YABBY1.2 subclades is reported. We observed differential expression according to tissue, where some FaYABBYs are expressed mainly in leaves and flowers and to a minor extent during fruit development of F. × ananassa. Specifically, the FaINO genes contain jasmonate-responsive cis-acting elements in their promoters which may be functional since FaINOs are upregulated in F. × ananassa fruit under MeJA treatment. This study suggests that YABBY TFs play an important role in the development- and environment-associated responses of the Fragaria genus.

Effects of Microabrasion Prior to In-office Bleaching on Hydrogen Peroxide Permeability, Color Change, and Enamel Morphology.

PURPOSE: This study evaluated hydrogen peroxide (HP) diffusion within the pulp chamber, as well as color change and the surface morphology of teeth subjected to various microabrasion (MA) protocols associated or not with in-office (IO) bleaching. METHODS: Forty sound premolars were randomly divided into the following four groups (n=10): no treatment (NC); IO bleaching only; IO immediately after MA (IMA), and IO seven days after MA (7MA). After treatments, the HP concentration (µg/mL) within the pulp chamber was determined using ultraviolet-visible (UV-Vis) spectrophotometry. The color change (ΔE*) was evaluated using the digital spectrophotometer before and 1 week after bleaching. The surface morphology was evaluated by scanning electron microscope (SEM). Data from each test were submitted to one-way ANOVA and Tukey tests (α=0.05). RESULTS: All experimental groups exhibited higher HP concentrations compared to the NC group (p<0.00001). However, higher amounts of HP were observed for the IMA group compared to the IO and 7MA groups (p<0.00001). No significant difference in color change was observed among the groups (p<0.001). Pronounced grooves in enamel were found in the IMA and 7MA groups. However, enamel erosion areas were observed only in the 7MA group. CONCLUSIONS: The association between MA and IO bleaching could significantly affect the amount of HP inside the pulp chamber. Therefore, it is highly recommended to wait for 1 week after MA procedures before performing IO bleaching.

Meta-analysis and systematic review of ADGRL3 (LPHN3) polymorphisms in ADHD susceptibility.

The gene encoding adhesion G protein-coupled receptor L3 (ADGRL3, also referred to as latrophilin 3 or LPHN3) has been associated with ADHD susceptibility in independent ADHD samples. We conducted a systematic review and a comprehensive meta-analysis to summarize the associations between the most studied ADGRL3 polymorphisms (rs6551665, rs1947274, rs1947275, and rs2345039) and both childhood and adulthood ADHD. Eight association studies (seven published and one unpublished) fulfilled criteria for inclusion in our meta-analysis. We also incorporated GWAS data for ADGRL3. In order to avoid overlapping samples, we started with summary statistics from GWAS samples and then added data from gene association studies. The results of our meta-analysis suggest an effect of ADGRL3 variants on ADHD susceptibility in children (n = 8724/14,644 cases/controls and 1893 families): rs6551665 A allele (Z score = -2.701; p = 0.0069); rs1947274 A allele (Z score = -2.033; p = 0.0421); rs1947275 T allele (Z score = 2.339; p = 0.0978); and rs2345039 C allele (Z score = 3.806; p = 0.0026). Heterogeneity was found in analyses for three SNPs (rs6551665, rs1947274, and rs2345039). In adults, results were not significant (n = 6532 cases/15,874 controls): rs6551665 A allele (Z score = 2.005; p = 0.0450); rs1947274 A allele (Z score = 2.179; p = 0.0293); rs1947275 T allele (Z score = -0.822; p = 0.4109); and rs2345039 C allele (Z score = -1.544; p = 0.1226). Heterogeneity was found just for rs6551665. In addition, funnel plots did not suggest publication biases. Consistent with ADGRL3's role in early neurodevelopment, our findings suggest that the gene is predominantly associated with childhood ADHD.

Vertebroplastia percutánea guiada por tomografía para el manejo del dolor en pacientes con fractura del cuerpo vertebral / CT-guided Vertebroplasty for Painful Vertebral Fractures

Objetivo Describir la técnica y resultados en cuanto a la mejoría del dolor y complicaciones al realizar este procedimiento mediante guía por tomografía computada. Materiales y Métodos Estudio observacional descriptivo de una serie de 108 pacientes a quienes se les realizó vertebroplastia percutánea guiada por tomografía computada realizadas en dos hospitales universitarios, entre mayo 2007 y mayo 2017. Todos los procedimientos se realizaron de forma ambulatoria con anestesia local y se valoró el dolor mediante la escala visual análoga. Resultados Se realizaron 125 vertebroplastias, en el 87,9% de los pacientes (n = 95) se realizó el procedimiento en un cuerpo vertebral, en el 8,3% (n = 9) y 3,7% (n = 4) de los pacientes se cementaron 2 y 3 vertebras respectivamente. El rango de dolor según la escala visual análoga (EVA) previo al tratamiento varió entre 5 y 10, donde un 94% (n = 102) de los pacientes manifestaban una intensidad 10/10. En el postratamiento el rango de dolor varió entre 0a7dondeel 98% de la población reportó un valor menor o igual a 3. Se presentaron 3 complicaciones: tromboembolismo pulmonar por metil-metacrilato, extravasación al plexo de Batson y extravasación al espacio interdiscal, cada una en tres pacientes diferentes. Conclusión La vertebroplastia percutánea guiada por TC ofrece una indiscutible mejora inmediata del dolor en pacientes con fractura de uno o más cuerpos vertebrales, con una baja tasa de complicaciones.

Objetive Describe the technique, results in terms of pain improvement and complications to perform this procedure by computed tomography. Materials and Methods A descriptive observational study of a 108 cases series of percutaneous vertebroplasty guided by computed tomography performed in two university hospitals between May 2007 and May 2017. All procedures were performed with local anesthesia on an outpatient basis, pain was assessed by means of the Visual analogue scale (VAS). Results A total of 125vertebroplasties were performed. In 87.9% (n = 95) of the patients, the procedure was performed in one vertebral body, in 8.3% (n = 9) and 3.7% (n = 4) of the patientshad two or three vertebrae cemented respectively. The range of pain according to VAS prior to treatment varied between 5 and 10, where 94% (n = 102) of the patients manifested a 10/10 intensity; after treatment, the range of pain varied between 0 to 7 where 98% of the population reported a value less than or equal to 3. Three complications were reported, one pulmonary thromboembolism due to methylmethacrylate, one extravasation in to the Batson plexus and one extravasation of cement to the interdiscal space. Conclusion CT-guided percutaneous vertebroplasty offers an undeniable immediate improvement of pain in patients with fracture of one or more vertebral bodies, with a low rate of complications.

Active haematological manifestations of systemic lupus erythematosus lupus are associated with a high rate of in-hospital mortality.

The aim of this study was to estimate the impact of the haematological manifestations of systemic lupus erythematosus (SLE) on mortality in hospitalized patients. For that purpose a case-control study of hospitalized patients in a medical referral centre from January 2009 to December 2014 was performed. For analysis, patients hospitalized for any haematological activity of SLE ( n = 103) were compared with patients hospitalized for other manifestations of SLE activity or complications of treatment ( n = 206). Taking as a variable outcome hospital death, an analysis of potential associated factors was performed. The most common haematological manifestation was thrombocytopenia (63.1%), followed by haemolytic anaemia (30%) and neutropenia (25.2%). In the group of haematological manifestations, 17 (16.5%) deaths were observed compared to 10 (4.8%) deaths in the control group ( P < 0.001). The causes of death were similar in both groups. In the analysis of the variables, it was found that only haematological manifestations were associated with intra-hospital death (odds ratio 3.87, 95% confidence interval 1.8-88, P < 0.001). Our study suggests that apparently any manifestation of haematological activity of SLE is associated with poor prognosis and contributes to increased hospital mortality.

Effect of Dialyzable Leukocyte Extract on chronic cervicitis in patients with HPV infection.

The objective of the study was to assess the clinical, histopathological and immunochemical changes induced by dialyzable leukocyte extract (DLE) treatment in patients with chronic cervicitis associated to HPV infection. Fifty-four female Mexican patients diagnosed with chronic cervicitis, cervical intra-epithelial neoplasia grade 1 (CIN 1) and HPV infection were divided into two groups: patients treated with placebo and patients treated with DLE. Clinical and colposcopy evaluations were performed before and after treatments. Cervix biopsies were obtained to analyze histopathological features and to determine the local immunological changes by immunohistochemistry analyses. Placebo-treated patients showed no significant changes in the evaluated parameters. Interestingly, in DLE-treated patients, clinical manifestations of cervicitis diminished and 89% of them remitted the colposcopic lesions. Histological analyses of biopsies from DLE-treated patients showed a decreasing leukocyte infiltrate. Immunochemical analyses showed an increased expression of TGF-ß, while expression of IFN-γ, PCNA, and IL-32 decreased. Our results suggest that DLE can stimulate innate immunity of cervical mucosae, diminishing chronic cervicitis in HPV-infected patients. TRIAL REGISTRATION: Register ISRCTN16429164 Abbreviations: HPV = Human Papilloma Virus; DLE = Dialyzable leukocyte extract.

[Cemented total knee replacement: comparative study between the use or not of tourniquet on the inmediate results]. / Artroplastía total cementada de rodilla: comparación entre el uso o no de isquemia en el resultado postoperatorio inmediato.

Comparison of immediate postoperative results of patients undergoing cemented total knee arthroplasty with and without ischemia. Observational, cross-sectional, retrospective, analytical, single-center study that included 180 patients who underwent total knee arthroplasty from 2011 to 2014: 120 without ischemia, 60 with ischemia. Mean age was 70 years with SD ± 7. Criteria to assess the immediate postoperative results include intraoperative bleeding, hemoglobin differential and pain. Exclusion criteria comprised patients being treated at a pain clinic, those on anticoagulants, with a history of bleeding disorders, psychiatric conditions, kidney failure or those intolerant to NSAIDs. In total knee arthroplasty without ischemia there is better pain control (p = 0.026). The hemoglobin differential and intraoperative bleeding were less with ischemia (p = 0.008). 32.8% of patients required blood transfusion, but no statistically significant relationship was established with the use or non-use of ischemia (p = 0.301). The most commonly reported pain was within a VAS of 0-3; 62.2% of cases reported mild pain. Mean hemoglobin differential was 3.7 with SD ± 1.3 with a range from 0 to 7.4. Patients in whom no ischemia was used during the surgical procedure experienced less pain. There was less bleeding and hemoglobin differential with the use of ischemia. However, this did not result in a statistically significant difference in the need for blood transfusion. The use of ischemia with caution and according to the surgeons preference is recommended.

Comparar el resultado postoperatorio inmediato en el paciente sometido a artroplastía total cementada de rodilla con y sin el uso de isquemia. Estudio observacional, transversal, retrospectivo, analítico y unicéntrico. 180 pacientes operados de artroplastía total cementada de rodilla: 120 sin isquemia, 60 con isquemia, de 2011 a 2014, edad promedio 70 años con DE ± 7 años, se comparará el sangrado operatorio, diferencial de hemoglobina y dolor como criterios de resultado postoperatorio inmediato. Se excluyeron pacientes de clínica de dolor, manejo con anticoagulantes, coagulopatía previa, patología siquiátrica, insuficientes renales o con intolerancia a AINEs. En artroplastía total cementada de rodilla sin isquemia se presenta mejor control del dolor (p = 0.026). El diferencial de hemoglobina y sangrado operatorio es menor cuando está asociado al uso de isquemia (p = .008). Se requirió transfusión sanguínea en 32.8%, sin establecer una relación entre el uso o exclusión de isquemia con relevancia estadística (p = 0.301). El dolor referido más común se encuentra entre 0 y 3 de EVA correspondiente a dolor leve en 62.2% de los casos. El diferencial de hemoglobina promedio se reporta en 3.7 con desviación estándar de ± 1.3 en un rango de 0 a 7.4. Existe menor dolor postoperatorio en el paciente al que no se aplica isquemia durante el procedimiento quirúrgico; hay menor sangrado y diferencial de hemoglobina con el uso de isquemia; sin embargo, esto no representa estadísticamente una diferencia en la necesidad de transfusión sanguínea. Se recomienda utilizar con cautela la isquemia y su uso queda a elección del cirujano.

Inflammatory myofibroblastic tumor of the esophagus treated by endoscopy.

Inflammatory myofibroblastic tumors are rare lesions that have been described in virtually every organ including the gastrointestinal tract. The esophagus is an extremely unusual site for these tumors, with only a few cases described in the literature. Surgery has been the most common therapeutic approach used for the resection of these lesions. In the present case, a patient diagnosed with an inflammatory myofibroblastic tumor of the upper esophagus was reported, and it was successfully removed by endoscopy with no complications.

Intervencionismo musculoesquelético en cuidados paliativos / Musculoskeletal interventionism on palliatives cares

El presente estudio descriptivo da cuenta de resultados en aplicación de intervencionismo para alivio del dolor musculoesquelético en enfermos con diagnóstico de cáncer terminal, pero que se mantienen activos, e ingresados a Unidad de Alivio del Dolor y Cuidados Paliativos del Hospital del Salvador en Santiago de Chile, entre los meses de julio del 2010 a marzo del 2011. Los principales diagnósticos causantes de dolor musculoesquelético fueron síndrome miofascial, artrosis y ambos diagnósticos combinados. Las técnicas usadas fueron infiltración de punto gatillo, infiltración intra-articular, o ambas. Los resultados mostraron disminución estadísticamente significativa en la intensidad del dolor en forma global en escala numérica, así como al analizar según tipo de intervención por separado. La media de duración del efecto fue de un mes en el caso de infiltración de puntos gatillo. Este tiempo podría constituir una ventana analgésica en pacientes con sobrevida limitada y controlaría el alza de analgésicos. Cuando el DME está presente, el uso de terapia intervencionista para DME podría ser una herramienta útil en Cuidados Paliativos, pero se requieren mayores estudios con mejor diseño estadístico para poder obtener conclusiones con mayor nivel de seguridad.

This descriptive study gives an account of results of interventionism implementation to the relief of musculoskeletal pain in patients that were diagnosed with terminal cancer; but have retained activity level, which are given they state of health at the Unit Pain Relief And Palliative Care at Hospital del Salvador in Santiago, Chile between the months of July 2010 to March 2011. The main causes of musculoskeletal pain diagnoses were Myofascial pain syndrome, arthritis and both combined conditions. The techniques used were trigger point infiltration, intra-articular joint infiltration or both together. The results showed statistical significant decrease in pain intensity on a numerical scale global, as well as the analysis by the type of separately intervention. The mean duration of effect was about a month in the case of infiltration of trigger points, this time window could be a survival analgesic in patients with limited and control the rise of analgesics. When the DME is present, the use of interventional therapy for DMA could be useful tool in palliative care, but require larger studies with better statistical design in order to draw conclusions with greater security.

Trypanosoma cruzi: an analysis of the minicircle hypervariable regions diversity and its influence on strain typing.

The current intraspecific nomenclature in Trypanosoma cruzi describes two major lineages, named T. cruzi I and T. cruzi II, and five sublineages within T. cruzi II, named IIa, IIb, IIc, IId and IIe. The polymorphism of minicircle hypervariable regions (mHVRs) of T. cruzi has been used in many studies for the molecular characterization of parasite populations directly from biological samples. However, the molecular bases that allow strain typing by these markers are still unclear. In this work we examined forty cloned mHVRs sequences of CL-Brener reference strain (IIe sublineage), and we found a predominant group of sequences, with 40% of frequency in this strain, with a 97% of identity among them. Out of the forty clones analyzed, we identified other less representative types, and a few unique ones. This predominant sequence is also present in different reference strains belonging to the other main T. cruzi lineages and sublineages (TcI, IIa, IIb, IIc and IId) although in a many thousand times lower frequency than in the CL-Brener strain, as shown by semiquantitative PCR. Similarly, predominant mHVR sequences previously described for TcIId strains, were clearly more frequent (many thousand times higher) in the IId reference strain analyzed by us (Mncl2) than within the reference strains belonging to the other lineages and sublineages. The analysis of the cloned sequences shows that more sequences than just the major one contribute to define the global pattern of mHVRs RFLP in the CL-Brener strain. The possible usefulness of these predominant sequences for typing TcIId and TcIIe sublineages by semiquantitative PCR, as well as the possible role of these sequences in genotype identification by mHVR probes are discussed.

Lesión digestiva alta grave por ingestión de ácido muriático (ácido clorhídrico) / Gastrointestinal injury by hydrochloric acid

La lesión digestiva aguda por caústicos es una patología que con cierta frecuencia se observa como motivo de consulta a los servicios de urgencias. Tiene un pronóstico reservado dada la cantidad de complicaciones quirúrgicas, médicas e infecciosas a las que están expuestos estos pacientes. Las secuelas que el paciente debe enfrentar en diferentes etapas de su evolución requieren de cuidados intensivos durante un tiempo prolongado además de muchos controles posteriores al alta para evaluar y tratar proiblemas de consideración, estenosis y otras lesiones faringo-esofágicas. Presentamos el caso de un adulto masculino que debido a un síndrome depresivo mayor cursa un intento suicida ingiriendo ácido muriático por boca con severa lesiones digestivas muy poco sintomáticas durante su evolución precoz, pero con un resultado fatal debido a sangrado digestivo agudo masivo.

The acute gastrointestinal injury by caustics is a condition that frequently is observed as a cause of consultations to emergency department. These patients have reserved prognosis given the number of surgical complications, medical and infections. The aftermath that the patient must face at different stages of their development require intensive care for a long time and post-discharge many patients required assess and treat problems, primarily stenosis and other injuries pharynx-esophageal. We report the case of an adult male with depressive syndrome and by suicide attempt with ingesting muriatic acid by mouth, he developed very little injuries digestive during his early trends, but with a fatal outcome due to acute massive gastrointestinal bleeding.

Parálisis facial periférica en el departamento de otorrinolaringología Hospital Militar Dr. Carlos Arvelo / Peripheral facial paralysis in the department of otolaryngology Military Hospital Dr. Carlos Arvelo

Se presenta un reporte preliminar de un estudio descriptivo, prospectivo, análitico en el cual se incluyó todos los pacientes con parálisis facial que acudieron al Departamento de Otorrinolaringología del Hospital Militar Carlos Arvelo, en el lapso comprendido entre enero y abril de 2006 (N:19). Los datos recolectaron en un formato que incluía edad y sexo, grado de parálisis facial (según la clasificación de House-Brackman), y diagnóstico etiológico. La información se analizó a través de estadística descriptiva por análisis de frecuencia. El promedio de edad fue de 47,47 años con un ligero predominio del sexo masculino (57,9 por ciento) sobre el femenino (42,1 por ciento). Al momento de la consulta los grados II y IV se manifestaron en 36,8 por ciento, mientras que el grado III (21,1 por ciento) y el IV (5,3 por ciento). El diagnóstico etilógico más frecuente fue parálisis de Bell (47,4 por ciento), traumática (26,3 por ciento), Ramsay-Hunt (15,8 por ciento), complicación de otitis media aguda (10,5 por ciento). Estos datos se correlacionan con estudios previos realizados a nivel mundial

Hidrops fetal no inmune: presentación de un caso y revisión de la literatura / No immune fetal hydrops: a case report and literature review

El hidrops fetal no inmune (HFNI) es una importante causa de pérdida perinatal, con mortalidad que varía entre 50-100 por ciento. El HFNI es una condición causada por un grupo heterogéneo de patologías. La fisiopatología del desorden que lo produce se conoce en muchos casos. Sin embargo, existen muchos casos en que la causa no se puede detérminar. Presentar un caso de hidrops fetal no inmune, el estudio realizado y la revisión de la literatura. Un caso de hidrops fetal no inmune, fue diagnósticado por ultrasonido antenatal a las 298 semanas de gestación. El feto murió al nacer, el cariotipo de muestra de sangre obtenida del cordón umbilical fue anormal. El examen postmorten fue compatible con Síndrome de Tuner e Higroma Quístico. En el presente caso el HFNI fue causado por la cromosomopatía tipo monosomía X y la anatomía linfática denominada higroma quístico. Todos los casos de HFNI deben ser evaluados prenatalmente para un adecuado diagnóstico y tratamiento cuando la mortalidad es prevenible.

Neoplasias en niños hospitalizados en pediatría médica: Hospital Central de San Cristóbal / Neoplasms in children hospitalized in medical pediatric: Hospital Central of San Cristobal

Se presenta la experiencia en 40 niños con cáncer ingresados al Hospital Central San Cristóbal entre junio 2004 y enero de 2005; de las historias clínicas se tomaron los datos sobre: Tipo de neoplasia, Método diagnóstico, Extensión de la enfermedad, Tratamiento, Evolución y Mortalidad. Los diagnósticos oncológicos fueron: Leucemia linfoblástica aguda (32,3 por ciento); Linfoma No Hodking (27,3 por ciento); Linfoma de Hodking y Astrocitoma (10 por ciento) cada uno; Tumor de Wilms y Retinoblastoma (7,5 por ciento); Hepatoblastoma y Meduloblastoma (2,5 por ciento). Se diagnósticaron con: Biopsia (55,0 por ciento), aspirado e inmunofenotipo de médula ósea (17,5 por ciento); sólo aspirado de médula ósea (12,3 por ciento); biopsia e inmunofenotipo y aspirado más biopsia más inmunofenotipo (7,5 por ciento). Predominó el estadio III (25 por ciento), seguido de II (12,5 por ciento), el IV (10 por ciento). Se trataron con quimioterapia (50,7 por ciento), resección quirúrgica parcial y radioterapia (17,8 por ciento). El (85 por ciento) de los casos tuvo evolución satisfactoria. Y la mortalidad afectó al (5 por ciento). En general se hizo un diagnóstico y tratamiento adecuado y oportuno evidenciado en la buena evolución de la mayoría de pacientes. Se debe fomentar la creación de unidades de atención y control del paciente oncológico infantil a fin de mantener una baja mortalidad.

Evaluación de la respuesta inmunitaria en niños con quemaduras / Evaluation of the immunity response in children with burns

En el paciente quemado se reúnen una serie de factores que favorecen la aparición de un desbalance en su respuesta inmunitaria que incrementan la susceptibilidad de los mismos a las infecciones. Las personas con quemaduras, sobretodo los niños, que presentan una mayor alteración inmunológica son aquellos con peor pronóstico y con mayores posibilidades de presentar complicaciones. El objetivo del presente trabajo es evaluar la utilidad de la respuesta proliferativa con mitogenos de los linfocitos en niños con quemaduras como un marcador pronóstico. Fueron estudiados 11 niños con quemaduras desde enero a marzo del 2004, de ambos sexos, provenientes del área rural, sin complicaciones infecciosas. Como controles se estudiaron 9 niños aparentemente sanos. Todos fueron estudiados luego de obtenerse el consentimiento informado de sus padres. Se utilizó sangre periférica, obtenida en forma estéril con heparina. Las células mononucleares fueron separadas sobre gradiente de Ficoll­Hypaque. Las células mononucleares (2,5 x 106 células/ml) fueron cultivadas en medio RPMI 1640 con 10% de suero fetal bovino (FBS), en triplicado a 37°C y 5% CO2 estimuladas con fitohemaglutinina­M (PHA­M). Como controles se utilizaron células mononucleares no estimuladas con PHA­M. La proliferación celular se midió utilizando un método colorimétrico MTT [3­(4.5 dimethylthiazol­2­yl)­2.5 diphenyl tetrazolium bromide].De nueve niños (82%) fueron masculinos y 2 ((18%) fueron femeninos. La edad media de los niños quemados fue de 4,03 ± 4,19 años y la de los niños controles 3,26 ± 5,62 años. En el grupo estudiado se observó en la proliferación celular una respuesta de los linfocitos disminuida en relación a los controles. (1,16 ± 0,31 versus 2,66 ± 0,37, p<0,01).Esto pone en evidencia una disminución significativa de la inmunidad celular en los niños, secundaria a las quemaduras. La elevada incidencia de las quemaduras en la edad pediátrica, su gravedad, la complejidad del mecanismo fisiopatológico y la enorme mortalidad que conllevan hace que sea importante la evaluación de la inmunosupresión en el niño quemado y de esta manera contribuir a la búsqueda de nuevas y mejores opciones para estos lesionados.

Burnt patients have several factors favoring the appearance of an imbalance in their immune response, increasing their susceptibility to infections. People with burns, especially children, presenting greater immunological alterations are those with worse prognosis and more possibilities of having complications. The aim of the present work is to evaluate the proliferative response of the lymphocytes in children with burns as a prognosis marker. Eleven boys and girls with burns were studied from January to March, 2004. They were from rural areas and did not have infectious complications. Nine apparently healthy children were included as controls. The children were included in the study with previous consent of their parents. Peripheral blood obtained in sterile form with heparin was used. The mononuclear cells were separated on Ficoll­Hypaque gradient and the cells (2,5 x 106cell/ml) were cultivated in RPMI 1640 with 10% of fetal bovine serum (FBS), in triplicate at 37°C y 5% CO2 stimulated with phytohemaglutinin­M (PHA­M). Non­stimulated mononuclear were used as control. The cellular proliferation was measured using a colorimetric method with MTT [3­(4.5 dimethylthiazol­2­yl)­2.5 diphenyl tetrazolium bromide]. Nine (82%) were male and 2(18%) were female. The mean age of the burnt children was of 4,03±4,19 years and that of the children control was 3,26±5,62 years. In the studied group, the cellular proliferation showed a decreased response of the lymphocytes in relation to the controls. (1,16±0,31 versus 2,66±0,37, p<0,01). This shows a significant decrease of the cellular immunity in these children, secondary to the burns. The high incidence of burns in paediatric age, seriousness of the lesions, complexity of the physiopathological mechanism and enormous mortality they have make very important the evaluation of the immunosuppression in the burnt child and hereby to contribute to the search of new and better options for these patients.

Cloning and expression of Blo t 1, a novel allergen from the dust mite Blomia tropicalis, homologous to cysteine proteases.

BACKGROUND: House dust mite allergens have been shown to be a very important stimulus in the causation of asthma and triggers for the exacerbation of symptoms. Therefore, characterization of mite-derived allergens at the molecular level is an important step for the development of effective diagnostic and therapeutic approaches, as well as for epidemiological studies. OBJECTIVE: To clone, express and characterize at the molecular level the cysteine protease from Blomia tropicalis (Bt). METHODS: A full-length cDNA encoding Blo t 1 was cloned from a Bt cDNA library using a PCR and RACE-based strategy. The cDNA was PCR-amplified, sequenced and subcloned into a prokaryotic expression vector. The allergenicity of the recombinant Blo t 1 was evaluated for IgE reactivity by Western blot. RESULTS: Blo t 1 cDNA encodes a 221 amino acids polypeptide with an estimated molecular weight of 25 kDa. The recombinant protein is 35% identical to other mite cysteine proteases. Recombinant Blo t 1 (rBlo t 1) bound IgE from 62% of Bt skin test-positive serum. Dermatophagoides pteronyssinus (Dp) skin test-positive sera did not react with rBlo t 1, indicating the possible presence of unique IgE epitopes on the rBlo t 1 molecule. A three-dimensional image of Blo t 1, constructed based on predicted analysis, showed conserved secondary and tertiary structure with other cysteine proteases. CONCLUSION: We report the cloning, expression and IgE reactivity of Blo t 1, a novel allergen from the domestic mite Blomia tropicalis (Bt), highly homologous to cysteine proteases. This putative cysteine protease, designated Blo t 1, may play a major role as an immunodominant allergen involved in dust mite-specific IgE-mediated hypersensitivity.

Mirada al gineco-obstetra en atención ambulatoria / A glance at the gyneco-obstetrician in outpatient health care

En el presente siglo, la mujer debe ser considerada por su propio valor. En medicina cobra gran importancia los derechos de los pacientes y su autonomía en la toma de decisiones. Se hace evidente conocer las perspectivas de nuestras usuarias en cuanto al perfil profesional que quisieran tener como tratante. Se aplicó durante un mes del año 2001, una encuesta a 104 pacientes que consultaron por primera vez en la atención ambulatorio de maternidad del Hospital Clínico Universidad de Chile. Se evaluaron factores de la relación médico-paciente: edad, sexo, presentación personal, empatía, puntualidad, capacidad de escuchar, de hacerse entender y seguridad del médico. Los resultados muestran que el 56 por ciento considera trascendente la edad del médico tratante: el 77 por ciento prefiere edades entre 40 y 50 años; el 41 por ciento considera importante la universidad de formación, y al 83 por ciento le importa la presentación personal del médico. Respecto a los atributos técnicos, el 96 por ciento valoró como muy importante la capacidad del médico para escucharla y explicarle claramente la enfermedad-tratamiento y la seguridad que expresa. Características ideales: 1° seguridad, 2° capacidad de explicar, 3° capacidad de escuchar y 4° empatía. Lo anterior permite concluir que nuestros usuarios priorizan cualidades humanas en la interacción médico-paciente por sobre características técnicas. Esto representa desafíos a nivel de la formación de nuevos profesionales de la salud, la planta médica y de la autoridad administrativa, sugiriendo la definición de estándares de atención desde la presentación personal de los miembros del equipo de salud hasta la educación e información del paciente.

Functional cross talk after activation of P2 and P1 receptors in oviductal ciliated cells.

The presence of ATP and adenosine receptors and their role in controlling ciliary activity in oviductal ciliated cells was studied by measuring the ciliary beat frequency (CBF) in oviductal tissue cultures. ATP, adenosine, and related compounds increased the CBF in a dose-dependent manner. We established that P2 receptors of subtype 2Y(2) and P1 receptors of subtype A(2a) mediated the responses to ATP and adenosine, respectively. We found evidence to suggest that stimulation of ciliary activity by ATP requires D-myo-inositol 1,4, 5-trisphosphate [Ins(1,4,5)P(3)] metabolism, intracellular Ca(2+) mobilization, and protein kinase C activation. On the other hand, the adenosine effect is mediated by activation of a G(s) protein-dependent pathway that enhances cAMP intracellular levels. To study the interaction between P2 and P1 receptors, cells were stimulated simultaneously with both agonists. We observed a synergistic increase of the CBF even at agonist concentrations (100 nM) that did not produce a significant response when added separately to the culture. Furthermore, a blocker of the cAMP pathway produced a reduction of the ATP response, whereas a blocker of the Ins(1,4,5)P(3) pathway also produced an inhibition of the adenosine response. Our evidence demonstrates that both ATP and adenosine receptors are present in a single ciliated cell and that a mechanism of cross talk could operate in the transduction pathways to control ciliary activity.