Cobalt-assisted route to rare carbocyclic C-ribonucleosides.

(Re)emerging RNA viruses have been major threats to public health in the past years, and from the few drugs available, nucleoside analogues are still at the cornerstone of the antiviral therapy. Among them, the synthesis of carbocyclic C-nucleosides is suffering from long syntheses and poor yields. Herein we report a concise stereoselective synthesis of rare carbocyclic C-nucleosides (11a-l) bearing non-canonical nucleobases through a cobalt-assisted-route as key step starting from the optically pure (-)-cyclopentenone 1. This approach paves the route for novel carbocyclic C-nucleoside discovery.

N-acetyl-cysteine blunts 6-hydroxydopamine- and L-buthionine-sulfoximine-induced apoptosis in human mesenchymal stromal cells.

Parkinson disease (PD) is characterized by the loss of dopaminergic (DAergic) neurons linked to environmental toxicants that cause oxidative stress (OS). The aim of this investigation was to establish the molecular response of human mesenchymal stroma cells (MSCs) depleted of glutathione (GSH) by the specific inhibitor L-buthionine-sulfoximine (BSO) to 6-hydroxydopamine (6-OHDA) and/or N-acetylcysteine (NAC) co-treatment. We found that treatment with BSO (10 mM) plus 6-OHDA (200 µM) induced apoptosis in MSCs through an oxidative stress (OS) mechanism involving H2O2, reflected by the detection of dichlorofluorescein-positive (DCF+) cells and oxidation of DJ-1 Cys106-SH into DJ-1 Cys106-SO3; an almost complete reduction in glutathione peroxidase 1 (GPX1) expression; activation of the transcription factor c-JUN, the pro-apoptotic protein BAX and BH-3-only protein PUMA; loss of mitochondrial membrane potential (∆Ψm); activation of the protease caspase-3 (CASP3) and apoptosis-inducing factor (AIF); chromatin condensation; and DNA fragmentation. Strikingly, co-treatment of MSCs with NAC (5 mM) and BSO + 6-OHDA significantly reduced the expression of OS and cell death markers but were unable to restore the expression of GPX1 compared to the expression in untreated or treated cells with NAC only. These findings highlighted the importance of the maintenance of the GSH-dependent (e.g., GPX1, GSH synthesis) and -independent (e.g., ROS scavenger molecules and thiol reducing activity) antioxidant systems (e.g., NAC) in the protection of MSCs from detrimental stress stimuli, thereby increasing the survival of stromal cells.

Novedades en Cirugía del pie en 2017 / What's new in ankle and foot surgery in 2017

Se ha realizado una revisión sobre cirugía de pie y tobillo, excluyendo la cirugía artroscopica basada en artículos publicados en revistas de impacto mediante el motor de búsqueda PubMed de acceso libre a la base de datos MEDLINE. En muchos de estos trabajos el nivel de evidencia científica es bajo, ya sea por su planteamiento o más frecuentemente por tratarse de muestras de pequeño tamaño. A pesar de esto, dichos artículos suponen una visión general de la tendencias actuales en nuestro campo

We made an update of concepts in foot and surgery, excluido arthroscopic surgery, based on a review of concepts by the search engine PubMed and MEDLINE database. Most of these papers, the level of scientific evidence is low, either by design or more usually because they are small samples of patients. However, reading these articles, we can draw the trending topics in our field of work

PARKIN overexpression in human mesenchymal stromal cells from Wharton's jelly suppresses 6-hydroxydopamine-induced apoptosis: Potential therapeutic strategy in Parkinson's disease.

BACKGROUND AIMS: Stem cell transplantation is an excellent option for regenerative or replacement therapy. However, deleterious microenvironmental and endogenous factors (e.g., oxidative stress) compromise ongoing graft survival and longevity. Therefore, (transient or stable) genetically modified cells may be reasonably thought to resist oxidative stress-induced damage. Genetic engineering of mesenchymal stromal cells (MSCs) obtained from Wharton's jelly tissue may offer some therapeutic potential. PARKIN is a multifunctional ubiquitin ligase able to protect dopaminergic cells against stress-related signaling. We, therefore, evaluated the effect of the neurotoxicant 6-hydroxydopamine (6-OHDA) on regulated cell death signaling in MSCs and investigated whether overexpression of PARKIN in MSCs was capable of modulating the effect of 6-OHDA. METHODS: We transiently transfected Wharton's jelly-derived MSCs with an mCherry-PARKIN vector using the Lipofectamine LTX method. Naïve MSCs and MSCs overexpressing PARKIN were exposed to increasing concentrations of 6-OHDA. We used light and fluorescence microscopy, flow cytometry, immunocytochemistry staining, in-cell Western and Western blot analysis. RESULTS: After 12-24 h of 6-OHDA exposure, we detected dichlorofluorescein (DCF)-positive cells (80%) indicative of reactive oxygen species (H2O2) production, reduced cell viability (40-50%), decreased mitochondrial membrane potential (ΔΨm, ~35-45%), DNA fragmentation (18-30%), and G1-arrested cell cycle in the MSCs. 6-OHDA exposure increased the expression of the transcription factor c-JUN, increased the expression of the mitochondria maintenance Phosphatase and tensin homologue-induced putative kinase 1 (PINK1) protein and increased the expression of pro-apoptotic PUMA, caspase-3 and apoptosis-inducing factor (AIF). 6-OHDA exposure also significantly augmented the oxidation of the oxidative stress sensor, DJ-1. Overexpression of PARKIN in MSCs not only significantly reduced the expression of cell death and oxidative stress markers but also significantly reduced DCF-positive cells (~50% reduction). DISCUSSION: 6-OHDA induced apoptosis in MSCs via generation of H2O2, activation of c-JUN and PUMA, mitochondrial depolarization and nuclei fragmentation. Our findings suggest that PARKIN protects MSCs against 6-OHDA toxicity by partly interacting with H2O2, reducing the expression of c-JUN, PUMA, AIF and caspase-3, and maintaining the mitochondrial ΔΨm.

Fast transdifferentiation of human Wharton's jelly mesenchymal stem cells into neurospheres and nerve-like cells.

BACKGROUND: The human mesenchymal stem cells derived from Wharton's jelly tissue (hWJ-MSCs) represent a tool for cell-based therapies and regenerative medicine. hWJ-MSCs form neurospheres (NSs) within 3-7 days. No data is available to establish the neuro-phenotypic markers and time of formation of nerve-like (NLCs) and glial cells from NSs derived from hWJ-MSCs. NEW METHOD: hWJ-MSCs were incubated with Fast-N-Spheres medium for 24 and 72h. The new formed NSs were in turn incubated with forskolin in neurogenic NeuroForsk medium for 1-7days. RESULTS: hWJ-MSCs cultured with Fast-N-Spheres medium trans-differentiated into NSs in just 24h compared to 72h for hWJ-MSCs cultured with classic growth factor medium. The NSs generated from the Fast-N-Spheres medium expressed reduced levels SOX2, OCT4 and NANOG, as markers of pluripotency compared to undifferentiated hWJ-MSCs. The formed NSs exposed to NeuroForsk medium differentiated into NLCs in 4days as evidenced by high levels of protein expression of the neuronal markers, and no expression of the glial marker GFAP. COMPARISON WITH EXISTING METHOD(S): Currently, the formation and harvest of NSs is expensive and time consuming. Published protocols require 3-7days to form NSs from whole human umbilical cord MSCs. We report for the first time, to our knowledge, the differentiation of NSs-derived from hWJ-MSCs into NLCs. CONCLUSIONS: The fastest method to obtain NSs and NLCs from hWJ-MSCs takes only five days using the two-step incubation media Fast-N-Spheres and NeuroForsk.

Integration of Multi-Plane Tissue Doppler and B-Mode Echocardiographic Images for Left Ventricular Motion Estimation.

Although modern ultrasound acquisition systems allow recording of 3D echocardiographic images, tracking anatomical structures from them is still challenging. In addition, since these images are typically created from information obtained across several cardiac cycles, it is not yet possible to acquire high-quality 3D images from patients presenting varying heart rhythms. In this paper, we propose a method to estimate the motion field from multi-plane echocardiographic images of the left ventricle, which are acquired simultaneously during a single cardiac cycle. The method integrates tri-plane B-mode and tissue Doppler images acquired at different rotation angles around the long axis of the left ventricle. It uses a diffeomorphic continuous spatio-temporal transformation model with a spherical data representation for a better interpolation in the circumferential direction. This framework allows exploiting the spatial relation among the acquired planes. In addition, higher temporal resolution of the transformation in the beam direction is achieved by uncoupling the estimation of the different components of the velocity field. The method was validated using a realistic synthetic dataset including healthy and ischemic cases, obtaining errors of 0.14 ± 0.09 mm for displacements, 0.96 ± 1.03% for longitudinal strain and 3.94 ± 4.38% for radial strain estimation. In addition, the method was also demonstrated on a healthy volunteer and two patients with ischemia.

Tumoración endonasal y fractura de cadera derecha como cuadro clínico de un caso de melanoma mucoso nasosinusal / Endonasal tumor and right hip fracture as clinical presentation of a case of sinonasal mucosal melanoma

El melanoma mucoso se considera un subtipo distinto al cutáneo. El 40% a 50% de los melanomas mucosos están localizados en la cabeza y el cuello, siendo los más frecuentes los nasosinusales y los de cavidad oral; en la porción anterior del tabique nasal y los cornetes inferior y medio. Estas neoplasias se originan de los melanocitos de la mucosa y submucosa nasosinusal. Generalmente se diagnostican tardíamente, frecuentemente con metástasis a distancia. Ante clínica nasosinusal unilateral sospechosa es muy importante una exploración exhaustiva de las vías aerodigestivas superiores y posteriormente, un estudio anatomopatológico. Se presenta a una paciente de 56 años, con historia de epistaxis de repetición de meses de evolución. En la exploración presenta una tumoración polipoidea que ocupa toda la fosa nasal derecha, con desviación septal y deformidad de la pirámide nasal. El estudio anatomopatológico informa de melanoma maligno infiltrante. Durante la hospitalización, la paciente presenta dificultad para caminar y dolor en cadera derecha, siendo diagnosticada por traumatología de fractura basicervical. Durante la cirugía, se envía fragmento óseo de cadera para estudio anatomopatológico, compatible con lesión de sustrato tisular óseo metastatizado por una proliferación celular de morfología e inmunofenotipo de melanoma.

The mucosal melanoma is considered a distinct subtype of cutaneous melanoma. The 40%-50% of cases of mucosal melanomas is located in the head and neck, the most common are found in sinonasal level and in the oral cavity; In the anterior portion of the nasal septum and the inferior and middle turbinates. Those neoplasms originate from the malignant cells found in the mucosa and submucosa. Usually are lately diagnosed, with distant metastases. If suspicious unilateral sinonasal manifestations appears is extremely important to realize an exhaustive exploration of superior aerodigestive vias and a histopathological examination of the lesion. We present a 56 year old with repeated epistaxis of several months of duration. The examination revealed a polypoid tumor occupying the entire right nostril, septal deviation and deformity of the nasal pyramid. Pathological studies reports infiltrating malignant melanoma. During the hospitalization the patient has difficulty walking and pain in the right hip, being diagnosed by Traumatology of fracture basicervical. During the surgery, a bone fragment hip is sent for anathomopathology study which is reported as bone tissue injury support substrate metastasized malignant cell proliferation by immunophenotype and morphology of melanoma.

HGF/c-Met signaling promotes liver progenitor cell migration and invasion by an epithelial-mesenchymal transition-independent, phosphatidyl inositol-3 kinase-dependent pathway in an in vitro model.

Oval cells constitute an interesting hepatic cell population. They contribute to sustain liver regeneration during chronic liver damage, but in doing this they can be target of malignant conversion and become tumor-initiating cells and drive hepatocarcinogenesis. The molecular mechanisms beneath either their pro-regenerative or pro-tumorigenic potential are still poorly understood. In this study, we have investigated the role of the HGF/c-Met pathway in regulation of oval cell migratory and invasive properties. Our results show that HGF induces c-Met-dependent oval cell migration both in normal culture conditions and after in vitro wounding. HGF-triggered migration involves F-actin cytoskeleton reorganization, which is also evidenced by activation of Rac1. Furthermore, HGF causes ZO-1 translocation from cell-cell contact sites to cytoplasm and its concomitant activation by phosphorylation. However, no loss of expression of cell-cell adhesion proteins, including E-cadherin, ZO-1 and Occludin-1, is observed. Additionally, migration does not lead to cell dispersal but to a characteristic organized pattern in rows, in turn associated with Golgi compaction, providing strong evidence of a morphogenic collective migration. Besides migration, HGF increases oval cell invasion through extracellular matrix, a process that requires PI3K activation and is at least partly mediated by expression and activation of metalloproteases. Altogether, our findings provide novel insights into the cellular and molecular mechanisms mediating the essential role of HGF/c-Met signaling during oval cell-mediated mouse liver regeneration.

Improved myocardial motion estimation combining tissue Doppler and B-mode echocardiographic images.

We propose a technique for myocardial motion estimation based on image registration using both B-mode echocardiographic images and tissue Doppler sequences acquired interleaved. The velocity field is modeled continuously using B-splines and the spatiotemporal transform is constrained to be diffeomorphic. Images before scan conversion are used to improve the accuracy of the estimation. The similarity measure includes a model of the speckle pattern distribution of B-mode images. It also penalizes the disagreement between tissue Doppler velocities and the estimated velocity field. Registration accuracy is evaluated and compared to other alternatives using a realistic synthetic dataset, obtaining mean displacement errors of about 1 mm. Finally, the method is demonstrated on data acquired from six volunteers, both at rest and during exercise. Robustness is tested against low image quality and fast heart rates during exercise. Results show that our method provides a robust motion estimate in these situations.

3D strain assessment in ultrasound (Straus): a synthetic comparison of five tracking methodologies.

This paper evaluates five 3D ultrasound tracking algorithms regarding their ability to quantify abnormal deformation in timing or amplitude. A synthetic database of B-mode image sequences modeling healthy, ischemic and dyssynchrony cases was generated for that purpose. This database is made publicly available to the community. It combines recent advances in electromechanical and ultrasound modeling. For modeling heart mechanics, the Bestel-Clement-Sorine electromechanical model was applied to a realistic geometry. For ultrasound modeling, we applied a fast simulation technique to produce realistic images on a set of scatterers moving according to the electromechanical simulation result. Tracking and strain accuracies were computed and compared for all evaluated algorithms. For tracking, all methods were estimating myocardial displacements with an error below 1 mm on the ischemic sequences. The introduction of a dilated geometry was found to have a significant impact on accuracy. Regarding strain, all methods were able to recover timing differences between segments, as well as low strain values. On all cases, radial strain was found to have a low accuracy in comparison to longitudinal and circumferential components.

Evolution of HIV incubation times in AIDS patients.

Since introduction of highly active antiretroviral therapy (HAART), the incidence of AIDS has gradually declined, although the incidence of HIV infection is largely unknown. We have studied a sample with 10,571 patients whose data were recorded by Spain's public health system, in the Andalusian Register of Cases of AIDS. The diagnoses correspond to the period January 1981 to June 2008. For this period, AIDS incubation times were analyzed by means of the survival and risk functions, using R survival and DTDA libraries. We have studied the evolution of incubation mean times according to specific variables from database. The obtained results show that the mean times of viral incubation presented a growing trend that was greater among women when the study was limited to heterosexual transmission. Stratifying by category of transmission, the longest incubation period was seen for intravenous drug users (IDU). Both gender and IDU transmission were associated with significantly greater survival without AIDS. In contrast, heterosexual transmission or pneumonia diagnosis were associated with lower survival without AIDS.

Increased plasma levels of total homocysteine but not asymmetric dimethylarginine in Hispanic subjects with ischemic stroke FREC-VI sub-study.

BACKGROUND AND PURPOSE: Despite sharing some metabolic and pathological mechanisms, the reported association between total homocysteine (tHcy), asymmetric dimethylarginine (ADMA) and stroke remains controversial, particularly in Hispanic populations from developing countries in which genetic, socioeconomic, and nutritional factors are different to those described in developed countries. Our objectives were to determine the relationships of these factors to stroke and to each other independent of other cardiovascular risk factors, and to explore potential sex differences. METHODS: This national (Colombia) multicenter case-control study included 238 cases and 238 controls to evaluate traditional and emerging risk factors for ischemic stroke including tHcy and ADMA plasma levels. RESULTS: The median plasma levels of tHcy were 8.48 µM for controls and 10.01 µM for cases (P<0.0001). Plasma levels of tHcy between 12 and 50µM were considered moderate hyperhomocysteinemia (HtHcy). There were no differences in plasma ADMA concentration between groups (P=0.40). Plasma levels of ADMA and creatinine were not correlated (P=0.47). After adjusting for confounding factors, the presence of HtHcy was strongly associated with stroke (OR 8.97; P<0.0001). The adjusted association between HtHcy and stroke in men (OR 9.98) was comparable to that in women (OR 8.98) (P=0.41). CONCLUSIONS: In this Hispanic population, with relatively normal renal function, plasma levels of tHcy but not ADMA were associated with stroke independent of other cardiovascular risk factors.

Sustained high prevalence of pneumococcal serotype 1 in paediatric parapneumonic empyema in southern Spain from 2005 to 2009.

The epidemiology and microbiological characteristics of paediatric parapneumonic empyema (PPE) before the introduction of the new generation of conjugate pneumococcal vaccines (10-valent and 13-valent) are described. All patients <14 years old admitted to a tertiary paediatric hospital with a diagnosis of PPE were prospectively enrolled from January 2005 to December 2009. Pneumococcal serotyping of culture-negative pleural fluid samples was performed using a multiplex real-time PCR assay. Overall, 219 patients had PPE. Incidence rates for PPE remained stable during the study period with a not significant increase in 2009 compared with 2005 (p 0.13), and were temporally associated with higher circulation of pandemic influenza A H1N1 during the last quarter in our population (p 0.001). Pneumococci were detected in 72% of culture-positive and 79% of culture-negative samples. Serotypes were determined in 104 PPE cases. Serotype 1 was the most prevalent serotype identified (42%) followed by serotypes 7F (20%), 3 (16%), 19A (8%) and 5 (7%). Serotype distribution remained similar during all time periods. Pneumococcal serotype 1 remained the most common cause of PPE during the 5-year study. The new generation of pneumococcal conjugate vaccines offers potential serotype coverage of 73% (10-valent) and 99% (13-valent) in the population studied suffering from PPE. Continuous epidemiological and molecular studies are paramount to monitor the impact of pneumococcal vaccines on the epidemiology of PPE.

Antibiotic susceptibility and molecular epidemiology of nasopharyngeal pneumococci from Spanish children.

Nasopharyngeal pneumococci were collected from 635 Spanish children aged 6 months to 6 years attending four primary healthcare centres (n = 276) or two hospital emergency rooms (n = 359); 36% of the children had received >/=1 dose of pneumococcal conjugate vaccine (PCV7). Overall, the carriage rate of Streptococcus pneumoniae was 31%, with no significant differences in carriage rates according to setting. Colonization with vaccine serotypes was significantly associated with the absence of PCV7 immunization (29.4% vs. 5.9%, p <0.001). Forty-seven per cent of all isolates were penicillin- and/or erythromycin-non-susceptible; 13 international antibiotic-resistant clones were represented among non-susceptible pneumococci and were similarly distributed among vaccine and non-vaccine serotypes.

Aspergilosis esfenoidal, una sospecha poco habitual / Sphenoid aspergillosis, an unusual suspect

La enfermedad aislada del seno esfenoidal constituye sólo el 2%-3% de toda la patología sinusal y en la mayoría de los pacientes es de tipo inflamatorio. Asimismo, es poco frecuente la Invasión fúngica de dicho seno esfenoidal en un individuo sano e inmunocompetente, siendo extremadamente rara en niños. Nos planteamos recordar esta patología haciendo presentación de nuestra última experiencia y obtener conclusiones para mantener siempre un espectro amplio en cuanto a los diagnósticos diferenciales a tener en cuenta. El presente caso clínico expone la experiencia vivida en nuestro centro con una patología poco frecuente como es la aspergilosis esfenoidal aislada, con los antecedentes personales, características clínicas, métodos diagnósticos, pronóstico y tratamientos óptimos. Presentamos el caso de un varón de 73 años con historia de cefaleas intensas de larga evolución inicialmente sensibles a tratamiento analgésico, de localización retroocular bilateral, y que en los últimos 2 meses se hacen resistentes al tratamiento y comienzan a irradiarse a región naso-frontal derecha con mayor intensidad y con isonofobia, fotofobia, cortejo neurovegetativo, pérdida de peso, dolor cervical frecuente, intenso prurito ocular y ocasionalmente visión borrosa. Sin rinorrea, fiebre, ni ningún otro síntoma propio de un cuadro infeccioso. Los síntomas iniciales de la enfermedad del seno esfenoidal son poco precisos, de instauración insidiosa y crónica, y difíciles de caracterizar. Hasta el 70%, se manifiestan por alteraciones visuales que generalmente, Indican complicaciones inmediatas. Está asociada a peor pronóstico que en otras localizaciones por la posible extensión intracraneal precoz. Así, podemos considerar que la aspergilosis fulminante de senos paranasales en general, y del seno esfenoidal particularmente, representa una importante causa de morbi/mortalidad en pacientes cuyo estado inmunitario es deficiente, pero actualmente el patrón...

Isolated sphenoid sinus disease represents only 2-3% of the total sinus pathology and when it is present, it usually has an inflammatory origin. It seldom affects an immunocompetent person, and it is very rare in children. Our goal is to draw attention to this pathology introducing our recent experience, and to draw conclusions in order to always bear in mind a wide spectrum of possible differential diagnoses. We present the clinical experience at our hospital with a rare pathology such as isolated sphenoidal aspergillosis, reviewing the patient's personal background, clinical features, diagnosis techniques, prognosis and optimal therapy. Our patient is a 73-year-old male with long-term intense headache located in the frontal and periocular regions. Initially, common analgesics were strong enough to relieve the pain, but eventually it became more and more intense, with no response to medication. In addition, he presented cervical pain, photophobia, sonophobia, weight loss, ocular tingling and blurred vision. There was no rhinorrea, fever, or any other infectious symptom. Initial sphenoid sinus pathology symptoms are not very precise, with a latent and chronic set up, and theyare also hard to characterize. Up to 70% of patients show visual disturbances, which generally derive in immediate complications. Prognosis is worse than in other location because of early intracranial dissemination. Thus, sphenoid aspergillosis can be considered as being a potentially lethal disease in immunodeficient patients, but nowadays, fungal behavior is changing. This was the case here, as the patient remained immunocompetent.

Epidemiología de la enfermedad de Kienböck / Epidemiology in Kienböck´s disease

La necrosis del semilunar presenta un curso progresivo queevoluciona hacia una artrosis dentro de un plazo variable. Elinicio de la enfermedad no es claramente identificable, perolos pacientes presentan características similares en elmomento de su diagnóstico.Presentamos los datos epidemiológicos de 20 pacientes tratadospor enfermedad de Kienböck en nuestra Unidad deCirugía de la Mano y se comparan con los obtenidos enotras series publicadas

The necrosis of the lunate is a progressive disease thatwith time will eventually evolve into osteoarthritis.The origin of the disease is not easy to identify but atdiagnosis, patients present with similar characteristics.We present the epidemiological data of 20 Kienböckdisease patients treated at our Hand Unit, and we comparethem with other cases published

Intervención de terapia ocupacional en prevención y tratamiento de obesidad y diabetes mellitus tipo II: nunca pensamos que era algo más que una dieta1 / O.T. intervention for prevention and treatment of obesity and diabetes: we never thought was more than a diet

El presente artículo muestra la experiencia de intervención de Terapia Ocupacional con personas Obesas y Pre Diabéticas, realizado en un Centro de Salud Familiar de la Comuna El Bosque. La experiencia se enmarca dentro de un Programa de Intervención Integral, para personas con Obesidad y Pre Diabetes, financiado por el Fondo Nacional de la Salud FONASA y desarrollado como una experiencia piloto en cinco establecimientos de salud durante el año 2004 Y 2005, experiencia que por sus resultados en el presente año, está siendo implementada a lo largo de todo Chile. La intervención, que considera el abordaje integral de las patologías antes señaladas, es llevada a cabo por un equipo multiprofesional compuesto por: Nutricionista, Médico, Terapeuta Ocupacional, Kinesiólogo y Auxiliar Paramédico. La experiencia en la práctica fue desarrollada por una Terapeuta Ocupacional, miembro del equipo del Centro de Salud Familiar y docente de la Universidad Andrés Bello, y cuatro alumnas en práctica de la Carrera de Terapia Ocupacional, de la misma casa de estudios, quienes realizaron intervenciones individuales y grupales por espacio de 10 meses, entre Julio de 2004 y Abril de 2005.Lo que se presenta en este artículo, así como el análisis y reflexiones que de éste surgen, constituyen un espacio innovador y pionero para la Terapia Ocupacional como disciplina y abren un camino para la inserción del Terapeuta Ocupacional en la prevención y tratamiento de patologías crónicas, así como la promoción de la salud en la atención primaria.

The present article is about the experience of working in Occupational Therapy with fat and pre-diabetic people, carried out in a Family Health Center in El Bosque commune. This knowledge is applied to a program of integral intervention to pre-diabetic and fat people, subsidized by FONASA National Funds of Health and realized as a pilot experience in five different establishment of health between 2004 and 2005. For its excellent results this experience in the current year is being applied to others communes of our country. The intervention that considers the complete attention of the pathologies before mentioned is performances by a multiprofessional team integrated by Nutritionist, Doctors, Occupational Therapist, Kinesyologist and Paramedical Assistant.Interventions that, in the practice were developed by an Occupational Therapists member of the team of the Family Health Center and teacher from Andres Bello University, and four students making practicing in the occupational therapy career from the some establishment, who carried out individual and group interventions approximately ten months between July 2004 and April 2005.The analysis and reflections we can observe in this paper constitute an innovative and pioneer space for the occupational therapy as a discipline, in the prevention and treatment of the chronic pathologies, and to the health promotion in the primary attention.

Ovine serum and pituitary isoforms of luteinising hormone during the luteal phase.

The relative abundance of the different isoforms of pituitary and circulating luteinising hormone (LH) in ewes, at different times after the administration of gonadotrophin-releasing hormone (GnRH), during the luteal phase of the oestrous cycle was investigated. Sixteen ewes on Day 9 of their cycle were divided into four groups (n = 4). The control group (T0) received saline solution; the remaining animals received 100 microg GnRH (i.m.) 30, 90 or 180 min (T30, T90 and T180, respectively) before serum and pituitary gland collection. Luteinising hormone polymorphism was analysed by chromatofocusing (pH 10.5-3.5). The LH eluted from each chromatofocusing was grouped on the basis of the following three criteria: (1) according to the pH of elution (pH > or = 10-3.5); (2) as either a basic (pH > or = 7.5), neutral (pH 7.4-6.5) and acidic (pH < or = 6.4) elution of LH of serum and hypophyseal origin; and (3) on the basis of distinct isoforms, of which 10 (A-J) were identifiable in hypophyseal extracts and four (A-D) were found in the serum. In general, the most abundant forms of LH in both the pituitary and serum, at all times, were basic. However, that proportion was greater in hypophyseal extracts (84 +/- 3%, 81 +/- 4%, 82 +/- 3% and 83 +/- 2% at T0, T30, T90 and T180, respectively) than in serum (51 +/- 5%, 48 +/- 10% and 54 +/- 6% at T30, T90 and T180, respectively). Neutral and acidic LH made up a larger proportion of the total LH in sera (neutral: 17 +/- 4%, 20 +/- 6% and 23 +/- 3% at T30, T90 and T180, respectively; acidic: 32 +/- 8%, 32 +/- 11% and 23 +/- 6% at T30, T90 and T180, respectively) than in the pituitary extracts (neutral: 4.0 +/- 0.7%, 10 +/- 4%, 7 +/- 2% and 5.0 +/- 0.5% at T0, T30, T90 and T180, respectively; acidic: 12 +/- 3%, 11 +/- 2%, 12 +/- 2% and 12 +/- 2% at T0, T30, T90 and T180, respectively) at all times. These data reveal that the relative composition of the LH present in the pituitary gland and the LH secreted into the circulation is different, with more neutral and acidic isoforms being secreted. The pattern of circulating LH isoforms changes between 30 and 180 min after GnRH peak induction, with a greater proportion of isoform C (eluting between pH 7.0 and 6.5) at T180 compared with T30 and T90.