Sobreexpresión del factor VIII, riesgo de trombosis y tratamiento / Overexpression of factor VIII: risk for thrombosis and treatment

Introducción: la trombosis venosa profunda (TVP) es una enfermedad multifactorial, la cual se ha relacionado con estados de hipercoagulabilidad, alteraciones del flujo sanguíneo y lesiones vasculares endoteliales. Se ha estimado una tasa de incidencia de 1 a 2 casos por mil habitantes año, y casi 2 millones de nuevos casos anuales en Estados Unidos. Existen factores de riesgo establecidos y las trombofilias parecen ocupar un lugar importante en su etiología y los estados de hipercoagulabilidad secundarios a niveles elevados de factor de coagulación VIII asociado a disfunción endotelial, y al incremento de adhesión plaquetaria confieren también una gran predisposición a la aparición de trombosis. Presentación del caso: paciente de 24 años de edad, sin antecedentes de importancia. Consulta por una masa indurada en región axilar derecha, que resultó ser TVP de la vena yugular externa, confluente yugulosubclavio, vena supraclavicular axilar y humeral con alto riesgo de embolización; a su vez se documentó tromboembolia pulmonar y se sospechó trombosis cerebral. La búsqueda de estados procoagulantes no arrojó ningún resultado, posteriormente se mide Factor VIII con sobreexpresión de 223% del valor normal y tras una revisión literaria del tratamiento documentada en el presente artículo se determina que el tratamiento más adecuado es warfarina

Introduction: Deep vein thrombosis (DVT) is a multifactorial medical condition that has been related to hypercoagulable states, alterations in blood flow and lesions in vessel endothelium. The incidence of DVT ranges between 1 and 2 cases per 1000 people and almost two million new cases per year in the United States. Some risk factors have been identified. Thrombophilias seem to play an important role in DVT etiology. Hypercoagulability states secondary to high blood coagulation factor VIII levels associated with endothelial dysfunction and increased platelet adhesion, pose a higher predisposition for thrombosis. Case report: we present the case of a 24-year-old male patient, with no relevant past history, who presented with an indurated mass in the right axillary region, which turned out to be a DVT of the external jugular vein, jugulo-subclavian confluence, supraclavicular, axillary and humeral veins with high risk of embolism. Pulmonary thromboembolism was documented and cerebral venous thrombosis was suspected. The search for procoagulant states yielded no results. Factor VIII levels were measured revealing an overexpression of factor VIII at 223% [normal range 50 ­ 200%]. A literature review determined warfarin to be the proper treatment

Impacto de las diferencias entre nativos e inmigrantes digitales en la enseñanza en las ciencias de la salud: revisión sistemática / Impact of the differences between digital natives and immigrants on health science teaching: a systematic review

Las tecnologías de la información y la comunicación han generado transformaciones en las relaciones entre nativos e inmigrantes digitales; por tanto, afectan el proceso de enseñanza y aprendizaje, ya que cada cual usa un lenguaje tecnológico diferente. El objetivo de este artículo es caracterizar a los nativos e inmigrantes digitales e identificar la influencia de la brecha digital en el ámbito educativo de ciencias de la salud. El método empleado fue una revisión sistemática de artículos científicos publicados desde el año 2014, en las bases de datos EBSCO, Google Scholar, Redalyc, Science direct, Scopus y Pubmed entre los meses de agosto y noviembre del año 2017. De 850 publicaciones encontradas, 60 estudios cumplieron con los criterios de inclusión. Con el fin de disminuir el impacto de la diferencia entre nativos e inmigrantes digitales en educación médica es importante promover la formación permanente de los profesores en el uso y en el manejo adecuado de las nuevas tecnologías, lo cual permite la generación de modelos pedagógicos y las estrategias de enseñanza más interactivas de acuerdo con las necesidades de futuros profesionales de la salud(AU)

Information and communication technologies have brought about transformations in the relationship between digital natives and immigrants. This has affected the teaching-learning process for digital natives and immigrants who use different technological languages. The purpose of the study was to characterize digital natives and immigrants, and identify the influence of the digital gap on health science teaching. A systematic review was conducted from August to November 2017 of scientific papers published in the databases EBSCO, Google Scholar, Redalyc, Science Direct, Scopus and PubMed since the year 2014. Of the 850 publications found, 60 met the inclusion criteria. In order to reduce the impact of the difference between digital natives and immigrants on medical education it is important to foster the permanent training of teachers in the use and adequate management of the new technologies. This will allow the generation of more interactive pedagogical models and teaching strategies in keeping with the needs of future health professionals(AU)

Impacto de las diferencias entre nativos e inmigrantes digitales en la enseñanza en las ciencias de la salud: revisión sistemática / Impact of the differences between digital natives and immigrants on health science teaching: a systematic review

Las tecnologías de la información y la comunicación han generado transformaciones en las relaciones entre nativos e inmigrantes digitales; por tanto, afectan el proceso de enseñanza y aprendizaje, ya que cada cual usa un lenguaje tecnológico diferente. El objetivo de este artículo es caracterizar a los nativos e inmigrantes digitales e identificar la influencia de la brecha digital en el ámbito educativo de ciencias de la salud. El método empleado fue una revisión sistemática de artículos científicos publicados desde el año 2014, en las bases de datos EBSCO, Google Scholar, Redalyc, Science direct, Scopus y Pubmed entre los meses de agosto y noviembre del año 2017. De 850 publicaciones encontradas, 60 estudios cumplieron con los criterios de inclusión. Con el fin de disminuir el impacto de la diferencia entre nativos e inmigrantes digitales en educación médica es importante promover la formación permanente de los profesores en el uso y en el manejo adecuado de las nuevas tecnologías, lo cual permite la generación de modelos pedagógicos y las estrategias de enseñanza más interactivas de acuerdo con las necesidades de futuros profesionales de la salud(AU)

Information and communication technologies have brought about transformations in the relationship between digital natives and immigrants. This has affected the teaching-learning process for digital natives and immigrants who use different technological languages. The purpose of the study was to characterize digital natives and immigrants, and identify the influence of the digital gap on health science teaching. A systematic review was conducted from August to November 2017 of scientific papers published in the databases EBSCO, Google Scholar, Redalyc, Science Direct, Scopus and PubMed since the year 2014. Of the 850 publications found, 60 met the inclusion criteria. In order to reduce the impact of the difference between digital natives and immigrants on medical education it is important to foster the permanent training of teachers in the use and adequate management of the new technologies. This will allow the generation of more interactive pedagogical models and teaching strategies in keeping with the needs of future health professionals(AU)

Endothelial differentiation of adipose tissue-derived mesenchymal stromal cells in glioma tumors: implications for cell-based therapy.

Multipotent human adipose tissue mesenchymal stromal cells (hAMSCs) are promising therapy vehicles with tumor-homing capacity that can be easily modified to deliver cytotoxicity activating systems in the proximity of tumors. In a previous work, we observed that hAMSCs are very effective delivering cytotoxicity to glioma tumors. However, these results were difficult to reconcile with the relatively few hAMSCs surviving implantation. We use a bioluminescence imaging (BLI) platform to analyze the behavior of bioluminescent hAMSCs expressing HSV-tTK in a U87 glioma model and gain insight into the therapeutic mechanisms. Tumor-implanted hAMSCs express the endothelial marker PECAM1(CD31), integrate in tumor vessels and associate with CD133-expressing glioma stem cells (GSC). Inhibition of endothelial lineage differentiation in hAMSCs by Notch1 shRNA had no effect on their tumor homing and growth-promoting capacity but abolished the association of hAMSCs with tumor vessels and CD133+ tumor cells and significantly reduced their tumor-killing capacity. The current strategy allowed the study of tumor/stroma interactions, showed that tumor promotion and tumor-killing capacities of hAMSCs are based on different mechanisms. Our data strongly suggest that the therapeutic effectiveness of hAMSCs results from their association with special tumor vascular structures that also contain GSCs.

Identification of male cardiomyocytes of extracardiac origin in the hearts of women with male progeny: male fetal cell microchimerism of the heart.

BACKGROUND: Fetal progenitor cells may cross the placenta during pregnancy, persist for decades in the maternal bloodstream, and find a microenvironment conducive to colonization in a variety of maternal solid organs. Whether extracardiac fetal progenitors are present in the heart of women with male issue is unknown. METHODS: The hearts from 2 non-pregnant women who had given birth to 2 and 3 male children, respectively, were studied. Myocardial specimens from 2 men and 2 women (without history of pregnancies) were used as controls. Real time polymerase chain reaction was performed to amplify the SRY gene located at the Y chromosome. Fluorescence in situ hybridization (FISH) with probes specific for X and Y chromosomes was combined with alpha-actin immunohistochemistry to identify cardiac muscle cells. Histocompatibility studies were conducted in both patients and their male relatives. RESULTS: The SRY gene was amplified in the myocardium of both patients. FISH analysis showed clear evidence of male cells with the typical cardiomyocyte phenotype within the myocardium. X- and Y-chromosome bodies in the nuclei were found in 0.25% and 0.20% of cells, respectively. Increased human leukocyte antigen compatibility was observed between patients and their sons. CONCLUSIONS: This study identified male cardiomyocytes of extracardiac origin, presumably fetal, in the hearts of 2 women with male progeny. Fetal progenitor cells may colonize the heart and under appropriate microenvironmental stimuli, differentiate into cardiomyocytes.