Perspectiva quirúgica del aparato digestivo : cirugía programada y de urgencia

[ES]Inmersos en pleno siglo XXI, es necesario mantener la capacidad de descubrimiento continuo en ciencias básicas. La investigación proporciona los fundamentos de nuestro conocimiento científico; el reto del futuro será trasladar ese conocimiento para expandir las capacidades de la práctica diaria, lo que permitirá trasladar los nuevos descubrimientos a la práctica clínica, evaluar las prácticas clínicas actuales y contestar a lo que se debe y no se debe hacer en Medicina: los pacientes son el comienzo del final de un proceso de descubrimiento. A través de este trabajo, se pretende plasmar una perspectiva quirúrgica del Aparato Digestivo en un Hospital Comarcal del Sistema Nacional de Salud y realizar una puesta a punto del tema, justificando las patologías quirúrgicas más frecuentes durante un período de 5 años (2009 al 2013). La función investigadora del Especialista en Cirugía General y del Aparato Digestivo, es necesaria, sin el menoscabo de la función asistencial. La revisión de datos, llevará a un nuevo aprendizaje, y los frutos que produzcan irán siempre dirigidos al beneficio de los pacientes a los que tratamos. La existencia de una enorme variabilidad no justificada en la práctica clínica (variación en las pautas clínicas) se debe a múltiples motivos, como son: la ausencia de evidencia científica suficiente en muchas de las actividades asistenciales, desconocimiento de algunos de nuestros resultados de la práctica clínica, la ausencia de protocolos de actuación… Todo ello impide la existencia de normas claras de actuación y da lugar a que se perpetúen hábitos, muchas veces no suficientemente fundamentados. La gestión de calidad, facilita en gran medida la disminución de dicha variabilidad, ya que impulsará el establecimiento de pautas de actuación, así como el conocimiento del resultado de los procesos. El término proceso define al conjunto de actividades secuenciales que transforman cierta “materia prima”(en la clínica es el paciente enfermo) en un elemento modificado al que se ha añadido un valor (paciente mejorado o curado, habitualmente). En el ámbito quirúrgico existe gran cantidad de procesos: hernia inguinal, colelitiasis, cáncer gástrico, cáncer de mama... Dentro de estos procesos, se incluyen aspectos estrictamente clínicos, como el diagnóstico y la propia intervención quirúrgica. El estudio de estos procesos en nuestro medio, permite averiguar si los cuidados son satisfactorios para mejorar la atención sanitaria y evitar la variabilidad en la asistencia prestada

The MicroRNA390/TAS3 Pathway Mediates Symbiotic Nodulation and Lateral Root Growth

Legume roots form two types of postembryonic organs, lateral roots and symbiotic nodules. Nodule formation is the result of the interaction of legumes with rhizobia and requires the mitotic activation and differentiation of root cells as well as an independent, but coordinated, program that allows infection by rhizobia. MicroRNA390 (miR390) is an evolutionarily conserved microRNA that targets the Trans-Acting Short Interference RNA3 (TAS3) transcript. Cleavage of TAS3 by ARGONAUTE7 results in the production of trans-acting small interference RNAs, which target mRNAs encoding AUXIN RESPONSE FACTOR2 (ARF2), ARF3, and ARF4. Here, we show that activation of the miR390/TAS3 regulatory module by overexpression of miR390 in Medicago truncatula promotes lateral root growth but prevents nodule organogenesis, rhizobial infection, and the induction of two key nodulation genes, Nodulation Signaling Pathway1 (NSP1) and NSP2. Accordingly, inactivation of the miR390/TAS3 module, either by expression of a miR390 target mimicry construct or mutations in ARGONAUTE7, enhances nodulation and rhizobial infection, alters the spatial distribution of the nodules, and increases the percentage of nodules with multiple meristems. Our results revealed a key role of the miR390/TAS3 pathway in legumes as a modulator of lateral root organs, playing opposite roles in lateral root and nodule development.Facultad de Ciencias Exacta

A phylogenetically conserved group of nuclear factor-Y transcription factors interact to control nodulation in legumes

The endosymbiotic association between legumes and soil bacteria called rhizobia leads to the formation of a new root-derived organ called the nodule in which differentiated bacteria convert atmospheric nitrogen into a form that can be assimilated by the host plant. Successful root infection by rhizobia and nodule organogenesis require the activation of symbiotic genes that are controlled by a set of transcription factors (TFs). We recently identified Medicago truncatula nuclear factor-YA1 (MtNF-YA1) and MtNF-YA2 as two M. truncatula TFs playing a central role during key steps of the Sinorhizobium meliloti-M. truncatula symbiotic interaction. NF-YA TFs interact with NF-YB and NF-YC subunits to regulate target genes containing the CCAAT box consensus sequence. In this study, using a yeast two-hybrid screen approach, we identified the NF-YB and NF-YC subunits able to interact with MtNF-YA1 and MtNF-YA2. In yeast (Saccharomyces cerevisiae) and in planta, we further demonstrated by both coimmunoprecipitation and bimolecular fluorescence complementation that these NF-YA, -B, and -C subunits interact and form a stable NF-Y heterotrimeric complex. Reverse genetic and chromatin immunoprecipitation-PCR approaches revealed the importance of these newly identified NF-YB and NF-YC subunits for rhizobial symbiosis and binding to the promoter of MtERN1 (for Ethylene Responsive factor required for Nodulation), a direct target gene of MtNF-YA1 and MtNF-YA2. Finally, we verified that a similar trimer is formed in planta by the common bean (Phaseolus vulgaris) NF-Y subunits, revealing the existence of evolutionary conserved NF-Y protein complexes to control nodulation in leguminous plants. This sheds light on the process whereby an ancient heterotrimeric TF mainly controlling cell division in animals has acquired specialized functions in plants.Instituto de Biotecnologia y Biologia Molecula

ACADÉMICAS MEXICANAS FRENTE A LA PANDEMIA. MIRADAS DESDE LA AUTOETNOGRAFÍA

The arrival of the pandemic caused by the CORONA 19 virus disrupted our lives and impacted on our academic work. Our Seminar, founded in 2014, which promptly met every month in the Centro de Investigaciones y Estudios Superiores en Antropología Social (CIESAS), was temporarily interrupted, When we resumed it on line, we realized that we needed to express the accumulation of emotions that each of us harbored. We decided to reorient our program of group work and write short texts, of an autoethnographic nature that would reveal our particular experiences in this historical moment of our lives. This text is the result of this collective exercise.   Keywords: CORONA19, pandemic, autoethnography, personal stories, México.  La llegada de la pandemia, causada por el COVID 19, trastocó nuestras vidas e impactó nuestro trabajo académico.  El Seminario de Narrativa del Centro de Investigaciones y Estudios en Antropología Social (CIESAS), -fundado en 2014-, donde puntualmente nos reuníamos cada mes,  se vio interrumpido temporalmente y, cuando lo retomamos de forma virtual, surgió la necesidad de expresar el cúmulo de emociones que anidaba en cada una de sus integrantes. Decidimos reorientar el trabajo grupal y redactar textos breves, de corte autoetnográfíco, que dieran cuenta de nuestras vivencias particulares en esta etapa histórica de nuestras vidas. Este texto colectivo es el resultado de dicho ejercicio. Palabras clave: COVID, pandemia, autoetnografía, relatos personales, México.A chegada da pandemia, causada pelo COVID 19, transtornou nossas vidas e impactou nosso trabalho acadêmico. O Seminário de Narrativa do Centro de Investigações e Estudos em Antropologia Social (CIESAS), fundado em 2014, onde potualmente nos reuníamos cada mês, se viu  interrompido temporariamente e, quando o retomamos de forma virtual, suegiu a necessidade de expressar o cúmulo de emoçoes que inundava cada uma de seus integrantes. Decidimos reorientar o trabalho grupal e redatar textos breves, de corte autoetnográfico, que deram conta de nostas vivências particulares nesta etapa histórica de nossas vidas. Este texto coletivo é o resultado do exercício. Palavras-Chave: COVID, pandemia, autoetnografia, relatos pessoais, México. &nbsp

The MicroRNA390/TAS3 Pathway Mediates Symbiotic Nodulation and Lateral Root Growth

Legume roots form two types of postembryonic organs, lateral roots and symbiotic nodules. Nodule formation is the result of the interaction of legumes with rhizobia and requires the mitotic activation and differentiation of root cells as well as an independent, but coordinated, program that allows infection by rhizobia. MicroRNA390 (miR390) is an evolutionarily conserved microRNA that targets the Trans-Acting Short Interference RNA3 (TAS3) transcript. Cleavage of TAS3 by ARGONAUTE7 results in the production of trans-acting small interference RNAs, which target mRNAs encoding AUXIN RESPONSE FACTOR2 (ARF2), ARF3, and ARF4. Here, we show that activation of the miR390/TAS3 regulatory module by overexpression of miR390 in Medicago truncatula promotes lateral root growth but prevents nodule organogenesis, rhizobial infection, and the induction of two key nodulation genes, Nodulation Signaling Pathway1 (NSP1) and NSP2. Accordingly, inactivation of the miR390/TAS3 module, either by expression of a miR390 target mimicry construct or mutations in ARGONAUTE7, enhances nodulation and rhizobial infection, alters the spatial distribution of the nodules, and increases the percentage of nodules with multiple meristems. Our results revealed a key role of the miR390/TAS3 pathway in legumes as a modulator of lateral root organs, playing opposite roles in lateral root and nodule development.Facultad de Ciencias Exacta

Uso de lanreotida en combinación con cabergolina o pegvisomant en la práctica clínica en pacientes con acromegalia: el estudio ACROCOMB

[Abstract] PURPOSE: To describe real-world use of lanreotide combination therapy for acromegaly. PATIENTS AND METHODS: ACROCOMB is a retrospective observational Spanish study of patients with active acromegaly treated with lanreotide combination therapy between 2006 and 2011. 108 patients treated at 44 Spanish Endocrinology Departments were analyzed separately: 61 patients received lanreotide/cabergoline (cabergoline cohort) and 47 lanreotide/pegvisomant (pegvisomant cohort). RESULTS: Patient median age was 50.8 years in the cabergoline cohort and 42.7 years in the pegvisomant cohort. Prior medical treatments were somatostatin analogue (SSA) monotherapy (40 [66%] patients) or dopamine agonists (7 [11%] patients) in the cabergoline cohort and SSA (29 [62%] patients) or pegvisomant monotherapy (16 [34%] patients) in the pegvisomant cohort. Across both cohorts 12 patients were previously untreated, and prior therapy was unknown/missing in 4 patients. Median duration of combined treatment was 1.6 years (0.1-6) and 2.1 years (0.4-6.3) in the cabergoline and pegvisomant cohorts, respectively. At baseline, median insulin growth factor (IGF)-I values were 149% upper limit of normal (ULN) (15-505%) in the cabergoline cohort and 156% ULN (15-534%) in the pegvisomant cohort, and decreased to 104% ULN (13-557%) p<0.001 and 86% ULN (23-345%) p<0.0001, respectively, at end of study (EOS). Normal age-adjusted values of IGF-I were obtained in 48% of lanreotide/cabergoline-treated patients and 70% of lanreotide/pegvisomant-treated patients at EOS. There were no significant changes in hepatic, cardiac or glycaemic parameters in either cohort. CONCLUSION: In clinical practice lanreotide treatment combinations are useful options for patients with acromegaly when monotherapy is insufficient; particularly, the combination of lanreotide and pegvisomant in patients not controlled with either SSA or pegvisomant alone has high efficacy and is well-tolerated.[Resumen] Propósito: Describir el uso de lanreotida en combinación terapéutica en acromegalia en la práctica clínica. Pacientes y métodos: ACROCOMB es un estudio observacional, retrospectivo, de pacientes con acromegalia activa tratados en centros hospitalarios españoles con lanreotida en combinación con cabergolina o pegvisomant entre 2006 y 2011. Se revisaron los datos clínicos de 108 pacientes tratados en 44 departamentos de endocrinología: 61 pacientes recibieron lanreótido/cabergolina (cohorte cabergolina) y 47 lanreotida/pegvisomant (cohorte pegvisomant). Resultados: La edad mediana de los pacientes fue de 50,8 años en la cohorte de cabergolina y 42,7 años en la de pegvisomant. Los tratamientos médicos previos a la combinación con lanreótido fueron análogos de somatostatina (SSA) en monoterapia (40 [66%] pacientes) o agonistas de la dopamina (7 [11%] pacientes) en la cohorte de cabergolina y SSA (29 [62%] pacientes) y pegvisomant en monoterapia (16 [34%] pacientes) en la de pegvisomant. Doce pacientes no habían recibido tratamiento previo y en 4 pacientes se desconocía la terapia previa. La mediana de duración del tratamiento fue de 1,6 años (0,1-6) y 2,1 años (rango 0,4 a 6,3) en las cohortes de cabergolina y pegvisomant, respectivamente. Al inicio del estudio el valor mediano del factor de crecimiento de insulina-I era 149% el límite superior normal (LSN) (15-505%) en la cohorte de cabergolina y 156% LSN (15-534%) en la de pegvisomant. Al final del estudio se redujeron a 104% LSN (13-557%) p < 0,001 y 86% LSN (23-345%) p < 0,0001, respectivamente. Al final del estudio, se reportaron valores normales de factor de crecimiento de insulina-I ajustados por edad en el 48% de los pacientes tratados con lanreotida/cabergolina y 70% de los tratados con lanreotida/pegvisomant. No hubo cambios significativos en los parámetros hepáticos, cardíacos o glucémicos. Conclusión: En la práctica clínica las combinaciones con lanreotida son una opción útil en el tratamiento de pacientes con acromegalia que no está bien controlada en monoterapia, ya sea con SSA carbegolina o pegvisomant; particularmente, la combinación de lanreotida y pegvisomant tiene una alta eficacia y se tolera bien

Acceleration of the DNA methylation clock among lynch syndrome‑associated mutation carriers

The research leading to these results has received funding from "la Caixa" Foundation (Ref: CAIXA2017/1) for library preparation, sequencing, and employment of research personnel, from The Fundacion Progreso y Salud, Junta de Andalucia, Spain and from DPI2017-84439-R of MINECO, Madrid and FEDER for sequencing and employment of research personnel. Finally, grant ref. A-BIO-470-UGR20 from University of Granada and FEDER has funded article processing charges (APC) and sample processing expenses.Background: DNA methylation (DNAm) age metrics have been widely accepted as an epigenetic biomarker for biological aging and disease. The purpose of this study is to assess whether or not individuals carrying Lynch Syndromeassociated mutations are affected in their rate of biological aging, as measured by the epigenetic clock. Methods: Genome-wide bisulfite DNA sequencing data were generated using DNA from CD4 + T-cells obtained from peripheral blood using 27 patient samples from Lynch syndrome families. Horvath’s DNAm age model based on penalized linear regression was applied to estimate DNAm age from patient samples with distinct clinical and genetic characteristics to investigate cancer mutation-related aging effects. Results: Both Lynch mutation carriers and controls exhibited high variability in their estimated DNAm age, but regression analysis showed steeper slope for the Lynch mutation carriers. Remarkably, six Lynch Syndrome-associated mutation carriers showed a strong correlation to the control group, and two sisters carrying Lynch Syndrome-associated mutations, with no significant difference in lifestyle and similar chronological age, were assigned very different DNAm age. Conclusions: Future studies will be required to explore, in larger patient populations, whether specific epigenetic age acceleration is predictive of time-to-cancer development, treatment response, and survival. Epigenetic clock DNAm metrics may be affected by the presence of cancer mutations in the germline, and thus show promise of potential clinical utility for stratified surveillance strategies based on the relative risk for imminent emergence of tumor lesions in otherwise healthy Lynch Syndrome-associated mutation carriers.La Caixa Foundation CAIXA2017/1Junta de AndaluciaSpanish Government DPI2017-84439-REuropean CommissionUniversity of Granada A-BIO-470-UGR2

Genetic complexity impacts the clinical outcome of follicular lymphoma patients

© The Author(s) 2021.Follicular lymphoma (FL) is the second most common non-Hodgkin lymphoma (NHL, 20–30%) after diffuse large B-cell lymphoma (DLBCL). Despite the introduction of rituximab and the high response rate to first-line treatment, approximately 20% of the FL patients relapse or progress within 2 years of receiving first-line therapy. Therefore, the major challenge is finding biomarkers that identify high-risk patients at diagnosis.This work was partially supported by the Instituto de Salud Carlos III (ISCIII), Spanish Ministry of Economy and Competitiveness PI15/01393, PI18/00410, CIBERONC-CB16/12/00233, and “Una manera de hacer Europa” (Innocampus; CEI-2010-1-0010)”, the Education Council or Health Council of the Junta de Castilla y León (CAS102P17, GRS 1180/A/15), Spanish Association Against Cancer (AECC; PROYE18020BEA), and Gilead Sciences (GLD17/00334). CJ, MES, and AMe are supported by the ISCII (CD19/00030, CPII18/00028, and FI19/00320). MGA, IPC, and CJ were supported by the Spanish Society of Hematology Foundation (FEHH). All Spanish funding is co-sponsored by the European Union FEDER program

A phylogenetically conserved group of nuclear factor-Y transcription factors interact to control nodulation in legumes

The endosymbiotic association between legumes and soil bacteria called rhizobia leads to the formation of a new root-derived organ called the nodule in which differentiated bacteria convert atmospheric nitrogen into a form that can be assimilated by the host plant. Successful root infection by rhizobia and nodule organogenesis require the activation of symbiotic genes that are controlled by a set of transcription factors (TFs). We recently identified Medicago truncatula nuclear factor-YA1 (MtNF-YA1) and MtNF-YA2 as two M. truncatula TFs playing a central role during key steps of the Sinorhizobium meliloti-M. truncatula symbiotic interaction. NF-YA TFs interact with NF-YB and NF-YC subunits to regulate target genes containing the CCAAT box consensus sequence. In this study, using a yeast two-hybrid screen approach, we identified the NF-YB and NF-YC subunits able to interact with MtNF-YA1 and MtNF-YA2. In yeast (Saccharomyces cerevisiae) and in planta, we further demonstrated by both coimmunoprecipitation and bimolecular fluorescence complementation that these NF-YA, -B, and -C subunits interact and form a stable NF-Y heterotrimeric complex. Reverse genetic and chromatin immunoprecipitation-PCR approaches revealed the importance of these newly identified NF-YB and NF-YC subunits for rhizobial symbiosis and binding to the promoter of MtERN1 (for Ethylene Responsive factor required for Nodulation), a direct target gene of MtNF-YA1 and MtNF-YA2. Finally, we verified that a similar trimer is formed in planta by the common bean (Phaseolus vulgaris) NF-Y subunits, revealing the existence of evolutionary conserved NF-Y protein complexes to control nodulation in leguminous plants. This sheds light on the process whereby an ancient heterotrimeric TF mainly controlling cell division in animals has acquired specialized functions in plants.Instituto de Biotecnologia y Biologia Molecula