Seguimiento de áreas cruentas cubiertas con queratinocitos autólogos cultivados en suero autólogo: Estudio multicéntrico en Bogotá

En 2009 se presento la estandarización de cultivos de queratinocitos autólogos cultivados en suero autólogo. En este estudio los autores describen la efectividad de estos parches de regeneración de piel, para la cobertura de áreas cruentas con indicación de injerto de piel parcial. El porcentaje de epitelización del área cruenta fue el punto principal. \ud Métodos: 47 pacientes fueron incluidos consecutivamente, equivalentes a 78 áreas cruentas. Las áreas fueron estratificadas según la profundidad: grupo 1:IIA (n=8) grupo 2: IIB (n=39); grupo 3,III (n=24) y grupo 4, etiología diferente: Otras (n=7). Todas las áreas fueron tratadas con injertos de queratinocitos autólogos cultivados en suero autólogo y se realizo registro fotográfico y del porcentaje de epitelización al día 5, 7, 15 y 30. \ud Resultados: La efectividad de los injertos de queratinocitos autólogos es de 53.16% ± 46.46%. El porcentaje de epitelización es mayor para el grupo 1 (100%) y grupo 2 (62.79%) que para el grupo 3 (27.57%) y el grupo 4 (33.86%). Se encontró relación entre la interacción de las medianas del porcentaje de epitelización entre área corporal y grado de quemadura (p<0.001 KW) siendo mayor para el grupo 1 en todas las áreas, grupo 2 en cara, grupo 3 en tronco y grupo 4 en cara; y el menor porcentaje de epitelización en el grupo 3 y grupo 4 de las áreas ubicadas tronco.\ud Conclusión: Los injertos de queratinocitos autólogos cultivados en suero autólogo son un método de cobertura eficaz para áreas cruentas producidas por quemaduras IIA y IIB independientemente del tamaño y la localización , y para las áreas cruentas pequeñas (<9cm2) de etiología diferente o grado III de profundidad.\ud Palabras Clave: Cultivo queratinocitos, cobertura áreas cruentas, efectividad.Recursos PropiosIntroduction: In 2009 took place the standardization of the culture of autologous keratinocytes cultured in autologous serum. In this study the authors describe the effectiveness of these patches of regeneration of skin, for the coverage of bloody areas with indication of partial skin graft. The percentage of epithelialization of the bloody area was the main point. \ud Methods: 47 patients were consecutively included, equivalent to 78 bloody areas. The areas were stratified according to depth: group 1: IIA (n=8) group 2: IIB (n=39); group 3:III (n=24) and group 4, different etiology: Other (n=7). All the areas were treated with grafts of autologous keratinocytes cultured in autologous serum and photographic record of the epithelialization percentage was carried out on days 5th , 7th, 15th and 30th. \ud Results: The effectiveness of the autologous keratinocytes grafts is 53.16% ± 46.46%. The epithelialization percentage is greater for groups 1 (100%) and 2 (62.79%) than for groups 3 (27.57%) and 4 (33.86%). A relation was found between the interaction of the medium percentage of epithelialization between the body area and degree of burn (p<0.001 KW) being greater for group 1 on all body areas, group 2 on face, group 3 on trunk and group 4 on face; and the lower percentage of epithelialization in groups 3 and 4 for the areas on the trunk.\ud Conclusion: The grafts of autologous keratinocytes cultured in autologous serum are an effective method of coverage for bloody areas due to burns IIA and IIB regardless of size and location, and for the small bloody areas (<9cm2) of different etiology or degree III of depth.\ud Key words: Keratinocytes culture, coverage bloody areas, effectiveness

The remains of the day in dissociative amnesia

Staniloiu A, Markowitsch HJ. The remains of the day in dissociative amnesia. Brain Sciences. 2012;2(4):101-129.Memory is not a unity, but is divided along a content axis and a time axis, respectively. Along the content dimension, five long-term memory systems are described, according to their hierarchical ontogenetic and phylogenetic organization. These memory systems are assumed to be accompanied by different levels of consciousness. While encoding is based on a hierarchical arrangement of memory systems from procedural to episodic-autobiographical memory, retrieval allows independence in the sense that no matter how information is encoded, it can be retrieved in any memory system. Thus, we illustrate the relations between various long-term memory systems by reviewing the spectrum of abnormalities in mnemonic processing that may arise in the dissociative amnesia—a condition that is usually characterized by a retrieval blockade of episodic-autobiographical memories and occurs in the context of psychological trauma, without evidence of brain damage on conventional structural imaging. Furthermore, we comment on the functions of implicit memories in guiding and even adaptively molding the behavior of patients with dissociative amnesia and preserving, in the absence of autonoetic consciousness, the so-called “internal coherence of life”