The critical role of innate immunity in kidney transplantation

For a long time now, kidney transplant rejection has been considered the consequence of either cellular or antibody-mediated reaction as a part of adaptive immunity response. The role of innate immunity, on the other hand, had been unclear for many years and was thought to be only ancillary. There is now consistent evidence that innate immune response is a condition necessary to activate the machinery of rejection. In this setting, the communication between antigen-presenting cells and T lymphocytes is of major importance. Indeed, T cells are unable to cause rejection if innate immunity is not activated. This field is currently being explored and several experiments in animal models have proved that blocking innate immunity activation can promote tolerance of the graft instead of rejection. The aim of this review is to systematically describe all the steps of innate immunity response in kidney transplant rejection, from antigen recognition to T-cells activation, with a focus on clinical consequences and possible future perspectives

Medical Aspects of mTOR Inhibition in Kidney Transplantation

The advances in transplant immunosuppression have reduced substantially the incidence of kidney graft rejection. In recent years, the focus has moved from preventing rejection to preventing the long-term consequences of long-standing immunosuppression, including nephrotoxicity induced by calcineurin inhibitors (CNI), as well as infectious and neoplastic complications. Since the appearance in the late 1990s of mTOR inhibitors (mTORi), these unmet needs in immunosuppression management could be addressed thanks to their benefits (reduced rate of viral infections and cancer). However, management of side effects can be troublesome and hands-on experience is needed. Here, we review all the available information about them. Thanks to all the basic, translational and clinical research achieved in the last twenty years, we now use mTORi as de novo immunosuppression in association with CNI. Another possibility is represented by the conversion of either CNI or mycophenolate (MPA) to an mTORi later on after transplantation in low-risk kidney transplant recipients. © 2022 by the authors

Bone Mineral Disease After Kidney Transplantation

Chronic kidney disease-mineral bone disorder (CKD-MBD) after kidney transplantation is a mix of pre-existing disorders and new alterations. The final consequences are reflected fundamentally as abnormal mineral metabolism (hypercalcemia, hypophosphatemia) and bone alterations [high or low bone turnover disease (as fibrous osteitis or adynamic bone disease), an eventual compromise of bone mineralization, decrease bone mineral density and bone fractures]. The major cause of post-transplantation hypercalcemia is the persistence of severe secondary hyperparathyroidism, and treatment options include calcimimetics or parathyroidectomy. On turn, hypophosphatemia is caused by both the persistence of high blood levels of PTH and/or high blood levels of FGF23, with its correction being very difficult to achieve. The most frequent bone morphology alteration is low bone turnover disease, while high-turnover osteopathy decreases in frequency after transplantation. Although the pathogenic mechanisms of these abnormalities have not been fully clarified, the available evidence suggests that there are a number of factors that play a very important role, such as immunosuppressive treatment, persistently high levels of PTH, vitamin D deficiency and hypophosphatemia. Fracture risk is four-fold higher in transplanted patients compared to general population. The most relevant risk factors for fracture in the kidney transplant population are diabetes mellitus, female sex, advanced age (especially > 65 years), dialysis vintage, high PTH levels and low phosphate levels, osteoporosis, pre-transplant stress fracture and high doses or prolonged steroids therapy. Treatment alternatives for CKD-MBD after transplantation include minimization of corticosteroids, use of calcium and vitamin D supplements, antiresorptives (bisphosphonates or Denosumab) and osteoformers (synthetic parathyroid hormone). As both mineral metabolism and bone disorders lead to increased morbidity and mortality, the presence of these changes after transplantation has to be prevented (if possible), minimized, diagnosed, and treated as soon as possible.info:eu-repo/semantics/publishedVersio

Identidad corporativa

El tema del presente trabajo es identidad Corporativa y el objetivo es poder evidenciar lo importante que es la identidad en las empresas en estos tiempos. La Identidad Corporativa es una estrategia expansiva de la marca, y una estrategia absoluta de comunicación. Es el reflejo de la empresa en su totalidad. Siendo un activo valioso ligado estrechamente al plan de negocio y al mercado que se desea atender. Está compuesta por tres elementos importantes y fundamentales: branding, comunicación y cultura corporatuva. La metodología de investigación es descriptiva y la investigación se realizó sobre una empresa mendocina llamada Durang S.R.L. dedicada a la elaboración, producción y fraccionamiento de productos encurtidos y aceitunas. Los resultados de la investigación mostraron y dejaron en evidencia que la empresa tiene una vocación al cliente y focalizada en la calidad de los productos, desarrollando su Identidad Corporativa desde hace años, y con permanentes cambios en el diseño de packaging de sus líneas de productos adaptándose a los mercados dinámicos. Como conclusión final notamos que la empresa tiene una trayectoria de 35 años que fortalece su cultura y filosofía corporativa, y que acompaña una eficiente comunicación a sus públicos, debiendo mejorar sus acciones en la publicidad la cual tiene bajo alcance. Otra conclusión destacada y como debilidad de la empresa es que no cuenta con una característica distintiva y diferenciadora que la haga única o diferencia de sus competidores.Fil: Cucchiari, Claudio Fabián. Universidad Nacional de Cuyo. Facultad de Ciencias Económicas

Erdheim-Chester disease : from palliative care to targeted treatment

Erdheim-Chester disease (ECD) is a life-threatening multi-systemic non-Langerhans histiocytosis with cardiovascular complications as the leading cause of death. ECD affects the kidneys in up to 30% of cases, with fibrotic tissue deposition in the perirenal fat and renal hilum. Diagnosis is usually based on histological analysis of the pathologic tissue, which typically shows xanthogranulomatous infiltrates of foamy CD68+/CD1a-histiocytes surrounded by fibrosis. A consistent percentage of patients affected by ECD develop renal failure and hypertension as a consequence of renal artery stenosis and hydronephrosis. These conditions have been generally treated with the placement of stents and nephrostomies that frequently led to disappointing outcomes. Before the introduction of interferon-alpha (IFN\u3b1) treatment, the mortality rate was as high as 57% in the long term. Recent studies have granted new insights into the pathogenesis of ECD, which seems to bear a dual component of clonal and inflammatory disease. These advances led to use specific therapies targeting either the oncogenes (BRAFV600E) or the effectors of the immune response implicated in ECD (IL-1, TNF\u3b1). Drugs such as anakinra (recombinant human IL-1 receptor antagonist), infliximab (monoclonal antibody against TNF\u3b1) and vemurafenib (inhibitor of mutant BRAF) showed promising results in small single-centre series. Although larger trials will be needed to address the impact of these drugs on ECD prognosis and to select the most effective treatment, targeted therapies hold the premises to drastically change the outcome of this condition. \ua9 2014 The Author

McKittrick-Wheelock syndrome : a rare cause of acute renal failure and hypokalemia not to be overlooked

McKittrick-Wheelock syndrome is a rare disorder in which a colorectal tumor (usually a villous adenoma) determines secretory mucous diarrhea, which in turn leads to prerenal acute renal failure, hyponatremia, hypokalemia and metabolic acidosis. Even though the outcome is usually favorable with complete recovery after surgery, the diagnosis is often delayed, making the patient susceptible to life-threatening complications, mainly severe acidosis and hypokalemia. We present two paradigmatic cases with extreme electrolytes imbalance and complete recovery following the appropriate treatment. The pathogenesis of this degenerative condition is discussed in detail. \ua9 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted

Presencia de Aedes aegypti en predio de la Facultad de Ciencias Veterinarias y Escuela Agrotécnica Libertador Gral. San Martín de la Universidad Nacional de Rosario, año 2017

El Aedes aegypti (Ae. aegypti) es un insecto de gran relevancia para la salud pública, siendo el principal vector a nivel mundial de los virus del dengue, zika, chikungunya y fiebre amarilla. Con el objetivo de determinar la presencia del vector, mediante la colocación de ovitrampas, se llevó adelante un estudio observacional en el predio Facultad de Ciencias Veterinarias y Escuela Agrotécnica Libertador General San Martín situado en la ciudad de Casilda. Se procedió a la colocación de 13 ovitrampas en distintos puntos estratégicos, considerando para su selección los hábitos y las características del ciclo del vector, la cercanía a diferentes fuentes de agua, la presencia de animales de producción y de personas que frecuenten el lugar, así como la disposición de los edificios en el predio. Durante el estudio se visualizaron huevos en seis de las zonas muestreadas. Pudo reconocerse al Hospital Escuela de Grandes y Pequeños animales como el lugar prevalente de oviposturas. De manera global, el método que resultó más eficiente en todos los muestreos con captura, fue el que utilizó papel secante como superficie de adherencia para los huevos. El monitoreo vectorial presenta para las instituciones una herramienta capaz de prevenir y controlar la reproducción del mosquito, así como determinar los factores asociados a su desarrolloFil: Cucchiari, Paulo. Universidad Nacional de RosarioFil: Gay Melina V.. Universidad Nacional de RosarioFil: Faini, M. Cecilia. Universidad Nacional de Rosari

A educação dramática na formação inicial de professores e educadores

As atividades de Educação Dramática convocam uma diversidade de possibilidades expressivas. Integradas no currículo de formação inicial de professores e educadores, os projetos de criação dramática, orientados para a performance, implicam, no seu processo criativo, um envolvimento grupal que deverá constituir matéria suficiente de análise e de avaliação por parte dos seus intervenientes em relação à sua própria participação e às relações interpares. O paradigma metodológico orientador do processo dramático-teatral a que nos remetemos assenta num modelo construtivista do processo educacional. Pelo seu caráter explorativo e experimental, a aprendizagem dramático-teatral deverá ser sustentada em estratégias colaborativas entre professor e aluno, implicando, para tal, a possibilidade de tomada de decisões partilhadas, num ambiente de respeito e igualdade.The activities of Drama Education are open to a diversity of expressive possibilities. Integrated in the pre-service training curriculum for teachers and educators, the dramatic creation projects, oriented to performance, imply, in its creative process, a group involvement that should be sufficient matter of analysis and evaluation by those involved in relation to its own participation and relations between peers. The methodological guidance paradigm of the dramatic and theatrical process that guide us is based on a constructivist model of the educational process. Due its exploratory and experimental character, dramatic and theatrical learning should be based on collaborative strategies between teacher and student, implying, to this end, that decision-making possibilities could be shared in an environment of respect and equality.CIEC - Centro de Investigação em Estudos da Criança, IE, UMinho (UI 317 da FCT), Portugal. Fundos Nacionais através da FCT (Fundação para a Ciência e a Tecnologia) e cofinanciado pelo Fundo Europeu de Desenvolvimento Regional (FEDER) através do COMPETE 2020 – Programa Operacional Competitividade e Internacionalização (POCI) com a referência POCI-01-0145-FEDER-007562info:eu-repo/semantics/publishedVersio