Visiones transversales de Puerto Rico y el Caribe

Con autorización de la editorial para este libro. La edición del libro estuvo a cargo de Beatriz Cruz Sotomayor y Félix R. Huertas González.Visiones transversales de Puerto Rico y el Caribe es producto de un proyecto internacional de investigación en el que han venido participando, por los pasados años, un grupo de historiadores y especialistas de diversas disciplinas en el área de los estudios caribeños. Como lo sugiere su título, el libro apuesta a la transversalidad como enfoque que permite explorar, desde múltiples perspectivas, la diversidad que ya de por sí implica la región caribeña y, en particular, la isla de Puerto Rico. Este persigue innovar en su metodología, marcos teóricos, perspectivas críticas y en una rica variedad de campos de estudio sobre Puerto Rico en el contexto del Caribe. Desde una diversidad de análisis, los ensayos transitan también un amplio espectro temático: esclavitud, urbanismo, ambiente, identidad, cultura, diáspora, economía, arte, literatura y política, entre otros.Connected Worlds: The Caribbean, Origin of the Modern World. Este proyecto ha recibido fondos del programa de investigación e innovación Horizon 2020 de la Unión Europea en virtud del acuerdo de subvención Marie Sklodowska-Curie Nº 823846. El proyecto está dirigido por la profesora Consuelo Naranjo Orovio del Instituto de Historia-CSIC.Peer reviewe

First World Consensus Conference on pancreas transplantation: Part II - recommendations.

Funder: Fondazione Pisa, Pisa, Italy; Id: http://dx.doi.org/10.13039/100007368Funder: Tuscany Region, Italy; Id: http://dx.doi.org/10.13039/501100009888Funder: Pisa University Hospital, Pisa, ItalyFunder: University of Pisa, Pisa, Italy; Id: http://dx.doi.org/10.13039/501100007514The First World Consensus Conference on Pancreas Transplantation provided 49 jury deliberations regarding the impact of pancreas transplantation on the treatment of diabetic patients, and 110 experts' recommendations for the practice of pancreas transplantation. The main message from this consensus conference is that both simultaneous pancreas-kidney transplantation (SPK) and pancreas transplantation alone can improve long-term patient survival, and all types of pancreas transplantation dramatically improve the quality of life of recipients. Pancreas transplantation may also improve the course of chronic complications of diabetes, depending on their severity. Therefore, the advantages of pancreas transplantation appear to clearly surpass potential disadvantages. Pancreas after kidney transplantation increases the risk of mortality only in the early period after transplantation, but is associated with improved life expectancy thereafter. Additionally, preemptive SPK, when compared to SPK performed in patients undergoing dialysis, appears to be associated with improved outcomes. Time on dialysis has negative prognostic implications in SPK recipients. Increased long-term survival, improvement in the course of diabetic complications, and amelioration of quality of life justify preferential allocation of kidney grafts to SPK recipients. Audience discussions and live voting are available online at the following URL address: http://mediaeventi.unipi.it/category/1st-world-consensus-conference-of-pancreas-transplantation/246

Neurobehavioral Effects of Levetiracetam in Brain Tumor Related Epilepsy

The neurobehavioral profile of antiepileptic drugs (AEDs) has been a recurrent research topic in the scientific literature. As pharmacological treatments for epilepsy continue to evolve, there is a general consensus that newer AEDs have less detrimental side effects in comparison to their older counterparts. Among newer AEDs and epilepsy patients, potential risk for neurobehavioral changes has been reported with levetiracetam. Conversely, limited data exists regarding the manifestation of this symptomatology in a subgroup of epilepsy patients with brain tumors. The current paper reviews the literature regarding the neurobehavioral profile of levetiracetam in brain-tumor related epilepsy and suggestions for future research will be discussed

Influence of portal blood on the development of systemic inflammation associated with experimental acute pancreatitis

The liver is a source of systemic proinflammatory mediators in acute pancreatitis. We have investigated the effects of blood from the pancreas and intestine in liver activation and lung inflammation during early stages of experimental acute pancreatitis in a rat model. A portosystemic shunt and a mesosystemic shunt were created to prevent the passage of blood coming from the pancreas and the intestine, respectively, to the liver. Pancreatitis was induced by retrograde injection of 5% sodium taurocholate into the biliopancreatic duct. After 3 hours, the inflammatory process in the lung and intestine, plasma levels of tumor necrosis factor (TNF)-α and their soluble receptor, and mRNA expression of inflammatory mediators in the lung were evaluated. Portocaval shunting of blood prevented the inflammatory process in the lung, an increase in plasma TNF-α concentration, and the expression of TNF-α, interleukin (IL)-1β, and heat-shock protein (HSP)-72 in the lung, but had no effect on plasma levels of soluble TNF-α receptor or on expression of inducible nitric oxide synthase (iNOS) and macrophage inflammatory protein (MIP)-2 in the lung. In contrast, mesocaval shunting of blood did not modify any of the parameters evaluated. Pancreatic blood, but not intestinal blood, plays a key role in liver activation during experimental acute pancreatitis.Supported by the 2001 Research Grant Program of the Hospital Clinic, University of Barcelona, and by FIS grant PI020286, and a grant from Institut d'Investigacions Biomèdiques August Pi i Sunyer (S.G.Peer Reviewe

Intestinal preconditioning is mediated by a transient increase in nitric oxide

The effect of ischemic preconditioning on the intestine, as well the implication of nitric oxide and prostacyclin in this process has been evaluated. Thus, intestinal ischemia-reperfusion was induced in rats, and the protection conferred by previous preconditioning was evaluated. In addition, the effect of nitric oxide inhibition and the administration of nitric oxide were determined. Results show that the increases observed in LDH release after ischemia-reperfusion were prevented after preconditioning. Inhibition of nitric oxide synthesis abolished the protective effect of preconditioning, and nitric oxide administration replicated this effect. Also, an increased synthesis of nitric oxide has been detected after preconditioning. Increases in 6 keto PGF(1α) were independent of nitric oxide. Altogether indicates that preconditioning is triggered by an initial increase in nitric oxide synthesis.This work was supported by Grant 95/1009 from the Fondo de Investigaciones SanitariasPeer Reviewe

Influencia del octreótido sobre la secreción exocrina pancreática después de la duodenopancreatectomía

Trabajo presentado en la XIII Reunión del Club Español Pancreático, celebrada en Alicante, España, del 19 al 21 de septiembre de 2013Peer Reviewe

Prospective randomized trial of the effect of octreotide on pancreatic juice output after pancreaticoduodenectomy in relation to histological diagnosis, duct size and leakage

Background Octreotide is generally administered based on the surgeon's interpretation of perceived risk for pancreatic fistula at the time of pancreaticoduodenectomy (PD). Methods A single-institution, prospective randomized trial was conducted between April 2009 and December 2011 involving 62 PD patients who were randomized to receive octreotide (100 μg subcutaneously every 8 h; n = 32) or placebo (n = 30). Pancreatic juice output was measured after the operation using a catheter inserted into the pancreatic duct. Postoperative complications were recorded. Results No significant differences in median output were found between the octreotide (82.5 ml) and placebo (77.5 ml) groups (P = 0.538). Median total output was significantly lower in patients with adenocarcinoma compared with those with periampullary tumours (P = 0.004) and in patients with a duct diameter of >5 mm compared with those with a duct diameter of <5 mm (P = 0.001). There were no significant differences in overall morbidity between the octreotide and placebo groups (P = 0.819). Grade B pancreatic fistula (International Study Group for Pancreatic Fistula) was observed in two and three patients in the octreotide and placebo groups, respectively. Conclusions Morbidity did not differ significantly between the groups. This study did not demonstrate an inhibitory effect of octreotide on exocrine pancreatic secretion. Based on these results, the routine use of octreotide after PD cannot be recommended. © 2012 International Hepato-Pancreato-Biliary Association.Peer Reviewe

Prospective randomized trial of the effect of octreotide on pancreatic juice output after pancreaticoduodenectomy in relation to histological diagnosis, duct size and leakage

AbstractBackgroundOctreotide is generally administered based on the surgeon's interpretation of perceived risk for pancreatic fistula at the time of pancreaticoduodenectomy (PD).MethodsA single‐institution, prospective randomized trial was conducted between April 2009 and December 2011 involving 62 PD patients who were randomized to receive octreotide (100 μg subcutaneously every 8 h; n = 32) or placebo (n = 30). Pancreatic juice output was measured after the operation using a catheter inserted into the pancreatic duct. Postoperative complications were recorded.ResultsNo significant differences in median output were found between the octreotide (82.5 ml) and placebo (77.5 ml) groups (P = 0.538). Median total output was significantly lower in patients with adenocarcinoma compared with those with periampullary tumours (P = 0.004) and in patients with a duct diameter of >5 mm compared with those with a duct diameter of <5 mm (P = 0.001). There were no significant differences in overall morbidity between the octreotide and placebo groups (P = 0.819). Grade B pancreatic fistula (International Study Group for Pancreatic Fistula) was observed in two and three patients in the octreotide and placebo groups, respectively.ConclusionsMorbidity did not differ significantly between the groups. This study did not demonstrate an inhibitory effect of octreotide on exocrine pancreatic secretion. Based on these results, the routine use of octreotide after PD cannot be recommended

Differential effect of nitric oxide inhibition as a function of preservation period in pancreas transplantation

The role of nitric oxide, produced during reperfusion as a function of preservation time, in the development of the inflammatory process in pancreas transplantation has been explored. For this purpose, the effect of nitric oxide synthase inhibition, as well as 6-keto-prostaglandin F(1α) leukotriene B4, and lipoperoxidation levels were evaluated in an experimental model of rat pancreas transplantation after different periods of cold preservation. The results show posttransplantation increases in 6-keto-prostaglandin F(1α), leukotriene B4, and lipoperoxidation levels in pancreatic tissue and in plasma lipase. When ischemia was induced for 30 min, nitric oxide synthase inhibition prevented these increases, and L-arginine was able to reverse this effect. By contrast, nitric oxide synthase inhibition has no effect when ischemia was prolonged for 12 hr. In summary, this study suggests that, during reperfusion, nitric oxide modulates 6-keto-prostaglandin F(1α) synthesis, lipoperoxidation levels, and the development of pancreatic injury but only when the ischemic period is quite short.This work was supported by grant 94/0645, Fondo de Investigaciones Sanitarias and by grant B.A.E. Fiss 94/5047Peer Reviewe