Arquitectos en Mendoza : biografías, trayectorias profesionales y obras (1900-1960) : tomo I

El libro, busca comenzar a dibujar el mapa de arquitectos que trabajaron en Mendoza durante el siglo XX para descubrir las singularidades de la producción local, como parte de un proceso mayor, orientado a la valoración de los bienes que estos autores produjeron. El análisis propuesto es original a escala local y supone un avance en el conocimiento de la historia arquitectónica y urbana de Mendoza, para su posterior inserción en la Historiografía de la Arquitectura en Argentina y el mundo. Se seleccionó un grupo de sesenta y un arquitectos, en los cuales se concentró el trabajo biográfico. La definición de este conjunto de agentes y de sus obras como corpus de análisis, no se apoyó en criterios generacionales, sino en la participación activa que todos tuvieron en la conformación del campo profesional en Mendoza; un campo reducido hasta promediar el siglo XX. Estos arquitectos, que recibieron su título hasta 1960, mendocinos algunos, foráneos radicados en la provincia otros; tuvieron una importante participación en organizaciones profesionales como la Sociedad de Arquitectos de Mendoza, en la formación de nuevos profesionales a través de la tarea docente en la Facultad de Arquitectura (UM), así como en la conformación de agencias estatales como la Dirección Provincial de Arquitectura o el Departamento de Obras de la UNCuyo

Lapatinib Induces Autophagy, Apoptosis and Megakaryocytic Differentiation in Chronic Myelogenous Leukemia K562 Cells

Lapatinib is an oral, small-molecule, dual tyrosine kinase inhibitor of epidermal growth factor receptors (EGFR, or ErbB/Her) in solid tumors. Little is known about the effect of lapatinib on leukemia. Using human chronic myelogenous leukemia (CML) K562 cells as an experimental model, we found that lapatinib simultaneously induced morphological changes resembling apoptosis, autophagy, and megakaryocytic differentiation. Lapatinib-induced apoptosis was accompanied by a decrease in mitochondrial transmembrane potential and was attenuated by the pancaspase inhibitor z-VAD-fmk, indicating a mitochondria-mediated and caspase-dependent pathway. Lapatinib-induced autophagic cell death was verified by LC3-II conversion, and upregulation of Beclin-1. Further, autophagy inhibitor 3-methyladenine as well as autophagy-related proteins Beclin-1 (ATG6), ATG7, and ATG5 shRNA knockdown rescued the cells from lapatinib-induced growth inhibition. A moderate number of lapatinib-treated K562 cells exhibited features of megakaryocytic differentiation. In summary, lapatinib inhibited viability and induced multiple cellular events including apoptosis, autophagic cell death, and megakaryocytic differentiation in human CML K562 cells. This distinct activity of lapatinib against CML cells suggests potential for lapatinib as a therapeutic agent for treatment of CML. Further validation of lapatinib activity in vivo is warranted

Interventions to minimise the initial use of indwelling urinary catheters in acute care: a systematic review

Background Indwelling urinary catheters (IUC) are the primary cause of urinary tract infection in acute care. Current research aimed at reducing the use of IUCs in acute care has focused on the prompt removal of catheters already placed. This paper evaluates attempts to minimise the initial placement of IUCs.ObjectivesTo evaluate systematically the evidence of the effectiveness of interventions to minimise the initial placement of IUCs in adults in acute care.Design Studies incorporating an intervention to reduce the initial placement of IUCs in an acute care environment in patients aged 18 and over that reported on the incidence of IUC placement were included in the review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist has been used as a tool to guide the structure of the review.Data SourcesMEDLINE, CINAHL, EMBASE, National Health Service Centre for Review and Dissemination and Cochrane Library.Review Methods A systematic review to identify and synthesise research reporting on the impact on interventions to minimise the use of IUCs in acute care published up to July 2011.Results 2689 studies were scanned for eligibility. Only eight studies were found that reported any change (increase or decrease) in the level of initial placement of IUCs as a result of an intervention in acute care. Of the eight, six had an uncontrolled before-after design. Seven demonstrated a reduction in the initial use of IUCs post-intervention. There was insufficient evidence to support or rule out the effectiveness of interventions due to the small number of studies, limitations in study design and variation in clinical environments. Notably, each study listed the indications considered to be acceptable uses of an IUC and there was substantial variation between the lists of indications.Conclusions More work is needed to establish when the initial placement of an IUC is appropriate in order to better understand when IUCs are overused and inform the development of methodologically robust research on the potential of interventions to minimise the initial placement of IUCs

Biofilm development on urinary catheters promotes the appearance of viable but non-culturable (VBNC) bacteria

Catheter-associated urinary tract infections have serious consequences, both for patients and in impacting on healthcare resources. Much work has been carried out to develop an antimicrobial catheter. Although such developments have shown promise under laboratory conditions, none have demonstrated a clear advantage in clinical trials.Using a range of microbiological and advanced microscopy techniques, a detailed laboratory study comparing biofilm development on silicone, hydrogel latex and silver alloy coated hydrogel latex catheters was carried out. Biofilm development by Escherichia coli, Pseudomonas aeruginosa and Proteus mirabilis on three commercially available catheters was tracked over time. Samples were examined with episcopic differential interference contrast (EDIC) microscopy, culture analysis and staining techniques to quantify viable but non-culturable (VBNC) bacteria.Both qualitative and quantitative assessment found biofilms to develop rapidly on all three materials. EDIC microscopy revealed the rough surface topography of the materials. Differences between culture counts and quantification of total and dead cells demonstrated the presence of VBNC populations, where bacteria retain viability but are not metabolically active.The use of non-culture based techniques showed the development of widespread VBNC populations. These VBNC populations were more evident on silver alloy coated hydrogel latex catheters, indicating a bacteriostatic effect at best. The laboratory tests reported here, that detect VBNC bacteria, allow more rigorous assessment of antimicrobial catheters offering an explanation for why there is often minimal benefit to patients.IMPORTANCE Several antimicrobial urinary catheter materials have been developed but, although laboratory studies may show a benefit, none have significantly improved clinical outcomes. The use of poorly designed laboratory testing and lack of consideration to the impact of VBNC populations may be responsible. While the presence of VBNC populations is becoming more widely reported, there remains a lack of understanding of the clinical impact or influence of exposure to antimicrobial products. This is the first study to investigate the impact of antimicrobial surface materials and the appearance of VBNC populations. This demonstrates how improved testing is needed prior to clinical trials uptake

Intermittent catheter techniques, strategies and designs for managing long‐term bladder conditions

BackgroundIntermittent catheterisation (IC) is a commonly recommended procedure for people with incomplete bladder emptying. Frequent complications are urinary tract infection (UTI), urethral trauma and discomfort during catheter use. Despite the many designs of intermittent catheter, including different lengths, materials and coatings, it is unclear which catheter techniques, strategies or designs affect the incidence of UTI and other complications, measures of satisfaction/quality of life and cost‐effectiveness.This is an update of a Cochrane Review first published in 2007. ObjectivesTo assess the clinical and cost‐effectiveness of different catheterisation techniques, strategies and catheter designs, and their impact, on UTI and other complications, and measures of satisfaction/quality of life among adults and children whose long‐term bladder condition is managed by intermittent catheterisation.Search methodsWe searched the Cochrane Incontinence Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, MEDLINE In‐Process, MEDLINE Epub Ahead of Print, CINAHL, ClinicalTrials.gov, WHO ICTRP and handsearching of journals and conference proceedings (searched 12 April 2021), the reference lists of relevant articles and conference proceedings, and we attempted to contact other investigators for unpublished data or for clarification.Selection criteriaRandomised controlled trials (RCTs) or randomised cross‐over trials comparing at least two different catheterisation techniques, strategies or catheter designs.Data collection and analysisAs per standard Cochrane methodological procedures, two review authors independently extracted data, assessed risk of bias and assessed the certainty of evidence using GRADE. Outcomes included the number of people with symptomatic urinary tract infections, complications such as urethral trauma/bleeding, comfort and ease of use of catheters, participant satisfaction and preference, quality of life measures and economic outcomes.Main resultsWe included 23 trials (1339 randomised participants), including twelve RCTs and eleven cross‐over trials. Most were small (fewer than 60 participants completed), although three trials had more than 100 participants. Length of follow‐up ranged from one month to 12 months and there was considerable variation in definitions of UTI. Most of the data from cross‐over trials were not presented in a useable form for this review.Risk of bias was unclear in many domains due to insufficient information in the trial reports and several trials were judged to have a high risk of performance bias due to lack of blinding and a high risk of attrition bias. The certainty of evidence was downgraded for risk of bias, and imprecision due to low numbers of participants. Aseptic versus clean techniqueWe are uncertain if there is any difference between aseptic and clean techniques in the risk of symptomatic UTI because the evidence is low‐certainty and the 95% confidence interval (CI) is consistent with possible benefit and possible harm (RR 1.20 95% CI 0.54 to 2.66; one study; 36 participants). We identified no data relating to the risk of adverse events comparing aseptic and clean techniques or participant satisfaction or preference. Single‐use (sterile) catheter versus multiple‐use (clean)We are uncertain if there is any difference between single‐use and multiple‐use catheters in terms of the risk of symptomatic UTI because the certainty of evidence is low and the 95% CI is consistent with possible benefit and possible harm (RR 0.98, 95% CI 0.55, 1.74; two studies; 97 participants). One study comparing single‐use catheters to multiple‐use catheters reported zero adverse events in either group; no other adverse event data were reported for this comparison. We identified no data for participant satisfaction or preference.Hydrophilic‐coated catheters versus uncoated cathetersWe are uncertain if there is any difference between hydrophilic and uncoated catheters in terms of the number of people with symptomatic UTI because the certainty of evidence is low and the 95% CI is consistent with possible benefit and possible harm (RR 0.89, 95% CI 0.69 to 1.14; two studies; 98 participants). Uncoated catheters probably slightly reduce the risk of urethral trauma and bleeding compared to hydrophilic‐coated catheters (RR 1.37, 95% CI 1.01 to 1.87; moderate‐certainty evidence). The evidence is uncertain if hydrophilic‐coated catheters compared with uncoated catheters has any effect on participant satisfaction measured on a 0‐10 scale (MD 0.7 higher, 95% CI 0.19 to 1.21; very low‐certainty evidence; one study; 114 participants). Due to the paucity of data, we could not assess the certainty of evidence relating to participant preference (one cross‐over trial of 29 participants reported greater preference for a hydrophilic‐coated catheter (19/29) compared to an uncoated catheter (10/29)). Authors' conclusionsDespite a total of 23 trials, the paucity of useable data and uncertainty of the evidence means that it remains unclear whether the incidence of UTI or other complications is affected by use of aseptic or clean technique, single (sterile) or multiple‐use (clean) catheters, coated or uncoated catheters or different catheter lengths. The current research evidence is uncertain and design and reporting issues are significant. More well‐designed trials are needed. Such trials should include analysis of cost‐effectiveness because there are likely to be substantial differences associated with the use of different catheterisation techniques and strategies, and catheter designs