Punto Letizia: mediateca cultural

Fil: Corrales, Romina Florencia. Universidad Católica de Córdoba. Facultad de Arquitectura; Argentina

Rutas críticas de niñas y adolescentes afectadas por la violencia: contribuciones para pensar las estrategias de intervención

Este trabajo se enmarca en la trayectoria asistencial de un grupo de trabajadoras sociales que integramos el equipo de Servicio Social del HIAEP Sor María Ludovica de La Plata. Nuestras trayectorias temporales y asistenciales son diversas, y son compartidas con compañeras/os de nuestra disciplina y de otras dentro del ámbito hospitalario. Nos proponemos indagar respecto del proceso de configuración y tránsito de las rutas críticas desplegadas por las niñas y adolescentes que son afectadas por la violencia intrafamiliar y/o de género, y que concurren al Hospital en calidad de pacientes o de familiares directas de los mismos. Entendemos por rutas críticas las acciones emprendidas por mujeres afectadas por situaciones de violencia, a las respuestas y obstáculos que se les presentan en ese tránsito, y al acompañamiento conseguido. Como correlato de ello, nos interrogaremos también sobre nuestros procesos interventivos en la asistencia de esas niñas y adolescentes, repensando cuáles de nuestras prácticas actúan como obstáculos y/o facilitadoras de esos tránsitos. A partir de esto y a modo de cierre, reflexionaremos sobre las prácticas y propuestas de asistencia y seguimiento que consideramos que podrían favorecer la atención de niñas y adolescentes afectadas por situaciones de violencia.This work is part of the attendance trajectory of a group of social workers who integrate the Social Service team of the Sup. Sor María Ludovica Hospital of La Plata city. Our temporary and attendance trajectories are diverse, and are shared with partners from our discipline and others within the hospital setting. We propose to investigate the process of configuration and transit of critical routes deployed by children and adolescents who are affected by intra-family and/or gender violence, and who attend to the Hospital as patients or their direct family members, understanding as critical routes to the actions undertaken by women affected by situations of violence, to the answers and obstacles that are presented to them in that transit, and to the accompaniment achieved. As a correlate of this, we will also ask ourselves about our intervention processes in the assistance of these children and adolescents, rethinking which of our practices act as obstacles and/or facilitators of these transits. From this and as a closure, we will consider on the practices and proposals for assistance and follow-up that we believe could favor the attention of children and adolescents who are affected by situations of violence.Facultad de Psicologí

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Evaluation of a New Diagnostic Algorithm for Acute Coronary Syndrome Using High-Sensitivity Troponin T Assay

Introduction: Chest pain represents 5 to 10% of annual visits to emergency departments. Its diagnosis is sometimes difficult, with the added problem of inappropriate discharge of patients with acute coronary syndrome or unnecessary hospitalizations.This has led to the development of different algorithms for the evaluation of these patients.Objective: The aim of this study was to validate, in terms of safety and length of hospital stay, a novel algorithm incorporatedin our center, which includes measurement of high-sensitivity troponin T in patients with suspected acute coronary syndrome.Methods: The study included 528 consecutive patients attending the emergency department with suspected acute coronarysyndrome and evaluated according to the chest pain unit protocol. Clinical and laboratory variables and functional tests wereanalyzed. Follow-up at 30 days was performed in all the patients.Results: After observation, 90.7% of the patients were discharged and 1.25% presented a cardiovascular event during follow-up,represented by percutaneous coronary intervention and hospitalization due to acute coronary syndrome. The specificity of theglobal algorithm for the diagnosis of acute coronary syndrome was 97% with a negative predictive value of 99%. Emergencydepartment length of stay was 4.5 ± 2.5 hours for all the patients.Conclusion: The novel algorithm incorporated in our center with measurement of high-sensitivity troponin T in patientswith suspected acute coronary syndrome has proved to be safe, as it prevents the discharge of patients with acute coronarysyndrome and at the same time reduces emergency department length of stay.Introducción: El dolor precordial representa entre el 5 y el 10 % de las consultas anuales a los departamentos de emergencias y su diagnóstico es dificultoso.  El objetivo de este trabajo es validar en términos de seguridad y tiempos de estadía hospitalaria un nuevo algoritmo incorporado en nuestro centro que incluye la medición de la troponina de alta sensibilidad, en pacientes con sospecha de síndrome coronario agudo. Materiales y Métodos: Se incluyeron 528 pacientes  que consultaron al servicio de emergencias por un síndrome coronario agudo dudoso y se les realizó el protocolo de unidad de dolor. Se analizaron variables clínicas, de laboratorio y el resultado de las pruebas funcionales efectuadas. Todos los pacientes fueron seguidos a los 30 días. Resultados: El 90,7 % de los pacientes fueron externados posterior a la observación y en el seguimiento el 1,25 % presentaron un evento cardíaco representado por angioplastia coronaria e internación por síndrome coronario agudo, siendo la especificidad del algoritmo global para el diagnóstico de síndrome coronario agudo del 97% y el valor predictivo negativo del  99 %. El tiempo de estadía en el servicio de emergencias del total de los pacientes fue de 4,5 ± 2,5 horas. Conclusión: El nuevo algoritmo incorporado en nuestro centro con troponina T de alta sensibilidad, en pacientes con sospecha de síndrome coronario agudo demostró ser seguro, evitando la externación de pacientes cursando un síndrome coronario agudo, como así también requerir una corta estadía hospitalaria en el servicio de emergencias

Pluripotent nontumorigenic adipose tissue-derived muse cells have immunomodulatory capacity mediated by transforming growthfactor-β1

Adult mesenchymal stromal cell-based interventions have shown promising results in a broad range of diseases. However, their use has faced limited effectiveness owing to the low survival rates and susceptibility to environmental stress on transplantation. We describe the cellular and molecular characteristics of multilineage-differentiating stress-enduring (Muse) cells derived from adipose tissue (AT), a subpopulation of pluripotent stem cells isolated from human lipoaspirates. Muse-AT cells were efficiently obtained using a simple, fast, and affordable procedure, avoiding cell sorting and genetic manipulation methods. Muse-AT cells isolated under severe cellular stress, expressed pluripotency stem cell markers and spontaneously differentiated into the three germ lineages. Muse-AT cells grown as spheroids have a limited proliferation rate, a diameter of ∼15 mm, and ultrastructural organization similar to that of embryonic stem cells. Muse-AT cells evidenced high stage-specific embryonic antigen-3 (SSEA-3) expression (∼60% of cells) after 7–10 days growing in suspension and did not form teratomas when injected into immunodeficient mice. SSEA-3+-Muse-AT cells expressed CD105, CD29, CD73, human leukocyte antigen (HLA) class I, CD44, and CD90 and low levels of HLA class II, CD45, and CD34. Using lipopolysaccharide-stimulated macrophages and antigen-challenged T-cell assays, we have shown that Muse-AT cells have anti-inflammatory activities downregulating the secretion of proinflammatory cytokines, such as interferon-γ and tumor necrosis factor-α.Muse-AT cells spontaneously gained transforming growth factor-β1 expression that, in a phosphorylated SMAD2-dependent manner, might prove pivotal in their observed immunoregulatory activity through decreased expression of T-box transcription factor in T cells. Collectively, the present study has demonstrated the feasibility and efficiency of obtaining Muse-AT cells that can potentially be harnessed as immunoregulators to treat immune-related disorders.Fil: Gimeno, Maria Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; ArgentinaFil: Fuertes, Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; ArgentinaFil: Barcala Tabarrozzi, Andrés Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; ArgentinaFil: Attorressi, Alejandra I.. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; ArgentinaFil: Cucchiani, Rodolfo. Hospital Universitario Austral; ArgentinaFil: Corrales, Luis. Hospital Universitario Austral; ArgentinaFil: Oliveira, Talita C.. Universidade de Sao Paulo; BrasilFil: Sogayar, Mari C.. Universidade de Sao Paulo; BrasilFil: Labriola, Leticia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidade de Sao Paulo; BrasilFil: Dewey, Ricardo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Investigaciones Biotecnológicas. Instituto de Investigaciones Biotecnológicas "Dr. Raúl Alfonsín" (sede Chascomús). Universidad Nacional de San Martín. Instituto de Investigaciones Biotecnológicas. Instituto de Investigaciones Biotecnológicas "Dr. Raúl Alfonsín" (sede Chascomús); ArgentinaFil: Perone, Marcelo Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentin

Reforma educativa y luchas docentes en América Latina Educational reform and teacher's struggles in Latin America

El presente artículo propone algunos ejes para el análisis de la conflictividad educativa en el marco más amplio de la intensificación de los procesos de conflictividad social y política que tuvieron y tienen lugar en los países de América Latina durante las últimas dos décadas. Buscando contribuir a una comprensión crítica de la conflictividad docente, los autores presentan algunos datos cuantitativos que permiten establecer tendencias generales respecto de las características y dinámicas adoptadas por las acciones de protesta impulsadas por las organizaciones magisteriales en 18 países de la región. Asimismo, intenta enriquecer e incentivar el debate en torno a la conflictividad educativa, procurando una definición y conceptualización del conflicto educativo y docente que, a partir de una reflexión acerca de las políticas y programas de reforma neoliberales, ofrezca elementos para el desarrollo de análisis alternativos sobre la problemática docente, así como para la construcción de propuestas y alternativas democráticas de cambio de los sistemas educativos latinoamericanos.<br>This article suggests some axes for the analysis of the learning activity, in the wider scope, of the intensification of processes of social and political conflicts that happened and, even today, in Latin American countries, during the last two decades, Attempting to contribute to a critic comprehension of the teachers' conflict, the author hereby bring some quantitative data that allow the establishment of general tendencies regarding the characteristics and dynamics adapted by actions of protest augmented by the teaching organization in eighteen countries of that region. Yet trying to enrich and encourage the debate about teachers' conflict of education, searching for an educational conflict definition and conceptualization, springing from a reflex ion with respect to politics and neoliberal reformation programs, may offer elements for the development of alternative analysis on teacher's difficulties, as well as for the building of proposals and democratic alternatives for the change of Latin American systems of education

Characteristics and outcomes of thymomas in Latin America: results from over 10 years of experience (CLICaP-LATimus)

Background: Thymomas are a group of rare neoplasms of the anterior mediastinum.The objective of this study was to describe the demographics, clinical characteristicsand treatment approaches in Latin America.Methods: This was a retrospective multicenter cohort study including patients withhistologically proven thymomas diagnosed between 1997 and 2018. Demographics, linicopathological characteristics and therapeutic outcomes were collected locallyand analyzed in a centralized manner.Results: A total of 135 patients were included. Median age at diagnos is was 53 yearsold (19–84), 53.3% (n = 72) of patients were female and 87.4% had an ECOG perfor-mance score ranging from 0–1. A total of 47 patients (34.8%) had metastatic diseaseat diagnosis. Concurrent myasthenia gravis occurred in 21.5% of patients. Surgerywas performed in 74 patients (54.8%), comprising 27 (20%) tumorectomies and47 (34.8%) thymectomies. According to the Masaoka-Koga system, overall survival(OS) at five-years was 73.4%, 63.8% and 51%, at stages I–II, III–IVA and IVB,respectively (p = 0.005). Furthermore, patients with low lactate dehydrogenase(LDH) (≤373 IU/L) at baseline and myasthenia gravis concur rence showed signifi-cantly better OS (p = 0.001 and p = 0.008, respectively). In multivariate analysis, highLDH levels (HR 2.8 [95% confidence interval [CI]: 1.1–7.8]; p = 0.036) at baselineand not performing a surgical resection (HR 4.1 [95% CI: 1.3–12.7]; p = 0.016) weresignificantly associated with increased risk of death.Conclusions: Our data provides the largest insight into the clinical characteristics andoutcomes of patients with thymomas in Latin America. Survival in patients withthymomas continues to be very favorable, especially when subjected to adequatelocal control

Immunotherapy at any line of treatment improves survival in patients with advanced metastatic non‐small cell lung cancer (NSCLC) compared with chemotherapy (Quijote‐CLICaP)

Background: To compare survival outcomes of patients with advanced or metastatic non-small cell lung cancer (NSCLC) who received immunotherapy as first-, second- or beyond line, versus matched patients receiving standard chemotherapy with special characterization of hyperprogressors. Methods: A retrospective cohort study of 296 patients with unresectable/metastatic NSCLC treated with either, first-, second-, third- or fourth-line of immunotherapy was conducted. A matched comparison with a historical cohort of first-line chemotherapy and a random forest tree analysis to characterize hyperprogressors was conducted. Results: Median age was 64 years (range 34–90), 40.2% of patients were female. A total of 91.2% of patients had an Eastern Cooperative Oncology Group (ECOG) performance score ≤ 1. Immunotherapy as first-line was given to 39 patients (13.7%), second-line to 140 (48.8%), and as third-line and beyond to 108 (37.6%). Median overall survival was 12.7 months (95% CI 9.67–14 months) and progression-free survival (PFS) of 4.27 months (95% CI 3.97–5.0). Factors associated with increased survival included treatment with immunotherapy as first-line (P < 0.001), type of response (P < 0.001) and PD-L1 status (P = 0.0039). Compared with the historical cohort, immunotherapy proved to be superior in terms of OS (P = 0.05) but not PFS (P = 0.2). A total of 44 hyperprogressors were documented (19.8%, [95% CI 14.5–25.1%]). Leukocyte count over 5.300 cells/dL was present in both hyperprogressors and long-term responders. Conclusions: Patients who receive immune-checkpoint inhibitors as part of their treatment for NSCLC have better overall survival (OS) compared with matched patients treated with standard chemotherapy, regardless of the line of treatment