Eficacia de la resección pancreática con preservación duodenal versus pancreaticoduodenectomía en el tratamiento de la pancreatitis crónica en adultos: Revisión Sistemática y Meta-análisis

Background: Studies comparing duodenum-preserving pancreatic head resection versus pancreaticoduodenectomy in the treatment of chronic pancreatitis demonstrate notable differences, however, the current evidence is inadequate to clearly establish the superiority of these approaches. Objective: To determine duodenum preserving pancreatic head resection is more effective than pancreaticoduodenectomy in treating chronic pancreatitis in adults. Material and Methods: A systematic review was conducted identifying and extracting data from seven randomized clinical trials and seven observational studies comparing the efficacy of duodenum-preserving pancreatic resection versus pancreaticoduodenectomy. Results: Bleeding had a mean difference (MD) of -0.18, 95% CI of -0.25 – -0.12, and p < 0.00001. Operative time had an MD of -1.32, 95% CI of -2.20 –      -0.44 and p = 0.003. Hospital stay had an MD of -3.94, 95% CI of -6.16 – -1.71 and p = 0.0005. Endocrine insufficiency had a RR of 0.78, 95% CI of 0.65 – 0.95 and p = 0.01. Pain Score showed an MD of -7.39, 95% CI of -13.05 – -1.74 and p = 0.01. Global quality of life, showed MD of 8.97, 95% CI of 4.05 - 13.90 and p = 0.0004. Conclusions: DPPHR is more effective than PD by reducing intraoperative bleeding, operative time, hospital stay, the risk of endocrine failure, and by providing better pain relief and quality of life.Introducción: Los estudios que comparan la resección pancreática con preservación duodenal (DPPHR) versus pancreaticoduodenectomía (PD) en el tratamiento de la pancreatitis crónica demuestran diferencias notables, sin embargo, la evidencia actual no es adecuada para establecer la superioridad de estos enfoques. Objetivo: Determinar si la resección pancreática con preservación duodenal es más eficaz que la pancreaticoduodenectomía en el tratamiento de la pancreatitis crónica en adultos. Material y métodos: Se realizó una revisión sistemática identificando y extrayendo datos de siete ensayos clínicos aleatorizados y siete estudios observacionales comparando la eficacia de la resección pancreática con preservación duodenal versus la pancreaticoduodenectomía. Resultados: La hemorragia tuvo una diferencia de medias (MD) de -0.18, IC al 95% de -0.25 – -0.12 y p < 0.00001. El tiempo operatorio tuvo una MD de -1.32, IC al 95% de -2.20 – -0.44 y p = 0.003. Estancia hospitalaria tuvo una MD de -3.94, IC al 95% de -6.16 – -1.71 y p = 0.0005. La insuficiencia endocrina tuvo RR de 0.78, IC al 95% de 0.65 – 0.95 y p = 0.01. Pain Score mostró una MD de -7.39, IC al 95% de -13.05 – -1.74 y p = 0.01. Calidad global de vida, mostró MD de 8.97, IC al 95% de 4.05 – 13.90 y p = 0.0004. Conclusiones: La DPPHR resulta más eficaz que la PD al disminuir el sangrado intraoperatorio, tiempo operatorio, estancia hospitalaria, el riesgo de insuficiencia endocrina y al proporcionar mejor alivio del dolor y calidad de vida.

Testing Einstein’s Formula on Brownian Motion Using Membrane Computing

Brownian motion refers to erratic movements of small particles of solid matter suspended in a fluid and it is the basis of the development of many fractals found in Nature. In this paper we use the Membrane Computing model of P systems with membrane creation and the software tool JPLANT in order to check the Einstein’s theory on the Mean Square Displacement of Brownian motion.Ministerio de Educación y Ciencia TIN2006-13425Junta de Andalucía TIC-58

RELACIÓN ENTRE LA ADHERENCIA AL TRATAMIENTO CON MICRONUTRIENTES Y EL NIVEL DE HEMOGLOBINA EN LOS NIÑOS MENORES DE 36 MESES-PERÚ

Objetivo: Determinar la relación existente entre la adherencia al tratamiento con micronutrientes y el nivel de hemoglobina en los niños menores de 36 meses que acuden al Centro de Salud “San Martin”, Lambayeque-Perú en el año 2016. Materiales y Métodos: Estudio cuantitativo con diseño correlacional transversal. La muestra estuvo conformada por 56 niños menores de 36 meses de edad y sus madres o cuidadoras, seleccionados por un muestreo probabilístico al azar a quienes se les aplicó el instrumento denominado “Cuestionario de Evaluación de la suplementación de micronutrientes” elaborado por las investigadoras con una confiabilidad mediante alfa de Cronbach (α) de 0.8. Resultados: 58,9% de las madres evidencian adherencia al tratamiento con micronutrientes; en cuanto al nivel de hemoglobina basal sólo el 37,5% de niños mantienen un nivel de hemoglobina normal, mientras el 62,5% presentan anemia (leve 60.7% y moderada 1.8%), después de la suplementación con micronutrientes el 82,1% (de los cuales presentó un nivel de adherencia adecuada a los (micronutrientes) presentó un nivel de hemoglobina normal, mientras que solo se evidenciaron niveles de anemia leve en 17.9% de los niños. Conclusiones: existe una relación significativa (p= 0.018) entre la adherencia al tratamiento con micronutrientes y el nivel de hemoglobina

STXBP1 promotes Weibel-Palade body exocytosis through its interaction with the Rab27A effector Slp4-a.

Vascular endothelial cells contain unique rod-shaped secretory organelles, called Weibel-Palade bodies (WPBs), which contain the hemostatic protein von Willebrand factor (VWF) and a cocktail of angiogenic and inflammatory mediators. We have shown that the Rab27A effector synaptotagmin-like protein 4-a (Slp4-a) plays a critical role in regulating hormone-evoked WPB exocytosis. Using a nonbiased proteomic screen for targets for Slp4-a, we now identify syntaxin-binding protein 1 (STXBP1) and syntaxin-2 and -3 as endogenous Slp4-a binding partners in endothelial cells. Coimmunoprecipitations showed that STXBP1 interacts with syntaxin-2 and -3, but not with syntaxin-4. Small interfering RNA-mediated silencing of STXBP1 expression impaired histamine- and forskolin-induced VWF secretion. To further substantiate the role of STXBP1, we isolated blood outgrowth endothelial cells (BOECs) from an early infantile epileptic encephalopathy type 4 (EIEE4) patient carrying a de novo mutation in STXBP1. STXBP1-haploinsufficient EIEE4 BOECs contained similar numbers of morphologically normal WPBs compared with control BOECs of healthy donors; however, EIEE4 BOECs displayed significantly impaired histamine- and forskolin-stimulated VWF secretion. Based on these findings, we propose that the Rab27A-Slp4-a complex on WPB promotes exocytosis through an interaction with STXBP1, thereby controlling the release of vaso-active substances in the vasculature

Molecular and mechanical control of single lumen formation during epithelial morphogenesis by Synaptotagmin-like proteins

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Ciencias, Departamento de Biología Molecular. Fecha de lectura; 16-06-2014Most epithelial organs are made of branching tubules that exert critical functions for the correct functioning of the living organisms. These tubules usually show a complex architecture that consists in a central cavity or lumen surrounded of polarized cells. To reach this geometry, it is necessary the coordination of different cues that come from the surrounding tissues, the extracellular matrix and the cell-cell interaction within the epithelial tissue itself. These cues promote a series of changes in the cells including the activation of transcriptional programs, deep rearrangements of the cytoskeleton, the activation of intracellular membrane trafficking pathways and the remodeling of the cell-cell junctions. How the cells can coordinate all these changes together with the others cells within the tissue it has been largely unknown, and only in the last few years we were beginning to understand this process. Based in changes in the transcriptional program we have developed a functional screening for the identification of previously unknown regulators of epithelial morphogenesis by means of organotypic cultures of MDCKII cells. Moreover, it has been functional and mechanistically characterized the role of one of the regulators in epithelial lumen formation, the protein of the Synaptotagmin-like protein family (Slp), Slp2-a. Together with Slp2-a, other member of the Slp family, Slp4-a, the Rab-GTPases Rab27/3/8 and the SNARE Syntaxin-3 constitute a new trafficking pathway ensures the apical markers are correctly targeted to the nascent apical membranes at early stages of lumen formation. To summarize, Slp2-a coordinate the trafficking of Rab27 positive vesicles to phosphatidylinositol- 4, 5-bisphosphate enriched membrane domains, whereas, Slp4-a controls the fusion of these vesicles through its interaction with Syntaxin-3. Furthermore, this study has been focused in the role these proteins develop in vivo in the zebrafish model. In the zebrafish embryos Slp2 and Slp4 are specifically expressed in the pronephric duct, the developing kidney. More specifically, the silencing of Slp4 by morpholinos impaired renal function in the larvae and causes the abnormal dilation of the distal part of the pronephric duct. Moreover, we have found that Slp4 silencing leads to the decrease of Claudin-2 in MDCKII cells and of Claudin-15a and F in the zebrafish pronephros. We hypothesize that the loss of claudins is responsible of the impaired renal function and the enlargement of the tubule diameter. Summarizing, the present work shows Synaptotagmin-like proteins are important for epithelial morphogenesis, homeostasis and function in both, organotypic cultures and vertebrate developing kidney

Eficacia de la resección pancreática con preservación duodenal versus pancreaticoduodenectomía en el tratamiento de la pancreatitis crónica en adultos: revisión sistemática

Los estudios que comparan la resección pancreática con preservación duodenal (DPPHR) versus pancreaticoduodenectomía (PD) en el tratamiento de la pancreatitis crónica demuestran diferencias notables, sin embargo, la evidencia actual no es adecuada para establecer la superioridad de estos enfoques. Objetivo: Determinar si la resección pancreática con preservación duodenal es más eficaz que la pancreaticoduodenectomía en el tratamiento de la pancreatitis crónica en adultos. Material y métodos: Se realizó una revisión sistemática identificando y extrayendo datos de siete ensayos clínicos aleatorizados y siete estudios observacionales comparando la eficacia de la resección pancreática con preservación duodenal versus la pancreaticoduodenectomía. Resultados: La hemorragia tuvo una diferencia de medias (MD) de -0.18, IC al 95% de -0.25 – -0.12 y p < 0.00001. El tiempo operatorio tuvo una MD de -1.32, IC al 95% de -2.20 – -0.44 y p = 0.003. Estancia hospitalaria tuvo una MD de -3.94, IC al 95% de -6.16 – -1.71 y p = 0.0005. La insuficiencia endocrina tuvo RR de 0.78, IC al 95% de 0.65 – 0.95 y p = 0.01. Pain Score mostró una MD de -7.39, IC al 95% de -13.05 – -1.74 y p = 0.01. Calidad global de vida, mostró MD de 8.97, IC al 95% de 4.05 – 13.90 y p = 0.0004. Conclusiones: La DPPHR resulta más eficaz que la PD al disminuir el sangrado intraoperatorio, tiempo operatorio, estancia hospitalaria, el riesgo de insuficiencia endocrina y al proporcionar mejor alivio del dolor y calidad de vida.Studies comparing duodenum-preserving pancreatic head resection versus pancreaticoduodenectomy in the treatment of chronic pancreatitis demonstrate notable differences, however, the current evidence is inadequate to clearly establish the superiority of these approaches. Aim: To determine duodenum preserving pancreatic head resection is more effective than pancreaticoduodenectomy in treating chronic pancreatitis in adults. Methods: A systematic review was conducted identifying and extracting data from seven randomized clinical trials and seven observational studies comparing the efficacy of duodenum-preserving pancreatic resection versus pancreaticoduodenectomy. Results: Bleeding had a mean difference (MD) of -0.18, 95% CI of -0.25 – -0.12, and p < 0.00001. Operative time had an MD of -1.32, 95% CI of -2.20 – -0.44 and p = 0.003. Hospital stay had an MD of -3.94, 95% CI of -6.16 – -1.71 and p = 0.0005. Endocrine insufficiency had a RR of 0.78, 95% CI of 0.65 – 0.95 and p = 0.01. Pain Score showed an MD of -7.39, 95% CI of -13.05 – -1.74 and p = 0.01. Global quality of life, showed MD of 8.97, 95% CI of 4.05 - 13.90 and p = 0.0004. Conclusions: DPPHR is more effective than PD by reducing intraoperative bleeding, operative time, hospital stay, the risk of endocrine failure, and by providing better pain relief and quality of life.Tesi

Cuadernos de pedagogía

Resumen tomado de la publicaciónExperiencia educativa que pone el foco en la realización de exposiciones orales como medio para desarrollar el lenguaje oral, así como para fortalecer la autoestima y el autoconcepto por parte del alumnado de Educación Infantil, desde los tres hasta los cinco años a través de los distintos proyectos de trabajos realizados en el aula.Biblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 planta; 28014 Madrid; Tel. +34917748000; [email protected]

Divide and polarize: recent advances in the molecular mechanism regulating epithelial tubulogenesis

Epithelial organs are generated from groups of non-polarized cells by a combination of processes that induce the acquisition of cell polarity, lumen formation, and the subsequent steps required for tubulogenesis. The subcellular mechanisms associated to these processes are still poorly understood. The extracellular environment provides a cue for the initial polarization, while cytoskeletal rearrangements build up the three-dimensional architecture that supports the central lumen. The proper orientation of cell division in the epithelium has been found to be required for the normal formation of the central lumen in epithelial morphogenesis. Moreover, recent data in cellular models and in vivo have shed light into the underlying mechanisms that connect the spindle orientation machinery with cell polarity. In addition, recent work has clarified the core molecular components of the vesicle trafficking machinery in epithelial morphogenesis, including Rab-GTPases and the Exocyst, as well as an increasing list of microtubule-binding and actin-binding proteins and motors, most of which are conserved from yeast to humans. In this review we will focus on the discussion of novel findings that have unveiled important clues for the mechanisms that regulate epithelial tubulogenesis.Work supported by grants from Human Frontiers Science Program (HFSP-CDA 00011/2009), Marie Curie (IRG-209382), MICINN (BFU2008-01916) and CONSOLIDER (CSD2009-00016) to FM-B. AER-F is recipient of a JAE fellowship, from CSIC, and MG is recipient of a FPI fellowship, from MICINN. An institutional grant from Fundación Ramón Areces to CBMSO is also acknowledged.Peer reviewe