Gestión de la tutoría telemática en educación a distancia

Este trabajo presenta una aplicación experimental de tutoría telemática mediante correo electrónico e Internet, realizada durante 1999 con los alumnos de la Primera Convocatoria del Curso Universitario de Postgrado en Educación a Distancia que se dictó en la República Argentina en la Universidad CAECE junto con la Fundación para el Desarrollo de los Estudios Cognitivos, FUNDEC. Se analiza esta experiencia pedagógico-didáctica, desarrollada durante la primera parte del Curso, entre abril y junio de 1999, con casi cien alumnos distribuidos en más de 2.800.000 km2, a la luz de las posibilidades de las herramientas informáticas utilizadas

Reflux and dyspeptic symptom patterns in patients with non erosive reflux disease (NERD) subclassified using 24-hour ambulatory intraluminal pH-Impedance

Ample evidence supports that prostate tumor metastasis originates from a rare population of cancer cells, known as cancer stem cells (CSCs). Unfortunately, little is known about the identity of these cells, making it difficult to target the metastatic prostate tumor. Here, for the first time, we report the identification of a rare population of prostate cancer cells that express the Tie-2 protein. We found that this Tie-2High population exists mainly in prostate cancer cell lines that are capable of metastasizing to the bone. These cells not only express a higher level of CSC markers but also demonstrate enhanced resistance to the chemotherapeutic drug Cabazitaxel. In addition, knockdown of the expression of the Tie-2 ligand angiopoietin (Ang-1) led to suppression of CSC markers, suggesting that the Ang-1/Tie-2 signaling pathway functions as an autocrine loop for the maintenance of prostate CSCs. More importantly, we found that Tie-2High prostate cancer cells are more adhesive than the Tie-2Low population to both osteoblasts and endothelial cells. Moreover, only the Tie-2High, but not the Tie-2Low cells developed tumor metastasis in vivo when injected at a low number. Taken together, our data suggest that Tie-2 may play an important role during the development of prostate tumor metastasis

Optimal management of constipation associated with irritable bowel syndrome.

Irritable bowel syndrome (IBS) is a common chronic functional disorder of the gastrointestinal tract, meanly characterized by recurrent abdominal pain or discomfort and altered bowel habit. It is a complex disorder involving biological, environmental, and psychosocial factors. The diagnosis is achieved according to the Rome III criteria provided that organic causes have been excluded. Although IBS does not constitute a life-threatening condition, it has a remarkable prevalence and profoundly reduces the quality of life with burdening socioeconomic costs. One of the principal concerns about IBS is the lack of effective therapeutic options. Up to 40% of patients are not satisfied with any available medications, especially those suffering from chronic constipation. A correct management of IBS with constipation should evolve through a global approach focused on the patient, starting with careful history taking in order to assess the presence of organic diseases that might trigger the disorder. Therefore, the second step is to examine lifestyle, dietary habits, and psychological status. On these bases, a step-up management of disease is recommended: from fiber and bulking agents, to osmotic laxative drugs, to new molecules like lubiprostone and linaclotide. Although new promising tools for relief of bowel-movement-related symptoms are being discovered, a dedicated doctor\u2013patient relationship still seems to be the key for succes

Recent insights on functional heartburn and reflux hypersensitivity

Purpose of review Rome IV experts have proposed that gastroesophageal reflux disease (GERD) should be diagnosed only in patients with abnormal esophageal acid exposure, and that reflux hypersensitivity (RH) and functional heartburn (FH) both should be considered functional conditions separate from GERD. Although past and recent evidence support that FH can be completely distinguished from GERD, the concept that RH is not GERD is highly questionable. This review attempts to provide current data on these issues. Recent findings Many recent investigations have provided new data on the different pathophysiological features characterizing RH and FH. Major differences have emerged from analyses of impedance-pH monitoring studies using the novel impedance metrics of baseline impedance (an index of mucosal integrity) and the rate of postreflux swallow-induced peristaltic waves (a reflection of the integrity of esophageal chemical clearance). The better ability to interpret impedance-pH tracings together with earlier data on the different prevalence of microscopic esophagitis in RH and FH patients, and recent studies documenting poor therapeutic efficacy of pain modulators and good results of antireflux surgery for RH support recategorization of RH within the GERD world. Further research is needed to correctly phenotype patients who have heartburn without mucosal breaks, and to guide their effective management

Effects of bariatric surgery on the esophagus

reserved3noPurpose of review: Bariatric surgery is the best therapeutic approach to patients with morbid obesity, but there is mounting evidence that it is associated with esophageal dysfunctions, including gastroesophageal reflux disease (GERD) and motor disorders. In the present review, we summarize the existing information on the complex link between bariatric surgery and esophageal disorders. Recent findings: Although high-quality studies on these effects are lacking, because of evident methodological flaws and retrospective nature, the review of published investigations show that pure restrictive procedures, such as laparoscopic adjustable gastric banding (LAPG) and laparoscopic sleeve gastrectomy (LSG), are associated with de novo development or worsening of GERD. Moreover, LAGB is the procedure with the greatest frequency of esophageal motor disorders, including impairment of LES relaxation and ineffective esophageal peristalsis associated with esophageal dilation. LSG seems to be less associated with esophageal dysmotility, although evidence derived from studies with objective measurements of esophageal dysfunction is limited. Finally, RYGB seems to be the best procedure for improvement of GERD symptoms and preservation of esophageal function. Summary: Overall, the restrictive-malabsorptive approach represented by RYGB must be preferred to pure restrictive operations in order to avoid the negative consequences of bariatric surgery on esophageal functions.mixedSavarino E.; Marabotto E.; Savarino V.Savarino, E.; Marabotto, E.; Savarino, V

Towards a more precise classification of esophageal motility disorders in patients with systemic sclerosis

Systemic sclerosis (SSc) is a chronic and generalized disease affecting the connective tissue of the skin and many internal organs, in particular the gastrointestinal tract. The esophagus is involved in up to 80% of the cases and represents a major cause of serious morbidities that deeply impact on the quality of life and survival of patients. Indeed, the presence of esophageal dysfunction is a good prognostic indicator in SSc, primarily due to its impact on pulmonary disease. Thus, the detection of esophageal motility alterations plays a critical role to prevent the development of both esophageal and pulmonary complications and to improve the survival of these patients. Currently, this diagnostic work-up has been limited to the use of esophageal manometry, which is considered the gold standard for the evaluation of motor physiology and pathophysiology of this organ in different clinical situations. However, in recent years, new equipments such as high-resolution (-impedance) manometry and functional luminal imaging probe have been developed and used in many esophageal clinical settings, including SSc. In this mini-review, we summarize current evidence regarding esophageal dysmotility, in the light of new data on secondary peristalsis published in this issue of the journal

La tutoría telemática en la educación a distancia

This work presents an experimental aplication of Communication–Tools Tutelage through a "Bulletin Board System", that was brought into action betwen 1996 and 1997, with students from Argentina. Those students were in the Postdegree and Master in Educational Informatic; both careers depend on the Distance University’s Education Faculty, from Spain.The informatic tele-processing gives a new work’s dimension. The users can interchange information through communication nets, allowing them not only an independent treatment of information but also people’s communication.It’s analized an experience about almost two hundreds of students, who were distributed on almost 2.800.000 km2, all of them working with more actual and strong communication–tools, such as e-mail and Internet. Este trabajo presenta una aplicación experimental de tutoría telemática mediante un "Bulletin Board System", realizada entre 1996 y 1997 con los alumnos de la República Argentina del Postgrado Especialista Superior Universitario y del Máster en Informática Educativa, ambos de la Facultad de Educación de la Universidad Nacional de Educación a Distancia –UNED– de España. El tele-procesamiento informático, o telemática, brinda una nueva dimensión de trabajo: hace realidad que los usuarios puedan intercambiar información a través de redes de comunicaciones, permitiendo no sólo un tratamiento autónomo de los datos sino también la comunicación entre personas.Se analiza una experiencia de casi doscientos alumnos, distribuídos en casi 2.800.000 km2, a la luz de herramientas telemáticas más actuales y potentes, como lo son el correo electrónico e Internet