Producción y análisis de un espacio comunicativo audiovisual de visibilización y reconstrucción de la memoria histórica del barrio Olaya Herrera de Cartagena : análisis de un programa piloto: "Apatapelá en Olaya"

Monsiváis (1992 citado en Rincón, 2002 p.41) describe a la televisión pública como la recreación audiovisual de los relatos en que se dice la cultura común. Sostiene además que la narración va ligada estrechamente a la identidad cultural, y que la principal función de la televisión pública es contarla para que sea tenida en cuenta. En el barrio Olaya Herrera de Cartagena no existen registros audiovisuales que cuenten o narren las tradiciones histórico-culturales de la comunidad, que a partir de la década de los 70‟s aparecen “poderosas máquinas de sonido que se instalaban en los playones del Suroriente cartagenero y en la parte posterior de las faldas del Cerro de la Popa. La champeta, nombre con el que se llamaba a la música africana y afrocaribeña, había desplazado la salsa del gusto musical popular de la ciudad y emergía con una fuerza incontenible y vital que se extendía por toda la ciudad a pesar de la negación histórica a la que ha sido sometida la cultura popular en una ciudad donde la élite siempre ha tenido una tendencia hispanizante” (Patiño, 2008, p.1). Esas tradiciones que empezaron a surgir desde aquella época fueron construyendo el imaginario de la comunidad olayera, en quienes se generaba un sentido de pertenencia multicultural. Es el mismo autor cartagenero quien manifestó que los pueblos construyen imaginarios y sentidos de pertenencia que se van afirmando.Incluye bibliografía, anexo

Teeth infection may shunt through Fontan in high-altitude conditions.

The Fontan surgery involves the creation a conduit between the inferior vena cava and the right pulmonary artery. This conduit has a small fenestration that shunts the blood from right to left in case the pulmonary blood flow is limited; namely, if the pulmonary vascular resistance (PVR) is increased then the shunt is increased. Bacteria may bypass the pulmonary circulation and easily get access to the systemic circulation (bacteremia). We report the case of a patient that underwent Fontan surgery in 2010 and remained in a high-altitude city for 7 years, during this time he was asymptomatic until 2017 when he developed a brain abscess due to Streptococcus gordonii, a pathogen of dental plaque. Since high-altitude may raise PVR in response to reduction in the partial pressure of oxygen, we conclude that the long-term outcome of increased altitude on Fontan hemodynamics can lead to the shunt of teeth flora and consequently leading to severe infections

Spontaneous Hemopneumothorax: A Case Report

El hemoneumotórax espontáneo es una condición inusual, caracterizada por la acumulación de aire y sangre en la cavidad pleural, no precedida por trauma. La radiografía de tórax es la herramienta principal en el diagnóstico de esta entidad. Se presenta el caso de un hombre de 22 años con hemoneumotórax espontáneo. El paciente se recuperó sin complicaciones luego de la cirugía.Spontaneous hemopneumothorax is an unusual condition, characterized by the accumulation of air and blood in the pleural cavity, not preceded by trauma. Chest radiography is the main tool in the diagnosis of this entity. We present, a case of a 22-year-old male with spontaneous hemopneumothorax. The patient recovered after surgery with no complications

Effect of a Multistrain Probiotic on Cognitive Function and Risk of Falls in Patients With Cirrhosis: A Randomized Trial.

Cirrhosis; Probiotic; Cognitive functionCirrosis; Probiòtic; Funció cognitivaCirrosis; Probiótico; Función cognitivaProbiotics can modulate gut microbiota, intestinal permeability, and immune response and could therefore improve cognitive dysfunction and help avoid potential consequences, such as falls, in patients with cirrhosis. The aim of this study was to evaluate the effect of a multistrain probiotic on cognitive function, risk of falls, and inflammatory response in patients with cirrhosis. Consecutive outpatients with cirrhosis and cognitive dysfunction (defined by a Psychometric Hepatic Encephalopathy Score [PHES] < -4) and/or falls in the previous year were randomized to receive either a sachet of a high-concentration multistrain probiotic containing 450 billion bacteria twice daily for 12 weeks or placebo. We evaluated the changes in cognitive function (PHES); risk of falls (Timed Up and Go [TUG] test, gait speed, and incidence of falls); systemic inflammatory response; neutrophil oxidative burst; intestinal barrier integrity (serum fatty acid-binding protein 6 [FABP-6] and 2 [FABP-2] and zonulin and urinary claudin-3); bacterial translocation (lipopolysaccharide-binding protein [LBP]); and fecal microbiota. Thirty-six patients were included. Patients treated with the probiotic (n = 18) showed an improvement in the PHES (P = 0.006), TUG time (P = 0.015) and gait speed (P = 0.02), and a trend toward a lower incidence of falls during follow-up (0% compared with 22.2% in the placebo group [n = 18]; P = 0.10). In the probiotic group, we observed a decrease in C-reactive protein (P = 0.01), tumor necrosis factor alpha (P = 0.01), FABP-6 (P = 0.009), and claudin-3 (P = 0.002), and an increase in poststimulation neutrophil oxidative burst (P = 0.002). Conclusion: The multistrain probiotic improved cognitive function, risk of falls, and inflammatory response in patients with cirrhosis and cognitive dysfunction and/or previous falls

Effect of a Multistrain Probiotic on Cognitive Function and Risk of Falls in Patients With Cirrhosis : A Randomized Trial

Probiotics can modulate gut microbiota, intestinal permeability, and immune response and could therefore improve cognitive dysfunction and help avoid potential consequences, such as falls, in patients with cirrhosis. The aim of this study was to evaluate the effect of a multistrain probiotic on cognitive function, risk of falls, and inflammatory response in patients with cirrhosis. Consecutive outpatients with cirrhosis and cognitive dysfunction (defined by a Psychometric Hepatic Encephalopathy Score [PHES] < −4) and/or falls in the previous year were randomized to receive either a sachet of a high-concentration multistrain probiotic containing 450 billion bacteria twice daily for 12 weeks or placebo. We evaluated the changes in cognitive function (PHES); risk of falls (Timed Up and Go [TUG] test, gait speed, and incidence of falls); systemic inflammatory response; neutrophil oxidative burst; intestinal barrier integrity (serum fatty acid-binding protein 6 [FABP-6] and 2 [FABP-2] and zonulin and urinary claudin-3); bacterial translocation (lipopolysaccharide-binding protein [LBP]); and fecal microbiota. Thirty-six patients were included. Patients treated with the probiotic (n = 18) showed an improvement in the PHES (P = 0.006), TUG time (P = 0.015) and gait speed (P = 0.02), and a trend toward a lower incidence of falls during follow-up (0% compared with 22.2% in the placebo group [n = 18]; P = 0.10). In the probiotic group, we observed a decrease in C-reactive protein (P = 0.01), tumor necrosis factor alpha (P = 0.01), FABP-6 (P = 0.009), and claudin-3 (P = 0.002), and an increase in poststimulation neutrophil oxidative burst (P = 0.002). Conclusion: The multistrain probiotic improved cognitive function, risk of falls, and inflammatory response in patients with cirrhosis and cognitive dysfunction and/or previous falls

Caracterización de la respuesta inmune innata a ligandos de TLR, infecciones bacterianas y tratamiento con probióticos en la cirrosis

La cirrosis ha sido definida como una etapa final de la enfermedad hepática, donde convergen diferentes fenómenos que afectan a la supervivencia de los individuos que la padecen. Dentro de estos fenómenos encontramos el paso de productos bacterianos al torrente sanguíneo, definido como translocación bacteriana patológica. Estos productos bacterianos al ser reconocidos por los Toll-like receptors de las células del sistema inmune, generan un estado pro-inflamatorio crónico. Este estado altera la respuesta inmune sistémica y predispone al desarrollo de infecciones bacterianas y complicaciones de la cirrosis, como la peritonitis bacteriana espontanea. Los probióticos pueden prevenir la translocación bacteriana patológica modulando la microbiota intestinal y mejorando la barrera intestinal. Sin embargo, se desconocen los mecanismos por los cuales mejoran estas condiciones. El primer objetivo de este trabajo ha sido evaluar como el polimorfismo en los TLRs influye en el estado pro-inflamatorio crónico y en concreto en la respuesta inmune sistémica de los pacientes con cirrosis. El segundo objetivo ha sido caracterizar la respuesta inmune innata local en los líquidos ascíticos de los pacientes con cirrosis. Por ultimo, se ha evaluado la influencia de los probióticos en el manejo de la cirrosis inducida con CCl4 en un modelo experimental de rata. A continuación se resumen los resultados de cada publicación. Cytokine production in patients with cirrhosis and TLR4 polymorphisms.% Nieto JC, Sánchez E, Román E, Vidal S, Oliva L, Guarner- Argente C, Poca M, Torras X, Juárez C, Guarner C, Soriano G. World Journal of Gastroenterology. 2014; 20(46): 17516-24. Se analizó la producción de citocinas de las células de sangre perférica de pacientes con cirrosis con o sin el polimorfismo de TLR4 D299G y/o T399I. Los pacientes con alguno de los polimosrfismos de TLR4 tuvieron una mayor incidencia de encefalopatía hepática previa que los pacientes wlid-type (78% vs 20%, P = 0.02). La producción espontanea de IL-6 e IL-10 fue menor en los pacientes con polimorfismos de TLR4 que en los pacientes wild-type [IL-6: 888.7 (172.0-2119.3) pg/mL vs. 5540.4 (1159.2-26053.9) pg/mL, P 0.001; IL-10: 28.7 (6.5-177.1) pg/mL vs 117.8 (6.5-318.1) pg/mL, P = 0.02]. Sin embargo la producción de TNF-α, IL-6 e IL-10 después de la estimulación con LPS y LTA fue similar en los dos grupos. La presencia de alguno de los polimorfismos de TLR4 en los pacientes con cirrosis se asoció con un patrón distinto en la producción de citocinas, sugiriendo que los polimorfismos en TLR4 tienen un papel importante en el desarrollo de las complicaciones de la cirrosis. Impaired innate immune response of leukocytes from ascitic fluid of patients with spontaneous bacterial peritonitis Juan Camilo Nieto, Elisabet Sánchez, Cristina Romero, Eva Román, Maria Poca, Carlos Guarner, Cándido Juárez, Germán Soriano, Silvia Vidal. Journal of Leukocyte Biology. Epub ahead of print August 7, 2015 - doi:10.1189/jlb.3AB0315-106R Se analizó la respuesta inmune en el líquido ascítico de pacientes con cirrosis y ascitis que presentaban: ascitis estéril, PBE de cultivo positivo bacteriano ó PBE de cultivo negativo, antes y después del tratamiento con antibióticos. En el momento del diagnóstico, se observaron altos niveles de IL-6 e IL-10 en el líquido ascítico de los pacientes con PBE con cultivo positivo y PBE con cultivo negativo. Además había una correlación de los niveles de IL-6 con el porcentaje de neutrófilos (R = 0.686, P , 0.001). En este entorno, los neutrófilos de PBE con cultivo positivo y negativo tenían un estallido respiratorio deficiente, y, después del tratamiento solamente los neutrófilos de PBE con cultivo negativo recuperaron su función completa. Las altas concentraciones de IL-6 e IL-10 se correlacionaban con macrófagos de baja granularidad y niveles bajos de la expresión de CD14 (R = - 0.436, P = 0.005 and R = 0.414, P = 0.007, respectivamente). Los macrófagos de pacientes con PBE con cultivo positivo expresaban niveles bajos de CD16, CD86, CD11b, CD206 y HLA-DR, sugiriendo una función global deficiente. El tratamiento con antibióticos incrementó todos los marcadores antigénicos analizados en los macrófagos de PBE con cultivo positivo. El tratamiento con antibióticos también aumentó la expresión de CD11b y CD86 en los macrófagos de PBE con cultivo negativo. En estos macrófagos, el incremento estuvo acompañado por la recuperación de la función fagocítica. En resumen, los antibióticos revirtieron los niveles de expresión de los marcadores analizados en los macrófagos de PBE con cultivo positivo y negativo a niveles de los macrófagos de la ascitis estéril y restauraron la función de las células de PBE con cultivo negativo. VSL#3 probiotic treatment decreases bacterial translocation in rats with carbon tetrachloride-induced cirrhosis Elisabet Sánchez*, Juan C. Nieto*, Ana Boullosa, Silvia Vidal, Francesc J. Sancho, Giacomo Rossi, Pau Sancho-Bru, Rosa Homs, Beatriz Mirelis, Caándido Juárez, Carlos Guarner, Germán Soriano. Liver International. 2015 Mar;35(3):735-45. *Los autores contribuyeron de igual manera en la publicación. Se estudió como el tratamiento con VSL#3 modificaba la translocación bacteriana, la barrera intestinal y la respuesta inmune en el modelo experimental de rata con cirrosis inducida con CCl4. La mortalidad fue similar en el grupo de ratas que habían tomado VSL#3 (10/22, 45%) y el grupo que solo había bebido agua (10/24, 42%). La incidencia de translocación bacteriana fue de 1/12 (8%) en el grupo VSL#3, 7/14 (50%) en el grupo que solo bebía agua (P=0.03 grupo agua vs. grupo VSL#3) y 0/11 (0%) en el grupo control (no cirrosis) (P=0.008 grupo control vs. grupo agua). La concentración de enterobacterias y enterococos ileal y cecal fue similar en los dos grupos de ratas con cirrosis. La concentración de ocludina fue mayor y los niveles de malondialdheido y TNF-α en el suero fueron menores en el grupo VSL#3 comparado con el grupo que solo bebió agua (P 0.05). En resumen, el VSL#3 disminuye la translocación bacteriana, el estado pro-inflamatorio y el daño oxidativo ileal, además incrementa la expresión de ocludinas en el modelo experimental de ratas con cirrosis.Cirrhosis has been defined as end-stage of liver disease that invariably leads to death. Liver damage can originate pathological bacterial translocation and the passage of bacteria and/or bacterial products to blood flow. Bacterial products can be recognized by immune cells with TLRs and subsequently develop a chronic proinflammatory state. This state alter immune responses predispose to bacterial infections and frequent complications such as spontaneous bacterial peritonitis (SBP). Probiotics can prevent pathological bacterial translocation by modulating intestinal microbiota, improving intestinal barrier and immune disturbances. However, mechanisms involved in better responses in cirrhosis are still unknown. The first objective of this study was to analyze how TLR polymorphisms influence the chronic pro-inflammatory state and specifically in the systemic immune response of patients with cirrhosis. The second objective was to characterize the local innate immune response in ascitic fluid of patients with cirrhosis. Finally, we evaluated the influence of probiotics in the management of cirrhosis induced in an experimental model rats with CCl4. We summarize the results of each publication in the next paragraphs. Cytokine production in patients with cirrhosis and TLR4 polymorphisms.% Nieto JC, Sánchez E, Román E, Vidal S, Oliva L, Guarner- Argente C, Poca M, Torras X, Juárez C, Guarner C, Soriano G. World Journal of Gastroenterology. 2014; 20(46): 17516-24. We analyze the cytokine production by peripheral blood cells from cirrhotic patients with and without TLR4 D299G and/or T399I polymorphisms. Patients with TLR4 polymorphisms had a higher incidence of previous hepatic encephalopathy than wild-type patients (78% vs. 20%, P = 0.02). Spontaneous production of interleukin (IL)-6 and IL-10 was lower in patients with TLR4 polymorphisms than in wild-type patients [IL-6: 888.7 (172.0-2119.3) pg/mL vs. 5540.4 (1159.2-26053.9) pg/mL, P 0.001; IL-10: 28.7 (6.5-177.1) pg/mL vs. 117.8 (6.5-318.1) pg/mL, P = 0.02]. However, the production of tumor necrosis factor-α, IL-6 and IL-10 after LPS and LTA stimulation was similar in the two groups. TLR4 polymorphisms were associated with a distinctive pattern of cytokine production in cirrhotic patients, suggesting that they play a role in the development of cirrhosis complications. Impaired innate immune response of leukocytes from ascitic fluid of patients with spontaneous bacterial peritonitis Juan Camilo Nieto, Elisabet Sánchez, Cristina Romero, Eva Román, Maria Poca, Carlos Guarner, Cándido Juárez, Germán Soriano, Silvia Vidal. Journal of Leukocyte Biology. Epub ahead of print August 7, 2015 - doi:10.1189/jlb.3AB0315-106R Immune response was analyzed in patients with cirrhosis and ascities with sterile ascites, bacterial positive culture SBP or negative culture SBP before and after antibiotic treatment. At diagnosis, a high concentration of IL-6 and IL-10 was found in the ascitic fluid from negative and positive bacteriological culture. The IL-6 concentration correlated with the percentage of neutrophils (R = 0.686, P = 0.001). In this context, positive and negative culture neutrophils had an impaired oxidative burst, and, after the antibiotic, the negative culture spontaneous bacterial peritonitis burst was fully recovered. Higher concentrations of IL-6 and IL-10 correlated with the presence of low granular CD14low macrophages (R = -0.436, P = 0.005 and R = 0.414, P = 0.007, respectively). Positive culture spontaneous bacterial peritonitis macrophages expressed the lowest levels of CD16, CD86, CD11b, and CD206, and HLA-DR, suggesting an impaired global function. Treatment increased all markers on the positive culture macrophages and CD11b and CD86 on negative culture macrophages. In negative culture spontaneous bacterial peritonitis, this increase was accompanied by phagocytic function recovery. The antibiotics then reverted the marker levels on positive and negative culture macrophages to the levels on sterile ascitis macrophages and restored ascitic negative culture cell function. VSL#3 probiotic treatment decreases bacterial translocation in rats with carbon tetrachloride-induced cirrosis Elisabet Sánchez*, Juan C. Nieto*, Ana Boullosa, Silvia Vidal, Francesc J. Sancho, Giacomo Rossi, Pau Sancho-Bru, Rosa Homs, Beatriz Mirelis, Caándido Juárez, Carlos Guarner, Germán Soriano. Liver International 2014 *Both authors contributed equally to the study. Bacterial translocation, Intestinal barrier and immune response were assessed in rats with CCl4 induced cirrhosis. Mortality during this study was similar in the VSL#3 group (10/22, 45%) and the water group (10/24, 42%). The incidence of bacterial translocation was 1/12 (8%) in the VSL#3 group, 7/14 (50%) in the water group (P = 0.03 vs. VSL#3 group) and 0/11 in the control group (P = 0.008 vs. water group). The concentration of ileal and caecal enterobacteria and enterococci was similar in the two groups of cirrhotic rats. The ileal occludin concentration was higher and ileal malondialdehyde and serum levels of TNF-α were lower in the VSL#3 group than in the water group (P 0.05). VSL#3 decreases bacterial translocation, the proinflammatory state and ileal oxidative damage and increases ileal occludin expression in rats with experimental cirrhosis

Experimental supporting data on the influence of platelet-derived factors of malignant pleural effusions on T cell effector functions and their relevance in predicting prognosis of lung adenocarcinoma patients with pleural metastasis

The data described in this article are supplementary to our primary article "Platelet factor 4 regulates T cell effector functions in malignant pleural effusions". Malignant pleural effusion (MPE) is a common complication of advanced lung adenocarcinoma (LAC) associated with a poor life expectancy [1]. Several challenges need to be addressed to identify non-invasive molecular biomarkers that help to predict the prognosis of LAC patients with MPE [2]. In the primary publication, we proposed that platelet-derived factors, especially platelet factor 4 (PF4), can negatively regulate T lymphocyte activation and granzyme B expression in pleural metastasis and its levels were associated with a worse prognosis. Here, we provide data on the influence of other platelet-derived factors, including transforming growth factor β (TGF-β), vascular endothelial factor (VEGF), and P-selectin on T lymphocyte response in MPE and their relevance as prognostic factors in lung cancer patients with pleural metastasis. Pleural fluids from 35 lung adenocarcinoma (LAC) and 20 heart failure (HF) patients were collected by thoracentesis and its platelet-derived factors' content was measured by specific enzyme-linked immunosorbent assay (ELISAs). Correlations between pleural levels of platelet-derived factors and T cell functions were analyzed by Pearson coefficients. Kaplan-Meier curves were used to estimate the effect of pleural concentrations of platelet-derived factors on overall survival of LAC patients with pleural metastasis. These analyses showed that the concentration of platelet-derived factors was not associated with T cell proliferation and cytotoxicity. Furthermore, their levels do not predict the survival of LAC with MPE

Bacteriophages immunomodulate the response of monocytes

Bacteriophages are present in fluids from cirrhosis patients. However, their effect on the immune response is unknown. In this work, we explore the role of phages in the phenotype, function, and cytokine production of monocytes. We stimulated healthy monocytes with five different butanol-purified phage suspensions infective for Gram-negative and Gram-positive bacteria. We studied the expression of the monocyte markers involved in lipopolysaccharide recognition (LPS; CD14), antigen presentation (HLA-DR) and co-stimulation (CD86), and the concentration of induced cytokines (TNF-α, IFN-α, and IL-10) by phages. To confirm the direct role of phages without the interference of contaminating soluble LPS in phage suspensions, polymyxin B was added to the cell cultures. Phagocytosis experiments were assessed by flow cytometry using labeled phage suspensions. We observed that butanol-purified phages reduced the surface levels of CD14 and CD86 in monocytes and increased the secreted levels of TNF-α and IL-10 compared with the control sample containing only butanol buffer. All phage suspensions showed downregulation of HLA-DR expression but only Staphylococcus aureus phage contaminated with Escherichia coli reached statistical significance. The addition of polymyxin B did not restore the monocytic response induced by phages, suggesting that the effect was not caused by the presence of LPS. Monocytes were able to phagocyte phages in a dose- and time-dependent manner. To conclude, the phagocytosis of butanol-purified phages altered the phenotype and cytokine production of monocytes suggesting they become tolerogenic