Identifying the direct effects of ammonia on the brain.

Elevated concentrations of ammonia in the brain as a result of hyperammonemia leads to cerebral dysfunction involving a spectrum of neuropsychiatric and neurological symptoms (impaired memory, shortened attention span, sleep-wake inversions, brain edema, intracranial hypertension, seizures, ataxia and coma). Many studies have demonstrated ammonia as a major player involved in the neuropathophysiology associated with liver failure and inherited urea cycle enzyme disorders. Ammonia in solution is composed of a gas (NH(3)) and an ionic (NH(4) (+)) component which are both capable of crossing plasma membranes through diffusion, channels and transport mechanisms and as a result have a direct effect on pH. Furthermore, NH(4) (+) has similar properties as K(+) and, therefore, competes with K(+) on K(+) transporters and channels resulting in a direct effect on membrane potential. Ammonia is also a product as well as a substrate for many different biochemical reactions and consequently, an increase in brain ammonia accompanies disturbances in cerebral metabolism. These direct effects of elevated ammonia concentrations on the brain will lead to a cascade of secondary effects and encephalopathy.

Mild hypothermia prevents brain edema and attenuates up-regulation of the astrocytic benzodiazepine receptor in experimental acute liver failure.

BACKGROUND/AIMS: Mild hypothermia has proven useful in the clinical management of patients with acute liver failure. Acute liver failure in experimental animals results in alterations in the expression of genes coding for astrocytic proteins including the "peripheral-type" (astrocytic) benzodiazepine receptor (PTBR), a mitochondrial complex associated with neurosteroid synthesis. To gain further insight into the mechanisms whereby hypothermia attenuates the neurological complications of acute liver failure, we investigated PTBR expression in the brains of hepatic devascularized rats under normothermic (37 degrees C) and hypothermic (35 degrees C) conditions. METHODS: PTBR mRNA was measured using semi-quantitative RT-PCR in cerebral cortical extracts and densities of PTBR sites were measured by quantitative receptor autoradiagraphy. Brain pregnenolone content was measured by radioimmunoassay. RESULTS: At coma stages of encephalopathy, animals with acute liver failure manifested a significant increase of PTBR mRNA levels. Brain pregnenolone content and [(3)H]PK 11195 binding site densities were concomitantly increased. Mild hypothermia prevented brain edema and significantly attenuated the increased receptor expression and pregnenolone content. CONCLUSIONS: These findings suggest that an attenuation of PTBR up-regulation resulting in the prevention of increased brain neurosteroid content represents one of the mechanisms by which mild hypothermia exerts its protective effects in ALF.

Oxidative stress: a systemic factor implicated in the pathogenesis of hepatic encephalopathy.

Although ammonia is considered the main factor involved in the pathogenesis of hepatic encephalopathy (HE), it correlates well with the severity of HE in acute liver failure, but not in chronic liver disease. Oxidative stress is another factor believed to play a role in the pathogenesis of this syndrome; it represents an imbalance between the production and neutralization of reactive oxygen species, which leads to cellular dysfunction. In the setting of liver disease, oxidative stress represents a systemic phenomenon induced by several mechanisms: decreased antioxidant synthesis, increased systemic release of oxidant enzymes, generation of reactive oxygen species, and impaired neutrophil function. High ammonia concentrations induce cerebral oxidative stress, thus contributing to severe hepatic encephalopathy, as observed in acute liver failure. In chronic liver disease, significantly lower degrees of hyperammonemia (<500 μM) do not induce cerebral nor systemic oxidative stress. Data from both animal and human studies sustain that there is a synergistic effect between systemic oxidative stress, and ammonia that is implicated in the pathogenesis of hepatic encephalopathy.

Increased 5-HT2C Receptor Binding in the Brain Stem And Cerebral Cortex During Liver Regeneration And Hepatic Neoplasia In Rats

In the present study, serotonin 2C (5-HT2c) receptor binding parameters in the brainstem and cerebral cortex were investigated during liver generation after partial hepatectomy (PH) and N-nitrosodiethylamine (NDEA) induced hepatic neoplasia in male Wistar rats. The serotonin content increased significantly (p<0.01) in the cerebral cortex after PH and in NDEA induced hepatic neoplasia. Brain stem serotonin content increased significantly (p<0.05) after PH and (p<0.001) in NDEA induced hepatic neoplasia. The number and affinity of the 5-HT2c receptors in the crude synaptic membrane preparations of the brain stem showed a significant (p<0.001) increase after PH and in NDEA induced hepatic neoplasia. The number and affinity of 5-HT2c receptors increased significantly (p<0.001) in NDEA induced hepatic neoplasia in the crude synaptic membrane preparations of the cerebral cortex. There was a significant (p<0.01) increase in plasma norepinephrine in PH and (p<0.001) in NDEA induced hepatic neoplasia, indicating sympathetic stimulation. Thus, our results suggest that during active hepatocyte proliferation 5-HT2c receptor in the brain stem and cerebral cortex are up-regulated which in turn induce hepatocyte proliferation mediated through sympathetic stimulation.

Hepatic GABAA receptor functional regulation during rat liver cell proliferation

Gamma aminohutyric acid (GAB A.) receptor tunctionaI status was artaIV se(l in pa It ial hcpatcctoIn ised.II'II). lead nitrate (LN) induced hyperplastic and N-nifrosodiethylantinc INDEAI treated nctplastic rat Iivers during peak DNA synthesis. The high-affinity I'HJGALA binding significantly decreased in PII and NDEi\ rats and the receptor affinity decreased in NDEA and increased in LN rats compared with control . in NDEA. displacement analysis of I'I IIGABA with muscimol showed loss of low-allinity site and a shill of high-allinity cite towards low-allinity . ' 1 he affinity sites shifted towards high-affinity in LN rats. 'file number of low-allinity 1'I Ilhicuc)lline receptors decreased cignilic:uttly in NDEA and I'll whereas it increased in LN rats. (ir\Bi\t receptor :gunist. unrscinrul. disc dependcnllyinhihilcd epidermal growth factor IEGI--) induced DNA synthesis :uul enhanced the tr:utsfnrnting grmvth )actor (Il I I'(il (tlI mediated DNA synthesis suppression in prim:uy hepalucvte cultures . Our results suggest that GABA,t reccjhtor act as an inhibitory signal fur hepatic cell prolifctatiun.

Biochemical Studies on the Protective Effect of Taurine on Experimentally Induced Fulminat Hepatic Failure in Rats

Fulminant hepatic failure (FHF) is a dramatic and challenging syndrome in clinical medicine. Although an uncommon disorder, it is usually fatal and occurs in previously healthy person. While the causes of FHF remain unclear, viral hepatitis and drug-induced liver injury account for the majority of cases. Hepatitis E causes large-scale epidemics of hepatitis in the Indian subcontinent, involving hundreds of thousands of cases with high mortality. FHF is associated with several clinical features like jaundice, shrunken liver, easy bruising, low levels of serum proteins, fatigue, multi-organ failure etc and metabolic derangements like hypoglycemia, hyperlipidemia, hyponatremia, defective protein synthesis, reduced energy production, decreased rate of urea production etc. These disturbances are predominantly attributed to oxidative stress, membrane destabilization and osmolytic imbalances. The options available for these patients are quite minimal with liver transplantation being one of them. But the procedure is ridden with issues causing it to find less favor among the patients and the caregivers. Use of hepatoprotective and cytoprotective drugs, is being considered to be a more acceptable alternative as a strategy to enhance liver regeneration. In this regard use of taurine a naturally occurring amino acid that plays a crucial role in many physiological processes would prove to be effective. In the present study, hepatoprotective effect of taurine on a rat model of induced FHF was studied. Taurine supplementation has effectively counteracted the metabolic and structural aberrations in the liver caused by D-galactosamine intoxication.

A Novel Isoform of the Hepatic Antimicrobial Peptide, Hepcidin (Hepc-CB1), from a Deep-Sea Fish, the Spinyjaw Greeneye Chlorophthalmus bicornis (Norman, 1939): Molecular Characterisation and Phylogeny

Hepcidin is cysteine-rich short peptide of innate immune system of fishes, equipped to perform prevention and proliferation of invading pathogens like bacteria and viruses by limiting iron availability and activating intracellular cascades. Hepcidins are diverse in teleost fishes, due to the varied aquatic environments including exposure to pathogens, oxygenation and iron concentration. In the present study, we report a 87-amino acid (aa) preprohepcidin (Hepc-CB1) with a signal peptide of 24 aa, a prodomain of 39 aa and a bioactive mature peptide of 24 aa from the gill mRNA transcripts of the deep-sea fish spinyjaw greeneye, Chlorophthalmus bicornis. Molecular characterisation and phylogenetic analysis categorised the peptide to HAMP2-like group with a mature peptide of 2.53 kDa; a net positive charge (?3) and capacity to form b-hairpin-like structure configured by 8 conserved cysteines. The present work provides new insight into the mass gene duplication events and adaptive evolution of hepcidin isoforms with respect to environmental influences and positive Darwinian selection. This work reports a novel hepcidin isoform under the group HAMP2 from a nonacanthopterygian deep-sea fish, C. bicornis

Molecular Characterisation and Phylogenetic Analysis of a Novel Isoform of Hepatic Antimicrobial Peptide, Hepcidin (Zc-hepc1), from the Coral Fish Moorish idol, Zanclus cornutus (Linnaeus,1758)

Hepcidin is a family of short cysteine-rich antimicrobial peptides (AMPs) participating in various physiological functions with inevitable role in host immune responses. Present study deals with identification and characterisation of a novel hepcidin isoform from coral fish Zanclus cornutus. The 81 amino acid (aa) preprohepcidin obtained from Z. cornutus consists of a hydrophobic aa rich 22 mer signal peptide, a highly variable proregion of 35 aa and a bioactive mature peptide with 8 conserved cysteine residues which contribute to the disulphide back bone. The mature hepcidin, Zc-hepc1 has a theoretical isoelectric point of 7.46, a predicted molecular weight of 2.43 kDa and a net positive charge of ?1. Phylogenetic analysis grouped Z. cornutus hepcidin with HAMP2 group hepcidins confirming the divergent evolution of hepcidin-like peptide in fishes. Zc-hepc1 can attain a b-hairpin-like structure with two antiparallel b-sheets. This is the first report of an AMP from the coral fish Z. cornutus.

Evaluación de una herramienta educativa en conocimiento de donación y trasplante de órganos y tejidos en Colombia

El trasplante de órganos es considerado uno de los avances más significativos de la medicina moderna y es un procedimiento cada vez más exitoso en términos de supervivencia de los pacientes, siendo actualmente la mejor opción de tratamiento para los pacientes con innumerables patologías. El proceso de donación es insuficiente para cubrir las necesidades de trasplante de la población, por lo tanto, se hace necesario el desarrollo de nuevas estrategias para fortalecer la experiencia y efectividad de los programas existentes. La falta de conocimiento de los profesionales de la salud, su percepción y actitud hacia temas relacionados con el proceso de donación, pueden convertirlos en facilitadores o barreras para la identificación de potenciales donantes. Por esta razón, los recursos disponibles, las actitudes hacia la donación, la legislación y conocimiento de los procesos involucrados en la donación de tejidos y órganos son críticos. Dada la influencia de los profesionales de salud se definen los objetivos de este proyecto de tesis: determinar cuál es el conocimiento y las habilidades de los profesionales de la salud encargados de los trasplantes de órganos y de tejidos en la regional 1, evaluados mediante una herramienta educativa para contribuir a mejorar un programa eficiente de Donación de Órganos y tejidos y así mismo, fijar recomendaciones en aras de aumentar las tasas de donación, con especial énfasis en la actividad hospitalaria en el país. METODOLOGIA Se realizó un estudio basado en el análisis de la evaluación de conocimientos del proceso donación- trasplante de órganos y tejidos en el personal de salud participante en la herramienta educativa llamada “Curso taller primer respondiente del potencial donante de órganos y tejidos”. Este curso incluía un formato evaluativo que fue diligenciado de manera anónima por los participantes antes y después de recibir el contenido del curso. El estudio se desarrolló en personal de la Salud de IPS pertenecientes a la Regional I, de la Red Nacional de donación y trasplantes de órganos y tejidos. Con el fin de evidenciar si existen diferencias en el conocimiento de los participantes del curso antes y después de asistir al mismo, se utilizó la prueba de McNemar (p< 0.05). RESULTADOS Entre julio del 2011 y junio del 2012, se realizó el “Curso taller primer respondiente del potencial donante de órganos y tejidos” y se obtuvieron 303 encuestados incluidos médicos, enfermeras y auxiliares de enfermería. Al inicio del curso las respuestas acertadas con relación a legislación, selección del donante, muerte encefálica y mantenimiento del donante estuvieron alrededor del 50%. No fue posible detectar la profesión que pudiese generar riesgo en la detección del donante y los procesos asociados. Posterior al curso, el 72% de las preguntas se respondieron de manera correcta, lo que representa un incremento estadísticamente significativo. Este cambio evidenció significancia estadística al usar la prueba de McNemar y arrojar un valor de p=0.00. .DISCUSIÓN El personal de salud participante en el curso taller proveniente de unidades involucradas como generadoras de donantes muestra un déficit de conocimientos del proceso donación trasplantes lo que puede convertirlos en limitantes para dicho proceso

Genotyping Klebsiella pneumoniae isolated from hepatic abscesses in three patients from Bogota, Colombia

Pyogenic liver abscess caused by Klebsiella pneumoniae represents an ever increasing entity which has mainly been described as occurring in Asia, even though, on a smaller scale, cases are being more frequently described from the USA and Europe, 13% overall mortality being reached worldwide. Affected patients are severely sick, suffering from fever, sweating, having increased acute phase reactants and risk factors such as Diabetes Mellitus, alcoholism and the inherent characteristics of the bacteria causing the disease. Objective: in this work we used a Multilocus Sequencing Typing (MLST), a nucleotide sequence-based method in order to characterize the genetic relationships among bacterial isolates. Materials and methods: the report is focused on three cases involving patients suffering from pyogenic liver abscess caused by Klebsiella pneumoniae in two hospitals in Bogota, Colombia, where phenotyping and hypermucoviscosity studies were carried out, as well as the genotyping of cultured Klebsiella isolates. Reults: it was found that the isolated microorganism in cases I and II corresponded to the same K. pneumoniae strain, having 100% sequence identity for the 5 genes being studied while the strain in Case III was genotypically different. Conclusion: it is important to carry out multidisciplinary studies allowing all pyogenic liver abscess cases reported in Colombia to be complied to ascertain the frequency of microorganisms causing this pathology in our country, as well as a genotyping study of different K. pneumoniae strains to compare them and confirm clonal and pathogenicity relationships through housekeeping gene analysis.

Concurso : ¿Qué me dices que coma?

Se describe el proyecto consistente en la realización de un concurso dirigido a niños (a partir de 12 años) y jóvenes, basado en la alimentación. Cada grupo de participantes elegía un producto alimenticio y su formato publicitario y se realizaba un análisis sobre diferentes aspectos como: información y mensaje que transmite de forma explícita o subliminal, público al que va dirigido, hábitos o valores que promueve, etc. Posteriormente se realizaba una memoria y finalmente se hacía una exposición en cualquier formato visual o audiovisual (panel mural, publicidad alternativa, etc.) Se especifican los objetivos de la experiencia, las etapas en la que se desarrolló el concurso y los resultados obtenidos.

Radio Punto y Coma.

Este proyecto de simulación de una emisora de radio, es continuación del llevado a cabo el curso 97/98. Los objetivos son trabajar la lengua mediante este medio de comunicación, herramienta didáctica de primer orden y motivadora; poner en práctica una metodología interdisciplinar, globalizada y activa que favorece la experimentación, reflexión, capacidad crítica y el aspecto lúdico del aprendizaje; conocer las características técnicas de la radio y las características lingüísticas de los medios de comunicación; desarrollar el espíritu crítico y selectivo de la oferta y contenido de los medios de comunicación. La metodología consiste en una primera fase donde se pone en común el proyecto, se analiza los resultados del curso anterior, y se comienza la formación técnica de los profesores. Después simultanea esta formación con el trabajo del alumno. Por último se recopila y archiva el material elaborado y se realiza la evaluación. Los alumnos elaboran, emiten y escuchan programas de radio. El grado de autonomía depende de su participación en el curso anterior. Con la evaluación se intenta conocer el grado de aplicación, implicación y logros conseguidos. Se realiza mediante la observación y control del trabajo del alumno, cuestionarios y encuestas. Los profesores tambien valoran el proyecto al comprobar le incidencia en la programación y dinámica escolar, las aportaciones y los inconvenientes y propuestas de mejora. Declaran su deseo de continuar con esta experiencia, incluso intentando que los programas se emitan en la localidad..

La participaci??n social y su impacto en los procesos de cohesi??n social en el barrio La Coma

Monogr??fico con el t??tulo: Propuestas metodol??gicas en la formaci??n de competencias de educadores/as sociales. Resumen basado en el de la publicaci??n. Resumen en ingl??s y catal??n

Figura de los facilitadores en los Cursos Online Masivos y Abiertos (COMA / MOOC) : nuevo rol profesional para los entornos educativos en abierto

Resumen basado en el de la publicaci??n

La interacci??n entre compa??eros y el feedback ling????stico en los COMA de lenguas extranjeras

Resumen basado en el de la publicaci??n