Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth

Avulsion of permanent teeth is the most serious of all dental injuries. The prognosis depends on the measures taken at the place of accident or the time immediately after the avulsion. Replantation is the treatment of choice, but cannot always be carried out immediately. An appropriate emergency management and treatment plan is important for a good prognosis. Guidelines are useful for delivering the best care possible in an efficient manner. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases in which the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the current best evidence based on literature research and professional opinion. In this second article of three, the IADT Guidelines for management of avulsed permanent teeth are presented.

Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth

Crown fractures and luxations occur most frequently of all dental injuries. An appropriate treatment plan after an injury is important for a good prognosis. Guidelines are useful for delivering the best care possible in an efficient manner. The International Association of Dental Traumatology (IADT) has developed a consensus statement after a review of the dental literature and group discussions. Experienced researchers and clinicians from various specialties were included in the group. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the IADT board members. The guidelines represent the current best evidence, based on literature research and professional opinion. In this first article of three, the IADT Guidelines for management of fractures and luxations of permanent teeth will be presented.

Sexuality and the ‘Relations of Ruling’: Using Institutional Ethnography to Research Lesbian and Gay Foster Care and Adoption.

This article makes use of institutional ethnography to research foster care and adoption by lesbians and gay men, drawing on the work of the feminist sociologist Dorothy E. Smith in order to demonstrate the investigation of social work institutional categories and the ‘relations of ruling’. Through an analysis of the ways in which ‘gender’ and the idea of the ‘gender role model’ is used within the assessment of gay and lesbian foster carers and adopters, the author shows how these categories are produced and used to police relationship forms and to identify ‘deviant instances’.

Chlamydia prevalence in young attenders of rural and regional primary care services in Australia: a cross-sectional survey.

OBJECTIVE To estimate chlamydia prevalence among 16-29-year-olds attending general practice clinics in Australia. DESIGN, PARTICIPANTS AND SETTING A cross-sectional survey was conducted from May 2010 to December 2012. Sexually experienced 16-29-year-olds were recruited from 134 general practice clinics in 54 rural and regional towns in four states and in nine metropolitan clinics (consecutive patients were invited to participate). Participants completed a questionnaire and were tested for chlamydia. MAIN OUTCOME MEASURE Chlamydia prevalence. RESULTS Of 4284 participants, 197 tested positive for chlamydia (4.6%; 95% CI, 3.9%-5.3%). Prevalence was similar in men (5.2% [65/1257]; 95% CI, 3.9%-6.4%) and women (4.4% [132/3027]; 95% CI, 3.5%-5.2%) (P = 0.25) and high in those reporting genital symptoms or a partner with a sexually transmissible infection (STI) - 17.0% in men (8/47; 95% CI, 2.8%-31.2%); 9.5% in women (16/169; 95% CI, 5.1%-13.8%). Nearly three-quarters of cases (73.4% [130/177]) were diagnosed in asymptomatic patients attending for non-sexual health reasons, and 83.8% of all participants (3258/3890) had attended for non-sexual health reasons. Prevalence was slightly higher in participants from rural and regional areas (4.8% [179/3724]; 95% CI, 4.0%-5.6%) than those from metropolitan areas (3.1% [17/548]; 95% CI, 1.5%-4.7%) (P = 0.08). In multivariable analysis, increasing partner numbers in previous 12 months (adjusted odds ratio [AOR] for three or more partners, 5.11 [95% CI, 2.35-11.08]), chlamydia diagnosis in previous 12 months (AOR, 4.35 [95% CI, 1.52-12.41]) and inconsistent condom use with most recent partner (AOR, 2.90 [95% CI, 1.31-6.40]) were significantly associated with chlamydia in men. In women, increasing partner numbers in previous 12 months (AOR for two partners, 2.59 [95% CI, 1.59-4.23]; AOR for three or more partners, 3.58 [95% CI, 2.26-5.68]), chlamydia diagnosis in previous 12 months (AOR, 3.13 [95% CI, 1.62-6.06]) and age (AOR for 25-29-year-olds, 0.23 [95% CI, 0.12-0.44]) were associated with chlamydia. CONCLUSIONS Chlamydia prevalence is similar in young men and women attending general practice. Testing only those with genital symptoms or a partner with an STI would have missed three-quarters of cases. Most men and women are amenable to being tested in general practice, even in rural and regional areas.

Isolation of Lautropia mirabilis from oral cavities of human immunodeficiency virus-infected children.

Lautropia mirabilis, a pleomorphic, motile, gram-negative coccus, has been isolated from the oral cavities of 32 of 60 (53.3%) children infected with human immunodeficiency virus (HIV) and 3 of 25 (12.0%) HIV-uninfected controls; the association of L. mirabilis isolation with HIV infection is significant (P < 0.001). All children in the study, both HIV-infected children and controls, were born to HIV-infected mothers. The presence of this bacterium was not associated with clinical disease in these children. The HIV-infected children with L. mirabilis did not differ from the HIV-infected children without L. mirabilis in immunological status, clinical status, or systemic medications. The role of HIV infection itself or concomitant factors in the establishment of L. mirabilis in the oral cavity remains to be elucidated.

Double-blind comparison of rectally administered diazepam to placebo for pediatric sedation: the cardiovascular response.

The sedative and cardiovascular effects of rectally administered diazepam (0.6 mg/kg) were compared to placebo in uncooperative children who required sedation during dental treatment. Twelve healthy preschool children, who required amalgam restorations, were treated during two standardized restorative appointments in a double-blind, crossover study. Blood pressure and pulse were obtained during four specified intervals during the appointment. The behavior of the children during the treatment visits was videotaped and later statistically analyzed using a kinesics/vocalization instrument. Behavioral ratings of cooperation were significantly improved during the treatment visit following diazepam. All interfering bodily movements, patient vocalizations and operator commands for the diazepam group were reduced significantly (p≤0.0001). No significant differences were observed for noninterfering behavioral response. Rectally administered diazepam did not alter blood pressure or pulse significantly in these sedated children when compared to the placebo. These findings indicate that rectal diazepam is an effective sedative agent with minimal effect on the cardiovascular system for the management of the young pediatric dental patient.

Characterization of the potential role for RNA-binding protein FUS in DNA damage response: A quantitative proteomic approach

FUS/TLS (fused in sarcoma/translocated in liposarcoma) is a ubiquitously expressed protein of the hnRNP family, that has been discovered as fused to transcription factors in several human sarcomas and found in protein aggregates in neurons of patients with an inherited form of Amyotrophic Lateral Sclerosis [Vance C. et al., 2009]. FUS is a 53 kDa nuclear protein that contains structural domains, such as a RNA Recognition Motif (RRM) and a zinc finger motif, that give to FUS the ability to bind to both RNA and DNA sequences. It has been implicated in a variety of cellular processes, such as pre-mRNA splicing, miRNA processing, gene expression control and transcriptional regulation [Fiesel FC. and Kahle PJ., 2011]. Moreover, some evidences link FUS to genome stability control and DNA damage response: mice lacking FUS are hypersensitive to ionizing radiation (IR) and show high levels of chromosome instability and, in response to double-strand breaks, FUS is phosphorylated by the protein kinase ATM [Kuroda M. et al., 2000; Hicks GG. et al., 2000; Gardiner M. et al., 2008]. Furthermore, preliminary results of mass spectrometric identification of FUS interacting proteins in HEK293 cells, expressing a recombinant flag-tagged FUS protein, highlighted the interactions with proteins involved in DNA damage response, such as DNA-PK, XRCC-5/-6, and ERCC-6, raising the possibilities that FUS is involved in this pathway, even though its role still needs to be clarified. This study aims to investigate the biological roles of FUS in human cells and in particular the putative role in DNA damage response through the characterization of the proteomic profile of the neuroblastoma cell line SH-SY5Y upon FUS inducible depletion, by a quantitative proteomic approach. The SH-SY5Y cell line that will be used in this study expresses, in presence of tetracycline, a shRNA that targets FUS mRNA, leading to FUS protein depletion (SH-SY5Y FUS iKD cells). To quantify changes in proteins expression levels a SILAC strategy (Stable Isotope Labeling by Amino acids in Cell culture) will be conducted on SH-SY5Y FUS iKD cells and a control SH-SY5Y cell line (that expresses a mock shRNA) and the relative changes in proteins levels will be evaluated after five and seven days upon FUS depletion, by nanoliquid chromatography coupled to tandem mass spectrometry (nLC-MS/MS) and bioinformatics analysis. Preliminary experiments demonstrated that the SH-SY5Y FUS iKD cells, when subjected to genotoxic stress (high dose of IR), upon inducible depletion of FUS, showed a increased phosphorylation of gH2AX with respect to control cells, suggesting an higher activation of the DNA damage response.

Proteomic characterization of the FUS/TLS interactome

FUS/TLS (fused in sarcoma/translocated in liposarcoma) is a ubiquitously expressed RNA-binding protein, that has been discovered as fused to transcription factors in several human sarcomas and found in protein aggregates in neurons of patients with an inherited form of Amyotrophic Lateral Sclerosis [1]. To date, FUS has been implicated in a variety of cellular processes such as gene expression control, transcriptional regulation, pre-mRNA splicing and miRNA processing [2]. In addition, some evidences link FUS to genome stability control and DNA damage response. In fact, mice lacking FUS are hypersensitive to ionizing radiation and show high levels of chromosome instability and in response to double-strand breaks, FUS gets phosphorylated by the protein kinase ATM [3, 4, 5]. Moreover, upon DNA damage stress, FUS mediates Ebp1 (ErbB3 receptor-binding protein) SUMOylation, a post-translational modification that is required for its onco-suppressive activity, by acting as SUMO E3 ligase [6]. The study aims to investigate the role of FUS in DNA damage response and SUMOylation, two cellular pathways tightly interconnected to each other. Moreover, we will exploit biochemical and mass spectrometry-based approaches in order to identify other potential substrates of the E3 SUMO ligase activity of FUS. Preliminary results of mass spectrometric identification of FUS interacting proteins, in HEK293 and SHSY5Y cells, highlighted the interaction of FUS with several proteins involved in DNA damage response and many of those have been described already as target of SUMOylation, such as XRCC5, DDX5, PARP1, Nucleophosmin, and others. These evidences strengthen the hypothesis that FUS might represent a link between these pathways, even thou its exact role still needs to be clearly addressed. [1] Vance C. et al. (2009) Science 323(5918): p. 1208-11 [2] Fiesel FC., Kahle PJ. (2011) FEBS J. 278(19): p. 3550-68 [3] Kuroda M. et al. (2000) Embo J. 19(3): p. 453-62 [4] Hicks GG. et al. (2000) Nat Genet. 24(2):p. 175-9 [5] Gardiner M. et al. (2008) Biochem J. 415(2): p. 297-307 [6] Oh SM. et al. (2010) Oncogene 29(7): p. 1017-30

Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization

The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain ∼8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD.

Radiocarbon dating of modern peat profiles: Pre- and post-bomb C-14 variations in the construction of age-depth models

We present studies of 9 modern (up to 400-yr-old) peat sections from Slovenia, Switzerland, Austria, Italy, and Finland. Precise radiocarbon dating of modern samples is possible due to the large bomb peak of atmospheric 14C concentration in 1963 and the following rapid decline in the 14C level. All the analyzed 14C profiles appeared concordant with the shape of the bomb peak of atmospheric 14C concentration, integrated over some time interval with a length specific to the peat section. In the peat layers covered by the bomb peak, calendar ages of individual peat samples could be determined almost immediately, with an accuracy of 23 yr. In the pre-bomb sections, the calendar ages of individual dated samples are determined in the form of multi-modal probability distributions of about 300 yr wide (about AD 16501950). However, simultaneous use of the post-bomb and pre-bomb 14C dates, and lithological information, enabled the rejection of most modes of probability distributions in the pre-bomb section. In effect, precise age-depth models of the post-bomb sections have been extended back in time, into the wiggly part of the 14C calibration curve.

The effect of specific carotenoids on lung cancer risk

A population-based case-comparison study of histologically confirmed lung cancer among white male and female residents of six Texas coastal counties was conducted from 1979-1982. Dietary information as well as information concerning smoking, alcohol consumption, occupational and residential exposures, and family history of cancer was obtained from 149 living cases and 359 comparison subjects.^ These data support the findings of previous studies that reported a protective association of total carotene intake with lung cancer (OR = 4.07, CI = 3.36-4.78), and no association for total Vitamin A or retinol. Of six specific carotenoids examined, these data reveal a statistically significant protective effect for alpha carotene (OR = 3.58, CI = 2.85-4.31), and an elevated, although non-significant effect for beta carotene (OR = 1.46, CI = 0.61-2.31). No consistent significant effect was found for cryptoxanthin, other xanthins, lutein or lycopene.^ Similar results were found for both males and females, and for both squamous cell and adenocarcinoma subtypes, although loss of power resulting from stratification may have rendered the celltype specific results more imprecise. These results should be considered with caution until confirmed by other studies, however, they suggest the importance of evaluating specific carotenoids in future diet-lung cancer investigations. ^

A Bayesian analysis for spatial processes with application to mapping

In geographical epidemiology, maps of disease rates and disease risk provide a spatial perspective for researching disease etiology. For rare diseases or when the population base is small, the rate and risk estimates may be unstable. Empirical Bayesian (EB) methods have been used to spatially smooth the estimates by permitting an area estimate to "borrow strength" from its neighbors. Such EB methods include the use of a Gamma model, of a James-Stein estimator, and of a conditional autoregressive (CAR) process. A fully Bayesian analysis of the CAR process is proposed. One advantage of this fully Bayesian analysis is that it can be implemented simply by using repeated sampling from the posterior densities. Use of a Markov chain Monte Carlo technique such as Gibbs sampler was not necessary. Direct resampling from the posterior densities provides exact small sample inferences instead of the approximate asymptotic analyses of maximum likelihood methods (Clayton & Kaldor, 1987). Further, the proposed CAR model provides for covariates to be included in the model. A simulation demonstrates the effect of sample size on the fully Bayesian analysis of the CAR process. The methods are applied to lip cancer data from Scotland, and the results are compared. ^

Un elixir de la palabra : Heterogeneidad interlingüe en la narrativa de Sandra Cisneros

Esta tesis doctoral explora la construcción de algunos aspectos enunciativos relacionados con la heterogeneidad lingüístico-cultural presentes en la narrativa de la escritora chicana Sandra Cisneros [n. 1954]. Más específicamente, esta investigación tiene como objetivo principal explicar el fenómeno de la desterritorialización de la lengua a partir del examen de la conformación de espacios lingüístico-culturales intersticiales a lo largo del desarrollo de la obra de Cisneros [1984, 1991, 2002], que conforma el corpus de nuestro trabajo. Nuestra hipótesis rectora indica que en la escritura de Cisneros. La constitución de la heterogeneidad y la gesta del sentido son ineludiblemente interlingües. Así, proponemos que la heterogeneidad interlingüe es la categoría que permite explicar la complejidad discursivo-enunciativa característica de nuestro corpus. A partir del concepto de heterogeneidad[es] enunciativa[s] elaborado por Authier-Revuz [1984]. Definimos la heterogeneidad interlingüe como un fenómeno enunciativo que se inscribe en el ámbito del dialogismo interdiscursivo [Bajtin [1952-3] 1982] y que se manifiesta a través de las marcas y formas que surgen en el discurso a través de los procesos de negociación y traducción Iingüistico-culturales actualizados en el encuentro constante y constitutivo de distintas lenguas. Según entendemos, la heterogeneidad interlingüe se articula a partir de tres dimensiones que se encuentran en permanente interacción: la conformación de una imagen discursiva o ethos [Ducrot, [1984] 1986; Amossy, 1999] asociado al responsable de la enunciación de la totalidad de los textos narrativos [Iocutor-Autor], la institución de sitios -formas y marcas- que se presentan como heterogéneos desde un punto de vista lingüístico-cultural y la configuración de una practica de lectura particular que exige una competencia discursivo-cultural de parte del lector que debe completar el sentido del texto y también del discurso. En atención alas dimensiones aludidas, esta tesis otorga atención específica a los siguientes aspectos: la constitución interlingüe de la paratextualidad, la alternancia de lenguas, los distintos modos de presencia de la traducción, los enunciados paremiológicos y la dimensión reflexiva de la enunciación. Entre los objetivos centrales de nuestra investigación, se cuentan: 1. la elaboración de un andamiaje teórico-metodológico pluridisciplinario que permita dar cuenta de las particularidades discursivas de nuestro corpus y ser referencia para el análisis de otras escrituras de minorías y narrativas de frontera; 2. la contribución al desarrollo de los estudios del discurso [Authier-Revuz, 1984, 1995; Ducrot. [1984] 1986, 2004] a través de la incorporación de la noción de interlingüismo a la discusión de la constitución de la heterogeneidad y de la gesta del sentido discursivo; 3. la articulación del concepto de desterritorializacion [Deleuze y Guattari, [1975] 1998] con algunas nociones originadas en los modelos provenientes de la teoría de la Frontera [Hicks, 1991; Arteaga, 1997] y de la teoría discursiva de Authier-Revuz [1984, 1995]. En cuanto a los objetivos particulares, este trabajo de tesis se propone examinar las distintas formas y marcas de la heterogeneidad interlingüe presentes en la narrativa de Cisneros y ofrecer un panorama analítico que pondere la evolución de la obra de la escritora chicana en relación con la construcción del responsable de la enunciación, los sitios de la heterogeneidad y la practica de lectura singular que impone esta escritura

Un elixir de la palabra : Heterogeneidad interlingüe en la narrativa de Sandra Cisneros

Esta tesis doctoral explora la construcción de algunos aspectos enunciativos relacionados con la heterogeneidad lingüístico-cultural presentes en la narrativa de la escritora chicana Sandra Cisneros [n. 1954]. Más específicamente, esta investigación tiene como objetivo principal explicar el fenómeno de la desterritorialización de la lengua a partir del examen de la conformación de espacios lingüístico-culturales intersticiales a lo largo del desarrollo de la obra de Cisneros [1984, 1991, 2002], que conforma el corpus de nuestro trabajo. Nuestra hipótesis rectora indica que en la escritura de Cisneros. La constitución de la heterogeneidad y la gesta del sentido son ineludiblemente interlingües. Así, proponemos que la heterogeneidad interlingüe es la categoría que permite explicar la complejidad discursivo-enunciativa característica de nuestro corpus. A partir del concepto de heterogeneidad[es] enunciativa[s] elaborado por Authier-Revuz [1984]. Definimos la heterogeneidad interlingüe como un fenómeno enunciativo que se inscribe en el ámbito del dialogismo interdiscursivo [Bajtin [1952-3] 1982] y que se manifiesta a través de las marcas y formas que surgen en el discurso a través de los procesos de negociación y traducción Iingüistico-culturales actualizados en el encuentro constante y constitutivo de distintas lenguas. Según entendemos, la heterogeneidad interlingüe se articula a partir de tres dimensiones que se encuentran en permanente interacción: la conformación de una imagen discursiva o ethos [Ducrot, [1984] 1986; Amossy, 1999] asociado al responsable de la enunciación de la totalidad de los textos narrativos [Iocutor-Autor], la institución de sitios -formas y marcas- que se presentan como heterogéneos desde un punto de vista lingüístico-cultural y la configuración de una practica de lectura particular que exige una competencia discursivo-cultural de parte del lector que debe completar el sentido del texto y también del discurso. En atención alas dimensiones aludidas, esta tesis otorga atención específica a los siguientes aspectos: la constitución interlingüe de la paratextualidad, la alternancia de lenguas, los distintos modos de presencia de la traducción, los enunciados paremiológicos y la dimensión reflexiva de la enunciación. Entre los objetivos centrales de nuestra investigación, se cuentan: 1. la elaboración de un andamiaje teórico-metodológico pluridisciplinario que permita dar cuenta de las particularidades discursivas de nuestro corpus y ser referencia para el análisis de otras escrituras de minorías y narrativas de frontera; 2. la contribución al desarrollo de los estudios del discurso [Authier-Revuz, 1984, 1995; Ducrot. [1984] 1986, 2004] a través de la incorporación de la noción de interlingüismo a la discusión de la constitución de la heterogeneidad y de la gesta del sentido discursivo; 3. la articulación del concepto de desterritorializacion [Deleuze y Guattari, [1975] 1998] con algunas nociones originadas en los modelos provenientes de la teoría de la Frontera [Hicks, 1991; Arteaga, 1997] y de la teoría discursiva de Authier-Revuz [1984, 1995]. En cuanto a los objetivos particulares, este trabajo de tesis se propone examinar las distintas formas y marcas de la heterogeneidad interlingüe presentes en la narrativa de Cisneros y ofrecer un panorama analítico que pondere la evolución de la obra de la escritora chicana en relación con la construcción del responsable de la enunciación, los sitios de la heterogeneidad y la practica de lectura singular que impone esta escritura

Un elixir de la palabra : Heterogeneidad interlingüe en la narrativa de Sandra Cisneros

Esta tesis doctoral explora la construcción de algunos aspectos enunciativos relacionados con la heterogeneidad lingüístico-cultural presentes en la narrativa de la escritora chicana Sandra Cisneros [n. 1954]. Más específicamente, esta investigación tiene como objetivo principal explicar el fenómeno de la desterritorialización de la lengua a partir del examen de la conformación de espacios lingüístico-culturales intersticiales a lo largo del desarrollo de la obra de Cisneros [1984, 1991, 2002], que conforma el corpus de nuestro trabajo. Nuestra hipótesis rectora indica que en la escritura de Cisneros. La constitución de la heterogeneidad y la gesta del sentido son ineludiblemente interlingües. Así, proponemos que la heterogeneidad interlingüe es la categoría que permite explicar la complejidad discursivo-enunciativa característica de nuestro corpus. A partir del concepto de heterogeneidad[es] enunciativa[s] elaborado por Authier-Revuz [1984]. Definimos la heterogeneidad interlingüe como un fenómeno enunciativo que se inscribe en el ámbito del dialogismo interdiscursivo [Bajtin [1952-3] 1982] y que se manifiesta a través de las marcas y formas que surgen en el discurso a través de los procesos de negociación y traducción Iingüistico-culturales actualizados en el encuentro constante y constitutivo de distintas lenguas. Según entendemos, la heterogeneidad interlingüe se articula a partir de tres dimensiones que se encuentran en permanente interacción: la conformación de una imagen discursiva o ethos [Ducrot, [1984] 1986; Amossy, 1999] asociado al responsable de la enunciación de la totalidad de los textos narrativos [Iocutor-Autor], la institución de sitios -formas y marcas- que se presentan como heterogéneos desde un punto de vista lingüístico-cultural y la configuración de una practica de lectura particular que exige una competencia discursivo-cultural de parte del lector que debe completar el sentido del texto y también del discurso. En atención alas dimensiones aludidas, esta tesis otorga atención específica a los siguientes aspectos: la constitución interlingüe de la paratextualidad, la alternancia de lenguas, los distintos modos de presencia de la traducción, los enunciados paremiológicos y la dimensión reflexiva de la enunciación. Entre los objetivos centrales de nuestra investigación, se cuentan: 1. la elaboración de un andamiaje teórico-metodológico pluridisciplinario que permita dar cuenta de las particularidades discursivas de nuestro corpus y ser referencia para el análisis de otras escrituras de minorías y narrativas de frontera; 2. la contribución al desarrollo de los estudios del discurso [Authier-Revuz, 1984, 1995; Ducrot. [1984] 1986, 2004] a través de la incorporación de la noción de interlingüismo a la discusión de la constitución de la heterogeneidad y de la gesta del sentido discursivo; 3. la articulación del concepto de desterritorializacion [Deleuze y Guattari, [1975] 1998] con algunas nociones originadas en los modelos provenientes de la teoría de la Frontera [Hicks, 1991; Arteaga, 1997] y de la teoría discursiva de Authier-Revuz [1984, 1995]. En cuanto a los objetivos particulares, este trabajo de tesis se propone examinar las distintas formas y marcas de la heterogeneidad interlingüe presentes en la narrativa de Cisneros y ofrecer un panorama analítico que pondere la evolución de la obra de la escritora chicana en relación con la construcción del responsable de la enunciación, los sitios de la heterogeneidad y la practica de lectura singular que impone esta escritura