Calorimetría indirecta versus Harris-Benedict para determinar gasto energético basal en pacientes ventilados

El inadecuado aporte nutricional en los pacientes con enfermedades criticas, ha llevado al desarrollo de complicaciones que incrementan la mortalidad y los costos de la atención en salud. Muchos factores están involucrados en el consumo de los nutrientes por el organismo, como: los traslados, las intervenciones quirúrgicas, el uso de vasopresores, la ventilación mecánica, entre otros. Si se presenta imprecisión en la de-terminación del gasto energético, puede conllevar a un sobre aporte alimenticio en el paciente el cual puede afectar la evolución y pronosti-co del individuo. Es de conocimiento universal que los costos en salud cada día se in-crementan, en especial cuando se presenta requerimiento del manejo de un paciente en la unidad de cuidados intensivos. Para predecir el gasto energético basal de los paciente en las UCI se cuentan con herramientas de evaluación sencillas, de fácil uso y económicas, como la ecuación de Harris-Benedict, o herramientas complejas y de difícil manejo como la Calorimetría Indirecta. El incremento en la demanda de servicios con mayor tecnología en el tratamiento de los pacientes, enfrenta al personal de salud para ser más crítico en el uso de la nueva tecnología, por tal motivo, se evaluó la presencia de correlación entre las ecuaciones de Harris-Benedict y Calorimetría Indirecta, encontrando que se presenta una buena correlación entre las ecuaciones, con un valor de Pearson de 0,700 y una p = 0.002. Por lo que se puede concluir que las ecuaciones pueden ser utilizadas para estimar el gasto energético basal de los pacientes en la UCI.

Descripción del comportamiento basal y transoperatorio de los nivels de NIRS cerebral en pacientes con cardiopatias congenitas cianosantes sometidos a cirugia paliativa o correctiva y su correlación con las variables fisiologicas determinantes del flujo sanguineo cerebral

La lesión neurológica es un riesgo latente en pacientes sometidos a cirugía cardiaca, en cirugía para corrección de cardiopatías congénitas puede tener una incidencia tan alta como del 26%, por lo cual es necesario contar con herramientas cada vez más acertadas y que puedan ayudar a disminuir esta incidencia; la saturación regional cerebral medida por NIRS constituye una herramienta válida, que permite una evaluación continua y de forma no invasiva, que puede servir para este fin. El presente estudio pretende determinar una asociación entre los niveles de saturación regional de oxígeno cerebral en los pacientes con cardiopatías congénitas cianosantes y las variables fisiológicas determinantes del aporte de oxígeno, asumiendo una hipoxemia crónica para estos pacientes. Se realizó un estudio de correlación para estas variables, para lo cual se evaluaron de forma sistemática estas en pacientes sometidos a cirugía cardiaca en la Fundación Cardioinfantil Instituto de Cardiología, que cumplían con los criterios de inclusión, hasta completar una muestra de 31 pacientes, en los cuales no se realizó ninguna intervención, catalogándolo como riesgo menor que el mínimo, cumpliendo con los criterios de Helsinki.Se encontró una correlación significativa entre los valores de NIRS cerebral con los contenidos arteriales, capilares y venoso de oxígeno en el análisis bivariado, encontrándose para estos pacientes niveles más bajos de estos contenidos como también para el consumo de oxígeno, no se encontró asociación significativa con la saturación arterial ni venosa de oxígeno, parece existir una relación significativa entre los niveles más bajos de NIRS con el resultado neurológico, estos hallazgos sin embargo no fueron significativos en el análisis multivariado.

Sala de estimulación basal en un centro de educación especial para alumnos gravemente afectados.

A través de este proyecto se pretende conectar al alumno con el medio que le rodea a través de sistemas sensoriales. Partiendo de esta premisa se tratará de: 1.- Descubrir las sensaciones táctiles que puede recibir el propio cuerpo a través de una estimulación intencionada. 2.- Ayudar al alumno a desarrollar la posibilidad de explorar la textura de las cosas, a integrarla y diferenciarla. 3.- Estimular zonas del cuerpo ignoradas por el sistema nervioso central o desensibilizar áreas hiperestésicas. 4.- Aprender a captar fenómenos acústicos de manera corporal. Asimilar las oscilaciones de frecuencia como cambios vibratorios en niños que tienen afectado su sistema auditivo pero integran las sensaciones táctiles profundas. 5.- Capacita de forma gradual a los alumnos para que adopten actitudes posturales adecuadas a actividades cotidianas, para un control progresivo del cuerpo y de las funciones, tolerando el cambio y establecimiento postural. 6.- Adquirir una orientación acústica en el espacio. 7.- Aprender a dirigir los movimientos visuales de una manera coordinada. 8.- Sensibilizar la boca ante nuevas impresiones gustativas y aprender a utilizar la boca para discriminar objetos o alimentos. 9.- Manifestar reacciones ante los estímulos olfativos. 10.- etc. Las actividades tendrán la asistencia de los técnicos del centro. Se desarrollarán actividades en entornos temáticos que permitan dar una información al alumno que de otro modo no podría captar..

El concepto de estimulación basal en educación.

Resumen tomado del autor

Nuevo modelo de intervención para alumnos con necesidades educativas graves y permanentes : proyecto de estimulación basal y sensorial.

Convocatoria de Premios Nacionales de Innovación Educativa del CIDE 2006. Mención Honorífica. Modalidad Innovación Educativa

Analysis of the consistency of alphabet symbol/speech sound correspondence in three basal reader series

This paper reviews a study to analyze the number of times alphabet symbols occur in three commonly used basal reader series.

Bone morphogenetic proteins (BMP)-4,-6, and-7 potently suppress basal and luteinizing hormone-induced androgen production by bovine theca interna cells in primary culture: Could ovarian hyperandrogenic dysfunction be caused by a defect in thecal BMP signaling?

We reported recently that bovine theca interna cells in primary culture express several type-I and type-II receptors for bone morphogenetic proteins (BMPs). The same cells express at least two potential ligands for these receptors (BMP-4 and - 7), whereas bovine granulosa cells and oocytes express BMP-6. Therefore, BMPs of intrafollicular origin may exert autocrine/paracrine actions to modulate theca cell function. Here we report that BMP-4, - 6, and - 7 potently suppress both basal ( P < 0.0001; respective IC50 values, 0.78, 0.30, and 1.50 ng/ml) and LH-induced ( P < 0.0001; respective IC50 values, 5.00, 0.55, and 4.55 ng/ml) androgen production by bovine theca cells while having only a moderate effect on progesterone production and cell number. Semiquantitative RT-PCR showed that all three BMPs markedly reduced steady-state levels of mRNA for P450c17. Levels of mRNA encoding steroidogenic acute regulatory protein, P450scc, and 3 beta-hydroxysteroid dehydrogenase were also reduced but to a much lesser extent. Immunocytochemistry confirmed a marked reduction in cellular content of P450c17 protein after BMP treatment ( P < 0.001). Exposure to BMPs led to cellular accumulation of phosphorylated Smad1, but not Smad2, confirming that the receptors signal via a Smad1 pathway. The specificity of the BMP response was further explored by coincubating cells with BMPs and several potential BMP antagonists, chordin, gremlin, and follistatin. Gremlin and chordin were found to be effective antagonists of BMP-4 and - 7, respectively, and the observation that both antagonists enhanced ( P < 0.01) androgen production in the absence of exogenous BMP suggests an autocrine/paracrine role for theca-derived BMP- 4 and - 7 in modulating androgen production. Collectively, these data indicate that an intrafollicular BMP signaling pathway contributes to the negative regulation of thecal androgen production and that ovarian hyperandrogenic dysfunction could be a result of a defective autoregulatory pathway involving thecal BMP signaling.

Molecular evidence from ascidians for the evolutionary origin of vertebrate cranial sensory placodes

Cranial sensory placodes are specialised areas of the head ectoderm of vertebrate embryos that contribute to the formation of the cranial sense organs and associated ganglia. Placodes are often considered a vertebrate innovation, and their evolution has been hypothesised as one key adaptation underlying the evolution of active predation by primitive vertebrates. Here, we review recent molecular evidence pertinent to understanding the evolutionary origin of placodes. The development of vertebrate placodes is regulated by numerous genes, including members of the Pax, Six, Eya, Fox, Phox, Neurogenin and Pou gene families. In the sea squirt Ciona intestinalis (a basal chordate and close relative of the vertebrates), orthologues of these genes are deployed in the development of the oral and atrial siphons, structures used for filter feeding by the sessile adult. Our interpretation of these findings is that vertebrate placodes and sea squirt siphon primordia have evolved from the same patches of specialised ectoderm present in the common ancestor of the chordates.

Purification and characterization of the flagellar basal body of Rhodobacter sphaeroides

Flagellar hook-basal body (HBB) complexes were purified from Rhodobacter sphaeroides. The HBB was more acid labile but more heat stable than that of Salmonella species, and protein identification revealed that HBB components were expressed only from one of the two sets of flagellar gene clusters on the R. sphaeroides genome, under the heterotrophic growth conditions tested here.

Supramolecular hydrogen-bond structures and magnetic interactions in basal-apical, dinuclear, azide-bridged copper(II) complexes

The synthesis, characterisation, X-ray single crystal structures and magnetic properties of three new basal-apical mu(2)-1,1-azide-bridged complexes [(CuLN3)-N-1](2) (1), [(CuLN3)-N-2](2) (2) and [(CuLN3)-N-3](2) (3) with very similar tridentate Schiff-base blocking ligands {HL1 = N-[2-(ethylamino) ethyl] salicylaldimine; HL2 = 7-(ethylamino)-4-methyl-5-azahept-3-en-2-one; HL3 = 7-amino-4-methyl-5-azaoct-3-en-2-one} have been reported [complex 1: monoclinic, P2(1)/c, a = 8.390(2), b = 7.512(2), c = 19.822(6) Angstrom, beta = 91.45(5)degrees; complex 2: monoclinic, P2(1)/c, a = 8.070(9), b = 9.787(12), c = 15.743(17) A, beta = 98.467(10)degrees; complex 3: monoclinic, P2(1)/n, a = 5.884(7), b = 16.147(18), c = 11.901(12) Angstrom, beta = 90.050(10)degrees]. The structures consist of neutral dinuclear entities resulting from the pairing of two mononuclear units through end-on azide bridges connecting an equatorial position of one copper centre to an axial position of the other, The copper ions adopt a (4+1) square-based geometry in all the complexes. In complex 2, there is no inter-dimer hydrogen-bonding. However, complexes 1 and 3 form two different supramolecular structures in which the dinuclear entities are linked by H-bonds giving one-dimensional systems. Variable temperature (300-2 K) magnetic-susceptibility measurements and magnetisation measurements at 2 K reveal that all three complexes have antiferromagnetic coupling. Magneto-structural correlations have been made taking into consideration both the azido bridging ligands and the existence of intermolecular hydrogen bonds. ((C) Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2004).

Effects of dietary fatty acid composition on basal and hormonestimulated hepatic lipogenesis and on circulating lipids in the rat

Thirty male rats were randomly assigned to one of three dietary groups in which the source of dietary fat was either a mixed oil, maize oil or fish oil. Effects of dietary fatty acid composition on in virro rates of [U-'4C]glucose incorporation into hepatic total lipids and into hepatic triacylglycerol were measured under basal, insulin (4 nM)-, gastric inhibitory polypeptide (GIP; 6 mi)- and insulin + GIP (4 nM + 6 n ~ ) - stimulated conditions. Effects of the three diets on postprandial plasma triacylglycerol, cholesterol, insulin and GIP concentrations were also measured. The fish-oil diet decreased rates of basal glucose incorporation into hepatic total lipids (P < 0.05) and hepatic triacylglycerol (P < 0.01) compared with the mixed-oil diet. The presence of insulin + GIP in the incubation medium stimulated glucose incorporation into hepatic total lipids in the maize-oil (P < 0.01) and fish-oil groups (P < OW), as well as into hepatic triacylglycerol in the maize-oil group (P < 0.005). In addition, the fish-oil diet decreased postprandial plasma triacylglycerol levels compared with both other dietary groups (P < 0-05 both cases), and the mixed-oil diet markedly increased postprandial plasma insulin levels compared with the other dietary groups (P c 0.001).

Crosstalk with insulin and dependence on PI3K/Akt/mTOR rather than MAPK pathways in upregulation of basal growth following long-term oestrogen deprivation in three human breast cancer cell lines

Background: MCF-7, T-47-D, ZR-75-1 human breast cancer cell lines are dependent on oestrogen for growth but can adapt to grow during long-term oestrogen deprivation. This serves as a model for identification of therapeutic targets in endocrine-resistant breast cancer. Methods: An overlooked complication of this model is that it involves more than non-addition of oestrogen, and inadequate attention has been given to separating molecular events associated with each of the culture manipulations. Results: Insulin and oestradiol were shown to protect MCF-7 cells against upregulation of basal growth, demonstrating a crosstalk in the growth adaptation process. Increased phosphorylation of p44/42MAPK and c-Raf reflected removal of insulin from the medium and proliferation of all three cell lines was inhibited to a lesser extent by PD98059 and U0126 following long-term oestrogen/insulin withdrawal, demonstrating a reduced dependence on the MAPK pathway. By contrast, long-term oestrogen/insulin deprivation did not alter levels of phosphorylated Akt and did not alter the dose-response of growth inhibition with LY294002 in any of the three cell lines. The IGF1R inhibitor picropodophyllin inhibited growth of all MCF-7 cells but only in the long-term oestrogen/insulin-deprived cells was this paralleled by reduction in phosphorylated p70S6K, a downstream target of mTOR. Long-term oestrogen/insulin-deprived MCF-7 cells had higher levels of phosphorylated p70S6K and developed increased sensitivity to growth inhibition by rapamycin. Conclusions: The greater sensitivity to growth inhibition by rapamycin in all three cell lines following long-term oestrogen/insulin deprivation suggests rapamycin-based therapies might be more effective in breast cancers with acquired oestrogen resistance. Keywords Akt, breast cancer cells, endocrine resistance, insulin, MAPK, MCF-7 cells, mTOR, oestrogen, oestrogen-deprived, PI3K, picropodophyllin, rapamycin, T-47-D cells, ZR-75-1 cells

Localization of calcitonin receptor-like receptor and receptor activity modifying protein 1 in enteric neurons, dorsal root ganglia, and the spinal cord of the rat

Calcitonin receptor-like receptor (CLR) and receptor activity modifying protein 1 (RAMP1) comprise a receptor for calcitonin gene related peptide (CGRP) and intermedin. Although CGRP is widely expressed in the nervous system, less is known about the localization of CLR and RAMP1. To localize these proteins, we raised antibodies to CLR and RAMP1. Antibodies specifically interacted with CLR and RAMP1 in HEK cells coexpressing rat CLR and RAMP1, determined by Western blotting and immunofluorescence. Fluorescent CGRP specifically bound to the surface of these cells and CGRP, CLR, and RAMP1 internalized into the same endosomes. CLR was prominently localized in nerve fibers of the myenteric and submucosal plexuses, muscularis externa and lamina propria of the gastrointestinal tract, and in the dorsal horn of the spinal cord of rats. CLR was detected at low levels in the soma of enteric, dorsal root ganglia (DRG), and spinal neurons. RAMP1 was also localized to enteric and DRG neurons and the dorsal horn. CLR and RAMP1 were detected in perivascular nerves and arterial smooth muscle. Nerve fibers containing CGRP and intermedin were closely associated with CLR fibers in the gastrointestinal tract and dorsal horn, and CGRP and CLR colocalized in DRG neurons. Thus, CLR and RAMP1 may mediate the effects of CGRP and intermedin in the nervous system. However, mRNA encoding RAMP2 and RAMP3 was also detected in the gastrointestinal tract, DRG, and dorsal horn, suggesting that CLR may associate with other RAMPs in these tissues to form a receptor for additional peptides such as adrenomedullin.

Plastic and evolutionary responses to heat stress in a temperate dung fly: negative correlation between basal and induced heat tolerance?

Extreme weather events such as heat waves are becoming more frequent and intense. Populations can cope with elevated heat stress by evolving higher basal heat tolerance (evolutionary response) and/or stronger induced heat tolerance (plastic response). However, there is ongoing debate about whether basal and induced heat tolerance are negatively correlated and whether adaptive potential in heat tolerance is sufficient under ongoing climate warming. To evaluate the evolutionary potential of basal and induced heat tolerance, we performed experimental evolution on a temperate source 4 population of the dung fly Sepsis punctum. Offspring of flies adapted to three thermal selection regimes (Hot, Cold and Reference) were subjected to acute heat stress after having been exposed to either a hot-acclimation or non-acclimation pretreatment. As different traits may respond differently to temperature stress, several physiological and life history traits were assessed. Condition dependence of the response was evaluated by exposing juveniles to different levels of developmental (food restriction/rearing density) stress. Heat knockdown times were highest, whereas acclimation effects were lowest in the Hot selection regime, indicating a negative association between basal and induced heat tolerance. However, survival, adult longevity, fecundity and fertility did not show such a pattern. Acclimation had positive effects in heat-shocked flies, but in the absence of heat stress hot-acclimated flies had reduced life spans relative to nonacclimated ones, thereby revealing a potential cost of acclimation. Moreover, body size positively affected heat tolerance and unstressed individuals were less prone to heat stress than stressed flies, offering support for energetic costs associated with heat tolerance. Overall, our results indicate that heat tolerance of temperate insects can evolve under rising temperatures, but this response could be limited by a negative relationship between basal and induced thermotolerance, and may involve some but not other fitness-related traits.