Análisis del gen adra2a receptor alfa 2a adrenergico en pacientes con trastorno de hiperactividad y déficit de atención

El trastorno de hiperactividad y déficit de atención (THDA), es definido clínicamente como una alteración en el comportamiento, caracterizada por inatención, hiperactividad e impulsividad. Estos aspectos son clasificados en tres subtipos, que son: Inatento, hiperactivo impulsivo y mixto. Clínicamente se describe un espectro amplio que incluye desordenes académicos, trastornos de aprendizaje, déficit cognitivo, trastornos de conducta, personalidad antisocial, pobres relaciones interpersonales y aumento de la ansiedad, que pueden continuar hasta la adultez. A nivel global se ha estimado una prevalencia entre el 1% y el 22%, con amplias variaciones, dadas por la edad, procedencia y características sociales. En Colombia, se han realizado estudios en Bogotá y Antioquia, que han permitido establecer una prevalencia del 5% y 15%, respectivamente. La causa específica no ha sido totalmente esclarecida, sin embargo se ha calculado una heredabilidad cercana al 80% en algunas poblaciones, demostrando el papel fundamental de la genética en la etiología de la enfermedad. Los factores genéticos involucrados se relacionan con cambios neuroquímicos de los sistemas dopaminérgicos, serotoninérgicos y noradrenérgicos, particularmente en los sistemas frontales subcorticales, corteza cerebral prefrontal, en las regiones ventral, medial, dorsolateral y la porción anterior del cíngulo. Basados en los datos de estudios previos que sugieren una herencia poligénica multifactorial, se han realizado esfuerzos continuos en la búsqueda de genes candidatos, a través de diferentes estrategias. Particularmente los receptores Alfa 2 adrenérgicos, se encuentran en la corteza cerebral, cumpliendo funciones de asociación, memoria y es el sitio de acción de fármacos utilizados comúnmente en el tratamiento de este trastorno, siendo esta la principal evidencia de la asociación de este receptor con el desarrollo del THDA. Hasta la fecha se han descrito más de 80 polimorfismos en el gen (ADRA2A), algunos de los cuales se han asociado con la entidad. Sin embargo, los resultados son controversiales y varían según la metodología diagnóstica empleada y la población estudiada, antecedentes y comorbilidades. Este trabajo pretende establecer si las variaciones en la secuencia codificante del gen ADRA2A, podrían relacionarse con el fenotipo del Trastorno de Hiperactividad y el Déficit de Atención.

Tratamiento de Artritis reumatoide con antagonistas del factor de necrosis tumoral alfa y su asociación con el desarrollo de melanoma cutáneo: revisión sistemática de la literatura y meta-análisis.

Introducción: El tratamiento con antagonistas del factor de necrosis tumoral alfa (anti TNF) ha impactado el pronóstico y la calidad de vida de los pacientes con artritis reumatoide (AR) positivamente, sin embargo, se interroga un incremento en el riesgo de desarrollar melanoma. Objetivo: Conocer la asociación entre el uso de anti TNF y el desarrollo de melanoma maligno en pacientes con AR. Metodología: Se realizó una búsqueda sistemática en MEDLINE, EMBASE, COCHRANE LIBRARY y LILACS para ensayos clínicos, estudios observacionales, revisiones y meta-análisis en pacientes adultos con diagnóstico de AR y manejo con anti TNF (Certolizumab pegol, Adalimumab, Etanercept, Infliximab y Golimumab). Resultados: 37 estudios clínicos cumplieron los criterios de inclusión para el meta-análisis, con una población de 16567 pacientes. El análisis de heterogeneidad no fue significativo (p=1), no se encontró diferencia en el riesgo entre los grupos comparados DR -0.00 (IC 95% -0.001; -0.001). Un análisis adicional de los estudios en los que se reportó al menos 1 caso de melanoma (4222 pacientes) tampoco mostró diferencia en el riesgo DR -0.00 (IC 95% -0.004 ; -0.003). Conclusión: En la evidencia disponible a la fecha no encontramos asociación significativa entre el tratamiento con anti TNF en pacientes con diagnóstico de AR y el desarrollo de melanoma cutáneo.

Análisis de la política exterior norteamericana hacia Turquía, en materia de seguridad, y su influencia en el Kurdistán. Periodo 2003-2009

Este estudio tiene como objetivo analizar los elementos que articulan la Política Exterior de los Estados Unidos hacia Turquía, en materia de seguridad, y su influencia en el Kurdistán, ya que en el periodo 2003-2009 se presentaron acontecimientos que marcaron la vida política, económica, militar y social de la región del Medio Oriente, caracterizado por la presencia de los Estados Unidos. Esta investigación se desarrollara de acuerdo con el modelo de monografía, para dar un análisis teórico sobre el tema delimitado anteriormente. Se espera que el presente estudio sirva para que el lector comprenda las diferentes actuaciones de los Estados Unidos en el escenario internacional, para la consecución de sus intereses y que tenga un acercamiento en las diferentes relaciones entre los Estados para entender mejor los acontecimientos que se presentaron en el periodo a analizar.

O ensino de filosofia no ensino médio mediado pela literatura sartriana

On analyse une expérience de l enseignement de philosophie dans l enseignement secondaire par la littérature. La scène d intervention a été l Institut Fédéral d Éducation, Science et Technologie du Rio Grande do Norte (IFRN), dans l année 2008. L étude à caractère qualitatif a adopté un modèle de recherche participant, dans laquelle le chercheur a intervenu dans son propre contexte de classe. On a utilisé l investigation d un ouvrage existentialiste de Jean-Paul Sartre, le roman La Nausée, comme contribution méthodologique pour l enseignement de philosophie. On a adopté le recours de la littérature avec contenu philosophique à partir de la proposition apportée para les Paramètres Curriculaires Nationaux pour l Enseignement Secondaire (PCNEM) : celle qu on ne doit ni avoir la prétention de former de philosophes professionnels ni banaliser la philosophie auprès des élèves. En partant du principe que l existentialisme a été un courant philosophique qui a utilisé la littérature entant qu expression d idées philosophiques, on a envisagé le potentiel pédagogique du voisinage communicant entre la philosophie et la littérature que lie l expérience littéraire avec les textes qui montrent aussi la discussion philosophique. L idée force a été celle de traiter concepts philosophiques a partir de la littérature comme invitation à la réflexion, en analysant l élément ludique dans la littérature comme jeu de la pensée. La pensée considérée comme action ludique arriverait parmi l idéal d en chercher de meilleures manières à comprendre la réalité en étant cet idéal esthétique assumé dans l effort d imprimer sens au chaos des expériences. Les situations pédagogiques en classe comptent fréquemment avec moment de dialogue a propos des problèmes existentiels affrontés par le protagoniste du roman, Antoine Roquentin, considérés comme questions philosophiques et débattues par l investigation dialogique tout suite après la lecture des parties du livre. Dans ce sens, on a cherché à suivre les marches de la méthode socratique dans lequel questionner e questionner à soi même soient les moles propulseurs de la réflexion philosophique. L investigation dialogique a été étendue pendant cinq rencontres de quatre-vingt-dix minutes interprétés par une analyse discursive qui a essayé d établir des rapports entre le discours de l enseignant et des élèves avec le discours de la tradition philosophique. Cette recherche a aussi envisagé à produire une réflexion sur la pratique de l auteur lui-même de l étude. Celui-ci peut-être soit l objectif le plus largement atteint : prendre conscience de l importance de la formation d un enseignant réflexif qui associe dans sa praxis le savoir faire avec la critique honnête de sa propre capacité professionnel

Haitï: évolution économique de l'année 2004 et les perspectives pour 2005

Inclut la bibliographie

Paul Flandrin (1811-1902), un nuovo sguardo sul paesaggio dell'Ottocento

Questa ricerca ha l’obiettivo di dare nuovi contributi alla conoscenza della pittura di paesaggio francese nell’Ottocento attraverso lo studio dell’opera di Paul Flandrin (1811-1902). Flandrin si colloca al crocevia di esperienze fondamentali nella ricerca artistica di metà Ottocento: l’eredità di Camille Corot, l’insegnamento di Jean-Auguste Dominique Ingres, la pratica del lavoro en plein air, la tradizione del paesaggio neoclassico. Il corpus di opere del pittore lionese Paul Flandrin (1811-1902) ricostruito in questa tesi è frutto di una sistematica operazione di ricerca sul campo e viene in seguito analizzato alla luce dei recenti studi sulla pittura di paesaggio neoclassico in Francia nel XIX secolo. La ricerca si fonda su una grande quantità di materiale inedito: dipinti, disegni, taccuini di studio en plein air, corrispondenza con colleghi e amici. Da questa ricerca la fisionomia artistica di Paul Flandrin emerge ben individuata singolarmente e al tempo stesso ancorata al contesto storico-artistico attraverso le relazioni con i colleghi, l’utilizzo di determinate tecniche, la frequentazione di mete comuni ai paesaggisti suoi contemporanei, la decisa presa di posizione a favore del paesaggio neoclassico.

Ringier (Familie)

Famille de pasteurs, politiciens et entrepreneurs de Zofingue, attestée pour la première fois en 1527, lorsque leur aïeul Jean, tonnelier originaire de Nîmes, obtint la bourgeoisie de Zofingue. Michael (1521-1605), avoyer, l'un de ses cinq fils, est l'ancêtre de la branche des imprimeurs et éditeurs. Après lui, de nombreux R. consolidèrent durablement l'influence de la famille. A partir du XVIIIe s., divers membres firent des carrières politiques, tels Samuel (1706-1786), avoyer, et Rudolf Friedrich (1805-1886), président de la ville. Les R. furent aussi très liés à l'Eglise. Le fils de Michael, Moritz (1557-1615), fut pasteur et doyen à Zofingue. Jusqu'au XIXe s., la famille compta une trentaine d'ecclésiastiques, essentiellement des pasteurs officiant sur le territoire bernois, tels Johann Heinrich ( -> 3) et Michael ( -> 8). Les conseillers Beat (1712-1778) et Niklaus (1734-1766) furent les premiers R. actifs dans la production protoindustrielle de drap. D'autres négociants suivirent jusqu'au milieu du XIXe s. L'architecte Niklaus Emanuel (1744-1815) construisit l'hôtel de ville de Zofingue (1792-1795) de style baroque tardif. Johann Rudolf ( -> 4) se distingua sous la République helvétique (1798-1803). Samuel (1767-1826), conseiller municipal de Zofingue, créa les armoiries du canton d'Argovie en 1803. Les R. s'affirmèrent sur le plan cantonal avec Karl Ludwig ( -> 6), chancelier, et Arnold ( -> 1), conseiller d'Etat et plusieurs fois landamman, et sur le plan fédéral avec Johann Rudolf ( -> 5), conseiller national, et Gottlieb ( -> 2), conseiller aux Etats et chancelier de la Confédération. Johann Rudolf (1803-1874) fonda, en 1833, l'imprimerie Ringier à Zofingue, reprise par son fils Franz Emil (1837-1898). A partir de 1898, Paul August ( -> 9), représentant de la troisième génération d'imprimeurs, agrandit l'entreprise dont il fit la principale imprimerie et maison d'édition de Suisse. Cette expansion se poursuivit après 1960 sous son fils Hans (1906-2003). Avec les fils de celui-ci, Christoph (naissance1941, dans la firme jusqu'en 1991) et Michael (naissance1949), Ringier devint, à partir de 1985, une entreprise multinationale et multimédia. Bibliographie – F. Schoder, Ortsbürger von Zofingen, 1962 – P. Meier, T. Häussler, Zwischen Masse, Markt und Macht, 2009

Genome-wide meta-analysis increases to 71 the number of confirmed Crohn's disease susceptibility loci

We undertook a meta-analysis of six Crohn's disease genome-wide association studies (GWAS) comprising 6,333 affected individuals (cases) and 15,056 controls and followed up the top association signals in 15,694 cases, 14,026 controls and 414 parent-offspring trios. We identified 30 new susceptibility loci meeting genome-wide significance (P < 5 × 10 ? ? ). A series of in silico analyses highlighted particular genes within these loci and, together with manual curation, implicated functionally interesting candidate genes including SMAD3, ERAP2, IL10, IL2RA, TYK2, FUT2, DNMT3A, DENND1B, BACH2 and TAGAP. Combined with previously confirmed loci, these results identify 71 distinct loci with genome-wide significant evidence for association with Crohn's disease.

Everolimus augments the effects of sorafenib in a syngeneic orthotopic model of hepatocellular carcinoma

Sorafenib targets the Raf/mitogen-activated protein kinase, VEGF, and platelet-derived growth factor pathways and prolongs survival patients in advanced hepatocellular carcinoma (HCC). Everolimus inhibits the mammalian target of rapamycin, a kinase overactive in HCC. To investigate whether the antitumor effects of these agents are additive, we compared a combined and sequential treatment regimen of everolimus and sorafenib with monotherapy. After hepatic implantation of Morris Hepatoma (MH) cells, rats were randomly allocated to everolimus (5 mg/kg, 2×/week), sorafenib (7.5 mg/kg/d), combined everolimus and sorafenib, sequential sorafenib (2 weeks) then everolimus (3 weeks), or control groups. MRI quantified tumor volumes. Erk1/2, 4E-BP1, and their phosphorylated forms were quantified by immunoblotting. Angiogenesis was assessed in vitro by aortic ring and tube formation assays, and in vivo with Vegf-a mRNA and vascular casts. After 35 days, tumor volumes were reduced by 60%, 85%, and 55%, relative to controls, in everolimus, the combination, and sequential groups, respectively (P < 0.01). Survival was longest in the combination group (P < 0.001). Phosphorylation of 4E-BP1 and Erk1/2 decreased after everolimus and sorafenib, respectively. Angiogenesis decreased after all treatments (P < 0.05), although sorafenib increased Vegf-a mRNA in liver tumors. Vessel sprouting was abundant in control tumors, lower after sorafenib, and absent after the combination. Intussusceptive angiogenic transluminal pillars failed to coalesce after the combination. Combined treatment with everolimus and sorafenib exerts a stronger antitumoral effect on MH tumors than monotherapy. Everolimus retains antitumoral properties when administered sequentially after sorafenib. This supports the clinical use of everolimus in HCC, both in combination with sorafenib or after sorafenib.

Meta-analysis identifies 29 additional ulcerative colitis risk loci, increasing the number of confirmed associations to 47

Genome-wide association studies and candidate gene studies in ulcerative colitis have identified 18 susceptibility loci. We conducted a meta-analysis of six ulcerative colitis genome-wide association study datasets, comprising 6,687 cases and 19,718 controls, and followed up the top association signals in 9,628 cases and 12,917 controls. We identified 29 additional risk loci (P < 5 × 10(-8)), increasing the number of ulcerative colitis-associated loci to 47. After annotating associated regions using GRAIL, expression quantitative trait loci data and correlations with non-synonymous SNPs, we identified many candidate genes that provide potentially important insights into disease pathogenesis, including IL1R2, IL8RA-IL8RB, IL7R, IL12B, DAP, PRDM1, JAK2, IRF5, GNA12 and LSP1. The total number of confirmed inflammatory bowel disease risk loci is now 99, including a minimum of 28 shared association signals between Crohn's disease and ulcerative colitis.

Increased uptake of 111In-octreotide in idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is characterized by an uncontrolled accumulation and activation of lung fibroblasts. A modulation of fibroblast activation has been observed in various systems with octreotide, a synthetic somatostatin analog with strong affinity for the somatostatin receptor subtype 2 (sst2). One aim of our study was to evaluate the expression of somatostatin receptors in the lungs of patients with IPF. A second aim was to evaluate the relationship between 111In-octreotide uptake and the effect of pulmonary fibrosis as assessed by lung function tests and parameters and by radiologic findings. METHODS: We investigated 11 patients with IPF, 6 patients with pulmonary fibrosis associated with systemic sclerosis (SSc), and 19 patients with disease not of the lung (control patients). The expression of somatostatin receptors was evaluated in vivo using 111In-octreotide scintigraphy. We evaluated the relationship between 111In-octreotide uptake and the activity of pulmonary fibrosis as assessed by lung function tests, bronchoalveolar lavage (BAL) cellularity, and high-resolution CT (HRCT) of the chest. Planar images and thoracic SPECT (24 h) were performed after injection of 222 MBq of 111In-octreotide. Lung uptake was quantified using the lung-to-background ratio (L/B). In addition, the expression of sst2 was evaluated in vitro, in frozen lung-tissue samples using autoradiography, and in human cultures of lung fibroblasts using a ligand-binding assay. RESULTS: Compared with lung uptake in control patients (median L/B, 1.25; range, 1.14-1.49), lung uptake was increased in all 11 IPF patients (median L/B, 2.63; range, 1.59-3.13; P < 0.001) and in 4 of 6 SSc patients (median L/B, 1.68; range, 1.42-2.16). The L/B was lower in SSc patients than in IPF patients (P = 0.011). Increased uptake correlated with the alteration of lung function (carbon monoxide diffusing capacity [rho = -0.655; P = 0.038], diffusing capacity for carbon monoxide and alveolar volume ratio [rho = -0.627; P = 0.047], vital capacity [rho = -0.609; P = 0.054], and total lung capacity [rho = -0.598; P = 0.058]) and with the intensity of alveolitis (total BAL cellularity [rho = 0.756; P = 0.045], neutrophil counts [rho = 0.738; P = 0.05]), and HRCT fibrosis score (rho = 0.673; P = 0.007). Autoradiography suggested that vascular structures were a prominent binding site. Lung fibroblasts expressed somatostatin receptors in vitro as measured by binding assay. CONCLUSION: Our preliminary results identified an increased expression of sst2 in (mainly idiopathic) pulmonary fibrosis. Lung uptake correlates with the alteration of lung function and with the intensity of alveolitis.

An immunohistochemical procedure to detect patients with paraganglioma and phaeochromocytoma with germline SDHB, SDHC, or SDHD gene mutations: a retrospective and prospective analysis

BACKGROUND: Phaeochromocytomas and paragangliomas are neuro-endocrine tumours that occur sporadically and in several hereditary tumour syndromes, including the phaeochromocytoma-paraganglioma syndrome. This syndrome is caused by germline mutations in succinate dehydrogenase B (SDHB), C (SDHC), or D (SDHD) genes. Clinically, the phaeochromocytoma-paraganglioma syndrome is often unrecognised, although 10-30% of apparently sporadic phaeochromocytomas and paragangliomas harbour germline SDH-gene mutations. Despite these figures, the screening of phaeochromocytomas and paragangliomas for mutations in the SDH genes to detect phaeochromocytoma-paraganglioma syndrome is rarely done because of time and financial constraints. We investigated whether SDHB immunohistochemistry could effectively discriminate between SDH-related and non-SDH-related phaeochromocytomas and paragangliomas in large retrospective and prospective tumour series. METHODS: Immunohistochemistry for SDHB was done on 220 tumours. Two retrospective series of 175 phaeochromocytomas and paragangliomas with known germline mutation status for phaeochromocytoma-susceptibility or paraganglioma-susceptibility genes were investigated. Additionally, a prospective series of 45 phaeochromocytomas and paragangliomas was investigated for SDHB immunostaining followed by SDHB, SDHC, and SDHD mutation testing. FINDINGS: SDHB protein expression was absent in all 102 phaeochromocytomas and paragangliomas with an SDHB, SDHC, or SDHD mutation, but was present in all 65 paraganglionic tumours related to multiple endocrine neoplasia type 2, von Hippel-Lindau disease, and neurofibromatosis type 1. 47 (89%) of the 53 phaeochromocytomas and paragangliomas with no syndromic germline mutation showed SDHB expression. The sensitivity and specificity of the SDHB immunohistochemistry to detect the presence of an SDH mutation in the prospective series were 100% (95% CI 87-100) and 84% (60-97), respectively. INTERPRETATION: Phaeochromocytoma-paraganglioma syndrome can be diagnosed reliably by an immunohistochemical procedure. SDHB, SDHC, and SDHD germline mutation testing is indicated only in patients with SDHB-negative tumours. SDHB immunohistochemistry on phaeochromocytomas and paragangliomas could improve the diagnosis of phaeochromocytoma-paraganglioma syndrome. FUNDING: The Netherlands Organisation for Scientific Research, Dutch Cancer Society, Vanderes Foundation, Association pour la Recherche contre le Cancer, Institut National de la Santé et de la Recherche Médicale, and a PHRC grant COMETE 3 for the COMETE network.

Local gene transfer and expression following intramuscular administration of FGF-1 plasmid DNA in patients with critical limb ischemia

NV1FGF is an expression plasmid encoding sp.FGF-1(21-154) currently under investigation for therapeutic angiogenesis in clinical trials. NV1FGF plasmid distribution and transgene expression following intramuscular (IM) injection in patients is unknown. The study involved six patients with chronic critical limb ischemia (CLI) planned to undergo amputation. A total dose of 0.5, 2, or 4 mg NV1FGF was administered as eight IM injections (0.006, 0.25, or 0.5 mg per injection) 3-5 days before amputation. Injected sites (30 cm(3)) were divided into equally sized smaller pieces to assess spatial distribution of NV1FGF sequences (PCR), NV1FGF mRNA (reverse transcriptase-PCR), and fibroblast growth factor-1 (FGF-1)-expressing cells (immunohistochemistry). Data indicated gene expression at all doses. The distribution area was within 5-12 cm for NV1FGF sequences containing the expression cassette, up to 5 cm for NV1FGF mRNA, and up to 3 cm for FGF-1-expressing myofibers. All FGF receptors were detected indicating robust potential for bioactivity after NV1FGF gene transfer. Circulating levels of NV1FGF sequences were shown to decrease within days after injection. Data support demonstration of plasmid-mediated gene transfer and expression in muscles from patients with CLI. FGF-1 expression was shown to be limited to injection sites, which supports the concept of multiple-site injection for therapeutic use.