Época Antigua (2014-2018)
https://hdl.handle.net/10481/68136
2024-03-28T10:52:30ZGeneral perspective of current knowledge and ways we may increase it in neuroscience
https://hdl.handle.net/10481/69797
General perspective of current knowledge and ways we may increase it in neuroscience
Echeverría Martín, Violeta
Brain function is a somewhat complex issue. However, based on the theory of the network system that includes concepts such as Modularity, Scaling, Connectome, Emergence and Specialization, we can draw some points in common that allow an approximation to the underlying mechanisms of cerebral connectivity. In the field of neuroimaging, there is a large number of techniques that allow the brain to
observe the anatomical and functional approaches in different ways and allow us to make correlations that guide us in order to unravel the mechanisms of brain function. The most commonly used techniques in
neuroscience are magnetic resonance, electroencephalogram, and magnetic stimulation. And it is by combining those theoretical concepts with the data obtained from the different techniques that allow neuroscientists to expand their knowledge in neuroscience. The aim of this work is to combine and facilitate the understanding of some complex concepts regarding the functioning of the brain and to serve as an introduction to research work in the field of neurology.
Decision-making in end-of-life care in pediatrics: ethical controversies and management of situations in clinical practice
https://hdl.handle.net/10481/69796
Decision-making in end-of-life care in pediatrics: ethical controversies and management of situations in clinical practice
Martínez Montoro, José Ignacio
The concept of “Limitation of the therapeutic effort” (LTE) is based on the withdrawal or non-initiation of futile treatments that delay the death of the patient and prolong their agony. Although medical advances have made it possible to reduce infant mortality rates, management of end-of-life decisions at these ages continues to be difficult and includes ethical and controversial issues of complex resolution. This paper reviews the medical literature and various reference guides aiming 1) to describe some of the most frequent ethical controversies described in the literature and 2) to offer guidance on how to deal with situations of uncertainty that can present themselves in the clinic, integrating them into the physician-family-patient relationship. To do this, the body of the review has been divided into several sections: first, we will review the most recent bibliography related to the complexity and types of LTE described, and the ethical controversies that this poses. Next, we will address the role of the doctor in LTE and the interaction between these ethical controversies and the doctor’s own morals, where an attempt will be made to establish a general orientation of the steps that the doctor should take when making decisions. The next step goes beyond the purely care setting and will consist of including the doctor in the decision-making process relating to the family, going through the bibliography that tells us about the most frequent needs and problems that can arise in this context. Finally, we will integrate the pediatric patient in this process, analyzing very briefly the most frequent problems that may occur in the last oments of life. All this makes us consider the importance of clinical practice guidelines in LTE.
Gallblader carcinomas from risk factors to targeted therapy
https://hdl.handle.net/10481/69794
Gallblader carcinomas from risk factors to targeted therapy
Betancor-Fernández, Isabel
To revise the epidemiology, pathogenesis, diagnosis, treatment and prognosis in gallbladder carcinomas. To revise the role of molecular pathology in this entity and its importance in therapeutic perspectives.
Methods: A revision of all the articles published between 2006-2016 and indexed in PubMed containing the keywords “gallbladder”, “cancer”,
“carcinoma”, “diagnosis”, “treatment”, “perspectives” and/or “targeted therapy ” was carried out.
Results: The incidence of gallbladder carcinoma varies greatly depending on the geographical area [considered]. Its natural history is related to chronic inflammation and cholelithiasis is its main risk factor. The diagnosis is usually made at a late stage and, despite the treatment, it shows/has a poor prognosis. Changes in p53 and K-Ras are common. Modulation of inflammation is postulated as a therapeutic alternative.
Conclusions: Gallbladder carcinoma is a neoplasm with an aggressive course. The improvement in its prognosis needs of the control of risk factors and early diagnosis supported by imaging tests. New surgical
techniques and the description of new therapeutic targets also offer promising prospects.
Development and comparative study of basement membrane in human lining epithelium generated through tissue engineering
https://hdl.handle.net/10481/69792
Development and comparative study of basement membrane in human lining epithelium generated through tissue engineering
Rivera Izquierdo, M.
Objetivos: Cualquier tejido corporal complejo compuesto por un estroma y un epitelio requiere necesariamente del correcto desarrollo y expresión de una membrana basal (MB) para tener funcionalidad completa. La MBs son estructuras con importantes funciones en la migración, diferenciación y proliferación de las células de dichos tejidos, sirviendo como soporte de los mismos y permitiendo una correcta unión e interacción epitelio-estromal. Para construir un tejido complejo mediante ingeniería tisular es, por tanto, de vital importancia el adecuado desarrollo de una MB que permita la correcta interacción entre el estroma y el epitelio y que, de esta manera,
reproduzca el tejido nativo con la mayor fiabilidad posible. El objetivo de este trabajo fue el estudio y comparación del desarrollo de MBs en los mismos, y caracterizar los componentes de las MBs en diferentes modelos de tejidos artificiales generados con una matriz de fibrina y agarosa para determinar si dichos constructos son adecuados para una posible futura aplicación clínica. Métodos: Los constructos de mucosa oral, piel y córnea se fabricaron con una matriz de fibrina y agarosa (0,1%), y se evaluaron mediante técnicas histológicas e inmunohistoquímicas específicas para
componentes de MB.
Resultados: En todos los tejidos artificiales podemos observar la generación de una MB más o menos definida a partir de la tercera semana de desarrollo in vitro, con diferentes patrones temporales pero todos con una fuerte expresión de laminina y colágenos I, III y IV. Algunos de ellos, incluso, empiezan a expresar colágeno tipo I desde la primera semana de evolución.
Conclusiones: Estos resultados sugieren que a partir de la tercera semana, los tejidos artificiales son capaces de generar membranas basales correctamente desarrolladas y funcionales, y demuestran que los epitelios de revestimiento generados con una matriz de fibrina-agarosa son óptimos para el desarrollo de tejidos artificiales.; Aim: Any complex body tissue comprised of stroma and epithelium ineluctably requires the correct development and expression of a basement membrane (BM) for its complete functionality. BMs are structures with an important role in the migration, differentiation and proliferation of cells, providing structural support and allowing a correct
epithelium-stroma union and interaction. To build a complex tissue through tissue engineering the adequate development of a BM that allows the correct interaction between stroma and epithelium and therefore replicate the native tissue as accurately as possible is thus of an utmost importance. The goal of this paper was the study and contrast of BMs development in these tissues, as well as the identification of BMs components in different artificial tissue models, generated with a fibrin and agarose matrix, in order to determine whether said constructs are fit for a possible future clinical application.
Methods: oral mucosa, skin and cornea constructs were made with a fibrin and agarose (0.1%) matrix and evaluated through BM component-specific histological and immunohistochemical techniques. Results: in every artificial tissue it is possible to observe the formation of a more or less defined BM from the third week of in vitro development, with different time patterns but sharing a common strong expression of laminin and collagen I, III and IV. Some of them even start expressing type I collagen from the first week. Conclusions: these results suggest that, from the third week, artificial tissues are able to generate properly developed and functional basement membranes, and show that lining epitheliums created with a fibrin-agarose matrix are optimal for artificial tissue development.
Perceptive learning and its implications in physical rehabilitation
https://hdl.handle.net/10481/69790
Perceptive learning and its implications in physical rehabilitation
Gil Muñoz, José Manuel
Los estímulos sensoriales proporcionan beneficios y mejores resultados cuando se combinan con un tratamiento motor, tanto cuando existe un déficit motor como en la correcta ejecución de patrones motores en personas sanas, por ejemplo, se ha demostrado la mejoría del patrón de la marcha cuando se acompaña de estímulos táctiles y/o visuales. Los estímulos sensoriales aumentan la excitabilidad de las neuronas motoras espinales, reduciendo el tiempo de respuesta motora a un patrón pedido.
Para entender completamente cómo podemos influir mediante el tratamiento por estímulos sensitivos para mejorar un patrón motor concreto debemos conocer por neuroimagen los centros y estructuras que se activan para cada tipo de estímulo sensorial en el sistema nervioso y qué tipo de relación guardan todas estas estructuras entre sí. Y además dejar claras las bases teóricas que actualmente respaldan este tipo de tratamiento tales como la sustitución sensorial, cross-modal, la integración sensorial, aprendizaje cognitivo. . . La principal aplicación de los estímulos sensoriales en la actualidad se dirige al aprendizaje y la intervención en
trastornos sensoriales como problemas visuales. Actualmente se conocen diferentes intervenciones desde la terapia ocupacional y la fisioterapia en las que se esta empezando a aplicar estímulos propioceptivos o vestibulares para mejorar patrones de ejecución motores. Un mayor conocimiento de los procesos neuronales que conectan las cortezas asociativas sensoriales con las encargadas de ejecutar una respuesta
motora permitiría dar un salto de calidad en las intervenciones de los profesionales y en la consecución de los resultados en los programas
de rehabilitación.; Sensory stimuli provide benefits and better results when combined with a motor treatment, both when there is a motor deficit and in the correct execution of motor patterns in healthy people.For example, the improvement of gait pattern has been demonstrated when it is accompanied of tactile and/or visual stimuli. Sensory stimuli increase the excitability of spinal motor neurons, reducing motor response time to a requested pattern. To fully understand how we can influence the treatment by sensory stimuli to improve a specific motor pattern, we must use neuroimaging to know the centres and structures that are activated for each type of sensory stimulus in the nervous system and to discover the relationship that these structures keep to each other. Besides, it is also important to make clear the theoretical bases that currently support this type of treatment, i.e., sensory substitution, cross-modal, sensory integration, cognitive learning, etc. Today, sensory stimuli are mainly used to learn about and intervene in sensory disorders such as visual mpairment. Nowadays, different interventions are known from occupational therapy and physiotherapy in which applying proprioceptive or vestibular stimuli are starting to be applied to improve motor performance patterns. A greater knowledge of the neural processes that connect the sensory associative cortexes with the ones in charge of executing a motor response would allow a qualitative leap in [the] interventions [of the professionals], as well as in [the achievement of the]results of the rehabilitation programs.