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M Lumbreras

Publications and source records attributed to M Lumbreras.

3 recordsLinked to original sources

Brain G protein-dependent signaling pathways in Down syndrome and Alzheimer's disease.

Premature aging and neuropathological features of Alzheimer's disease (AD) are commonly observed in Down syndrome (DS). Based on previous findings in a DS mouse model, the function of signaling pathways associated with adenylyl cyclase (AC) and phospholipase C (PLC) was assessed in cerebral cortex and cerebellum of age-matched adults with DS, AD, and controls. Basal production of cAMP was reduced in DS but not in AD cortex, and in both, DS and AD cerebellum. Responses to GTPgammaS, noradrenaline, SKF 38393 and forskolin were more depressed in DS than in AD cortex and cerebellum. Although no differences in PLC activity among control, DS and AD cortex were observed under basal and GTPgammaS- or Ca-stimulated conditions, the response of DS cortex to serotonergic and cholinergic stimulation was depressed, and that of AD was only impaired at cholinergic stimulation. No differences were documented in cerebellum. Our results demonstrate that PLC and AC were severely disturbed in the aged DS and AD brains, but the alterations in DS were more severe, and differed to some extent from those observed in AD.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗

[Self-training in needle-knife sphincterotomy].

AIM: To analyze our experience in self-training in needle-knife sphincterotomy and to estimate the number of procedures necessary to reach competence in this technique. METHOD: Retrospective analysis of the first 60 needle-knife sphincterotomies performed, paying attention to success rates, the need for one or two attempts and the incidence and severity of early complications. The results were analyzed and divided into 2-year periods. The training period was subsequently determined using a qualitative method which combines the three above-mentioned criteria and sets competence level at 90%. RESULTS: Of the 60 attempted needle-knife sphincterotomies (five in Billroth-II patients), 54 (90%) were completed. The procedure was required in 20% of all the sphincterotomies completed. Needle-knife sphincterotomy was completed at the first attempt in 39 (65%) patients and complications appeared in 13 (22%), three (5%) of which were serious but not fatal. Analysis of 2 year periods showed an almost 100% increase in the total number of needle-knife sphincterotomies completed and in those completed at the first attempt, as well as a reduction in the complication rate, which subsequently stabilized at below 15%. Forty needle-knife sphincterotomies were needed to reach competence level. CONCLUSION: Needle-knife sphincterotomy can be learned without training from an endoscopist with experience in this technique. Competence can be reached after 40 procedures. Nevertheless, we propose an alternative method to our own to achieve competence in less time and with fewer complications.

Clinical Competence↗