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Este artículo efectúa una reflexión crítica sobre la producción y reproducción de las formaciones de alteridad que han tenido lugar en Argentina desde el surgimiento del Estado-Nación hasta la actualidad. Desde una sociología de las sensibilidades, y con base en una estrategia documental, se indagan las tensiones y transformaciones que han confluido sobre la categoría “negro”, en tanto locus privilegiado de los procesos de subalternización en el país. Para alcanzar dicho objetivo, primero, se sistematizan algunas estrategias de “invisibilización” de la población afrodescendiente que han operado a nivel nacional. En segundo lugar, se aborda el proceso de “negrificación” de la alteridad como parte de las políticas de las sensibilidades,ofreciendo un conjunto de reflexiones en torno a la “política de la mirada” como nodo analítico para observar las prácticas de racialización actuales. Se concluye que, desde el siglo XIX, en Argentina ha operado un continuo y complejo proceso de racialización de la alteridad que, en clara conexión con la clase, ha hecho de la extinción de la negritud, primero, y de su subalternización generalizada, después, características propias de las “humanidades excedentes” que perpetúan la matriz de la explotación y el dominio colonial en pleno siglo XXI.

Calcifying pseudoneoplasm of the neuraxis (CAPNON) is an extremely rare entity with fewer than 150 cases reported in the literature and mostly with a supratentorial or spinal location. Posterior fossa CAPNON has been reported scarcely, and association with perilesional edema is a topic not yet approached which might play a significant role in treatment decision and clinical progression. Our objective is to report, to our knowledge, the first series of 3 posterior fossa CAPNON surgically treated in a single institution and assess features that help provide a systematic approach to diagnosis and timely treatment.This was a monocentric, retrospective study of surgical patients diagnosed with a posterior fossa CAPNON in the last 5 years. A thorough bibliographic research was conducted.Three patients were included. Locations involved IV ventricle, right cerebellopontine angle with extension to foramen magnum, and cerebellar vermis. Two of them presented with symptoms linked to acute hydrocephalus, and the other one presented with progressive cranial nerve palsy and brainstem compression signs. The 3 of them showed radiological signs of perilesional edema on their preoperative magnetic resonance imaging. Gross total resection was accomplished in one case, with near and subtotal resections in the others. There were no complications. The outcome was favorable in all cases.It is essential to contemplate this infrequent diagnosis in cases of calcified lesions involving the posterior fossa. When symptoms manifest, surgery should be considered. Perilesional edema could be associated with symptomatic progression and hence a sign suggesting the need for surgical treatment.

Si algo caracteriza a la dinámica urbana es un vasto repertorio de sonoridades que opera y se proyecta como parte de su propia complejidad y funcionamiento. Sin embargo, a partir de la pandemia por COVID-19, las ciudades del mundo quedaron sumidas en un silencio inédito. El objetivo de este artículo es indagar el silencio y las sensibilidades en la ciudad pandémica, partiendo del supuesto de que dicha condición sonora es un “síntoma” de procesos sociales estructurales. Metodológicamente, se analiza una encuesta online administrada en Argentina en abril de 2020 sobre una muestra no probabilística de 918 personas adultas que se encontraban cumpliendo con la cuarentena obligatoria. En el marco de una sistematización teórica sobre el oído y la “política de la audición” elaborada desde una sociología de las sensibilidades, se discuten algunos resultados de la mencionada encuesta tomando como nodos problemáticos diversos registros del miedo asociados con el silencio urbano que emergieron en el país durante las primeras semanas de la pandemia. Se concluye presentando dos modulaciones que reviste el miedo (repliegue hacia el ámbito de lo privado y generalización de temores hacia la alteridad) y se presentan algunas articulaciones teórico-políticas sobre la escucha en el contexto del régimen aural del capitalismo contemporáneo.

INTRODUCTION: Prolactinomas are the most frequent pituitary tumor subtype. Despite most of them respond to medical treatment, a proportion are resistant and become a challenge in clinical management. Wnt/β-Catenin pathway has been implicated in several cancers including pituitary tumors and other sellar region malignancies. Interestingly, Wnt/β-Catenin inhibition augments the cytotoxicity of the chemotherapeutic agent Temozolomide (TMZ) in different cancers. TMZ is now being implemented as rescue therapy for aggressive pituitary adenoma treatment. However, the molecular mechanisms associated with TMZ action in pituitary tumors remain unclear. OBJECTIVES: Our aims in the present study were to evaluate differential β-Catenin expression in human resistant prolactinomas and Wnt/β-Catenin signaling activation and involvement in Prolactin (PRL) secreting experimental models treated with TMZ. RESULTS: We first evaluated by immunohistochemistry β-Catenin localization in human resistant prolactinomas in which we demonstrated reduced membrane β-Catenin in prolactinoma cells compared to normal pituitaries, independently of the Ki-67 proliferation indexes. In turn, in vivo 15 mg/kg of orally administered TMZ markedly reduced PRL production and increased prolactinoma cell apoptosis in mice bearing xenografted prolactinomas. Intratumoral β-Catenin strongly correlated with Prl and Cyclin D1, and importantly, TMZ downregulated both β-Catenin and Cyclin D1, supporting their significance in prolactinoma growth and as candidates of therapeutic targets. When tested in vitro, TMZ directly reduced MMQ cell viability, increased apoptosis and produced G2/M cell cycle arrest. Remarkably, β-Catenin activation and VEGF secretion were inhibited by TMZ in vitro. CONCLUSIONS: We concluded that dopamine resistant prolactinomas undergo a β-Catenin relocalization in relation to normal pituitaries and that TMZ restrains experimental prolactinoma tumorigenicity by reducing PRL production and β-Catenin activation. Together, our findings contribute to the understanding of Wnt/β-Catenin implication in prolactinoma maintenance and TMZ therapy, opening the opportunity of new treatment strategies for aggressive and resistant pituitary tumors.

BackgroundRecently, it was defined that the sellar barrier entity could be identified as a predictor of cerebrospinal fluid (CSF) intraoperative leakage. The aim of this study is to validate the application of the sellar barrier concept for predicting intraoperative CSF leak in endoscopic endonasal surgery for pituitary adenomas with a machine learning approach.MethodsWe conducted a prospective cohort study, from June 2019 to September 2020: data from 155 patients with pituitary subdiaphragmatic adenoma operated through endoscopic approach at the Division of Neurosurgery, Università degli Studi di Napoli “Federico II,” were included. Preoperative magnetic resonance images (MRI) and intraoperative findings were analyzed. After processing patient data, the experiment was conducted as a novelty detection problem, splitting outliers (i.e., patients with intraoperative fistula, n = 11/155) and inliers into separate datasets, the latter further separated into training (n = 115/144) and inlier test (n = 29/144) datasets. The machine learning analysis was performed using different novelty detection algorithms [isolation forest, local outlier factor, one-class support vector machine (oSVM)], whose performance was assessed separately and as an ensemble on the inlier and outlier test sets.ResultsAccording to the type of sellar barrier, patients were classified into two groups, i.e., strong and weak barrier; a third category of mixed barrier was defined when a case was neither weak nor strong. Significant differences between the three datasets were found for Knosp classification score (p = 0.0015), MRI barrier: strong (p = 1.405 × 10−6), MRI barrier: weak (p = 4.487 × 10−8), intraoperative barrier: strong (p = 2.788 × 10−7), and intraoperative barrier: weak (p = 2.191 × 10−10). We recorded 11 cases of intraoperative leakage that occurred in the majority of patients presenting a weak sellar barrier (p = 4.487 × 10−8) at preoperative MRI. Accuracy, sensitivity, and specificity for outlier detection were 0.70, 0.64, and 0.72 for IF; 0.85, 0.45, and 1.00 for LOF; 0.83, 0.64, and 0.90 for oSVM; and 0.83, 0.55, and 0.93 for the ensemble, respectively.ConclusionsThere is a true correlation between the type of sellar barrier at MRI and its in vivo features as observed during endoscopic endonasal surgery. The novelty detection models highlighted differences between patients who developed an intraoperative CSF leak and those who did not.

Background The scalpel sign is a radiological finding observed on sagittal magnetic resonance imaging and computed tomography myelography corresponding to an indentation in the dorsal aspect of the spinal cord resembling a surgical scalpel blade. It is said to be a pathognomonic imaging discovery linked to dorsal arachnoid webs. However, other spine-related conditions may mimic dorsal arachnoid webs on magnetic resonance imaging, such as spinal arachnoid cysts or ventral spinal cord herniation, leading to misdiagnosis. Methods A retrospective review was performed of cases involving 3 different diagnoses at our institution in the last 5 years that shared in common the characteristic focal dorsal indentation of the spinal cord. Results Of 7 cases identified, all but 1 were treated and confirmed intraoperatively. All lesions were located at the dorsal spinal cord. Magnetic resonance imaging was the study of choice for evaluation. Clinical manifestations included back pain and lower extremity numbness and weakness together with compressive myelopathy signs and urinary symptoms. Mean follow-up was 16.8 months with satisfactory postoperative results. Conclusions Isolated radiological presentation of the scalpel sign is not sufficient to distinguish between dorsal arachnoid webs, arachnoid cysts, and ventral herniation of the spine. However, awareness of its importance is relevant for accurate curative surgical planning.

[This corrects the article DOI: 10.7150/thno.39072.].

Objective: To analyze and find risk factors associated with the development of DI using a multicenter case series via TSE. Materials and methods: Medical records of patients who underwent TSS for PA resection between 2010-2021 at three different neurosurgical centers by four experienced neurosurgeons were retrospectively analyzed. The patients were divided into two groups (DI Group or Control Group). Logistic regression analysis was conducted to identify risk factors associated with postoperative DI. Univariate logistic regression was performed to identify variables of interest, and covariates with a p-value < 0.15 were incorporated into multivariate logistic regression models to identify independently associated risk factors for DI. All statistical tests were conducted using RStudio. Results: 344 patients were included; 68% were women, the mean age was 46.5 years, and non-functioning adenomas were the most frequent (171, 49.7%). The mean tumor size was 20.3 mm. Covariates associated with postoperative DI were female gender, cavernous sinus invasion (left or bilateral), intraoperative CSF leak, endoscopic surgery, left preoperative visual field involvement, complete tumor resection, Knosp score of 2 and 4, and macroadenomas. Age was associated with a lower OR for postoperative DI. Multivariable model showed female gender (OR 3.34 CI 1.50-7.99, p=0.004) and intraoperative CSF leak (OR 3.25 CI 1.25-8.85, p=0.017) were found to be independently associated with higher OR of developing postoperative DI. Age was not shown to be a protective factor for DI (OR 0.97; CI: 0.94-1.00; p=0.038). Conclusions: The independent risk factors for the development of DI were female patients and intraoperative CSF leak.

Background: The type of sellar barrier observed between a pituitary tumor and cerebrospinal fluid (CSF) on preoperative magnetic resonance imaging (MRI) may predict intraoperative CSF leak during endonasal pituitary surgery. This is the first multicentric prospective cohort trial to study the sellar barrier concept and CSF leak rate during endoscopic pituitary surgery. Methods: This multi-center, international study enrolled patients operated for pituitary adenomas via fully endoscopic endonasal surgery over a period of 4 months. The independent variable was the subtype of sellar barrier observed on preoperative MRI (strong, mixed or weak); the dependent variable was the presence of an intraoperative CSF leak. The primary goal was to determine the association between a particular type of sellar barrier and the risk of intraoperative CSF leak. Appropriate statistical methods were then applied for data analysis. Results: Over the study period, 310 patients underwent endoscopic endonasal surgery for pituitary tumor. Preoperative imaging revealed a weak sellar barrier in 73 (23.55%), a mixed sellar barrier in 75 (24.19%), and a strong sellar barrier in 162 (52.26%) patients. The overall rate of intraoperative CSF leak among all patients was 69 (22.26%). A strong sellar-type barrier was associated with significantly reduced rate of intraoperative CSF leak (RR = 0.08; 95% CI 0.03–0.19; p < 0.0001), while a weak sellar barrier associated with higher rates of CSF leak (RR = 8.54; 95% CI 5.4–13.5; p < 0.0001). Conclusions: The preoperative MRI of pituitary patients can suggest intraoperative CSF leak rates, utilizing the concept of the sellar barrier. Patients with a weak sellar barrier carry a higher risk for an intraoperative CSF leak, whereas a strong sellar barrier on MRI seems to mitigate intraoperative CSF leak. We propose that preoperatively assessment of the sellar barrier can prepare surgeons for intraoperative CSF leak repair.

Resumen Objetivo La laminoplastia «open door» es una tecnica ampliamente utilizada para el tratamiento de la mielopatia cervical multinivel. A pesar de presentar resultados funcionales y radiologicos satisfactorios a largo plazo, la paralisis de C5 postoperatoria continua siendo una complicacion severa e invalidante con una incidencia variable en la literatura. El objetivo del presente trabajo es describir e ilustrar la tecnica quirurgica paso a paso con el agregado de la foraminotomia unilateral C4-5, y evaluar los resultados obtenidos hasta el momento, haciendo especial enfasis en la paralisis de C5. Material y metodos Estudio retrospectivo de 20 pacientes intervenidos por mielopatia cervical mediante la tecnica de laminoplastia cervical «extendida» con foraminotomia unilateral, para la cual se detallan los pasos. Resultados Entre enero de 2013 y abril de 2019 se trataron 20 pacientes con «laminoplastia cervical extendida». Un solo paciente agrego deficit de C5 postoperatorio (5%). El porcentaje de recuperacion del Japanese Orthopaedic Association score (JOA modificado) postoperatorio fue del 54,5%, siendo similar a lo observado en otras series. Conclusion Se desarrollo e ilustro la tecnica de laminoplastia cervical «extendida» con foraminotomia unilateral de C4-5 para la prevencion de la paralisis de C5. Se analizaron los resultados, y se obtuvo una incidencia de paralisis de C5 coincidente con el menor porcentaje reportado en la literatura. Seria de utilidad un estudio prospectivo y aleatorizado para valorar el rol de la foraminotomia preventiva C4-5 unilateral.

Biliary atresia is managed surgically by the Kasai portoenterostomy (KP). It has been reported by some groups that the outcomes of patients who have an early failed KP requiring a liver transplant (LTx) within the first year of life are worse than the outcomes of patients who undergo a primary LTx. The aim of this study was to identify preoperative parameters that could help predict what patients are at risk for the early failure of the procedure. We conducted a retrospective chart review of all patients who underwent a KP between January 2008 and May 2018. The following preoperative parameters were analyzed: age at KP, anatomical variant of the biliary atresia, degree of liver fibrosis, CMV status, and PELD score. The main outcome of the study was the early failure of the KP (EF-K), which was defined as the need for LTx before 1 year of age, or BA-related death before 1 year of age. Second, we analyzed the risk factors associated with death without LTx within the first year of life. A total of 58 patients were included in the analysis. The native liver survival (NLS) was 56.5% and 48% at 1 and 5 years post KP, respectively. Overall survival (OS) was 79% and 76% at 1 and 5 years post KP, respectively. Early failure of KP occurred in 23 (39.7%) patients. OS in this group was 47% and 40% at 1 and 5 years, respectively. On the contrary, the OS of the remaining 35 (60.3%) patients was 100% at 1 and 5 years (P 4, and the PELD score. Nevertheless, on multivariate analysis, only PELD score was found as a statistically significant variable. Due to bad prognosis found in EF-K patients, we believe that it could be reasonable to offer them a primary LTx. PELD score was found to be the strongest preoperative parameter that allows predicting which patient will likely have an early failed KP. Further prospective and multicenter studies are needed to reinforce these results.

Resumen Objetivo Los hemangiopericitomas intracraneanos (HPC) son tumores de muy baja frecuencia, alta recidiva local y riesgo de metastasis extracraneal. El objetivo del siguiente trabajo es presentar los resultados en el tratamiento de los HPC en nuestra institucion en los ultimos 20 anos y realizar una revision de la literatura del tema. Material y metodos Se realizo un estudio retrospectivo que incluyo a los pacientes con diagnostico de tumor fibroso solitario/hemangiopericitoma (TFS/HPC) intracraneanos intervenidos quirurgicamente en el periodo 1997-2017. Se incluyeron pacientes con inmunomarcacion positiva para STAT-6 y grado histologico II-III. Se recabaron datos demograficos, caracteristicas tumorales, tratamiento y sobrevida de estos pacientes. Resultados Un total de 19 pacientes cumplieron los criterios de inclusion. La mediana de seguimiento fue de 96 meses (12-230). La mortalidad fue del 21% (n = 4). El 57,9% presentaron al menos una recidiva tumoral (n = 11) (con una recurrencia del 6, del 67 y del 90% a 1, 5 y 10 anos, respectivamente). Cinco pacientes presentaron metastasis extracraneal. Tuvieron mayor sobrevida los pacientes con tumores Conclusiones Se presento una serie de pacientes operados de TFS/HPC segun los nuevos criterios de la OMS. El tamano es un factor predictor de sobrevida. Actualmente no existen criterios validados de reseccion quirurgica en esta patologia. Una clasificacion con orientacion quirurgica seria de utilidad en el futuro.

Objective Intracranial hemangiopericytoma (HPC) is a rare central nervous system tumor characterized by its low incidence, high rate of local recurrence and risk of metastasis. The main objectives of this paper are two: to show the results in the treatment of HPC in our institution in the last 20 years and to make a review of the literature on this topic. Methods Retrospective review that includes patients diagnosed with intracranial solitary fibrous tumor/hemangiopericytoma (TFS/HPC) that have undergone surgery from 1997 to 2017. It includes patients that had nuclear expression of STAT6 (detected by immunohistochemistry) and grade II/III histopathological diagnosis (defined by the World Health Organization in 2016). We collected demographic data, tumor characteristics, treatment and survival of these patients. Results A total of 19 patients fulfilled inclusion criteria. The median follow up was 96 months (12–230). The mortality rate was 21% (n = 4). The median follow up survival was 19.16 years. 57.9% of patients presented at least 1 tumor recurrence (n = 11) (recurrences of 6%, 67% y 90% at 1, 5 and 10 years). Five patients presented extracranial metastasis. Patients with tumors Conclusions A series of patients undergoing TFS / HPC were presented according to the new WHO criteria. Size is a predictor of survival. Currently there are no validated criteria for surgical resection in this pathology. A classification with surgical guidance would be useful.

Calcifying pseudoneoplasm of the neuroaxis (CAPNON) is a rare, slow growing, and generally benign fibro osseous mass that can emerge throughout the entire central nervous system (CNS). When diagnosed, prompt surgical treatment can determine a good neurological outcome and possibly curative resolution. The objective of the present work is to present a step by step technical report with its video. We present a 37 year old female presented with occipital headache and cervical pain associated with dysphagia, nausea, and gait disturbances. Computed tomography (CT) scan showed a focal calcified lesion on the floor of the IV ventricle projecting toward the vermis with associated supratentorial hydrocephalus and transependymal edema. The telovelar approach was chosen for the procedure. The outcome was favorable, with no complications. Postoperative CT was performed, which revealed no residual lesion. A step by step report of a IV ventricle CAPNON that manifested with hydrocephalus is described.

Resumen Introduccion El abordaje suboccipital lateral es de practica habitual en neurocirugia para exponer la region del angulo pontocerebeloso. El dolor poscraniectomia (DPC) es una de las complicaciones mas frecuentes que disminuyen la calidad de vida de los pacientes. Objetivo Comparar el DPC en pacientes operados de neurinomas vestibulares por un abordaje suboccipital lateral mediante 2 incisiones distintas. Material y metodos Estudio de investigacion prospectivo aleatorizado. Se realizo seguimiento de un grupo de pacientes operados por neurinomas vestibulares entre julio de 2017 y mayo de 2019 (n = 40) por un mismo cirujano. Un grupo recibio la incision lineal clasica (n = 20) y otro grupo la incision alternativa en «U» invertida o «Dandy modificada» (n = 20). La intensidad del dolor fue evaluada mediante escala numerica. Se realizo un seguimiento minimo de 3 meses. El impacto en la calidad de vida se objetivo mediante cuestionario SF-36 version corta tanto pre- como posquirurgico. Resultados La edad promedio fue 46,1 anos. El indice global de DPC fue del 27,5% (n = 11) de los pacientes. La incidencia de cefalea en el grupo que recibio la incision clasica (A) fue del 20% (n = 4), en el grupo B fue del 35% (n = 7). Conclusion Encontramos un mayor indice de DPC en los pacientes que recibieron una incision tipo «Dandy modificada». Estos son datos preliminares de un estudio que continua y esperamos obtener datos mas representativos en el futuro. Recomendamos el seguimiento interdisciplinario para el tratamiento integral del DPC.

In health-related professions, education has unique challenges. Problem-based learning can be extremely useful and driven by strategies such as group-work (GW) and peer assessment (PA), which are both used as formative and assessment tools. This study aimed to explore experience and perceptions about GW and PA held by educators and students in optometry. In a first survey, 45 Italian educators (43.8 ± 13.0 years old) of optometric clinical modules answered an email questionnaire investigating their attitudes towards GW and PA. In a second survey, 66 3rd-year undergraduates (22.5 ± 2.0 years old) answered a questionnaire investigating the perception and attitudes towards GW and PA at the beginning and at the end of a module of Advanced Optometry structured with a formative/summative GW activity with a final PA. Two-thirds of optometry educators declared they use GW, but not as a summative assessment tool. Only a quarter of the sample answered that they used PA at least once. Educators’ attitudes towards GW were more positive than PA (p < 0.001). About 60% and 80% of the interviewed students stated they have never participated in GW and PA, respectively. Students’ pre-course attitudes towards GW and PA resulted in values close to the middle of the scale with no significant differences and positive correlations between them (p < 0.001). When students’ GW attitudes were compared with educators’ GW attitudes, the latter were more positive. Students’ post-course attitudes towards GW and PA were enhanced. Although GW and PA are considered very good strategies to improve teaching, the results of the present study have demonstrated that the use of these strategies in Italian optometric higher education is limited. However, the study has also demonstrated that Italian optometry educators have positive attitudes towards “social” teaching strategies especially for GW. Furthermore, optometry students showed improved attitudes towards these strategies once exposed to them. Overall, the results of the study open the possibility to integrate “social” teaching strategies to improve the effectiveness of optometry education.

En el trabajo se exponen algunas conexiones teóricas entre segregación socioespacial, biografías y experiencias del habitar, identificadas desde los estudios de las sensibilidades. Con base en una investigación con residentes de villas de emergencia y asentamientos informales de la ciudad de La Plata, Argentina, se delimitan los conceptos experiencias del habitar y trayectorias de habitabilidad, utilizadosen el estudio; se establecen correspondencias analíticas para la observación de la estructuración socio-espacial vigente; asimismo, se argumenta una propuesta teórico-metodológica para el abordaje de las trayectorias de habitabilidad, reflexionando sobre los límites y las potencialidades del método biográfico para la indagación de la segregación urbana desde las experiencias individuales.

Background Pituicytoma is a rare neoplasm arising in the sellar region (World Health Organization grade I). Clinically, pituicytomas mimic nonfunctioning pituitary macroadenomas and are occasionally incidentally discovered at autopsy. Pituitary adenomas can occur with other sellar pathologies, and the term “collision sellar lesions” has been coined for this rare entity. There have only been a few reports of the coexistence of pituicytoma and pituitary adenoma. We present 2 cases of pituicytoma coexisting with acromegaly and Cushing disease. Case Description Case 1: A 29-year-old woman had acromegaly. The macroadenoma was partially removed in her first surgery; thus an endonasal reoperation was required for debulking and posterior radiosurgery. Pituicytoma coexisting with somatotropinoma was diagnosed on pathologic examination. Case 2: A 33-year-old woman had adrenocorticotropic hormone–dependent Cushing disease. She underwent endonasal resection. Undetectable postoperative cortisol levels provided evidence that the underlying adrenocorticotropic hormone source was successfully removed. On the basis of morphologic features and the immunohistochemical profile, pituicytoma was diagnosed on pathologic examination. Pituitary adenoma was not confirmed histologically in this patient. Conclusions Only 117 cases of pituicytoma have been reported since it was first described in 1955. Before our report, only 5 cases of patients with pituicytoma coexisting with pituitary adenoma had been described. The coexistence of these 2 entities may not just be a mere coincidence but may be due to a yet unknown pathophysiologic link or common progenitor lineage of both lesions. Association between pituicytoma and pituitary adenoma is increasingly being reported.

Este artículo indaga algunas conexiones entre políticas de las sensibilidades y prácticas de racialización. Tomando por caso la problemática de afrodescendientes en Argentina, el propósito general es ofrecer una discusión sobre las sensibilidades, entendidas como estructuras del sentir que traducen las tramas de la dominación social en la vida cotidiana. Desde esta perspectiva, interesa analizar cómo las sensibilidades interceden en las prácticas de racialización que acompañan y hacen posible el desarrollo capitalista en sus aspiraciones neocoloniales. Asumir este posicionamiento teórico supone considerar que las sensibilidades regulan, entre otros aspectos, los modos racializados de observar/sentir/percibir el mundo que tienen los sujetos, y que se ponen en juego en forma radical en contextos interculturales. Para alcanzar dicho objetivo, en primer lugar, se presenta un conjunto de inflexiones analíticas que conectan las prácticas de racialización con las políticas de las sensibilidades. Seguidamente, con base en un análisis documental, se exploran las clasificaciones raciales y sociales operantes en Argentina, indagando en los procesos de subalternidad configurados en torno a la figura del “negro” desde el surgimiento del Estado-Nación hasta la actualidad. Se concluye que el “maniqueísmo categorial” imperante en las clasificaciones raciales, junto con la “negrificación” del mundo subalterno que se afianza desde mediados del siglo XX, tornan relevante la discusión sobre la interculturalidad como problema epistémico y proyecto político.//This article examines some connections between politics of sensibilities and racialization practices. Taking the problem of afrodescendants in Argentina as a case study, the overall objective is to discuss sensibilities, understood as structures of feeling that translate the plots of social domination into everyday life. From this perspective, we analyze how the sensibilities intercede in the racialization practices that accompany and make capitalist development possible in its neo-colonial aspirations. This theoretical position implies considering that sensibilities regulate, among other aspects, racialized ways of observing / feeling / perceiving the world that subjects have, and that they are radically put into play in intercultural contexts. To achieve this objective, first, a set of analytical inflections that connect the practices of racialization with the politics of sensibilities is presented. Then, based on document analysis, the racial and social classifications operating in Argentina are explored, investigating the subalternity processes configured around the figure of the “Black” from the emergence of the Nation State until today. We conclude that the “categorical manichaeism” prevailing in racial classifications, and the “negrification” of the subaltern world that has been consolidated since the mid-twentieth century, makes the discussion on interculturality relevant as an epistemic problem and political project.

Arterial ischemic stroke in children is a severe disorder with significant morbidity and mortality. Urgent diagnosis is mandatory in order to save lives or minimize neurological sequelae. However, recognition of stroke in children is more difficult than in adults. Barriers such as low suspicion, diverse risk factors, difficulties performing neuroimages, and a lack of protocols for diagnosis and treatment make stroke management in children a challenge. This article aims to review the approach to arterial stroke in children. Recently, more focus has been placed in the development of comprehensive stroke centers for treatment of stroke in children. Shortening time for diagnosis allows initiating a prompt and successful hyperacute treatment. Neuroprotection must be initiated before diagnosis confirmation. As in adult patients, widening the thrombolytic treatment time window and optimizing secondary stroke prevention are main points to develop. Early decompressive hemicraniectomy in children with malignant infarct should be considered. A multidisciplinary team is necessary for the diagnosis and treatment of children with brain attack. A particular “stroke code” must be established in each institution for stroke management and evidence-based guidelines should be developed.

Spinal synovial cysts are degenerative extradural lesions mostly found in the lumbar region, and more rarely at cervical or thoracic levels and in a bilateral presentation. We report a patient with a history of progressive paraparesis associated with bilateral cervicothoracic synovial cysts, causing spinal canal narrowing and cord compression, ultimately resulting in myelopathy. A review of the literature summarizes previous reports on this topic. Surgical excision of the extradural mass, decompression of the spinal canal and instrumented fusion were performed, improving lower limb deficit and gait. Post-surgical MRI showed evidence of complete cyst resection, and good arthrodesis consolidation with adequate sagittal balance. Surgical excision is indicated in case of medical treatment failure or increasing symptom severity. Given the strong pathophysiological link between synovial cysts and spinal instability, concomitant instrumented fusion may help improve outcome.

We report 3 cases of Global rostral midbrain syndrome (GRMS) and Corpus Callosum (CC) infarction, in the context of hydrocephalus followed by shunt dysfunction and slit ventricles. Prior shunt implantation had been indicated for adult-onset hydrocephalus secondary to aqueductal stenosis of varying causes. All three patients had been stable for months before developing repeated shunt dysfunctions, ultimately progressing to parkinsonism, Parinaud syndrome, akinetic mutism, pyramidal signs, cognitive impairment, CC infarction and slit ventricles, in the context of CSF overdrainage. Parkinsonism-related symptoms responded to dopa in all cases, but Parinaud syndrome and cognitive impairment persisted. Although GRMS has been described in the context of a transtentorial pressure gradient after shunt blockage, in these three cases with similar clinical presentation, reverse transtentorial pressure gradient and slit ventricles due to shunt overdrainage was the likely cause. The authors discuss the role of CC infarction and provide a detailed analysis after gathering previously described data, to unify information under a recognizable clinical entity and better understand the underlying pathophysiology, treatment options and outcome.

Biliary atresia is managed surgically by the Kasai portoenterostomy (KP). It has been reported by some groups that the outcomes of patients who have an early failed KP requiring a liver transplant (LTx) within the first year of life are worse than the outcomes of patients who undergo a primary LTx. The aim of this study was to identify preoperative parameters that could help predict what patients are at risk for the early failure of the procedure.We conducted a retrospective chart review of all patients who underwent a KP between January 2008 and May 2018. The following preoperative parameters were analyzed: age at KP, anatomical variant of the biliary atresia, degree of liver fibrosis, CMV status, and PELD score. The main outcome of the study was the early failure of the KP (EF-K), which was defined as the need for LTx before 1 year of age, or BA-related death before 1 year of age. Second, we analyzed the risk factors associated with death without LTx within the first year of life.A total of 58 patients were included in the analysis. The native liver survival (NLS) was 56.5% and 48% at 1 and 5 years post KP, respectively. Overall survival (OS) was 79% and 76% at 1 and 5 years post KP, respectively. Early failure of KP occurred in 23 (39.7%) patients. OS in this group was 47% and 40% at 1 and 5 years, respectively. On the contrary, the OS of the remaining 35 (60.3%) patients was 100% at 1 and 5 years (P 0.0001). When we compared all preoperative parameters, the only predictor of EF-K was the PELD score. When we analyzed the cases in the EF-K group who died without LTx, we found that the significant predictors were the cystic variant, a degree of liver fibrosis4, and the PELD score. Nevertheless, on multivariate analysis, only PELD score was found as a statistically significant variable.Due to bad prognosis found in EF-K patients, we believe that it could be reasonable to offer them a primary LTx. PELD score was found to be the strongest preoperative parameter that allows predicting which patient will likely have an early failed KP. Further prospective and multicenter studies are needed to reinforce these results.

Introduction Pseudo-Chiari malformation results from caudal displacement of brain structures secondary to cerebrospinal fluid (CSF) hypotension. Some case reports in the syringomyelia literature are associated with a pseudo-Chiari malformation. We present an example of a case of this type, treated surgically at our institution and review the literature on this rare condition. Case Description: A 27-year-old female patient with a history of headache, brachial paresthesias, progressive motor deficit and gait instability presented, 12 mm caudal descent of the cerebellar tonsils into the foramen magnum on MRI, holocord syringomyelia as well as signs of pseudo-Chiari malformation, compatible CSF hypotension secondary to CSF fistula. Intervention: Surgical treatment included posterior decompression with repair using a dural patch and an epidural blood patch. Patient had a favorable clinical outcome in line with imaging findings observed during follow-up. Conclusion Posterior decompression surgery combined with epidural blood patch allowed successful clinical management and good results on imaging.

Background: Pituitary adenomas can become invasive and aggressive, and in turn produce tumor recurrence. Endocan or endothelial cell specific molecule-1 (ESM1) has been associated with angiogenesis and tumor growth in gliomas, and lung, kidney, liver among other cancers, but there is a scarcity of information regarding its role in pituitary adenomas. In the search for biomarkers of tumor behavior our objective was to determine the relationship between endocan (ESM1) mRNA expression and cavernous sinus invasion, and its association with gene expression of VEGF, FGF2 and PDGF angiogenic factors in human pituitary adenomas.Methods: ESM1, VEGF, FGF2 and PDGF expression was determined by qRT-PCR in 28 pituitary tumor samples and tumor invasion was determined by the Knosp grade classification. Results were associated with clinical data. Results: We found that ESM1 was expressed in 75% of the tumors. FGF2 expression was higher in ESM1-positive compared to ESM1-negative tumors, and a significant negative correlation in the expression of FGF2 and PDGF was found. Although ESM1 expression did not show any differences in invasive and non-invasive tumors, a positive correlation between ESM1 and Knosp grade was reached when grade 0-3 tumors were considered, suggesting its participation in the initial periods of tumor invasion. Finally, no difference in ESM1 expression was found between functioning and non-functioning adenomas, or patients age. Conclusions: Our study points to a precise pattern of angiogenic factor expression in pituitary tumors, and its relation to invasive behavior, which should be considered in the tailoring of drug treatments for aggressive and resistant pituitary adenomas.

This final chapter is a three-part device that seeks to allow the reader to capture some fragments of the sensibilities of cities in the COVID-19 pandemic. It is an irregular look, diverse across each of the three elements, which reflects the feelings of those who have looked through these three mirrors, constituting them. It is a playful ending: the reader can start and end with any of its parts and also borrow its metaphorical force from the kaleidoscope to reach unknown terrain by known means. They are reflections open to dialogue and multiple endings, to multiple images, to multiple observations. It is a chapter where beauty will be a matter for the reader, since it will be his or her eye that validates, denies or rewrites the policies of the sensibilities of the cities today. The chapter has three sections that operate as three “chapters”. We have decided to claim authorship of each section separately, for having had the experience in different cities, for being impacted by dissimilar practices of being in the city, and for valuing how the collective does not eliminate the personal, hence the selection of the title of the chapter as a whole.

Aim of the study. Inhaled ammonium persulphate (AP) reduces non adrenergic, non cholinergic (NANC) relaxation in the guinea pig trachea, as a part of its inflammatory effects. Peroxisome Proliferator-Activated Receptor (PPAR) stimulation has shown anti-inflammatory properties. This study aimed at evaluating whether the PPAR-α agonist WY 14643 can prevent the reduction in NANC relaxation caused by inhaled AP in the guinea pig trachea. Materials and Methods. Four groups of ten male guinea pigs were treated for three weeks with inhaled AP (10 mg/m3, 30 min per day, group A), saline (group B), AP and WY 14643 (0.36 μM/die, per os, group C), and AP, WY 14643 and the PPAR-α antagonist GW 6471 (0.36 μM/die, per os, group D). NANC relaxations to electrical field stimulation (EFS) at 3 Hz were evaluated in whole tracheal segments as intraluminal pressure changes. Results. The tracheal NANC relaxations were reduced by 90.3% in group A, as compared to group B. In group C, they were reduced by only 22.2%. In group D, they were reduced by 92.6 %. PPAR-α receptors were detected in inhibitory nerve fibers within the trachea as shown by immonohistochemical analysis. Conclusions. The PPAR-α agonist WY 14643 protects the NANC inhibitory system of the guinea pig trachea from the effect of inhaled ammonium persulphate and its protective effect is antagonized by GW 6471. PPAR-α might be exploited.Scopo dello studio. L’inalazione di ammonio persolfato (AP) riduce il rilasciamento non adrenergico, non colinergico (NANC) nella trachea di cavia, come parte dei suoi effetti infiammatori. La stimolazione dei Peroxisome Proliferator- Activated Receptor (PPAR) ha mostrato di possedere effetti antiinfiammatori. Questo studio ha avuto lo scopo di valutare se l’agonista per i PPAR-α WY 14643 sia in grado di prevenire la riduzione del rilasciamento NANC causata dall’inalazione di AP nella trachea di cavia. Materiali e metodi. Quattro gruppi di dieci cavie maschio sono stati trattati con l’inalazione di AP (10 mg/m3, 30 minuti al giorno, gruppo A), con soluzione fisiologica (gruppo B), con AP e WY 14643 (0.36 μM/die, per os, gruppo C), e con AP, WY 14643 e con l’antagonista PPAR-α GW 6471 (0.36 μM/die, per os, group D). I rilasciamenti NANC indotti dalla stimolazione con campo elettrico, alla frequenza di 3 Hz, sono stati valutati immunodecome variazioni di pressione intraluminale in segmenti tracheali interi. Risultati. I rilasciamenti NANC tracheali erano ridotti del 90.3% nel gruppo A, a confronto con il gruppo B. Nel gruppo C essi erano ridotti solo del 22.2%. Nel gruppo D i rilasciamenti erano ridotti del 92.6%. È stata rilevata la presenza di recettori PPAR-α nelle fibre nervosa inibitorie intrinseche della trachea, mediante analisi immunoistochimica. Conclusioni. L’agonista per i PPAR-α WY 14643 protegge il sistema NANC inibitorio della tracea di cavia dall’effetto dell’inalazione di ammonio persolfato e il suo effetto protettivo è antagonizzato dall’antagonista specifico GW 6471. I PPAR-α potrebbero essere sfruttati come bersaglio farmacologico nella terapia dell’asma.

Objective The open-door laminoplasty technique is widely used in the treatment of multilevel cervical myelopathy. Despite the satisfactory functional and radiological results of this technique, postoperative C5 palsy is still a severe and disabling complication with a variable incidence in the literature. The objective of this article is to describe and demonstrate the surgical technique step by step with the addition of unilateral C4-5 foraminotomy and to evaluate the results obtained to date, with special emphasis on C5 palsy. Material and methods Retrospective study of 20 patients operated on for cervical myelopathy using the "extended" laminoplasty technique, which is described step by step. Results Between January 2013 and April 2019, 20 patients were operated on using the extended laminoplasty technique. Only one patient (5%) presented postoperative C5 palsy. The postoperative recovery rate of the modified JOA (Japanese Orthopaedic Association) score was 54.5%, similar to that observed in other series. Conclusion The extended cervical laminoplasty technique with unilateral C4-5 foraminotomy was developed and demonstrated for the prevention of C5 palsy. The results were analysed and an incidence of C5 palsy coinciding with the lowest percentage reported in the literature was obtained. A prospective randomised study would be useful to assess the role of preventive unilateral C4-5 foraminotomy.

Increased levels of the proto-oncogene pituitary tumor-transforming gene 1 (PTTG) have been repeatedly reported in several human solid tumors, especially in endocrine-related tumors such as pituitary adenomas. Securin PTTG has a critical role in pituitary tumorigenesis. However, the cause of upregulation has not been found yet, despite analyses made at the gene, promoter and mRNA level that show that no mutations, epigenetic modifications or other mechanisms that deregulate its expression may explain its overexpression and action as an oncogene. We describe that high PTTG protein levels are induced by the RWD-containing sumoylation enhancer (RWDD3 or RSUME), a protein originally identified in the same pituitary tumor cell line in which PTTG was also cloned. We demonstrate that PTTG and RSUME have a positive expression correlation in human pituitary adenomas. RSUME increases PTTG protein in pituitary tumor cell lines, prolongs the half-life of PTTG protein and regulates the PTTG induction by estradiol. As a consequence, RSUME enhances PTTG transcription factor and securin activities. PTTG hyperactivity on the cell cycle resulted in recurrent and unequal divisions without cytokinesis, and the consequential appearance of aneuploidies and multinucleated cells in the tumor. RSUME knockdown diminishes securin PTTG and reduces its tumorigenic potential in a xenograft mouse model. Taken together, our findings show that PTTG high protein steady state levels account for PTTG tumor abundance and demonstrate a critical role of RSUME in this process in pituitary tumor cells. Fil: Fuertes, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Sapochnik, Melanie Denise. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Tedesco, Lucas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Senin, Sergio Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Attorresi, Alejandra Inés. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Ajler, Pablo. Hospital Italiano; Argentina Fil: Carrizo, G.. Hospital Italiano; Argentina Fil: Cervio, A.. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina Fil: Sevlever, Gustavo. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina Fil: Bonfiglio, Juan José. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Stalla, G. K.. Max Planck Institute of Psychiatry; Alemania Fil: Arzt, Eduardo Simon. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina

Objetivo: Presentar nuestra experiencia en el tratamiento quirúrgico de los meningiomas espinales. Material y métodos: Estudio descriptivo retrospectivo que incluye a 24 pacientes operados de meningiomas espinales durante el período Julio de 2009 a Diciembre de 2016. Se analizaron datos epidemiológicos, antecedentes personales, sintomatología preoperatoria, características radiológicas, hallazgos intraoperatorios, grado de resección, descripción histológica y evolución post operatoria. Resultados: Se operaron 24 pacientes siendo 83% de sexo femenino. En cuanto a la localización, 79% fueron dorsales, 17% cervicales y 4% lumbares. La anatomía patológica reveló meningiomas grado I (OMS) en todos los casos. En el 63% se abordó la lesión por hemilaminectomía, logrando en éstas un grado de resección satisfactorio (Simpson 2). El 66% de los pacientes presentaron mejoría clínica post operatoria, 30% sin cambios significativos y solo un caso (4%) de empeoramiento. El periodo de seguimiento promedio fue de 14,9 meses. Conclusión: La cirugía continúa siendo el tratamiento de elección en los meningiomas espinales. El abordaje por hemilaminectomía es una opción útil en lesiones con base de implantación lateral. Lesiones predominantemente ventrales, con componente cálcico y alteraciones motoras preoperatorias suelen presentar mayor complejidad quirúrgica y peor evolución.

Aims Cell therapy trials using cardiac-resident progenitor cells (CPCs) and bone marrow-derived mesenchymal stem/progenitor cells (BMCs) in patients after myocardial infarction have provided encouraging results. Exosomes, nanosized extracellular vesicles of endosomal origin, figure prominently in the bioactivities of these cells. However, a head-to-head comparison of exosomes from the two cell types has not been performed yet. Methods and results CPCs and BMCs were derived from cardiac atrial appendage specimens and sternal bone marrow, respectively, from patients (n = 20; age, 69.9 ± 10.9) undergoing heart surgery for aortic valve disease and/or coronary artery disease. Vesicles were purified from cell conditioned media by centrifugation/filtration and ultracentrifugation. Vesicle preparations were predominantly composed of exosomes based on particle size and marker expression (CD9, CD63, CD81, Alix, and TSG-101). CPC-secreted exosomes prevented staurosporine-induced cardiomyocyte apoptosis more effectively than BMC-secreted exosomes. In vivo, CPC-secreted exosomes reduced scar size and improved ventricular function after permanent coronary occlusion in rats more efficiently than BMC-secreted exosomes. Both types of exosomes stimulated blood vessel formation. CPC-secreted exosomes, but not BMC-derived exosomes, enhanced ventricular function after ischaemia/reperfusion. Proteomics profiling identified pregnancy-associated plasma protein-A (PAPP-A) as one of the most highly enriched proteins in CPC vs. BMC exosomes. The active form of PAPP-A was detected on CPC exosome surfaces. These vesicles released insulin-like growth factor-1 (IGF-1) via proteolytic cleavage of IGF-binding protein-4 (IGFBP-4), resulting in IGF-1 receptor activation, intracellular Akt and ERK1/2 phosphorylation, decreased caspase activation, and reduced cardiomyocyte apoptosis. PAPP-A knockdown prevented CPC exosome-mediated cardioprotection both in vitro and in vivo. Conclusion These results suggest that CPC-secreted exosomes may be more cardioprotective than BMC-secreted exosomes, and that PAPP-A-mediated IGF-1 release may explain the benefit. They illustrate a general mechanism whereby exosomes may function via an active protease on their surface, which releases a ligand in proximity to the transmembrane receptor bound by the ligand.

Background Primary central nervous system lymphomas (PCNSL) are infrequent. The traditional treatment of choice is chemotherapy. Complete resections have generally not been recommended, because of the risk of permanent central nervous system deficits with no proven improvement in survival. The aim of the current study was to compare survival among patients with PCNSL who underwent biopsy versus surgical resection. Methods A retrospective study was conducted on 50 patients with a confirmed diagnosis of PCNSL treated at our center from January 1994 to July 2015. Results Patients in the resection group exhibited significantly longer median survival time, relative to the biopsy group, surviving a median 31 months versus 14.5 months; p = 0.016. Conclusions In our series, patients who had surgical resection of their tumor survived a median 16.5 months longer than patients who underwent biopsy alone. RESUMO Introducción Los linfomas primarios del sistema nervioso central (LPSNC) son infrecuentes. Tradicionalmente el tratamiento de elección es la quimioterapia. Existe un paradigma de no indicar resección, por el riesgo de déficit neurológico sin aumento de la sobrevida. El objetivo del presente estudio es comparar la sobrevida de pacientes con LPSNC sometidos a biopsia versus resección. Métodos Estudio retrospectivo que incluye 50 pacientes con diagnóstico confirmado de LPSNC tratados en nuestra Institución desde enero de 1994 hasta julio de 2015. Resultados Los pacientes del “grupo resección” mostraron una sobrevida media significativamente mayor respecto a los del “grupo biopsia”; 31 meses versus 14,5 meses respectivamente, p = 0,016. Conclusiones En nuestra serie, los pacientes que con resección quirúrgica de su tumor tuvieron una sobrevida media de 16,5 meses superior que los pacientes biopsiados.

The present paper aims is to characterize the mechanical behavior of a new embedded point-fixing device for laminated glass for combined tension–shear load cases. This kind of support is based on the principle known as “interlayer junction” in which the anchor is bonded to the interlayer and embedded in the glass panes during the lamination process. The purposes of this innovative point-fixing device are nowadays mainly focused on interior architecture applications: e.g. balustrades, stairs, doors, elevator cars and wells, design furniture, etc., taking advantage of the beautiful aesthetic of an “all-glass” element. This is due to the fact that, contrary to traditional point-fixing bolted connections, the countersunk hole is not passing through the outer glass layer, so that the stainless steel anchor looks like embedded in the glass mass. A comprehensive experimental investigation on the load-bearing capacity under the combined action of tension and shear forces is performed by means of specifically designed test apparatus and procedure. The failure modes in the different direction of load applications are identified and discussed. Finally, in addition to the interaction domain given for combined load cases between tension and shear forces, a simplified analytical interaction expression is also proposed, intended to be used in the practical design applications.

Surgical management of vestibular schwannomas has improved over the last 30 years. Whereas in the past the primary goal was to preserve the patient’s life, today neurological function safeguarding is the main objective, with numerous strategies involving single resection, staged resections, postoperative radiosurgery, or single radiosurgery. The retrosigmoid approach remains the primary pathway for surgical access to the cerebellopontine angle (CPA). The use of an endoscope has great advantages. It contributes to the visualization and resection of residual tumor and also reduces the need for cerebellar retraction. The authors present a fully endoscopic resection of a large-sized vestibular schwannoma with facial nerve preservation. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21106