Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
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PARTE A. Diagrama: Tras leer el texto Pancreas: Function, Location & Diseases,
completa con vocabulario relacionado a esta lectura el diagrama posterior; con ello se
confirma que reconoces la cohesión del texto.
PARTE B. En un siguiente espacio lee los tres textos; identifica aquél que no posee
cohesión ni coherencia y en un máximo de 80 palabras en español justifica tu
respuesta; apóyate en los elementos revisados en la lección.
PARTE C. Redacta la idea principal de cada uno de los textos en español.
PARTE A
Pancreas: Function, Location & Diseases
The pancreas is an abdominal organ that is located behind the stomach and is surrounded by
other organs, including the spleen, liver and small intestine. The pancreas is about 6 inches
(15.24 centimeters) long, oblong and flat.
The pancreas plays an important role in digestion and in regulating blood sugar. Three diseases
associated with the pancreas are pancreatitis, pancreatic cancer and diabetes.
Function of the pancreas
The pancreas serves two primary functions, according to Jordan Knowlton, an advanced
registered nurse practitioner at the University of Florida Health Shands Hospital. It makes
"enzymes to digest proteins, fats, and carbs in the intestines" and produces the hormones
insulin and glucagon, he said.
Dr. Richard Bowen of Colorado State University's Department of Biomedical Sciences wrote in
Hypertexts for Pathophysiology: Endocrine System, "A well-known effect of insulin is to decrease
the concentration of glucose in blood." This lowers blood sugar levels and allows the body's cells
to use glucose for energy.
Insulin also allows glucose to enter muscle and other tissue, works with the liver to store glucose
and synthesize fatty acids, and "stimulates the uptake of amino acids," according to Bowen.
Insulin is released after eating protein and especially after eating carbohydrates, which increase
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
glucose levels in the blood. If the pancreas does not produce sufficient insulin, type 1 diabetes
will develop.
Unlike insulin, glucagon raises blood sugar levels. According to the Johns Hopkins University Sol
Goldman Pancreatic Cancer Research Center, the combination of insulin and glucagon maintains
the proper level of sugar in the blood.
The pancreas' second, exocrine function is to produce and release digestive fluids. After food
enters the stomach, digestive enzymes called pancreatic juice travel through several small ducts
to the main pancreatic duct and then to the bile duct, according to the Medical University of
South Carolina’s Digestive Disease Center. The bile duct takes the juice to the gallbladder, where
it mixes with bile to aid in digestion.
Location of the pancreas
"The pancreas is located in the upper abdomen behind the stomach," Knowlton said. The right
end of the pancreas is wide and called the head. From the head, the organ tapers to the left. The
middle sections are called the neck and body, while the narrow end on the left side of the body
is called the tail.
The Hume-Lee Transplant Center at Virginia Commonwealth University described the pancreas
as "j-shaped." The portion of the pancreas called the uncinate process bends backward from the
head and underneath the body, according to the Pancreatic Cancer Action Network.
Pancreas pain
Intense pancreatic pain is usually associated with acute pancreatitis. It can be hard to identify
pancreas pain and evaluate pancreas diseases because the organ sits deep in the abdomen,
according to The National Pancreas Association. Other signs that the pain may be pancreatic
include jaundice, itchy skin and unexplained weight loss. If you are experiencing pancreas pain,
consult your doctor.
Pancreatitis
The National Institutes of Health defines pancreatitis as inflammation of the pancreas, happening
when "digestive enzymes start digesting the pancreas itself." It can be acute or chronic, but both
forms should be taken seriously and may lead to additional health problems.
Chronic pancreatitis
There are up to 23 cases of chronic pancreatitis per 100,000 people per year worldwide. In just
the United States, it results in more than 122,000 outpatient visits and more than 56,000
hospitalizations per year, according to the Cleveland Clinic.
"Chronic pancreatitis is a persistent inflammation (greater than three weeks) of the pancreas
that causes permanent damage," Knowlton said. The condition is often caused by "heavy,
ongoing" alcohol consumption, but she added that there are other causes, including "those that
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
cause acute pancreatitis attacks." Other causes may be cystic fibrosis, high levels of calcium or
fat in the blood and autoimmune disorders.
Symptoms include upper abdominal pain, nausea, vomiting, weight loss, and oily stools.
According to Peter Lee and Tyler Stevens, in an article for the Cleveland Clinic, "clinically
apparent" oily stools (steatorrhea) do not appear until "90 percent of pancreatic function has
been lost."
"Chronic pancreatitis requires dietary modifications, including a low-fat diet and cessation of
alcohol [intake] and smoking," Knowlton said. Chronic pancreatitis does not heal and tends to
worsen with time, and "treatment options are mostly for pain relief." She added that treatments
"may include a pancreas stent or, for severe cases, surgery (either a lateral
pancreaticojejunostomy, or a Whipple procedure)." Pancreatiocojejunostomies are designed to
decrease pancreatic leakage while the Whipple procedure removes the head of the pancreas
where, according to the Mayo Clinic, most tumors occur.
There may be a link between chronic pancreatitis and pancreatic cancer. According to the
University of California Los Angeles Center for Pancreatic Diseases, "Recent studies reveal a 2-5
times increase in the incidence of pancreatic cancer in patients with chronic pancreatitis from a
variety of causes."
Acute pancreatitis
"Acute pancreatitis is inflammation of the pancreas (lasting less than three weeks), that is most
often caused by gallstones," said Knowlton. It usually comes on suddenly and disappears within
a few days of treatment. In addition to gallstones, Knowlton said that causes "may include
medications, high triglycerides, high calcium in the blood and high alcohol consumption."
Pancreas pain is the chief symptom of acute pancreatitis, according to Medscape. The pain is
usually severe and sudden. It increases in severity until it becomes a constant ache. This
pancreas pain is felt in the upper abdomen. The Mayo Clinic noted that the pain can radiate
through to the back, and Knowlton pointed out that it might be worse after eating. Other
symptoms of acute pancreatitis include nausea, vomiting, fever and diarrhea.
According to Knowlton, "This patient often looks acutely ill, and requires hospitalization (typically
for three to five days), intravenous (IV) hydration, nothing by mouth (for bowel rest), pain
medication, treatment of underlying conditions, and possibly a radiologic procedure called an
endoscopic retrograde cholangiopancreatography (ERCP), which can more specifically target the
problem." If the acute pancreatitis was caused by gallstones, doctors may recommend removing
the gallbladder.
Pancreatic cancer
It is hard to diagnose pancreatic cancer early. The Mayo Clinic noted that symptoms typically
don't occur until the cancer has advanced. Knowlton said, "Unfortunately, symptoms can be
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
vague, but can include abdominal pain, jaundice, severe itching, weight-loss, nausea, vomiting,
and digestive problems."
Making matters even more complicated is the pancreas' deep-in-the-abdomen location. The NIH
pointed out that as a result, tumors cannot usually be felt by touch. Because of the difficulty of
early diagnosis and the rapidity with which pancreatic cancer spreads, the prognosis is often
poor.
Risk factors for pancreatic cancer include smoking, long-term diabetes and chronic pancreatitis,
according to the National Cancer Institute.
According to the American Cancer Society, pancreatic cancer usually begins in the cells that
produce pancreatic (digestive) juices or in the cells that line the ducts. In rare occasions,
pancreatic cancer will begin in the cells that produce hormones.
According to the University of Texas MD Anderson Cancer Center, to diagnose pancreatic cancer,
doctors typically conduct physical exams, blood tests, imaging tests, endoscopic ultrasounds and
tests and biopsies. Treatment options include surgery, radiation, chemotherapy and therapies
targeted to attack cancer cells without harming normal cells.
Artificial pancreas
When a person's pancreas isn't functioning properly or has to be removed, doctors may replace
or supplement it with an artificial pancreas. These devices that automatically monitor blood
glucose and provide the appropriate insulin doses are often called closed-loop systems,
automated insulin delivery systems, or autonomous systems for glycemic control, according to
the Food and Drug Administration.
In a 2014 study published in the journal The Lancet Diabetes & Endocrinology, researchers
found that an artificial pancreas offer people with type 1 diabetes a reliable way to keep glucose
levels in check, when compared to other treatments. "Our study confirms that both artificial
pancreas systems improve glucose control and reduce the risk of hypoglycemia compared to
conventional pump therapy," study author Ahmad Haidar, of Institut de Recherches Cliniques de
Montreal, said in a statement.
Referencia:
Szalay, J. (2018, April 12). Live Science. In Pancreas: Function, Location & Diseases. Consultado
de https://www.livescience.com/44662-pancreas.html
Diagrama
(Puedes utilizar el sugerido o puedes incluir uno propio)
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
Valor: 1 punto por cada respuesta correcta.
Functions
Pancreas
Locations
Disease
PARTE B
Valor: 4 puntos por respuesta correcta.
TEXTO
The nervous system is a complex collection of
nerves and specialized cells known as neurons
that transmit signals between different parts
of the body. It is essentially the body's
electrical wiring.
Structurally, the nervous system has two
components: the central nervous system and
the peripheral nervous system. According to
the National Institutes of Health, the central
nervous system is made up of the brain,
spinal cord and nerves. The peripheral
nervous system consists of sensory neurons,
ganglia (clusters of neurons) and nerves that
connect to one another and to the central
nervous system.
Functionally, the nervous system has two
main subdivisions: the somatic, or voluntary,
component;
and
the
autonomic,
or
Justificación
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
involuntary, component. The autonomic
nervous system regulates certain body
processes, such as blood pressure and the
rate of breathing, that work without conscious
effort, according to Merck Manuals. The
somatic system consists of nerves that
connect the brain and spinal cord with
muscles and sensory receptors in the skin.
Description of the nervous system
Nerves are cylindrical bundles of fibers that
start at the brain and central cord and branch
out to every other part of the body, according
to the University of Michigan Medical School.
Neurons send signals to other cells through
thin fibers called axons, which cause
chemicals known as neurotransmitters to be
released at junctions called synapses, the NIH
noted. There are over 100 trillion neural
connections in the average human brain,
though the number and location can vary. For
example, a new study published January 2018
in the journal Proceedings of the National
Academy of Sciences found that out of the
160 participants studied, the brains of highly
creative people have more connections among
three specific regions of the brain than less
creative thinkers.
"You have these three different systems that
are all located in different parts of the brain,
but they are all co-activated at once," said
lead study author Roger Beaty, a postdoctoral
fellow studying cognitive neuroscience at
Harvard University. "People who are better
able to co-activate them [came] up with
more-creative responses."
A synapse gives a command to the cell and
the entire communication process typically
takes only a fraction of a millisecond. Signals
travel along an alpha motor neuron in the
spinal cord 268 mph (431 km/h); the fastest
transmission in the human body, according to
Discover magazine.
Sensory neurons react to physical stimuli such
as light, sound and touch and send feedback
to the central nervous system about the
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
body's surrounding environment, according to
the American Psychological Association. Motor
neurons, located in the central nervous
system or in peripheral ganglia, transmit
signals to activate the muscles or glands.
[Here's What You'd Look Like as Just a
Nervous System]
Glial cells, derived from the Greek word for
"glue," are specialized cells that support,
protect or nourish nerve cells, according to
the Oregon Institute of Health and Science
University.
The brain's connections and thinking ability
grew over thousands of years of evolution.
For example, a virus bound its genetic code to
the genome of four-limbed animals, and the
code can still be found in humans' brains
today, according to two papers published in
the January 2018 journal Cell. This code
packages up genetic information and sends it
from nerve cells to other nearby nerve cells, a
very important process in the brain.
The human brain is the command center for
the human nervous system. The human brain
receives signals from the body's sensory
organs and outputs information to the
muscles and body. The human brain has the
same basic structure as other mammal brains
but is larger and amazing in relation to body
size than any other brains when it receives
several commands.
Numbers about the human brain
The human brain is the largest brain of
all vertebrates relative to body size.
It
weighs
about
3.3
lbs.
(1.5
kilograms).
The average male has a brain volume
of 1,274 cubic centimeters (cm3).
The average female brain has a volume
of 1,131 cm3.
The brain makes up about 2 percent of
a human's body weight.
The cerebrum makes up 85 percent of
the brain's weight.
It contains about 86 billion nerve cells
(neurons) — the "gray matter."
It contains billions of nerve fibers
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
(axons and dendrites) — the "white
matter."
These neurons are connected by
trillions of connections, or synapses.
The largest part of the human brain is the
cerebrum, which is divided into hemispheres,
according to the Mayfield Clinic. Underneath
lies the brainstem, and behind that sits the
cerebellum. The outermost layer of the
cerebrum is the cerebral cortex, which
consists of four lobes.
Like all vertebrate brains, the human brain
develops from three sections known as the
forebrain, midbrain and hindbrain. Each of
these contains fluid-filled cavities called
ventricles. The forebrain develops into the
cerebrum and underlying structures; the
midbrain becomes part of the brainstem; and
the hindbrain gives rise to regions of the
brainstem and the cerebellum.
Introduction
Around one billion adults worldwide smoke,1
with high prevalence in developing countries,
where 49% of men and 11% of women use
tobacco.2 Although the prevalence of current
smokers has decreased over time in several
countries, the global absolute number of
smokers has increased owing to population
growth.3
Policies
have
successfully
encouraged people to quit, using aids such as
nicotine replacement therapy and electronic
cigarettes (e-cigarettes).
In the Health Survey for England (2013 and
2014), 26% of current smokers reported that
they wanted to cut consumption down but
were not trying to stop, and 40-41% said that
they smoked less than in the previous year.5
The percentage of smokers who consume one
to five cigarettes per day has steadily risen
(from 18.2% to 23.6% between 2009 and
20145), with a similar pattern in the US,
where the proportion of smokers who
consume less than 10 cigarettes per day
increased from 16% to 27% between 2005
and 2014.6 A recent Cochrane review
discussed the evidence for ways of helping
smokers
who
wish
to
reduce
their
consumption.
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
Smoking few cigarettes is generally believed
to be relatively safe, as has been incorrectly
assumed for light/low nicotine cigarettes.8
Among 24 658 US adolescents, 10% thought
that light smoking was not harmful, and only
35% of light smokers considered their habits
to be associated with “a lot of harm.”9
Reducing consumption might be expected to
reduce harm in a proportionate way—that is,
that smoking one instead of 20 cigarettes per
day has about one twentieth (5%) of the risk.
This seems to be the case for lung cancer, for
which the large American Cancer Society
Prevention Study II showed an approximately
linear relation between risk of lung cancer and
number of cigarettes smoked per day, but the
dose-response for cardiovascular disease is
steep at low consumption and then levels
off,10 consistent with the shape reported
previously.
In a seminal systematic review of secondhand smoke and coronary heart disease
among never smokers published in the BMJ
20 years ago, Law and colleagues drew
attention to the 1.30 risk ratio being relatively
large compared with the 2-3 typically seen in
studies of active smokers.12 Their conclusions
on second-hand smoke were supported by a
meta-analysis of active cigarette smoking and
risk of coronary heart disease from five cohort
studies, in which the modelled relative risk for
smoking one cigarette per day (1.39) was
consistent with that for exposure to secondhand smoke.
Although the non-linear relation between
coronary heart disease and low cigarette
consumption has been reported before
(individual studies, as well as official reports
from the US Surgeon General), it still is still
not commonly known by the general public or
health professionals, particularly those not
involved in tobacco and health. We thus
aimed to extend the previous work on
coronary heart disease,12 by using a
systematic review to provide a major body of
evidence. We also aimed to show that a
similar non-linear relation exists between
Lección 9. Cohesión y coherencia
¡Domínalo!
Médico cirujano
stroke and low cigarette consumption.
PARTE C
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TEXTO
Texto 1
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IDEA PRINCIPAL
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