Efficacy and safety of misoprostol compared to methotrexate plus misoprostol for the medical management of abortion in Bogotá, Colombia. A randomized clinical trial

Evaluar la eficacia y seguridad del misoprostol frente al metotrexato más misoprostol para el manejo médico de pacientes con aborto retenido o embarazo anembrionado. Se realizó un estudio clínico aleatorizado en el que se incluyeron pacientes con embarazo anembrionado o aborto retenido de hasta 63 días y diagnosticado por ecografía. Estas fueron aleatorizadas a metotrexato 50 mg intramuscular más misoprostol 800 mcg intravaginal (grupo 1) u 800 mcg de misoprostol intravaginal (grupo 2). A continuación se evaluó la tasa de aborto completo, incluyendo las pacientes que requirieron un segundo ciclo de rescate con sus respectivas complicaciones. Un total de 52 pacientes fueron aleatorizadas al grupo de terapia combinada y 66 al grupo de monoterapia. 92% de las pacientes en el grupo de misoprostol más metotrexato presentaron aborto completo por ecografía frente a 86% de las pacientes en el grupo de misoprostol (p=0,24). Por otro lado, dos de las pacientes del grupo de terapia combinada (6%) requirieron dosis de rescate en comparación con cinco en el grupo de misoprostol (11%), (p=0,348). De igual modo, tres pacientes requirieron legrado uterino obstétrico en el grupo de terapia combinada frente a cinco pacientes en el grupo de monoterapia con misoprostol (p=0,69). En definitiva, los dos esquemas resultaron seguros para las pacientes. Los resultados permitieron concluir que, en el manejo médico del aborto retenido o embarazo anembrionado menor a 63 días, la monoterapia con una dosis de 800 mcg de misoprostol intravaginal no mostró diferencias significativas en comparación con un esquema de terapia combinada con metotrexato y misoprostol.Evaluating the efficacy and safety of misoprostol compared to methotrexate plus misoprostol for the medical management of patients suffering from retained abortion/anembryonic pregnancy. This was a randomized clinical experiment. Patients having a gestational age of less than 63 days who were suffering anembryonic pregnancy/retained abortion as diagnosed by ecography were included. They were randomized into 2 groups receiving 50 mg intra muscular methotrexate plus 800 mcg intravaginal misoprostol (group 1) or 800 mcg intravaginal misoprostol (group 2). The complete abortion rate was evaluated, including patients who required a rescue dose with their respective complications. Results: a total of 52 patients were randomized to the combined therapy group and 66 to the monotherapy group; 92% presented complete abortion by ecography in the misoprostol plus methotrexate group and 86% in the misoprostol group (p=0.24). Two of the patients from the combined therapy group (6%) required a rescue dose compared to five in the misoprostol group (11%) (p=0.348). Three patients required obstetric uterine dilation and curettage (D&C) (in the combined therapy group whilst five needed it in the monotherapy with misoprostol group (p=0.69). Both schemes proved safe for the patients. The profile for medical management of females having a gestational age of less than 63 days who were diagnosed as having retained abortion or anembryonic pregnancy receiving intravaginal 800 mcg de misoprostol monodosis did not show significant differences when compared to a combined methotrexate and misoprostol therapy scheme

Three dimensional extended i m aging in the prenatal diagnosisof Galen vein aneurism: a case report

Galen vein aneurism (GVA) corresponds to a vascular dilation of the sinus venous in central nervous system (CNS). GVA is a rare category of congenital anomalies with a high mortality in neonatal and pediatric life. Regular diagnostic methods consist of 2D ultrasound and transvaginal neurosonogram when possible. Arteriovenous malformation are a heterogeneous group of dilated deep vein anomalies of Galen system with abnormal communications of the mid line. It is presented in 1 : 250000 deliveries. Main complications include heart failure in the neonatal period, hydrocephalus, brain calcifications, encephalomalacia, cerebral atrophy, bleeding and neurological progressive compromise. We describe a case of GVA diagnosed at 38 wo. Fetal evaluation was performed using Accuvix V10 ultrasonographic equipment (Medison. Seoul-Korea). Cerebral images were obtained using Virtual Organ Computer-aided AnaLysis (VOCALTM , 3DXI, Medison Sonoview Pro, Seoul, Korea) with 30 degrees swept. The obtained volumes were analyzed in the postprocessor software 3DXI viewer and clinically correlated

Capsule Switching among C:2b:P1.2,5 Meningococcal Epidemic Strains after Mass Immunization Campaign, Spain

A mass immunization campaign for 18-month to 19-year-olds was undertaken in Spain in 1996–1997 because of an epidemic of serogroup C meningococcal disease associated with a C:2b:P1.2,5 strain belonging to the A4 lineage. Surveillance for the “capsule-switching” phenomenon producing B:2b:P1.2,5 isolates was undertaken. Of 2,975 meningococci characterized, B:2b:P1.2,5 and B:2b:P1.2 antigenic combinations were found in 18 isolates; 15 meningococci were defined as serogroup B belonging to the A4 lineage

Administration time effect of dietary proanthocyanidins on the metabolome of Fischer 344 rats is sex- and diet-dependent

Proanthocyanidins (PAs) are one of the most commonly ingested polyphenols in the human diet, with a wide range of beneficial health effects. Remarkably, PAs have been reported to influence core and peripheral clock genes expression, and their effects may change in a time-of-day dependent manner. Therefore, the aim of this study was to investigate whether the capacity of PAs to modulate the metabolome is conditioned by the time-of-day in which these compounds are consumed in a diet- and sexdependent manner. To do this, a grape seed proanthocyanidin extract (GSPE) was administered to female and male Fischer 344 rats at ZT0 (in the morning) and ZT12 (at night) and the GSPE administration time effect was evaluated on clock genes expression, melatonin hormone and serum metabolite levels in a healthy and obesogenic context. The results showed an administration time effect of GSPE on the metabolome in a sex and diet-dependent manner. Specifically, there was an effect on amino acid, lipid and cholate metabolite levels that correlated with the central clock genes expression. Therefore, this study shows a strong influence of sex and diet on the PAs effects on the metabolome, modulated in turn by the time-of-day

MEP-2 programa de computador para manejo de praderas con bovinos en el trópico Colombiano I - desarrollo informático.

sumarios (En, Es)Se diseñó y desarrolló una herramienta informática (Manejo Experto de Praderas: MEP-2®) para simular el comportamiento de las gramíneas tropicales frente al pastoreo con bovinos y para establecer los períodos de uso y recuperación de las praderas, en función de la producción de biomasa comestible, su calidad y consumo por parte de los animales. Así mismo, MEP-2® incorpora variables de calidad del forraje y de distensión del rumen, de acuerdo con un modelo de simulación de consumo de materia seca (MS) simple y de fácil implementación. El sistema fue estructurado previamente en hoja de cálculo y posteriormente trasladado a Visual Basic 6T, la información de identificación de la finca, tipo de ganado, especies de pastos y sistema de pastoreo se almacenó en formato AccessT. El programa consta de seis ventanas que se abren secuencialmente una vez se diligencia la información solicitada: dos ventanas corresponden a la evaluación de la disponibilidad de forraje según el tipo de gramínea: erecta o postrada. Otras dos ventanas registran información de la finca y las praderas con sus características individuales. De las dos ventanas finales, una corresponde a los resultados de la simulación y la otra a su interpretación, además de algunas recomendaciones generales. El propósito de la herramienta es proporcionar a ganaderos y asistentes técnicos un sistema objetivo para la toma de decisiones en el manejo de las praderas contribuyendo de esta manera a su sostenibilidad y a una mayor eficiencia de los animales.Ganadería bovin

MEP-2 programa de computador para manejo de praderas con bovinos en el trópico Colombiano. II - evaluación en el campo del programa.

"sumarios (En, Es)Se evaluó un programa de computador diseñado para predecir la utilización de praderas con bovinos bajo diferentes sistemas de pastoreo en distintos escenarios y regiones de Colombia y se compararon las predicciones de disponibilidad de biomasa, tiempos de pastoreo y de recuperación contra los datos observados en cada una de las fincas. Se incluyeron una finca en el Valle del Cesar con vacas doble propósito secas bajo pastoreo rotacional en praderas de pasto Guinea, una finca en el Piedemonte del Meta con novillos de ceba bajo pastoreo alterno de Brachiaria decumbens, una finca en el Magdalena Medio santandereano con novillos de ceba en pastoreo rotacional de Brachiaria humidícola y una finca en la Sabana de Bogotá con vacas de ordeño bajo pastoreo de Kikuyo-Ryegrass en franjas de un día. En cada una de las fincas se evaluaron dos rotaciones completas en cada época climática (sequía, lluvias). El análisis de las predicciones contra las observaciones en las variables días de ocupación, descanso y disponibilidad de forraje, se realizó mediante una comparación de medias con prueba de ""t"" (a de 5 por ciento). El consumo animal de MS predicho por el programa se analizó en relación con variables de calidad del forraje: proteína cruda, digestibilidad y Fibra en Detergente Neutro, mediante regresión lineal simple, encontrándose una correlación media para las tres variables con el consumo. Se concluye que el programa de simulación ayuda a la toma de decisiones sobre manejo de praderas, con mayor precisión durante la época de lluvias, mientras que para la época seca, los resultados deben tomarse con precaución realizando una evaluación o aforo de las praderas cuidadosa."Ganado de leche-Ganadería lech

CD8+ cytolytic T cell clones derived against the Plasmodium yoelii circumsporozoite protein protect against malaria

Immunization of BALB/c mice with radiation-attenuated Plasmodium yoelii sporozoites induces cytotoxic T lymphocytes (CTL) specific for an epitope located within the amino acid sequence 277-288 of the P. yoelii circumsporozoite (CS) protein. Several CD8+ CTL clones were derived from the spleen cells of sporozoite-immunized mice, all displaying an apparently identical epitope specificity. All the clones induced high levels of cytolysis in vitro upon exposure to peptide-incubated MHC-compatible target cells. The adoptive transfer of two of these clones conferred complete protection against sporozoite challenge to naive mice. This protection is species and stage specific. Using P. yoelii specific ribosomal RNA probes to monitor the in vivo effects of the CTL clones, we found that their target was the intrahepatocytic stage of the parasite. The protective clones completely inhibited the development of the liver stages of P. yoelii. Some CTL clones were only partially inhibitory in vivo, while others failed completely to alter liver stage development and to confer any detectable degree of protection. The elucidation of the effector mechanism of this CTL mediated protection against rodent malaria should facilitate the design of an effective malaria vaccine. From a broader perspective this model may provide further insight into the mechanism(s) of CTL mediated killing of intracellular non-viral pathogens in general

Effector and Naturally Occurring Regulatory T Cells Display No Abnormalities in Activation Induced Cell Death in NOD Mice

BACKGROUND: Disturbed peripheral negative regulation might contribute to evolution of autoimmune insulitis in type 1 diabetes. This study evaluates the sensitivity of naïve/effector (Teff) and regulatory T cells (Treg) to activation-induced cell death mediated by Fas cross-linking in NOD and wild-type mice. PRINCIPAL FINDINGS: Both effector (CD25(-), FoxP3(-)) and suppressor (CD25(+), FoxP3(+)) CD4(+) T cells are negatively regulated by Fas cross-linking in mixed splenocyte populations of NOD, wild type mice and FoxP3-GFP trangeneess. Proliferation rates and sensitivity to Fas cross-linking are dissociated in Treg cells: fast cycling induced by IL-2 and CD3/CD28 stimulation improve Treg resistance to Fas-ligand (FasL) in both strains. The effector and suppressor CD4(+) subsets display balanced sensitivity to negative regulation under baseline conditions, IL-2 and CD3/CD28 stimulation, indicating that stimulation does not perturb immune homeostasis in NOD mice. Effective autocrine apoptosis of diabetogenic cells was evident from delayed onset and reduced incidence of adoptive disease transfer into NOD.SCID by CD4(+)CD25(-) T cells decorated with FasL protein. Treg resistant to Fas-mediated apoptosis retain suppressive activity in vitro. The only detectable differential response was reduced Teff proliferation and upregulation of CD25 following CD3-activation in NOD mice. CONCLUSION: These data document negative regulation of effector and suppressor cells by Fas cross-linking and dissociation between sensitivity to apoptosis and proliferation in stimulated Treg. There is no evidence that perturbed AICD in NOD mice initiates or promotes autoimmune insulitis