Amnion-Derived Multipotent Progenitor Cells Improve Achilles Tendon Repair in Rats

Objective: Tendon injuries produce considerable morbidity, long-lasting disability, and remain a considerable challenge for clinicians and patients. The objective of the study was to assess the effect of amnion-derived multipotent progenitor (AMP) cells and amnion-derived cell cytokine solution on Achilles tendon healing by using a rat model. Methods: Achilles tendons of Sprague-Dawley rats were exposed and transected. The distal and proximal ends were injected with either saline, amnion-derived cell cytokine solution, or AMP cells in a standardized fashion and then sutured by using a Kessler technique. Tendons from each group (n = 6-13) were collected at weeks 1, 2, and 4 postoperatively and assessed for material properties (ultimate tensile strength, Young modulus, yield strength, and breaking strength). Tendons were also evaluated histologically for cross-sectional area by using hematoxylin-eosin and trichrome stains. Results: Mechanical testing showed that the Young modulus was significantly higher in AMP cells–treated tendons at week 4 compared with both saline-treated and amnion-derived cell cytokine solution–treated tendons. Yield strength was significantly higher in the AMP cells–treated group compared with saline-treated controls at week 4. No significant differences were observed between the study groups at weeks 1 and 2. Discussion: Amnion-derived multipotent progenitor cells have a positive effect on healing tendons by improving mechanical strength and elastic modulus during the healing process. The presented findings suggest the clinical utility of AMP cells in facilitating the healing of ruptured tendons. Both the Young modulus and yield strengths of tendons increased significantly following treatment with AMP cells

Atopic Dermatitis and Erythrodermia Associated With Systemic Lupus Erythematosus: A Case Report

La eritrodermia es una dermatosis inflamatoria que involucra capas parciales o totales de la piel. La mortalidad es del 16%. Los síntomas sistémicos incluyen fiebre, taquicardia, hinchazón de las extremidades, adenomegalia y hepatomegalia. Las causas infecciosas son las más frecuentes, estando presentes hasta en un 40%, seguidas de ictiosis y dermatitis en el 15% de los casos

Assessment of Darkling Beetle Fauna after Implementation of an Environmental Restoration Program in the Southern Iberian Peninsula Affected by the Aznalcóllar Toxic Spill

This study is part of the Follow up Restoration Program of animal communities that colonize the Guadiamar River Basin. In 1998, the area was affected by a release of toxic sludge after the retention walls of the Aznalcóllar Mines (southern Iberian Peninsula) broke. The main objective of this study was to assess the current state of the population of Tenebrionidae, one of the most representative groups of edaphic Coleoptera inhabiting the Guadiamar River Basin. This paper analyses the progress made by the darkling beetle community six years after the disaster occurred and the Restoration Program was implemented. The study is based on faunistic data from systematic sampling carried out for six years to monitor plots distributed across the damaged area. To make an overall assessment of the tenebrionid fauna in relation to adjacent areas qualitative and quantitative ecological indices were applied, and temporal follow up and biogeographical comparisons were also made. The results indicate that, on the whole, tenebrionid fauna was somewhat affected by the Aznalcóllar Mine spill, and that a greater loss of fauna was detected closer to the accident site. The analysis of the temporal population dynamic suggests that the most affected zones are undergoing a process of re-colonization. However, this process varies widely by species and has not yet reached the expected levels of a non-affected river basin in the southern Iberian Peninsula

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

Introduction: Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors. Methods: Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit. Results: The median [p25–p75] time from discharge to follow-up was 3.57 [2.77–4.92] months. Median age was 60 [53–67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO < 80% and 24% having DLCO < 60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO < 60% were chronic lung disease (CLD) (OR: 1.86 (1.18–2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37–1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18–1.63)), urea (OR: 1.16 (0.97–1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73–1.06)). Bacterial pneumonia (1.62 (1.11–2.35)) and duration of ventilation (NIMV (1.23 (1.06–1.42), IMV (1.21 (1.01–1.45)) and prone positioning (1.17 (0.98–1.39)) were associated with fibrotic lesions. Conclusion: Age and CLD, reflecting patients’ baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities

Cartilage repair in the degenerative ageing knee: A narrative review and analysis

Background and purpose Cartilage damage can develop due to trauma, resulting in focal chondral or osteochondral defects, or as more diffuse loss of cartilage in a generalized organ disease such as osteoarthritis. A loss of cartilage function and quality is also seen with increasing age. There is a spectrum of diseases ranging from focal cartilage defects with healthy surrounding cartilage to focal lesions in degenerative cartilage, to multiple and diffuse lesions in osteoarthritic cartilage. At the recent Aarhus Regenerative Orthopaedics Symposium (AROS) 2015, regenerative challenges in an ageing population were discussed by clinicians and basic scientists. A group of clinicians was given the task of discussing the role of tissue engineering in the treatment of degenerative cartilage lesions in ageing patients. We present the outcomes of our discussions on current treatment options for such lesions, with particular emphasis on different biological repair techniques and their supporting level of evidence. Results and interpretation Based on the studies on treatment of degenerative lesions and early OA, there is low-level evidence to suggest that cartilage repair is a possible treatment for such lesions, but there are conflicting results regarding the effect of advanced age on the outcome. We concluded that further improvements are needed for direct repair of focal, purely traumatic defects before we can routinely use such repair techniques for the more challenging degenerative lesions. Furthermore, we need to identify trigger mechanisms that start generalized loss of cartilage matrix, and induce subchondral bone changes and concomitant synovial pathology, to maximize our treatment methods for biological repair in degenerative ageing joints

SUGARCANE MOLASSE AND WHEY AS ADDITIVES IN THE SILAGE OF LEMONGRASS ( Cymbopogon citratus [DC.] Stapf) LEAVES

After extraction of essential oil from lemongrass ( Cymbopogon citratus [DC.] Stapf) leaves by steam distillation (heat treatment), large amounts of organic wastes are obtained. This by-product could easily be used as animal feed. The potential of sugarcane molasse and whey as additives to ensile lemongrass leaves was investigated. The vegetative material was obtained after essential oils were extracted from lemongrass leaves with steam distillation. Lemongrass leaves were chopped, mixed with sugarcane molasse and whey, placed in cylindrical plastic containers, hermetically closed. The experimental design for pH optimization was a response surface 3-level factorial design 32 with three replicates. Sugarcane molasse at 5, 10 and 15% (w/w) and whey at 20, 25 and 30% (w/w) were used. The pH of the silage decreased significantly in each treatment, but it was faster when sugarcane molasse was added. The lactic acid concentration was 2.8 g kg-1 DM in silage amended with 15% molasse plus 25% whey and was higher than in silage supplemented with commercial additive after 15 d. In conclusion, it was shown that lemongrass leaves obtained as by product after extracting essential oils can be effectively ensiled with whey and sugarcane molasse as additives inducing a faster production of lactic acid