Top-Down proteomic analysis of CSF proteins from ALS patients

Comunicaciones a congreso

Comparison of epidemiology and clinical characteristics of infections by human parechovirus vs. those by enterovirus during the first month of life

Human parechoviruses (HPeV) have been recently recognized as important viral agents in paediatric infections. The aims of this study were to investigate the HPeV infection prevalence in infants <1 month in Spain and, secondly, to analyse the clinical and epidemiological characteristics of the infected patients compared with those infected by enterovirus (EV). Infants <1 month with neurological or systemic symptoms were included in a multicentre prospective study. EV and HPeV detection by RT-PCR and genotyping were performed in cerebrospinal fluids (CSF), sera or throat swabs. Out of the total of 84 infants studied during 2013, 32 were EV positive (38 %) and 9 HPeV positive (11 %). HPeV-3 was identified in eight cases and HPeV-5 in one. Mean age of HPeV-positive patients was 18 days. Diagnoses were fever without source (FWS) (67 %), clinical sepsis (22 %) and encephalitis (11 %). Leukocytes in blood and CSF were normal. Pleocytosis (p = 0.03) and meningitis (p = 0.001) were significantly more frequent in patients with EV infections than with HPeV. Conclusions: Although HPeV-3 infections were detected less frequently than EV, they still account for approximately 10 % of the cases analysed in infants younger than 1 month. HPeV-3 was mainly associated with FWS and without leukocytosis and pleocytosis in CSF. In these cases, HPeV screening is desirable to identify the aetiologic agent and prevent unnecessary treatment and prolonged hospitalization.This study was partially supported by a grant from the Spanish National Health Institute PI12-00904.S

Comparison of epidemiology and clinical characteristics of infections by human parechovirus vs. those by enterovirus during the first month of life

Human parechoviruses (HPeV) have been recently recognized as important viral agents in paediatric infections. The aims of this study were to investigate the HPeV infection prevalence in infants <1 month in Spain and, secondly, to analyse the clinical and epidemiological characteristics of the infected patients compared with those infected by enterovirus (EV). Infants <1 month with neurological or systemic symptoms were included in a multicentre prospective study. EV and HPeV detection by RT-PCR and genotyping were performed in cerebrospinal fluids (CSF), sera or throat swabs. Out of the total of 84 infants studied during 2013, 32 were EV positive (38 %) and 9 HPeV positive (11 %). HPeV-3 was identified in eight cases and HPeV-5 in one. Mean age of HPeV-positive patients was 18 days. Diagnoses were fever without source (FWS) (67 %), clinical sepsis (22 %) and encephalitis (11 %). Leukocytes in blood and CSF were normal. Pleocytosis (p = 0.03) and meningitis (p = 0.001) were significantly more frequent in patients with EV infections than with HPeV. Conclusions: Although HPeV-3 infections were detected less frequently than EV, they still account for approximately 10 % of the cases analysed in infants younger than 1 month. HPeV-3 was mainly associated with FWS and without leukocytosis and pleocytosis in CSF. In these cases, HPeV screening is desirable to identify the aetiologic agent and prevent unnecessary treatment and prolonged hospitalization

Factores obstétricos claves en los resultados neonatales y a los dos años de seguimiento en la prematuridad extrema

Objetivo: Analizar la morbimortalidad en pretérminos extremos evaluando la influencia de factores obstétricos. Método: Estudio retrospectivo de 132 casos nacidos entre las semanas 23 y 27 en el Hospital La Paz, desde 2003 a 2005. Se establecieron tres grupos obstétricos: Amenaza de Parto Pretérmino, Rotura Prematura de Membranas y la asociación de ambas. Se evaluaron como variables obstétricas: tocolisis, corticoterapia, motivo de finalización de la gestación y vía de parto, y como variables en niños: mortalidad y morbilidad respiratoria, neurológica, visual y auditiva en neonatos y a los dos años. Resultados: Los casos con amenaza de parto pretérmino presentaron mayor displasia broncopulmonar y ductus arterioso persistente que los otros dos grupos obstétricos (p=0,03). Las pacientes con amenaza de parto pretérmino y tocolisis desarrollaron menos hemorragia intraventricular [36,4%(12/33)] e infarto periventricular (0%) que los casos sin tocolisis, en los que aparecieron en el 68,4% (13/19) y 31,6%(6/19), respectivamente (p=0,03 y p=0,001). Además en este subgrupo, los casos que recibieron corticoterapia desarrollaron menos infarto periventricular (0%) y parálisis cerebral a los 2 años [6,7% (2/30)], que los que no la recibieron, en los que apareció un 40% (6/15) de infarto y un 40% (4/10) de parálisis cerebral, respectivamente (p=0,0001 y p=0,02). La hemorragia intraventricular y la parálisis cerebral fueron más frecuentes en partos vaginales de casos con amenaza de parto pretérmino que en cesáreas [63,3% (19/30) y 26,1% (6/23) frente a 27,3% (6/22) y 0%; p=0,01 y 0,03]. Conclusión: La conducta obstétrica puede modificar el pronóstico neonatal y a los 2 años de seguimiento.Objective: Analyse morbidity and mortality in extreme preterm at birth and at 2 year follow-up evaluating the influence of obstetrical factors. Methods: Retrospective study of 132 cases born between weeks 23 and 27 at La Paz Hospital from 2003 to 2005. Three obstetrical groups were established: Threat of Preterm Birth, Premature Rupture of Membranes and the combination of both. The following were evaluated as obstetrical variables: tocolysis, corticosteroid therapy and type of delivery. As variables in children: mortality and respiratory, neurological, visual and auditive morbidity in neonates and two years of age. Results: In the cases of threat of preterm birth a greater bronchopulmonary dysplasia and persistent ductus arteriosus appeared than in the other two obstetrical groups (p=0.03). Focusing on the threat of birth group, the cases with maternal tocolysis developed fewer neurological complications, intraventricular hemorrhage of 36.4% (12/33) and periventricular infarct of 0%, whereas the cases without tocolysis showed 68.4% (13/19) and 31.6% (6/19) respectively (p=0.03, p=0.001). Also in this subgroup, the cases that received corticosteroid therapy developed less periventricular infarct (0%) and cerebral palsy at age 2 [6.7% (2/30)] than the ones that did not receive it in which the percentages were 40% (6/15) and 40% (4/10) (p=0.0001 and p=0.02 respectively). Also, intraventricular hemorrhage and cerebral palsy were more frequent in vaginal delivery than in caesarean sections in this subgroup [63.3% (19/30) and 26.1% (6/23) against 27.3% (6/22) and 0%; p=0.01 and p=0.03)]. Conclusion: Obstetrical characteristics and behaviour can have a decisive impact in the neonatal outcome and after two-year follow-up