Amniotic Fluid Embolism. Is a New Pregnancy Possible? Case Report.

Amniotic fluid embolism (AFE) is a rare but potentially catastrophic clinical condition, characterized by a combination of signs and symptoms that reflect respiratory distress, cardiovascular collapse and disseminated intravascular coagulation (DIC). Its pathogenesis is still unclear. More recently, the traditional view of obstruction of pulmonary capillary vessels by amniotic fluid emboli as the main explanation for the etiology has been ruled out, and immunologic factors and the activation of the inflammatory cascade took on an important role. Amniotic fluid embolism has an unpredictable character, its diagnosis is exclusively clinical, and the treatment consists mainly of cardiovascular support and administration of blood products to correct the DIC. No diagnostic test is recommended until now, though multiple blood markers are currently being studied. The authors present a case report of a woman who had survived AFE in her previous pregnancy and had a subsequent pregnancy without recurrence, providing one more clinical testimony of the low risks for the pregnancy after AFE.info:eu-repo/semantics/publishedVersio

Viral Loads and Disease Severity in Children with Rhinovirus-Associated Illnesses

The role of rhinoviruses (RVs) in children with clinical syndromes not classically associated with RV infections is not well understood. We analyzed a cohort of children <= 21 years old who were PCR+ for RV at a large Pediatric Hospital from 2011 to 2013. Using univariate and multivariable logistic regression, we analyzed the associations between demographic, clinical characteristics, microbiology data, and clinical outcomes in children with compatible symptoms and incidental RV detection. Of the 2473 children (inpatients and outpatients) with an RV+ PCR, 2382 (96%) had compatible symptoms, and 91 (4%) did not. The overall median age was 14 months and 78% had underlying comorbidities. No differences in RV viral loads were found according to the presence of compatible symptoms, while in children with classic RV symptoms, RV viral loads were higher in single RV infections versus RV viral co-infections. Bacterial co-infections were more common in RV incidental detection (7.6%) than in children with compatible symptoms (1.9%, p < 0.001). The presence of compatible symptoms independently increased the odds ratio (OR, 95% CI) of hospitalization 4.8 (3.1-7.4), prolonged hospital stays 1.9 (1.1-3.1), need for oxygen 12 (5.8-25.0) and pediatric intensive care unit (PICU) admission 4.13 (2.0-8.2). Thus, despite comparable RV loads, disease severity was significantly worse in children with compatible symptoms

Genetic and phenotypic diversity characterization of natural populations of the parasitoid Parvilucifera sinerae

Parasites exert important top-down control of their host populations. The host−parasite system formed by Alexandrium minutum (Dinophyceae) and Parvilucifera sinerae (Perkinsozoa) offers an opportunity to advance our knowledge of parasitism in planktonic communities. In this study, DNA extracted from 73 clonal strains of P. sinerae, from 10 different locations along the Atlantic and Mediterranean coasts, was used to genetically characterize this parasitoid at the species level. All strains showed identical sequences of the small and large subunits and internal transcribed spacer of the ribosomal RNA, as well as of the β-tubulin genes. However, the phenotypical characterization showed variability in terms of host invasion, zoospore success, maturation time, half-maximal infection, and infection rate. This characterization grouped the strains within 3 phenotypic types distinguished by virulence traits. A particular virulence pattern could not be ascribed to host-cell bloom appearance or to the location or year of parasite-strain isolation; rather, some parasitoid strains from the same bloom significantly differed in their virulence traits. Identical markers such as ITS and β-tubulin genes of P. sinerae strains from different geographic areas and from different years precludes their use in assessing intra-specific diversity and could indicate a recent dispersion of this species.Versión del editor2,393

Histerectomia pós-parto: revisão de 15 anos

Overview and Aims: Postpartum Hysterectomy (PPH) is considered an obstetrical emergency. Profuse bleeding, the most common indication, may jeopardize the puerperal woman. If not controlled by conservative measures, it may require PPH. Its incidence varies between 0.13 to 5.38 per 1000 births. Women with underlying conditions such as placenta previa, fi- broleiomyomas or previous cesarean section (CS) are at increased risk. We evaluated the incidence of PPH, its indications, risk factors and complications. Material and Methods: Retrospective study of PPH conducted at a tertiary care hospital in 15 years (1997-2011). Results: We found 41 cases of PPH (0.6 per 1000 births). Twenty eight occurred after CS (1.34 /1000) and 13 followed vaginal deliveries (0.27/1000), resulting in an odds ratio of 4.94 (2.56 to 9.54, p < 0.001) for CS vs vaginal delivery. Sixteen patients had a previous uterine surgery (CS and/or curettage) and 8 were nulliparous. The most common indication was uterine atony in 18 cases (43.9 %), followed by unspecified hemorrhage in 8 (19.5 %), placenta accreta in 7 (17.1%) and uterine dehiscence/rupture in 4 (9.8%). In 30 cases it was performed a total hysterectomy, being subtotal in the remaining 11 cases. The main complications were the need for red blood cell transfusion (39), disseminated intravascular coagulation (8) and febrile syndrome (6); 21 postpartum women were admitted in Intensive Care Unit. There were no maternal deaths. Pathologic examination of uterus and placenta showed normal postpartum changes in 11 (26.8 %), placenta accreta in 12 (29.3 %), changes consistent with uterine atony in 8 (19.5 %), fibroleiomyomas in 5 (12.2%) and uterine rupture in 3 (7.3%). Conclusions: hysterectomy remains a required procedure in the treatment of postpartum bleeding resistant to conservative management, being uterine atony the most frequent indication with CS accounting for a five times higher risk than vaginal delivery

Results of the Spanish survey in NAFO Division 3NO

Greenland halibut (Reinhardtius hippoglossoides), American plaice (Hippoglossoides platessoides), Atlantic cod (Gadus morhua), yellowtail flounder (Limanda ferruginea), redfish (Sebastes spp.), witch flounder (Glyptocephalus cynoglossus), roughhead grenadier (Macrourus berglax), thorny skate (Amblyraja radiata), white hake (Urophycis tenuis), squid (Illex illecebrosus) and capelin (Mallotus villosus) indices from the bottom trawl survey that Spain carries out in Spring since 1995 in Divisions 3NO of the NAFO Regulatory Area are presented. In 2020, the survey was not carried out due to the COVID pandemic situation. The presented indices are biomass by stratum, total length distribution and a and b parameters for the length-weight relationship; age distribution is also presented for Greenland halibut, Atlantic cod and American plaice.Versión del editor

Results for Greenland halibut, American plaice and Atlantic cod of the Spanish survey in NAFO Div. 3NO for the period 1997-2019

Greenland halibut (Reinhardtius hippoglossoides), American plaice (Hippoglossoides platessoides) and Atlantic cod (Gadus morhua) indices from the bottom trawl survey that Spain carries out in Spring since 1995 in Div. 3NO of the NAFO Regulatory Area are presented. Biomass, stratified mean catches and mean number per tow for the three species are presented since 1997, year in which the survey extended the depth strata. Mean catch per tow, length distribution and age distribution (this last except for American plaice) are presented for the last five years (2015-2019). Greenland halibut biomass and abundance estimates presented a decreasing trend since 1999, cut in 2007- 2009 with a high increase. In 2011 the biomass drops under the 2008 value, being stable since then until 2014 with a slight increase in 2015-2019 comprising a big increase in 2017, reaching the maximum of the series. In last years it can be seen a presence of juveniles, mainly in 2004, but the greatest lengths have failed, although in 2009 there is a quite good presence of individuals of ages 6-7 and in 2010 between 5-7. In 2011-2019 the presence of all ages is poor. In 2018 the mode was at 1-2 years, and 2-3 years in 2019, suggesting a fairly strong 2017 cohort. For American plaice we can see a slightly increasing trend from 1999 to 2015, reaching a maximum of mean catch and number in 2006, and a severe decline since 2016, being the 2019 the lowest value of the entire series. The greatest recruitment in the presented series occurred in 2004 and we can follow their mode along the years. No good recruitments were seen since then. In last years the level of all the ages is low. No 2019 age indices are available at this moment. For Atlantic cod, it can be seen a low biomass until 2008, being higher and variable since then, reaching a historical maximum in 2014. From 2015, biomass decreased reaching in 2019 poor values at the level of the 2005 biomass. In 2007-2008 the youngest length classes were much over the rest of the length classes. With the 2006 cohort the series reaches the maximum number of its historical values at five years in 2011. There have been no good recruitments since 2009, although in 2015 and 2016 a discrete presence of individuals of age 1 can be seen

Tuberculosis of the female reproductive tract: 10 years’ experience

Introdução: A tuberculose é um problema emergente de saúde pública e uma causa rara de infeção do trato genital feminino. Objectivo: Apresentar os casos de tuberculose genital do nosso serviço, no que se refere à sintomatologia, fatores de risco, modo de apresentação e diagnóstico, intervenção terapêutica, complicações e coexistência de doença sistémica. Material e Métodos: Estudo retrospetivo descritivo compreendendo todos os casos ocorridos durante 10 anos (2002-2011), num hospital de nível II. Resultados: Identificaram-se seis casos de tuberculose genital. A idade média foi de 39 anos com três doentes na pós-menopausa. Um caso estava associado a infeção por VIH. A principal sintomatologia foi a dor pélvica (cinco pacientes), com apenas um caso assintomático. As doentes apresentaram-se com quadros clínicos sugestivos de doença inflamatória pélvica com abcesso tubo-ovárico, suspeita de lesão endometrial, ascite e endometrite pós-parto. Quatro doentes foram submetidas a intervenção cirúrgica. Conclusões: A ocorrência de tuberculose genital feminina é rara na pós-menopausa; no entanto na nossa série, 50% eram pós-menopáusicas. O espectro clínico e a forma de apresentação da tuberculose genital são variáveis, pelo que é necessário um elevado grau de suspeição para o seu diagnóstico, já que pode mimetizar um quadro clínico agudo e condicionar a fertilidade futura

Doença inflamatória pélvica: um desfecho inesperado

Pelvic inflammatory disease is a polymicrobial infection of the upper genital tract, representing the most common complication of sexually transmitted diseases. Multiple agents are frequently involved, although some unusual agents have also been reported. The presentation is frequently sub-clinical, but may assume an acute form. We report a clinical case of a 39-year-old woman with recurrent pelvic inflammatory disease, resistant to systemic antibiotics, submitted to an exploratory surgery, with a histologic finding of tubal cysticercosis

Bloom dynamics and life cycle strategies of two toxic dinoflagellates in a coastal upwelling system (NW Iberian Peninsula)

A study of Gymnodinium catenatum and Alexandrium minutum blooms on the Galician coast was conducted from 2005 to 2007 in order to increase knowledge of the mechanisms governing recurrent blooms of these species. Considerable differences in their bloom dynamics were observed. G. catenatum blooms occurred in autumn and winter, following the pattern previously reported in the literature: they began offshore and were advected to the Galician rias when a relaxation of the coastal upwelling occurred. On the other hand, A. minutum blooms developed inside embayments in spring and summer during the upwelling season and were associated with water stability and stratification. Both the vegetative population and the cyst distribution of A. minutum were related to less saline water from freshwater river outputs, which supports a saline-gradient relationship postulated herein for this species. Dinoflagellates may produce both long-term double-walled cysts (resting) and short-term pellicle cysts. Resting cyst deposition and distribution in sediments showed that seeding occurred during the blooms of both species. However, the relationship between the cyst distribution in the sediments in Baiona Bay and the intensity and occurrence of G. catenatum blooms, suggests that the latter are not directly related to resting cyst germination. Moreover, the results presented in the present study point to other difference between the two species, such as the detection of pellicle cysts only for A. minutum. Finally we discuss how the life cycle strategies of these two species may help to explain the different mechanisms of bloom formation reported herein.Versión del editor2,277

Colección de cultivos de microalgas nocivas del Centro Oceanográfico de Vigo. Resultados experimentales de algunas especies

En el Centro Oceanográfico de Vigo (COV) existe una colección de cultivos de fitoplancton que incluye la mayor parte de las microalgas relacionadas con floraciones tóxicas o nocivas de la costa de la península Ibérica. En este informe se detalla una lista con todas las cepas mantenidas en esta colección, el nombre de la especie, la procedencia de la muestra original desde la que fue aislada y su toxicidad en el caso de que haya sido probada. Además, se muestran los resultados de los estudios sobre crecimiento de tres especies de dinoflagelados en cultivos de esa colección y que son consideradas las más inportantes por su producción de biotoxinas marinas: Gymnodinium catenatum Graham, Alexandrium minutum Halim y Prorocentrum lima (Ehrenberg) Dodge. Se mencionan también numerosas publicaciones de estudios realizados con esos cultivos tanto en el COV como por investigadores de otras instituciones. En el apartado de material y métodos se describe la metodología seguida para el aislamiento y mantenimiento de los cultivos de fitoplancton, así como para el cálculo de la tasa de crecimiento de los mismosCultures of different toxic phytoplankton species related with harmful algal blooms are maintained in a culture collection at the Vigo Oceanographic Center. In the present report, we list all the strains from this culture collection. The list indicates the names of the strains and species, the original sample location from which they were isolated and their toxicity in cases in which this has been tested. This report also present the results of the studies on growth of three dinoflagellates from the culture collection. These species are: Gymnodinium catenatum Graham, Alexandrium minutum Halim and Prorocentrum lima (Ehrenberg) Dodge, and they are remarkably important in toxic phytoplankton research because of their toxin production. Different studies of these cultures described in different publications are also mentioned. In material and methods we describe the methodology for the isolation and maintenance of microalgae cultures, the method of growth rate calculation is also explained.Versión del editor0,000