Manejo exitoso con stent en un prematuro con síndrome de vena cava superior. Reporte de caso

El síndrome de vena cava superior en la infancia es una complicación inusual al uso de catéter venoso central en la unidad de cuidados intensivos neonatales. Otras causas en niños son la cirugía para enfermedades congénitas del corazón la cual ocupa la mayoría de los casos, y los linfomas, que constituyen la segunda causa más frecuente de obstrucción. Se describe el caso de un recién nacido prematuro de 25 semanas, con síndrome de vena cava superior secundario al uso de catéter venoso central para manejo de sepsis. Se destaca la importancia de un diagnóstico y tratamiento precoz. Así mismo, se reporta el manejo exitoso con stent para el síndrome de vena cava superior.Superior vena cava syndrome in infancy is an unusual complication of the use of central venous catheters in neonatal intensive care unit. Other causes of this syndrome in children are surgery for congenital heart disease which accounts for most of the cases, and lymphomas, that constitute the second most common cause of obstruction. We describe the case of a premature infant born at 25 weeks with superior vena cava syndrome secondary to a central venous catheter for management of sepsis. The importance of early diagnosis and treatment is highlighted. We also report the successful management with stenting for superior vena cava syndrome

Phenolic Compounds Recovery from Grape Fruit and By- Products: An Overview of Extraction Methods

Phenolic compounds are considered as bioactive compounds having beneficial effects on human health. Because of their biological properties, they have wide applications on pharmaceutical and food industries, and for this reason, it is important to identify most appropriate procedures, which permits the standardization for recovery of these compounds from several plant materials including grapes. Grape fruit and by-products are excellent sources of bioactive compounds such as pigments, organic acids, and phenolic compounds. Several convectional and emerging technologies have been evaluated in order to recover phenolic compounds from grape fruits and wastes such as chemical, physical, and biotechnological techniques, which offer different advantages related to economic, environmental, time-saving, and yield aspects. Nowadays, there is no updated information, which provides an overview about the techniques applied of these bioactive compound recovery in order to obtain high-quality and high-activity extracts rich in phenolic compounds from grape fruit and by-products. This chapter offers relevant aspects related to the techniques employed during the last five years by researches for phenolic compound recovery from grapes

Differentiation of primate primordial germ cell-like cells following transplantation into the adult gonadal niche.

A major challenge in stem cell differentiation is the availability of bioassays to prove cell types generated in vitro are equivalent to cells in vivo. In the mouse, differentiation of primordial germ cell-like cells (PGCLCs) from pluripotent cells was validated by transplantation, leading to the generation of spermatogenesis and to the birth of offspring. Here we report the use of xenotransplantation (monkey to mouse) and homologous transplantation (monkey to monkey) to validate our in vitro protocol for differentiating male rhesus (r) macaque PGCLCs (rPGCLCs) from induced pluripotent stem cells (riPSCs). Specifically, transplantation of aggregates containing rPGCLCs into mouse and nonhuman primate testicles overcomes a major bottleneck in rPGCLC differentiation. These findings suggest that immature rPGCLCs once transplanted into an adult gonadal niche commit to differentiate towards late rPGCs that initiate epigenetic reprogramming but do not complete the conversion into ENO2-positive spermatogonia

Clinical and immunological characteristics of tegumentary leishmaniasis cases in Bolivia

Background Tegumentary leishmaniasis (TL) is a parasitic disease that can present a cutaneous or mucocutaneous clinical form (CL and MCL, respectively). The disease is caused by different Leishmania species and transmitted by phlebotomine sand flies. Bolivia has one of the highest incidences of the disease in South America and the diagnosis is done by parasitological techniques. Our aim was to describe the clinical and immunological characteristics of CL and MCL patients attending the leishmaniasis reference center in Cochabamba, Bolivia, in order to gain updated clinical and epidemiological information, to evaluate the diagnostic methods used and to identify biomarkers related to clinical disease and its evolution. Methodology/Principal findings The study was conducted from September 2014 to November 2015 and 135 patients with lesions compatible with CL or MCL were included. Epidemiological and clinical data were collected using a semi-structured questionnaire. Two parasitological diagnostic methods were used: Giemsa-stained smears and culture of lesion aspirates. Blood samples obtained from participants were used to measure the concentrations of different cytokines. 59.2% (80/135) were leishmaniasis confirmed cases (CL: 71.3%; MCL: 28.7%). Sixty percent of the confirmed cases were positive by smears and 90.6% were positive by culture. 53.8% were primo-infections. Eotaxin and monokine induced by IFN-γ presented higher serum concentrations in the MCL clinical presentation compared to CL cases and no-cases. None of the cytokines presented different concentrations between primo-infections and secondary infections due to treatment failure. Conclusions/Significance In Bolivia, parasitological diagnosis remains the reference standard in diagnosis of leishmaniasis because of its high specificity, whereas the sensitivity varies over a wide range leading to loss of cases. Until more accurate tools are implemented, all patients should be tested by both smears and culture of lesion aspirates to minimize the risk of false negatives. Our results showed higher concentrations of several cytokines in MCL compared to CL, but no differences were observed between CL and no-cases. In addition, none of the cytokines differed between primary and secondary infections. These results highlight the need of further research to identify biomarkers of susceptibility and disease progression, in addition to looking at the local cellular immune responses in the lesions

Embarazo postrasplante hepático: reporte de un caso y revisión de la evidencia actual

Se estima que en Chile, hasta marzo de 2008 se han efectuado 637 trasplantes hepáticos ortotópicos (THO), siendo la principal causa la cirrosis hepática. Según estadísticas norteamericanas, en el año 2006 existían 3000 mujeres con THO en edad reproductiva. Presentamos el caso de una paciente de 25 años, trasplantada hepática hace 6 años, en terapia inmunosupresora, con buen resultado materno-perinatal

Study protocol for the multicentre cohorts of Zika virus infection in pregnant women, infants, and acute clinical cases in Latin America and the Caribbean: The ZIKAlliance consortium

Background: The European Commission (EC) Horizon 2020 (H2020)-funded ZIKAlliance Consortium designed a multicentre study including pregnant women (PW), children (CH) and natural history (NH) cohorts. Clinical sites were selected over a wide geographic range within Latin America and the Caribbean, taking into account the dynamic course of the ZIKV epidemic. Methods: Recruitment to the PW cohort will take place in antenatal care clinics. PW will be enrolled regardless of symptoms and followed over the course of pregnancy, approximately every 4 weeks. PW will be revisited at delivery (or after miscarriage/abortion) to assess birth outcomes, including microcephaly and other congenital abnormalities according to the evolving definition of congenital Zika syndrome (CZS). After birth, children will be followed for 2 years in the CH cohort. Follow-up visits are scheduled at ages 1-3, 4-6, 12, and 24 months to assess neurocognitive and developmental milestones. In addition, a NH cohort for the characterization of symptomatic rash/fever illness was designed, including follow-up to capture persisting health problems. Blood, urine, and other biological materials will be collected, and tested for ZIKV and other relevant arboviral diseases (dengue, chikungunya, yellow fever) using RT-PCR or serological methods. A virtual, decentralized biobank will be created. Reciprocal clinical monitoring has been established between partner sites. Substudies of ZIKV seroprevalence, transmissio

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700