Abscess and cecum carcinoma in inguinal hernia: case report

Cecal adenocarcinoma within an inguinal hernial sac is an uncommon clinical condition. A primary adenocarcinoma of the cecum in a right sided inguinal hernia is presented and discussed. This case represents one of the unexpected findings in a hernia sac and also very rare septic evolution. This particular condition is a main dignostic and therapeutic challenge

Accuracy of Plateau Pressure and Stress Index to Identify Injurious Ventilation in Patients with Acute Respiratory Distress Syndrome.

BACKGROUND: Guidelines suggest a plateau pressure (PPLAT) of 30 cm H(2)O or less for patients with acute respiratory distress syndrome, but ventilation may still be injurious despite adhering to this guideline. The shape of the curve plotting airway pressure versus time (STRESS INDEX) may identify injurious ventilation. The authors assessed accuracy of PPLAT and STRESS INDEX to identify morphological indexes of injurious ventilation. METHODS: Indexes of lung aeration (computerized tomography) associated with injurious ventilation were used as a "reference standard." Threshold values of PPLAT and STRESS INDEX were determined assessing the receiver-operating characteristics ("training set," N = 30). Accuracy of these values was assessed in a second group of patients ("validation set," N = 20). PPLAT and STRESS INDEX were partitioned between respiratory system (Pplat,Rs and STRESS INDEX,RS) and lung (PPLAT,L and STRESS INDEX,L; esophageal pressure; "physiological set," N = 50). RESULTS: Sensitivity and specificity of PPLAT of greater than 30 cm H(2)O were 0.06 (95% CI, 0.002-0.30) and 1.0 (95% CI, 0.87-1.00). PPLAT of greater than 25 cm H(2)O and a STRESS INDEX of greater than 1.05 best identified morphological markers of injurious ventilation. Sensitivity and specificity of these values were 0.75 (95% CI, 0.35-0.97) and 0.75 (95% CI, 0.43-0.95) for PPLAT greater than 25 cm H(2)O versus 0.88 (95% CI, 0.47-1.00) and 0.50 (95% CI, 0.21-0.79) for STRESS INDEX greater than 1.05. Pplat,Rs did not correlate with PPLAT,L (R(2) = 0.0099); STRESS INDEX,RS and STRESS INDEX,L were correlated (R(2) = 0.762). CONCLUSIONS: The best threshold values for discriminating morphological indexes associated with injurious ventilation were Pplat,Rs greater than 25 cm H(2)O and STRESS INDEX,RS greater than 1.05. Although a substantial discrepancy between Pplat,Rs and PPLAT,L occurs, STRESS INDEX,RS reflects STRESS INDEX,L

Desarrollos electrónicos y fotónicos en sistemas de comunicaciones ópticas

En este trabajo se hace una breve descripción de las principales líneas de investigación y desarrollo del grupo de Sistemas de Comunicaciones Ópticas. Dentro del grupo se desarrollan las siguientes líneas de trabajo:Fotónica en Microondas y RF (MW & RF Photonics) consiste en actividades de I+D en tecnologías y dispositivos fotónicos que procesen, controlen, reciban o generen señales de MW y RF. Entre los sistemas más conocidos que operan en MW se encuentran los radares, conformador de haces, comunicaciones satelitales, transpondedores satelitales, enlaces de radio, a los cuales mediante tecnología fotónica se intenta agregarle o mejorarle alguna de sus características.Facultad de Ingenierí

APHRODITE: Design and Preliminary Tests of an Autonomous and Reusable Photo-sensing Device for Immunological Test aboard the International Space Station

Preliminary results of the design and manufacturing of APHRODITE, a compact and versatile device for carrying out analyses of biological fluids during space missions that will be used as a technological demonstrator on board the International Space Station (ISS) for the quantitative determination of salivary biomarkers indicators of alterations of functionality of the immune system. The paper addresses the design of the main subsystems of the analytical device and the preliminary results obtained during the first implementations of the device subsystems and testing measurements. In particular, the system design and the experiment data output of the lab-on-chip photosensors and of the front-end readout electronics are reported in detail

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Parvovirus B19/B19V primary infection in pregnant women can be transmitted to the embryo/fetus and cause anomalies associated with TORCH syndrome. Local knowledge of the infection can help visualize the clinical picture to achieve early diagnosis. The objectives were to identify B19V in suspected cases of parvoviral infection during pregnancy and to describe the clinical manifestations present in positive cases. Descriptive, cross-sectional study. Inclusion criteria: pregnant patients with suspected B19V infection (compatible maternal or fetal-neonatal clinical manifestations or with epidemiological link), newborns (NB) of mothers with suspected or confirmed infection and NB with signs/symptoms associated with congenital infection (still present or not at birth), selected according to medical records of the clinical history. Viral DNA (PCR), specific IgM and IgG (ELISA) were determined in serum samples stored at the institution’s biobank. Ethical Committee of participating centers approved the protocol: Clinica Universitaria Reina Fabiola, Hospital Universitario de Maternidad y Neonatología, Clínica Privada Vélez Sársfield (2018-2022). A total of 242 patients were included (epidemiological weeks/EW 1-52, 171 pregnant women and 71 NB, 60 of them were mother-NB pair). Infection was confirmed in 27/242 (11.1%) cases, the majority (24/27, 88.9%) in pregnant women and 3/27 (11.1%) in NB. In the mother-NB pair group, 9 pregnant women and 2 NB were positive (vertical transmission rate: 22.2%). Epidemiological characteristics of B19V+ cases: mean age of pregnant women 30.1±6.3 years (p=0.45 versus study sample; median 30.5), 96% in EW 15-52 (autumn-spring). Clinical manifestations in pregnant women: maternal anemia 14/24 (58.3%), hydrops fetalis 5/24 (20.8%), abortion 5/24 (20.8%), fetal anemia 2/24 (8.3%), polyhydramnios 1/24 (4.2%), rash and arthralgia 1/24 (4.2%). One NB presented hydrops, another anemia, and one was asymptomatic, born to mother with rash, arthralgia, and anemia). Laboratory markers of infection: 16/27 (59.3%) cases were confirmed by detection of viral DNA (DNA+/IgM-/IgG+). During the study period, B19V was detected in 11% of the sample, being frequent in symptomatic pregnant women (24/171, 14%), with a rate of transmission to the fetus of 22%. Upon clinical suspicion, the complementary determination of virus and antibodies can improve diagnostic performance.La primoinfección por parvovirus B19/B19V en la embarazada puede transmitirse al embrión/feto y causar manifestaciones clínicas asociadas al síndrome de TORCH. Conocer la infección en nuestro medio puede contribuir a visibilizar su presentación clínica y promover el diagnóstico temprano. Los objetivos fueron identificar B19V en casos sospechosos de infección parvoviral durante la gestación y describir las manifestaciones clínicas presentes en los casos positivos. Estudio descriptivo, transversal. Se incluyeron pacientes embarazadas con sospecha de infección por B19V (manifestaciones clínicas maternas o feto-neonatales compatibles o nexo epidemiológico), RN de madres con infección sospechada o confirmada y RN con signos/síntomas asociables a infección congénita (aún presentes o no al nacer), seleccionados a partir de los datos de la historia clínica. Se determinó ADN viral (PCR), IgM e IgG específicas (ELISA) en muestras de suero recuperadas del biobanco. Protocolo aprobado por los Comités de Ética de los centros participantes: Clínica Universitaria Reina Fabiola, Hospital Universitario de Maternidad y Neonatología, Clínica Privada Vélez Sársfield (2018-2022). Se estudiaron 242 pacientes (semanas epidemiológicas/SE 1-52, 171 embarazadas y 71 RN, de ellos 60 constituían binomio madre-RN), confirmándose la infección en 27/242 (11,1%), la mayoría (24/27, 88,9%) en embarazadas y 3/27 (11,1%) en RN. En el grupo de binomios, fueron positivos 9 embarazadas y 2 RN (tasa de transmisión vertical: 22,2%). Características epidemiológicas de los casos B19V+: edad promedio de las embarazadas 30,1±6,3 años (p=0,45 versus muestra estudiada; mediana 30,5), 96% en las SE 15-52 (otoño-primavera). Manifestaciones marcadoras en embarazadas: anemia materna 14/24 (58,3%), hydrops fetal 5/24 (20,8%), aborto 5/24 (20,8%), anemia fetal 2/24 (8,3%), polihidramnios 1/24 (4,2%), exantema y artralgia 1/24 (4,2%). Un RN presentó hydrops, otro anemia y otro fue asintomático (con antecedente de madre positiva con exantema, artralgia y anemia en la madre). Marcadores laboratoriales de infección: 16/27 (59,3%) casos fueron confirmados por detección de ADN viral (ADN+/IgM-/IgG+). En el período estudiado se detectó B19V en 11% de la muestra, siendo frecuente en embarazadas sintomáticas (24/171, 14%), con una tasa de transmisión al feto de 22%. Ante la sospecha clínica, la determinación complementaria de virus y anticuerpos puede mejorar el rendimiento diagnóstico.

Circulating Angiopoietins-1 and -2, Angiopoietin Receptor Tie-2 and Vascular Endothelial Growth Factor-A as Biomarkers of Acute Myocardial Infarction: a Prospective Nested Case-Control Study

<p>Abstract</p> <p>Background</p> <p>Angiogenesis is up-regulated in myocardial ischemia. However, limited data exist assessing the value of circulating angiogenic biomarkers in predicting future incidence of acute myocardial infarction (AMI). Our aim was to examine the association between circulating levels of markers of angiogenesis with risk of incident acute myocardial infarction (AMI) in men and women.</p> <p>Methods</p> <p>We performed a case-control study (nested within a large cohort of persons receiving care within Kaiser Permanente of Northern California) including 695 AMI cases and 690 controls individually matched on age, gender and race/ethnicity.</p> <p>Results</p> <p>Median [inter-quartile range] serum concentrations of vascular endothelial growth factor-A (VEGF-A; 260 [252] vs. 235 [224] pg/mL; p = 0.01) and angiopoietin-2 (Ang-2; 1.18 [0.66] vs. 1.05 [0.58] ng/mL; p < 0.0001) were significantly higher in AMI cases than in controls. By contrast, endothelium-specific receptor tyrosine kinase (Tie-2; 14.2 [3.7] vs. 14.0 [3.1] ng/mL; p = 0.07) and angiopoietin-1 levels (Ang-1; 33.1 [13.6] vs. 32.5 [12.7] ng/mL; p = 0.52) did not differ significantly by case-control status. After adjustment for educational attainment, hypertension, diabetes, smoking, alcohol consumption, body mass index, LDL-C, HDL-C, triglycerides and C-reactive protein, each increment of 1 unit of Ang-2 as a Z score was associated with 1.17-fold (95 percent confidence interval, 1.02 to 1.35) increased odds of AMI, and the upper quartile of Ang-2, relative to the lowest quartile, was associated with 1.63-fold (95 percent confidence interval, 1.09 to 2.45) increased odds of AMI.</p> <p>Conclusions</p> <p>Our data support a role of Ang-2 as a biomarker of incident AMI independent of traditional risk factors.</p

The PROVENT-C19 registry: A study protocol for international multicenter SIAARTI registry on the use of prone positioning in mechanically ventilated patients with COVID-19 ARDS

Background The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality. Methods and analysis Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the "PROVENT-C19 Registry", endorsed by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care. . .'(SIAARTI). The PROVENT-C19 Registry wishes to describe 1. The real clinical practice on the use of PP in COVID-19 patients during the pandemic at a National and International level; and 2. Potential baseline and clinical characteristics that identify subpopulations of invasively ventilated patients with COVID-19 that may improve daily from PP therapy. This web-based registry will provide relevant information on how the database research tools may improve our daily clinical practice. Conclusions This multicenter, prospective registry is the first to identify and characterize the role of PP on clinical outcome in COVID-19 patients. In recent years, data emerging from large registries have been increasingly used to provide real-world evidence on the effectiveness, quality, and safety of a clinical intervention. Indeed observation-based registries could be effective tools aimed at identifying specific clusters of patients within a large study population with widely heterogeneous clinical characteristics. Copyright

Regulation of Endothelial Cell Adhesion Molecule Expression by Mast Cells, Macrophages, and Neutrophils

Leukocyte adhesion to the vascular endothelium and subsequent transendothelial migration play essential roles in the pathogenesis of cardiovascular diseases such as atherosclerosis. The leukocyte adhesion is mediated by localized activation of the endothelium through the action of inflammatory cytokines. The exact proinflammatory factors, however, that activate the endothelium and their cellular sources remain incompletely defined.Using bone marrow-derived mast cells from wild-type, Tnf(-/-), Ifng(-/-), Il6(-/-) mice, we demonstrated that all three of these pro-inflammatory cytokines from mast cells induced the expression of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), P-selectin, and E-selectin in murine heart endothelial cells (MHEC) at both mRNA and protein levels. Compared with TNF-α and IL6, IFN-γ appeared weaker in the induction of the mRNA levels, but at protein levels, both IL6 and IFN-γ were weaker inducers than TNF-α. Under physiological shear flow conditions, mast cell-derived TNF-α and IL6 were more potent than IFN-γ in activating MHEC and in promoting neutrophil adhesion. Similar observations were made when neutrophils or macrophages were used. Neutrophils and macrophages produced the same sets of pro-inflammatory cytokines as did mast cells to induce MHEC adhesion molecule expression, with the exception that macrophage-derived IFN-γ showed negligible effect in inducing VCAM-1 expression in MHEC.Mast cells, neutrophils, and macrophages release pro-inflammatory cytokines such as TNF-α, IFN-γ, and IL6 that induce expression of adhesion molecules in endothelium and recruit of leukocytes, which is essential to the pathogenesis of vascular inflammatory diseases

Randomized Dose-Ranging Controlled Trial of AQ-13, a Candidate Antimalarial, and Chloroquine in Healthy Volunteers

OBJECTIVES: To determine: (1) the pharmacokinetics and safety of an investigational aminoquinoline active against multidrug–resistant malaria parasites (AQ-13), including its effects on the QT interval, and (2) whether it has pharmacokinetic and safety profiles similar to chloroquine (CQ) in humans. DESIGN: Phase I double-blind, randomized controlled trials to compare AQ-13 and CQ in healthy volunteers. Randomizations were performed at each step after completion of the previous dose. SETTING: Tulane–Louisiana State University–Charity Hospital General Clinical Research Center in New Orleans. PARTICIPANTS: 126 healthy adults 21–45 years of age. INTERVENTIONS: 10, 100, 300, 600, and 1,500 mg oral doses of CQ base in comparison with equivalent doses of AQ-13. OUTCOME MEASURES: Clinical and laboratory adverse events (AEs), pharmacokinetic parameters, and QT prolongation. RESULTS: No hematologic, hepatic, renal, or other organ toxicity was observed with AQ-13 or CQ at any dose tested. Headache, lightheadedness/dizziness, and gastrointestinal (GI) tract–related symptoms were the most common AEs. Although symptoms were more frequent with AQ-13, the numbers of volunteers who experienced symptoms with AQ-13 and CQ were similar (for AQ-13 and CQ, respectively: headache, 17/63 and 10/63, p = 0.2; lightheadedness/dizziness, 11/63 and 8/63, p = 0.6; GI symptoms, 14/63 and 13/63; p = 0.9). Both AQ-13 and CQ exhibited linear pharmacokinetics. However, AQ-13 was cleared more rapidly than CQ (respectively, median oral clearance 14.0–14.7 l/h versus 9.5–11.3 l/h; p ≤ 0.03). QTc prolongation was greater with CQ than AQ-13 (CQ: mean increase of 28 ms; 95% confidence interval [CI], 18 to 38 ms, versus AQ-13: mean increase of 10 ms; 95% CI, 2 to 17 ms; p = 0.01). There were no arrhythmias or other cardiac AEs with either AQ-13 or CQ. CONCLUSIONS: These studies revealed minimal differences in toxicity between AQ-13 and CQ, and similar linear pharmacokinetics