Parto gemelar asincrónico: informe de un caso

ANTECEDENTES: El parto gemelar asincrónico consiste en diferir el nacimiento del segundo gemelo, cuando el del primero se produce de manera inevitable en etapas tempranas de la gestación. CASO CLÍNICO: Paciente de 39 años, con embarazo gemelar bicorial, logrado después de un tratamiento de fecundación in vitro. Atendida en el Hospital Universitario Miguel Servet por amenaza de parto prematuro. A su ingreso se comprobó la muerte del primer gemelo y se decidió extraerlo en la semana 23 + 2 semanas. Posteriormente se objetivó la retracción cervical, con dilatación de 2-3 cm y cese de la dinámica uterina. La bolsa amniótica del segundo gemelo permaneció íntegra, sin signos de pérdida del bienestar fetal, por lo que se intentó el parto asincrónico. Durante el intervalo entre ambos gemelos se administraron cuatro ciclos de fármacos tocolíticos con atosiban y maduración pulmonar fetal con corticoides por amenaza de parto prematuro. Finalmente, se retiró el cerclaje a las 34 + 2 semanas del embarazo, por dinámica uterina regular, aún con la administración de tocolíticos, produciéndose el parto del segundo gemelo. El recién nacido pesó 1810 g, con Apgar de 9 al mi- nuto y de 10 a los 5 minutos, y pH del cordón de 7.39. Su evolución fue favorable y permaneció en la unidad de cuidados intermedios neonatales durante 13 días, para darlo de alta con 2070 g. El estudio posmortem del primer gemelo no reportó expresión morfológica de la causa de muerte, ni se objetivaron signos de infección. El resultado del array fue normal y el cariotipo fue 46 XY. El estudio microbiológico de la placenta no demostró signos de corioamnionitis. La paciente fue dada de alta tres días posteriores al parto, con evolución satisfactoria y sin contratiempos durante el puerperio. CONCLUSIONES: El parto diferido del segundo gemelo es una alternativa para emba- razos gemelares debidamente seleccionados en los que el parto del primer gemelo se produjo en semanas de prematurez extrema y el feto superviviente puede continuar en gestación hasta alcanzar las semanas que le permitan el mejor pronóstico

Prognostic value of p27(Kip1 )expression in Basaloid Squamous Cell Carcinoma of the larynx

BACKGROUND: Very few reports have investigated the role of cell cycle regulators as biomarkers in Basaloid Squamous Cell Carcinoma (BSCC) of the larynx, a definite morphologic, uncommon, very aggressive variant of squamous cell carcinoma. Lower expression of Ki67/Mib-1, a proliferation marker highly expressed in the majority of tumours, and p53, a tumour suppressor protein that can induce an arrest of the G1-S transition, was related to a better prognosis in laryngeal BSCC. In the head and neck, p27(kip1), a member of the Cip1/Kip1 family of cyclin-dependent kinase inhibitors, has emerged as an independent prognostic factor, able to identify low-expressing tumours with unfavourable course. Up to date the role of this protein was never studied in BSCC. Aim of our study was to investigate the potential prognostic value of p27(kip1 )levels and their correlation with Ki67/Mib-1 and p53 expression in BSCC of the larynx. METHODS: The retrospective study group consisted of 15 male and 1 female patients, affected by laryngeal BSCC, ranging in age from 44 to 69 years (mean 58). The tumour originated from the supraglottis in thirtheen cases and from the glottis in the remaining three. Ten patients had metastatic cervical lymph nodes at presentation and were classified as N+. Post surgical stage was IV in four patients, III in nine, II in two cases and I in the remaining one. Follow-up ranged from a minimum of 5 months up to 9 years. Paraffin-embedded tissue sections of each laryngeal tumour were analyzed for p27(kip), Ki67/Mib-1 and p53 expression by immunohistochemistry. RESULTS: The immunohistochemical study showed p27(kip1 )expression in 40% of the patients with no evidence of disease (NED) and in none (0%) of the patients dead of disease (DOD), whilst p53 was expressed in 60% of patients in NED status and in 90% of patients in DOD status. Ki67/Mib-1 was positive in 80% of NED patients and in 100% of DOD patients. At multivariate analysis, performed by means of Discriminant analysis, low levels of p27(kip1 )expression significantly correlated with poor prognosis (P < 0.05). CONCLUSION: p27(kip1 )protein has been shown to be a significant independent prognostic factor in laryngeal SCC. In our series of laryngeal BSCC the resulting data seem to confirm the clinical prognostic relevance of p27(kip1 )low expression, which directly correlated with biological aggressiveness and consequent shortened survival

A collaboratively derived international research agenda on legislative science advice

© 2019, The Author(s). The quantity and complexity of scientific and technological information provided to policymakers have been on the rise for decades. Yet little is known about how to provide science advice to legislatures, even though scientific information is widely acknowledged as valuable for decision-making in many policy domains. We asked academics, science advisers, and policymakers from both developed and developing nations to identify, review and refine, and then rank the most pressing research questions on legislative science advice (LSA). Experts generally agree that the state of evidence is poor, especially regarding developing and lower-middle income countries. Many fundamental questions about science advice processes remain unanswered and are of great interest: whether legislative use of scientific evidence improves the implementation and outcome of social programs and policies; under what conditions legislators and staff seek out scientific information or use what is presented to them; and how different communication channels affect informational trust and use. Environment and health are the highest priority policy domains for the field. The context-specific nature of many of the submitted questions—whether to policy issues, institutions, or locations—suggests one of the significant challenges is aggregating generalizable evidence on LSA practices. Understanding these research needs represents a first step in advancing a global agenda for LSA research

Salivary Markers for Oral Cancer Detection

Oral cancer refers to all malignancies that arise in the oral cavity, lips and pharynx, with 90% of all oral cancers being oral squamous cell carcinoma. Despite the recent treatment advances, oral cancer is reported as having one of the highest mortality ratios amongst other malignancies and this can much be attributed to the late diagnosis of the disease. Saliva has long been tested as a valuable tool for drug monitoring and the diagnosis systemic diseases among which oral cancer. The new emerging technologies in molecular biology have enabled the discovery of new molecular markers (DNA, RNA and protein markers) for oral cancer diagnosis and surveillance which are discussed in the current review

Scientific research groups&apos; cooperation with firms and government agencies: Motivations and barriers Scientific research groups&apos; cooperation with firms and government agencies: Motivations and barriers

Abstract. The behavior of academic researchers who engage in cooperation with industrial partners has already been the subject of considerable research. A lack of understanding exists regarding the motivations of scientific research groups to engage in cooperation with other types of external non-academic organizations and the perceived barriers that may inhibit this activity. In this paper we analyse the motivations and perceptions of risks that shape scientific research groups&apos; cooperation with industry and government partners. We find that motivations to cooperate are partly dependent on the type of partner organization involved, with advancing research goals mainly acting as an inducement to cooperate with government agencies, while searching for opportunities to apply knowledge motivates partnerships with firms. We also find that the majority of research groups cooperate with both firms and government, with their major motivation being to apply their knowledge. Among research groups that only cooperate with firms, interaction effects between motivations influence the likelihood of cooperation. Research groups do not consider risk to scientific autonomy a barrier to cooperating with firms, while risk to scientific credibility inhibits cooperation independently of the type of external partner. However, being motivated to advance research can reduce the effect of perceived barriers, independent of the type of partner organisation

Reducing costs, improving profits: A low-cost culture media for woody plants micropropagation

12 páginas, 4 figuras, 1 tablaMicropropagation has enormous potential in the forestry industry for the mass production of elite genotypes. A limiting factor that hinders a wider adoption of this technique is its high associated cost, dissuading small producers and laboratories from its use. Thus, it is important to develop low-cost protocols to increase the competitiveness of micropropagation. The goal of the present study was to elaborate a low-cost culture medium that would allow plant growth without diminishing plant quality and production. The replacement of laboratory sucrose with commercial sugar as a carbon source, and laboratory agar with locally produced agar as a gelling agent was tested. To validate the effects of the medium for woody species micropropagation, two relevant forest species, chestnut and birch, were used and several phenotypic characteristics were recorded. Our data indicated that the substitutions made in the media composition did not alter growth or rooting parameters. Substitution of laboratory sucrose and Bacto agar by table sugar and local commercial agar provides a valuable alternative for forest species micropropagation and for increasing their potential profitability.Supported by Xunta de Galicia (Spain) through the projects IN607A and 'Contrato Programa' 2021 (AGI/CSIC I + D + I 2021, Ref-ACAM 20210200033).Peer reviewe