Hepatitis B And C In Hematopoietic Stem Cell Transplant

Although the risk of acquisition of hepatitis B or hepatitis C virus through blood products has considerably reduced since the last decade, some infected patients are candidates to stem cell transplantation. Others may have no alternative than an infected donor. In all these cases, recipients of transplant are prone to short and long term liver complications. The evolution of liver tests under chemotherapy before transplant may give useful information to anticipate on the risk of hepatitis reactivation after transplant, both for HBv and HCv. More than sixty percent of the patients who are HBsAg-positive before transplant reactivate after transplant, and 3% develop acute severe liver failure. Because both viral replication and immune reconstitution are the key factors for reactivation, it is crucial to closely follow liver function tests and viral load during the first months of transplant, and to pay a special attention in slowly tapering the immunosuppression in these patients. Lamivudine reduces HBv viremia, but favors the emergence of HBv polymerase gene mutants and should be individually discussed. Both in case of HBv or HCv hepatitis reactivation with ALT ≥ 10N concomitantly to an increase in viral load at time of immune reconstitution, steroids should be given. In case there is no alternative than a HBv or HCv positive geno-identical donor, the risk of viral hepatitis, including acute liver failure and late complications, should be balanced with the benefit of transplant in a given situation

Dictyota dichotoma (phaeophyceae) methanolic extracts exhibit antitumoral effects on breast cancer cells and induce osteoblasts differentiation

There is a growing interest in macroalgae as natural products with antioxidant and anticancer activity. In this work, we studied the anti-tumoral effect of an algal extract (AE) derived from the marine alga Dictyota dichotoma on human breast cancer cells (MCF-7). We also evaluated the cytotoxic effects on non-tumorigenic cells and the effects on ostoblastogenesis in vitro. We found that the AE contains high levels of polyphenols and anti-oxidant activity measured by DPPH and Folin-Ciocalteu methods, respectively. Using trypan blue and MTS assays we demonstrated a significant inhibition of MCF-7 cell proliferation and viability. The changes in protein phosphorylation levels were examined through Western blot analysis, finding a decrease of phosphorylated AKT (Ser473) and its target molecule BAD (Ser136). In addition, AE inhibits cell migration determined through the wound healing assay and decreases cellular adhesion at all concentrations probed. Interestingly, AE does not affect the number and morphology of normal osteoblastic human cells, indicating its selectivity. Moreover, using colorimetric methods, we found that low doses of AE increase the production of osteoblastogenesis markers. These findings indicate that D. dichotoma is a valuable source of bioactive compounds for its regulatory effects on processes involved in metastasis and healthy effects in osteoblasts.Fil: Lezcano, Virginia Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Ciencias Biológicas y Biomédicas del Sur. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia. Instituto de Ciencias Biológicas y Biomédicas del Sur; ArgentinaFil: Mariani, Florencia. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia. Laboratorio de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca; ArgentinaFil: Fernández, Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Parodi, Elisa Rosalia. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia. Laboratorio de Química Biológica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca; ArgentinaFil: Morelli, Susana Ana. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia. Laboratorio de Química Biológica; Argentin

Robotic Heller-Dor myotomy: 10-year monocentric experience compared with POEM

Achalasia is a rare motility disorder caused by an incomplete relaxation of the lower esophageal sphincter and loss of esophageal peristalsis. As a consequence, the bolus swallowing is hindered and the patients complain dysphagia, regurgitation, chest pain, respiratory symptoms and weight loss. Achalasia’s treatment has been varied over time, from therapies aiming to relax the lower sphincter of the esophagus, including drugs andBotox injection or mechanical dilatations, to surgical myotomy. Robotic or laparoscopic Heller-Dor procedure is considered the gold standard surgical treatment for symptomatic achalasia as it is proved to be effective and safe. As an alternative, Per-Oral Endoscopic Myotomy (POEM) was applied over the past decade, aiming to combine the same results of mini-invasive procedure to the advantages of endoscopic approach. In this study, we are going to compare the medium-long term results of mini-invasive Heller-Dor procedure, routinely performed in our Department, with those of POEM reported in literature

Testing for relics of past strong buckling events in edge-on galaxies: Simulation predictions and data from S4G

The short-lived buckling instability is responsible for the formation of at least some box/peanut (B/P) shaped bulges, which are observed in most massive, z = 0, barred galaxies. Nevertheless, it has also been suggested that B/P bulges form via the slow trapping of stars onto vertically extended resonant orbits. The key difference between these two scenarios is that when the bar buckles, symmetry about the mid-plane is broken for a period of time. We use a suite of simulations (with and without gas) to show that when the buckling is sufficiently strong, a residual mid-plane asymmetry persists for several Gyrs after the end of the buckling phase, and is visible in simulation images. On the other hand, images of B/P bulges formed through resonant trapping and/or weak buckling remain symmetric about the mid-plane. We develop two related diagnostics to identify and quantify mid-plane asymmetry in simulation images of galaxies that are within 3○ of edge-on orientation, allowing us to test whether the presence of a B/P-shaped bulge can be explained by a past buckling event. We apply our diagnostics to two nearly edge-on galaxies with B/P bulges from the Spitzer Survey of Stellar Structure in Galaxies, finding no mid-plane asymmetry, implying these galaxies formed their bulges either by resonant trapping or by buckling more than ∼5 Gyr ago. We conclude that the formation of B/P bulges through strong buckling may be a rare event in the past ∼5 Gyr

The dynamical state of bars in cluster dwarf galaxies: The cases of NGC 4483 and NGC 4516

Dwarf barred galaxies are the perfect candidates for hosting slowly-rotating bars. They are common in dense environments and they have a relatively shallow potential well, making them prone to heating by interactions. When an interaction induces bar formation, the bar should rotate slowly. They reside in massive and centrally-concentrated dark matter halos, which slow down the bar rotation through dynamical friction. While predictions suggest that slow bars should be common, measurements of bar pattern speed, using the Tremaine-Weinberg method, show that bars are mostly fast in the local Universe. We present a photometric and kinematic characterisation of bars hosted by two dwarf galaxies in the Virgo Cluster, NGC 4483 and NGC 4516. We derive the bar length and strength using the Next Generation Virgo Survey imaging and the circular velocity, bar pattern speed, and rotation rate using spectroscopy from the Multi Unit Spectroscopic Explorer. Including the previously studied galaxy IC 3167, we compare the bar properties of the three dwarf galaxies with those of their massive counterparts from literature. Bars in the dwarf galaxies are shorter and weaker, and rotate slightly slower with respect to those in massive galaxies. This could be due to a different bar formation mechanism and/or to a large dark matter fraction in the centre of dwarf galaxies. We show that it is possible to push the application of the Tremaine-Weinberg method to the galaxy low mass regime

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)