Matrix metalloproteinase multiplex screening identifies increased MMP-2 urine concentrations in women predicted to develop preeclampsia.

BACKGROUND: Preeclampsia, a pregnancy disorder characterized by hypertension and proteinuria, represents the leading cause of fetal and maternal morbidity and mortality in developing countries. The identification of novel and accurate biomarkers that are predictive of preeclampsia is necessary to improve the prognosis of patients with preeclampsia. OBJECTIVE: The objective of this study is to evaluate the usefulness of nine urinary metalloproteinases to predict the risk of preeclampsia development. METHODS: MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-10, MMP-12 and MMP-13 were analyzed in urine (early-pregnancy) from 17 women predicted to develop preeclampsia and 48 controls using the Bio-Plex Pro-Human MMP panel (Bio-Rad, Hercules, CA). RESULTS: Urinary MMP-2 showed differences between groups which allowed us to calculate an increased risk for PE development of up to 20 times among the study population. CONCLUSION: Increased urinary concentration of MMP-2 at 12 and 16 weeks of gestation predicted an increased risk of developing preeclampsia in the study population.

Diced and crushed cartilage plus autologous fibrin matrix obtained by a simple process for dorsal augmentation of the Mestizo nose.

Several alternatives can be used for nasal dorsum augmentation. We report the use of crushed diced cartilage embedded in an autologous fibrin matrix. This construct is placed on the nasal dorsum and is gently molded according to the characteristics of each patient. Rhinoplasty and nasal dorsum augmentation were performed in 45 patients with Mestizo characteristics after a complete medical history and development of a surgical plan. A crushed diced cartilage autologous graft and an autologous fibrin matrix from peripheral blood processed using the Choukroun method was used. Pre- and postoperative photographs were taken at short- and long-term follow-up. Two separate variables were evaluated: reabsorption and irregularities. Three plastic surgeons evaluated the results, using a Likert scale: the first variable was considered very excellent in 88.9%, very good in 6.7%, good in 4.4% with no poor or very poor results. In the second variable, results were excellent in 88.9%, very good in 4.4%, good in 3.4%, and poor in 3.3% with no very poor results. Our patients carry a volume with an aesthetically pleasing contour and form with no changes over a mean follow-up period of 4 years. Long-term effectiveness continues to be the main topic of discussion; however, this method can be considered an alternative not only to augment but also to smoothen irregularities of the nasal dorsum. We used a simple method with good and stable long-term clinical results.

Mini-invasive boomerang-plasty for esthetic restoration of lower third face aging.

INTRODUCTION: There is an increased demand to improve facial appearance and preserve a youthful appearance for as long as possible. Minimally invasive facial procedures have boomed among young patients with less evidence of scars, low risk, and rapid recovery being some of the attractions. Some patients are even only interested in the treatment of specific units of the face. We present an alternative technique to treat jowls through truly limited incisions. MATERIAL AND METHODS: The surgical protocol included a complete medical history, analysis of the degree of prominence of jowls, and development of a surgical plan. We obtained pre- and postoperative medium and long-term photographs and evaluated the results. The procedure is complemented with neck liposuction and platysmoplasty. RESULTS: In general, edema and ecchymosis disappeared within 2 weeks. The recovery period was 2 to 3 weeks. The pre- and retroauricular scars over time were nearly imperceptible. Permanence of the results has been demonstrated in a follow-up period of 4 years. CONCLUSIONS: Our philosophical concept lies in the preventive benefit because it is mostly performed in relatively young patients. Boomerang-plasty anatomically restores the mandibular contour from the angle to the chin by eliminating jowls and establishes an esthetically harmonious visual difference between the face and neck. It is a simple procedure with highly satisfactory and stable effects.

Lipoinjection with Adipose Stem Cells for Nasal Modeling: Rhino Cell, a Highly Versatile Alternative.

It is undeniable that a significant number of patients who want to improve their facial appearance is increasingly interested in nonsurgical procedures. Without a doubt, the use of autologous fat could not be left out as a magnificent alternative for nasal modeling simply because of four influential factors: ease of collection, compatibility, the temporality of the results, and safety. This work describes an innovative alternative technique for nasal modeling using micrografts enriched with adipose-derived mesenchymal stem cells (ASCs). With this technique, fat was collected and divided into two samples, nanofat and microfat. Nanofat was used to isolate the ASCs; microfat was enriched with ASCs and used for nasal modeling. Lipoinjection was performed in a supraperiosteal plane on the nasal dorsum. Through a retrolabial access, the nasal tip and base of the columella were lipoinjected. We consider that nonsurgical nasal modeling using micrografts enriched with ASCs can be an attractive and innovative alternative. This technique will never be a substitute for surgical rhinoplasty. It can be performed in a minor procedure area with rapid recovery and return to the patient's daily activities the next day. If necessary, the procedure can be repeated.

Unusual presentation of orbital compartment syndrome due to complicated herpes zoster ophthalmicus: A case report.

Herpesvirus reactivates from a latent infection in older adults and critically ill and immunocompromised individuals. Herpes zoster ophthalmicus (HZO) is a latent infection that affects the fifth cranial nerve. It is an infrequent cause of increased intraocular pressure. We present the case of a 50-year-old man with a reactivation of latent varicella-zoster virus infection involving the ophthalmic branch of the fifth cranial nerve. The patient was initially managed as an outpatient with an antiviral, but his clinical evolution worsened and required urgent surgical decompression. Lateral canthotomy was performed with cantholysis of the inferior crus of the lateral canthal tendon. Only partial decompression was achieved, so cantholysis of the upper crus was performed with significant tissue tension release. The patient evolved well and was discharged after 6 days without symptoms for outpatient management.

Human bone morphogenetic protein 2-transduced mesenchymal stem cells improve bone regeneration in a model of mandible distraction surgery.

BACKGROUND: Bone morphogenetic proteins (BMPs) are actively involved in ossification, and BMP-2 participates throughout the entire process. Gene therapy for bone regeneration using adenovirus-expressing BMPs has been successful in small mammals, but it has not been satisfactory in large mammals. METHODS: We generated a 3-component implant (3C graft) comprising autologous mesenchymal stem cells (MSCs), ex vivo transduced with an adenovirus vector-expressing BMP-2 and embedded in a demineralized human bone matrix (DBM). RESULTS: In vitro studies demonstrated vector-induced osteogenesis; osteoblast population and mineralization of the extracellular matrix were greater in the vector-transduced cultures than in the controls (nontransduced MSCs stimulated with osteogenic media were used as positive controls, and nontransduced MSCs served as a negative control). The 3-component grafts were used to fill osteotomies created by bone distraction surgery in mongrel dogs. Control groups comprised dogs with bone distraction alone and dogs with nontransduced MSC grafts. The radiography follow-up, performed 10 weeks after distraction, demonstrated a remarkable reduction in the consolidation period compared with controls. Postmortem mandibles submitted for anatomic and histologic analyses showed improved remodeling and bone maturation in the 3C-grafted dogs. Inflammatory infiltrates were not observed in any of the treated areas, and no liver toxicity was detected. CONCLUSIONS: We demonstrated acceleration of osteogenesis in a dog model for bone distraction by using an implant of BMP-2 modified MSCs. These results are helpful for future clinical trials of mandible bone distraction.

Surgical management of palatal teratoma (epignathus) with the use of virtual reconstruction and 3D models: a case report and literature review.

Epignathus is a rare congenital orofacial teratoma that arises from the sphenoid region of the palate or the pharynx. It occurs in approximately 1:35,000 to 1:200,000 live births representing 2% to 9% of all teratomas. We present the case of a newborn of 39.4 weeks of gestation with a tumor that occupied the entire oral cavity. The patient was delivered by cesarean section. Oral resection was managed by pediatric surgery. Plastic surgery used virtual 3-dimensional models to establish the extension, and depth of the tumor. Bloc resection and reconstruction of the epignathus were performed. The mass was diagnosed as a mature teratoma associated with cleft lip and palate, nasoethmoidal meningocele that conditions hypertelorism, and a pseudomacrostoma. Tridimensional technology was applied to plan the surgical intervention. It contributed to a better understanding of the relationships between the tumor and the adjacent structures. This optimized the surgical approach and outcome.

A procedure to prevent cephalic rotation of cartilage grafts in the nasal tip.

BACKGROUND: The mestizo patient usually has a small nose with a wide base, round nostrils, and a convex dorsum. The alar cartilages are weak, thin, and short, providing deficient structural support and poor definition of the nasal tip. Cartilage grafts in the nasal tip are very often used to correct this condition, but a common problem of this procedure is the cephalic or lateral rotation of these grafts. OBJECTIVE: We used an angulated extended columellar graft to give columellar support and projection to nasal tip grafts for better control and prediction of the position and effect of these grafts. METHODS: The surgical protocol included a medical history, development of a surgical plan by analysis of the deformity, and the use of pre- and postoperative photographs taken at both intermediate and long-term follow-up visits for evaluation of the results. RESULTS: Sixty-seven patients underwent surgery using this procedure, 56 with an open technique and 11 with a closed technique. Follow-up ranged from 6 months to 4 years. The results obtained were satisfactory, showing better control and prediction of the shape of the nasal tip. CONCLUSIONS: The angulated extended columellar graft provides better control of the projection and angularity of cartilage grafts placed in the nasal tip.

[Molecular physiopathology of the spinocerebellar ataxia type 6 (SCA6)]. / Fisiopatología molecular de la ataxia espinocerebelar tipo 6 (SCA6).

Spinocerebellar ataxia type 6 (SCA6) is a neurodegenerative, monogenic, and autosomic dominant disease which is characterized by a global cerebellar atrophy. Typically the onset is at mature age and undergoes a moderate evolution. This illness has been associated with a mutation in the gene CACNA1A, that encodes for subunit alpha1A of P/Q type voltage/dependent calcium channel. The mutation results in the expansion of a CAG triplet repeat located in the last exon of the gene, which is translated into a polyglutamine chain in the carboxyl tail of the calcium channel subunit. Several studies have been made to clarify the mechanism for the toxicity of polyglutamines in cerebellar neurons; SCA6 could be considered a polyglutamine proteinopathy linked to caspases mediated death pathway. However, SCA6 is also considered a channelopathy, like paroxysmal diseases as hemiplegic familiar migraine and episodic ataxia type 2. The goal of this review is to analyze the intracellular mechanism triggering neuronal death in cerebellum, and the subsequent neurodegeneration.

Análisis del efecto de la sal en el desarrollo de obesidad / Analysis of the effect of salt intake on the development of obesity

Introducción: el transporte de la glucosa y de muchos aminoácidos en el intestino es realizado por el cotransportador SGLT1 únicamente si esta unido al ion sodio. La sal aporta un ion sodio por cada molécula que se consume y en los humanos su ingesta comúnmente es de diez veces más de la cantidad necesaria y generalmente se acompaña de dietas ricas en carbohidratos. Este trabajo se planteo pensando en que una estrategia simple para reducir de peso sería el disminuir la cantidad de sal en los alimentos. Objetivo: estudiar el efecto que tiene la sal en la dinámica de la absorción de glucosa y el efecto de una dieta rica en carbohidratos y sal en el desarrollo de obesidad en ratas Wistar. Métodos: para corroborar la hipótesis se evaluó el efecto de la sal en la dinámica de la absorción de la glucosa en el intestino realizando curvas de tolerancia a la glucosa con sal y sin sal. También se analizó si una dieta rica en carbohidratos y sal favorece el desarrollo de obesidad en ratas Wistar. Resultados: los experimentos mostraron que la ingesta de sal no influye en la dinámica de la absorción intestinal de la glucosa, ni en el desarrollo de obesidad en la rata Wistar. Conclusión: el sodio que de manera natural recircula desde el citoplasma de los enterocitos hacia la luz del intestino mantiene saturado al cotransportador de la glucosa SGLT1 y garantiza en todo momento el transporte de la glucosa que se ingiere en la dieta.

Introduction: Intestinal transport of glucose and many amino acids is performed by the SGLT1 cotransporter only when the latter is bound to the sodium ion. Salt contributes a sodium ion per molecule ingested. Human salt intake is often tenfold the required amount, and is generally accompanied by a carbohydrate-rich diet. The present study is based on the assumption that reducing the amount of salt in foods is a simple weight-loss strategy. Objective: Study the effect of salt on glucose absorption dynamics and the effect of a diet rich in carbohydrates and salt on the development of obesity in Wistar rats. Methods: To corroborate the hypothesis, an evaluation was conducted of the effect of salt on intestinal glucose absorption, based on glucose tolerance curves with and without salt. An analysis was also made of whether a diet rich in carbohydrates and salt leads to the development of obesity in Wistar rats. Results: Experiments showed that salt intake does not influence intestinal glucose absorption or the development of obesity in Wistar rats. Conclusion: Sodium naturally recirculating from the cytoplasm of enterocytes to the intestinal lumen keeps the SGLT1 glucose cotransporter saturated and at all times ensures the transport of the glucose ingested in the diet.

Comparación de la respuesta inmunológica frente a cepas de S. pneumoniae, evaluada por hemaglutinación, en niños inmunizados con vacuna neumocócica heptavalente (dos primovacunaciones con o sin refuerzo) / Comparison of the immune response against strains of S. pneumoniae, assessed by hemagglutination, in children immunized with heptavalent conjugated pneumococcal vaccine (two primary vaccinations with or without reinforcement)

Introducción. Diferentes esquemas de inmunización con la vacuna antineumocócica heptavalente han probado su eficacia. Aunque se recomiendan pautas vacunales de dos o tres primovacunaciones con su respectivo refuerzo adicional, aún hay niños con primovacunaciones sin refuerzo. El objetivo de este trabajo fue comparar la respuesta inmunológica contra S. pneumoniae en niños bajo distintos esquemas de inmunización (dos o tres dosis) con vacuna antineumocócica heptavalente. Métodos. Se realizó un estudio observacional y transversal para comparar la respuesta inmunológica entre los grupos A (dos primovacunaciones sin refuerzo) y B (dos primovacunaciones con refuerzo). Se analizó la respuesta inmunológica escasa por medio de hemaglutinación positiva (dilución ≤ 1:2). Se calculó la razón de momios (OR) y se aplicó la prueba exacta de Fisher. Resultados. No se encontraron diferencias clínicas entre los grupos A (n = 14) y B (n = 15). Hubo mayor proporción de respuesta inmunológica escasa en el grupo A [57% vs 13%; OR 8.7 (IC 95% 1.3-53.8); p = 0.017]. Conclusiones. La respuesta inmunológica escasa contra S. pneumoniae es mayor en los esquemas de dos dosis de primovacunación sin refuerzo que cuando se utilizan dos dosis de primovacunación con refuerzo.

Background. Different patterns of heptavalent conjugated pneumococcal vaccine immunization have proven effective. Although three and four doses are recommended, there are still children who are administered schemes of two primary vaccination doses without reinforcement. The aim of this study was to compare the immune response against S. pneumoniae in children (group A and group B) submitted to different immunization schemes (two primary vaccination doses with or without reinforcement). Methods. We conducted an observational, cross-sectional study comparing the immune response between group A and group B, analyzing the weak immune response with positive hemagglutination dilution ≤1:2. Odds ratio (OR) and Fisher's exact test were used. Results. There were no clinical differences between group A (n = 14) and group B (n = 15). There was a higher proportion of weak immune response in group A (57% vs. 13%, OR 8.7 (95% CI 1.3-53.8, p = 0.017). Conclusions. Weak immune response against S. pneumoniae is higher in schemes primed with two doses of heptavalent conjugated pneumococcal vaccine without reinforcement than using the two-dose schedule + a booster of heptavalent conjugated pneumococcal vaccine.