Experimental demonstration of an OpenFlow based software-defined optical network employing packet, fixed and flexible DWDM grid technologies on an international multi-domain testbed.

Software defined networking (SDN) and flexible grid optical transport technology are two key technologies that allow network operators to customize their infrastructure based on application requirements and therefore minimizing the extra capital and operational costs required for hosting new applications. In this paper, for the first time we report on design, implementation & demonstration of a novel OpenFlow based SDN unified control plane allowing seamless operation across heterogeneous state-of-the-art optical and packet transport domains. We verify and experimentally evaluate OpenFlow protocol extensions for flexible DWDM grid transport technology along with its integration with fixed DWDM grid and layer-2 packet switching.

Influenza A H1N1/2009 infection in pediatric solid organ transplant recipients.

AIM AND METHOD: The aim of this study was to describe the clinical characteristics and outcome of pandemic influenza A H1N1/2009 (pH1N1) infection, in a retrospective cohort of pediatric patients with kidney and/or liver transplant and confirmed pH1N1 infection from June to December 2009, diagnosed in 2 Spanish teaching hospitals. RESULTS: Forty-nine patients were included. Pneumonia was diagnosed in 4 patients (8.2%), and 3 of them required respiratory support. There were no related deaths. CONCLUSION: Antiviral treatment within 48 h was associated with a lower likelihood of pneumonia (0/38, 0%) than treatment started after 48 h (4/11, 36.3%) (P < 0.01).

Delayed graft function is reduced with antithymocyte globulin induction in pediatric kidney transplantation.

Reduction of delayed graft function (DGF) is critical to the success of renal transplantation. We report graft outcomes with antithymocyte globulin (ATG) induction compared with using interleukin-2 receptor antagonist basiliximab (IL-2RA). Twelve pediatric patients received a pediatric deceased donor kidney. We treated them with ATG (group A, ATG; n = 6) or IL-2RA (group B, n = 6). DGF was observed in 0 cases (group A) and in 6 cases (group B), which showed a mean of 7 +/- 3 days (P < .001). In group A, lymphopenia occurred routinely resolving after 3-6 months, none with serious infection. The incidence of opportunistic infections was 0% in both groups. One-year patient and graft survivals were 100% in both groups. ATG induction significantly reduced the incidence of delayed graft function. Both induction treatments led to a good patient and graft survival.

[Acquired aplastic anemia in children. Therapy using androgens and antilymphocyte gamma globulin]. / Anemia aplástica adquirida en niños. Terapéutica con andrógenos y con gammaglobulina antilinfocítica.

Authors describe initial characteristics, clinical course and response to treatment of 13 children, aged from eight months to nine years, with acquired aplastic anaemia. Six of the children had been exposed to products with potential bone-marrow toxicity: chloranphenicol (1), pirazolones (3) and insecticides (2). Pancytopenia was severe in twelve and moderate in one. Five patients with severe aplastic anaemia were given antilymphocytic (2) or antithymocytic (3) (ATG) gammaglobulins; two of those treated with ATG responded after two and five months respectively and there was no response in the other three. Twelve patients were given androgen treatment (oxymetholone or nandrolone decanoate): four, two of whom previously had received ATG, followed a favorable course. None of the severe initial pancytopenic patients responded to androgen single agent treatment. No marrow transplant was performed in any of the children. Eight of the thirteen patients died one to 37 months after onset (median, 6 months) and five (38%) are alive after 21 months to 10 years, corresponding to two patients with moderate and three with severe initial pancytopenia. Importance of an appropriate supportive treatment during initial stages of the disease and the probable efficacy or immunosupressive treatment in certain patients must be underlined.

[Nephropathy in Schoenlein-Henoch purpura. Long-term developmental aspects in 55 cases]. / Nefropatía en la púrpura de Schoenlein-Henoch. Aspectos evolutivos a largo plazo en 55 observaciones.

Fifty five patients with Schöelein-Henoch nephropathy were reviewed. These patients were divided into five groups according to the clinical picture initially presented: 1. Hematuria with proteinuria. 2. Hematuria with nephrotic syndrome. 3. Isolated hematuria. 4. Hematuria, nephrotic syndrome and renal failure. 5. Proteinuria. From a histopathological point of view, they were classified into six groups according to ISKDC criteria. A strong correlation was found between clinical presentation and histological lesion. The worst prognosis corresponded to patients with nephrotic syndrome and renal failure, whose biopsy revealed more than 75% of glomeruli with epithelial crescents.

[Juvenile malignant osteopetrosis. Clinico-radiological study of 7 cases]. / Osteopetrosis infantil maligna. Estudio clinicorradiológico de siete casos.

Clinical and radiological studies of seven patients with autosomic recessive malignant osteopetrosis are presented. Diagnosis was established before the age of 3 months in six cases and at 7 months in one. In all cases the presenting signs were pallor and hepatosplenomegaly with associated neurological involvement in five. All patients had normocytic normochromic anemia, leucopenia and thrombocytopenia with features of extramedullary hematopoiesis. Radiological studies revealed increase in the density of bones with "mask" appearance of facial bones and diminished size of optic foramina. Long bones showed absence of normal trabeculae and anomalies in modeling with methaphiseal bands and "bone within bone" images. There was hypocalcemia and hypophosphatemia with slight increases in alkaline phosphatase; parathormone was normal. Clinical course was characterized by progressive pancytopenia, recurrent infections and neurological deterioration with convulsions, nistagmus and optic atrophy. Five out of the seven patients died after a median of 3 months, due to infections or haemorrhage. The patient diagnosed at 7 months of age presented bilateral optic atrophy and moderate anemia; no other complications appeared after 2 year follow-up. Histological findings included substitution of bone marrow by chondro-osseous tissue; focal obsteoblastic and osteoclastic activity in calcified cartilage, and myeloid metaplasia in liver, spleen, lymph nodes and kidneys. The lesions are in agreement with the concept of a defect in bone formation-resorbtion balance; dysfunction of both osteoclasts and osteocytes is implicated in the pathogenesis. Unlike experimental disease, osteopetrosis in man is probably an heterogeneous disease and appropriate therapy should be individualized. Nevertheless, at present, the only favorable results have been obtained with bone-marrow transplantation.

Control a largo plazo de 55 ninos com nefropatia secundaria a purpura de Schoenlein-Henoch. / Long-term control of 55 children with nephropathy secondary to Schoenlein-Henoch purpura

Exponemos nuestra experiencia en cincuenta y cinco casos de sindrome de Schoenlein-Henoch con afeccion renal. Desde el punto de vista clinico se clasificaron en cinco grupos: 1) Hematuria y proteinuria, 2) Hematuria y sindrome nefrotico, 3) Hematuria 4) Hematuria, sindrome nefrotico e insuficiencia renal y 5) proteinuria. Desde el punto de vista anatomico se clasificaron en seis tipos segun los criterios del ISKDC. Se halla correlacion en cuanto a peor pronostico en la forma clinica de inicio con sidrome nefrotico e insuficiencia renal y en la lesion anatomica con semilunas en porcentaje superior al 75% de los glomerulos