Maternal and perinatal outcomes and placental pathologic examination of 29 SARS-CoV-2 infected patients in the third trimester of gestation.

AIM: On December 31, 2019, an unknown outbreak of pulmonary disease was reported in China. The novel coronavirus SARS-CoV-2 was the etiologic agent of this disease, and responsible of the current pandemic of COVID-19. Accumulated evidence on placental features is based most on case-reports and small case-series, with differing results. METHODS: We gathered a cohort of 29 infected pregnant mothers who delivered 32 newborns, and had placentas available for pathologic examination. Placentas were compared with a control group. RESULTS: Of the 29 mothers, clinical and radiological features were similar to what was already described in COVID-19. Pregnancy modified some analytical parameters. One of the mothers succumbed to the disease. Of the 32 newborns, 1 developed an early infection, with positive reverse-transcriptase polymerase chain reaction (RT-PCR) at 48 h of life, with an initial RT-PCR negative. SARS-CoV-2 presence was assessed on placental tissue with immunohistochemistry and RT-PCR, both were negative. All newborns had good clinical outcomes. No differences in morphological placental findings were found among both groups. CONCLUSION: Lack of statistically significant differences among case and control groups suggest that placentas from SARS-CoV-2 infected mothers represent a cohort of normal placentas only submitted because of maternal SARS-CoV-2 status. To the best of our knowledge, no irrefutable cases of vertical transmission have been yet described. Other authors have failed to demonstrate presence of viral RNA in placental tissue. Accumulated knowledge suggests that if vertical transmission is possible, it is a rare event.

[Sphincterotomy followed by papillary large balloon in the management of cholecolithiasis. Therapeutic success and safety in a Lima-Peru hospital]. / Esfinterotomía seguida de dilatación con balón de gran tamaño en el manejo de coledocolitiasis. Eficacia y seguridad en un hospital de Lima-Perú.

OBJECTIVE: We present a descriptive analysis of our cases of sphincterotomy followed by papillary large balloon dilation in a single session (ES-LBD) in the management of difficult to extract calculi, with the objective of assessing rates of therapeutic success and complications in local experience. MATERIAL AND METHODS: ERCP procedures with ES-LBD performed for choledocholithiasis between January 2009 and December 2014 in patients older than 18 years and without preexistent sphincterotomy were selected from records of the Gastroenterology Service at Cayetano Heredia National Hospital. A descriptive analysis of therapeutic success and complications was performed. RESULTS: 73 procedures in 73 patients were included (65.8% female, 34.2% male). Patient's average age was 59.4±19.8 years. Average diameter of calculi was 14.6±3.3mm. Average diameter of dilations was 14.6±2.27 mm. In 8 cases mechanical lithotripsy was performed. Complete calculi extraction was achieved in 56 procedures (76.7%). Complications occurred in 4 cases (5.5%). There were no deaths. CONCLUSION: Our figures of therapeutic success and complications with ES-LBD for difficult to extract calculi are similar to those reported in literature. ES-LBD is an effective and safe technique for management of choledocholithiasis.

Spatially resolved tissue imaging to analyze the tumor immune microenvironment: beyond cell-type densities.

INTRODUCTION: The tissue immune microenvironment is associated with key aspects of tumor biology. The interaction between the immune system and cancer cells has predictive and prognostic potential across different tumor types. Spatially resolved tissue-based technologies allowed researchers to simultaneously quantify different immune populations in tumor samples. However, bare quantification fails to harness the spatial nature of tissue-based technologies. Tumor-immune interactions are associated with specific spatial patterns that can be measured. In recent years, several computational tools have been developed to increase our understanding of these spatial patterns. TOPICS COVERED: In this review, we cover standard techniques as well as new advances in the field of spatial analysis of the immune microenvironment. We focused on marker quantification, spatial intratumor heterogeneity analysis, cell‒cell spatial interaction studies and neighborhood analyses.