Cutaneous Endometriosis: A Case Report and Review of the Literature.

BACKGROUND Endometriosis is a unique entity described in ample literature as the decidualization of endometrial tissues under the influence of gynecological hormones outside the uterine cavity. The post-surgical presence of ectopic endometrial tissue on the skin is known as abdominal wall endometriosis, cutaneous endometriosis, or scar endometriosis. Iatrogenic implantation of detached endometrial tissues at the incision site is the most widely accepted theory for this rare monad. The unspecific scar endometriosis presentation makes it challenging to diagnose. Moreover, it can easily be confused with hematoma, hernia, lipoma, abscess, scar granuloma, and tumor. Here, we report and discuss a rare case of scar endometriosis with various available treatment modalities. CASE REPORT We delineate a case of a 39-year-old woman with abdominal wall cutaneous endometriosis. An "inverted T" incision opened the abdominal and uterine cavity as it was a problematic preterm breech in labor. After an uneventful postoperative and postpartum period, she presented with a painful, discolored nodular mass of approximately 3 cm in diameter at the left border of the cesarian scar, developed over 1.5 years, often accompanied by drainage of brownish discharge. Ultrasonography with color Doppler showed a hypoechoic lesion with internal vascularity, corroborated our preliminary diagnosis of scar endometriosis, which was further confirmed by surgical excision and histopathology. CONCLUSIONS A proper surgical resection is the standard treatment line for scar endometriosis. However, patients need regular follow-up to look for recurrences, even after treatment. Further studies are recommended to establish factors associated with cutaneous endometriosis recurrence.

Spray-drying encapsulation of microwave-assisted extracted polyphenols from Moringa oleifera: Influence of tragacanth, locust bean, and carboxymethyl-cellulose formulations.

In this work, polyphenols from Moringa oleifera (Mor) leaves were extracted by microwave-assisted extraction (MAE) and encapsulated by spray-drying (SD). Particularly, we explored the influence of tragacanth gum (TG), locust bean gum (LBG), and carboxymethyl-cellulose (CMC) as wall-materials on the physicochemical behavior of encapsulated Mor. Single or combined wall-material treatments (100:00 and 50:50 ratios, and total solid content 1%) were tested. The results showed the wall-material had a significant effect on the process yield (55.7-68.3%), encapsulation efficiency (24.28-35.74%), color (yellow or pale-yellow), total phenolic content (25.17-27.49 mg GAE g-1 of particles), total flavonoid content (23.20-26.87 mg QE g-1 of particles), antioxidant activity (DPPH• = 5.96-6.95 mg GAE g-1; ABTS•+ = 5.61-6.18 mg TE g-1 of particles), and particle size distribution (D50 = 112-1946 nm) of the encapsulated Mor. On the other hand, SEM analysis showed smooth and spherical particles, while TGA and DSC analyses confirmed the encapsulation of bioactive compounds based on the changes in thermal peaks. Finally, XRD analysis showed that the particles have an amorphous behavior. The encapsulated Mor produced with individual TG or CMC demonstrated better properties than those obtained from mixed gums. Thus, TG or CMC might be feasible wall materials for manufacturing encapsulated Mor that conserve the phenolic content and antioxidant activity.

Uso de la manzanilla en el tratamiento de las enfermedades periodontales / Chamomile use in the treatment of periodontal diseases

RESUMEN Fundamento: existe una gama de productos naturales, dentro de los que están los fitoterapéuticos, donde se destaca la manzanilla para tratar la enfermedad periodontal inflamatoria debido a la acción antiinflamatoria, cicatrizante, antialérgica, analgésica, antiséptica y bacteriostática que esta planta posee. Se ha demostrado que la manzanilla actúa también sobre la placa dentobacteriana, principal factor de riesgo de la enfermedad periodontal y es utilizada para el tratamiento de procesos agudos y crónicos periodontales. Objetivo: establecer las bases científicas del empleo de la manzanilla en el tratamiento de las enfermedades periodontales. Métodos: la búsqueda de la información se realizó en un periodo de seis meses y se emplearon las siguientes palabras: manzanilla, matricaria recutita; a partir de la información obtenida se realizó una revisión bibliográfica de un total de 150 artículos publicados en las bases de datos PubMed, Hinari, SciELO y Medline mediante el gestor de búsqueda y administrador de referencias EndNote, de ellos se utilizaron 52 citas seleccionadas para realizar la revisión, 40 de ellas de los últimos cinco años. Resultados: la manzanilla es nativa en muchos países de Europa, y se cultivan en países como Alemania, Egipto, Francia, España, Italia, Marruecos, y en partes de Europa del Este. Las diversas plantas de manzanilla son muy distintas y requieren su propio conjunto de condiciones para crecer. Sus propiedades, acciones terapéuticas y principios activos varían de una especie a otra. Conclusiones: la Matricaria chamomilla y la Phania matricarioides son de probada eficacia terapéutica en el tratamiento de enfermedades periodontales agudas y crónicas.

ABSTRACT Background: there is a range of natural products, including phytotherapeutic, which highlights the chamomile to treat inflammatory periodontal disease due to the anti-inflammatory, healing, antiallergic, analgesic, antiseptic and bacteriostatic that this plant possesses. It has been shown that chamomile also acts on dentobacterial plaque, the main risk factor for periodontal disease and is used for the treatment of acute and chronic periodontal processes. Objective: to establish the scientific basis of the use of chamomile in the treatment of periodontal diseases. Methods: the search of the information was carried out in a period of six months and the following words were used: chamomile, matricaria recutita; Based on the information obtained, a bibliographic review was made of a total of 150 articles published in the PubMed, Hinari, SciELO and Medline databases by means of the search manager and the EndNote reference manager. Of these, 52 selected citations were used to perform the review, 40 of them from the last five years. Results: Chamomile is native to many countries in Europe, and is grown in countries such as Germany, Egypt, France, Spain, Italy, Morocco, and in parts of Eastern Europe. The various chamomile plants are very different and require their own set of conditions to grow. Its properties, therapeutic actions and active principles vary from one species to another. Conclusions: Matricaria chamomilla and Phania matricarioides are of proven therapeutic efficacy in the treatment of acute and chronic periodontal diseases.

Human parthenogenetic neural stem cell grafts promote multiple regenerative processes in a traumatic brain injury model.

International Stem Cell Corporation human parthenogenetic neural stem cells (ISC-hpNSC) have potential therapeutic value for patients suffering from traumatic brain injury (TBI). Here, we demonstrate the behavioral and histological effects of transplanting ISC-hpNSC intracerebrally in an animal model of TBI. Methods: Sprague-Dawley rats underwent a moderate controlled cortical impact TBI surgery. Transplantation occurred at 72 h post-TBI with functional readouts of behavioral and histological deficits conducted during the subsequent 3-month period after TBI. We characterized locomotor, neurological, and cognitive performance at baseline (before TBI), then on days 0, 1, 7, 14, 30, 60, and 90 (locomotor and neurological), and on days 28-30, 58-60, and 88-90 (cognitive) after TBI. Following completion of behavioral testing at 3 months post-TBI, animals were euthanized by transcardial perfusion and brains harvested to histologically characterize the extent of brain damage. Neuronal survival was revealed by Nissl staining, and stem cell engraftment and host tissue repair mechanisms such as the anti-inflammatory response in peri-TBI lesion areas were examined by immunohistochemical analyses. Results: We observed that TBI groups given high and moderate doses of ISC-hpNSC had an improved swing bias on an elevated body swing test for motor function, increased scores on forelimb akinesia and paw grasp neurological tests, and committed significantly fewer errors on a radial arm water maze test for cognition. Furthermore, histological analyses indicated that high and moderate doses of stem cells increased the expression of phenotypic markers related to the neural lineage and myelination and decreased reactive gliosis and inflammation in the brain, increased neuronal survival in the peri-impact area of the cortex, and decreased inflammation in the spleen at 90 days post-TBI. Conclusion: These results provide evidence that high and moderate doses of ISC-hpNSC ameliorate TBI-associated histological alterations and motor, neurological, and cognitive deficits.

Derivation of Neural Stem Cells from Human Parthenogenetic Stem Cells.

We have previously shown that human parthenogenetic stem cells (hpSC) can be chemically directed to differentiate into a homogeneous population of multipotent neural stem cells (hpNSC) that are scalable, cryopreservable, express all the appropriate neural markers, and can be further differentiated into functional dopaminergic neurons. Differentiation of hpSC into hpNSC provides a platform to study the molecular basis of human neural differentiation, to develop cell culture models of neural disease, and to provide neural stem cells for the treatment of neurodegenerative diseases. Additionally, the hpNSC that are generated could serve as a platform for drug discovery and the determination of pharmaceutical-induced neural toxicity. Here, we describe in detail the stepwise protocol that was developed in our laboratory that facilitates the highly efficient and reproducible differentiation of hpSC into hpNSC.

Novel Approach to Stem Cell Therapy in Parkinson's Disease.

In this commentary we discuss International Stem Cell Corporation's (ISCO's) approach to developing a pluripotent stem cell based treatment for Parkinson's disease (PD). In 2016, ISCO received approval to conduct the world's first clinical study of a pluripotent stem cell based therapy for PD. The Australian regulatory agency Therapeutic Goods Administration (TGA) and the Melbourne Health's Human Research Ethics Committee (HREC) independently reviewed ISCO's extensive preclinical data and granted approval for the evaluation of a novel human parthenogenetic derived neural stem cell (NSC) line, ISC-hpNSC, in a PD phase 1 clinical trial ( ClinicalTrials.gov NCT02452723). This is a single-center, open label, dose escalating 12-month study with a 5-year follow-up evaluating a number of objective and patient-reported safety and efficacy measures. A total of 6 years of safety and efficacy data will be collected from each patient. Twelve participants are recruited in this study with four participants per single dose cohort of 30, 50, and 70 million ISC-hpNSC. The grafts are placed bilaterally in the caudate nucleus, putamen, and substantia nigra by magnetic resonance imaging-guided stereotactic surgery. Participants are 30-70 years old with idiopathic PD ≤13 years duration and unified PD rating scale motor score (Part III) in the "OFF" state ≤49. This trial is fully funded by ISCO with no economic involvement from the patients. It is worth noting that ISCO underwent an exhaustive review process and successfully answered the very comprehensive, detailed, and specific questions posed by the TGA and HREC. The regulatory/ethic review process is based on applying scientific and clinical expertise to decision-making, to ensure that the benefits to consumers outweigh any risks associated with the use of medicines or novel therapies.

Supplementation of specific carbohydrates results in enhanced deposition of chondrogenic-specific matrix during mesenchymal stem cell differentiation.

Repair or regeneration of hyaline cartilage in knees, shoulders, intervertebral discs, and other assorted joints is a major therapeutic target. To date, therapeutic strategies utilizing chondrocytes or mesenchymal stem cells are limited by expandability or the generation of mechanically inferior cartilage. Our objective is to generate robust cartilage-specific matrix from human mesenchymal stem cells suitable for further therapeutic development. Human mesenchymal stem cells, in an alginate 3D format, were supplied with individual sugars and chains which comprise the glycan component of proteoglycans in articular cartilage (galactose, hyaluronic acid, glucuronic acid, and xylose) during chondrogenesis. After an initial evaluation for proteoglycan deposition utilizing Alcian blue, the tissue was further evaluated for viability, structural elements, and hypertrophic status. With the further addition of serum, a substantial increase was observed in viability, the amount of proteoglycan deposition, glycosaminoglycan production, and an enhancement of Hyaluronic Acid, Collagen II and Aggrecan deposition. Suppression of hypertrophic markers (COL1A1, COL10A1, MMP13, and RUNX2) was also observed. When mesenchymal stem cells were supplied with the raw building materials of proteoglycans and a limited amount of serum during chondrogenesis, it resulted in the generation of viable hyaline-like cartilage with deposition of structural components which exceeded previously reported in vitro-based cartilage.

Neural Stem Cell Tumorigenicity and Biodistribution Assessment for Phase I Clinical Trial in Parkinson's Disease.

Human pluripotent stem cells (PSC) have the potential to revolutionize regenerative medicine. However undifferentiated PSC can form tumors and strict quality control measures and safety studies must be conducted before clinical translation. Here we describe preclinical tumorigenicity and biodistribution safety studies that were required by the US Food and Drug Administration (FDA) and Australian Therapeutic Goods Administration (TGA) prior to conducting a Phase I clinical trial evaluating the safety and tolerability of human parthenogenetic stem cell derived neural stem cells ISC-hpNSC for treating Parkinson's disease (ClinicalTrials.gov Identifier NCT02452723). To mitigate the risk of having residual PSC in the final ISC-hpNSC population, we conducted sensitive in vitro assays using flow cytometry and qRT-PCR analyses and in vivo assays to determine acute toxicity, tumorigenicity and biodistribution. The results from these safety studies show the lack of residual undifferentiated PSC, negligible tumorigenic potential by ISC-hpNSC and provide additional assurance to their clinical application.

Neural Stem Cell Transplantation and CNS Diseases.

In neurological disorders, pathological lesions in the central nervous system (CNS) may be globally dispersed throughout the brain or localized to specific regions. Although native neural stem cells (NSCs) are present in the adult mammalian brain, intrinsic self-repair of injured adult CNS tissue is inadequate or ineffective. The brain's poor regenerative ability may be due to the fact that NSCs are restricted to discrete locations, are few in number, or are surrounded by a microenvironment that does not support neuronal differentiation. Therapeutic potential of NSC transplantation in CNS diseases characterized by global degeneration requires that gene products and/or replaced cells be widely distributed. Global degenerative CNS diseases include inherited pediatric neurodegenerative diseases (inborn errors of metabolism, including lysosomal storage disorders (LSDs), such as Tay-Sachs-related Sandhoff disease), hypoxic or ischemic encephalopathy, and some adult CNS diseases (such as multiple sclerosis). Both mouse and human NSCs express many chemokines and chemokine receptors (including CXCR4 and adhesion molecules, such as integrins, selectins, and immunoglobulins) that mediate homing to sources of inflammatory chemokines, such as SDF-1α. In mammalian brains of all ages, NSCs may be attracted even at a great distance to regions of neurodegeneration. Consequently, NSC transplantation presents a promising strategy for treating many CNS diseases.

Contextualización de las ecuaciones para la estimación de la estatura a partir de la hemibraza en una población santiaguera / Equations for the height estimate from the hemimainbrace in Santiago de Cuba population

Se realizó un estudio descriptivo y transversal de 265 adultos (101 hombres y 164 féminas) de la Facultad de Medicina No. 1 de Santiago de Cuba, desde septiembre hasta octubre del 2014, con vistas a determinar las ecuaciones para la estimación de la estatura y verificar si las que fueron validadas en adultos de otras nacionalidades tienen aplicabilidad en esta población. Se encontró una elevada correlación entre la estatura y la hemibraza (p<0,001), r=0,889; 0,803 y 0,765 para hombres y mujeres, respectivamente. El error entre los modelos y la estatura medida fue menor (0,27 para ellos y 0,36 para ellas) en el propuesto que en los de Bassey (8,83; 9,89) y Shahar (11,72; 12,11). La correlación entre la estatura y la hemibraza posibilitó la obtención de ecuaciones contextualizadas en este medio, lo cual reafirmó la necesidad de poseer dichas ecuaciones para cada población.

A descriptive and cross-sectional study of 265 adults (101 men and 164 women) of the Medicine Faculty No. 1 in Santiago de Cuba, was carried out from September to October, 2014, aimed at determining the equations for the height estimate and verifying if those that were validated in adults of other nationalities have applicability in this population. A high correlation between the height and the hemimainbrace (p<0.001), r=0.889; 0.803 and 0.765 for men and women, respectively was found. The error between the models and the measured height was lower (0.27 for men and 0.36 for women) in the proposed model than in Bassey (8.83; 9.89) and Shahar models (11.72; 12.11). The correlation between height and hemimainbrace facilitated the obtaining of contextualized equations in this mean, which confirmed the necessity to possess these equations for each population.

Anestesia epidural para artrodesis e instrumentación de columna lumbar porvia posterior en paciente con tromboastenia de glanzmann - informe de caso y revisión sistematica / Epidural anesthesia for posterior spinal fusion and lumbar surgery in a patient with glanzmann's thrombasthenia - Case report and systematic review

Introduction: Lumbar spine arthrodesis under regional epidural anesthesia provides adequate hemodynamic stability and timely treatment of acute postoperative pain to patients undergoing the procedure. However, the presence of intimidating comorbidities limits its widespread practice. Objetives: To describe the use of epidural anesthesia for spinal fusion in a patient with Glanzmann's Thrombasthenia and high anesthetic risk of cardiovascular complications. Methodology: Case reports and clinical discussion based on a systematic search of the medical literature. Results: Upon selecting the strategies for a literature search on various databases, some articles were selected from Pubmed, LILACS, and sciencedirect. The articles were screened based on title and abstract and 19 full text articles were analyzed and submitted for discussion of an appointed panel of experts (Anesthesiology Group) for inclusion herein. Conclusion: The use of epidural anesthesia in spinal surgery of a patient with significant hematological and cardiovascular complications was a successful approach and represents one further step forward in the implementation of protocols and robust clinical trials for the management of complex patients like the one herein described.

Introducción: La artrodesis de columna lumbar, bajo anestesia regional epidural, permite a los pacientes programados para éste tipo de procedimiento mantener una adecuada estabilidad hemodinámica y ser tratados oportunamente de su dolor postoperatorio agudo. Sin embargo, la presencia de intimidantes comorbilidades limita su práctica de forma generalizada. Objetivos: Describir la utilización de anestesia epidural para artrodesis lumbar en un paciente con Tromboastenia de Glanzmann y alto riesgo anestésico de complicaciones de predominio cardiovascular. Metodologia: Reporte de Casos y discusión clínica basada en búsqueda sistemática de la literatura médica. Resultados: Tras la selección de estrategias para la búsqueda de la literatura en diferentes bases de datos, se obtuvieron artículos de Pubmed, LILACS y sciencedirect. Posterior a exclusión por titulo y resumen, analizamos 19 artículos en texto completo, los cuales fueron sometidos a sesiones de discusión por parte de un panel de expertos designado (Grupo de Anestesiología), y fueron incluidos en esta revisión. Conclusión: Para este caso, el uso de la anestesia epidural en cirugía de columna, en un paciente con importantes comorbilidades hematológicas y cardiovasculares, fue una medida exitosa, y representa un paso más en la implementación de protocolos y estudios clínicos robustos para su uso en pacientes complejos como el descrito.

Neural Stem Cells Derived from Human Parthenogenetic Stem Cells Engraft and Promote Recovery in a Nonhuman Primate Model of Parkinson's Disease.

Cell therapy has attracted considerable interest as a promising therapeutic alternative for patients with Parkinson's disease (PD). Clinical studies have shown that grafted fetal neural tissue can achieve considerable biochemical and clinical improvements in PD. However, the source of fetal tissue grafts is limited and ethically controversial. Human parthenogenetic stem cells offer a good alternative because they are derived from unfertilized oocytes without destroying potentially viable human embryos and can be used to generate an unlimited supply of neural cells for transplantation. We have previously reported that human parthenogenetic stem cell-derived neural stem cells (hpNSCs) successfully engraft, survive long term, and increase brain dopamine (DA) levels in rodent and nonhuman primate models of PD. Here we report the results of a 12-month transplantation study of hpNSCs in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned African green monkeys with moderate to severe clinical parkinsonian symptoms. The hpNSCs manufactured under current good manufacturing practice (cGMP) conditions were injected bilaterally into the striatum and substantia nigra of immunosuppressed monkeys. Transplantation of hpNSCs was safe and well tolerated by the animals with no dyskinesia, tumors, ectopic tissue formation, or other test article-related serious adverse events. We observed that hpNSCs promoted behavioral recovery; increased striatal DA concentration, fiber innervation, and number of dopaminergic neurons; and induced the expression of genes and pathways downregulated in PD compared to vehicle control animals. These results provide further evidence for the clinical translation of hpNSCs and support the approval of the world's first pluripotent stem cell-based phase I/IIa study for the treatment of PD (Clinical Trial Identifier NCT02452723).

Factores bioquímicos relacionados con el estado nutricional del binomio madre-hijo / Biochemical factors related to the nutritional state of the binomial mother-son

Se efectuó una investigación descriptiva, longitudinal y prospectiva de 53 embarazadas, atendidas en el Policlínico Docente "30 de Noviembre'' de Santiago de Cuba, con vistas a determinar la relación entre los factores bioquímicos y el estado nutricional del binomio madre-hijo, durante el 2014. Para la realización de las determinaciones bioquímicas, se hicieron extracciones de sangre en el primer y tercer trimestres de la gestación. Se utilizó la prueba de Ji al cuadrado de independencia con un nivel de significación de 5 %. Existió asociación entre las variables bioquímicas en relación con el estado nutricional del binomio madre-hijo. Entre los efectos adversos asociados a la mala nutrición de las gestantes sobresalieron: anemia, diabetes gestacional y dislipidemias.

A descriptive, longitudinal and prospective investigation of 53 pregnant women, assisted at "30 de Noviembre" Teaching Polyclinic in Santiago de Cuba was carried out, aimed at determining the relationship between the biochemical factors and the nutritional state of the binomial mother-son, during 2014. Blood extractions were made in the first and third trimester of pregnancy in order to make biochemical determinations. The chi-square test of independence was used with a 5 % level of significance. There was an association between the biochemical variables in connection with the nutritional state of the binomial mother-son. Among the adverse effects associated to the pregnant women poor nutrition there were: anemia, gestational diabetes mellitus and dyslipemias.

Bystander Effect Fuels Human Induced Pluripotent Stem Cell-Derived Neural Stem Cells to Quickly Attenuate Early Stage Neurological Deficits After Stroke.

UNLABELLED: : Present therapies for stroke rest with tissue plasminogen activator (tPA), the sole licensed antithrombotic on the market; however, tPA's effectiveness is limited in that the drug not only must be administered less than 3-5 hours after stroke but often exacerbates blood-brain barrier (BBB) leakage and increases hemorrhagic incidence. A potentially promising therapy for stroke is transplantation of human induced pluripotent stem cell-derived neural stem cells (hiPSC-NSCs). To date, the effects of iPSCs on injuries that take place during early stage ischemic stroke have not been well studied. Consequently, we engrafted iPSC-NSCs into the ipsilesional hippocampus, a natural niche of NSCs, at 24 hours after stroke (prior to secondary BBB opening and when inflammatory signature is abundant). At 48 hours after stroke (24 hours after transplant), hiPSC-NSCs had migrated to the stroke lesion and quickly improved neurological function. Transplanted mice showed reduced expression of proinflammatory factors (tumor necrosis factor-α, interleukin 6 [IL-6], IL-1ß, monocyte chemotactic protein 1, macrophage inflammatory protein 1α), microglial activation, and adhesion molecules (intercellular adhesion molecule 1, vascular cell adhesion molecule 1) and attenuated BBB damage. We are the first to report that engrafted hiPSC-NSCs rapidly improved neurological function (less than 24 hours after transplant). Rapid hiPSC-NSC therapeutic activity is mainly due to a bystander effect that elicits reduced inflammation and BBB damage. SIGNIFICANCE: Clinically, cerebral vessel occlusion is rarely permanent because of spontaneous or thrombolytic therapy-mediated reperfusion. These results have clinical implications indicating a much extended therapeutic window for transplantation of human induced pluripotent stem cell-derived neural stem cells (hiPSC-NSCs; 24 hours after stroke as opposed to the 5-hour window with tissue plasminogen activator [tPA]). In addition, there is potential for a synergistic effect by combining hiPSC-NSC transplantation with tPA to attenuate stroke's adverse effects.

Proof of concept studies exploring the safety and functional activity of human parthenogenetic-derived neural stem cells for the treatment of Parkinson's disease.

Recent studies indicate that human pluripotent stem cell (PSC)-based therapies hold great promise in Parkinson's disease (PD). Clinical studies have shown that grafted fetal neural tissue can achieve considerable biochemical and clinical improvements in PD. However, the source of fetal tissue grafts is limited and ethically controversial. Human parthenogenetic stem cells offer a good alternative because they are derived from unfertilized oocytes without destroying viable human embryos and can be used to generate an unlimited supply of neural stem cells for transplantation. Here we evaluate for the first time the safety and engraftment of human parthenogenetic stem cell-derived neural stem cells (hpNSCs) in two animal models: 6-hydroxydopamine (6-OHDA)-lesioned rodents and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated nonhuman primates (NHPs). In both rodents and nonhuman primates, we observed successful engraftment and higher dopamine levels in hpNSC-transplanted animals compared to vehicle control animals, without any adverse events. These results indicate that hpNSCs are safe, well tolerated, and could potentially be a source for cell-based therapies in PD.

Deriving dopaminergic neurons for clinical use. A practical approach.

New small molecules that regulate the step-wise differentiation of human pluripotent stem cells into dopaminergic neurons have been identified. The steroid, guggulsterone, was found to be the most effective inducer of neural stem cells into dopaminergic neurons. These neurons are extensively characterized and shown to be functional. We believe this new approach offers a practical route to creating neurons of sufficient quality to be used to treat Parkinson's disease patients.

Importancia del consumo de hierro y vitamina C para la prevención de anemia ferropénica / Importance of the iron and vitamin C consumption for the prevention of iron-deficiency anemia

El déficit de hierro ha sido señalado como la causa más frecuente de anemia en el mundo, tanto en países con bajo grado de desarrollo como en los altamente industrializados. En Cuba, la anemia ferropénica constituye un problema de salud que afecta fundamentalmente a lactantes mayores, adolescentes, mujeres en edad fértil y embarazadas. Se revisó la bibliografía especializada desde elementos nutricionales, balance y metabolismo del hierro hasta aspectos socioculturales que inciden directa e indirectamente en esa condición. Lo revisado y compilado en este artículo sentó pautas para una intervención educativa, durante la cual se demostró la validez de acciones específicas para enfrentar el problema identificado.

The iron deficiency has been pointed out as the most frequent cause of anemia in the world, both in countries with low level of development and in the highly industrialized ones. In Cuba, the iron-deficiency anemia constitutes a problem of health that affects fundamentally older infants, adolescents, women in fertile age and pregnant women. The specialized bibliography was reviewed from nutritional elements, balance and iron metabolism to sociocultural aspects that impact direct and indirectly on that condition. What was reviewed and compiled in this article stated rules for an educational intervention, during which the validity of specific actions was demonstrated to face the identified problem.

Gonadotropin-releasing hormone receptor in spinal cord neurons of embryos and adult rats.

Mammalian gonadotropin-releasing hormone (GnRH) and its receptor have been found in the neuroendocrine reproductive axis. However, they can be localized in other extra-pituitary tissues as well including the central nervous system. The present study reports the expression of GnRH receptor and its mRNA in spinal cord neurons of rat embryos and adult rats, using immunohistochemistry and reverse transcriptase polymerase chain reaction (RT-PCR). Immunohistochemistry showed that the spinal cord neurons of rat embryos and adult rats expressed the GnRH receptor. The study of GnRH receptor mRNAs revealed that both cultured spinal cord neurons of rat embryos and adult rats expressed the GnRH receptor mRNA. Additional in vitro experiments showed that the expression of GnRH receptor mRNA was less in the spinal cord neurons exposed to GnRH compared to unexposed ones. These results raise the possibility that GnRH may play other roles independently from its participation in reproductive function.

Síndrome de Boerhaave: Reporte de un caso y revisión de la literatura

El síndrome de Boerhaave o perforación esofágica espontánea es una enfermedad grave que pone en riesgo la vida y amerita un diagnóstico oportuno. Sin tratamiento médico o quirúrgico es prácticamente letal. El cuadro clásico es el del paciente que presenta vómito y posteriormente dolor epigástrico o retroesternal. Caso Clínico: se rata de peciente femenina de 23 años de edad quien consulto por presentar Posterior a ingesta de alimentos sensación de deglución incompleta, vómitos de contenido Hematico y dolor retroesternal. Se realiza Gastroscopia evidenciándose en esófago a 25 cm. laceración lineal profunda que se extiende hasta los 33cm TAC de tórax reporto: Neumonediastino, Signos sugestivos de perforación esofágica; Se realizo Toracotomia Posterolateral derecha, encantándose 50cc de liquido libre en cavidad, hematoma mediastinal de 4 x 4 cm y enfisema mediastinal. La paciente permaneció hospitalizada por varios días recibiendo tratamiento medico evolucionando satisfactoriamente sin complicaciones. Conclusiones: el diagnóstico y tratamiento precoces del SB es muy importantes ya que permiten reducir las altas tasas de morbilidad y mortalidad asociadas a este cuadro. Sin embargo, el diagnóstico de esta entidad muestra en general retraso en prácticamente todas las series (en la mitad de los casos el diagnóstico se realiza con más de 24 horas de evolución), ya que en muchas ocasiones los síntomas son inespecíficos y no típicos, además los hallazgos clínicos y radiológicos pueden no ser aparentes en las primeras horas tras la perforación. Estudios de Endoscopia, esofagograma, TAC proporcionan el diagnóstico.

Boerhaave syndrome or spontaneous esophageal perforation is a serious condition that endangers the patient´s life and deserves an opportune diagnosis. Without medical or surgical treatment is practically lethal. The classic presentation is the patient who presents with vomits and immediately after with epigastric or retrosternal pain. Clinical case: a 23 years old female patient consulted presenting, after food ingestion, a subsequent sensation of incomplete swallowing, vomits with hematic content and retrosternal pain. A gastroscopy was performed demonstrating deep linear esophagial laceration at 25 cm extending at 33cm CT scan reported pneumonediastin, with suggestive signs of esophageal perforation; She went through a right posterolateral toracotomy, 50cc of free liquid was found in cavity, a 4 x 4 cms mediastinal hematoma and emphysema. The patient remained hospitalized for several days receiving medical treatment without complications. Conclusions: early diagnosis and treatment of BS is important becuase it reduces the high morbidity and mortality rates associated with this syndrome. Nevertheless, the diagnosis is usually delayed in practically all series (in half of the cases the diagnosis is done after more than 24 hours), since in many occasions the symptoms are inespecífic and non-typical. in addition the clinical and radiological findings are not apparent in the first hours after perforation. Studies as endoscopy, esophagogram, CT scan provide the diagnosis.