Method development and application to sediments for multi-residue analysis of organic contaminants using gas chromatography-tandem mass spectrometry.

A method for the determination of four classes of potentially toxic substances (PTSs) was developed and applied in marine sediments, including (i) polycyclic aromatic hydrocarbons (PAHs), (ii) polychlorinated biphenyls (PCBs), (iii) polybrominated diphenyl ethers (PBDEs), and (iv) organochlorinated pesticides (OCPs). The method is based on ultrasonic extraction with a mixture of dichloromethane:methanol (9:1 v/v) and gas chromatography coupled with tandem mass spectrometry analysis (GC-MS/MS) in multiple reaction monitoring (MRM) mode. A total of 89 compounds were identified using two precursor-product ion standards for each analyte. The method detection limit (MDL; 0.001-0.055 ng g-1 dw) and method quantification limit (MQL; 0.002-0.184 ng g-1 dw) are below the usual thresholds of pollution adopted by international sediment quality guidelines. The method proved to be selective, sensitive, accurate, and linear, with the advantage of reducing sample handling time and consumable expenses (solvent, adsorbents). The developed method was successfully applied to surface sediments of Sepetiba Bay, Rio de Janeiro State, Brazil. Total concentrations of PAH (29.20-209.5 ng g-1 dw), PCB (0.06-2.16 ng g-1 dw), OCP (0.03-0.33 ng g-1 dw), and PBDE (0.06-0.21 ng g-1 dw) represent a baseline for these compounds and revealed mild to low levels of contamination in comparison to other coastal bays in SE Brazil. By using the proposed method, we expect this preliminary dataset can be expanded and include other similar coastal systems from developing countries marked by scarcity of information about levels, risk assessment, and specific sediment quality guidelines encompassing multiple classes of regulated and emerging organic contaminants.

Metabolic requirements of NK cells during the acute response against retroviral infection.

Natural killer (NK) cells are important early responders against viral infections. Changes in metabolism are crucial to fuel NK cell responses, and altered metabolism is linked to NK cell dysfunction in obesity and cancer. However, very little is known about the metabolic requirements of NK cells during acute retroviral infection and their importance for antiviral immunity. Here, using the Friend retrovirus mouse model, we show that following infection NK cells increase nutrient uptake, including amino acids and iron, and reprogram their metabolic machinery by increasing glycolysis and mitochondrial metabolism. Specific deletion of the amino acid transporter Slc7a5 has only discrete effects on NK cells, but iron deficiency profoundly impaires NK cell antiviral functions, leading to increased viral loads. Our study thus shows the requirement of nutrients and metabolism for the antiviral activity of NK cells, and has important implications for viral infections associated with altered iron levels such as HIV and SARS-CoV-2.

Stem cell transplantation as treatment for major histocompatibility class I deficiency.

Major histocompatibility class I deficiency, due to genetic lesions in TAP1, TAP2, TAPBP, or B2M, manifests with recurrent sinopulmonary infections and granulomatous skin ulceration, and is predominately treated with antimicrobial prophylaxis and chest physiotherapy. One previous report of hematopoietic stem cell transplantation has been described in the literature, demonstrating cure of the immune defect without significant graft-versus-host disease. In this report, we expand the literature on HSCT in MHC-I deficiency with follow-up of the original patient, demonstrating maintained resolution of normal immune function and regression of the granulomatous rash 15 years post-transplant, and describe a further patient with mycobacterial disease whose transplant course was complicated by severe graft-versus-host disease.

Fructose reprogrammes glutamine-dependent oxidative metabolism to support LPS-induced inflammation.

Fructose intake has increased substantially throughout the developed world and is associated with obesity, type 2 diabetes and non-alcoholic fatty liver disease. Currently, our understanding of the metabolic and mechanistic implications for immune cells, such as monocytes and macrophages, exposed to elevated levels of dietary fructose is limited. Here, we show that fructose reprograms cellular metabolic pathways to favour glutaminolysis and oxidative metabolism, which are required to support increased inflammatory cytokine production in both LPS-treated human monocytes and mouse macrophages. A fructose-dependent increase in mTORC1 activity drives translation of pro-inflammatory cytokines in response to LPS. LPS-stimulated monocytes treated with fructose rely heavily on oxidative metabolism and have reduced flexibility in response to both glycolytic and mitochondrial inhibition, suggesting glycolysis and oxidative metabolism are inextricably coupled in these cells. The physiological implications of fructose exposure are demonstrated in a model of LPS-induced systemic inflammation, with mice exposed to fructose having increased levels of circulating IL-1ß after LPS challenge. Taken together, our work underpins a pro-inflammatory role for dietary fructose in LPS-stimulated mononuclear phagocytes which occurs at the expense of metabolic flexibility.

Prognostic factors and clinical outcomes after stereotactic radiotherapy for primary lung tumors.

AIM: To characterize the population treated with SBRT for early-stage primary lung tumors in our institution, determine their outcomes, and identify potential prognosis factors. BACKGROUND: Stereotactic radiotherapy (SBRT) is an alternative treatment for inoperable patients with early-stage lung cancer. It confers a local control rate around 90% at 3 years, and 2-3 year overall survival rates of 43-60% in this population. MATERIALS AND METHODS: We retrospectively analyzed all patients treated in our department between 2012 and 2017 and evaluated local progression-free survival (L-PFS), nodal or distant progression-free survival (ND-PFS), global progression-free survival (G-PFS), overall survival (OS), and disease specific survival (DSS). Univariate (UVA) and multivariate (MVA) models were built to assess the influence of each variable. RESULTS: We identified 218 patients with 233 tumors. Most were male (78.9%) with a median age of 73 years. Median follow-up was 22 months. At 18 months, L-PFS was 93.7%, ND-PFS was 82.2%, G-PFS was 76.0%, DSS was 90.5%, and OS was 78.0% in ≤ T2 tumors. On UVA, T2 tumors were associated with lower L-PFS, G-PFS and DSS than T1, with no significant impact on ND-PFS or OS, an effect that persisted on MVA. On UVA, L-PFS and G-PFS were negatively influenced by female gender and a 5-fraction schedule was associated with worse G-PFS, which was not confirmed on MVA. CONCLUSION: Our local and distant control rates and survival were similar to those previously reported. On MVA, T2 tumors displayed lower L-PFS, G-PFS and DSS, with no difference in OS.

Diretrizes para a assistência da terapia ocupacional na pandemia da COVID-19 e perspectivas pós-pandemia / Guidelines for occupational therapy assistance in COVID-19 pandemic and post-pandemic perspectives

RESUMO: INTRODUÇÃO: A COVID-19 é uma doença altamente contagiosa, de apresentação recente, causada pelo novo coronavírus, denominado SARS-CoV-2 por ser da família SARS (Síndrome Respiratória Aguda Grave). São necessárias diretrizes cientificamente fundamentadas sobre as intervenções dos terapeutas ocupacionais no cuidado de pessoas com a COVID-19 e sobre as perspectivas de atenção pós-pandemia. OBJETIVO: Apresentar diretrizes e recomendações aos terapeutas ocupacionais sobre o manejo clínico de pacientes com COVID-19 em diferentes níveis de atenção à saúde, para favorecer a assistência segura e com qualidade técnico-científica. MÉTODO: Dez terapeutas ocupacionais de diferentes estados brasileiros, experts em suas áreas de atuação, reuniram-se, por meio de web conferências, para desenvolver diretrizes para a atuação do terapeuta ocupacional na pandemia da COVID-19. O público-alvo destas diretrizes é composto porterapeutas ocupacionais, gestores e outros profissionais interessados no conhecimento e nas ações da terapia ocupacional com pacientes com COVID-19 e seus familiares. Como ainda não existem estudos e revisões sistemáticas de evidências científicas relativas à terapia ocupacional na COVID-19, foram analisadas as melhores diretrizes e evidências disponíveis na literatura. Foi realizada uma ampla revisão de documentos nacionais e internacionais publicados sobre o tema, como artigos científicos e resoluções da Organização Mundial da Saúde e do Ministério da Saúde do Brasil. Foram também revisadas publicações disponibilizadas por sociedades ou organizações profissionais internacionais de terapia ocupacional, como a Federação Mundial de Terapeutas Ocupacionais, a Associação Americana dos Terapeutas Ocupacional, o Royal College of Occupational Therapists, do Reino Unido, e o Colegio Profesional de Terapeutas Ocupacionales de la Comunidad de Madrid, Espanha. RESULTADOS: As diretrizes reunidas nesta publicação não substituem as políticas institucionais e nacionais. Estão baseadas nos princípios da Ciência Ocupacional e nas melhores evidências disponíveis na literatura, balizadas pela experiência de todos os profissionais envolvidos na produção deste documento. Foram abordados temas como a privação ocupacional decorrente da pandemia e da estratégia de distanciamento social e os recursos técnicos recomendados para a promoção do desempenho ocupacional e manejo de dor e de sintomas em diferentes contextos, com destaque para a atuação do terapeuta ocupacional na atenção básica, na atenção hospitalar e nos cuidados paliativos. CONSIDERAÇÕES FINAIS: Dada a recente apresentação da COVID-19, há necessidade de constante atualização das informações e novas evidências científicas poderão ser publicadas. O raciocínio clínico é imprescindível para o planejamento e implementação da assistência aos pacientes e seus familiares ou cuidadores e será necessário o acompanhamento dos pacientes positivos para o SARS-CoV-2 para a verificação das consequências da COVID-19, das necessidades e demandas de reabilitação das pessoas acometidas, pós-hospitalização e pós-pandemia. (AU)

ABSTRACT: INTRODUCTION: COVID-19 is a highly contagious disease of a recent presentation, caused by the new coronavirus called SARS-CoV-2 because it belongs to the SARS family (Severe Acute Respiratory Syndrome). Scientifically grounded guidelines are needed on occupational therapists' interventions in caring for people with COVID-19 and on prospects for post-pandemic care. OBJECTIVE: To present guidelines and recommendations to occupational therapists on the clinical management of patients with COVID-19 at different levels of health care, to favor safe care with technical and scientific quality. METHOD: Ten occupational therapists from different Brazilian states, experts in their areas of expertise, met, through web conferences, to develop guidelines for the work of the occupational therapist in the pandemic of COVID-19. The target audience of these guidelines is composed of occupational therapists, managers, and other professionals interested in the knowledge and actions of Occupational Therapy with patients with COVID-19 and their families. As there are still no studies and systematic reviews of scientific evidence related to occupational therapy in COVID-19, the best guidelines and evidence available in the literature were analyzed. A wide review of national and international documents published on the subject, such as scientific articles and resolutions of the World Health Organization and the Ministry of Health of Brazil, was carried out. Publications made available by international occupational therapy societies or professional organizations, such as the World Federation of Occupational Therapists, the American Association of Occupational Therapists, the Royal College of Occupational Therapists from United Kingdom, and the Colegio Profesional de Terapeutas Ocupacionales de la Comunidad from Madrid, Spain. RESULTS: The guidelines in this publication do not replace institutional and national policies. They are based on the principles of Occupational Science and the best evidence available in the literature and the experience of all professionals involved in the production of this document. Topics such as occupational deprivation resulting from the pandemic and the strategy of social detachment and the technical resources recommended for the promotion of occupational performance and management of pain and symptoms in different contexts were addressed, with emphasis on the role of the occupational therapist in primary care, hospital care and palliative care. FINAL CONSIDERATIONS: Given the recent presentation of COVID-19, there is a need for constant updating of information, and new scientific evidence may be published. Clinical reasoning is essential for planning and implementing assistance to patients and their families or caregivers. It will be necessary to monitor patients who tested positive for SARS-CoV-2 to verify the consequences of COVID-19, their needs and demands of rehabilitation, post-hospitalization, and post-pandemic. (AU)

Intracellular adenosine released from THP-1 differentiated human macrophages is involved in an autocrine control of Leishmania parasitic burden, mediated by adenosine A2A and A2B receptors.

Leishmania infected macrophages have conditions to produce adenosine. Despite its known immunosuppressive effects, no studies have yet established whether adenosine alter Leishmania parasitic burden upon macrophage infection. This work aimed at investigating whether endogenous adenosine exerts an autocrine modulation of macrophage response towards Leishmania infection, identifying its origin and potential pharmacological targets for visceral leishmaniasis (VL), using THP-1 differentiated macrophages. Adenosine deaminase treatment of infected THP-1 cells reduced the parasitic burden (29.1 ± 2.2%, P < 0.05). Adenosine A2A and A2B receptor subtypes expression was confirmed by RT-qPCR and by immunocytochemistry and their blockade with selective adenosine A2A and A2B antagonists reduced the parasitic burden [14.5 ± 3.1% (P < 0.05) and 12.3 ± 3.1% (P < 0.05), respectively; and 24.9 ± 2.8% (P < 0.05), by the combination of the two antagonists)], suggesting that adenosine A2 receptors are tonically activated in infected THP-1 differentiated macrophages. The tonic activation of adenosine A2 receptors was dependent on the release of intracellular adenosine through equilibrative nucleoside transporters (ENT1/ENT2): NBTI or dipyridamole reduced (~25%) whereas, when ENTs were blocked, adenosine A2 receptor antagonists failed to reduce and A2 agonists increase parasitic burden. Effects of adenosine A2 receptors antagonists and ENT1/2 inhibitor were prevented by L-NAME, indicating that nitric oxide production inhibition prevents adenosine from increasing parasitic burden. Results suggest that intracellular adenosine, released through ENTs, elicits an autocrine increase in parasitic burden in THP-1 macrophages, through adenosine A2 receptors activation. These observations open the possibility to use well-established ENT inhibitors or adenosine A2 receptor antagonists as new therapeutic approaches in VL.

The Absence of HIF-1α Increases Susceptibility to Leishmania donovani Infection via Activation of BNIP3/mTOR/SREBP-1c Axis.

Hypoxia-inducible factor-1 alpha (HIF-1α) is considered a global regulator of cellular metabolism and innate immune cell functions. Intracellular pathogens such as Leishmania have been reported to manipulate host cell metabolism. Herein, we demonstrate that myeloid cells from myeloid-restricted HIF-1α-deficient mice and individuals with loss-of-function HIF1A gene polymorphisms are more susceptible to L. donovani infection through increased lipogenesis. Absence of HIF-1α leads to a defect in BNIP3 expression, resulting in the activation of mTOR and nuclear translocation of SREBP-1c. We observed the induction of lipogenic gene transcripts, such as FASN, and lipid accumulation in infected HIF-1α-/- macrophages. L. donovani-infected HIF-1α-deficient mice develop hypertriglyceridemia and lipid accumulation in splenic and hepatic myeloid cells. Most importantly, our data demonstrate that manipulating FASN or SREBP-1c using pharmacological inhibitors significantly reduced parasite burden. As such, genetic deficiency of HIF-1α is associated with increased lipid accumulation, which results in impaired host-protective anti-leishmanial functions of myeloid cells.

Autosomal recessive hyper-IgE syndrome successfully treated with hematopoietic stem cell transplantation.

Autosomal recessive hyper-IgE syndrome is a primary immunodeficiency that results from a mutation in the DOCK8 gene. We report a case of a patient presenting with severe eczema, atopy, and recurrent skin infections since the first months of life. The diagnosis of autosomal recessive hyper-IgE syndrome was made at the age of 7 by a positive DOCK8 genetic test. The patient underwent hematopoietic stem cell transplantation, with complete remission of the various manifestations.

Evaluating the Role of Host AMPK in Leishmania Burden.

The study of host AMP-activated protein kinase (AMPK) activation during Leishmania infection imposes distinct types of techniques to measure protein expression and activation, as well as to quantify, at transcription and translational levels, its downstream targets. The investigation of host AMPK protein modulation during Leishmania infection should primarily be assessed during in vitro infections using as a host murine bone marrow-derived macrophages (BMMos). The infection outcome is assessed measuring the percentage of infected cells in the context of BMMos. To evaluate AMPK activity during infection, the expression of AMPK phosphorylated at Thr172 as well as the transcription and translational levels of its downstream targets are evaluated by quantitative PCR and immunoblotting. The modulation of AMPK activity in vivo is determined specifically in sorted splenic macrophages harboring Leishmania parasites recovered from infected mice using fluorescent-labeled parasites in the infectious inocolum. The modulation of AMPK activity was assessed by AMPK activators and inhibitors and also using AMPK, SIRT1, or LKB1 KO mice models. The infection outcome in BMMos and in vivo was further determined using these two different approaches. To finally understand the metabolic impact of AMPK during infection, in vitro metabolic assays in infected BMMos were measured in the bioenergetic profile using an extracellular flux analyzer.

When an Unexpected Diagnosis Occurs: a Vaginal Premenopausal Sarcoma.

Vaginal cancer is a rare entity. The evidence on its management resides mostly in clinical cases or small case series. Of the histological types, the most frequent is the squamous cell carcinoma, followed by adenocarcinoma. But what to do when identifying an even more infrequent sarcoma in a premenopausal woman? In this study, we describe the case of a 53-year-old woman presenting with metrorrhagia for two months, who was evaluated after an intense episode. A necrotic and ulcerative vaginal swelling was documented and then submitted to biopsy, which revealed a vaginal sarcoma. The patient was referred to radiation therapy with 50 Gy (aiming to control the symptoms and to cause tumor reduction for posterior pelvic exenteration with intraoperative radiotherapy) and developed an extra-pelvic metastization at the end of the treatment, which caused a fast negative outcome. Despite the initial poor prognosis, a chemo-irradiation or primary surgery regimen might have achieved (although with greater side effects) a better survival. This case-report entails a discussion about the strategies to manage vaginal sarcoma in advanced stage and in premenopausal women.

O cancro vaginal é uma doença rara. A evidência para a sua abordagem reside fundamentalmente em casos clínicos ou pequenas séries de casos. Dentre os tipos de cancro histológicos, o mais frequente é o carcinoma espinocelular, seguido do adenocarcinoma. Mas o que fazer em presença de um sarcoma ainda mais raro numa mulher pré-menopáusica? No presente estudo, descrevemos o caso de uma mulher de 53 anos apresentando metrorragia por dois meses, avaliada após um episódio intenso. Foi então documentada uma tumefacção vaginal necrótica e ulcerativa, submetida a biópsia, que revelou um sarcoma vaginal. A paciente foi encaminhada para radioterapia com 50 Gy (com os objetivos de controlo da sintomatologia e de redução tumoral para posterior exenteração pélvica com radioterapia intraoperatória) e desenvolveu, ao final do tratamento, um quadro de mestastização extra pélvica, que ocasionou um desfecho negativo rápido. Apesar do mau prognóstico inicial, um esquema de quimiorradiação ou cirurgia primária poderiam ter alcançado (ainda que com maiores efeitos laterais) uma maior sobrevivência. Este estudo de caso aborda uma discussão sobre as estratégias de abordagem do sarcoma vaginal em estádios avançados e na mulher pré-menopáusica.

When an unexpected diagnosis occurs: a vaginal premenopausal sarcoma / Quando um diagnóstico inesperado ocorre: um sarcoma vaginal na pré-menopausa

Abstract Vaginal cancer is a rare entity. The evidence on its management resides mostly in clinical cases or small case series. Of the histological types, the most frequent is the squamous cell carcinoma, followed by adenocarcinoma. But what to do when identifying an even more infrequent sarcoma in a premenopausal woman? In this study, we describe the case of a 53-year-old woman presenting with metrorrhagia for two months, who was evaluated after an intense episode. A necrotic and ulcerative vaginal swelling was documented and then submitted to biopsy, which revealed a vaginal sarcoma. The patient was referred to radiation therapy with 50 Gy (aiming to control the symptoms and to cause tumor reduction for posterior pelvic exenteration with intraoperative radiotherapy) and developed an extra-pelvic metastization at the end of the treatment, which caused a fast negative outcome. Despite the initial poor prognosis, a chemo-irradiation or primary surgery regimen might have achieved (although with greater side effects) a better survival. This case-report entails a discussion about the strategies to manage vaginal sarcoma in advanced stage and in premenopausal women.

Resumo O cancro vaginal é uma doença rara. A evidência para a sua abordagem reside fundamentalmente em casos clínicos ou pequenas séries de casos. Dentre os tipos de cancro histológicos, o mais frequente é o carcinoma espinocelular, seguido do adenocarcinoma. Mas o que fazer em presença de um sarcoma ainda mais raro numa mulher pré-menopáusica? No presente estudo, descrevemos o caso de uma mulher de 53 anos apresentando metrorragia por dois meses, avaliada após um episódio intenso. Foi então documentada uma tumefacção vaginal necrótica e ulcerativa, submetida a biópsia, que revelou um sarcoma vaginal. A paciente foi encaminhada para radioterapia com50 Gy (comos objetivos de controlo da sintomatologia e de redução tumoral para posterior exenteração pélvica com radioterapia intraoperatória) e desenvolveu, ao final do tratamento, umquadro demestastização extra pélvica, que ocasionou um desfecho negativo rápido. Apesar do mau prognóstico inicial, um esquema de quimiorradiação ou cirurgia primária poderiam ter alcançado (ainda que com maiores efeitos laterais) uma maior sobrevivência. Este estudo de caso aborda uma discussão sobre as estratégias de abordagem do sarcoma vaginal em estádios avançados e na mulher pré-menopáusica.

Estudio epidemiológico, observacional, transversal sobre el efecto de la nutrición parenteral en niños con comorbilidades con menos de 1,500 gramos y más 1,500 gramos de la unidad de cuidados intensivos neonatales del hospital gineco obstétrico de nueva aurora "luz elena arismendi" y "hospital matilde hidalgo de procel" en el año 2018 / Estudio epidemiológico, observacional, transversal sobre el efecto de la nutrición parenteral en niños con comorbilidades con menos de 1,500 gramos y más 1,500 gramos en la unidad de cuidados intensivos neonatales del hospital obstétrico de la nueva aurora "luz elena arismendi" y "hospital matilde hidalgo de procel "en el año 2018

Contexto: Los neonatos son susceptibles de adquirir déficits de macronutrientes por sus bajas reservas de glucógeno y grasa combinadas con mayores requerimientos de energía y proteínas para sostener su crecimiento. Por lo tanto, se recomienda el uso macronutrientes. Los beneficios del uso de nutrición parenteral incluyen un mejor equilibrio del nitrógeno, anabolismo y crecimiento, mejor control de la hiperglucemia y tasas reducidas de retinopatía del prematuro (ROP) y enterocolitis necrotizante. La NT temprana proporcionó beneficios para resultados a corto plazo sin evidencia de aumento de la morbilidad y mortalidad. Propósito: Determinar la evolución clínica y antropométrica de los neonatos con peso < 1500 gramos y > de 1500 gramos que recibieron alimentación parenteral en el servicio de neonatología del Hospital Gineco-obstétrico Luz Elena Arismendi y Hospital Matilde hidalgo de Procel. Sujetos y métodos: Diseño observacional, epidemiológico, transversal con 2 cohortes. El tipo de muestreo será propositivo debido que tenemos criterios de selección de muestra. Se llevó a cabo con 107 pacientes, total 214 pacientes. Resultados y Conclusiones: La recuperación del peso, talla y PC de los neonatos >1500 gramos y menores de 1500 gramos que recibieron nutrición parenteral presentó un incremento en ambos grupos, llegando a estabilizarse a partir del día 14. Observándose en relación a la talla un ligero incremento en los pacientes con un peso >1500 gramos, siendo la complicación más frecuente en ambos grupos.

Context: Neonates are susceptible to macronutrient deficits due to their low glycogen and fat reserves combined with higher energy and protein requirements for their growth. Therefore, the use of macronutrients is recommended. The benefits of using NT include better nitrogen balance, anabolism and growth, better control of hyperglycemia, and reductions in retinopathy of prematurity and necrotising enterocolitis. Of morbidity and mortality. Purpose: To determine the clinical and anthropometric evolution of neonates weighing <1500 grams and> 1500 grams that provide a parenteral feeding in the neonatology service of the Gineco-obstetric hospital Luz Elena Arismendi and Hospital Matilde Hidalgo de Procel. Subjects and methods: Observational, epidemiological, cross-sectional design with 2 cohorts.The type of sampling will be proactive because we have sample selection criteria. For the purposes of this study, a total of 107 patients were included, a total of 214 patients. Results and conclusions: The recovery of weight, height and CP of neonates> 1500 grams and those less than 1500 grams that respond to parenteral care. reaching a stabilization from day 14. Observing in relation to height a slight increase in patients with a weight> 1500 grams, being the most frequent complication in both groups cholestasis.

ANÁLISIS DEL MÉTODO MADRE CANGURO EN RECIÉN NACIDOS PREMATUROS MENORES DE 36 SEMANAS Y MENORES DE 2500 GRAMOS HOSPITALIZADOS EN LA UNIDAD DE CUIDADOS INTENSIVOS NEONATALES DEL HOSPITAL GINECO OBSTÉTRICO DE NUEVA AURORA "LUZ ELENA ARISMENDI" Y "HOSPITAL MATILDE HIDALGO DE PROCEL" EN EL AÑO 2018 / Analysis of the kangaroo mother method in preterm infants under 36 weeks and under 2500 grams hospitalized in the neonatal intensive care unit of the New Aurora obstetric gynecological hospital "Luz Elena Arismendi" and "Hospital Matilde Hidalgo de Procel" in 2018

Contexto: A nivel mundial más de 15 millones de niños nacen prematuros y 1 millón de muertes se dan como resultado directo de las complicaciones del parto prematuro y cuanto más inmaduro es el neonato, más lenta es la recuperación de la pérdida de peso. La estimulación cinestésica en posición con el método madre canguro evidencia mejor ganancia en peso y longitud. El método mejora las tasas de lactancia materna, disminuye los requerimientos neonatales y complicaciones. Propósito: Analizar los beneficios del método madre canguro en prematuros y menores de 2500 gramos hospitalizados en Unidad de Cuidados Intensivos Neonatales del Hospital Gineco Obstétrico Nueva Aurora "Luz Elena Arismendi" y el Hospital Matilde Hidalgo de Procel en 2018. Sujetos y métodos: Diseño observacional, epidemiológico, transversal de 2 cohortes: posición canguro versus los que se encuentran en incubadoras. El estudio se limitó 212 neonatos para el análisis la muestra se distribuyó en partes iguales 106 neonatos de cada cohorte. Resultados y Conclusiones: El rango de edad gestacional en los grupos de investigación mayoritario fueron 32 a 36 semanas 66,98% en grupo de madre canguro y 46,23% incubadora. El método madre canguro se relaciona de hospitalización 7 días, la disminución de requerimientos de oxígeno, ausencia de sepsis clínica y disminución de la necesidad alimentación parenteral, peso >1.500 gr, talla >40 cm y PC >30 cm. Por lo cual es considerado un método eficaz de cuidados neonatales y neonatos de bajo peso en países de recursos bajos

Context: Worldwide more than 15 million children born preterm and 1 million deaths as a direct result of the complications of preterm birth and the more in the newborn the newborn, the slower the recovery of weight loss, the kinesthetic estimation in position with the kangaroo mother method shows better gain in weight and length. The method of improving breastfeeding rates, neonatal requirements and complications. Purpose: To analyze the benefits of the mother method in preterm infants and under 2500 grams hospitalized in the Neonatal Intensive Care Unit of the Nueva Aurora Obstetrician Gynecology Hospital "Luz Elena Arismendi" and the Matilde Hidalgo Hospital in Procel in 2018. Subjects and methods: Observational Design, Epidemiological, transversal of 2 cohorts: kangaroo position versus those found in incubators. The study was limited to 212 infants from each cohort. Results and Conclusions: gestational age range in the major research groups were 32 to 36 weeks 66.98% in the kangaroo mother group and 46.23% incubator. The kangaroo mother method is related to hospitalization 7 days, the decrease in oxygen needs, the absence of clinical sepsis and the decrease in the need for parenteral feeding, weight> 1,500 gr, height> 40 cm and PC> 30 cm. So it is considered an effective method of neonatal care and low birth weight infants in low resource countries.

Infection of hematopoietic stem cells by Leishmania infantum increases erythropoiesis and alters the phenotypic and functional profiles of progeny.

Immunosuppression is a well-established risk factor for Visceral Leishmaniasis. Post-immunosuppression leishmaniasis is characterized by an increase of parasite burden, hematopoietic disorders and unusual clinical manifestations. Although there are many reports on bone marrow findings in VL, less is known about the relationship between parasite dynamics in this organ and the function of either hematopoietic stem cells and progenitor cells themselves. In the present study, we tackle these issues using a new approach of infecting human stem cells derived from bone marrow with L. infantum. Using this strategy, we show that human hematopoietic stem cells (hHSC) are able to phagocytize L. infantum promastigotes and release modulatory and pro-inflammatory cytokines, mainly TNF-α. Our results demonstrated that L. infantum infection in vitro enhances hematopoiesis, favoring the development of erythrocitic lineage through a mechanism yet unknown. Moreover, we found that L. infantum infection alters the phenotypic profile of the hematopoietic progeny; modifying the surface markers expression of differentiated cells. Thus, our study represents a rare opportunity to monitor the in vitro differentiation of human stem cells experimentally infected by L. infantum to better understand the consequences of the infection on phenotypic and functional profile of the cell progeny.

Isomerismo derecho (síndrome de ivemark): presentación de un caso / Right isomerism (ivemark syndrome): presentation of a case

El Síndrome de Ivemark se clasifica como un trastorno de Heterotaxia o un trastorno de lateralidad de baja incidencia, que debuta con manifestaciones clínicas caracterizados por latidos cardiacos a la derecha y asplenia entre otras malformaciones, se puede asociar a un patrón de herencia autosómico recesivo que es el más frecuente. Se destaca que entre las malformaciones más frecuentes del aparato digestivo se encuentra la mal rotación intestinal la cual fue descartada y los signos de distensión abdominal y mala tolerancia alimentaria se debió a la descompensación gradual del paciente. El diagnóstico prenatal mediante la ecocardiografía es pieza clave en el manejo posterior del paciente, debido que permite programar su nacimiento en centros de III nivel, por su alta complejidad y requerimiento de cirugía cardiotorácica, el manejo terapéutico de asplenia determina el pronóstico del paciente.

The Ivemark Syndrome is classified as a Heterotaxia disorder or a low incidence laterality disorder, which debuts with the clinical characteristics for right heartbeats and asplenia among other malformations, it can be associated with an autosomal recessive inheritance pattern that is the most frequent It is emphasized that the most frequent, malformations of the digestive system are in the phase of abdominal rotation that the discarded and the signs of abdominal distension and food intolerance were due to the gradual decompensation of the patient. Prenatal diagnosis through echocardiography is the key to the management of the birth of the patient, which allows to schedule its birth in the centers of III level, for its high complexity and requirement of cardiothoracic surgery, the therapeutic management of Asplenia determines the prognosis of the patient.

Bioactive packaging using antioxidant extracts for the prevention of microbial food-spoilage.

Bioactive food packaging is an innovative approach for the prevention of the growth of food-spoilage microorganisms. Four active extracts from agroindustrial subproducts (Eucalyptus wood, almond shells, corn cobs and grape pomace) with demonstrated antioxidant activity have been investigated for bestowing antimicrobial activity to bioactive packaging. To carry out this evaluation, the antioxidant extracts were tested against five food pathogenic bacteria, namely, Escherichia coli, Pseudomonas aeruginosa, Listeria monocytogenes, Staphylococcus aureus and Salmonella spp. The results obtained showed that all the tested extracts inhibited the growth of all five pathogenic bacteria. From the analysis of the minimal bactericidal concentrations (MBCs), the Eucalyptus wood extract was the most active, being necessary only 2% (v/v) to inhibit Pseudomonas aeruginosa, Listeria monocytogenes, and Staphylococcus aureus, whereas almond shells extract were less active requiring 4% (w/v) to inhibit the growth of Escherichia coli and Pseudomonas aeruginosa and the extract from corn cobs was bactericidal against Escherichia coli and Staphylococcus aureus at a concentration of 4% (w/v). After checking their antimicrobial activity, the antioxidant extracts have been incorporated into sodium alginate films and the maintenance of their antimicrobial properties was confirmed. This work showed that the antioxidant extracts from agroindustrial byproducts exhibited antimicrobial activity and were suitable for incorporation into edible films that could be used in bioactive packaging systems.