Suprahepatic Cava Thrombus Due to Wilms Tumor: Technique Without Cardiopulmonary Bypass.

Wilms tumor is a frequent malignant neoplasia in pediatric population. Extension to the inferior vena cava is a complication that occurs in approximately 4%-15% of cases. Surgical techniques derived from the field of adult transplant surgery allow the resection of the tumor with its thrombus extension. In the case of a 6-year-old male patient with a stage III Wilms tumor that originated from the left renal vein, thrombectomy and left radical nephroureterectomy were accomplished without extracorporeal circulation. Surgical technique applied in adult transplant surgery for removal of advanced renal tumors, could be a safe and feasible technique in pediatric population.

A Long-Amplicon Viability-qPCR Test for Quantifying Living Pathogens that Cause Bacterial Spot in Tomato Seed.

Bacterial spot is one of the most serious diseases of tomato. It is caused by four species of Xanthomonas: X. euvesicatoria, X. gardneri, X. perforans, and X. vesicatoria. Contaminated or infected seed can be a major source of inoculum for this disease. The use of certified pathogen-free seed is one of the primary management practices to reduce the inoculum load in commercial production. Current seed testing protocols rely mainly on plating the seed extract and conventional PCR; however, the plating method cannot detect viable but nonculturable cells, and the conventional PCR assay has limited capability to differentiate DNA extracted from viable or dead bacterial cells. To improve the sensitivity and specificity of the tomato seed testing method for bacterial spot pathogens, a long-amplicon quantitative PCR (qPCR) assay coupled with propidium monoazide (PMA-qPCR) was developed to quantify selectively the four pathogenic Xanthomonas species in tomato seed. The optimized PMA-qPCR procedure was evaluated on pure bacterial suspensions, bacteria-spiked seed extracts, and seed extracts of inoculated and naturally infected seed. A crude DNA extraction protocol also was developed, and PMA-qPCR with crude bacterial DNA extracts resulted in accurate quantification of 104 to 108 CFU/ml of viable bacteria when mixed with dead cells at concentrations as high as 107 CFU/ml in the seed extracts. With DNA purified from concentrated seed extracts, the PMA-qPCR assay was able to detect DNA of the target pathogens in seed samples spiked with ≥75 CFU/ml (about 0.5 CFU/seed) of the viable pathogens. Latent class analysis of the inoculated and naturally infected seed samples showed that the PMA-qPCR assay had greater sensitivity than plating the seed extracts on the semiselective modified Tween Medium B and CKTM media for all four target species. Being much faster and more sensitive than dilution plating, the PMA-qPCR assay has potential to be used as a standalone tool or in combination with the plating method to improve tomato seed testing and advance the production of clean seed.

Lactoferrin and Its Derived Peptides: An Alternative for Combating Virulence Mechanisms Developed by Pathogens.

Due to the emergence of multidrug-resistant pathogens, it is necessary to develop options to fight infections caused by these agents. Lactoferrin (Lf) is a cationic nonheme multifunctional glycoprotein of the innate immune system of mammals that provides numerous benefits. Lf is bacteriostatic and/or bactericidal, can stimulate cell proliferation and differentiation, facilitate iron absorption, improve neural development and cognition, promote bone growth, prevent cancer and exert anti-inflammatory and immunoregulatory effects. Lactoferrin is present in colostrum and milk and is also produced by the secondary granules of polymorphonuclear leukocytes, which store this glycoprotein and release it at sites of infection. Lf is also present in many fluids and exocrine secretions, on the surfaces of the digestive, respiratory and reproductive systems that are commonly exposed to pathogens. Apo-Lf (an iron-free molecule) can be microbiostatic due to its ability to capture ferric iron, blocking the availability of host iron to pathogens. However, apo-Lf is mostly microbicidal via its interaction with the microbial surface, causing membrane damage and altering its permeability function. Lf can inhibit viral entry by binding to cell receptors or viral particles. Lf is also able to counter different important mechanisms evolved by microbial pathogens to infect and invade the host, such as adherence, colonization, invasion, production of biofilms and production of virulence factors such as proteases and toxins. Lf can also cause mitochondrial and caspase-dependent regulated cell death and apoptosis-like in pathogenic yeasts. All of these mechanisms are important targets for treatment with Lf. Holo-Lf (the iron-saturated molecule) can contain up to two ferric ions and can also be microbicidal against some pathogens. On the other hand, lactoferricins (Lfcins) are peptides derived from the N-terminus of Lf that are produced by proteolysis with pepsin under acidic conditions, and they cause similar effects on pathogens to those caused by the parental Lf. Synthetic analog peptides comprising the N-terminus Lf region similarly exhibit potent antimicrobial properties. Importantly, there are no reported pathogens that are resistant to Lf and Lfcins; in addition, Lf and Lfcins have shown a synergistic effect with antimicrobial and antiviral drugs. Due to the Lf properties being microbiostatic, microbicidal, anti-inflammatory and an immune modulator, it represents an excellent natural alternative either alone or as adjuvant in the combat to antibiotic multidrug-resistant bacteria and other pathogens. This review aimed to evaluate the data that appeared in the literature about the effects of Lf and its derived peptides on pathogenic bacteria, protozoa, fungi and viruses and how Lf and Lfcins inhibit the mechanisms developed by these pathogens to cause disease.

Inhibition of ß-amyloid Aggregation of Ugni molinae Extracts.

The ß-amyloid peptide (1-42) is a molecule capable of aggregating into neurotoxic structures that have been implicated as potential etiological factors of Alzheimer's Disease. The aim of this study was to evaluate the inhibition of ß-amyloid aggregation of ethyl acetate and ethanolic extracts obtained from Ugni molinae leaves on neurotoxic actions of ß-amyloid aggregates. Chemical analyses were carried out with the extracts in order to determine their phenolic profile and its quantification. Both extracts showed a tendency to reduce neuronal deaths caused by ß-amyloid. This tendency was inversely proportional to the evaluated concentrations. Moreover, the effect of EAE and ETE on ß-amyloid aggregation was studied by fluorimetric T Thioflavin assay and transmission electronic microscopy (TEM); the extracts showed a modulation in the aggregation process. Partly, it is believed that these effects can be attributed to the polyphenolic compounds present in the extracts.

Manejo no farmacológico del dolor en la atención del parto: experiencia desde las prácticas formativas / Non-pharmacological pain management in childbirth care: an experience from educational internship / Manejo não farmacológico da dor no atendimento do parto: experiência baseada nas práticas formativas

Resumen Introducción Describir las percepciones del estudiante de enfermería de una universidad privada, sobre la experiencia en la aplicación de las medidas no farmacológicas para el manejo del dolor en la atención del parto en el componente teórico y práctico. Materiales y Métodos Investigación cualitativa, con técnica de grupo focal, se utilizó entrevista semiestructurada y se organizaron dos grupos focales en el que participación 16 estudiantes de los cursos de V a VIII semestre matriculados durante el primer periodo del 2018. Resultados De los participantes, el 62.5% fueron mujeres y el 37.5% fueron hombres, la edad promedio fue 24.4 años (6.6%). Del análisis de las narrativas del grupo focal emergieron 2 categorías y 10 subcategorías definitivas: dentro de las categorías se destaca que los participantes identifican medidas no farmacológicas que se presentan en el componente teórico, pero no todas se logran realizar en los escenarios de práctica formativa, también surge inquietudes respecto a los mínimos insumos requeridos para conformar un kit para la realización de las medidas no farmacológicas para el manejo del dolor. Discusión A partir de los artículos investigados y el análisis realizado varios autores definen diferentes medidas no farmacológicas que son aplicables a la materna siendo estas efectivas y las cuales los estudiantes de enfermería aplican en su mayoría teniendo como resultado aspectos positivos y a mejorar. Conclusiones En general todos los participantes reconocen la importancia del uso de las medidas no farmacológicas para el manejo del dolor en la gestante durante la atención del parto, e identifican que estas medidas disminuyen la intensidad del dolor, ayudan disminuir el tiempo del trabajo de parto, y facilita la comunicación entre el personal de enfermería y la gestante.

Abstract Introduction To describe the perceptions of private-university nursing students on the experience from the implementation of non-pharmacological methods to manage pain in childbirth care in the theoretical and practical components. Materials and Methods Qualitative research with focus group technique; a semi-structured interview was used, and two focus groups were created with 16 students from 5-to-7-semester courses enrolled during the first term of 2018. Results 62.5% of the participants were women and 37.5% were men; the average age was 24.4 (6.6%). 2 categories and 10 subcategories emerged upon analyzing the narratives of the focus group. It is worth mentioning about the categories that the participants identify non-pharmacological methods present in the theoretical component, but not all methods can be implemented in educational internship scenarios; concerns also arose about the minimum inputs required to develop a kit for the implementation of non-pharmacological methods to manage pain. Discussion Based on the researched articles and the analysis performed, several authors established different non-pharmacological methods that are effective and applicable to mothers; nursing students apply such methods and generally obtain positive outcomes and lessons for improvement. Conclusions In general, all participants recognize the importance of using non-pharmacological methods to manage pain in pregnant women during childbirth care, and they also identify that these methods reduce pain intensity, help reducing the length of labor, and facilitate communication between nursing staff and pregnant women.

Resumo Introdução Descrever as percepções do estudante de enfermagem de uma universidade privada, sobre a experiência na aplicação das medidas não farmacológicas para o manejo da dor no atendimento do parto no componente teórico e prático. Materiais e Métodos Pesquisa qualitativa, com técnica de grupo focal, foi utilizado o método de entrevista semiestructurada e organizaram-se dois grupos focais onde participaram 16 estudantes dos cursos de V a VIII semestre matriculados durante o primeiro período de 2018. Resultados Dos participantes, 62,5% foram mulheres e 37,5% foram homens, a idade média foi de 24,4 anos (6,6%). A partir da análise das narrativas do grupo focal surgiram duas categorias e 10 subcategorias definitivas: dentro das categorias destaca-se que os participantes identificam medidas não farmacológicas que se apresentam no componente teórico, mas não todas são realizáveis no âmbito da prática formativa, também surgem inquietudes a respeito dos insumos mínimos requeridos para conformar um kit para a aplicação das medidas não farmacológicas para o manejo da dor. Discussão Com base nos artigos pesquisados e conforme a análise realizada, vários autores definem diferentes medidas não farmacológicas que são aplicáveis à materna sendo elas medidas efetivas que os estudantes de enfermagem aplicam predominantemente produzindo como resultado aspectos positivos e de melhora. Conclusões Em geral, todos os participantes reconhecem a importância do uso das medidas não farmacológicas para o manejo da dor na gestante durante o atendimento do parto e identificam que estas medidas diminuem a intensidade da dor, ajudam a diminuir o tempo do trabalho de parto, e facilita a comunicação entre o pessoal de enfermagem e a gestante.

The Ethyl Acetate Extract of Leaves of Ugni molinae Turcz. Improves Neuropathological Hallmarks of Alzheimer's Disease in Female APPswe/PS1dE9 Mice Fed with a High Fat Diet.

The most common type of dementia is Alzheimer's disease (AD), a progressive neurodegenerative disease characterized by impairment in cognitive performance in aged individuals. Currently, there is no effective pharmacological treatment that cures the disease due to the lack of knowledge on the actual mechanisms involved in its pathogenesis. In the last decades, the amyloidogenic hypothesis has been the most studied theory trying to explain the origin of AD, yet it does not address all the concerns relating to its development. In the present study, a possible new preclinical treatment of AD was evaluated using the ethyl acetate extract (EAE) of leaves of Ugni molinae Turcz. (synonym Myrtus ugni Molina Family Myrtacea). The effects were assessed on female transgenic mice from a preclinical model of familial AD (APPswe/PS1dE9) combined with a high fat diet. This preclinical model was selected due to the already available experimental and observational data proving the relationship between obesity, gender, metabolic stress, and cognitive dysfunction; related to characteristics of sporadic AD. According to chemical analyses, EAE would contain polyphenols such as tannins, flavonoid derivatives, and phenolic acids, as well as pentacyclic triterpenoids that exhibit neuroprotective, anti-inflammatory, and antioxidant effects. In addition, the treatment evidenced its capacity to prevent deterioration of memory capacity and reduction of progression speed of AD neuropathology.

Anti-inflammatory, antinociceptive and antioxidant properties of Schinopsis brasiliensis bark.

ETHNOPHARMACOLOGICAL RELEVANCE: Schinopsis brasiliensis is a native plant from Brazil, popularly used in folk medicine to relieve pain and treat inflammation. This study evaluated the antinociceptive and anti-inflammatory activities and antioxidant properties of the hydroethanol extract (HEE) and ethyl acetate fraction (EAF) obtained from S. brasiliensis bark. MATERIALS AND METHODS: The HEE and EAF of S. brasiliensis bark (10, 30 and 100mg/kg, p.o.) were evaluated using models of analgaesia (formalin-induced licking and hot-plate models) or inflammation (licking response by formalin-induced and carrageenan-induced cell migration into the subcutaneous air pouch). The antioxidant activities of HEE and EAF (50, 100 and 200µg/ml) were evaluated using the lipoperoxidation method induced in egg yolk by 2'-azobis(2-amidinopropane) dihydrochloride (AAPH) and FeSO4. RESULTS: HEE and EAF presented a central antinociceptive effect (at 100mg/kg dose), increasing the baseline and area under the curve in the hot plate model. EAF (100mg/kg) significantly reduced (p< 0.005) the pain response in the first (45%) and second (35%) phases of the formalin-induced licking model, while HEE (100mg/kg) reduced (38%) only the pain response in the second phase. Regarding anti-inflammatory activity, EAF (100mg/kg) also inhibited the inflammatory process induced by subcutaneous carrageenan injection in the SAP model, reducing the amount of the cytokine TNF-α produced. CONCLUSION: HEE and EAF from S. brasiliensis bark show pharmacological interest because they were able to inhibit the peripheral and central transmission of pain. Our data also suggest that the anti-inflammatory activity caused by EAF exposure occurs through the inhibition of the pro-inflammatory cytokine TNF-α, also reducing the spreading of the inflammatory processes by neutralizing reactive oxygen species, which are by-products in the biosynthesis of pain mediators.

Ceftaroline fosamil monotherapy for methicillin-resistant Staphylococcus aureus bacteremia: a comparative clinical outcomes study.

OBJECTIVES: Vancomycin is the treatment of choice for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia; however, its use has been subject to scrutiny due to failure in severe infections. Ceftaroline fosamil (CPT-F) is approved for MRSA acute bacterial skin and skin structure infections, but not for bloodstream infections. The clinical outcomes of treatment with CPT-F in patients with MRSA bacteremia were evaluated. METHODS: Patients diagnosed with MRSA bacteremia at Henry Ford Hospital in Detroit, Michigan, USA, involving isolates with a vancomycin minimum inhibitory concentration ≥1.0mg/l and susceptible in vitro to CPT-F, were systematically reviewed retrospectively. Ceftaroline fosamil-treated patients were matched with at least two vancomycin- and/or one daptomycin-treated control patient based on age-patients age 65 years or greater or less than 65 years of age. Outcomes evaluated included the duration of hospitalization, duration of therapy, adverse events, relapse, hospital readmission, and death. RESULTS: Thirty consecutive cases of MRSA bacteremia treated with CPT-F during the period May 2011 to June 2013 were identified; these patients were matched to 56 MRSA bacteremia patients treated with vancomycin and 46 MRSA bacteremia patients treated with daptomycin. The primary source of MRSA bacteremia in the cohort treated with CPT-F was endocarditis (n=7, 23%), skin/wound (n=9, 30%), and bone/joint (n=8, 27%). The MRSA bacteremia in those treated with CPT-F was community-acquired in 43% of cases, healthcare-associated in 43%, and hospital-acquired in 13%. The mean length of hospital stay for these patients was 22 days. The overall 30-day mortality rate was 13% (n=4) in CPT-F patients versus 24% (n=11) in daptomycin patients and 11% (n=6) in vancomycin patients (p=0.188). CONCLUSIONS: CPT-F demonstrated comparable clinical outcomes in MRSA bacteremia patients compared with the other agents, especially as salvage therapy.

Ateneo General de la Residencia de Psicopedagogía: ¿Quién ser y qué hacer en el Siglo XXI? Adolescentes en el espacio de Orientación Vocacional Ocupacional / General athenaeum of the Psychopedagogy Residence: Who to be and what to do in the 21st century? Adolescents in the occupational vocational guidance space

Ateneo del equipo de residentes de Psicopedagogía del Hospital D. Vélez Sarsfield de la Ciudad de Buenos Aires. Ante la disminución en las demandas de adolescentes por un proceso de Orientación Vocacional Ocupacional, surgieron interrogantes como eje de este trabajo: ¿Por qué son cada vez menos los adolescentes que se acercan al Área Programática del hospital en busca de un proceso de Orientación Vocacional Ocupacional? ¿Cuánta influencia tiene el contexto, los pares y la familia a la hora de elegir una vocación / ocupación? ¿Cuál es el rol de la escuela? ¿Guarda todo esto alguna relación con los tiempos actuales? ¿De qué manera? Incluye bibliografía y los anexos: Compendio de técnicas para Orientación Vocacional, y Encuestas realizadas a jóvenes que se encuentran finalizado o ya han finalizado la escuela secundaria.

Abscisic acid is involved in the response of grape (Vitis vinifera L.) cv. Malbec leaf tissues to ultraviolet-B radiation by enhancing ultraviolet-absorbing compounds, antioxidant enzymes and membrane sterols.

We investigated the interactions of abscisic acid (ABA) in the responses of grape leaf tissues to contrasting ultraviolet (UV)-B treatments. One-year-old field-grown plants of Vitis vinifera L. were exposed to photosynthetically active radiation (PAR) where solar UV-B was eliminated by using polyester filters, or where PAR was supplemented with UV-B irradiation. Treatments combinations included weekly foliar sprays of ABA or a water control. The levels of UV-B absorbing flavonols, quercetin and kaempferol were significantly decreased by filtering out UV-B, while applied ABA increased their content. Concentration of two hydroxycinnamic acids, caffeic and ferulic acids, were also increased by ABA, but not affected by plus UV-B (+UV-B) treatments. Levels of carotenoids and activities of the antioxidant enzymes, catalase, ascorbate peroxidase and peroxidase were elevated by +ABA treatments, but only if +UV-B was given. Cell membrane beta-sitosterol was enhanced by ABA independently of +UV-B. Changes in photoprotective compounds, antioxidant enzymatic activities and sterols were correlated with lessened membrane harm by UV-B, as assessed by ion leakage. Oxidative damage expressed as malondialdehyde content was increased under +UV-B treatments. Our results suggest that the defence system of grape leaf tissues against UV-B is activated by UV-B irradiation with ABA acting downstream in the signalling pathway.