Increase of Diversity of Mumps Virus Genotype G SH Variants Circulating Among a Highly Immunized Population: Spain, 2007-2019.

MuV caused three epidemic waves in Spain since genotype G emerged in 2005, despite high vaccination coverage. SH gene sequencing according to WHO protocols allowed the identification of seven relevant variants and 88 haplotypes. While the originally imported MuVi/Sheffield.GBR/1.05/-variant prevailed during the first two waves, it was subsequently replaced by other variants originated by either local evolution or importation, according to the additional analysis of hypervariable NCRs. The time of emergence of the MRCA of each MuV variant clade was concordant with the data of the earliest sequence. The analysis of Shannon entropy showed an accumulation of variability on six particular positions as the cause of the increase on the number of circulating SH variants. Consequently, SH gene sequencing needs to be complemented with other more variable markers for mumps surveillance immediately after the emergence of a new genotype, but the subsequent emergence of new SH variants turns it unnecessary.

Agreements and uncertainties in autologous haematopoietic stem cell mobilization and collection. A Spanish consensus document.

Although many experts position statements on autologous stem cell mobilization have been published, there are some aspects that are still under discussion. A Spanish Hematologist expert group was summoned to settle on agreements and uncertainties on PBSCs mobilization, including factors not always considered; as apheresis and cytometry key factors that determine a successful PBSC collection. This document reviews critical factors that define poor mobilizer patients and the tools to better collect the desired stem cells for a successful autologous haematopoietic stem cell transplant.

Association of a single nucleotide polymorphism in the ubxn6 gene with long-term non-progression phenotype in HIV-positive individuals.

OBJECTIVES: The long-term non-progressors (LTNPs) are a heterogeneous group of HIV-positive individuals characterized by their ability to maintain high CD4+ T-cell counts and partially control viral replication for years in the absence of antiretroviral therapy. The present study aims to identify host single nucleotide polymorphisms (SNPs) associated with non-progression in a cohort of 352 individuals. METHODS: DNA microarrays and exome sequencing were used for genotyping about 240 000 functional polymorphisms throughout more than 20 000 human genes. The allele frequencies of 85 LTNPs were compared with a control population. SNPs associated with LTNPs were confirmed in a population of typical progressors. Functional analyses in the affected gene were carried out through knockdown experiments in HeLa-P4, macrophages and dendritic cells. RESULTS: Several SNPs located within the major histocompatibility complex region previously related to LTNPs were confirmed in this new cohort. The SNP rs1127888 (UBXN6) surpassed the statistical significance of these markers after Bonferroni correction (q = 2.11 × 10-6). An uncommon allelic frequency of rs1127888 among LTNPs was confirmed by comparison with typical progressors and other publicly available populations. UBXN6 knockdown experiments caused an increase in CAV1 expression and its accumulation in the plasma membrane. In vitro infection of different cell types with HIV-1 replication-competent recombinant viruses caused a reduction of the viral replication capacity compared with their corresponding wild-type cells expressing UBXN6. CONCLUSIONS: A higher prevalence of Ala31Thr in UBXN6 was found among LTNPs within its N-terminal region, which is crucial for UBXN6/VCP protein complex formation. UBXN6 knockdown affected CAV1 turnover and HIV-1 replication capacity.

Comparative pathogenicity of type 1 and type 2 isolates of porcine reproductive and respiratory syndrome virus (PRRSV) in a young pig infection model.

Porcine reproductive and respiratory syndrome virus (PRRSV) isolates are classified in two different genotypes, based on genomic heterogeneity: type 1, which comprises European type isolates, and type 2, which includes North American type isolates. It is believed that members of both genotypes differ in some biological properties including pathogenicity, however extensive studies comparing isolates of both genotypes have never been carried out. The objective of the present study was to compare the pathogenic properties of six different PRRSV isolates, three of type 1 and three of type 2, in a young pig infection model. For this purpose, a total of 105 3-week-old piglets were divided in 7 groups of 15 animals that were exposed on day 0 of the experiment to one of the six isolates tested or were mock infected (negative control group). Clinical signs and rectal temperatures were recorded daily and blood samples were taken on days 3, 6, 9, 12, 15, 18 and 21 of the experiment. On days 7, 14 and 21 post-inoculation five animals per group were sacrificed, macroscopic lung lesions were evaluated and different tissue samples were collected to determine viral organic distribution. The results obtained indicate that type 2 isolates are more pneumovirulent than type 1 isolates, as demonstrated by the recording of respiratory clinical signs only in pigs exposed to type 2 viruses and by the severity of macroscopic and microscopic lung lesions in those pigs. However, no clear differences could be established between genotypes in systemic clinical signs or viral load and viral distribution after challenge. These results support the general idea that type 2 isolates induce more severe respiratory disease than type 1 isolates.

Emergency laparoscopic treatment for acute massive bleeding of an esophageal ulcer.

Laparoscopic fundoplication is now considered the treatment of choice for the management of severe gastroesophageal reflux disease (GERD) and its complications. The laparoscopic approach achieves the same good results as open surgery in elective surgery for GERD; it also has all the advantages of minimally invasive surgery. Today, laparoscopy plays also a significant role in a great variety of emergency abdominal situations and acute abdominal pain. A 30-year-old man was admitted to our center due to an upper gastrointestinal bleed caused by a esophageal ulcer over a Barrett's esophagus located in lower third of the esophagus. Two therapeutic esophagogastroscopies were done in 24 h, but urgent surgical intervention was indicated because of recurrent transfusion-demanding bleeding. A combined laparoscopic-endoscopic approach was followed. Surgery began with a complete hiatal dissection, including the distal third of the esophagus, diaphragmatic crus, and wide retrogastric window. Intraoperative flexible esophagoscopy revealed an active ulcer bleeding on the right anterior quadrant in the lower esophagus. Two transfixive stitches were applied through the wall of the esophagus at the site indicated by the light of the flexible endoscope, and complete hemostasis was achieved. Finally, employing the anterior wall of the fundus, a short Nissen-Rossetti fundoplication was performed. The operating time was 140 min. There were no complications and there has been no recurrence of the bleeding.

Bloqueo auriculoventricular familiar. Presentación de un caso clínico / Familial atrioventricular heart block. A case report

Se presenta una familia con antecedentes de síncope y trastornos de conducción. Dos de sus miembros, de 18 años varón y 20 años mujer padecieron cuadros sincopales. Tenían examen físico, electrocardiograma, radiografía de tórax, ecocardiograma transtorácico y laboratorio normales. En ambos, sendos registros Holter pusieron en evidencias episodio de bloqueo auriculoventricular paroxístico de alto grado en un caso y Mobitz II en otro, sin trastornos de conducción en las ramas del haz de His. G.S. recibió el implante de un marcapasos hace 18 meses, luego continuó asintomático. R.S. padeció síncope hace 5 años pero luego continuó asintomática. Se revisa la literatura

Bloqueo auriculoventricular familiar. Presentación de un caso clínico / Familial atrioventricular heart block. A case report

Se presenta una familia con antecedentes de síncope y trastornos de conducción. Dos de sus miembros, de 18 años varón y 20 años mujer padecieron cuadros sincopales. Tenían examen físico, electrocardiograma, radiografía de tórax, ecocardiograma transtorácico y laboratorio normales. En ambos, sendos registros Holter pusieron en evidencias episodio de bloqueo auriculoventricular paroxístico de alto grado en un caso y Mobitz II en otro, sin trastornos de conducción en las ramas del haz de His. G.S. recibió el implante de un marcapasos hace 18 meses, luego continuó asintomático. R.S. padeció síncope hace 5 años pero luego continuó asintomática. Se revisa la literatura (AU)

Lymphangiosarcoma in a chronic lymphedematous limb: a case report.

A 69-year-old-woman developed a lymphangiosarcoma of the limb on chronic lymphedema after radical mastectomy and radiotherapy for primary breast cancer 12 years before. Since 1948, when Stewart and Treves described this entity, 200 cases have been described. We report this case because of its extremely rare frequency. Concepts of etiology, treatment and prognosis are reviewed.

[Idiopathic hepatic adenoma in the adult]. / Adenoma epatico idiopatico nell'uomo adulto.

Hepatic adenoma is an infrequent evenience, not wellknown till oral contraceptive diffusion in the 60s. The lesion may also be associated to the use of androgenic steroids, and to both type I and type III glycogen storage disease. Hepatic adenoma may be single or, more rarely, multiple. Recently the term of multiple adenomatosis has been adopted for the cases in which ten hepatic adenomas or more are found in a single liver. In this report, a case of hepatic adenoma involving a patient with no risk factors for such lesion as well as diagnosis and therapy are illustrated.

[Cause of death, survival, and prognostic factors in a series of 98 patients with chronic myeloid leukemia]. / Causas de muerte, supervivencia y factores pronósticos en una serie de 98 pacientes con leucemia mieloide crónica.

PURPOSE: To analyse the survival from diagnosis to blastic crisis, as well as the causes of death and the significance of different features in patients diagnosed of chronic myelogenous leukaemia (CML). MATERIAL AND METHODS: The series includes 98 patients who died of CML in Asturias Central Hospital and other nearby hospital between 1970 and 1990. The CML diagnosis had been established according to conventional criteria. The blastic crisis was diagnosed in accordance with morphologic and cytochemical studies, complemented in some cases with the assay of TdT or other markers. The Kaplan-Meier curves and long-rank test were applied to the statistical analysis of survival. The prognostic factors were evaluated by univariate correlation. RESULTS: The series' mean age was 48.57 years (range: 6-90) and the M/F ratio was 56/42. Cytogenetic study had been performed in 35 patients, of whom 33 had the Ph' chromosome. Death occurred in the blastic crisis in 67 cases (72%), in the accelerated phase in 14 cases (15%) and in the chronic phase in 12 cases (13%). The cause of death could be determined in 47 cases; of them, 24 (51%) died of infection, 11 (23.4%) of haemorrhage, and the remaining 12 (25.6%) of different complications. The median survival of the group as a whole was 32 months (range: 4-137). For the blastic crisis this figure was reduced to 2.5 months (range: 1-14), the lymphoid forms doing better, 5 months, than the non-lymphoid ones; 1.5 months (p < 0.03). Out of the data evaluated at diagnosis, only haemoglobin and the percentage of blast cells in peripheral blood showed any correlation with survival (r = +0.28, p < 0.05 for haemoglobin, and r = -0.30, p < 0.01 for blast cells). CONCLUSIONS: (1) Although most patients die from infection or haemorrhage during the blast crisis, CML increases the risk of death in the accelerated and chronic stages as well. (2) Non-lymphoid blastic crisis has poorer prognosis than the lymphoid form. (3) The concentration of blast cells and haemoglobin in peripheral blood at diagnosis acquire prognostic significance in the present study.

11-Oxycorticosteroid-dependent antibody in the serum of a patient with bladder neoplasm.

An IgM 11-oxycorticosteroid-dependent antibody was identified in the serum of a patient with bladder malignancy, which at 4-37 degrees C reacted with all the 11-oxycorticosteroids tested but not with desoxycorticosterone, testosterone, nortestosterone and progesterone. The resulting drug-antidrug antibody complex combines nonspecifically with red blood cells causing agglutination. This reactivity is enhanced both by acid pH and by high drug solution concentrations as well as by ficin test. The antibody is complement-independent and has no blood group specificity. No in vivo or in vitro hemolysis was observed.

[Transfusion evaluation measured by a retrospective audit]. / Evaluación transfusional mediante audit retrospectivo.

From a sample of 759 transfusions requests (2123 Units) for 392 patients, evaluated by retrospective audits the incidence of inappropriate transfusion at our Hospital was found to be 25.8% of request, affecting 23.3% of units and 39.3% of patients. The most frequent causes were: non-surgical and surgical use of whole blood in patients without hypovolaemia, use of fresh frozen plasma in patients with normal coagulation study red blood cells transfusion in patients with chronic anaemia and haematocrit of 24-30% without risk factors, surgical overtransfusion and prophylactic platelet transfusion in patients with platelet count above 20 x 10(9)/L. 17.3% of units could have been saved, and 32.3% of patients were overexposed or unnecessarily exposed to the risks inherent in any transfusion.