Development and Validation of a Laparoscopy Simulation Model of Pyeloplasty for Pediatric Patients.

Introduction: Given the extensive training required for laparoscopic pyeloplasty and the difficulties achieving this training, there is a need to recreate the activity in a controlled environment, but high-fidelity models are unavailable or expensive. Our objective was to develop a model of pyeloureteral junction stenosis, resembling the anatomical details and consistency of natural tissue, for a replicable, cheaper, and realistic simulation model of laparoscopic pyeloplasty in children. Materials and Methods: A three-dimensional, printed synthetic model was created from magnetic resonance urography. The model comprises a plastic kidney as the reusable structure and a silicone renal pelvis and ureter as the interchangeable structure. We evaluated realism and performance with surgeons and residents at different levels of training, comparing operative time and complications of the procedure. Results: Twenty-four participants were recruited; 41.7% had previous experience in laparoscopic pyeloplasty, with 5.5 years of experience in laparoscopic surgery (interquartile range [IQR] 2-7.75). There were no cases of stenosis, but leaks accounted for 41.7%. The procedure lasted 72 minutes (IQR 55-90), with significant differences according to the level of training (85 minutes for residents, 68 minutes for pediatric surgeons and urologists, and 40 minutes for laparoscopic surgeons; P: .011) and years of previous experience in laparoscopic surgery (P: .003). Conclusions: A high-fidelity, replicable, and low-cost pyeloureteral stenosis model was developed to simulate laparoscopic pyeloplasty in pediatric patients.

Reiterative infusions of MSCs improve pediatric osteogenesis imperfecta eliciting a pro-osteogenic paracrine response: TERCELOI clinical trial.

BACKGROUND: Osteogenesis imperfecta (OI) is a rare genetic disease characterized by bone fragility, with a wide range in the severity of clinical manifestations. The majority of cases are due to mutations in the COL1A1 or COL1A2 genes, which encode type I collagen. Mesenchymal stem cells (MSCs), as the progenitors of the osteoblasts, the main type I collagen secreting cell type in the bone, have been proposed and tested as an innovative therapy for OI with promising but transient outcomes. METHODS: To overcome the short-term effect of MSCs therapy, we performed a phase I clinical trial based on reiterative infusions of histocompatible MSCs, administered in a 2.5-year period, in two pediatric patients affected by severe and moderate OI. The aim of this study was to assess the safety and effectiveness of this cell therapy in nonimmunosuppressed OI patients. The host response to MSCs was studied by analyzing the sera from OI patients, collected before, during, and after the cell therapy. RESULTS: We first demonstrated that the sequential administration of MSCs was safe and improved the bone parameters and quality of life of OI patients along the cell treatment plus 2-year follow-up period. Moreover, the study of the mechanism of action indicated that MSCs therapy elicited a pro-osteogenic paracrine response in patients, especially noticeable in the patient affected by severe OI. CONCLUSIONS: Our results demonstrate the feasibility and potential of reiterative MSCs infusion for two pediatric OI and highlight the paracrine response shown by patients as a consequence of MSCs treatment.

Determination of mutagenic amines in water and food samples by high pressure liquid chromatography with amperometric detection using a multiwall carbon nanotubes-glassy carbon electrode.

A chromatographic method, using amperometric detection, for the sensitive determination of six representative mutagenic amines was developed. A glassy carbon electrode (GCE), modified with multiwall carbon nanotubes (GCE-CNTs), was prepared and its response compared to a conventional glassy carbon electrode. The chromatographic method (HPLC-GCE-CNTs) allowed the separation and the determination of heterocyclic aromatic amines (HAAs) classified as mutagenic amines by the International Agency for Research of Cancer. The new electrode was systematically studied in terms of stability, sensitivity, and reproducibility. Statistical analysis of the obtained data demonstrated that the modified electrode provided better sensitivity than the conventional unmodified ones. Detection limits were in the 3.0 and 7.5 ng/mL range, whereas quantification limits ranged between 9.5 and 25.0 ng/mL were obtained. The applicability of the method was demonstrated by the determination of the amines in several types of samples (water and food samples). Recoveries indicate very good agreement between amounts added and those found for all HAAs (recoveries in the 92% and 105% range).

Two mutations in IFITM5 causing distinct forms of osteogenesis imperfecta.

The IFITM5 gene has recently been found to be mutated in patients with autosomal dominant osteogenesis imperfecta (OI) type V. This form of OI is characterized by distinctive clinical manifestations, including hyperplastic callus formation at the site of fractures, calcification of the interosseous membrane of the forearm, and dislocation of the head of the radius. Notably, in spite of the fact that a considerable number of patients with IFITM5 mutations have been identified, to date all of them have been shown to have the same heterozygous mutation (c.-14C>T). Herein, we describe one patient with a de novo c.119C>T heterozygous mutation in IFITM5, which predicts p.Ser40Leu, and another with the recurrent c.-14C>T transition that was also apparently de novo. While the patient with the p.Ser40Leu mutation had none of the typical signs of OI type V and was diagnosed with limb shortening at prenatal stages, the patient with the c.-14C>T mutation developed hyperplastic calluses and had calcification of the forearm interosseous membrane. This study challenges the lack of allelic and clinical heterogeneity in IFITM5 mutations.

Determination of sulfonamides in milk samples by HPLC with amperometric detection using a glassy carbon electrode modified with multiwalled carbon nanotubes.

A sensitive and accurate method for determining five sulfonamides based on HPLC with amperometric detection and using a glassy carbon electrode modified with multiwalled carbon nanotubes is proposed. Optimal conditions for the quantitative separation of selected sulfonamides were studied, and glassy carbon electrodes with and without modification with carbon nanotubes were systematically investigated as electrodic materials. Statistical analysis of the obtained results demonstrated that these modified electrodes achieved considerably better stability and sensitivity than the conventional unmodified ones. Detection limits were in the 1.2-6.0 ng/mL range. The usefulness of the method was demonstrated by the analysis of milk samples, taking into account the European legislation on residues in food products, following both a screening method to classify the samples and a confirmation method to provide more detailed information in the case of positive samples.

[The usefulness of protective creams on fragile and aged skin]. / Utilidad de las cremas protectoras pieles frágiles y envejecidas.

The ADDERMIS protective cream has these properties: it prevents skin maceration, exercises a regenerative effect, has bacteriostatic and bactericide activity, possesses a noted anti-inflammatory effect and reduces the risk of mycotic infections. Its application is indicated for use in cases of: skin lesions, such as bed sores or leg ulcers, which require the use of a barrier product; dermatitis lesions in zones of skin folds or due to diaper use; to prevent friction zones; fragile skin; peeling, zones where cracks in the skin appear...and to use for cases of incontinence when diapers are required.

[Hyaluronic acid: a new trend to cure skin injuries an observational study]. / Acido hialurónico, una nueva tendencia en la curación de heridas cutáneas.

The authors made an observational study to evaluate the efficiency of Jaloplast (hyaluronic acid AH) as treatment for skin injuries having different etiologies. The authors highlight its results regarding cicatrisation (69%) and the improvement of lesions (15.38%). Moreover 80% of lesions have cicatrized in a time less than 11 weeks, without showing any adverse effects nor secondary effects. From these observations, the authors deduce the importance of this molecule formed by glucosamine glycane (hyalyuronate) at the organic level in general and specifically in the process of cicatrisation.

[LCT (lipocolloid technology) in lesions of venous etiology]. / TLC (Tecnología Lipocoloidal) en lesiones de etiología venosa.

This article reports on a spanish study to evaluate the effectiveness of dressings using a Technology Lipido-Colloid to treat skin lesions with "Urgotul". Has been included 18 of this 60 lesions were leg ulcers. We have decided to focus our analysis in these difficult to treat chronic wounds. This study noted better results in relation to the evolution of these lesions and in the quality of life for these patients who suffered these lesions in terms of pain control, skin deterioration or lesions in the same spot related to changing dressings, and an improvement in the skin nearby the lesion.

Apósito combinado de espuma de poliuretano e hidrogel (Indafoam(R)) / Combined polyurethane foam and hydrogel dressing

Valoración observacional sobre el comportamiento de los apósitos de la gama Indafoam(R) para el tratamiento de lesiones cutáneas de diferente etiología con evolución aguda y crónica, aportando una información muy valiosa para los profesionales que en su práctica habitual utilizan apósitos de CAH. Su composición permite considerarlos apósitos combinados (en una sola estructura) que mantienen la temperatura de la lesión estable, presentan elevada capacidad de absorción evitando la maceración de la piel perilesional y protegen las lesiones de contaminación por gérmenes exógenos (AU)

Prevención de úlceras por presión. Perspectiva actual desde la urgencia hospitalaria / Preventing pressure ulcers. Current perspective from the Casualty Department

Las úlceras por presión (UPP) constituyen un importante reto para el Sistema de Salud y hasta ahora parece un problema olvidado por los servicios de urgencias (SU), ya que un compromiso vital en el enfermo, hacen que estas lesiones "menores" puedan quedar relegadas a otros planos del cuidado, y considerarlas propias de otras unidades del hospital. Numerosos enfermos con úlceras por presión y otros catalogados como en situación de riesgo de padecerlas (lesionados medulares, ancianos, inmovilizados, etc.), acuden con frecuencia a los SU hospitalarios. Entendemos que sería necesario tomar conciencia de que para determinados pacientes estos servicios, por sus especiales circunstancias, son territorios de riesgo "especial" para desarrollar UPP, haciéndose necesario establecer planes de cuidados integrales que engloben este problema, iniciando el proceso con el desarrollo de sistemas de registros específicos, que permitan disminuir la incidencia de UPP en los mismos y que alerten a otras unidades hospitalarias y niveles asistenciales sobre su existencia desde y por los SU. (AU)

[Combined polyurethane foam and hydrogel dressing. Outcome in lesions of diverse etiology]. / Apósito combinado de espuma de poliuretano e hidrogel (Indafoam). Comportamiento ante lesiones de diferente etiología.

The authors present an observational evaluation on the effectiveness of a dressing included in the Indafoam brand for treatment of skin lesions due to different etiology which have an acute or chronic diagnosis; the authors include some very valuable information for professionals who use combined polyurethane foam and hydrogel dressings in their daily practice. Due to their composition, these dressings may be considered combined dressings having only one structure which maintains a stable temperature at the lesion site; these dressings have a high absorption capacity which prevents maceration of the skin surrounding lesions and protects lesions from contamination by exogenous germs.