Clinical importance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index in dogs with leishmaniasis.

Leishmaniasis is a zoonotic disease caused by Leishmania spp., impacts multiple systems and organs. While hematological and biochemical profiles aren't definitive for diagnosis, recent studies have identified the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) as predictors of morbidity and mortality in critically ill human and dog patients. This study examined 100 dogs diagnosed with leishmaniasis, categorized by the International Renal Interest Society (IRIS) stages 1-4. Additionally, the dogs were divided based on whether they survived less or more than one year (L1Y and G1Y). Control group consisted of 43 dogs. The NLR increased as the disease progressed (IRIS 1-4), presenting statistically significant differences (P<0.05) when compared to the control group (2,37±2,08) IRIS 3 and 4 (4,59±13,39 and 6,99±12,86, respectively), and G1Y and L1Y (3,60±4,02 and 4,87±5,82, respectively). Significant changes in SII were only evident in short-term survivors (L1Y 951,93±1402) and advanced renal disease cases (IRIS 4 stage 1073,68±1901,09). Conversely, PLR remained largely unchanged. In conclusion, these results suggest that the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) may serve as potential markers for assessing disease progression and prognosis in dogs diagnosed with leishmaniasis.

Erratum: Ratchet universality in the bidirectional escape from a symmetric potential well [Phys. Rev. E 103, 022203 (2021)].

This corrects the article DOI: 10.1103/PhysRevE.103.022203.

Evaluation of circulating microRNA profiles in blood as potential candidate biomarkers in a subacute ruminal acidosis cow model - a pilot study.

BACKGROUND: Subacute ruminal acidosis (SARA) is a metabolic disorder often observed in high-yielding dairy cows, that are fed diets high in concentrates. We hypothesized that circulating miRNAs in blood of cows could serve as potential candidate biomarkers to detect animals with metabolic dysbalances such as SARA. MicroRNAs (miRNAs) are a class of small non-coding RNAs, serving as regulators of a plethora of molecular processes. To test our hypothesis, we performed a pilot study with non-lactating Holstein-Friesian cows fed a forage diet (FD; 0% concentrate, n = 4) or a high-grain diet (HG; 65% concentrate, n = 4) to induce SARA. Comprehensive profiling of miRNA expression in plasma and leucocytes were performed by next generation sequencing (NGS). The success of our model to induce SARA was evaluated based on ruminal pH and was evidenced by increased time spent with a pH threshold of 5.8 for an average period of 320 min/d. RESULTS: A total of 520 and 730 miRNAs were found in plasma and leucocytes, respectively. From these, 498 miRNAs were shared by both plasma and leucocytes, with 22 miRNAs expressed exclusively in plasma and 232 miRNAs expressed exclusively in leucocytes. Differential expression analysis revealed 10 miRNAs that were up-regulated and 2 that were down-regulated in plasma of cows when fed the HG diet. A total of 63 circulating miRNAs were detected exclusively in the plasma of cows with SARA, indicating that these animals exhibited a higher number and diversity of circulating miRNAs. Considering the total read counts of miRNAs expressed when fed the HG diet, differentially expressed miRNAs ( log2 fold change) and known function, we have identified bta-miR-11982, bta-miR-1388-5p, bta-miR-12034, bta-miR-2285u, and bta-miR-30b-3p as potential candidates for SARA-biomarker in cows by NGS. These were further subjected to validation using small RNA RT-qPCR, confirming the promising role of bta-miR-30b-3p and bta-miR-2285. CONCLUSION: Our data demonstrate that dietary change impacts the release and expression of miRNAs in systemic circulation, which may modulate post-transcriptional gene expression in cows undergoing SARA. Particularly, bta-miR-30b-3p and bta-miR-2285 might serve as promising candidate biomarker predictive for SARA and should be further validated in larger cohorts.

The connective tissue graft as a membrane to improve esthetics according the defect.

Dental implants are now one of the most useful therapies worldwide with higher rates of success from simple to complex cases, but also, with different results regarding the esthetics, cost and long-term success maintenance. In the beginning, dental implants therapy function and survival was the main goal. Nevertheless, through the years, the success criteria have increased, evolved, and improved beyond function to include esthetic and patient-related outcomes. Parallel to implant therapy, guide bone regeneration and periodontal plastic surgery have also evolved to achieve predictable, functional, and esthetic results in shallow and complex defects. However, they are mostly performed during different surgical procedures at different stages, raising the treatment time and cost for patients, directly related to the bio materials used and surgical times. The purpose of this case series is to present a simplified clinical scenario using a connective tissue graft as a membrane to improve esthetics and patient satisfaction while reducing treatment time and cost.

[Delayed administration of thrombolytic therapy in minor stroke]. / Retraso en la administración de tratamiento trombolítico en el ictus minor.

INTRODUCTION: Minor strokes are considered to be those that present with few symptoms, although up to 40% of them entail long-term disability. The rate of thrombolysis in these patients is also lower than in other strokes. The aim of this study is to explore whether there are any differences in intravenous thrombolysis care times in minor strokes. PATIENTS AND METHODS: We conducted a retrospective review of strokes treated with intravenous thrombolysis at our centre and a comparative analysis of the care times in minor strokes and in the other types. RESULTS: Longer times were found in minor strokes in terms of door-to-CT scan and door-to-needle time. This was not the case, however, for the time from the onset of symptoms to arrival at the hospital. CONCLUSIONS: The presence of few symptoms in minor strokes can make them difficult to recognise and could be a reason for delaying treatment. Training among staff caring for these patients is essential to improve this aspect.

TITLE: Retraso en la administración de tratamiento trombolítico en el ictus minor.Introducción. Se considera ictus minor a aquel que se presenta con escasos síntomas; sin embargo, hasta un 40% presenta discapacidad a largo plazo. La tasa de trombólisis en estos pacientes también es inferior a la del resto de ictus. En este estudio se pretende explorar si existen diferencias en los tiempos de atención en la trombólisis intravenosa en los pacientes con ictus minor. Material y métodos. Revisión retrospectiva de los ictus tratados con trombólisis intravenosa en nuestro centro y análisis comparativo de los tiempos de asistencia entre ictus minor y el resto. Resultados. Se encontraron tiempos más alargados en los casos de ictus minor en cuanto al tiempo puerta-tomografía computarizada y puerta-aguja. No fue así, sin embargo, para el tiempo desde el inicio de los síntomas hasta la llegada al hospital. Conclusiones. La presencia de escasos síntomas en el ictus minor puede hacer difícil su reconocimiento y podría ser un motivo de retraso en el tratamiento. La formación entre el personal que atiende a estos pacientes es fundamental para mejorar este aspecto.

Retraso en la administración de tratamiento trombolítico en el ictus minor / Delayed administration of thrombolytic therapy in minor stroke

Introducción: Se considera ictus minor a aquel que se presenta con escasos síntomas; sin embargo, hasta un 40% presenta discapacidad a largo plazo. La tasa de trombólisis en estos pacientes también es inferior a la del resto de ictus. En este estudio se pretende explorar si existen diferencias en los tiempos de atención en la trombólisis intravenosa en los pacientes con ictus minor. Material y métodos. Revisión retrospectiva de los ictus tratados con trombólisis intravenosa en nuestro centro y análisis comparativo de los tiempos de asistencia entre ictus minor y el resto. Resultados: Se encontraron tiempos más alargados en los casos de ictus minor en cuanto al tiempo puerta-tomografía computarizada y puerta-aguja. No fue así, sin embargo, para el tiempo desde el inicio de los síntomas hasta la llegada al hospital. Conclusiones: La presencia de escasos síntomas en el ictus minor puede hacer difícil su reconocimiento y podría ser un motivo de retraso en el tratamiento. La formación entre el personal que atiende a estos pacientes es fundamental para mejorar este aspecto.(AU)

Introduction: Minor strokes are considered to be those that present with few symptoms, although up to 40% of them entail long-term disability. The rate of thrombolysis in these patients is also lower than in other strokes. The aim of this study is to explore whether there are any differences in intravenous thrombolysis care times in minor strokes. Patients and methods: We conducted a retrospective review of strokes treated with intravenous thrombolysis at our centre and a comparative analysis of the care times in minor strokes and in the other types. Results: Longer times were found in minor strokes in terms of door-to-CT scan and door-to-needle time. This was not the case, however, for the time from the onset of symptoms to arrival at the hospital. Conclusions: The presence of few symptoms in minor strokes can make them difficult to recognise and could be a reason for delaying treatment. Training among staff caring for these patients is essential to improve this aspect.(AU)

Ratchet universality in the bidirectional escape from a symmetric potential well.

The present work discusses symmetry-breaking-induced bidirectional escape from a symmetric metastable potential well by the application of zero-average periodic forces in the presence of dissipation. We characterized the interplay between heteroclinic instabilities leading to chaotic escape and breaking of a generalized parity symmetry leading to directed ratchet escape to an attractor either at ∞ or at -∞. Optimal enhancement of directed ratchet escape is found to occur when the wave form of the zero-average periodic force acting on the damped driven oscillator matches as closely as possible to a universal wave form, as predicted by the theory of ratchet universality. Specifically, the optimal approximation to the universal force triggers the almost complete destruction of the nonescaping basin for driving amplitudes which are systematically lower than those corresponding to a symmetric periodic force having the same period. We expect that this work could be potentially useful in the control of elementary dynamic processes characterized by multidirectional escape from a potential well, such as forced chaotic scattering and laser-induced dissociation of molecular systems, among others.

Emerging new avian reovirus variants from cases of enteric disorders and arthritis/tenosynovitis in Brazilian poultry flocks.

1. The objective of this study was to characterise circulating Brazilian avian reovirus (ARV) strains by genetic analysis of the σC protein encoded by segment 1 of the viral genome and compare these with those of viral strains used for immunising commercial poultry.2. The analysis detected the presence of ARV genomes by quantitative reverse transcriptase PCR (RT-qPCR) in the enteric samples and the joint tissues (JT) of birds with signs of viral arthritis/tenosynovitis. Nucleotide sequencing used 16 strains (three commercial vaccines, 10 from enteric tissues and three from JT). The results indicated high variability in the amino acid sequences of 13 wild strains, showing between 40% and 75% similarity compared with the vaccine strains (S1133 and 2177).3. The sequences were grouped into three well-defined clusters in a phylogenetic tree, two of these clusters together with previous Brazilian σC ARV sequences, and one cluster (VII) that was novel for Brazilian strains. Antigenic analysis showed that there were amino acids within putative epitopes located on the surface of the receptor-binding region of the σC protein with a high degree of variability.4. The study confirmed the presence of ARV genetic variants circulating in commercial birds in Brazil, and according to the antigenic prediction, the possibility of antigenic variants appears to be high.

Coronavirus Optimization Algorithm: A Bioinspired Metaheuristic Based on the COVID-19 Propagation Model.

This study proposes a novel bioinspired metaheuristic simulating how the coronavirus spreads and infects healthy people. From a primary infected individual (patient zero), the coronavirus rapidly infects new victims, creating large populations of infected people who will either die or spread infection. Relevant terms such as reinfection probability, super-spreading rate, social distancing measures, or traveling rate are introduced into the model to simulate the coronavirus activity as accurately as possible. The infected population initially grows exponentially over time, but taking into consideration social isolation measures, the mortality rate, and number of recoveries, the infected population gradually decreases. The coronavirus optimization algorithm has two major advantages when compared with other similar strategies. First, the input parameters are already set according to the disease statistics, preventing researchers from initializing them with arbitrary values. Second, the approach has the ability to end after several iterations, without setting this value either. Furthermore, a parallel multivirus version is proposed, where several coronavirus strains evolve over time and explore wider search space areas in less iterations. Finally, the metaheuristic has been combined with deep learning models, to find optimal hyperparameters during the training phase. As application case, the problem of electricity load time series forecasting has been addressed, showing quite remarkable performance.

Cefalea y déficit neurológico: piensa en HaNDL / Headache and neurological deficit: think of HaNDL

El síndrome HaNDL constituye una entidad poco frecuente caracterizada por la aparición de episodios de cefalea intensa y focalidad neurológica transitoria con peculiaridades en el LCR. Es considerado como un trastorno de curso benigno por su carácter reversible y autolimitado. Presentamos el caso de una niña de 12 años que consulta por cefalea de dos semanas de evolución y monoparesia del miembro superior izquierdo posterior que se percibió en su valoración inicial en Urgencias. Se realizó una TAC, con resultado normal, y de la punción lumbar se obtuvo un LCR donde destacaba una pleocitosis linfocitaria. La RMN cerebral mostró datos compatibles con HTIC. Tras los resultados de las pruebas complementarias fue diagnosticada de síndrome de HaNDL e inició tratamiento sintomático, presentando mejoría clínica progresiva. El síndrome HaNDL se trata de una entidad clínica rara y poco conocida que por sus peculiaridades puede generar inquietud. Existen casos y series de casos publicados en la literatura en pacientes adultos, siendo una patología más rara en la población pediátrica. Su diagnóstico diferencial es amplio y abarca patologías potencialmente letales, por lo que conocer las características clínicas y la evolución natural de este proceso resulta de utilidad en el diagnóstico diferencial de las cefaleas con déficit neurológico transitorio

HaNDL syndrome is a rare clinical condition characterized where episodes of severe headache and transient neurological focus with peculiarities in the CSF occur. It is considered a benign course disorder due to its reversible and self-limiting nature. We report the case of a 12-year-old girl who visits the hospital for a two-week headache and monoparesis of her left upper limb. After initial assessment in the emergency department, a CT scan was performed with normal results and a lumbar puncture from which a CSF was obtained showing lymphocytic pleocytosis. Brain MRI showed intracranial hypertension (IH) compatible data. After the results of the complementary tests, she was diagnosed with HaNDL syndrome and was prescribed symptomatic treatment, showing progressive clinical improvement. HaNDL syndrome is a rare and little-known clinical entity which, due to its peculiarities, may cause concern. Cases and series of cases published in the literature exist in adult patients, being a rarer pathology in the paediatric population. Its differential diagnosis is wide and includes potentially lethal pathologies. Therefore, it is useful to know the clinical characteristics and natural evolution of this process in the differential diagnosis of headaches with transient neurological déficit

[Profile of drug use in adolescents. Protective factors]. / Perfil de consumo de drogas en adolescentes. Factores protectores.

OBJECTIVE: To determine the patterns of drug use in an adolescent population and to analyse the role of personal and social protective factors in alcohol consumption. MATERIAL AND METHODS: A descriptive cross-sectional study was carried out in five secondary schools in the city of Cuenca (Spain) in the period 2015-2016. The groups were randomly selected (3rd - 4th GCSE and 1st - 2nd GCE), with a total of 844 students giving their consent. A self-administered questionnaire was used, which included sociodemographic variables, consumption data, CD-RISC 10 scale to evaluate resilience, and KIDSCREEN-52 questionnaire to measure individual and social aspects associated with health-related quality of life in adolescents. Descriptive bivariate and multivariate analyses were performed. RESULTS: Just over half (55.7%) of the pupils selected were girls, and the mean age was 16.3±1.01 years. The pupils began consumption when they became 13-14 years old. The percentages of habitual consumption were 70.9% for alcohol, 26.4% for tobacco, and 14.2% for cannabis. Multiple drug use was also found in 35%. The regression model for alcohol showed that non-consumers showed better values in emotional moods, self-perception, relationships with their parents, and their school environment. CONCLUSIONS: Adolescents start using drugs, especially cannabis, at an earlier age. Availability and the perception of low-risk make alcohol the most widespread drug. Actions aimed at fostering emotional well-being and family support provides security for adolescents, as well as the resources that help them overcome the pressures of the group.

Emergence of chaos in starlike networks of dissipative nonlinear oscillators by localized parametric excitations.

We study the effectiveness of locally controlling the impulse transmitted by parametric periodic excitations at inducing and suppressing chaos in starlike networks of driven damped pendula, leading to asynchronous chaotic states and equilibria, respectively. We found that the inducing (suppressor) effect of increasing (decreasing) the impulse transmitted by the parametric excitations acting on particular nodes depends strongly on their number and degree of connectivity as well as the coupling strength. Additionally, we provide a theoretical analysis explaining the basic physical mechanisms of the emergence and suppression of chaos as well as the main features of the chaos-control scenario. Our findings constitute proof of the impulse-induced control of chaos in a simple model of complex networks, thus opening the way to its application to real-world networks.

Comparison of myocardial damage among dogs at different stages of clinical leishmaniasis and dogs with idiopathic chronic kidney disease.

Canine leishmaniasis (CanL) is a systemic disease caused by the protozoan parasite Leishmania infantum. Myocarditis in CanL has been described previously in CanL by histopathological analysis of post-mortem specimens and by evaluation of cardiac troponin I (cTnI) levels. However, the degree of myocardial damage at different stages of CanL and the role that concurrent azotaemia plays in this myocardial injury are unknown. The aim of this study was to prospectively evaluate and compare the presence of myocardial injury in dogs at different stages of clinical CanL and in dogs with severe idiopathic chronic kidney disease (CKD) by measuring cTnI. Forty-eight dogs were included in the study, divided into four groups: (1) group A (10 healthy dogs); (2) group B (17 dogs with CanL without renal azotaemia, classified as mild to severe in the LeishVet scheme); (3) group C (11 dogs with CanL and renal azotaemia, classified as very severe in the LeishVet scheme); and (4) group D (10 dogs with idiopathic CKD). Dogs in group C had significantly higher cTnI than dogs in groups B and D, although cTnI was also elevated in these groups. Dogs in group A had normal cTnI values. Dogs in groups D and C had similar renal IRIS classification scorers. Severe lymphoplasmocytic myocarditis and a positive real time PCR of L. infantum DNA were observed in all dogs in group C. Dogs with very severe CanL exhibit more myocardial injury than dogs with milder CanL or dogs with idiopathic CKD.

Aerotransporte de pacientes con alto riesgo de contaminación por enfermedad infecciosa, a propósito de tres casos / High risk infections patients Air Medevec. Our experience after 3 medical cases

Las tropas españolas destacadas en operaciones internacionales en áreas tropicales con enfermedades infecciosas emergentes pueden verse en situación de riesgo de contagio, a lo que se suma el potencial uso de armas biológicas en los actuales conflictos de guerra desigual. Este riesgo puede hacerse extensivo a toda la población bajo responsabilidad española. Esta situación hizo que la Sanidad Militar Española y, en el caso que se presenta, la Unidad Médica de Aeroevacuación (UMAER) actualizase sus procedimientos de defensa NBQ en vigor desde el inicio de las misiones de las Fuerzas Armadas en territorio africano. Se reforzó la respuesta a la amenaza biológica en dichos ambientes tropicales y se trabajó y entrenó en la posibilidad de transporte aéreo de pacientes con enfermedades infecciosas transmisibles para su tratamiento definitivo en territorio nacional. Este artículo es un informe de lo sucedido durante estas misiones. Es un reconocimiento a todas las personas involucradas y sus esfuerzos

Spanish troops deployed on international operations all over African tropical areas can be exposed to high-risk situations due to severe infectious diseases that can affect the population under their responsibility as well as to the possible use of biological weapons in current international conflicts. In this situation the Spanish Unified Defense Medical Command and, in this particular case, the Spanish Unit Medical Evacuation (UMAER) updated their NBC defense procedures since the beginning of these missions of Spanish armed forces in Africa. Initially the response capability to this biological threat was reinforced in these territories, and afterwards training was carried out for the possibility of MEDEVAC missions of patients with infectious diseases in order to receive definitive treatment on national territory. This article is a report of what happened during these missions. It is recognition of all people involved and their efforts

Aeroevacuación médica táctica y estratégica de la fuerza desplegada en Afganistán / Tactical and strategic air evacuation of the military deployed in Afghanistan

Desde el inicio del trabajo de nuestras Fuerzas Armadas en Afganistán en 2002, hasta la actualidad, muchos efectivos han sido desplegados en esta Zona de Operaciones. La cadena logística sanitaria diseñada para el apoyo sanitario a la Fuerza desplegada tiene una clara misión, procurar a los heridos una asistencia sanitaria tan eficaz como la que se dispone en Territorio Nacional y una vez estabilizados solicitar su evacuación médica, que continúe y adelante los cuidados en ruta para un tratamiento definitivo en nuestro País. Esta responsabilidad corresponde a la Unidad Médica de Aeroevacuación, del Ejército del Aire. En un estudio descriptivo y retrospectivo del archivo de la unidad, se analizan las evacuaciones realizadas con origen en Afganistán, en cuanto a la naturaleza de las lesiones, los medios aéreos empleados y los recursos humanos y materiales que se implican en cada misión encomendada

Since the beginning of the Spanish Military deployment in Afghanistan in the year 2002 to the present, many troops have been deployed in the Operations Theatre. It has been designed a medical-supply chain to support the contingents, whose main aim is to provide the injured people with medical assistance as efficient as it is in their home country. Once those injured people have been stabilized, an AeroMedical evacuation is needed to take them to a role 4 facility for the definitive treatment. In this Aeromedical Evacuation the treatment should be continued or even have the possibility of start a new one. The MedEvac responsibility relays on the Aeromedical Evacuation Unit (UMAER). Aeromedical evacuations preformed from Afghanistan have been reviewed in a descriptive and retrospective study using the unite archives. In this study we analyze the wounds nature, aeronautical assets that have been employed and the material and human resources used in every mission

Impulse-induced generation of stationary and moving discrete breathers in nonlinear oscillator networks.

We study discrete breathers in prototypical nonlinear oscillator networks subjected to nonharmonic zero-mean periodic excitations. We show how the generation of stationary and moving discrete breathers are optimally controlled by solely varying the impulse transmitted by the periodic excitations, while keeping constant the excitation's amplitude and period. Our theoretical and numerical results show that the enhancer effect of increasing values of the excitation's impulse, in the sense of facilitating the generation of stationary and moving breathers, is due to a correlative increase of the breather's action and energy.

Tubeless percutaneous nephrolithotomy without losing the possibility of second-look nephroscopy: The perfect combinationu / Nefrolitectomía percutánea tubeless con posibilidad de reexploración: la combinación perfecta

Objectives: To evaluate an alternative approach to tubeless surgery that allows a second per- cutaneous procedure using the same nephrostomy tract. Methods: Twenty patients underwent percutaneous nephrolithotomy from September 2012 to May 2013 at our institution. Inclusion criteria were: absence of urinary infection, single puncture and operative time less than 2 h. Following the procedure the initially placed ureteral catheter was exteriorized through the working sheath by tying a non-absorbable suture to its end. On postoperative day 1 all patients were studied with non-enhanced CT or X-ray film. If the patient was rendered stone free, the stent was removed along with the urethro-vesical catheter. If a residual stone was present, we recovered the ureteral catheter and used the same nephros- tomy tract for a second endoscopic procedure. Patients were assessed for pain, postoperative complications, length of stay, stone free rate, hematocrit and creatinine variations. Results: Thirteen patients met the inclusion criteria. No major complications related to the stent placement and its exteriorization were seen. Two patients required a second percutaneous procedure successfully achieved recovering the ureteral catheter through the nephrostomy tract. Conclusion: We present a safe and simple modification of tubeless percutaneous nephrolitho- tomy, with its well-known clinical benefits but maintaining a safe path for an eventual second look procedure if necessary.(AU)

Objetivos: Evaluar una sencilla modificación de la nefrolitectomía percutánea tubeless que permita un segundo procedimiento endoscópico utilizando el mismo trayecto percutáneo. Métodos: Veinte pacientes fueron sometidos a nefrolitectomía percutánea en decúbito supino modificado entre septiembre de 2012 y mayo de 2013 en nuestro centro. Los criterios de inclusión para el estudio fueron: ausencia de infección urinaria, punción única y tiempo opera- torio menor de 2 h. Al finalizar el procedimiento se instaló una rienda de sutura en el extremo del catéter ureteral, quedando exteriorizada a través del trayecto de nefrostomía para su recuperación en caso de necesidad. Se realizó tomografía computarizada o radiografía simple a todos los pacientes el primer día postoperatorio. Si el paciente estaba «libre de cálculos¼, el catéter ureteral fue retirado junto con la sonda Foley. En caso de litiasis residual se realizó un segundo procedimiento percutáneo, utilizando el mismo trayecto inicial, exteriorizando el catéter ureteral a través del trayecto de la nefrostomía. En todos los pacientes se objetivaron las complicaciones postoperatorias, la estadía hospitalaria y la presencia de litiasis residual, además de la caída del hematocrito y la creatinina. Resultados: Trece pacientes cumplieron los criterios de inclusión. No hubo complicaciones may- ores relacionadas con la colocación del catéter ureteral y su exteriorización. Dos pacientes requirieron una segunda intervención percutánea, lograda con éxito mediante el uso del catéter ureteral reexteriorizado. Conclusión: Se presenta una modificación segura y sencilla de la nefrolitectomía percutánea tubeless sin renunciar a la posibilidad de recuperar el trayecto de nefrostomía original.(AU)

Safety and efficacy of allogeneic adipose tissue-derived mesenchymal stem cells for treatment of dogs with inflammatory bowel disease: Endoscopic and histological outcomes.

Systemic administration of mesenchymal stem cells (MSCs) has been shown to be safe and efficacious in humans with Crohn's disease. The aim of this study was to evaluate the safety of an intravenous (IV) infusion of adipose tissue-derived mesenchymal stem cells (ASCs) and to assess macroscopic and histological effects in the digestive tract of dogs with inflammatory bowel disease (IBD). Eleven dogs with confirmed IBD received a single ASC infusion (2 × 10(6) cells/kg bodyweight). Full digestive endoscopic evaluation was performed pre-treatment and between 90 and 120 days post-treatment with mucosal changes being assessed using a fit-for-purpose endoscopic scale. Endoscopic biopsies from each digestive section were evaluated histologically according to the World Small Animal Veterinary Association (WSAVA) Gastrointestinal Standardization Group criteria. The pre- and post-treatment canine IBD endoscopic index (CIBDEI) and histological score (HS) were calculated and compared using the Wilcoxon test. Remission was defined as a reduction of >75% of the CIBDEI and HS compared with pre-treatment. No acute reactions to ASC infusion or side effects were reported in any dog. Significant differences between pre- and post-treatment were found in both the CIBDEI (P = 0.004) and HS (P = 0.004). Endoscopic remission occurred in 4/11 dogs with the remaining dogs showing decreased CIBDEI (44.8% to 73.3%). Histological remission was not achieved in any dog, with an average reduction of the pre-treatment HS of 27.2%. In conclusion, a single IV infusion of allogeneic ASCs improved gastrointestinal lesions as assessed macroscopically and slightly reduced gastrointestinal inflammation as evaluated by histopathology in dogs with IBD.

Safety and efficacy of allogeneic adipose tissue-derived mesenchymal stem cells for treatment of dogs with inflammatory bowel disease: Clinical and laboratory outcomes.

Mesenchymal stem cells (MSCs) have shown immunomodulatory and anti-inflammatory effects in experimental colitis, and promising clinical results have been obtained in humans with Crohn's disease and ulcerative colitis. The aim of this study was to determine the safety and feasibility of adipose tissue-derived MSC (ASC) therapy in dogs with inflammatory bowel disease (IBD). Eleven dogs with confirmed IBD received one ASC intravascular (IV) infusion (2 × 10(6) cells/kg bodyweight). The outcome measures were clinical response based on percentage reduction of the validated Clinical Inflammatory Bowel Disease Activity Index (CIBDAI) and Canine Chronic Enteropathy Clinical Activity Index (CCECAI), as well as normalisation of C-reactive protein (CRP), albumin, folate and cobalamin serum concentrations at day 42 post-treatment. The Wilcoxon test was used to compare variables before and after treatment. No acute reaction to ASC infusion and no side effects were reported during follow-up in any dog. Six weeks post-treatment, the CIBDAI and CCECAI decreased significantly and albumin, cobalamin and folate concentrations increased substantially. Differences in CRP concentrations pre- and post-treatment were not significant (P = 0.050). Clinical remission (defined by a reduction of initial CIBDAI and CCECAI >75%) occurred in 9/11 dogs at day 42. The two remaining dogs showed a partial response with reduction percentages of 69.2% and 71.4%. In conclusion, a single IV infusion of allogeneic ASCs was well tolerated and appeared to produce clinical benefits in dogs with severe IBD.

Diabetes latente autoinmune en el joven. Una nueva aportación / Latent autoimmune diabetes in the young. A new case

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