Afectación ocular secundaria a la infección por Monkeypox virus / Ocular involvement secondary to Monkeypox virus infection

Presentamos el caso de un paciente varón de 37años con cuadro compatible con conjuntivitis adenovírica de 5días de evolución. Se pautaron corticoides tópicos, lubricantes y retirada de pseudomembranas. El análisis mediante PCR del exudado conjuntival resultó positivo para Monkeypox virus. Durante el seguimiento presentó úlceras corneales de evolución tórpida, por lo que precisó ingreso para instaurar tratamiento con tecovirimat. La afectación ocular por Monkeypox virus suele ser leve y autolimitada. Se han descrito casos con afectación visual severa cuando hay daño corneal, tal y como se ejemplifica en este caso. Tras el ingreso hospitalario para tratamiento sistémico, presentó una evolución favorable. (AU)

We present the case of a 37-year-old male patient with symptoms compatible with adenoviral conjunctivitis of 5days’ evolution. Topical corticosteroids, lubricants and removal of pseudomembranes were prescribed. PCR analysis of conjunctival exudate was positive for Monkeypox virus. During follow-up, the patient developed corneal ulcers with a torpid course, requiring admission for treatment with tecovirimat. Ocular involvement by Monkeypox virus is usually mild and self-limiting. Cases with severe visual involvement have been described when there is corneal damage, as exemplified in this case. After admission to hospital for systemic treatment, the patient progressed favourably. (AU)

Ocular involvement secondary to Monkeypox virus infection.

We present the case of a 37-year-old male patient with symptoms compatible with adenoviral conjunctivitis of 5 days' evolution. Topical corticosteroids, lubricants and removal of pseudomembranes were prescribed. PCR analysis of conjunctival exudate was positive for Monkeypox virus. During follow-up, the patient developed corneal ulcers with a torpid course, requiring admission for treatment with Tecovirimat. Ocular involvement by Monkeypox virus is usually mild and self-limiting. Cases with severe visual involvement have been described when there is corneal damage, as exemplified in this case. After admission to hospital for systemic treatment, the patient progressed favourably.

Manejo anestésico de las pacientes embarazadas tetrapléjicas durante el parto: una revisión sistemática / Anaesthetic management of tetraplegic pregnant patients during child delivery: A systematic review

Introducción: El embarazo en pacientes con lesión de la médula espinal tiene unas características específicas. Sin embargo, las guías para orientar su manejo son escasas. Métodos: Se realizó una revisión sistemática de la literatura sobre el manejo anestésico durante el parto de pacientes embarazadas con lesión de la médula espinal cervical. Resultados: Se observó una mayor incidencia de parto prematuro y cesárea. El manejo anestésico fue diverso, aunque la mayoría de las pacientes embarazadas recibieron analgesia epidural. Los síntomas de disreflexia autónoma se observaron en el 51% de las mujeres. Conclusión: El manejo adecuado de estas pacientes podría reducir posiblemente la tasa de cesáreas y partos prematuros, y minimizar las complicaciones comunes, reduciendo al mismo tiempo los costes. Se recomienda una derivación precoz a la consulta de anestesiología y un enfoque multidisciplinario.(AU)

Introduction: Pregnancy in spinal cord injured patients has specific issues that must be carefully addressed. However, guidelines for their management are scarce. Methods: A systematic review of the literature regarding the anaesthetic management during delivery of pregnant patients with cervical spinal cord injury was performed on the electronic databases of PubMed (Medline) and Cochrane. Results: A higher incidence of preterm birth and caesarean delivery were seen. Anaesthetic management was diverse, although most pregnant patients received epidural analgesia. Autonomic dysreflexia symptoms were present in 51% of pregnancies. Conclusion: Timely management of these patients could possibly reduce caesarean and preterm delivery rates, avoid or minimize common complications, as well as reduce costs. An early reference to anaesthesiology consultation and a multidisciplinary approach is recommended.(AU)

Anaesthetic management of tetraplegic pregnant patients during child delivery: A systematic review.

BACKGROUND: Pregnancy in spinal cord injured patients has specific issues that must be carefully addressed. However, guidelines for their management are scarce. METHODS: A systematic review of the literature regarding the anaesthetic management during delivery of pregnant patients with cervical spinal cord injury was performed on the electronic databases of PubMed (Medline) and Cochrane. RESULTS: Twenty-two papers were included. A higher incidence of preterm birth and caesarean delivery were seen. Anaesthetic management was diverse, although most pregnant patients received epidural analgesia. Autonomic dysreflexia symptoms were present in 51% of pregnancies. CONCLUSION: Timely management of these patients could possibly reduce caesarean and preterm delivery rates, avoid or minimize common complications, as well as reduce costs. An early reference to anaesthesiology consultation and a multidisciplinary approach is recommended.

Substratos, concentrações de ácido indolbutírico e tipos de miniestacas no enraizamento de melaleuca (Melaleuca alternifolia Cheel) / Substrates, indolebutyric acid levels and types of minicuttings on the rooting of tea tree (Melaleuca alternifolia Cheel)

Melaleuca alternifolia tem como produto principal o óleo essencial extraído das folhas devido às propriedades antifúngicas e antibacterianas. Pouco se tem relatado sobre a propagação desta espécie, sendo a miniestaquia uma alternativa para a propagação vegetativa de clones superiores visando à implantação de campo de produção. Este trabalho teve como objetivo avaliar o efeito de diferentes substratos, concentrações de AIB, e tipo de miniestaca, no enraizamento de Melaleuca alternifolia. No primeiro experimento foram testados os substratos, areia de granulometria média, Plantmax HT®, Golden-Mix® e vermiculita. No segundo experimento foram avaliadas diferentes concentrações de AIB (0, 500, 1000 e 2000 mg L-1), em dois tipos de miniestacas (apical e mediana). As miniestacas foram confeccionadas com 5 cm de comprimento, mantidas em casa de vegetação com nebulização intermitente, e, após 45 dias do plantio, foram avaliadas as porcentagens de miniestacas enraizadas, com calos e não responsivas, o número de raízes formadas por miniestaca e o comprimento das três maiores raízes (cm). O substrato Golden-Mix® e as miniestacas coletadas da porção apical do ramo submetidas ao tratamento com 500 mg L-1 de AIB apresentaram maior porcentagem de enraizamento e melhor qualidade do sistema radicial.

Melaleuca alternifolia has as major product the essential oil extracted from its leaves due to its antifungal and antibacterial properties. There are scarce reports about the propagation of this species, and minicutting is an alternative for vegetative propagation of superior clones in order to establish a production field. This study aimed to evaluate the effect of different substrates, IBA levels and types of minicuttings on the rooting of Melaleuca alternifolia. In the first experiment, the following substrates were tested: medium sand, Plantmax HT®, Golden-Mix® and vermiculite. In the second experiment, different IBA levels (0, 500, 1000 and 2000 mg L-1) were tested for two minicutting types (apical and medium). Minicuttings were prepared with 5 cm length and were kept in a greenhouse with intermittent mist; then, at 45 days after planting, we evaluated: the percentages of rooted minicuttings, with callus and non-responsive, the number of roots per minicutting and the length of the three longest roots. The substrate Golden-Mix® and the minicuttings collected from the apical part of the branch and treated with 500 mg L-1 IBA presented the largest rooting percentage and the best root system quality.

Precise control of superluminal and slow light propagation by transverse phase modulation.

We have used a heterodyne Z-scan technique to produce both superluminal and slow light propagation in media that present either thermal or Kerr nonlinearities. The sample position determines the magnitude and sign of the group velocity and this property was used to control it, with an experimental setup much simpler than those previously reported in similar investigations. The observed effect is attributed to the transverse phase modulation produced by a focused Gaussian beam, and is capable of producing both positive and negative group velocities in the range 1.5 m/s < |upsilon(g)| < c.

Does the efficacy of BCG decline with time since vaccination?

OBJECTIVE: To investigate whether the protective efficacy of bacille Calmette-Guérin (BCG) against tuberculosis decreases with time since vaccination. DESIGN: A quantitative review of all 10 randomized trials of BCG against tuberculosis in purified protein derivative (PPD)-negative individuals, that presented data for discrete periods. For each trial, we derived log rate ratios for the annual change in the efficacy of BCG. We also compared efficacy in the first two years, and the first 10 years, to that in the rest of the trial. RESULTS: There was considerable heterogeneity between trials in the annual change in the efficacy of BCG. In seven efficacy decreased overtime, while in three it increased. Average annual change in efficacy was not related to overall efficacy. Efficacy also varied between trials in the first two years after vaccination, at more than two years after vaccination and in the first ten years after vaccination. However the variation in efficacy between trials more than 10 years after vaccination was not statistically significant (P = 0.26). We therefore calculated that the average efficacy more than 10 years after vaccination was 14% (95% confidence interval -9% to 32%). CONCLUSION: BCG protection can wane with time since vaccination. There is no good evidence that BCG provides protection more than 10 years after vaccination.

Effect of sodium oleate on oxidative metabolism of isolated mitochondria and submitochondrial particles.

Using conventional polarographic and spectrophotometric methods, the effect of sodium oleate on isolated mitochondria dn submitochondrial particles was analysed. A loose coupling was developed in isolated mitochondria in the presence of about 10 nmoles oleate per mg protein. Oleate stimulates and activity of bovine heart mitochondrial Mg-ATPase, and it was found to be dependent on substrate concentration. Investigation of the membrane potential showed that the delta psi is abolished at high concentration of oleate. The deterioration of the morphological appearance of mitochondria, occurring on addition of oleate, is also described.