Transplantes de microbiota fecal para tratamento da colite pseudomembranosa(1958-2013): prioridade de descoberta e estilos de pensamento na literatura acadêmica / Fecal microbiota transplants in the treatment of pseudomembranous colitis (1958-2013): priority of discovery and thought styles in the academic literature

Em 1958, Eiseman e colaboradores publicaram o primeiro artigo científico relatando o uso de transplante de microbiota fecal para tratar casos graves de colite pseudomembranosa. A relevância desse trabalho inovador só foi reconhecida em 1990. A literatura acadêmica sobre o tema caracteriza-se por sucessivas reconstruções. Sugerimos que tais reconstruções foram orientadas por questões de atribuição de prioridade de descoberta científica nos termos propostos por Merton. A retomada do uso de transplantes de microbiota fecal é interpretada como processo de gênese de um fato científico, conforme Fleck: ocorre a mudança de um estilo de pensamento baseado no uso de antibióticos no tratamento de doenças infecciosas para outro que considera as relações ecológicas entre hospedeiros, vetores e agentes etiológicos de doença

[Human head transplantation].

Since the beginning of the 20th century, head transplantation (cephalosomatic anastomosis) has been studied in animal models including mice, rats and monkeys. A recently proposed protocol for head transplantation in humans has revived the interest for the procedure. However, key elements in the procedure, such as functional spinal cord fusion, sufficient neuroprotection and post-operative pain control are still undocumented. Ethical issues remain concerning the scientific validity of the proposed project as well as general concerns regarding the entire concept of human head transplantation.

Uterine Transplantation: Surgical Innovation in the Treatment of Uterine Factor Infertility.

Uterine factor infertility (UFI) is a condition that affects thousands of women and is estimated to have a prevalence as high as one in five hundred reproductive-aged women. A wide range of circumstances can lead to UFI and include women with congenital absence of a uterus (Mayer Rokitansky Kuster Hauser or MRKH syndrome), women who have undergone iatrogenic removal of the uterus, or women who have uteri that are in situ but have been damaged by infection or surgical instrumentation. There have been 17 published reports of human uterine transplantation in the world. This article will summarize the history of human uterine transplantation and discuss our current understanding of the medical, surgical, and ethical considerations surrounding this innovative procedure.

New contributions to the study of the life and work of Vinko Franciskovic (1919-1984), pioneer of Croatian cardiothoracic and transplantation surgery.

AIM: To explore personal biography of Vinko Franciskovic (1919-1984), to improve the understanding of the beginnings of Croatian cardiothoracic and transplantation surgery. METHODS: Comparative critical analysis of written published materials, archival materials and information collected through oral history interviews. RESULTS: Vinko Serafin Franciskovic was born in Praputnjak, a settlement of the eastern surroundings of Rijeka, Croatia. He was raised up in the Italian language and culture by hisaunt, a mother's sister and her husband. He went to the Royal Classical Grammar School Giovanni Prati in Trento. On July 15, 1943, he defended his thesis, titled A contribution to the surgical therapy of fractures of the femoral neck at the Faculty of Medicine, University of Padua. CONCLUSION: The represented data about Vinko Franciskovic's life, especially those concerning his secondary and higher education, explain some of his crucial personal traits and his later professional pathway.

Twenty-eight years of intestinal transplantation in Paris: experience of the oldest European center.

Our aim was to describe our achievements in pediatric intestinal transplantation (ITx) and define areas for improvement. After a period (1987-1990) of nine isolated small bowel transplants (SBTx) where only one patient survived with her graft, 110 ITx were performed on 101 children from 1994 to 2014: 60 SBTx, 45 liver-small bowel, four multivisceral (three with kidneys), and one modified multivisceral. Indications were short bowel syndrome (36), motility disorders (30), congenital enteropathies (34), and others (1). Induction treatment was introduced in 2000. Patient/graft survival with a liver-containing graft or SBTx was, respectively, 60/41% and 46/11% at 18 years. Recently, graft survival at 5/10 years was 44% and 31% for liver-containing graft and 57% and 44% for SBTx. Late graft loss occurred in 13 patients, and 7 of 10 retransplanted patients died. The main causes of death and graft loss were sepsis and rejection. Among the 55 currently living patients, 21 had a liver-containing graft, 19 a SBTx (17 after induction), and 15 were on parenteral nutrition. ITx remains a difficult procedure, and retransplantation even more so. Over the long term, graft loss was due to rejection, over-immunosuppression was not a significant problem. Multicenter studies on immunosuppression and microbiota are urgently needed.

CD4+CD25+ T Regulatory Cells in Transplantation Tolerance: 25 Years On.

In the 1970s, the capacity of T cells to inhibit immunity and those from transplant tolerant hosts to transfer alloantigen-specific suppression to lymphopenic recipients was described. CD4 T suppressor cells that ex vivo reverted to effector cells were described in the 1980s. Their antigen-specific suppressor function could be preserved by stimulation by specific donor alloantigen and cytokines from activated lymphocytes. This led to the finding that alloantigen-specific T suppressor cells express IL-2 receptor (CD25) and that IL-2 in part promotes their survival.Whether these alloantigen-specific CD4CD25FOXP3 regulatory T (Treg) cells are progeny of thymic-derived CD4CD25FOXP3 Treg (tTreg) cells or are induced from peripheral effector CD4CD25FOXP3T cells (iTreg) cells is still debated.In vitro studies of antigen specific Treg has been difficult as they die in the absence of cytokines produced by immune activated cells. The antigen-specific CD4CD25 T cells that control rejection in tolerant hosts differ from the naive tTreg. Thymic-derived Treg cells are not antigen-specific, and very high ratios are required to suppress rejection. Thymic-derived Treg cells can be expanded ex vivo and are currently being tested in trials to control allograft rejection and graft versus host disease.Thymic-derived Treg cells with specific receptors for alloantigen are activated by either IL-2 or IL-4 but rapidly become dependent on other cytokines, respectively, IFN-γ or IL-12 if activated by IL-2, or IL-5 if activated by IL-4. The Th1 and Th2 pathways for activation of tTreg produce more potent antigen-specific Treg that only suppress specific donor rejection. After 25 years, much remains unknown about antigen-specific CD4CD25FOXP3 Treg-mediating transplant tolerance.

La Unidad de Oncología e Inmunohematología Pediátricas del Hospital Universitario Miguel Servet en 2015 / Pediatric oncology and immunology unit of the Hospital Universitario Miguel Servet in 2015

La Unidad de Oncología e Inmunohematología Pediatricas del Hospital Universitario Miguel Servet (HUMS) de Zaragoza es la única de referencia en la Cornunidad Autónoma de Aragón para el tratamiento integral y seguimiento de los pacientes pediátricos con cáncer y otras enfermedades hematológicas e inmunológicas graves. Asiste, también, a un número importante de pacientes de otras provincias limítrofes con Aragón, como la Rioja y Soria. Las labores asistencial e investigadora de esta Unidad, que se revisaran a continuación, han evolucionado y se han ampliado de forma continua desde su inauguración, hace mas de 30 años (AU)

Hospital Miguel Servet Pediatric Oncology and Immunohematology Unit, is the only reference center in Aragon for the treatment and follow-up of children with cancer and other severe hematological and immunological diseases. It is also responsible for a significant number of patients from nearby regions to Aragon, such as La Rioja and Soria. Its clinical activity and research work, which will be reviewed next, has improved continuously since its opening, over more than 30 years ago (AU)