Resveratrol loaded Pickering emulsions stabilized by OSA modified rice starch granules.

Resveratrol is a photosensitive, bioactive molecule which has received increasing research interest during the past decade for its antioxidant properties. However, it has low solubility in water or common triglyceride oils. Resveratrol solubilization in oil can only be achieved in essential oils, such as flavour oils, but the stability of emulsions produced with this type of oils is low as they are prone to creaming phenomena and Oswald ripening. In this study, resveratrol was first dissolved in orange oil which was mixed into a medium-chain triglyceride (Miglyol) at different ratios and used as the internal phase of oil-in-water emulsions (O/W). The emulsions were stabilized by octenyl succinic anhydride (OSA) modified rice starch granules using two different ratios of starch particle:oil to study the influence of interfacial coverage on the final emulsion droplet size and emulsion stability. The results of this study indicated that stable Pickering emulsions could be prepared using OSA-modified rice starch granules even at partial coverage conditions. Emulsions prepared at an oil fraction of 0.5 using 30% v/v mixture of orange oil in Miglyol as the dispersed phase seemed to be an appropriate resveratrol carrier system, obtaining encapsulation efficiency values close to 90% which results in emulsions with a resveratrol concentration of 8.45 mg/L. Hence, the emulsions prepared are suitable for food fortification applications.

Secondary dengue virus infections during the 2009 outbreak in Buenos Aires.

OBJECTIVES: To evaluate the occurrence of secondary dengue virus (DENV) infections during the 2009 outbreak in a non-endemic area. Viral loads were evaluated in serum from acute-phase patients, comparing primary and secondary infection. METHODS: Serum samples from patients with clinical diagnosis of suspected dengue were referred to the Virology Laboratory at 'Ricardo Gutiérrez' Children's Hospital. Dengue-positive samples were classified as primary or secondary DENV infections through serological methods (anti-DENV IgM and IgG). Viral loads were measured by quantitative real-time PCR (qRT-PCR) in samples obtained in the first 5 days of infection. Statistical analyses were performed to evaluate factors that might correlate with differences in the viral load of primary or secondary infection. RESULTS: A total of 229 DENV cases were confirmed; among them, 22.7% were secondary infections. No significant differences were found between the viral load of primary and secondary infections. CONCLUSION: We detected a high percentage of secondary DENV infections in a non-endemic area; this finding might correspond to socio-demographic characteristics of the group under study or indicate a previous cryptic DENV circulation causing inapparent infections.

¿Dengue, siempre una enfermedad importada en España? / Dengue? Always an imported disease in Spain?

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Abordaje terapéutico de la artritis séptica pediátrica, ¿somos demasiado agresivos? / Therapeutic approach to paediatric septic arthritis: are we too aggressive?

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Tos ferina, una enfermedad reemergente / Whooping cough, a re-emerging disease

Objetivo. Estamos asistiendo a una reemergencia de la tos ferina. Los lactantes que no han completado la primo-vacunación son el grupo de riesgo más vulnerable. La transmisión de la infección se asocia normalmente a un contacto domiciliario. Para ponerlo de manifiesto hemos desarrollado esta revisión. Material y métodos. Estudios descriptivo, retrospectivo, mediante revisión de serie de casos de pacientes con diagnóstico microbiológico de tos ferino ingresados en el Hospital Universitario Virgen Macarena desde Enero de 2006 a Junio de 2013. Resultados. Total de pacientes diagnosticados de tos ferina: 49. Aumento de la incidencia de la enfermedad en los últimos años, con un 75,5% de los casos entre enero de 2010 a junio de 2013. Un 83,7% de los pacientes fueron menores de 6 meses. Dos de ellos son diagnosticados de tos ferina maligna con evolución favorable tras exanguinotransfusión. Mayor días de ingreso para los pacientes de menor edad. El estudio mediante PCR en secreción nasofaríngea fue positivo en un 53,8% de los familiares estudiados. Conclusiones. Parece importante plantear un cambio en la estrategia de vacunación actual frente a la tos ferina, para disminuir la incidencia de la misma en los distintos grupos de edad y sus complicaciones como la tos ferina maligna (AU)

Goal. We are witnessing a resurgence of pertussis, being the infants who have not completed the primary vaccination yet the most vulnerable risk group. The transmission of the infection is usually associated to a household contact. To show it, we have developed this review. Material and methods. A Descriptive, retrospective study based on the review of a number of cases of patients with microbiological diagnosis of pertussis admitted to the Virgen Macarena University Hospital from January 2006 to June 2013. Results. The total number of patients diagnosed with pertussis was 49. It shows an increase in the incidence of the disease in recent years, with 75.5% of cases between January 2010 to June 2013. Most patients, 83,7%, were less than 6 moths. Two of them are diagnosed with malignant pertussis favorable outcome after exchange transfusion. The average time of hospitalization is higher for younger patients. The study by PCR in nasopharyngeal secretions was positive in 53,8% of the relatives studied. Conclusions. In view of the data presented, it seems important to change the current vaccination strategy with respect to the pertussis to reduce its incidence in the different age groups and its complications such as malignant pertussis (AU)

Are tendon transfers justified in very old hand radial palsies?

There have been very few reports about results of tendon transfers carried out in very old radial palsies affecting the hand. We present two cases of radial palsy operated 52 and 30 years after the original injury, which also had after-effects in pronosupination due to elbow injuries. In the first patient, with high radial-nerve palsy, we made a triple transfer of the pronator teres to the extensor carpi radialis brevis, the flexor carpi ulnaris to the extensor digitorum communis and the palmaris longus to the extensor pollicis longus. In the second case, which had posterior interosseous nerve palsy, we transferred the flexor carpi radialis to the extensor digitorum communis, and the brachiorradialis to the extensor pollicis longus. The surgical findings showed a 'gelatinous degeneration' in some of the receiving tendons, which did not prevent the sutures from being resistant. The first patient, who had a stiff elbow, with pronosupination blocked since childhood, showed disuse atrophy of the pronator teres, which conditioned a late rupture of the tenomuscular junction and required a second surgery for wrist arthrodesis. Results after postoperative period of 30 months after surgery in the first patient, and 14 months after surgery in the second one, showed functional recovery in finger range of extension, grip and key-pinch strength and a significantly higher QuickDASH score, restoring the natural aesthetical appearance of the limb. This facilitated the return to professional and daily activities, re-establishing a fine ability to grab and release objects.

Thumb metacarpophalangeal joint ligament reconstruction with a triangular tendon graft in posttraumatic chronic instability.

UNLABELLED: The purpose of this study was to report the results of static triangular ligament reconstruction, in thumb metacarpophalangeal (MCP) joint chronic posttraumatic laxity using a tendon graft with a proximal apex in ten patients. The mean postoperative follow-up was 40.2 months. The mean postoperative thumb MCP joint stress testing was 43° less than before surgery, and 6.5° less than in the non-injured hand. The mean range of flexion was 10.5° lower in the operated thumb than in the contralateral one, and the mean range of extension was 8° lower. Minimal differences in the values of the Kapandji score, grip and key-pinch strength were found. The preoperative pain became an occasional discomfort after surgery. All patients had a subjective sense of stability until final follow-up. All patients returned to their work or daily activities. LEVEL OF EVIDENCE IV: For therapeutic studies investigating the results of treatment.

Molecular typing of adenoviruses in pediatric respiratory infections in Buenos Aires, Argentina (1999-2010).

BACKGROUND: The human adenovirus (HAdV) types most commonly found in respiratory samples belong to HAdV species C (HAdV-C1, -C2, -C5, and -C6) and to HAdV species B (HAdV-B3 and -B7). Several studies in South America have shown the association between severe respiratory infections and subspecies B1. OBJECTIVES: The aim of this study was to identify the adenovirus types associated with acute lower respiratory tract infections in children, found as single or coinfections, throughout a 12-year period. STUDY DESIGN: All samples that tested positive for adenovirus by immunofluorescence assay from January 1999 to December 2010 were typed by evaluating a set of four viral genes (E1A, VA, hexon and fiber). Quantitative PCRs for HAdV-B and HAdV-C species were performed to compare the viral load found in single infections and coinfections. RESULTS: From a total of 743 HAdV, 654 (88%) were single infections and 89 (12%) coinfections. From the 654 single HAdV infections, members of four species were present: species B (n=492, 75.23%), species C (n=138, 21.1%), species E (n=19, 2.91%), and species D (n=5, 0.76%). Only members of species B (n=109, 57.67%) and species C (n=80, 42.33%) were detected in coinfections. HAdV-B7 and HAdV-B3 were the most prevalent types (n=308, 36.54%; n=230, 27.28% respectively) and HAdV-C1, -C2, -E4, -C5, -C6, -D8, -B11, -B14 and -B21 were also detected. Viral loads for species C viruses were higher in single infections than in coinfections (p<0.01), whereas the opposite was observed for species B viruses (p<0.0001). CONCLUSIONS: This study provides a thorough description of adenovirus circulation and diversity in Buenos Aires in a 12-year period. The high proportion of coinfections found in this work shows that this phenomenom might be more common than expected.

Carcinoma linfoepitelial del cuello uterino / Linfoepitelial cancer of the cervix

El cáncer linfoepitelial del cuello uterino es excepcional en nuestro continente, el propósito de la presente publicación es evaluar la etiología, diagnóstico y tratamiento de un caso clínico. El estudio anátomo-patológico ofreció ciertas dificultades, por lo que se recurrió a la inmunohistoquímica para hacer el diagnóstico diferencial con el carcinoma epidermoide, el carcinoide de células grandes y el linfoma anaplásico. El compromiso del virus de Epstein-Barr y el virus del Papiloma Humano, con el cáncer linfoepitelial, no fueron con-cluyentes. Se encontró tinción positiva granular en el citoplasma de células epiteliodeas aisladas en relación al primero, e indicios de daño coilocitico en el epitelio pavimentoso en relación al segundo. La enfermedad se presentó como lesión única sangrante en el labio anterior del cuello uterino. El tratamiento fue quirúrgico con erradicación completa, lo que favorece el pronóstico.

Linfoepitelial cancer of the cervix is exceptional in our continent. The purpose of this publication is to evaluate the etiology, diagnosis and treatment. Anatomical and pathological study offered certain difficulties; immunohistochemistry was used to make the differential diagnosis with squamous carcinoma, large cell carcinoid and anaplastic lymphoma. Compromise of Epstein - Barr virus and virus of Human Papilloma, with linfoepitelial cancer, were not conclusive. We found positive granular staining in the cytoplasm of isolated epithelioid cells in relation to the first virus and koilocytic damage of the squamous epithelium in regard to the second. The disease was presented as unique, bloody injury, in the anterior lip of the cervix. The treatment was surgical with complete eradication, which favors the prognosis.

Genetic and phylogenetic analyses of influenza A H1N1pdm virus in Buenos Aires, Argentina.

An influenza pandemic caused by swine-origin influenza virus A/H1N1 (H1N1pdm) spread worldwide in 2009, with 12,080 confirmed cases and 626 deaths occurring in Argentina. A total of 330 H1N1pdm viruses were detected from May to August 2009, and phylogenetic and genetic analyses of 21 complete genome sequences from both mild and fatal cases were achieved with reference to concatenated whole genomes. In addition, the analysis of another 16 hemagglutinin (HA), neuraminidase (NA), and matrix (M) gene sequences of Argentinean isolates was performed. The microevolution timeline was assessed and resistance monitoring of an NA fragment from 228 samples throughout the 2009 pandemic peak was performed by sequencing and pyrosequencing. We also assessed the viral growth kinetics for samples with replacements at the genomic level or special clinical features. In this study, we found by Bayesian inference that the Argentinean complete genome sequences clustered with globally distributed clade 7 sequences. The HA sequences were related to samples from the northern hemisphere autumn-winter from September to December 2009. The NA of Argentinean sequences belonged to the New York group. The N-4 fragment as well as the hierarchical clustering of samples showed that a consensus sequence prevailed in time but also that different variants, including five H275Y oseltamivir-resistant strains, arose from May to August 2009. Fatal and oseltamivir-resistant isolates had impaired growth and a small plaque phenotype compared to oseltamivir-sensitive and consensus strains. Although these strains might not be fit enough to spread in the entire population, molecular surveillance proved to be essential to monitor resistance and viral dynamics in our country.

Whole genome analysis of the action of interferon-beta.

OBJECTIVES: To characterize the IFNbeta1a-regulated gene expression on leukocytes of Multiple Sclerosis (MS) patients using microarrays with whole human genome representation. METHODS: Genes differentially expressed by interferon-beta were identified by a microarray in vitro study performed in leukocytes obtained from 5 MS relapsing-remitting patients. RESULTS: Following the culture of peripheral blood mononuclear cells from MS relapsing-remitting patients for 24 hs with IFNbeta1a, the expression of 868 genes was modified: 545 increased (including CXCL11, CCL8, INDO, IFI27, CFB, CXCL10 and IFIT1) and 323 diminished (including RBP7, SEPT5, RNF8, ADORA2B and FOS). CONCLUSIONS: Since many of them were previously recognized as involved in MS pathogenesis, the IFNbeta1a mechanism of action could imply a compensatory regulation of systems deregulated in MS.

Two recombinant human interferon-beta 1a pharmaceutical preparations produce a similar transcriptional response determined using whole genome microarray analysis.

OBJECTIVES: Recombinant human interferon-beta (IFN-b) is a well-established treatment for multiple sclerosis (MS). The regulatory process for marketing authorization of biosimilars is currently under debate in certain countries. In the EU, EMEA has clearly defined the process including overarching and product-specific guidelines, which includes clinical testing. Biosimilarity needs to be based on comparability criteria, including at least molecular characterization, biological activity relevant for the therapeutic effect and relative bioavailability ("bioequivalence"). In the case of such complex diseases as MS, where the effect of treatment is not so directly measurable, in vitro tools can provide additional data to support comparability. Genomic microarrays assays might be useful to compare multisource biopharmaceuticals. The aim of the present study was to compare the pharmacodynamic genomic effects (in terms of transcriptional regulation) of two recombinant human IFN-I(2)1a preparations on lymphocytes of multiple sclerosis patients using a whole genome microarray assay. METHODS: We performed an ex vivo whole genome expression profiling of the effect of two preparations of IFN-I(2)1a on non-adherent mononuclears from five relapsing-remitting MS patients analyzing microarrays (CodeLink Human Whole Genome). Patients blood was drawn, PBMCs isolated and cultured in three different conditions: culture medium (control), 1,000 U/ml of IFN-I(2)1a (BLA- (STOFERON, Bio Sidus) and 1,000 U/ml of IFN-I(2)1a (REBIF, Serono) RNA was purified from non-adherent cells (mostly lymphocytes), amplified and hybridized. Raw data were generated by CodeLink proprietary software. Data normalization, quality control and analysis of differential gene expression between treatments were done using linear model for microarray data. Functional annotation analysis of IFN-I(2)1a MS treatment transcription was done using DAVID. RESULTS: Out of the approximately 45,000 human sequences examined, no evidence of differential regulation was found when both treatments were compared (minimum adjusted p-value > 0.999). The IFN-I(2)1a effect differentially regulated the expression of 868 genes. The expression of standard markers such as GTP cyclohidrolase, MxA, and OAS isoenzymes A and B changed as a consequence of the action of IFN-I(2)1a. CONCLUSIONS: This exhaustive and highly sensitive assay did not show differences in the genomic expression profile of these two products under the assayed experimental conditions. These results suggest that this technology might be useful for the initial comparison of biosimilars, being part of a comprehensive comparability program that includes clinical testing.

Correlación anatomopatológica de las hiperplasias endometriales antes y después de la histerectomía / Histopathological correlation of endometrial hyperplasia: before and after of hysterectomy

Objetivo: Correlacionar histológicamente las biopsias del legrado uterino con las biopsias de las piezas de histerectomía en pacientes con hiperplasia endometrial (HE). Método: Se diagnosticaron con biopsia de legrado uterino 90 pacientes con HE entre enero de 2001 y diciembre de 2005. De estas pacientes, 46 correspondieron a HE con atipia (grupo 1) y 44 a HE sin atipia (grupo 2). Todas las pacientes del grupo 1 se sometieron a histerectomía total más salpingooforectomía bilateral. A 28 pacientes del grupo 2 se les realizó la misma cirugía por patologías ginecológicas asociadas. Se compararon los resultados de las biopsias pre y postoperatorias de las 74 pacientes operadas, evaluándose la concordancia entre ellas. Resultados: En la biopsia de la pieza de histerectomía del grupo 1 se observan 31 casos con HE con atipia (67,4 por ciento), 13 casos (28,3 por ciento) sin atipias y 2 casos (4,3 por ciento) de cáncer endometrial. En el grupo 2 hubo 16 casos (57,1 por ciento) con HE sin atipia, 10 casos (35,7 por ciento) con endometrio normal y 2 (7,1 por ciento) casos de HE con atipia. La concordancia fue de un 63 por ciento (p=0,000) entre ambas biopsias y resultó significativamente más baja en el subgrupo de pacientes que presentaban atipias en la biopsia preoperatorio, respecto a las pacientes sin atipias (p=0,028). El likehood ratio de la biopsia preoperatorio de pacientes con HE con atipias fue de 33,2. Conclusión: El diagnóstico con biopsia preoperatoria por legrado, de las pacientes con HE, tuvo una precisión aceptable en comparación a la biopsia de la pieza operatoria, apoyando su utilidad en el manejo de estas pacientes.

Objective: To evaluate the hystopathologic correlation between curettage and hysterectomy specimens in patients with endometrial hyperplasia. Methods: 90 patients were diagnosed with endometrial hyperplasia in curettage specimens between January 2001 and December 2005. Of these patients 46 were found to have atypical hyperplasia (group 1) and 44 hyperplasia without atypias (group 2). All the patients in group 1 had a total hysterectomy plus bilateral anexectomy; 28 patients of group 2 had the same surgery because of associate gynecological pathology. Curettage and hysterectomy specimens of 74 patients were compared and evaluated the concordance between them. Results: Of hysterectomy specimens in group 1, 31 cases had atypical hyperplasia (67.4 percent), 13 cases (28.3 percent) hyperplasia without atypias and 2 cases (4.3 percent) with endometrial carcinoma. In group 2, 16 cases (57.1 percent) of hyperplasia without atypias, 10 cases (35.7 percent) with normal endometrium and 2 (7.1 percent) cases of atypical hyperplasia were found. The agreement of the hysto-pathological diagnosis of endometrial hyperplasia between both biopsies was 63 percent (p=0.000) and it was significantly lower in the subgroup of patients that had atypias on the curettage biopsy with respect to the patients with hyperplasia with no atypias (p=0.028). The likehood ratio of the biopsy by curettage of patients with atypias was of 33.2. Conclusion: The accuracy of the curettage biopsies as compared with hysterectomy specimens in patients with endometrial hyperplasia was acceptable, supporting its usefulness in the management of these patients.

Bloqueo del cordón espermático como tratamiento del dolor crónico testicular / No disponible

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Manejo anestésico en la inmunodeficiencia de inmunoglobulina a asociada a artritis crónica juvenil / No disponible

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Tumor borderline mucinoso ovárico gigante con microinvasión / Borderline mucinous ovarian tumor with microinvasion

Se presenta caso clínico de tumor borderline mucinoso gigante de ovario derecho operado. Se describe una breve revisión de la literatura, incluyendo los conceptos de microinvasión, arquitectura micropapilar, implantes, así como algunas características de su patogenia y tratamiento.