Epidural Anesthesia for Cesarean Section in a Pregnant Woman With Acute Pulmonary Edema: A Case Report.

Although rare, acute pulmonary edema is the most common cause of death in pregnant women with severe hypertension. The authors report a case involving a pregnant woman at 36 weeks of gestation with preeclampsia, who exhibited pulmonary edema and required immediate cesarean delivery. The patient had type 1 respiratory failure and needed supplemental oxygenation with a Venturi mask. The cesarean section was performed successfully under epidural anesthesia. Women with severe preeclampsia and acute pulmonary edema remain a challenge when presented for cesarean delivery, and the best anesthetic option remains controversial.

Closing the Gap: A Case Report on a Blood Patch Solution for Cerebrospinal Fluid Leak.

Spontaneous intracranial hypotension is a condition resulting from cerebrospinal fluid leaks at the spinal level that disrupt the regulation of intracranial pressure. This disorder is an uncommon cause of debilitating headaches but can have variable clinical manifestations, which contributes to delayed diagnosis and potentially severe consequences. The standard treatment consists of conservative measures such as bed rest, hydration, and a pharmacological approach with paracetamol, caffeine, ergotamine, and dexamethasone. When conservative measures fail, an epidural blood patch is the gold standard treatment, where a small amount of blood is injected into the epidural space to form a clot to seal any existing leak. Recent studies showed a success rate of 64% without the need for further intervention. The authors report a case of a 55-year-old woman with a three-month history of daily severe headaches. Imaging exams showed subdural collections, suggesting the hypothesis of cerebrospinal fluid hypotension. After the failure of conservative measures, an epidural blood patch was performed with progressive clinical improvement.  This case demonstrates the potential effectiveness of an epidural blood patch in the management of spontaneous intracranial hypotension and its complications, offering an encouraging option for those unresponsive to conservative measures. It also highlights the importance of a multidisciplinary approach involving neurologists and anesthesiologists.

In Situ Monitoring of Additive Manufacturing Using Digital Image Correlation: A Review.

This paper is a critical review of in situ full-field measurements provided by digital image correlation (DIC) for inspecting and enhancing additive manufacturing (AM) processes. The principle of DIC is firstly recalled and its applicability during different AM processes systematically addressed. Relevant customisations of DIC in AM processes are highlighted regarding optical system, lighting and speckled pattern procedures. A perspective is given in view of the impact of in situ monitoring regarding AM processes based on target subjects concerning defect characterisation, evaluation of residual stresses, geometric distortions, strain measurements, numerical modelling validation and material characterisation. Finally, a case study on in situ measurements with DIC for wire and arc additive manufacturing (WAAM) is presented emphasizing opportunities, challenges and solutions.

Electrical Stimulation Directs Migration, Enhances and Orients Cell Division and Upregulates the Chemokine Receptors CXCR4 and CXCR2 in Endothelial Cells.

Natural direct current electric fields (DC EFs) within tissues undergoing angiogenesis have the potential to influence vessel formation, but how they affect endothelial cells is not clear. We therefore quantified behaviours of human umbilical vein endothelial cells (HUVEC) and human microvasculature endothelial cells (HMEC) stimulated by EFsin vitro. Both cell types migrated faster and toward the cathode; HUVECs responded to fields as low as 50mV/mm, but the HMEC threshold was 100 mV/mm. Mitosis was stimulated at 50 mV/mm for HMEC and at 150 mV/mm for HUVECs, but the cleavage plane was oriented orthogonal to the field vector at 200 mV/mm for both cell types. That different field strengths induced different cell responses suggests distinct underlying cellular mechanisms. A physiological electric field also upregulated expression of CXCR4 and CXCR2 chemokine receptors and upregulated phosphorylation of both chemokines in HUVEC and HMEC cells. Evidence that DC EFs direct endothelial cell migration, proliferation and upregulate chemokines involved in wound healing suggests a key role for electrical control of capillary production during healing. Our data contribute to the molecular mechanisms by which DC EFs direct endothelial cell behaviour and present a novel signalling paradigm in wound healing, tissue regeneration and angiogenesis-related diseases.

Doddering but dear even in the eyes of young children? Age stereotyping and prejudice in childhood and adolescence.

This study aims to explore age prejudice, and to examine age stereotyping in children and adolescents by adopting the Stereotype Content Model (SCM) as a theoretical framework. It was hypothesised that children are socialised into adopting an ambivalent representation of old age (socialisation hypothesis) and that this cognitive bias becomes weaker in adolescence due to greater cognitive maturity (developmental hypothesis). By analysing representative data from Portugal (European Social Survey; N = 2367), it was ascertained that the ambivalent age stereotype (higher evaluations of warmth than competence for older people) is indeed a shared social representation of older people in Portuguese society. A total of 103 Portuguese children (6-10 year olds) and adolescents (11-15 year olds) were then sampled from a local school and responded to age-appropriate measures assessing age prejudice as well as age stereotypes. Contrary to previous studies, the findings do not provide evidence for the existence of age prejudice because both children and adolescents reported positive feelings towards older people. However, the socialisation hypothesis was corroborated by showing that the ambivalent old age stereotype was already present in childhood. Contrary to the stipulated developmental hypothesis, the magnitude of this cognitive bias was very similar in adolescence.

Tatuagens: de temporárias a permanentes / Tattoos: from temporary to permanent

A realização de tatuagens temporárias é frequente, sendo percebida como inofensiva. A tinta usada deriva da henna, pigmento castanho-avermelhado obtido de uma planta. No entanto, para obter "henna negra" e facilitar a realização da tatuagem, são adicionados outros compostos, mais frequentemente a parafenilenodiamina. Esta está associada a reações alérgicas, por vezes graves e com sequelas. Os autores apresentam um caso de uma criança de 10 anos com uma reação alérgica exuberante com provável sobreinfecção bacteriana em local de tatuagem temporária. Havia história de sensibilização prévia, pelo que a reação foi precoce e mais agressiva. Os sinais inflamatórios francos motivaram o internamento sob corticoterapia sistêmica e antibioticoterapia endovenosa. Apesar da boa evolução clínica, permaneceu uma lesão hipopigmentada sequelar. Pretende-se alertar para os perigos desta realidade e também para a falta de legislação existente.

Temporary tattoos are quite popular, and they are perceived as harmless. The ink used in temporary tattoos is made from henna, a reddish-brown coloring pigment obtained from a shrub. However, in order to obtain "black henna" and facilitate the tattooing process, other compounds are added to the mixture, especially p-phenylenediamine. This compound is associated with allergic reactions that are sometimes severe and may leave sequelae. The authors describe a case of a 10-year old child presenting with allergic reaction and probable bacterial superinfection in a temporary tattoo area. The patient had a history of prior skin sensitization, and therefore the reaction was early and more aggressive. The severity of the inflammatory signs motivated hospital admission for systemic corticosteroid therapy and intravenous antibiotic therapy. Despite the good clinical evolution, a hypopigmented lesion persisted. Our goal is to raise awareness on the dangers of this practice and to highlight the lack of legislation in the area.

Group B streptococcal neonatal parotitis.

Acute neonatal parotitis (ANP) is a rare condition, characterised by parotid swelling and other local inflammatory signs. The most common pathogen is Staphylococcus aureus, but other organisms can be implicated. We describe the case of a 13-day-old term newborn, previously healthy, with late-onset group B Streptococcus (GBS) bacteraemia with ANP, who presented with irritability, reduced feeding and tender swelling of the right parotid. Laboratory evaluation showed neutrophilia, elevated C reactive protein and procalcitonin, with normal serum amylase concentration. Ultrasound findings were suggestive of acute parotitis. Empiric antibiotic therapy was immediately started and adjusted when culture results became available. The newborn was discharged after 10 days, with clinical improvement within the first 72 h. Although S. aureus is the most common pathogen implicated in ANP, GBS should be included in the differential diagnosis.

A quantitative study of the cell-type specific modulation of c-Rel by hydrogen peroxide and TNF-α.

Hydrogen peroxide (H2O2) at moderate steady-state concentrations synergizes with TNF-α, leading to increased nuclear levels of NF-κB p65 subunit and to a cell-type specific up-regulation of a limited number of NF-κB-dependent genes. Here, we address how H2O2 achieves this molecular specificity. HeLa and MCF-7 cells were exposed to steady-state H2O2 and/or TNF-α and levels of c-Rel, p65, IκB-α, IκB-ß and IκB-ε were determined. For an extracellular concentration of 25 µM H2O2, the intracellular H2O2 concentration is 3.7 µM and 12.5 µM for respectively HeLa and MCF-7 cells. The higher cytosolic H2O2 concentration present in MCF-7 cells may be a contributing factor for the higher activation of NF-κB caused by H2O2 in this cell line, when compared to HeLa cells. In both cells lines, H2O2 precludes the recovery of TNF-α-dependent IκB-α degradation, which may explain the observed synergism between H2O2 and TNF-α concerning p65 nuclear translocation. In MCF-7 cells, H2O2, in the presence of TNF-α, tripled the induction of c-Rel triggered either by TNF-α or H2O2. Conversely, in HeLa cells, H2O2 had a small antagonistic effect on TNF-α-induced c-Rel nuclear levels, concomitantly with a 50 % induction of IκB-ε, the preferential inhibitor protein of c-Rel dimers. The 6-fold higher c-Rel/IκB-ε ratio found in MCF-7 cells when compared with HeLa cells, may be a contributing factor for the cell-type dependent modulation of c-Rel by H2O2. Our results suggest that H2O2 might have an important cell-type specific role in the regulation of c-Rel-dependent processes, e.g. cancer or wound healing.

Substrate binding to a nitrite reductase induces a spin transition.

The multiheme enzyme nitrite reductase catalyzes a 6-electron reduction of nitrite to ammonia. The reaction is initiated by substrate binding to the free axial position of the high spin penta-coordinated heme active site. The spin configuration of the resulting complex is crucial for discrimination between the heterolytic vs homolytic character of the cleavage of the N-O bond and, therefore, subsequent steps of the catalytic cycle. Here, we report the first experimental evidence, based on resonance Raman spectroscopy, that nitrite binding to the enzyme from D. vulgaris induces a transition from the high spin to the low spin configuration in the catalytic heme, thereby favoring the heterolytic route.