Pacientes pediátricos en insuficiencia hepática y pasibles de trasplante: Correlación del tiempo de protrombina y Razón Internacional Normatizada (RIN) entre dos combinaciones de reactivos e instrumentos de medición / Pediatric patients with liver failure who are candidates for transplantation: correlation of prothrombin time and international normalized ratio (INR) in two combinations of reagents and measurement instruments

El objetivo de este trabajo es correlacionar el tiempo de protrombina y RIN en dos combinaciones de reactivos e instrumentos de medición en muestras de pacientes pediátricos con insuficiencia hepática asistidos en el Hospital de Pediatría Juan P. Garrahan y pasibles de trasplante. Se estudiaron 62 muestras de sangre obtenidas de pacientes, con presencia de patología hepática, definida con evidencia bioquímica de injuria hepática. Se utilizaron 2 (dos) analizadores, un coagulómetro BCT de detección foto-óptica y un Sta Compact de detección electromagnética. Para el analizador BCT se utilizó el reactivo Thromborel S, en el Sta Compact el Sta Neoplastine. Se trabajó con el ISI correspondiente a cada Reactivo /Instrumento. El análisis estadístico se realizó con el programa informático Stata 9.0, aplicando los tests estadísticos de coeficiente de correlación (rho) y el intervalo de confianza 95%; se determino la ecuación de la recta, para cada caso, se determino la equivalencia clínica a través del EP evaluator. Nuestra conclusión es que en los pacientes con insuficiencia hepática, se halló mejor correlación estadística y clínica para el TP%, debido a que se independiza del Tiempo (seg.) y de la calidad de la tromboplastina (diferentes concentraciones de factor tisular). Según nuestros resultados el sistema ISI/RIN, no seria válido para aplicarlo a pacientes con falla hepática y pasible de trasplante. Una de las causas es la falta de un reactivo de Tromboplastina calibrado con plasmas de pacientes con insuficiencia hepática, ya que para el cálculo del ISI, se usan plasmas de pacientes con terapia ACO (AU)

The objective of this study was to correlate prothrombin time (PT) and INR in two combinations of reagents and measurement instruments samples of pediatric patients with liver failure seen at the Hospital de Pediatría Juan P. Garrahan and who are candidates for liver transplantation. Sixtytwo blood samples were studied obtained from patients with liver pathology defined by biochemical evidence of liver injury. Two analyzers were used: a BCT coagulometer with photo-optical clot detection and a Sta Compact with an electromagnetic detection system. For the BCT analyzer Thromborel S was used and in the Sta Compact Sta Neoplastine was used. The ISI corresponding to each Reagent /Instrument was used. Statistical analysis was done with Stata 9.0, with correlation coefficient (rho) and a 95% confidence interval; for each case the equation of the straight line was determined. Clinical equivalence was determined through the EP evaluator. Our conclusion is that in patients with liver failure a better statistical and clinical correlation was found for PT%, as it is independent of Time (sec.) and of thromboplastin quality (different concentrations of tissue factor). According to our results, the ISI/INR system is not adequate in patients with liver failure who are candidates for liver transplantation. One of the reasons is that we lack a thromboplastin reagent that is calibrated against plasma of patients with liver failure, as for the ISI calculation plasma of patients with OAC therapy is used (AU)

Genetic divergence within the Drosophila mayaguana subcluster, a closely related triad of Caribbean species in the repleta species group.

The mayaguana triad of the Drosophila repleta species group includes D. mayaguana, D. straubae, and D. parisiena, the latter two of which are very similar when examined morphologically. Many morphological characters used to define these taxa are quantitative and overlap substantially among some forms--it is only through suites of such characters that species can be identified. We apply Population Aggregation Analysis and tree building methods to five rapidly evolving gene regions--the mitochondrial AT rich region and the nuclear acetylcholinesterase, hunchback, mastermind, and vestigial loci to test the morphological species delineations within the morphocryptic mayaguana triad. We find that D. mayaguana is diagnosable using DNA sequences, but the other two species form a non-diagnosable paraphyletic assemblage. A single ecological factor, oviposition substrate, is an important diagnostic character distinguishing D. straubae from D. parisiena, highlighting the importance of examining a diverse array of data (morphological, molecular, ecological, and behavioral) when defining species limits.

Polytene chromosomes as indicators of phylogeny in several species groups of Drosophila.

BACKGROUND: Polytene chromosome banding patterns have long been used by Drosophila evolutionists to infer degree of relatedness among taxa. Recently, nucleotide sequences have preempted this traditional method. We place the classical Drosophila evolutionary biology tools of polytene chromosome inversion analysis in a phylogenetic context and assess their utility in comparison to nucleotide sequences. RESULTS: A simultaneous analysis framework was used to examine the congruence of the chromosomal inversion data with more recent DNA sequence data in four Drosophila species groups - the melanogaster, virilis, repleta, and picture wing. Inversions and nucleotides were highly congruent with one another based on incongruence length difference and partitioned Bremer support values. Inversion phylogenies were less resolved because of fewer numbers of characters. Partitioned Bremer supports, corrected for the number of characters in each matrix, were higher for inversion matrices. CONCLUSIONS: Polytene chromosome data are highly congruent with DNA sequence data and, when placed in a simultaneous analysis framework, are shown to be more information rich than nucleotide data.

Phylogenetic analysis of the repleta species group of the genus Drosophila using multiple sources of characters.

The species in the repleta group of the genus Drosophila have been placed into five subgroups-the mulleri, hydei, mercatorum, repleta, and fasciola subgroups. Each subgroup has been further subdivided into complexes and clusters. Extensive morphological and cytological analyses of the members of this species group have formed the foundation for the proposed relationships among the members of the repleta species group. Fifty-four taxa, including 46 taxa belonging to the repleta species group, were sequenced for fragments of four genes-16S ribosomal DNA (16S), cytochrome oxidase II (COII), and nitrogen dehydrogenase 1 (ND1) of the mitochondrial genome and a region of the hunchback (hb) nuclear gene. We also generated a partial data set of elongation factor 1-alpha (Ef1alpha) sequences for a subset of taxa. Our analysis used both DNA characters and chromosomal inversion data. The phylogenetic hypothesis we obtained supports many of the traditionally accepted clades within the mulleri subgroup, but the monophyly of taxonomic groups outside of this subgroup appears not to be supported. Phylogenetic analysis revealed one well-supported, highly resolved clade that consists of closely related members of the mulleri and buzzatii complexes. The remaining taxa, a wide assortment of taxonomic groups, ranging from members of other species groups to members of several subgroups and members of three species complexes from the mulleri subgroup are found in poorly supported arrangements at the base of the tree.

[Clinical aspects of pelvic histangiopathies. New therapeutic possibilities with danazol]. / Alcuni aspetti clinici delle istangiopatie pelviche. Nuove possibilità di terapia con danazolo.

Menometrorrhagia and hypermenorrhoea are often present in patients who also suffer from a state of insufficiency of the utero-adnexal venous system interpretable as a clinical entity of system pathology and accompanied by pictures of acquired venous ectasis. The lack of any easy clinical characteristic objectivisation often prevents easy recognition and complex diagnostic investigation is therefore indispensable. Treatment is often destructive surgery following the failure of the various medical or conservative surgical therapies that are tried. Personal experience in cases in which the clinical picture (big uterus, menometrorrhagia, pelvic pain) presents a pathology of the venous vascular system, can report considerable benefit first and disappearance later of the symptomatology, with treatment using danazol at a dose of 200-300-400 mg/die. This makes demolition surgery, which is not often well accepted by the patient, inopportune.

Cisplatin and cyclophosphamide in early epithelial ovarian carcinoma.

Toxicity and efficacy of adjuvant cisplatin-based chemotherapy were assessed in 41 patients with FIGO stage I-II ovarian carcinoma. Chemotherapy consisted of cisplatin 50 mg/m2 and cyclophosphamide 600 mg/m2 administered on a one-day schedule q 28 d for six courses. Inclusion criteria were based on appropriate staging procedures and absence of macroscopic disease after primary surgery; patients with stage IAi G1-G2 or with borderline tumors were excluded from the study. Second look laparotomy was performed 2 months after termination of chemotherapy. At 60 months the actuarial survival is 77.5%. Recurrences were observed in 8 patients; in 1 case relapse was diagnosed at second look laparotomy. Toxicity was acceptable with only 1 treatment drop-out due to reversible neurotoxicity. Our results demonstrate that short-term chemotherapy including cisplatin is a safe and effective regimen and is suitable for administration on a outpatient basis. In our experience second-look laparotomy has limited value for early detection of relapses.

[Obstetrico-pediatric aspects of physiopathology of lipid metabolism. I. Synthesis of the physiological bases with special regard to hormonal regulation and classification of dyslipidemias]. / Aspetti ostetrico pediatrici della fisiopatologia del metabolismo lipidico. Nota I: sintesi delle basi fisiologiche con particolare riguardo alla regolazione ormonale e classificazione delle dislipidemie

PIP: This work is the 1st of a research program on the behavior of lipid metabolism during pregnancy and in the 1st years of life. Theories on the subject of the biochemistry of cholesterol and triglycerides are summarized and lipid physiology, particularly from the viewpoint of hormone regulation and the behavior of some important enzyme systems, is examined. Lipid transport systems, in the form of lipoproteins, is discussed, followed by a description and classification of hyper- and hypolipemia and of the relation between some forms of hyperlipemia and atherosclerosis. It is concluded that it would be very useful to obtain an early identification of subjects with a high risk of atherosclerosis in order to begin prophylactic treatment, if possible, during early infancy or even during pregnancy.^ieng