Inter- and Intraobserver Agreement in First Trimester Ultrasound Evaluation of Placental Biometry.

OBJECTIVE: The aim of this study was to assess the clinical applicability of a new analytical software program by determining the inter- and intraobserver agreement for 2D placental biometry and three-dimensional (3D) placental volume (PV) in the first trimester. METHODS: A prospective study of 25 singleton pregnancies between 11 and 14 weeks was conducted. 3D datasets were captured, and PV was estimated using the Phillips QLAB GI3DQ ultrasound quantification software. The basal plate (BP), chorionic plate (CP), placental thickness (PT), and the free uterine surface (FUS) area not occupied by placenta were considered for 2D biometry evaluation. Each variable was measured in 2 orthogonal planes with mean values used for the analysis. Intra- and interobserver agreement was evaluated. RESULTS: Intraobserver agreement for both 2D and 3D measurements was high, particularly for the PV and PT (interclass correlation coefficient [ICC] 0.989 [95% confidence interval (CI) 0.97-0.99] and ICC 0.936 [95% CI 0.86-0.97], respectively). Interobserver agreement was good for the PV (ICC 0.963 [95% CI 0.91-0.98]), PT (ICC 0.822 [95% CI 0.63-0.91]), and CP (ICC 0.708 [95% CI 0.44-0.86]), but moderate for BP and FUS. CONCLUSIONS: PV, PT, and CP are reproducible measurements to evaluate first trimester placental biometry. Further research is needed to assess the clinical utility of these variables as predictors of poor obstetric outcomes.

Crystal structure and specific location of a germin-like protein with proteolytic activity from Thevetia peruviana.

Peruvianin-I is a cysteine peptidase (EC 3.4.22) purified from Thevetia peruviana. Previous studies have shown that it is the only germin-like protein (GLP) with proteolytic activity described so far. In this work, the X-ray crystal structure of peruvianin-I was determined to a resolution of 2.15 Å (PDB accession number: 6ORM) and its specific location was evaluated by different assays. Its overall structure shows an arrangement composed of a homohexamer (a trimer of dimers) where each monomer exhibits a typical ß-barrel fold and two glycosylation sites (Asn55 and Asn144). Analysis of its active site confirmed the absence of essential amino acids for typical oxalate oxidase activity of GLPs. Details of the active site and molecular docking results, using a specific cysteine peptidase inhibitor (iodoacetamide), were used to discuss a plausible mechanism for proteolytic activity of peruvianin-I. Histological analyses showed that T. peruviana has articulated anastomosing laticifers, i.e., rows of cells which merge to form continuous tubes throughout its green organs. Moreover, peruvianin-I was detected exclusively in the latex. Because latex peptidases have been described as defensive molecules against insects, we hypothesize that peruvianin-I contributes to protect T. peruviana plants against herbivory.

MYC-induced nuclear antigen (MINA) and preeclampsia.

BACKGROUND: Inadequate trophoblast invasion and the subsequent inflammatory response have been implicated in preeclampsia (PE) pathogenesis. Because MYC-induced nuclear antigen (MINA) gene expression is involved in cell proliferation and differentiation, inflammatory response modulation, and the unpaired regulation of which is associated with human diseases, we sought to investigate the connection between MINA and PE. OBJECTIVE: The aim of this study was to evaluate the possible relationship between the MINA rs4857304 variant and susceptibility to PE development as well as to estimate placental MINA gene expression and its association with PE. METHODS: About 242 pregnant women (126 PE cases and 116 controls) were included. MINA genotyping and gene expression were evaluated by quantitative real-time polymerase chain reaction using TaqMan probes. RESULTS: The G/G genotype of the MINA rs4857304 variant was associated with severe PE (p = 0.027, OR = 1.8, 95% CI = 1.8-3.2). Carriers of one G allele of the MINA rs4857304 variant exhibited a 1.7-fold increased risk of severe PE (p = 0.029, 95% CI = 1.1-3.0). MINA was underexpressed in preeclamptic placentas and MINA expression differed between the mild and severe PE groups. Differences in the expression levels of MINA were found among women with the T/T genotype of the rs4857304 polymorphism and carriers of at least one G allele (p = 0.024). CONCLUSION: PE and its severity are associated with the underexpression of placental MINA, and the G/G genotype of the MINA rs4857304 variant may modify the risk of severe PE among the PE cases evaluated.

Maternal risk factors and obstetric complications in late preterm prematurity.

OBJECTIVE: Late preterm prematurity has been related to poorer neonatal outcomes. However, research has focused on the neonatal outcomes of late preterm infants, maternal characteristics of these births have been less evaluated. The aim of the study was to compare maternal risk factors and obstetric complications in late preterm births (LPTB) and term births. These factors were also assessed comparing spontaneous LPTB with medically-indicated LPTB. STUDY DESIGN: We conducted a retrospective cohort study with two groups. All singleton LPTB occurred at our University Hospital between January 1, 2009 and December 31, 2010 were included in the first cohort (n=171). A comparison cohort of term births was configured in a ratio 2:1 (n=342). Well-dated pregnancies without congenital malformations, congenital infections or chromosome abnormalities were eligible. LPTB were classified into two groups, spontaneous LPTB and medically-indicated LPTB following delivery indications. Statistical analysis of categorical variables was performed using either χ(2) or Fisher's exact. Continuous variables were compared using the Student's t-test. RESULTS: Women with LPTB had more medical conditions than women with term births (29% vs 15.7%; P=0.002). Prior preterm births (9.7% vs 2%; P<0.001), prior adverse obstetric outcomes (6.9% vs 2.3%; P<0.001), and obstetric complications were also more frequent in LPTB than in term births. However, no differences were found in maternal medical conditions when spontaneous LPTB and medically-indicated LPTB were compared. Women with medically-indicated LPTB were older (33.69 vs 31.07; P=0.003) and mainly nulliparous (75.8% vs 49.4%; P=0.002). Obstetric complications were more frequent in medically-indicated LPTB than in spontaneous LPTB. CONCLUSIONS: Maternal risk factors and obstetric complications are significantly higher in LPTB than in term births. These factors should be considered to identify women at risk for either spontaneous or medically-indicated LPTB.

Lepra de Lucio: presentación de dos casos y revisión bibliográfica / Lucio's leprosy: report of 2 cases and literature review

La lepra de Lucio es una forma de lepra lepromatosa que se observa fundamentalmente en México, siendo excepcional su presentación en nuestro medio. Se caracteriza por presentar una infiltración difusa generalizada de la piel, seguida de la presencia del fenómeno de Lucio. Presentamos dos casos diagnosticados en nuestra sala, oriundos ambos de la provincia de Buenos Aires, que presentaban infiltración cutánea, formación de ampollas hemorrágicas y úlceras, con alteración de la sensibilidad termoalgésica en los cuatro miembros. Una evolución de diez y tres años respectivamente los llevó a consultar a diferentes facultativos sin obtener diagnóstico ni mejoría con los tratamientos instituidos

Lepra de Lucio: presentación de dos casos y revisión bibliográfica / Lucios leprosy: report of 2 cases and literature review

La lepra de Lucio es una forma de lepra lepromatosa que se observa fundamentalmente en México, siendo excepcional su presentación en nuestro medio. Se caracteriza por presentar una infiltración difusa generalizada de la piel, seguida de la presencia del fenómeno de Lucio. Presentamos dos casos diagnosticados en nuestra sala, oriundos ambos de la provincia de Buenos Aires, que presentaban infiltración cutánea, formación de ampollas hemorrágicas y úlceras, con alteración de la sensibilidad termoalgésica en los cuatro miembros. Una evolución de diez y tres años respectivamente los llevó a consultar a diferentes facultativos sin obtener diagnóstico ni mejoría con los tratamientos instituidos (AU)