Reprogramming adipose tissue derived mesenchymal stem cells into insulin-producing cells

b-cell replacement is currently considered the most promising treatmentfor type 1 diabetes. However it is strongly limited by the scarcityof transplantable material, i.e. islets of Langerhans from cadavericdonors. In this context, stem cells are an alternative source dueto their potential to duplicate and differentiate into certain lineagesunder specific culture conditions. Both embryonic and adult stemcells can differentiate into insulin-producing cells, however existingprotocols still require substantial improvements. Concerning embryonicstem cells, there are also certain ethical limitations that constrainits possible clinical use. Adult stem cells, on the other hand, donot present these problems. In addition, as seen with adipose tissuederivedmesenchymal stem cells, they can be easily isolated andtransplanted again, once reprogrammed, to the donor without theneed of immunosuppresors. Theoretically, the differentiation of mesenchymalstem cells, either from adipose tissue or bone marrow, toinsulin-producing cells can be achieved by various strategies, whichcan be grouped, according to the existing information, into coaxialand directional protocols

Efficacy and safety of argon plasma coagulation for the treatment of hemorrhagic radiation proctitis.

OBJECTIVE: To evaluate the efficacy, safety and medium-/long-term clinical course of patients undergoing endoscopic treatment with argon plasma coagulation for hemorrhagic radiation proctopathy. DESIGN: Descriptive, retrospective study with medium- and long-term follow-up. PATIENTS, MATERIAL AND METHODS: Ten patients were treated with argon plasma coagulation for hemorrhagic radiation proctopathy between July 1998 and February 2003. Inclusion criteria were: evidence of chronic rectal bleeding, consistent endoscopic findings, and absence of any other cause of hematochezia after a comprehensive ano-rectal examination and complete colonoscopy. The equipment used was a standard colonoscope, an argon delivery unit, an argon plasma coagulation probe 1.5 mm in internal diameter, and a high-frequency electrosurgical generator. Consecutive treatment sessions were programmed whenever it was considered necessary until all mucosal lesions had been treated. Clinical and evolutive follow-up was performed with a focus on tolerance, efficacy, and potential argon plasma coagulation-related complications. Data were updated by personal or telephonic interview. RESULTS: In all patients, chronic rectal bleeding stopped after the last treatment session. The mean number of treatment sessions to stop symptoms was 1.7. Mean follow-up was 31.1 months. All sessions were well tolerated, similarly to standard rectoscopy. In one case a recurrence of rectal bleeding was observed four months later, which required two repeat sessions. Four patients were anemic at inclusion. Three of them reported a resolved anemia at the end of the study. No delayed argon plasma coagulation-related complications such us ulcers or strictures were seen. CONCLUSIONS: Argon plasma coagulation appears to be a useful, effective and safe treatment for rectal bleeding resulting from chronic radiation proctitis when compared to standard medical and endoscopic treatments. These successful outcomes seem to persist even after long-term follow-up.

Fallo hepático fulminante inducido por flutamida / Fulminant hepatic failure associated with flutamide

No disponible

Colitis isquémica asociada a déficit de antitrombina III / Ischemic colitis associated with antithrombin deficiency

La isquemia colónica es una de las patologías que más frecuentemente afectan al colon en ancianos, aunque puede también aparecer en personas jóvenes. El sigma y el colon izquierdo son las zonas que con más frecuencia se afectan. Aunque en la mayoría de los casos no se identifica una causa específica de isquemia, en otras ocasiones existe una causa desencadenante. Presentamos el caso de una enferma que desarrolló una colitis isquémica asociada a déficit congénito de antitrombina III (AU)