Cell Therapy of Vascular and Neuropathic Complications of Diabetes: Can We Avoid Limb Amputation?

Globally, a leg is amputated approximately every 30 seconds, with an estimated 85 percent of these amputations being attributed to complications arising from diabetic foot ulcers (DFU), as stated by the American Diabetes Association. Peripheral arterial disease (PAD) is a risk factor resulting in DFU and can, either independently or in conjunction with diabetes, lead to recurring, slow-healing ulcers and amputations. According to guidelines amputation is the recommended treatment for patients with no-option critical ischemia of the limb (CTLI). In this article we propose cell therapy as an alternative strategy for those patients. We also suggest the optimal time-frame for an effective therapy, such as implanting autologous mononuclear cells (MNCs), autologous and allogeneic mesenchymal stromal cells (MSC) as these treatments induce neuropathy relief, regeneration of the blood vessels and tissues, with accelerated ulcer healing, with no serious side effects, proving that advanced therapy medicinal product (ATMPs) application is safe and effective and, hence, can significantly prevent limb amputation.

The role of an expert discussion panel on shaping the views of the undergraduate in health sciences on the use of stem cells and pre-implantation embryos / La influencia de un panel de discusión de expertos en la formación de opinión sobre el uso de células madre y embriones preimplantacionales en los estudiantes de ciencias de la salud de pregrado

INTRODUCTION: There are four objectives to this paper: (1) To determine whether undergraduates enrolled in Health-Sciences studies agree with the use of human stem cells for medical research, treatment and genetic uses. (2) Whether they would consider the use of pre-implantation-embryos for medical research. (3) Whether attitudes toward the previous two issues are linked to gender, field of study, transcendental/spiritual convictions and political biases. (4) A panel of discussion will modify their opinion. RESULTS: The present study shows that, before attending a discussion panel session, media was the main source of information that the students had on the surveyed topics. A discussion panel was useful for clarifying respondents' opinions on the explored items. Significantly, the discussion panel had an influence on those respondents who did not have a formed opinion on the explored items. CONCLUSIONS: A discussion panel is a convenient, but limited tool, in the shaping of undergraduate opinions on ethically controversial scientific matters

INTRODUCCIÓN: Los objetivos de este artículo son conocer si: 1) los estudiantes de pregrado matriculados en titulaciones de grado de ciencias de la salud están de acuerdo con la utilización de las células madre humanas para la investigación médica de los embriones preimplantatorios, la cura de enfermedades y los usos génicos; 2) consideran el uso de los embriones preimplantatorios humanos para la investigación; 3) las actitudes hacia los 2 temas anteriores están relacionadas con el género, el grado universitario en curso, la afiliación política y las convicciones trascendentales o espirituales, y 4) conocer si un panel de discusión, con expertos, modifica esas opiniones. RESULTADOS: Los resultados del presente estudio mostraron que antes del panel de discusión, los medios de comunicación eran la principal fuente de información de los encuestados sobre los temas estudiados. El panel de discusión fue útil para aclarar las opiniones de los encuestados, aprobar o desaprobar los ítems explorados. Significativamente, el panel de discusión influyó en los encuestados que dijeron que no tenían una opinión formada sobre los ítems explorados antes del panel de discusión. CONCLUSIONES: El panel de discusión es una herramienta conveniente pero limitada en la formación de las opiniones de los estudiantes de pregrado en titulaciones de ciencias de la salud sobre cuestiones científicas éticamente controvertidas

The prognostic value of the temporal course of S100beta protein in post-acute severe brain injury: A prospective and observational study.

PRIMARY OBJECTIVE: To study the predictive capacity of early S100beta samples for long-term outcome prediction after severe TBI. METHODS AND PROCEDURES: Eighty-seven patients with severe TBI were studied. Clinical and CT scan were taken at admission. S100beta concentration was quantified at admission and 24, 48 and 72 hours post-TBI (days 0, 1, 2 and 3). Outcome was assessed 12 months after discharge using Glasgow Outcome Score (GOS). RESULTS: Significant negative correlations were found between 1-year GOS and S100beta concentrations on days 1-3, but not on day 0. Deceased patients showed higher S100beta concentration than survivors on days 1-3. Good (GOS = 4-5) vs poor outcome (GOS = 1-3) differed significantly on day 3. Death outcome was independently predicted by day 2 (>2.37 microg l(-1)), day 3 (>1.41 microg l(-1)) samples and absence of pupillary reaction. Poor outcome was predicted independently only by pupillary reaction and the 72-hour sample (>1.1 microg l(-1)), but this predictive model was less satisfactory than the predictive model for death. CONCLUSIONS: A temporal profile of S100beta release from admission to 72 hours post-TBI is strongly recommended for use in identifying patients at risk of developing a worse outcome. The S100beta protein might be an early biomarker for predicting long-term outcome in patients with acute severe TBI.

Hiperplasia adenomatoide de glándula salival mucosa. Presentación de un caso / Adenomatoid hyperplasia of mucous salivary glands. A case report

Introduccion: La hiperplasia adenomatoide de glándulasalival mucosa es una rara entidad clinico patológica descritapor Giansanti et al en 1971. Material y métodos: El caso quenosotros presentamos corresponde a una paciente de 47 añosde edad con cuadros repetitivos de dolor a nivel sublingual.Resultados: Microscópicamente las secciones muestrannumerosos lóbulos de glándula salival con acinos mucosos deapariencia normal en un estroma de tejido conectivo fibroso.Conclusiones: La hiperplasia adenomatoide de glándula salivalmucosa no puede ser diferenciada clínicamente de neoplasiasde glándula salival, siendo necesario que la lesión seaexcindida y sometida a examen microscópico

Background: Adenomatoid hyperplasia of the mucoussalivary glands is an uncommon clinicopathologic entitydescribed by Giansanti et al in 1971. Methods: The reportedcase corresponds to a 47 year-old patient complaining ofsublingual pain repeated crises. Results: Microscopic sectionsshowed numerous salivary gland lobules with normalappearing mucinous acini within a fibrous connective tissuestroma. Conclusions: Adenomatoid hyperplasia of mucoussalivary glands can not be clinically differentiated from salivarygland neoplasms. It is necessary that the lesion be excisedand submitted for microscopic examination

Tumor mülleriano mixto maligno (carcinosarcoma heterólogo) de trompa uterina / Malignant mixed mullerian tumor of the fallopian tube (heterologous carcinosarcoma)

Introducción: El Tumor mülleriano mixto maligno esun tumor de localización ginecológica poco común. Latrompa de Falopio es la localización menos frecuente.Material y Métodos: El caso que nosotros describimoscorresponde a una paciente de 66 años con dolor abdominaly presencia de una masa pélvica en el anejo izquierdo. Serealiza histerectomía y doble anexectomía. Resultados: Laneoplasia distendía y distorsionaba la trompa de Falopioizquierda. Al corte, la trompa estaba ocupada por un tumorblando con áreas hemorrágicas. Microscópicamente eltumor estaba compuesto por elementos malignos epitelialesy estromales con focos diferenciación rabdomiosarcomatosay cartilaginosa. Conclusiones: Cuatro teorías han sidoformuladas para explicar la histogénesis tumoral de los carcinosarcomasde trompa de Falopio. La sobreexpresión dec-erbB-2 en ambos componentes, epitelial y mesenquimal,sugiere un mecanismo carcinogénico común y apoya lahipótesis de histogénesis por conversión implicando unpapel dominante del componente epitelial

Background: Malignant mixed mullerian tumor is anuncommon neoplasm of the female genital tract. The Fallopiantube is most uncommon site. Patients and Methods:The reported case corresponds to a 66 year old woman withabdominal pain. A total hysterectomy with bilateral salpingo-oophorectomy was performed. Results: The neoplasmdistended and distorted the left Fallopian tube. On cut sectionthe tube was filled and expanded by a soft tumor withhemorrhagic areas. Microscopically it was composed ofmalignant epithelial and stromal elements with foci of cartilaginousand rhabdomyosarcomatous differentiation. Conclusions:Four theories have been put forward to explain theorigins of the Fallopian tube carcinosarcomas. C-erbB-2over-expression in both epithelial and mesenchymal componentssuggests a common carcinogenic mechanism for bothcomponents and supports the conversion-histogenesis hypothesisimplicating a dominant role for epithelial component

Adenocarcinoma y linfoma gástricos sincrónicos en el contexto de una gastropatía hipertrófica / Gastric synchronous adenocarcinoma and lymphoma in a case of hypertrophic gastrophaty. Case history

Introducción: La coexistencia de un adenocarcinomagástrico y un linfoma gástrico primario fue descrito por primeravez en 1931. Material y Metodos: Presentamos uncaso en una paciente de 40 años con epigastralgia y perdidade peso. La gastroscopia muestra un engrosamiento de plieguesgástricos. Se realiza gastrectomía total. Resultados: Elexamen histológico muestra un adenocarcinoma de patróndifuso con presencia de células en anillo de sello en el senode un infiltrado linfoide denso y difuso con presencia detípicas lesiones linfoepiteliales. Conclusiones: La presentaciónsimultanea de un adenocarcinoma gástrico y un linfomatipo M.A.L.T en un mismo paciente es muy infrecuente,siendo la infección por Helicobacter pylori un factor etiopatogénicoen el desarrollo de ambas neoplasias

Background: A case of simultaneous gastric adenocarcinomaand primary gastric lymphoma was first describedin 1931. Methods: The case we describe corresponds to a40 year-old patient suffering from epigastralgia and loss ofweight. The gastroscopy shows thickened gastric folds. Acomplete gastrectomy is performed. Results: The histologicalexamination shows an adenocarcinoma with a diffusepattern presenting signet ring cells in the core of a dense anddiffuse lymphoid infiltrate, which also presents typicallymphoepithelial lesions. Conclusions: The case of simultaneousgastric adenocarcinoma and mucous associatedlymphoid tissue lymphoma in a patient is very infrequent.The infection by Helicobacter Pylori is an etopathogenicfactor in the development of both neoplasms