Measles, mumps and rubella vaccine 12 months after hematopoietic stem cell transplantation

ABSTRACT The measles, mumps and rubella (MMR) vaccine is usually recommended from 24 months after a hematopoietic stem cell transplant (HSCT). Some authors have demonstrated that the MMR vaccination can be safe from 12 months post-HSCT in non-immunosuppressed patients, as recommended by the Brazilian National Immunization Program/Ministry of Health, since 2006. The objectives of this study were to evaluate when patients received MMR vaccine after an HSCT in our care service and if there were reports of any side effects. We retrospectively reviewed the records of HSCT recipients who received at least one MMR dose in our care service, a quaternary teaching hospital in Sao Paulo city, Brazil, from 2017 to 2021. We identified 82 patients: 75.6% (90.1% in the autologous group and 45.1% in the allogeneic group) were vaccinated before 23 months post-transplantation. None reported side effects following the vaccination. Our data support that the MMR vaccination is safe from 12 to 23 months after HSCT.

Safety analysis of children of different ages vaccinated with measles, mumps and rubella combined attenuated live vaccine/measles and rubella combined attenuated live vaccine in Jilin Province from 2015 to 2022 / 中国生物制品学杂志

@#Objective To analyze the safety of children of different ages vaccinated with measles,mumps and rubella combined attenuated live vaccine(MMR in brief)/measles and rubella combined attenuated live vaccine(MR in brief)in Jilin Province from 2015 to 2022.Methods The actual vaccination data of MMR and MR from January 1,2015 to December 31,2022 were collected through the Jilin information management system for immunization programming,and all AEFI case information reported after vaccination with MMR and MR in this period was collected through the national adverse event following immunization(AEFI) monitoring and reporting system.The incidence rates of AEFI reports were compared among8-month-old children vaccinated with the first dose of MMR(MMR 8 group) and MR(MR8 group),18-month-old children vaccinated with the first dose of MMR(vaccinated with MR at 8 months old,MMR18-1 group) and the second dose of MMR(vaccinated with the first dose of MMR at 8 months old,MMR18-2 group) to preliminarily evaluate the safety of children vaccinated with MMR and MR at different ages.Results The reported incidence of AEFI in MMR8,MR8,MMR18-1 and MMR18-2 groups were 374.41/100 000,350.81/100 000,101.70/100 000 and 104.91/100 000,respectively,with significant difference among the four groups(χ~2=1 145.47,P=0.00);There was no significant difference between MMR8 and MR8,as well as MMR18-1 and MMR18-2 groups(χ~2=3.780 and 0.194,respectively,each P> 0.05);There were significant differences between MMR8 and MMR18-1,MMR8 and MMR18-2,as well as MR8 and MMR18-1groups(χ~2=920.440,412.110 and 1 021.120,respectively,each P=0.00).Most of the adverse reactions were general reactions,mainly fever,local redness and induration;A few were abnormal reactions,which were mainly allergic reactions(rash,papules,urticaria,etc.).Only one case of coincidence was reported in MMR8 group,and no psychogenic reaction,vaccine quality accident and vaccination accident occurred.All AEFI turned out to be improved or cured.Conclusion The differences of AEFI reported incidence of 8-month-old children vaccinated with MMR and MR were all small,and the difference of AEFI reported incidence of 18-month-old children vaccinated with the second dose of MMR was small regardless of the initial vaccination with MMR or MR.It is safe to use MMR instead of MR for the first vaccination in8-month-old children.

Comparative study of scientific articles on MMR vaccines published from India over the last few decades

The MMR vaccine as we know is a vital vaccine to protect against three disease-causing microbes- measles, mumps, and rubella. To commemorate 75 years of Indian independence, the present study delves into the achievement of Indian research and lists out articles retrieved from the Web of Science Core Collection database on the domain of MMR vaccine research. The data has been restricted to the publication from India, thereby, has throwing some understanding into the MRR vaccine research in India over the last 28 years- 1994 to 2021. The data have been compared based on scientometric analysis. Qualitative and quantitative analysis have also been taken into account in order to give a comparative insight into the research. The comparison was done based on citation data, usage count data, year of publication, journals, publication media, domains focussed on the papers, and type of document. Astonishingly, in 2021, the most number of papers were published, most of them have related MMR vaccine as a potential immunity developer against COVID-19 infection. A total of 43 articles were retrieved from the search, the numbers are quite big, and the highest citation among them being 99 which was published in 2014, which is quite impressive for such a short duration of time. The comparative study suggests a positive growth of MMR vaccine research in India.

Maternal Near Miss-Experience At A Tertiary Care Teaching Hospital In Western India

Background:Pregnancy-related morbidity and mortality continue to have a huge impact on the lives of Indian women and their newborns. Any pregnant woman can develop life-threatening complications with little or no advance warning. All women need access to quality maternal health services that can detect and manage such complications1. Complications during pregnancy and childbirth remain a leading cause of death among women of reproductive age in India2. Each year in India, roughly 28 million women experience pregnancy and 26 million have a live birth. Of these estimated 67000 maternal and 10,00000 newborn deaths occur every year3. The maternal near-miss event was defined as “any acute obstetric complication that immediately threatens a woman’s survival but does not result in her death either by chance or because of hospital care she receives during pregnancy, labor or within 6 weeks of termination of pregnancy4.Maternal mortality data in practical terms is the tip of an iceberg while the maternal near-miss data is invisible and whic h is a very important tool to reduce maternal mortality.Material And Methods:This is a retrospective observational study carried out among 80 maternal near-miss cases who were admitted in obstetric ICU fulfilling criteria for identification for maternal near-miss cases as per Maternal Near Miss Review Operational Guideline (December 2014)in the Department of Obstetrics and Gynecology, in our tertiary care teaching hospital, between October 1, 2018, to October 31,2020.Patient fulfilling criteria for identification of near-miss cases as per Maternal Near miss Review Operational Guideline (December, 2014)Minimum 3 criteria were included in the study.Result:During the study period total of 18360 obstetric patients were admitted, out of which 80 patients ended up becoming maternal near-miss cases. Among them majority of patients were in age group of 18-25 years and occurrence was high in multipara women. In many patients more than one underlying disorder was present. Hemorrhage (67.5%) followed by a hypertensive disorder of pregnancy (30.0%) was the commonest presenting disorder in near-miss cases. In spite of being highly preventable, maternal sepsis (6.2%) also contributes to being a major cause of morbidity.In our study, 15% of near-miss cases had associated medical conditions. 5 % of cases (n=4) in the present study faced acute severe respiratory depression (ARDS) after getting infected with covid-19 infection. There was need for massive blood transfusions in 63.75 %, magnesium sulfate therapy in 17.25%, use of cardiotonic /vasopressor drugs in 10.0%, obstetric hysterectomy in 23.75 % of cases. More than one management modality was followed in many patients. All the near-miss cases were covered with broad spectrum antibiotic therapy. Total 21 near-miss cases (26.25%) were identified to have delays. Delay in the decision to seek care (Delay 1) occurred in 2.5% of women. Educational backwardness, ignorance of pregnancy itself, lack of regular antenatal care, and failure to give importance to warning signals may be the contributing factors. Delay in accessing adequate care (Delay 2) was identified in 7.5% of women. Conclusion: Hemorrhage, hypertensive disorders of pregnancy, abnormalities of labor, anemia, and sepsis are still major contributing factors for maternal near-miss cases. Anticipation, early diagnosis, and prompt treatment of maternal complications can reduce maternal morbidity and mortality. Sensitization of the population for proper utilization of available maternal health care facilities is very vital for reducing maternal near-miss cases.All the maternal near-miss cases are living le ssons, who de spite their misery show us our deficiencies.

Evaluation of microsatellite instability in routine examinations of surgical samples

Context: Approximately 20%–30% of colon cancer cases have a hereditary basis. The genetic defect may involve mismatch repair (MMR) genes, which results in microsatellite instability (MSI). MMR-deficient colorectal cancer may occur due to germline mutation (Lynch syndrome) or be a sporadic one. A tumor's histological features, supported by a panel of immunohistochemistry stains, enables pathologists to assess the MMR status, which in turn has beneficial effects on clinical management. Aims: We aimed to show the relations between histopathological features identified during routine examinations and MMR genes' mutations. Methods and Material: We reviewed retrospectively the material of the Department of Pathology fulfilling the revised Bethesda Guidelines. Statistical Analysis Used: We used Chi-square test, Spearman test, and epidemiological analysis. Results: For the PMS2 gene, the positive predictive value (PPV) indicates that 91% of cases neither present any histological lesions nor have genetic abnormalities. The negative predictive value (NPV) indicates that only 50% of cases have both histological and genetic changes. For the MSH6 gene, the PPV indicates that 85% of tumors without specific histological features do not have genetic abnormalities. Conclusions: We advise universal staining for MLH1, MSH2, MSH6, and PMS2 in every newly diagnosed colon cancer, but due to costly analyses we suggest a protocol for the selection of cases for MMR examinations.

Two cases of measles after vaccination with measles mumps and rubella combined live attenuated vaccine / 上海预防医学

Measles is an acute respiratory infectious disease caused by the measles virus. It is highly infectious and easy to occur in children. It causes many serious complications such as tracheitis， otitis media and pneumonia. Since the promotion of the measles vaccine in China， the measles epidemic has been effectively controlled. From June 1， 2020， the immunization procedure of measles-containing vaccine for children in Shanghai has been adjusted to one dose of measles， mumps and rubella combined live attenuated vaccine （MMR） at the age of 8 months， 18 months and 6 years. There is generally no local reaction after the injection of the MMR vaccine. A few individuals may have transient fever and scattered rash， which generally fade away by themselves. However， because it is a live vaccine， it may cause vaccine related diseases in extremely rare cases. This paper reports two cases of measles after vaccination with the MMR vaccine.

The development of Basic Emergency Obstetric and Newborn Care (BEmONC) and Maternal Health in the Philippines: A historical literature review

Introduction@#Implementation of Basic Emergency Obstetric and Newborn Care (BEmONC) aims to curb maternal mortality. However, the Philippines failed to significantly reduce the maternal mortality rate (MMR) targeted in the Millennium Development Goals (MDGs). Currently, the country is still far from the targeted Sustainable Development Goals (SDGs). This review describes the historical development of BEmONC in the Philippines over the past 13 years and provides insights on its role in decreasing MMR. @*Methods@#We searched online for journal articles, publications, reports, policies, and other issuances related to BEmONC and maternal health in the Philippines. We accessed updates and data via correspondence with the Department of Health (DOH). Statistics were compiled from public databases. The identified citations were screened, appraised, synthesized, and analyzed in a historical approach. @*Results@#A direct result of the Emergency Obstetric Care Approach, BEmONC was developed to respond to the high MMR in the Philippines, in line with global efforts to improve maternal health. However, BEmONC functionality generally remained inadequate. @*Conclusions@#Although the provision of BEmONC services increased facility-based deliveries and skilled birth attendance during childbirth, this failed to decrease MMR and achieve targeted goals substantially. Further capacity-building is needed, especially in rural and resource-poor areas. Government issuances at the national and local levels should be aligned to complement each other. There should be a health systems approach that considers the building blocks of an efficient health care system and the social determinants that impact them.

RNA-binding protein with serine-rich domain 1 regulates microsatellite instability of uterine corpus endometrial adenocarcinoma

OBJECTIVE: To determine the role of RNA-binding protein with serine-rich domain 1 (RNPS1) in uterine corpus endometrial carcinoma (UCEC), the role of RNPS1 knockdown in UCEC development in vitro and in vivo, and the relationship between RNPS1 and mismatch repair (MMR) in UCEC. METHODS: We predicted the potential function of RNPS1 using bioinformatics systems. The expression of RNPS1 in tissues and cell lines was analyzed by western blotting and immunohistochemistry. The expression of RNPS1 in MMR was assessed using bioinformatics and western blotting. The proliferation and apoptosis of UCEC cells were assessed under RNPS1 knockdown conditions, and RNPS1 regulation in MMR was detected by suppressing Notch signaling. Associations between RNPS1 and gene mutations in UCEC and prognosis were analyzed. RESULTS: The RNPS1 level was higher in UCEC tumors than in normal tissues and tumors or RL952 cells. Prognostic outcomes were worse when UCEC showed abundant RNPS1 expression. Lentiviral RNPS1 knockdown weakened tumor cell proliferation and suppressed biomarker expression, reduced the tumor volume, promoted apoptosis in vitro and in vivo, and inhibited UCEC development. Increased MutS homolog 2 (MSH2) and MutS homolog 6 (MSH6) levels in MMR after RNPS1 knockdown were reversed by inhibiting Notch signaling. Furthermore, RNPS1 was associated with mutations in NAA11, C2orf57, NUPR1, and other genes involved in UCEC prognosis. CONCLUSION: RNPS1 may regulate the expression levels of MSH2 and MSH6 in MMR, enhancing the proliferation, development, and prognosis of UCEC through a Notch signaling pathway in UCEC. Our study offers a new method and strategy for delaying UCEC development through modulating MMR.

Meningitis aséptica por virus parotídeo asociada a la vacuna

Resumen Comunicamos el caso de un lactante mayor previamente sano, que luego de tres semanas de recibir la vacuna SPR (sarampión, parotiditis, rubeola) presentó fiebre, aumento de volumen parotídeo y compromiso de conciencia. Se diagnosticó una meningitis aséptica, con pleocitosis en el LCR de predominio mononuclear, detectándose virus parotídeo en LCR por biología molecular. En el Instituto de Salud Pública de Chile se realizó serología (IgM e IgG) que resultó positiva. La muestra de saliva confirmó la etiología por virus parotídeo con genotipo N. La evolución fue favorable, sin secuelas al seguimiento a seis meses. Ante esta situación clínica, se revisó la información respecto a la asociación y causalidad de esta entidad clínica y vacuna SPR, focalizado en diferentes cepas del virus parotiditis.

Abstract We report the case of an older infant with no prior morbidity that approximately 3 weeks after receiving MMR vaccination (measles, mumps, rubella) was hospitalized for feverish symptoms, increased parotid volume and compromised consciousness. Aseptic meningitis was diagnosed, detecting pleocytosis in the CSF, predominantly mononuclear, and confirming by molecular biology, presence of parotid virus in CSF. A study was carried out by the Institute of Public Health of Chile, where serology (IgM and IgG) was positive. Saliva sample confirmed the etiology of parotid virus with genotype N. The evolution was favorable and at 6-month follow-up, there were no sequelae. Given this clinical situation, information regarding the association and causality of this clinical entity and the MMR vaccine, focused on different strains of the mumps virus, was reviewed.

MMR-proficient and MMR-deficient colorectal cancer cells: 5-Fluorouracil treatment response and correlation to CD133 and MGMT expression

Cancer stem cells (CSCs) from colorectal cancer (CRC), characterized by CD133 expression, have beenassociated with 5-fluorouracile (5-FU) chemoresistance. DNA repair mechanisms, such as O6-alkylguanineDNA alkyltransferase (MGMT) and mismatch repair (MMR) systems, have also been correlated to 5-FUresistance in CRC. The aim of this study was to evaluate the modulation of CD133 and MGMT in MMRproficient and MMR-deficient CRC cells under 5-FU treatment and the effect of this drug in CSCs. CD133 andMGMT methylation status were determined in MMR-proficient (SW480 and HT29) and MMR-deficient (RKOand HCT116) cell lines by methylation-specific PCRs. SW480 and RKO were selected to determine modulation of CD133, MGMT and MMR expression after 5-FU treatment by qPCR. In addition, CD133, MGMTand MMR were analyze in SW480 and RKO CSCs. No association between promoter methylation and MGMTand CD133 expression was found. 5-FU treatment increased CD133 expression independently to MMR statusin SW480 and RKO and was able to increase hMLH1 expression in RKO, a MMR-deficient cell line. RKO/CSCs overexpressed CD133 and MMR (hMSH2 and hMSH6) while SW480/CSCs showed a significantincrease in CD133, MMR (hMLH1, hMSH2 and hMSH6) and MGMT, moreover 5-FU resistance thanparental cell lines. Thus, although CSCs 5-FU chemoresistance appears to be independently to MMR status,hMLH1 might play a key role in CSC response to 5-FU. New drugs exploding these differences could benefitthe prognostic of patients with CRC.

A longitudinal study of immunization status and reasons for non-vaccination of children in OPD and pediatric ward of a teaching hospital

Background: The present study was to find out the immunization status of children in the age group of 0-7 years from OPD and those admitted in hospital attached to Deccan College of Medical Sciences with respect to primary immunization (BCG,OPV/DPT 1, 2, 3, measles), 1st booster dosage of OPV, DPT and also primary doses of Hepatits-B vaccine and coverage of vitamin A with measles vaccine. The objectives of this research work were to study factors which influence the immunization status and to know reasons for partial and non-immunization and their follow up over 2 years. Also, to know proportion of vaccine preventable diseases in children under study group.Methods: An oral questionaire method was adopted for parent of children in the age group 0-7 years to assess their immunization status and social factors influencing immunization coverage. Systemic random sampling method was applied to select 200 chlildren i.e. every 5th child admitted in the age group of 0-7 years was taken for analysis.Results: The study showed that out of 200 children 115 were fully immunized, 78 were partially immunized and 7 were non- immunized, 66 children among male and 49 among females were fully immunized, & the study shows that males had better immunization than females.Conclusions: Out of total 200 cases 57.6% were fully immunized, 38 % were partially immunized while 3.5% were unimmunized. Immunization coverage was better in urban children than rural children.

Brotes epidémicos de parotiditis, revisión de la literatura / Mumps outbreaks, literature review

La parotiditis es un infección viral producida por el virus parotídeo. Clínicamente se caracteriza por aumento de volumen de la glándula parótida generalmente bilateral. La estrategia que ha mostrado ser más eficaz para la prevención de esta infección ha sido la implementación de la vacuna tres vírica en los programas de inmunización. En países con población altamente inmunizada como Chile, se logró una importante disminución de la incidencia de esta enfermedad. Sin embargo, a pesar de la efectividad de la vacuna se siguen reportando brotes en todo el mundo, evidenciándose un cambio epidemiológico, trasladándose la edad de presentación clínica desde la niñez y adolescencia hacia los adultos jóvenes. Este aumento en el número de casos ha sido estudiado, determinando que el efecto protector inmunitario de la vacuna decaería con el transcurso del tiempo, contribuyendo a la propagación de los brotes. Con respecto a posibles estrategias para el manejo de los brotes la aplicación de una dosis adicional de la vacunas tres vírica en población expuesta sería una medida que mejoraría el control de los brotes.

Mumps is a viral infection caused by mumps virus. Clinically, it is characterized by increased parotid volume. The most effective strategy for preventing this infection, has been the implementation of measles-mumps-rubella (MMR) vaccine in the national immunization program. Among countries with a highly immunized population, like Chile, there has been an important reduction in the incidence of this disease. Nevertheless, despite the effectivity of the MMR, there are reports of outbreaks worldwide, with an epidemiological change, from clinical presentation in childhood, to adolescents and adults. This outbreaks have been studied, and it has been determined that they are due to the waning of vaccine-derived immunity. Regarding strategies for the management of new outbreaks, the administration of an additional dose of MMR, would be an alternative.

Meningitis aguda posterior a vacuna tresvírica / Acute meningitis following mumps vaccine

Resumen En Chile, la cepa del virus parotídeo utilizada en la vacuna es Leningrad-Zagreb (L-Z). Aunque la relación entre meningitis y la cepa L-Z sigue siendo controvertida, la mayoría de los casos reportados han presentado un cuadro de curso benigno y sin secuelas neurológicas. Presentamos el caso de una paciente que tres semanas post-inmunización con la vacuna tresvírica evolucionó con una meningitis aséptica de predominio mononuclear, con serología para IgM positiva contra el virus parotídeo. En este caso clínico, existió una relación temporal entre la vacunación, el inicio del cuadro parotídeo y posteriormente el meníngeo; la curva de inmunoglobulinas demostró una infección aguda posterior a la vacuna. Si bien no se logró aislar el virus en LCR, es razonable atribuir el cuadro a una infección post-vacunal.

In Chile, the strain of the mumps virus used in the vaccine is Leningrad-Zagreb (L-Z). Although the relationship between meningitis and the L-Z strain remains controversial, most of the reported cases have shown a benign course without permanent neurological sequelae. We present a case of a patient who presented an aseptic meningitis three weeks after immunization with a mumps vaccine; and laboratory confirmation showed positive serum mumps IgM antibody. In this clinical case, there was a temporal relationship between vaccination and the onset of the mumps and subsequently the meningeal involvement; the immunoglobulin curve demonstrates acute infection after vaccination. Although it was not possible to isolate the virus in CSF, it is reasonable to attribute the picture to a post-vaccinal infection.

Global outbreak of deadly measles in 2019

Measles is an infection of the respiratory system caused by a virus, especially a Paramyxovirus of the genus Morbillivirus, a single stranded negative sense RNA virus. Infants younger than 12 months, school-aged children or young adults depending upon local immunization practice are highly susceptible for the disease.

Role of ERCC1 expression in colorectal adenoma-carcinoma sequence and relation to other mismatch repair proteins expression, clinicopathological features and prognosis in mucinous and non-mucinous colorectal carcinoma

Background: There are several DNA repair pathways that protect cellular DNA from injury, such as nucleotide excision repair (NER) and mismatch repair (MMR). The protein product of the excision repair cross-complementation group 1 (ERCC1) gene plays a pivotal role in NER. The exact relationship between MMR proteins and ERCC1 is not well known in colorectal carcinoma (CRC). Aim of the Study: To investigate expression of ERCC1 and MMR proteins in colorectal mucinous carcinoma (MA) and non-mucinous carcinoma (NMA) using tissue microarray technique. Material and Methods: We studied tumor tissue specimens from 150 patients with colorectal mucinous (MA) and non-mucinous adenocarcinoma (NMA). Tissue microarrays were constructed using modified mechanical pencil tips technique and immunohistochemistry for ERCC1, MLH1, MSH2, MSH6, and PMS2. Results: NMA showed a significantly more frequent aberrant cytoplasmic expression than MA while MA showed a more frequent intact nuclear expression than NMA. There were no significant differences between the NMA and MA groups in the expression of MMR proteins. In NMA cases, ERCC1 expression was significantly related to MMR status while was not significantly related in MA cases. ERCC1 expression was not significantly related to overall and disease-free survival in both NMA and MA groups. Conclusion: this study is the first to investigate the relation between MMR status and ERCC1 expression in colorectal MA and NMA. ERCC1 expression was significantly related to MMR status only in NMA cases. Hence, the current study emphasizes that further research about the relation between various DNA repair pathways is needed.

Towards safe motherhood to - are we moving in the right direction?: experience from an urban health facility in South India

Background: This study was designed to evaluate the institutional Maternal Mortality Ratio (iMMR) in our institution, a tertiary private medical college hospital and to suggest recommendations and possible interventions to reduce it.Methods: This retrospective descriptive study was conducted by reviewing the hospital records over a period of ten years from January 2009-December 2018. The case records were reviewed for maternal demographic characteristics and complications.Results: The total number of deaths during the study period was 21, giving an iMMR of 85.268 per 100000 live births. Most of the maternal deaths (>80%) occurred postpartum. Obstetric causes contributed to 57% of the deaths with hypertension and hemorrhage topping the list. Other causes were sepsis and non obstetric causes including one case of maternal suicide. 52.38% of the women died more than 48 hours after admission to the hospital, while 28.57% succumbed in less than six hours. Secondary complications noted were ICU admission, extended intubation, massive transfusion, operative intervention and multi organ dysfunction.Conclusions: The classical triad of Hypertension, Hemorrhage and Sepsis continues to be the major determinant of maternal mortality and are potentially preventable by promoting universal access to quality health care, strengthening of health services and ensuring accountability.

Review of maternal mortality in a tertiary care urban teaching hospital: 10 year retrospective study

Background: The objectives of this study were to calculate the maternal mortality ratio, causes for maternal death in our institution and the duration of hospital admission to death interval.Methods: The study included collecting and analyzing the details of maternal death in women who were admitted to St. Johns Medical College Hospital, Bengaluru, from January 2007 to December 2016. Results: Total maternal deaths were 61 and live births were 26,001 during the study period. The maternal mortality ratio (MMR) was 234.6 per 100,000 live births. Majority of maternal deaths occurred in women aged 18 - 35 years 56 (91.80%) women, primipara 45 (73.77%) and referred cases to our institution from other hospitals 52 (85.24%).                      Most of the women died in the postnatal period 54 (88.52%). Direct obstetric causes accounted for 44 (72.13%) maternal deaths and indirect causes 17 (27.86%) deaths. Preeclampsia and eclampsia were the leading causes for death 13 (21.31%) followed by acute fatty liver of pregnancy 12 (19.67%), hemorrhage 7 (13.11%) and sepsis 6 (9.83%). Anemia was present in 77.04% of women at the time of admission to our hospital. Thirty six (59.01%) women died within a week of admission to the hospital, in which 13 (21.31%) women died in less than 24hours of admission. Twenty five (40.98%) women died after a week of admission to hospital.Conclusions: Apart from the triad of preeclampsia, obstetric haemorrhage and sepsis, acute fatty liver of pregnancy has emerged as an important cause of maternal death. Most of the maternal deaths are preventable. Early detection of complications and timely referral to tertiary care hospital in St. Johns Medical College Hospital, Bengaluru, Karnataka, India decreases maternal morbidity and mortality.

Pesquisa inmuno-epidemiológica en niños con meningoencefalitis vírica vacunados contra la parotiditis, rubeola y sarampión / Immuno-epidemiological inquiry in children suffering viral meningoncephalitis vaccinate against mumps, rubella and measles

En las meningoencefalitis de etiología viral se encuentran implicados los paramixovirus (virus de la parotiditis, sarampión y rubeola). Las vacunas combinadas trivalentes han sido utilizadas durante años en muchos países. El objetivo del trabajo es determinar la respuesta poliespecífica de anticuerpos de tipo IgG anti parotiditis, rubeola y sarampión en pacientes pediátricos con meningoencefalitis víricas agudas. Se realizó un estudio retrospectivo en el año 2018 en muestras de pacientes pediátricos con meningoencefalitis viral aguda vacunados con la triple viral, donde se utilizó el índice de anticuerpos específicos anti-parotiditis, anti-rubeola y anti-sarampión para identificar el estado de respuesta inmunológica contra dichos virus en la muestra estudiada, procedentes de la serorraquioteca de LABCEL. Las determinaciones se hicieron por ELISA. Todos los pacientes presentaron respuesta poliespecífica intratecal, disminución significativa del índice de anticuerpos IgG anti-parotiditis con respecto a la edad y al tiempo de respuesta. Se evidencia un acortamiento del tiempo de respuesta de los anticuerpos de tipo IgG específicos anti-parotiditis en relación a la edad de vacunación(AU)

Paramixovirus like mumps, rubella and measles are involved in some viral meningoencephalitis. Triple combined vaccines have been employed for several years in many countries. The aim of this work is to determine the IgG anti mumps, rubella and measles polyspecific response in pediatric patients with acute viral meningoencephalitis. A 2018 retrospective study in pediatric patients with acute viral meningoencephalitis previously vaccinated with the triple viral vaccine MMR was performed to identify the immune response status against mumps, rubella and measles in samples from LABCEL serum and cerebrospinal fluid collection. Quantification of IgG specific antibody was performed by ELISA. Intrathecal polyspecific response was present in all patients. A significant decrement of anti IgG mumps specific antibody index was observed according to age and response time. A shortage of the response time of IgG mumps specific antibodies according to the age of vaccination was demonstrated(AU)

Cáncer de colon en Colombia, fenotipo molecular: tamizaje para síndromes con agregación familiar / Colorectal cancer in Colombia molecular phenotype: screening for syndromes with familial aggregation

Objetivo: Caracterizar las características clínico-patológicas y algunos fenotipos moleculares del cáncer colorrectal (CCR), en 1278 pacientes de la región andina colombiana. Métodos: Se analizó una muestra de 1278 pacientes con CCR. Análisis de expresión de los genes MMR-Mismatch Repair-hMLH1, utilizando métodos inmunohistoquímicos (IHC). Para inestabilidad microsatelital-MSI se utilizó ADN de tejido tumoral-normal mediante PCR. Resultados: Promedio de edad 57,4 años, la enfermedad es más frecuente en el género femenino 53,2%. La frecuencia de pacientes menores de 50 años (26,5%) es mayor a la esperada, el CCR en estos casos se asoció a tipos histológicos agresivos -carcinoma mucinoso y carcinoma en anillo de sello- p=<0,000, los cuales, a su vez, resultaron asociados a inestabilidad microsatelital (MSI-H). La localización más frecuente: recto (31,1%), p=0,002, el diagnóstico se produjo en estados avanzados de la enfermedad T3-T4 (75,1%) p=0,022. Tipo histológico más frecuente: adenocarcinoma. La sensibilidad del análisis inmunohistoquímico de MLH1 para la detección de MSI+, fue de 71% (CI: 49 - 87). El análisis por IHC-MLH1 en 575 casos mostró pérdida de la expresión en el 7% de los pacientes. Las pruebas de MSI se realizaron en 451 casos de CCR; el 23% presentaron alta inestabilidad microsatelital (MSI-H). Conclusión: La determinación de inestabilidad microsatelital y la inmunohistoquímica para MMR permiten identificar pacientes en riesgo de ser portadores de mutaciones relacionadas con síndrome de Lynch en pacientes colombianos.

Objective: To characterize the main clinicopathological features and the molecular phenotypes of Colorectal Carcinoma (CRC), in 1,278 patients from the Colombian Andean region. Methods: 1278 patients with CRC. Analyses of the MMR (Mismatch Repair) genes hMLH1, immunohistochemical methods (IHC) were used. To evaluate microsatellite instability (MSI), DNA from tumoral-normal tissue by PCR. Results: The average age of Colombian CRC patients is 57.4 years. The disease is more common in females (53.2%). The frequency of patients younger than 50 years (26.5%) is higher than expected; the CRC in these cases was associated with histological types: aggressive, mucinous carcinoma and singlet ring carcinoma (P= <0.000), which in turn were associated with microsatellite instability (MSI-H). The most frequent location was in the rectum (31.3%), p=0.002 and the diagnosis occurred in advanced stages of the disease T3-T4 (75.1%) p=0.022. The most common histological type was adenocarcinoma. The sensitivity of the immunohistochemical analysis of MLH1 for the detection of MSI+ was 71% (Cl: 49-87). In 575 cases, the IHC-MLH1 analysis showed loss of expression in 7% of patients. MSI analysis was performed in 451 cases of CRC, with 25% show in high microsatellite instability (MSI-H). Conclusions: The determination of microsatelital instability and immunohistochemistry for MMRs allow to identify patients at risk of being carriers of mutations related to Lynch syndrome in Colombian patients.