Gestante pretérmino con la COVID-19 asociada a preeclampsia agravada / Preterm pregnant woman with COVID-19 associated with aggravated pre-eclampsia

RESUMEN Introducción: La enfermedad por coronavirus 2019 (COVID-19), es una infección respiratoria aguda causada por el SARS-CoV-2, que potencialmente puede provocar un síndrome respiratorio agudo grave y causar la muerte de la paciente. Objetivo: Presentar una paciente con la COVID -19 asociado a preeclampsia agravada, en una gestante pretérmino. Caso clínico: Paciente de 25 años con gestación de 35,2 semanas, antecedentes de salud aparente que fue recibida desde su llegada a la unidad de cuidados intensivos, remitida por ser positiva a la COVID-19, con síntomas respiratorios de una neumopatía asociada, como cifras tensionales elevadas, sin otra sintomatología. Mediante el examen físico y estudios complementarios humorales se diagnóstica una preeclampsia agravada y un oligoamnios por una rotura de membranas ovulares. Fue tratada y compensada; se inició inducción y durante el procedimiento se diagnostica un riesgo de pérdida de bienestar fetal, por lo que se decidió realizar cesárea urgente. Se recibió recién nacido sano. La paciente no presentó complicaciones postquirúrgicas y se trató acorde a las normas actuales para los casos de madre grave con la COVID-19; tuvo una evolución favorable. Conclusiones: El diagnóstico y tratamiento precoz de una gestante con la COVID- 19 y preeclampsia asociada permite una evolución satisfactoria del binomio madre-feto.

ABSTRACT Introduction: Coronavirus disease 2019 (COVID-19) is an acute respiratory infection caused by SARS-CoV-2, which can potentially cause severe acute respiratory syndrome and cause the death of the patient. Objective: To present a patient with COVID -19 associated with aggravated preeclampsia, in a preterm pregnant woman. Clinical case: A 25-year-old patient with a gestation of 35.2 weeks, a history of apparent health that was received since her arrival at the intensive care unit, referred for being positive for COVID-19, with respiratory symptoms of an associated lung disease, as high blood pressure figures, without other symptoms. Through physical examination and complementary humoral studies, an aggravated preeclampsia and oligohydramnios were diagnosed due to rupture of the ovular membranes. She was treated and compensated; Induction was started and during the procedure a risk of loss of fetal well-being was diagnosed, so it was decided to perform an urgent cesarean section. A healthy newborn was received. The patient did not present post-surgical complications and was treated according to current standards for cases of severe mother with COVID-19; she had a favorable evolution. Conclusions: The early diagnosis and treatment of a pregnant woman with COVID-19 and associated preeclampsia allows a satisfactory evolution of the mother-fetus binomial.

Intestinal microbiota alterations by dietary exposure to chemicals from food cooking and processing. Application of data science for risk prediction.

Diet is one of the main sources of exposure to toxic chemicals with carcinogenic potential, some of which are generated during food processing, depending on the type of food (primarily meat, fish, bread and potatoes), cooking methods and temperature. Although demonstrated in animal models at high doses, an unequivocal link between dietary exposure to these compounds with disease has not been proven in humans. A major difficulty in assessing the actual intake of these toxic compounds is the lack of standardised and harmonised protocols for collecting and analysing dietary information. The intestinal microbiota (IM) has a great influence on health and is altered in some diseases such as colorectal cancer (CRC). Diet influences the composition and activity of the IM, and the net exposure to genotoxicity of potential dietary carcinogens in the gut depends on the interaction among these compounds, IM and diet. This review analyses critically the difficulties and challenges in the study of interactions among these three actors on the onset of CRC. Machine Learning (ML) of data obtained in subclinical and precancerous stages would help to establish risk thresholds for the intake of toxic compounds generated during food processing as related to diet and IM profiles, whereas Semantic Web could improve data accessibility and usability from different studies, as well as helping to elucidate novel interactions among those chemicals, IM and diet.

ShExML: improving the usability of heterogeneous data mapping languages for first-time users.

Integration of heterogeneous data sources in a single representation is an active field with many different tools and techniques. In the case of text-based approaches-those that base the definition of the mappings and the integration on a DSL-there is a lack of usability studies. In this work we have conducted a usability experiment (n = 17) on three different languages: ShExML (our own language), YARRRML and SPARQL-Generate. Results show that ShExML users tend to perform better than those of YARRRML and SPARQL-Generate. This study sheds light on usability aspects of these languages design and remarks some aspects of improvement.

High-resolution microbiome profiling uncovers Fusobacterium nucleatum, Lactobacillus gasseri/johnsonii, and Lactobacillus vaginalis associated to oral and oropharyngeal cancer in saliva from HPV positive and HPV negative patients treated with surgery and chemo-radiation.

Microbiome studies show altered microbiota in head and neck squamous cell carcinoma (HNSCC), both in terms of taxonomic composition and metabolic capacity. These studies utilized a traditional bioinformatics methodology, which allows for accurate taxonomic assignment down to the genus level, but cannot accurately resolve species level membership. We applied Resphera Insight, a high-resolution methodology for 16S rRNA taxonomic assignment that is able to provide species-level context in its assignments of 16S rRNA next generation sequencing (NGS) data. Resphera Insight applied to saliva samples from HNSCC patients and healthy controls led to the discovery that a subset of HNSCC saliva samples is significantly enriched with commensal species from the vaginal flora, including Lactobacillus gasseri/johnsonii (710x higher in saliva) and Lactobacillus vaginalis (52x higher in saliva). These species were not observed in normal saliva from Johns Hopkins patients, nor in 16S rRNA NGS saliva samples from the Human Microbiome Project (HMP). Interestingly, both species were only observed in saliva from Human Papilloma Virus (HPV) positive and HPV negative oropharyngeal cancer patients. We confirmed the representation of both species in HMP data obtained from mid-vagina (n=128) and vaginal introitus (n=121) samples. Resphera Insight also led to the discovery that Fusobacterium nucleatum, an oral cavity flora commensal bacterium linked to colon cancer, is enriched (600x higher) in saliva from a subset of HNSCC patients with advanced tumors stages. Together, these high-resolution analyses on 583 samples suggest a possible role for bacterial species in the therapeutic outcome of HPV positive and HPV negative HNSCC patients.

16S rRNA amplicon sequencing identifies microbiota associated with oral cancer, human papilloma virus infection and surgical treatment.

Systemic inflammatory events and localized disease, mediated by the microbiome, may be measured in saliva as head and neck squamous cell carcinoma (HNSCC) diagnostic and prognostic biomonitors. We used a 16S rRNA V3-V5 marker gene approach to compare the saliva microbiome in DNA isolated from Oropharyngeal (OPSCC), Oral Cavity Squamous Cell Carcinoma (OCSCC) patients and normal epithelium controls, to characterize the HNSCC saliva microbiota and examine their abundance before and after surgical resection.The analyses identified a predominance of Firmicutes, Proteobacteria and Bacteroidetes, with less frequent presence of Actinobacteria and Fusobacteria before surgery. At lower taxonomic levels, the most abundant genera were Streptococcus, Prevotella, Haemophilus, Lactobacillus and Veillonella, with lower numbers of Citrobacter and Neisseraceae genus Kingella. HNSCC patients had a significant loss in richness and diversity of microbiota species (p<0.05) compared to the controls. Overall, the Operational Taxonomic Units network shows that the relative abundance of OTU's within genus Streptococcus, Dialister, and Veillonella can be used to discriminate tumor from control samples (p<0.05). Tumor samples lost Neisseria, Aggregatibacter (Proteobacteria), Haemophillus (Firmicutes) and Leptotrichia (Fusobacteria). Paired taxa within family Enterobacteriaceae, together with genus Oribacterium, distinguish OCSCC samples from OPSCC and normal samples (p<0.05). Similarly, only HPV positive samples have an abundance of genus Gemellaceae and Leuconostoc (p<0.05). Longitudinal analyses of samples taken before and after surgery, revealed a reduction in the alpha diversity measure after surgery, together with an increase of this measure in patients that recurred (p<0.05). These results suggest that microbiota may be used as HNSCC diagnostic and prognostic biomonitors.

Long-term biochemical results after high-dose-rate intensity modulated brachytherapy with external beam radiotherapy for high risk prostate cancer.

BACKGROUND: Biochemical control from series in which radical prostatectomy is performed for patients with unfavorable prostate cancer and/or low dose external beam radiation therapy are given remains suboptimal.The treatment regimen of HDR brachytherapy and external beam radiotherapy is a safe and very effective treatment for patients with high risk localized prostate cancer with excellent biochemical control and low toxicity.

Biochemical outcome after high-dose-rate intensity modulated brachytherapy with external beam radiotherapy: 12 years of experience.

UNLABELLED: Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Biochemical control from series in which radical prostatectomy is performed for patients with unfavorable prostate cancer and/or low dose external beam radiation therapy are given remains suboptimal. The treatment regimen of HDR brachytherapy and external beam radiotherapy is a safe and very effective treatment for patients with high risk localized prostate cancer with excellent biochemical control and low toxicity. OBJECTIVE: • To investigate the long-term oncological outcome, during the PSA era, of patients with prostate cancer who were treated using high-dose-rate (HDR) brachy therapy (BT) combined with external beam radiation therapy (EBRT). PATIENTS AND METHODS: • From June 1998 to April 2007, 313 patients with localized prostate cancer were treated with 46 Gy of EBRT to the pelvis with a HDR-BT boost. • The mean (median) follow-up was 71 (68) months. • Toxicity was reported according to the Common Toxicity Criteria for Adverse Event, V.4. RESULTS: • The 10-year actuarial biochemical control was 100% for patients with no high-risk criteria, 88% for patients with two intermediate-risk criteria, 91% with one high-risk criterion and 79% for patients with two to three high-risk criteria (P= 0.004). • The 10-year cancer-specific survival was 97% (standard deviation ± 1%). • The multivariate Cox regression analyses identified, Gleason score and T stage as independent prognostic factors for biochemical failure. • Gleason score was the only factor to significantly affect distant metastases. • Grade ≥ 3 late toxicity was not detected. CONCLUSION: • The 10-year results confirm the feasibility and effectiveness of EBRT with conformal HDR-BT boost for patients with localised prostate cancer.

Transperineal injection of hyaluronic acid in the anterior perirectal fat to decrease rectal toxicity from radiation delivered with low-dose-rate brachytherapy for prostate cancer patients.

PURPOSE: Monitored rectal late morbidity using proctoscopy and a modified radiation therapy oncology group rectal bleeding scoring scale, in patients treated with permanent implant of I-125 and submitted to rectal protection with hyaluronic acid (HA) injecting in the perirectal fat to increase the distance between the prostate and the anterior rectal wall to decrease rectal toxicity. This is the first article looking at such injections in low-dose-rate brachytherapy patients and subsequent rectal toxicity. METHODS AND MATERIALS: Between January 2005 and July 2006, a total of 69 consecutive outpatients with low- and intermediate-risk prostate cancer were enrolled in a clinical trial. First group received brachytherapy alone with I-125 and the second group received brachytherapy I-125 and protection of the rectal wall with HA. We injected 6-8cc of HA in the perirectal fat, to increase the distance between the prostate and the anterior rectal wall. Proctoscopic examinations with scoring of mucosal damage were performed according to a descriptive scale, described by Wachter et al. The median follow-up at time of endoscopy was 18 months. Toxicity measures included modified radiation therapy oncology group late bleeding toxicity grading. RESULTS: The hyaluronic and non-hyaluronic groups were similar for most patients, in tumor, treatment, and dosimetric characteristics. Patients treated with brachytherapy I-125 and rectal protection with HA had significantly smaller incidence of mucosal damage at the proctoscopic examinations (5% vs. 36%, p=0.002) and no macroscopic rectal bleeding (0% vs. 12%, p=0.047) than those treated with brachytherapy I-125 alone without HA. No toxicity was produced from the HA or its injection. CONCLUSIONS: The increased distance between the rectal wall and the prostate, as a result from the injection of HA in the perirectal fat, has significantly decreased the rectal dose from low-dose-rate brachytherapy. Patients treated with brachytherapy I-125 and protection rectal with HA had significantly smaller incidence of mucosal damage at the proctoscopic examinations and no macroscopic rectal bleeding than those treated with brachytherapy I-125 alone without HA.