Aerobic digestibility of waste aerobic granular sludge (AGS) assessed by respirometry, physical-chemical analyses, modeling and 16S rRNA gene sequencing.

Research has evolved on aerobic granular sludge (AGS) process, but still there are very few studies on the treatment of excess AGS sludge, with almost none considering its aerobic digestion. Here therefore, the aerobic digestibility of typical AGS sludge was assessed. Granules were produced from acetate-based synthetic wastewater (WW) and were subjected to aerobic digestion for 64 d. The stabilization process was monitored over time through physical-chemical parameters, oxygen uptake rates (OUR) and 16S rRNA gene sequencing. The microbial analyses revealed that the cultivated granules were dominated by slow-growing bacteria, mainly ordinary heterotrophic organisms with potential for polyhydroxyalkanoates (PHA) aerobic storage (PHA-OHOs), polyphosphate and glycogen accumulating organisms (PAOs and GAOs), fermentative anaerobes and nitrifiers (AOB and NOB). Differential abundance analysis of the bacterial data (before versus after digestion) discriminated between the most vulnerable microbiome genera and those most resistant to aerobic digestion. Furthermore, modeling of the stabilization process determined that the endogenous decay rate constant (bH) for the heterotrophs present in the granules was notably low; bH = 0.05 d-1 (average), four times less than for common activated sludge (AS), which is rated at 0.2 d-1. For first time, the research reveals another important feature of AGS sludge, i.e. the slow-decaying character of its bacteria (along with their known slow-growing character). This results in slower stabilization, need of bigger digesters and reconsideration of the specific OUR limits in biosolids regulations (SOUR limit of 1.5 mg/gTSS.h), for waste AGS compared to conventional waste AS. The study suggests that aerobic digestion of waste AGS (fully-granulated) could differ from that of conventional AS. Future work is needed on aerobic digestibility of real AGS sludges from municipal and industrial WWs, compared to synthetic WWs.

Stabilization of betalains by encapsulation-a review.

Betalains are pigments that have properties that benefit health, such as antioxidant, anticancer, and antimicrobial activity, and they also possess a high ability to provide color. However, these pigments, although used as colorants in certain foods, have not been able to be potentialized to diverse areas such as pharmacology, due to their instability to physicochemical factors such as high temperature, pH changes and high water activity. For this reason, different stabilization methods have been reported. The method that has presented best results for diversifying the use of betalains has been encapsulation. Encapsulation is a method of entrapment where the objective is to protect a compound utilizing more stable matrices from encapsulation technologies. This method has been employed to provide greater stability to betalains, using different matrices and encapsulation technologies. However, a review does not exist, to our knowledge, which analyzes the effect of matrices and encapsulation technologies on betalains stabilization. Therefore, the objective of this review article was to evaluate the different matrices and encapsulation techniques that have been employed to stabilize betalains, in order to arrive at specific conclusions concerning the effect of encapsulation on their stabilization and to propose new techniques and matrices that could promote their stabilization.

Un caso familiar de microduplicación distal 22q11.2 / A family case of distal 22q11.2 microduplication

INTRODUCCIÓN: La microduplicación distal 22q11.2 es una entidad rara, pero de la que están apareciendo cada vez más casos en la literatura, ampliando en cada referencia el espectro de manifestaciones. Presentamos dos casos dentro de la misma familia. PRESENTACIÓN DEL CASO: El caso índice es un recién nacido prematuro, con historia clínica neonatal de sepsis precoz, displasia broncopulmonar, ductus arterioso persistente, hiperbilirrubinemia que precisa exanguinotransfusión, raquitismo grave e hipoacusia neurosensorial profunda bilateral. En su seguimiento evolutivo destacan la talla baja, así como unos rasgos dismórficos, entre los que resaltan macrocefalia con frente amplia, epicanto y braquidactilia. En la RMN de cráneo se detecta ventriculomegalia, sin otras alteraciones, y a los 4 años de edad presenta moderado retraso del lenguaje. Su madre tiene unos rasgos faciales similares, con baja estatura e hiperlordosis, pero sin alteraciones en el aprendizaje. Se realiza hibridación genómica comparativa (aCGH), demostrando una secuencia duplicada de 1,5 Mb en la región 22q11.2, tanto en el paciente como en su madre. DISCUSIÓN: La microduplicación distal de la región 22q11.2 se presenta con una amplia variabilidad clínica, tanto interindividual como dentro de una misma familia. Es difícil una sospecha clínica previa, realizándose el diagnóstico gracias al estudio con aCGH

INTRODUCTION: Distal chromosome 22q11.2 microduplication is a rare condition, but increasingly reported in the medical literature. It is often inherited and shows phenotypic variability. We report two cases in the same family. CASE REPORT: The index case is a preterm newborn with a neonatal clinical history of early-onset sepsis, bronchopulmonary dysplasia, patent ductus arteriosus, exchange transfusion for hyperbilirubinemia, severe rickets and profound bilateral sensorineural hearing loss. As the patient grew, he presented with short stature, broad forehead, macrocephaly, epicanthal folds and brachydactyly. A MRI was performed revealed mild ventriculomegaly. At the age of 4, he has moderate language disability. His mother shows similar dysmorphic features plus lumbar hyperlordosis but without learning disabilities. CGH-Array revealed a 1.5 Mb duplication of chromosome 22q11.2 in both the proband and his mother. DISCUSSION: Distal 22q11.2 microduplication presents with a broad range of characteristics, and inter-individual and intra-familial clinical variability. The diagnosis is usually made by CGH-Array

Impacto de la maternidad adolescente en los resultados perinatales / Perinatal outcomes among adolescent pregnancies

INTRODUCCIÓN: Este estudio tiene como objetivo evaluar la repercusión de la maternidad adolescente en el peso de los recién nacidos, y de forma secundaria en otros resultados perinatales. PACIENTES Y MÉTODOS: Estudio descriptivo retrospectivo que compara los resultados perinatales de dos poblaciones de mujeres gestantes del Hospital Universitario de Fuenlabrada entre los años 2004 y 2016: un grupo de madres adolescentes (menores de 19 años al inicio de la gestación) y otro grupo control de gestantes con edades entre los 20 y 35 años al inicio de la gestación. Los datos del embarazo y del periodo neonatal inmediato se recogieron a partir de las historias clínicas informatizadas de madres/hijos. RESULTADOS: Se recogieron todos los partos de gestaciones adolescentes durante este periodo de tiempo (n= 377, 1,3% del total de gestaciones de nuestro hospital en dicho periodo) y se compararon con un grupo control de madres no adolescentes (n= 143). De forma significativa, las gestantes adolescentes fueron con mayor frecuencia extranjeras, tuvieron un peor control gestacional, y una menor proporción de partos instrumentalizados y cesáreas. No se encontraron diferencias significativas entre los dos grupos en cuanto a edad gestacional, peso al nacimiento, prematuridad, consumo de tóxicos durante la gestación, pH del cordón, tipo de lactancia, ingreso en la unidad neonatal, días de hospitalización ni morbilidad del recién nacido. CONCLUSIONES: No se aprecia en nuestro estudio un aumento del riesgo de resultados perinatales adversos en relación con el embarazo adolescente

INTRODUCTION: This study aims to assess the impact of adolescent motherhood on the weight of newborns, and secondarily on other perinatal outcomes. PATIENTS AND METHODS: Descriptive and retrospective study, comparing perinatal results of two pregnant women cohorts, between 2004 and 2016: a first group of adolescent mothers (younger than 19 years old at the beginning of their pregnancy), and a second group of mothers 20-35 years old (control group). Patient data about pregnancy and immediate perinatal period were retrieved from electronic medical notes. RESULTS: Adolescent deliveries during 2004-2016 were 377 (1,3% of the total number of childbirths). They were compared with a control group of non-adolescent deliveries (n= 143). Adolescent mothers were more frequently immigrant, they had worse prenatal care, and less proportion of caesarean and instrumental deliveries. No significant differences were found about gestational age, birthweight, prematurity, drug consumption, umbilical cord pH, lactation, neonatal unit admission, days of hospital stay or neonatal morbidity. CONCLUSIONS: We have not found in our study an increased risk of adverse perinatal outcomes in relation to adolescent pregnancy

Sospecha prenatal de malformación congénita de las vías respiratorias pulmonares: casuística de 10 años en un hospital de segundo nivel / Prenatal suspicion of congenital pulmonary airway malformation: cases for ten years on a second level hospital

Introducción: La malformación congénita de las vías aéreas pulmonares (MCVAP), anteriormente denominada malformación adenomatoidea quística, es un raro trastorno del desarrollo del tracto respiratorio bajo. Los pacientes pueden estar asintomáticos durante muchos años, o bien presentar una dificultad respiratoria neonatal. Muchos casos actualmente se detectan mediante ecografía prenatal. El objetivo de este estudio era describir los casos diagnosticados en un hospital de segundo nivel durante un periodo de observación de 10 años. Casos clínicos: Encontramos 6 casos de MCVAP, tras un seguimiento desde los 7 meses a los 9 años de edad. El diagnóstico se realizó mediante ecografía prenatal. La incidencia en nuestro hospital resultó ser de 2,44 casos por 10.000 recién nacidos vivos. Conclusiones: El tratamiento quirúrgico es definitivo, y debe realizarse en un hospital con experiencia en cirugía pediátrica. En los pacientes asintomáticos, el manejo dependerá de las características asociadas al riesgo de complicaciones. Para los pacientes asintomáticos y de bajo riesgo, ambas opciones (operar o manejo conservador) son razonables, siempre tras una adecuada información a la familia

Introduction: Congenital pulmonary airway malformation, previously known as congenital cystic adenomatoid malformation, is a rare developmental anomaly of the lower respiratory tract. Affected patients may present with respiratory distress in the newborn period or may remain asymptomatic until later in life. Many cases are now detected by routine prenatal ultrasound examination. Our objective was to describe the fetal-neonatal outcome of our cases of 10 years on a second level hospital. Clinical cases: Six cases of congenital cystic adenomatoid malformation of the lung are reported. The incidence in our hospital was 2.44 per 10,000 live births. They were followed up over a period of 7 months to 9 years. Diagnosis was made by prenatal ultrasound. Conclusion: Surgical resection is the definitive treatment in a hospital with experienced pediatric surgery. In asymptomatic infants subsequent management depends on whether there are characteristics that suggest a high risk of complications. For asymptomatic infants and children with small lesions and none of the high-risk features, either elective surgical resection or conservative management with observation are reasonable options, always after a detailed discussion with the family

Frecuentación en urgencias de los neonatos en un área suburbana de Madrid / Neonatal emergency attendance in a suburban area of Madrid

Objetivo: Determinar la frecuencia y los motivos de las visitas a urgencias de los neonatos de nuestro centro. Métodos: Estudio prospectivo analítico-descriptivo de los recién nacidos en un hospital de segundo nivel entre junio y agosto de 2014. Se realizó una entrevista personal a los progenitores tras el nacimiento y otra, por vía telefónica, al mes de vida del neonato. Las variables recogidas fueron las siguientes: edad, nacionalidad y nivel de estudios de los padres, número de hijos, sexo, tipo de parto, peso al nacimiento, edad gestacional, tipo de lactancia, alta precoz, distancia al centro de salud de referencia y al hospital, y días de vida en primera valoración en su centro de salud. El análisis de los datos se realizó mediante el programa estadístico SPSS (versión 22). Resultados: Durante el periodo referido nacieron 514 pacientes. Firmaron el consentimiento para el estudio 425 padres, de los cuales 384 completaron la segunda entrevista, lo que constituyó la muestra analizada. Acudió al servicio de urgencias un 24,5% de los pacientes. Los motivos más frecuentes de consulta fueron los siguientes: problemas del cordón umbilical (10,1%), intolerancia digestiva (9,4%), infección respiratoria y problemas de lactancia (ambos 8,6%). El 27,6% requirió algún tipo de prueba complementaria, y el 12,9% precisó ingreso o derivación a un especialista. Las variables relacionadas con el mayor número de visitas a urgencias fueron el hecho de tener menos hijos, haber tenido un parto instrumental y una mayor edad gestacional en el momento del nacimiento. En el resto de variables no se encontraron diferencias significativas. Conclusiones: El 24,5% de los nacidos en nuestro hospital acudió a urgencias durante su primer mes de vida, aunque la mayor parte de los motivos no era urgente. Los factores de riesgo relacionados con el mayor número de visitas a urgencias fueron: menor número de hijos, parto instrumental y mayor edad gestacional (AU)

Objective: To determine the frequency and reasons to visit emergency room in newborns in our centre. Methods: Analytical and descriptive prospective study of neonates born in a secondary hospital from June to August 2014. Data were collected by two interviews: one personal at birth and another, by telephone, at one month of life. The variables studied were: age, nationality and parental education level, number of children, sex, type of delivery, birth weight, gestational age, type of feeding, early discharge, distance to the health centre and referral hospital, and days of life in first assessment in the corresponding health centre. Data analysis was performed using SPSS (version 22). Results: During the period referred 514 patients were born. Informed consent was signed in 425. Of these, 384 completed the second interview, being this the sample final number. 24.5% neonates visited the emergency room. The most common reasons were: umbilical cord problems (10.1%), vomits (9.4%), respiratory infection and breastfeeding problems (both 8.6%). 27.6% of the neonates required some form of complementary test; 12.9% required admission or referral to a specialist. The variables associated with more number of visits to the hospital were: having less children, instrumental deliveries and higher gestational age. No significant differences were found in other variables. Conclusions: 24.5% of the neonates born in our hospital were attended in the emergency room during their first month of life, most of them for no urgent reasons. Risk factors related to an increased number of visits to the hospital were: having less children, instrumental delivery or higher gestational age (AU)

Pilot study of a novel pain management strategy: evaluating the impact on patient outcomes.

BACKGROUND: Our objective was to evaluate the impact of a novel multimodal pain management strategy on intraoperative opioid requirements, postoperative pain, narcotic use, and length of stay. METHODS: Consecutive patients undergoing elective laparoscopic colorectal resection were managed with an experimental protocol. The protocol uses a post-induction, pre-incision bilateral TAP block and local peritoneal infiltration at port sites with long-acting liposomal bupivacaine (20 mL long-acting liposomal bupivacaine, 30 mL 0.25 % bupivacaine, 30 mL saline). Experimental patients were matched on age, body mass index, gender, comorbidity, diagnosis, and procedure to a control group that received no block or local wound infiltration. Both groups followed a standardized enhanced recovery pathway. Demographics, perioperative, and postoperative outcomes were evaluated. The main outcome measures were intraoperative opioids, postoperative pain, opioid use, and length of stay. RESULTS: Fifty patients were analyzed-25 experimental and 25 controls. Patients were well matched on all demographics. In both cohorts, the main diagnosis was colorectal cancer and primary procedure performed a segmental resection. Operative times were similar (p = 0.41). Experimental patients received significantly less intraoperative fentanyl (mean 158 mcg experimental vs. 299 mcg control; p < 0.01). The experimental group had significantly lower initial (p < 0.01) and final PACU pain scores (p = 0.04) and shorter LOS (3.0 vs. 4.1 days, p = 0.04) compared to controls. Experimental patients trended toward shorter PACU times and lower opioid use and daily pain scores throughout the hospital stay. Postoperative complication and readmission rates were similar across groups. There were no reoperations or mortality. CONCLUSIONS: Our multimodal pain management strategy reduced intraoperative opioid administration. Postoperatively, improvements in PACU time, postoperative pain and narcotic use, and lengths of stay were seen in the experimental cohort. With the favorable finding from the pilot study, further investigation is warranted to fully evaluate the impact of this pain management protocol on patient satisfaction, clinical and financial outcomes.

Minimally invasive colorectal surgery: status and technical specifications.

Laparoscopy was the most significant technologic advance in colorectal surgery in the last quarter century. The safety, feasibility and oncologic equivalence have been proven, and undisputed clinical benefits have also been demonstrated over open approaches. Despite proven benefits, laparoscopic has not dominated the market, especially for colon and rectal cancer cases. Adaptations in laparoscopic technique were developed to increase use of minimally invasive surgery. Concurrently, there has been a paradigm shift toward less invasive technologies to further optimize patient outcomes. From these needs, hand assisted laparoscopic surgery (HALS), single incision laparoscopic surgery (SILS), and robotic assisted laparoscopic surgery (RALS) were applied to colorectal surgery. Each platform has unique costs and benefits, and similar outcomes when likened to each other in comparative studies. However, conventional laparoscopy, HALS, SILS, and RALS actually serve a complementary role as tools to increase the use of minimally invasive colorectal surgery. The goal of this paper is to review the history, current status, technical specifications, and evolution of the major minimally invasive platforms for colorectal surgery.

Functional diversity of phytochrome family in the control of light and gibberellin-mediated germination in Arabidopsis.

In several species, seed germination is regulated by light in a way that restricts seedling emergence to the environmental conditions that are likely to be favourable for the success of the new individual, and therefore, this behaviour is recognized to have adaptive value. The phytochromes are one of the most relevant photoreceptors involved in light perception by plants. We explored the redundancy and diversity functions of the phytochrome family in the control of seed responsiveness to light and gibberellins (GA) by using a set of phytochrome mutants of Arabidopsis. Our data show that, in addition to the well-known role of phyB in the promotion of germination in response to high red to far-red ratios (R/FR), phyE and phyD stimulate germination at very low R/FR ratios, probably by promoting the action of phyA. Further, we show that phyC regulates negatively the seed responsiveness to light, unravelling unexpected functions for phyC in seed germination. Finally, we find that seed responsiveness to GA is mainly controlled by phyB, with phyC, phyD and phyE having relevant roles when acting in a phyB-deficient background. Our results indicate that phytochromes have multiple and complex roles during germination depending on the active photoreceptor background.

[Endoscopic treatment of carpal tunnel syndrome]. / Tratamiento endoscópico del síndrome de túnel del carpo.

BACKGROUND: Surgical treatment of carpal tunnel syndrome is possible with an open or an endoscopic approach. However, indications and results are still under discussion. This study reports the results in a group of patients using the double-port endoscopic technique. METHODS: A group of patients who underwent endoscopic surgery at an orthopedic hospital were assessed; their symptoms and postoperative satisfaction were reported. Results were considered as excellent when symptoms subsided completely and as poor if symptoms persisted. RESULTS: Results were excellent or good in 60% of cases; results were fair or poor in the remaining 40%. CONCLUSIONS: Endoscopic treatment is only one more alternative for the treatment of carpal tunnel syndrome. It is necessary to determine in which cases it is best indicated to properly select patients and get better results.

Genetic risk factors for inflammatory bowel disease in a North-eastern Mexican population.

The purpose of this study was to assess the role of Helicobacter pylori and several genetic polymorphisms in relation to inflammatory bowel disease (IBD). We studied 44 unrelated patients with IBD and 75 subjects with no history of IBD as controls. Using pyrosequencing technology, we identified gene polymorphisms in IL-10, TNF-A, ILB-31, and TLR4. H. pylori status was determined by serology. Individuals homozygous for IL10-592 A or IL10-1082 A genotypes show significantly lower occurrence of IBD (P=0.03 and P<0.01, respectively). Individuals heterozygous at IL10-1082 have significantly increased occurrence of IBD, both ulcerative colitis and Crohn's disease (P<0.01). There was no difference in the prevalence of H. pylori infection between cases and controls. This study provides evidence that variation in IL10 is correlated with IBD occurrence in this Mexican population.

Evaluation of immune responses raised against Tc13 antigens of Trypanosoma cruzi in the outcome of murine experimental infection.

We have previously reported that genetic immunization with Tc13Tul antigen of Trypanosoma cruzi, the aetiological agent of Chagas' disease, triggers harmful effects and non-protective immune responses. In order to confirm the role of Tc13 antigens during T. cruzi infection, herein we studied the humoral and cellular immune responses to the Tc13Tul molecule and its EPKSA C-terminal portion in BALB/c T. cruzi-infected mice or mice immunized with recombinant Tc13Tul. Analysis of the antibody response showed that B-cell epitopes that stimulate a sustained IgM production along the infection and high levels of IgG in the acute phase are mainly located at the Tc13 N- and C-terminal domains, respectively. DTH assays showed that T-cell epitopes are mainly at the Tc13 N-terminal segment and that they do not elicit an efficient memory response. Recombinant Tc13Tul did not induce IFN-gamma secretion in either infected or immunized mice. However, a putative CD8+Tc13Tul-derived peptide was found to elicit IFN-gamma production in chronically infected animals. Immunization with recombinant Tc13Tul did not induce pathology in tissues and neither did it protect against the infection. Our results show that in the outcome of T. cruzi infection the Tc13 family protein mainly triggers non-protective immune responses.

Thermoluminescence response of new KCl(X)Br(1-X):EuCl3 sintered phosphors exposed to beta and gamma radiation.

Alkali halides crystals have been the subject of intense research for an understanding of their radiation-induced defects and luminescence properties. They exhibit noteworthy thermoluminescence (TL) properties when exposed to ionising radiation. Currently, these materials are grown employing expensive and rather complicated techniques. In this work, the results on the TL properties of new alkali halides phosphors fabricated by a simple and inexpensive procedure are presented. The samples were made by mixing KCl, KBr and EuCl3 salts, and compressing them at a pressure of 3.2 x 10(7) Pa during 3 min, followed by sintering at 700 degrees C during 24 h under air atmosphere. The dosimetric response of the samples showed an increase with radiation dose in the 1.5-20.0 Gy dose range for beta and gamma radiation. The TL glow curves in sintered samples presented significant differences in their peak structures compared with monocrystalline samples, indicating that the nature of the trapping states and the recombination mechanisms may be different.

Infección respiratoria por Chlamydia trachomatis en lactantes. Presentación clínica y evolución de 18 casos / Respiratory infection due to chlamydia trachomatis in infants. Clinical presentation and outcome in 18 patients

Antecedentes: Chlamydia trachomatis es un patógeno responsable, en el hombre, de epididimitis, prostatitis, etc., y en la mujer de uretritis, endocervicitis y enfermedad inflamatoria pélvica, entre otras enfermedades. Durante la época pediátrica suele cursar con conjuntivitis y afectación de vías respiratorias bajas, que ocasionalmente puede requerir ingreso hospitalario. Objetivo: Llamar la atención sobre esta enfermedad que suele pasar desapercibida y que puede llegar a ser potencialmente grave. Métodos: Revisión retrospectiva de las historias clínicas de lactantes menores de 6 meses con manifestaciones clínicas de infección respiratoria de vías bajas y detección del antígeno de C. trachomatis por enzimoinmunoanálisis. Resultados: Se detectaron 18 casos durante los años 1993 a 2002, precisando ingreso 17 y vigilancia en la unidad de cuidados intensivos pediátricos (UCIP) un total de cinco. La estancia media fue de 9,6 días. Tres pacientes eran inmigrantes. La edad media de aparición fue de 6,6 semanas. Presentaron: pausas de apnea 5 sujetos. En 5 lactantes había infiltrados intersticiales en la radiografía de tórax. El tratamiento definitivo en 16 de los pacientes fue eritromicina, con buena evolución en todos los casos. Conclusiones: Aunque la infección respiratoria de vías bajas por C. trachomatis suele tratarse de forma ambulatoria, en ocasiones puede llegar a requerir ingreso hospitalario e incluso estancia en la UCIP. Esta infección debería descartarse en lactantes menores de 6 meses con síntomas compatibles y en los que no se hallen otros gérmenes que justifiquen el cuadro (AU)

[Respiratory infection due to Chlamydia trachomatis in infants. Clinical presentation and outcome in 18 patients]. / Infección respiratoria por Chlamydia trachomatis en lactantes. Presentación clínica y evolución de 18 casos.

BACKGROUND: Among other diseases, Chlamydia trachomatis causes epididymitis and prostatitis in men and urethritis, cervicitis and pelvic inflammatory disease in women. In children, it most usually causes conjunctivitis and is also responsible for lower respiratory tract disease, occasionally requiring hospital admission. OBJECTIVE: To draw attention to this disease, which is usually overlooked and which can be potentially serious. METHODS: We retrospectively reviewed the medical records of infants aged less than 6 months with symptoms of lower respiratory tract disease in whom C. trachomatis antigen was detected by enzyme immunoassay. RESULTS: We identified 18 patients with C. trachomatis between 1993 and 2002. Of these, 17 patients required hospital admission and five required monitoring in the pediatric intensive care unit. The mean length of hospital stay was 9.6 days. Three patients were immigrants. The mean age at admission was 6.6 weeks. Apnea occurred in five infants. Chest x-ray showed interstitial infiltrates in five infants. Sixteen patients were treated with erythromycin and all made a complete recovery. CONCLUSIONS: Although lower respiratory tract disease caused by C. trachomatis is usually managed on an outpatient basis, it sometimes requires hospital admission or even management in the intensive care unit. Therefore, C. trachomatis infection should be ruled out in infants aged less than 6 months with clinical symptoms of lower respiratory tract disease for which no other pathogen can be found.

Pulmonary reactions during treatment with amphotericin B: review of published cases and guidelines for management.

Acute respiratory events occasionally have been observed during the infusion of amphotericin B. Herein we analyze the 21 cases that have been reported, including a fatal reaction observed by us. Some useful guidelines are provided that likely will allow treatment to be continued safely for patients who have experienced such reactions.

Prosthetic vascular graft infection due to Aspergillus species: case report and literature review.

A case of Aspergillus prosthetic graft infection is reported here, accompanied by a review of the literature on this topic. The literature search revealed only 13 other cases reported to date. This infection is usually acquired through contamination at the time of surgery and affects immunocompetent patients. Aspergillus fumigatus is the causative species in most cases. Remarkably, fever is absent in about one-half of all cases, and blood cultures are usually negative. Concomitant vertebral osteomyelitis is commonly observed when the aorta is involved. Cure of this serious infection may be achieved with antifungal therapy, excision of the infected graft and extra-anatomic bypass.

Implantación de prótesis autoexpandibles sobre estenosis aórticas por arteritis de Takayasu asociada a enfermedad de Crohn / The implantation of autoexpandible prostheses in aortic stenosis by Takayasu arteritis associated with Crohn's disease

Presentamos el caso de una mujer diagnosticada de enfermedad de Crohn que desarrolló una estenosis severa de la aorta abdominal por enfermedad de Takayasu manifestada por claudicación de ambos miembros inferiores. La colocación de prótesis intravasculares autoexpandibles (stents) sobre las lesiones aórticas estenóticas resolvió el cuadro, tanto desde el punto de vista hemodinámico como clínico de forma inmediata. (AU)