Allogeneic adipose-derived mesenchymal stem cell therapy in dogs with refractory atopic dermatitis: clinical efficacy and safety.

Canine atopic dermatitis (AD) is a common skin disease with a 10-15 per cent prevalence. Current treatments vary in their efficacy and safety. The immunomodulatory properties of mesenchymal stem cells (MSCs) make them a promising alternative treatment. The aim of this study was to evaluate the therapeutic efficacy and safety of allogeneic canine adipose MSCs (cAd-MSCs) in dogs with refractory AD. Twenty-six dogs, suffering from AD for at least 12 months, not responding to conventional therapy, received an intravenous dose of 1.5×106 cAd-MSCs/kg bodyweight. Clinical signs, haematological and biochemistry profiles, and AD severity were assessed in a six-month follow-up using a validated scoring system (Canine Atopic Dermatitis Extent and Severity Index, version 4 (CADESI-04)). The degree of pruritus was quantified using a validated visual analogue scale, and also owner's global assessment of treatment efficacy. Twenty-two animals completed the study. Pruritus and CADESI-04 scores decreased significantly after one week or month of treatment, respectively, and remained stable for six months. Owner's global assessment score was 2.15±1.15 for all the animals in the study. In conclusion, systemic administration of allogeneic cAd-MSCs appeared to be a simple therapy with positive outcome in the remission of clinical signs for AD refractory to conventional medications, for at least six months and with no adverse events.

Eficacia de canulación biliar y riesgo de pancreatitis de dos técnicas de precorte empleadas de forma precoz / Biliary cannulation effectiveness and pancreatitis risk using two early precut techniques

Introducción: las técnicas de precorte permiten alcanzar tasas de canulación biliar próximas al 100% aunque pueden elevar el riesgo de complicaciones. Recientemente, el precorte de aguja precoz se ha demostrado seguro y se propone como recurso preventivo de pancreatitis en casos de canulación difícil. El objetivo del presente estudio es evaluar las tasas de canulación y pancreatitis de dos técnicas de precorte ejecutadas precozmente. Pacientes y método: estudio retrospectivo de las colangio- pancreatografías retrógradas endoscópicas (CPRE) realizadas entre 2013 y 2016. Se analiza la eficacia y seguridad de la canulación simple, del precorte de aguja y del precorte transpancreático. Resultados: de 503 CPRE analizables se obtuvo la canulación simple en 369 (73,4%). En 53 casos se realizó un precorte de aguja, con éxito en 51 (96,2%), y en 78 casos se realizó un precorte transpancreático, con éxito en 75 (96,2%). La tasa global de canulación fue del 98,4%. En total se registraron once pancreatitis (2,4%), seis (1,8%) en las canulaciones simples (dos graves y una fatal), cinco (6,3%) en los precortes transpancreáticos (dos graves) y cero en los precortes de aguja. En los pacientes sometidos a precorte se registraron siete perforaciones (dos graves) y siete hemorragias, siendo la tasa global de complicaciones del 14,4%. Conclusiones: el empleo complementario de ambas técnicas de precorte permite alcanzar una tasa de canulación biliar satisfactoria. No obstante, la tasa de pancreatitis y otras complicaciones graves del precorte transpancreático es superior a la del precorte de aguja, lo que aconseja modificar la indicación de cada técnica (AU)

Introduction: Precut techniques allow for successful biliary cannulation rates approaching 100% but there may be an associated increase in the risk of complications. Recently, early needle-knife precut has been shown to be a safe procedure and is now used as a pancreatitis prevention resource for difficult cannulation cases. The goal of the present study was to assess cannulation and pancreatitis rates using two early precut techniques. Patients and methods: This was a retrospective study of endoscopic retrograde cholangio-pancreatography (ERCP) procedures performed from 2013 to 2016. The efficacy and safety of simple cannulation, needle-knife precut and transpancreatic precut were assessed. Results: Simple cannulation was achieved in 369 (73.4%) of 503 evaluable ERCP procedures. Needle-knife precut was successful in 51 (96.2%) of 53 attempts and transpancreatic precut was successful in 75 (96.2%) of 78 attempts. The overall cannulation rate was 98.4%. There were eleven (2.4%) pancreatitis events, six (1.8%) with simple cannulation (two severe, one fatal), five (6.3%) with transpancreatic precut (two severe) and zero events with the needle-knife precut procedure. Among the patients undergoing the precut procedure, seven experienced perforations (two severe) and there were seven bleeding events. The overall complication rate was 14.4%. Conclusions: The complementary use of either precut technique provides a satisfactory biliary cannulation rate. However, the rates of pancreatitis and other severe complications are higher for transpancreatic versus needle-knife precut, therefore the indications for both techniques should be modified (AU)

Insights into genotype-phenotype correlation in hypertrophic cardiomyopathy. Findings from 18 Spanish families with a single mutation in MYBPC3.

BACKGROUND: Mutations in the cardiac myosin-binding protein C (MYBPC3) gene are frequently found as a cause of hypertrophic cardiomyopathy (HCM). However, only a few studies have analysed genotype-phenotype correlations in small series of patients. The present study sought to determine the clinical characteristics, penetrance and prognosis of HCM with an identical mutation in MYBPC3. METHODS: 154 non-related patients with HCM (aged 55±16 years, 100 (64.9%) males) were studied. 18 (11.7%) were found to have an identical mutation in the MYBPC3 gene (IVS23+1G→A). Pedigree analysis, including both clinical evaluation and genotyping, was performed. RESULTS: 152 individuals (mean age 37±18 years, 53.3% males) from 18 families were evaluated. 65 carriers of the IVS23+1G→A mutation were identified, 61.5% of whom met HCM diagnostic criteria. Penetrance of the disease increased with age, with 50% affected at 46 years of age. Males tended to develop the disease earlier than females. 7 (15.6%) had systolic dysfunction. Compared with the rest of the HCM cohort, probands with the mutation had more hypertrophy and were younger at diagnosis. There was a trend towards a reduced survival free from sudden death (SD) (HR 1.71; 95% CI 0.98 to 2.98, p=0.059). There were 17 SD cases in 12 families with the mutation. CONCLUSIONS: The MYBPC3 IVS23+1G→A mutation is associated with middle-age onset disease and poor outcome, with a significant proportion of patients developing systolic impairment and a high SD risk profile.