Neurotrophic bone marrow cellular nests prevent spinal motoneuron degeneration in amyotrophic lateral sclerosis patients: a pilot safety study.

The objective of this article is to assess the safety of intraspinal infusion of autologous bone marrow mononuclear cells (BMNCs) and, ultimately, to look for histopathological signs of cellular neurotrophism in amyotrophic lateral sclerosis (ALS) patients. We conducted an open single arm phase I trial. After 6 months observation, autologous BMNCs were infused into the posterior spinal cord funiculus. Safety was the primary endpoint and was defined as the absence of serious transplant-related adverse events. In addition, forced vital capacity (FVC), ALS-functional rating scale (ALS-FRS), Medical Research Council scale for assessment of muscle power (MRC), and Norris scales were assessed 6 and 3 months prior to the transplant and quarterly afterward for 1 year. Pathological studies were performed in case of death. Eleven patients were included. We did not observe any severe transplant-related adverse event, but there were 43 nonsevere events. Twenty-two (51%) resolved in ≤2 weeks and only four were still present at the end of follow-up. All were common terminology criteria for adverse events grade ≤2. No acceleration in the rate of decline of FVC, ALS-FRS, Norris, or MRC scales was observed. Four patients died on days 359, 378, 808, and 1,058 post-transplant for reasons unrelated to the procedure. Spinal cord pathological analysis showed a greater number of motoneurons in the treated segments compared with the untreated segments (4.2 ± 0.8 motoneurons per section [mns per sect] and 0.9 ± 0.3 mns per sect, respectively). In the treated segments, motoneurons were surrounded by CD90+ cells and did not show degenerative ubiquitin deposits. This clinical trial confirms not only the safety of intraspinal infusion of autologous BMNC in ALS patients but also provides evidence strongly suggesting their neurotrophic activity.

Haematopoietic progenitor cells from adult bone marrow differentiate into cells that express oligodendroglial antigens in the neonatal mouse brain.

Stem cells are self-renewable, pluripotent cells that, in adult life, proliferate by a characteristic asymmetric division in which one daughter cell is committed to differentiation whereas the other remains a stem cell. These cells are also characterized by their ability to differentiate into various cell types under heterotopic environmental influences. In the present study, we have explored the potential of adult haematopoietic bone marrow cells to differentiate into cells of oligodendroglial lineage under physiological, active myelinating conditions. We present evidence of generation of cells expressing oligodendroglial specific markers from a bone marrow subpopulation enriched on adult haematopoietic progenitor cells (CD117+) in vivo after intracerebral transplantation into the neonatal mouse brain. Our results suggest that adult bone marrow cells have the capacity to undergo differentiation from haematopoietic to oligodendroglial cells and add support the validity of bone marrow transplants as an alternative treatment for demyelinating diseases of the CNS including Multiple Sclerosis.

Deformidades seudorreumatoides y enfermedad de Parkinson / Rheumatoid like deformities in Parkinson's disease

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Vasculitis necrotisante a medicamentos: Hospital Dr. Dario Contreras / Necrotizing vasculitis due to drugs: Hospital Dr Dario Contreras

Se estudiaron dos casos de niños internados por referimientos, en el Hospital Dr. Dario Contreras, con los diagnósticos de Meningitis Bacteriana y Cangrena Seca en ambas piernas. Estos niños llegaron de lugares diferentes, pero con igual historia de administración de medicamentos diferentes en cortos períodos de tiempo en cada uno de ellos. El primero llegó desde el Hospital Materno Infantil San Lorenzo de Los Minas, y el segundo desde el Hospital de San Juan de la Maguana, ambos pacientes antes de ser ingresados fueron medicados por sus madres, con antipiréticos y antipalúdidos, y llevados a los centros donde fueron tratados y luego referidos. Durante su ingreso en esos centros hospitalarios les fueron hechos varios estudios entre ellos de orina, hemáticos, L.C.R., etc. y les administraron analgésicos, antipiréticos y antibióticos sin lograr la mejoría deseada por lo que fueron referidos con fines quirúrgicos. El primer caso nos llegó referido en el mes de septiembre de 1984, en tan malas condiciones que aunque fue tratado quirúrgicamente no sobrevivió, porque presentó una septisemia tipo fulminante dos días después de la cirugía. No se obtuvo en estos casos el mismo resultado, ya que la administración de los medicamentos específicos dependía del resultado de laboratorio y de la biopsia, cultivos y antibiogramas y de la rapidez con que ellos fueran reportados

Tipos de fracturas más frecuentes llevadas a la sala de reducción del Hospital Doctor Darío Contreras / Types of the fractures more common in the reduction room in the Hospital Dr. Darío Contreras

Se tomaron los casos de pacientes enviados a la sala de Reducción desde la emergencia del Hospital Doctor Darío Contreras, en el semestre comprendido del 1§ de Enero al 30 de Junio de 1984, con el fin de determinar el o los tipos de fracturas más frecuentes, además, la edad, sexo y tipo de anestésicos usados para la reducción de dichas fracturas. Pudimos determinar que el tipo más frecuente de fractura lo constituyó la fractura del 1/3 distal de cúbito y radio con 17.4% además que el sexo más frecuente fue el masculino con 62.7% y que prevaleció el uso de anestesia general en el tratamiento de éstos pacientes