The percentage of CD39+ monocytes is higher in pregnant COVID-19+ patients than in nonpregnant COVID-19+ patients.

Current medical guidelines consider pregnant women with COVID-19 to be a high-risk group. Since physiological gestation downregulates the immunological response to maintain "maternal-fetal tolerance", SARS-CoV-2 infection may constitute a potentially threatening condition to both the mother and the fetus. To establish the immune profile in pregnant COVID-19+ patients, a cross-sectional study was conducted. Pregnant women with COVID-19 (P-COVID-19+; n = 15) were analyzed and compared with nonpregnant women with COVID-19 (NP-COVID-19+; n = 15) or those with physiological pregnancy (P-COVID-19-; n = 13). Serological cytokine and chemokine concentrations, leucocyte immunophenotypes, and mononuclear leucocyte responses to polyclonal stimuli were analyzed in all groups. Higher concentrations of serological TNF-α, IL-6, MIP1b and IL-4 were observed within the P-COVID-19+ group, while cytokines and chemokines secreted by peripheral leucocytes in response to LPS, IL-6 or PMA-ionomicin were similar among the groups. Immunophenotype analysis showed a lower percentage of HLA-DR+ monocytes in P-COVID-19+ than in P-COVID-19- and a higher percentage of CD39+ monocytes in P-COVID-19+ than in NP-COVID-19+. After whole blood polyclonal stimulation, similar percentages of T cells and TNF+ monocytes between groups were observed. Our results suggest that P-COVID-19+ elicits a strong inflammatory response similar to NP-COVID19+ but also displays an anti-inflammatory response that controls the ATP/adenosine balance and prevents hyperinflammatory damage in COVID-19.

[Active management of postpartum hemorrhage and Bakri balloon placement in primiparous and multiparous]. / Tratamiento activo de la hemorragia posparto y colocación del balón de Bakri en pacientes primigestas y multigestas.

OBJECTIVE: To evaluate the usefulness of active management of the third stage of labor plus Bakri balloon in primiparous and multiparous. patients with postpartum hemorrhage. MATERIAL AND MET HOD: A retrospective, cross-sectional analytical study in the Hospital of Women, from 1st January 2013 to 31st December 2014. We use uterotonics and after persistence of postpartum hemorrhage also considered Bakri balloon placement, and further transfusion management were evaluated. Analysis descriptive and inferential statistics were performed (Mann-Whitney U and linear regression) and the relationship between inter- and intra-group variables analyzed, a significance level of p <0.05 was established. RESULTS: We choice 47 patients (26 primiparous and 21 multiparous). The 100% of cases avoids obstetric hysterectomy, average age was lower in primiparous than multiparous (p <0.05). Both groups required transfusion of blood products at similar. The relationship between days of hospitalization vs bleeding volume was directly proportional to primiparous, but inversely proportional to the multiparous (p <0.05), the analysis for combinations of uterotonics in the management of post-partum hemorrhage, shown that misoprostol (800 mg, rectally) stressed this relationship in primiparous while effect disappears in multiparous. CONCLUSION: The Bakri balloon placement decreases the number of fatalities and hysterectomies in obstetric patients in both primiparous and multiparous with postpartum hemorrhage that does not response to the treatment with .uterotonic drugs.

Análisis de marcadores de superficie celular de utilidad en el diagnóstico de la sepsis neonatal: Reporte preliminar / Utility of the cellular surface markers in the diagnosis of neonatal sepsis: Preliminary report

La cuantificación de poblaciones leucocitarias en sangre periférica puede realizarse con ayuda del análisis por citometría de flujo. Los valores de poblaciones leucocitarias en neonatos son frecuentemente contrastados con sangre periférica de adultos. El presente reporte preliminar muestra el análisis de tres muestras de sangre de cordón umbilical de pacientes sanos y tres muestras de sangre periférica de neonatos con diagnóstico de sepsis tardía. Los resultados obtenidos muestran que CD69, CD71 y CD45RO pueden ser de utilidad para diferenciar estados de sepsis en neonatos. En un estudio futuro, la propuesta es realizar un análisis multiparamétrico por citometría de flujo que permita un análisis integral de la sepsis neonatal.

Quantification of leukocyte populations in peripheral blood can be performed using flow cytometry. The leukocyte populations are often contrasted between neonate and adult peripheral blood. This preliminary report shows the analysis of three samples of umbilical cord blood of healthy subjects and three peripheral blood samples of newborns diagnosed with late sepsis. Our results show that CD69, CD71 and CD45RO could be useful to differentiate states of sepsis in neonates. We propose a subsequent study to generate a multiparametric flow cytometry analysis that will allow a comprehensive analysis of neonatal sepsis.

Sporadic type composite pheochromocytoma with neuroblastoma: clinicomorphologic, DNA content and ret gene analysis.

Composite pheochromocytomas (CP) account for only 3% of all pheochromocytomas. We analyzed the clinical, immunohistochemical, ultrastructural, DNA content, and 634 ret mutation features in a 56-year-old Mexican woman with CP localized in the right adrenal gland and associated to a blood pressure of 140/90 mmHg. Clinical symptoms were absent after surgery. The tumor showed pheochromocytoma and neuroblastoma components. This dual phenotype was supported by light microscopy and corroborated by immunohistochemistry and ultrastructural findings. Flow cytometric analysis showed that both components were diploid. A genetic mutational analysis of the ret oncogene in exon 11 showed no 634 mutation. This case demonstrates the indolent behavior of neuroblastoma associated to a sporadic-type CP in an adult patient.