Síndrome celulitis-adenitis por "Streptococcus agalactiae" en gemelos / Cellulitis-adenitis syndrome by Streptococcus agalactiae in twins

La sepsis tardía por Streptococcus agalactiae, o Streptococcus del grupo B (SGB), es una entidad que aparece entre los 7 días y 3 meses de edad y que suele manifestarse como bacteriemia/sepsis sin foco; no obstante, puede aparecer a modo de infección local, como en el caso del síndrome celulitis-adenitis. Se describen 2 casos clínicos en hermanos gemelos con aparición de sepsis tardía por SGB acompañado de síndrome celulitis-adenitis con un intervalo de separación de 3 semanas

Late-onset sepsis by Streptococcus agalactiae is an entity that appears between 7 days and 3 months of age and it usually manifests as bacteremia/sepsis without focus. However, it may appear as a local infection such as cellulitis-adenitis syndrome. Two clinical cases are described in twins with the occurrence of late-onset sepsis by group B Streptococcus (GBS) with cellulitis-adenitis syndrome in a time interval of 3 weeks

Inesperada reagudización de enfermedad de Kawasaki / Unexpected exacerbation of Kawasaki disease

Introducción: La enfermedad de Kawasaki (EK) es la segunda vasculitis más frecuente de la infancia, después de la púrpura de Schönlein-Henoch, y la primera causa de enfermedad cardiaca adquirida en la infancia en los países desarrollados. Caso clínico: Se presenta un caso clínico de EK con reagudización y aparición de aneurismas gigantes coronarios como complicación secundaria. Discusión: El diagnóstico se basa en la combinación de criterios clínicos y analíticos, como presencia de fiebre (duración ≥ 5 días) y 4 de los siguientes: conjuntivitis bilateral no supurativa, linfadenopatía cervical, exantema polimorfo que afecta a las palmas y las plantas, cambios en las mucosas (lengua aframbuesada, enrojecimiento labial) y cambios en las extremidades (edema y eritema de las palmas, descamación del pulpejo de los dedos). El tratamiento consiste en la administración temprana de gammaglobulina intravenosa 2 g/kg y ácido acetilsalicílico 50 mg/kg/día. La secuela más importante es la afectación del sistema cardiovascular, en especial de las arterias coronarias, que puede llegar a desarrollar aneurismas coronarios que evolucionen hacia una estenosis y una posterior isquemia miocárdica. Conclusiones: Para disminuir la morbimortalidad de este proceso es importante un inicio precoz del tratamiento, lo que precisa una alta sospecha diagnóstica ante cuadros febriles prolongados, así como una correcta evaluación de los factores de riesgo de evolución tórpida, para elegir el tratamiento más adecuado

Introduction: Kawasaki disease is the second most common vasculitis of childhood and the leading cause of acquired heart disease in children in developed countries. Case report: We present the case of an infant with Kawasaki disease and acute exacerbation with coronary aneurysms as a secondary complication arises Discussion: Diagnosis is based on the combination of clinical and laboratory criteria: fever (over five days) plus 4 of the following: non-suppurative bilateral conjunctivitis, cervical lymphadenopathy, polymorphous rash affecting the palms and soles, changes in the mucous membranes (strawberry tongue, redness lip) and changes in the extremities (edema and erythema of the palms, peeling the heel of the fingers). The treatment consists of early administration of intravenous immunoglobulin 2 g/kg and acetylsalicylic acid 50 mg/kg/day. The most important consequence is the involvement of the cardiovascular system, especially the coronary arteries may develop coronary aneurysms evolve towards stenosis and subsequent myocardial ischemia. Conclusion: To decrease the morbidity and mortality of this process is important early initiation of treatment, which requires a high suspicion diagnosis before prolonged febrile illness, and an accurate assessment of risk factors torpid, to choose the most appropriate treatment

Deficiency of the macrophage growth factor CSF-1 disrupts pancreatic neuroendocrine tumor development.

Tumor-associated macrophages have recently emerged as a key regulatory cell type during cancer progression, and have been found to promote tumor malignancy in the majority of studies performed to date. We show in this study that CD68(+) macrophages positively correlate with tumor grade and liver metastasis in human pancreatic neuroendocrine tumors (PNETs). To investigate the potential mechanisms whereby macrophages can promote PNET progression, we crossed the RIP1-Tag2 (RT2) mouse model of pancreatic islet cancer to colony-stimulating factor-1 (CSF-1)-deficient Csf1(op/op) mice, which have reduced numbers of tissue macrophages. Csf1(op/op) RT2 mice had a substantial reduction in cumulative tumor burden, which interestingly resulted from a significant decrease in angiogenic switching and tumor number, rather than an evident effect on tumor growth. In the tumors that did develop in CSF-1-deficient animals, however, there were no significant differences in tumor cell proliferation, apoptosis, angiogenesis or invasion. CSF-1 deficiency decreased macrophage infiltration by approximately 50% during all stages of RT2 tumor progression. Interestingly, several cytokines were upregulated in CSF-1-deficient RT2 tumors, and neutrophil infiltration was increased. These results show that macrophages are important for promoting PNET development and suggest that additional factors contribute to the recruitment and survival of myeloid cells in RT2 tumors in the absence of CSF-1.

Fresh human orthotopic ovarian cortex transplantation: long-term results.

BACKGROUND: Ovarian orthotopic transplantation in patients with premature ovarian failure is reported to result in full-term pregnancies. Ischaemia and freezing/thawing are potentially injurious for tissues. This study was designed to analyse the effect of ischaemia on long-term ovarian function in humans. METHODS: Prospective case-control study. Subjects were 12 premenopausal women undergoing hysterectomy and fresh orthotopic transplantation of the entire ovarian cortex plus a control group of five patients undergoing hysterectomy only. Follow-up lasted 2 years. Serum FSH and anti-Müllerian hormone (AMH) were recorded, and ovulatory cycles were determined by vaginal ultrasound and serum progesterone levels. RESULTS: Follow-up showed that ovulation was restored in 11 of the 12 patients who received grafts over the duration of the study (9.3 +/- 1.73 ovulations versus 12.0 +/- 0.86 in controls, NS), and 9 of 12 patients remained ovulatory after 2 years. We identified four patterns of FSH secretion during the study, 5 of 12 (41.7%) women having the same pattern as controls. There was a trend for serum AMH levels 7 days after surgery (0.16 +/- 0.02 microg/l) to be lower than pre-surgery levels (0.38 +/- 0.09 microg/l, P = 0.07) and higher in women whose FSH patterns suggested normal ovarian function, but the results did not reach significance. After transplantation, FSH correlated more closely (r = -0.639, P = 0.02) with normal ovarian function than AMH (r = 0.465, P = 0.12). CONCLUSIONS: Fresh orthotopic ovarian cortex transplantation is a viable procedure. It maintains normal ovarian function after 2 years in 75% of cases and preserves ovarian function against ischaemia in 41.7% of patients.

Comparison of three different staining methods for the assessment of epididymal red deer sperm morphometry by computerized analysis with ISAS.

When collection of ejaculated sperm samples is not possible, as is the case with wild species, the epididymides of sacrificed wild males become the only possible source of spermatozoa. Mature cauda epididymal spermatozoa display characteristics similar to those of ejaculated sperm cells. The present work proposes a sperm staining technique suitable for the morphometric evaluation of red deer epididymal sperm using a new computerized system. Epididymides from wild animals were extracted no later than 2h post mortem. After epididymal sectioning, sperm samples were collected, cooled to and equilibrated at 5 degrees C, and frozen in liquid nitrogen. Before staining, sperm samples were thawed for 20s at 37 degrees C, and used for the preparation of slides. Three different sperm stains were tested: Hemacolor, Diff-Quik, and Harris' Hematoxylin. Morphometric analyses of sperm samples were performed using the morphologic module of the ISAS. Two hundred spermatozoa per sample and stain were captured at random and analyzed. Sperm morphometric values were significantly affected by the staining technique used. Moreover, significant differences were observed between animals. In our study, Diff-Quik could be considered to be the best sperm staining method, as it provided the highest percentage of well automatically analyzed cells by the ISAS, and discriminates better between animals. This sperm staining technique also proved to be a useful method for characterizing and discriminating between sperm samples of different animals.

An aerobic recA-, umuC-dependent pathway of spontaneous base-pair substitution mutagenesis in Escherichia coli.

Antimutator alleles indentify genes whose normal products are involved in spontaneous mutagenesis pathways. Mutant alleles of the recA and umuC genes of Escherichia coli, whose wild-type alleles are components of the inducible SOS response, were shown to cause a decrease in the level of spontaneous mutagenesis. Using a series of chromosomal mutant trp alleles, which detect point mutations, as a reversion assay, it was shown that the reduction in mutagenesis is limited to base-pair substitutions. Within the limited number of sites than could be examined, transversions at AT sites were the favored substitutions. Frameshift mutagenesis was slightly enhanced by a mutant recA allele and unchanged by a mutant umuC allele. The wild-type recA and umuC genes are involved in the same mutagenic base-pair substitution pathway, designated "SOS-dependent spontaneous mutagenesis" (SDSM), since a recAumuC strain showed the same degree and specificity of antimutator activity as either single mutant strain. The SDSM pathway is active only in the presence of oxygen, since wild-type, recA, and umuC strains all show the same levels of reduced spontaneous mutagenesis anaerobically. The SDSM pathway can function in starving/stationary cells and may, or may not, be operative in actively dividing cultures. We suggest that, in wild-type cells, SDSM results from basal levels of SOS activity during DNA synthesis. Mutations may result from synthesis past cryptic DNA lesions (targeted mutagenesis) and/or from mispairings during synthesis with a normal DNA template (untargeted mutagenesis). Since it occurs in chromosomal genes of wild-type cells, SDSM may be biologically significant for isolates of natural enteric bacterial populations where extended starvation is often a common mode of existence.