Myelopexy: A novel technique in posttraumatic syringomyelia / Mielopexia: una técnica novedosa para la siringomielia postraumática

Posttraumatic syringomyelia (PTS) is a well-reported phenomenon that usually takes place in the long-term course of patients following spinal cord injury. Different surgical procedures have been described: spinal cordectomy is usually a last option technique, but might be an excellent choice in patients with severe spinal cord injuries. We present a young patient with complete spinal cord injury after spine trauma, who developed posttraumatic syringomyelia with progressive motor deterioration twelve years after fixation. We performed a novel surgical technique (myelopexy) with excellent resolution of syringomyelia, sparing the negative implications of complete cord transection. Some artistic illustrations made by one of the corresponding authors are included, to better understanding of operative details (AU)

La siringomielia postraumática (SPT) es un fenómeno bien documentado, que suele ocurrir en la recuperación a largo plazo de los pacientes después de una lesión de la médula espinal. Se han descrito diferentes procedimientos quirúrgicos: la cordectomía de la médula espinal es generalmente una técnica que se considera como última opción, pero podría ser una excelente elección para pacientes con lesiones graves en dicha zona. Presentamos el caso de un paciente joven con una lesión completa de la médula espinal después de un traumatismo de la columna vertebral, que desarrolló una siringomielia postraumática con un deterioro motor progresivo 12 años después de la fijación. Aplicamos una novedosa técnica quirúrgica (mielopexia) con una excelente resolución de la siringomielia, evitando las implicaciones negativas de la transección completa de la médula. Se incluyen algunas ilustraciones realizadas por uno de los autores para una mejor comprensión de los detalles de la intervención quirúrgica (AU)

Tissue dielectric constant (TDC) as an index of localized arm skin water: differences between measuring probes and genders.

An easily measured, non-invasive, quantitative estimate of local skin tissue water is useful to assess local lymphedema and its change. One method uses skin tissue dielectric constant (TDC) values that at 300 MHz TDC depend on free and bound water within the measurement volume. In practice such measurements have been done with a research-type multi-probe, but recently a hand-held compact-probe has become available that may be more clinically convenient. Because most available published data is based on multiprobe measurements it is important to characterize possible differences between devices that unless known might lead to ambiguous quantitative comparisons between TDC values. Thus, our purpose was to evaluate potential differences in measured TDC values between multi-probe and compact-probe devices with respect to probe effective sampling depth, anatomical site, and gender and also to compare compact-probe TDC values measured on women with and without breast cancer (BC). TDC was measured bilaterally on forearms and biceps of 32 male and 32 female volunteers and on 12 female patients awaiting surgery for breast cancer. Results show that 1) TDC values at 2.5 mm depth were significantly less than at 1.5 mm; 2) Female TDC values were significantly less than male values; 3) TDC values were not different between females with and without BC; and 4) dominant/non-dominant arm TDC ratios were not significantly different for any probe among genders or arm anatomical site. These findings indicate that probe type differences in absolute TDC values are present and should be taken into account when TDC values are compared. However, comparisons based on inter-arm TDC ratios are not statistically different among probes with respect to gender or anatomical location.

[Pica diagnosis during pregnancy and micronutrient dificiency in Argentine women]. / Diagnóstico de pica durante el embarazo y deficiencia de micronutrientes en mujeres argentinas.

OBJECTIVE: To evaluate by biochemical parameters iron and zinc nutritional status in women with and without pica diagnosis during pregnancy. METHODOLOGY: During puerperium 109 women were evaluated at Fiorito Hospital, Argentina. Pica diagnosis was made in 42 women while 67 did not refer the practice. Fasting blood samples were obtained and analyzed in a hematology analyzer for values of red blood cells, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and hematocrit. Serum zinc and erythrocyte zinc was analyzed by atomic absorption spectrophotometry. RESULTS: Substances consumed during pica practice were: earth, ice, brick, paper, desinfectant and dog food. Women with pica diagnosis had higher a rate of family history of pica and personal antecedents of pica in childhood (OR: 15.9). Sociodemographic and anthropometric characteristics and neonatal birth weight were similar between both groups, although women with pica diagnosis had lower values in mean corpuscular volume (p = 0,008), mean corpuscular hemoglobin (p = 0,009) and erythrocyte zinc (0,008). Applying a logistic regression model, erythrocyte zinc was the only biochemical indicator associated with pica practice (p = 0,028). CONCLUSIONS: At puerperium, women with pica during pregnancy could have lower levels in biochemical parameters for iron and zinc status so we suggest that early diagnosis of pica could help to identify micronutrient deficient.

Characteristics of pica practice during pregnancy in a sample of Argentine women.

The purpose of this study was to describe the practice of pica during pregnancy in Argentine women. Maternal and fetal characteristics as well as the practice of pica were evaluated during the puerperium in a sample of 1,014 women from five different geographical areas. Pica prevalence for the total sample was 23.2% (95% CI 20.6-25.8). Pagophagia (ice consumption) was the main type of pica practice, followed by geophagia (earth intake) and the ingestion of soap, toothpaste and chalk. The onset of the practice was mainly in the first months of pregnancy. A total of 49.8% of women revealed a family history of pica; 30.6% had pica in childhood and 13.2% suffered from polypica. Women with pica during pregnancy had similar age, pre-pregnancy body mass index (BMI), parity, neonatal birth weight and gestational age compared with non-pica mothers, although maternal haemoglobin concentration was lower in women with pica than in non-pica mothers (p = 0.0001).

High dietary and plasma levels of the omega-3 fatty acid docosahexaenoic acid are associated with decreased dementia risk: the Rancho Bernardo study.

OBJECTIVE: This study examined the association of plasma DHA, dietary DHA, and fish intake with dementia and Alzheimer's Disease (AD) in older adults. DESIGN: Case-cohort study. SETTING: Clinic visit in 1991-93. PARTICIPANTS: 266 community dwelling men and women aged 67-100 years (mean=80.2). MEASUREMENTS: Participants had neurological and neuropsychological evaluations for dementia in 1991-93. Plasma DHA was measured in blood samples obtained at that visit. Dietary intakes of DHA and fish were obtained from an earlier (1988-91) visit. Three DHA exposure variables were used in separate analyses; plasma DHA, dietary DHA, and consumption of cold-water fish. All-cause dementia included AD and other types of possible or probable dementia. RESULTS: Among these 266 participants, 42 had dementia and 30 had possible or probable AD. Plasma DHA in the highest tertile was associated with a 65% reduced odds of all-cause dementia (95% CI: 0.17, 0.92) and a 60% reduced odds of AD (95% CI: 0.15, 1.10). Dietary DHA in the highest tertile was associated with a 73% reduced odds of all-cause dementia (95% CI: 0.09, 0.79) and a 72% reduced odds of AD (95% CI: 0.09, 0.93). Fish intake had similar, though not significant, reduced odds of dementia (OR = 0.51; 95% CI: 0.20, 1.32) and AD (OR = 0.55; 95% CI: 0.20, 1.48). CONCLUSIONS: Plasma and dietary DHA appear to protect against dementia. Increasing DHA intake from marine sources may be recommended for reducing dementia risk.

Kinetics of factor VIII:C inhibitors and treatment response in severe hemophilia A patients.

Severe hemophilia A (HA) patients develop inhibitory alloantibodies to factor VIII:C and therefore require bypass agents that are scarce, expensive and may provoke secondary effects. Twenty-three severe HA patients who were high-responders to FVIII inhibitors were studied. FVIII:C activity in plasma was measured by one-stage activated partial thromboplastin time method, and the quantification of FVIII:C inhibitors was carried out by the Nijmegen-Bethesda method. Inhibition kinetics was assessed through serial plasma dilutions. FVIII:C activity was <1% in all patients. Kinetics behavior of the inhibitors was classified as type I in 14 patients, type II in four and an intermediate pattern that we named type III in one case. We were unable to apply the regression model to the remaining four of 23 patients in the study because of their low inhibitory titer (<3 Nijmegen-Bethesda units per ml). Seventy-eight percent of the patients with inhibitor type I did not respond to high doses of FVIII therapy, whereas 50% of patients with type II kinetics did (P = 0.5323). Generally, patients belonging to the same family had similar kinetics behavior as well as concordant treatment response. Although nonsignificant, our results suggest an association between kinetics behavior and treatment response that may be a valuable prognostic parameter for the management of these patients.

[Nutrient intake in women with pagophagia and other forms of pica during the pregnancy]. / Ingesta de nutrientes en mujeres con pagofagia y otras formas de pica durante el embarazo.

OBJECTIVE: The aim of this investigation was to know and assess the characteristics of nutrient intake in pregnant women diagnosed with pica (consumption of non nutritive substances). MATERIALS AND METHODS: We studied a group of 71 women presenting pagophagia (compulsive consumption of ice) and other forms of pica, which was compared to a control group including the same number of women with similar socio-cultural and anthropometrical characteristics but without the eating disorder. Both groups were randomly selected among women assisted at the Hospital de la Matanza, province of Buenos Aires, Argentina. RESULTS: we did not observed statistically significant differences in energy, total proteins, iron, and calcium consumption. However, women with pica showed lower intakes (p < 0.03) of carbohydrates, animal proteins, hemic iron, and zinc. The median values for women with and without the disorder were, respectively: carbohydrates (g): 379/426; animal proteins (g): 35/39; hemic iron (mg): 1.5/1.9; zinc (mg): 7.1/8.1, calcium (mg): 625/612. In both groups, meat was the main source of iron and zinc, and its intake was lower in the group with pica. The daily average amounts consumed were 117 + 53 g for women with pica and 154 + 71 g (p < 0.03) for the control group. Only 22% of pregnant women with the disorder referred using iron supplements during their pregnancy. CONCLUSIONS: As compared with control women, pregnant women with pica disorder showed lower intake in traditionally marginal nutrients such as iron and zinc. These results show the need for early diagnosing this disorder during pregnancy in order to prevent or correct it and properly counseling pregnant women about food selection and supplementation regimens.

[Assessment of protein quality in foods by calculating the amino acids score corrected by digestibility]. / Evaluación de la calidad de las proteínas en los alimentos calculando el escore de aminoácidos corregido por digestibilidad.

The protein score reflects its amino acids (AA) content in comparison with the ideal protein. However, when there is a need to know the use of AA by the organism it is necessary to do a correction of the score value by protein digestibility (PDCAAS). Since this information is not available for usually consumed foods, the present work aimed at calculating the PDCAAS values of these foods. The score was calculated the limiting AA of 70 foods, taking as reference protein the AA pattern for children > 1 year old and adults proposed by the U.S. National Academy of Sciences for the year 2002. The PDCAAS value was obtained in each case by multiplying the score value by the digestibility index. For vegetable foods the obtained score values and PDCAAS were, respectively: vegetables 88.5% / 73.4%, tubercles 89.44% / 74.24%, fresh fruits 75.6% / 64.3%, dried fruits 65.6% / 48.1%, legumes in general 89.2% / 69.58%, chickpea and soybean 100% / 78%, cereals and derivatives 68.8% / 58.5%. Creation of table that contents the score values, digestibility values, and PDCAAS of foods is a useful tool when food selection for a dietary plan based on its protein quality is desirable.

How laminin-1 can be recognized by the protozoan parasite Tritrichomonas foetus: possible role played by the extracellular matrix glycoprotein in both cytoadhesion and cytotoxicity exerted by the parasite.

The isoform 1 of the extracellular matrix glycoprotein Laminin is known to be an important ligand for some parasitic protozoa including Trichomonas vaginalis. The bovine parasite Tritrichomonas foetus seems to display a similar recognition process to laminin-1, as some amino acid sequences found in the LNS module of laminin-1 can also be recognized by this parasite. Which of the laminin-1 residing adhesion sequences are recognized by T. foetus, and the role played by such a protein-cell recognition process in both cytoadhesion and cytotoxicity exerted by the parasite are the subjects briefly reviewed and discussed here.

Strategies by which some pathogenic trichomonads integrate diverse signals in the decision-making process.

The interaction between each one of Trichomonas vaginalis and Tritrichomonas foetus with their hosts is a complex process in which components associated to the cell surfaces of both parasites and host epithelial cells, and also to soluble components found in vaginal/urethral secretions, are involved. Either cytoadhesion or the cytotoxicity exerted by parasites to host cells can be dictated by virulence factors such as adhesins, cysteine proteinases, laminin-binding proteins, integrins, integrin-like molecules, a cell detachment factor, a pore-forming protein, and glycosidases among others. How trichomonads manipulate informations from the extracellular medium, transduce such informations, and respond to them by stimulating the activities of some surface molecules and/or releasing enzymes are the aspects concerning trichomonal virulence which are here briefly reviewed and discussed.

[Effect of iron supplementation and its frequency during pregnancy]. / Efecto de la suplementación con hierro y su frecuencia en gestantes.

The iron (Fe) nutritional status of 203 healthy pregnant women was assessed at the first prenatal visit (To) (gestational age: 16.9 weeks +/- 3.81. Women were randomly assigned to one of three groups: G1 and G2 were supplemented with ferrous fumarate (60 mg elemental Fe) daily or intermittently (three times a week), respectively; and GC was the control group, without supplementation. The follow up was carried out until 34-37 weeks of gestational age (Tf), but only 43% of pregnant women completed the trial. At To and Tf fasting blood samples were collected and Hematocrit (Hct), Hemoglobin (Hb), Erythrocyte Protoporphyrin (EP) and Serum Ferritin (FERR) were determined. The percentage of women with abnormal biochemical values at To (n = 203) was: Hb (g/dl) < 10.5: 2.6%; PE (microgram/dl of red blood cells) > 70: 4.8%; FERR (ng/ml) < 10: 4.4%. Results (X +/- DE) of women that completed the follow up were at To and Tf, respectively: Hct (%): GC: 37.7 +/- 3.4 and 36.0 +/- 3.2 (p < 0.05); G1: 38.8 +/- 2.2 and 38.0 +/- 2.6; G2: 39.0 +/- 2.7 and 37.7 +/- 3.7; Hb (g/dl): GC: 12.5 +/- 1.2 and 11.9 +/- 1.3 (p < 0.05); G1: 12.6 +/- 1.1 and 12.8 +/- 1.1; G2: 12.9 +/- 0.9 and 12.2 +/- 1.5; PE (microgram/dl red blood cells): GC: 30 +/- 17 and 43 +/- 22 (p < 0.01); G1: 26 +/- 13 and 38 +/- 21 (p < 0.01); G2: 26 +/- 16 and 31 +/- 26; FERR (ng/ml): GC: 75 +/- 67 and 31 +/- 49 (p < 0.01); G1: 46 +/- 34 and 19 +/- 10 (p < 0.01); G2: 43 +/- 11 and 11 +/- 7 (p < 0.01). These results show: a) Fe administration was efficient to mitigate Hb decrease; b) Fe stores decreased during pregnancy regardless of Fe supplementation and frequency; c) EP values indicate that intermittent Fe administration was more efficient to maintain normal erythropoiesis.

[Biochemical status and iron intake in a population of pregnant women of Buenos Aires, Argentina]. / Indicadores bioquimicos e ingesta de hierro en un grupo de gestantes del gran Buenos Aires.

The iron (Fe) nutritional status was studied in 113 healthy pregnant women, age: 24.8 +/- 6.1 Ys. During the second trimester (gestational age: 16.9 +/- 3.8 weeks), a 24 h dietary recall was carried out and daily Fe intake was calculated, according to Latinoamerican and German Food Composition Tables. On the same day, hematocrit (Hct), hemoglobin (Hb), erythrocyte protoporphyrin (EP) and serum ferritin (SF) were determined in fasting blood samples. Mean daily Fe intake was 10.8 +/- 4.6 mg. The percentage of population with abnormal biochemical values was: Hb (g/dL) < 10.5: 2%; PE > 70 microgram/dL of red blood cells: 6.5%; SF (ng/mL) < 12-20: 16%. According to the new recommendations of the American Institute of Medicine, Fe supplementation would be necessary in women with SF < 20 ng/ml (22%). Therefore, the follow-up of iron stores would be necessary in those with SF > 20 ng/mL before Fe administration.

Production of recombinant human monoclonal antibody using ras-amplified BHK-21 cells in a protein-free medium.

A ras oncogene-amplified recombinant BHK-21 cell line (ras-rBHK-IgG) has been established, and was shown to hyperproduce the recombinant IgG chimeric human monoclonal antibody (hMAb) AE6F4, which recognizes lung cancer cells. We found that the ras-rBHK-IgG cell could be easily cultured in a protein-free ERDF medium supplemented with iron(III) nitrate, hydroxyethyliminodiacetic acid, and non-protein synthetic attachment factor as well as in a serum-free ERDF medium supplemented with insulin, transferrin, ethanolamine, and sodium selenite. The productivity of recombinant hMAb from the cells cultured in dishes at high cell densities was higher in protein-free medium than in serum-containing medium. True high density culture of the ras-rBHK-IgG cells was done in protein-free medium using the Tecnomouse, which is a novel hollow fiber bioreactor system. After culture for 30 days in protein-free culture, a total amount of about 14 mg of the recombinant hMAb AE6F4 was obtained, and was shown to be reactive against lung cancer cells in tissues.