Neural crest derivatives and neuroendocrine cells in the gut of anencephalic and fetuses without congenital defects.

BACKGROUND: The enteric nervous system (ENS), a component of the peripheral nervous system in the intestinal walls, regulates motility, secretion, absorption, and blood flow. Neural crest (NC) migration, fundamental for ENS development, may be altered by central nervous system development alterations, such as neural tube defects (NTD). Intestinal innervation anomalies have been correlated to NTD. We aim to describe the ENS on a fetus with NTD and fetuses without congenital defects (FWCD). CASES: Two male and four female FWCD, 18-20 weeks-gestation (WG), and a 25 WG female anencephalic fetus. Samples from the pancreatoduodenal groove, jejunum, cecum, rectum, and appendix were analyzed by immunohistochemistry. Nervous plexuses were marked with Neuron-specific enolase and S-100; enteric glial cells with CD56; neuroendocrine cells with chromogranin and synaptophysin, and interstitial cells of Cajal (ICC) with CD117. RESULTS AND CONCLUSION: The anencephalic fetus presented a rudimentary brainstem with a cerebellum. Partial frontal, temporal, and occipital bones were found. A large atrial septal defect, an enlarged kidney with a duplex collecting system and a single adrenal gland were found. NSE, S100, and CD56, showed the presence of the myenteric and submucous plexuses of the ENS; scarce interplexus reactivity may indicate inadequate development. Pancreatic and gut neuroendocrine cells, identified with chromogranin and CD56, showed that the enteroendocrine system is present. Findings on FWCD using these markers are consistent with literature descriptions. Vagal NC migration appears to be unaffected despite the presence of anencephaly, although maturation of the ENS may be altered.

Relation between pregestational obesity and characteristics of the placenta.

Objective: To evaluate the morphology of the placenta in patients with pregestational overweight (OW), pregestational obesity (PGOB), or normal weight.Methods: A cross-sectional study including women (n = 114) ≥20 years of age with a singleton pregnancy was carried out. The groups were integrated according to pregestational body mass index (BMI): 51 patients had a normal BMI (18.5-24.99 kg/m2), 30 were overweight (25-29.99 kg/m2), and 33 women were obese (≥30.0 kg/m2). A morphometric study of the placenta was performed and the placental maturity index (PMI) was calculated according to the formula: PMI = number of vasculo-syncytial membranes (VSM) in 1 mm2/VSM thickness. In the histopathological study, the presence of infarcts, calcifications, hemorrhage, thrombosis, fibrosis, cysts, and edema was determined.Results: The weight and length of newborns at birth were greater in the group with PGOB (p < .01). We observed a lower number of VSM (29 ± 9 versus 39 ± 13 and 34 ± 11) and a greater thickness (1.05 ± 0.24 versus 0.95 ± 0.08 and 0.89 ± 0.09) and, therefore, a lower PMI (29.75 ± 12.63 versus 40.88 ± 15.25 and 39.28 ± 14.4) in the group of women with PGOB compared with the group of women with OW or normal weight (p < .01). The histopathological analyses showed a greater frequency of edema and cysts in the PGOB group.Conclusion: PGOB is associated with a higher placental weight and newborn weight, a lower PMI, and the presence of histopathological alterations. The preceding points highlight the importance of promoting an appropriate pregestational weight in women of reproductive age.

Incremento de síndrome de burnout en estudiantes de Medicina tras su primer mes de rotación clínica / Increase in burnout syndrome in medical students during their first month of clinical rotation

INTRODUCCIÓN: Se ha demostrado que el desarrollo de burnout en los médicos se inicia desde su formación académica y puede repercutir en su vida personal. OBJETIVO: Evaluar la prevalencia de burnout al inicio y tras un mes de rotación clínica. MATERIAL Y MÉTODOS: Se empleó el Maslach Burnout Inventory-Human Services Survey de 22 reactivos. Se evaluaron al inicio de la rotación, después de un período vacacional, y después de un mes de rotación clínica. Se estableció la prevalencia y las diferencias entre las 2 mediciones. RESULTADOS: Veintiún (12,3%) alumnos presentaban síntomas de severidad al inicio del trimestre y 34 (19,8%) después del primer mes (p = 0,059). Tras eliminar la realización personal, 54 (31,6%) y 76 (44,2%) alumnos presentaron severidad en el resto de las dimensiones (p = 0,016), respectivamente. CONCLUSIÓN: Después de un mes de exposición clínica se presentó un incremento significativo en la presencia de cansancio emocional, despersonalización y burnout

INTRODUCTION: It has been demonstrated that the development of burnout in physicians begins during their academic training and it can affect their personal life. OBJECTIVE: To evaluate the prevalence of burnout in medical students at the beginning, and after one month of clinical rotation. MATERIALS AND METHODS: We evaluated students at the beginning of surgical clinical rotation and one month after using the Maslach Burnout Inventory-Human Services Survey. The prevalence and differences between the 2 measurements were calculated. RESULTS: Twenty-one (12.3%) students showed symptoms of severity at the beginning, and 34 (19.8%) after the first month (P = .059). After eliminating the personal accomplishment scale, 54 (31.6%) and 76 (44.2%) students had severity of symptoms in the rest of the dimensions at the beginning and after one month, respectively (P = .016). CONCLUSION: Medical students showed an increase in the presence of severe burnout, as well as emotional exhaustion and depersonalisation after one month of clinical rotation

Holoprosencefalia semilobar y malformaciones asociadas: reporte de caso y algunas consideraciones / Semilobar holoprosencephaly and associated malformations: case report and some considerations

RESUMEN: El defecto más común del prosencéfalo es la holoprosencefalia (HPE), caracterizada por ausencia en la división del prosencéfalo. La holoprosencefalia tiene una prevalencia de 1/10.000 en recién nacidos; la ciclopía de 1/100.000 nacidos y la agnatia asociada a holoprosencefalia de 0,8 a 10 %. El objetivo fue describir las características morfológicas e histopatológicas de un feto humano con holoprosencefalia y sus malformaciones asociadas. Se estudió un feto masculino. Se le realizó microdisección bajo el estereomicroscopio, toma de microfotografías con cámara AxioCam y software AxioVision 4.8, y estudio histopatológico. La edad gestacional estimada fue de 12,4-13,2 semanas, encontrándose como hallazgos la HPE semilobar asociada a ciclopía, esbozo oral hipoplásico sin apertura oral, cubierta por una membrana y ausencia de labios. El estudio histopatológico reportó: ojo con lente, retina y córnea únicos; en la cara, probóscide con cartílago tubular en formación asociado a mesénquima y cubierta muscular esquelética, y cavidad oral pequeña, circunscrita por mandíbula hipoplásica conformada por cartílago. Se revisa la literatura y se reafirma la necesidad de estudio multidisciplinario de esta patología para mejorar su comprensión.

SUMMARY: The most common defect of the forebrain is holoprosencephaly (HPE), characterized by absence in the forebrain division. Holoprosencephaly has a prevalence of 1 / 10,000 in newborns; the cyclopia of 1 / 100,000 births and the agnathia, in a series of cases of holoprosencephaly ranges from 0.8 to 10 %. The objective was the description of the morphological and histopathological characteristics of fetus with holoprosencephaly and its associated malformations. A male fetus was studied. Microdissection was performed under the stereomicroscope, taking microphotographs with AxioCam camera and AxioVision 4.8 software, and histopathological study. The estimated gestational age was 12.4-13.2 weeks, the findings were semilobar HPE, associated with cyclopia, hypoplastic oral outline without buccal opening, covered by a membrane and lips absence. The histopathological study reported: eye with lens, retina and cornea only; in the face, proboscis with tubular cartilage in formation associated with mesenchyme and musculoskeletal sheath, and small oral cavity, delimited by hypoplastic mandible conformed by cartilage. The literature is reviewed and reaffirmed the need for multidisciplinary studies of this disease to improve their understanding.

Células neuroendocrinas en yemas gustativas primordiales / Neuroendocrine cells in primordial taste buds

El objetivo del trabajo fue identificar la presencia de células neuroendócrinas en yemas gustativas primordiales (fetales) humanas. Fueron utilizadas 15 lenguas fetales humanas obtenidas de abortos espontáneos (tiempo de gestación 23 semanas) de pacientes ingresados en el Hospital General, Chihuahua, México. Una muestra representativa del ápex lingual fue embebida en parafina y cortada a 3 micras para ser procesadas con la técnica inmunohitoquímica utilizando los siguientes anticuerpos: Anti-sinaptofisina; anti-proteína neurofilamento; anti-cromogranina; anti-citoqueratina 20; y anti proteínas-S100. El protocolo de investigación fue aprobado por los comités de bioética de las instituciones participantes. Se obtuvo la autorización de los padres para la utilización del material biológico. Las células gustativas fetales fueron fuertemente positivas a cromogranina, y negativas a sinaptofisina. Las papilas gustativas fetales humanas mostraron inmunorreactividad positiva contra citoqueratina 20, mientras que fibras nerviosas intragemulares mostraron inmunorreactividad contra anticuerpos anti-proteína neurofilamento. Las fibras nerviosas subyacentes al epitelio gustativo fueron positivas a proteína S100. Se muestra evidencia inmunohistoquímica de la presencia de células neuroendócrinas gustativa en yemas gustativas linguales primordiales humanas. Esto sugiere una probable participación neuroendocrina o paracrina en el desarrollo de las yemas gustativas humanas.

The objective was to identify the presence of neuroendocrine cells in primary taste buds (fetal) cells. We used 15 human embryionic fetal tongues derived from human spontaneous abortions (23 weeks gestation time) of patients admitted to the General Hospital, Chihuahua Mexico. A representative sample of lingual apex was embedded in paraffin and cut to 3 microns processed by immune histochemical technique using the following antibodies: anti-synaptophysin, neuro filament anti-protein, anti chromogranin; anti-citokeratin 20 and S100 anti proteins. Research was approved by bioethics committees of the participating institutions. Permission was obtained from the parents to use the biological material. The taste bud fetal cells were significantly positive for chromogranin and synaptophysin negative. The human fetal taste buds showed positive immunoreactivity against cyto keratin 20, while nerve fibers underlying the gustatory epithelium were positive for S100 protein. Immunohistochemical evidence shows the presence of neuro endocrine cells in human primordial taste bud papilla. This suggests a probable neuro endocrine or paracrine participation in the development of human taste buds.

[Sirenomelia apus. Case report]. / Sirenomelia apus: reporte de un caso clínico.

We report a case of Sirenomelia. The mother began prenatal care in the second trimester. Transabdominal ultrasound was determined anhydramnios, cardiac abnormalities and lumbosacral spine. We obtained a single fetus of 21 weeks' gestation with fused lower extremities from the hip to finish in a stump without the presence of feet. Heart with transposition of the great vessels, among other birth defects. It was classified as symelia, Apodi apus, monopodio sirenoide, siren ectropodia, type VI. It is important to diagnose early, because it is a serious and deadly disorder.

Tetrasodium EDTA as a novel central venous catheter lock solution against biofilm.

BACKGROUND: Central venous catheter (CVC)-related bloodstream infections (BSIs) are known to increase rates of morbidity and mortality in both inpatients and outpatients, including hematology-oncology patients and those undergoing hemodialysis or home infusion therapy. Biofilm-associated organisms on the lumens of these catheters have reduced susceptibility to antimicrobial chemotherapy. This study tested the efficacy of tetrasodium EDTA as a catheter lock solution on biofilms of several clinically relevant microorganisms. METHODS: Biofilms of Staphylococcus epidermidis, methicillin-resistant S. aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, and Candida albicans were grown to levels of approximately 1 x 10(5) colony-forming units (CFU)/cm(-1) on CVC segments in a model system, then subjected to the tetrasodium EDTA lock treatment. RESULTS: Comparisons of biofilms before and after exposure to the 40-mg/mL(-1) tetrasodium EDTA lock for 21 hours showed that the biofilm viable cell counts of all organisms tested were significantly reduced (P < .05) after exposure to the treatment. CONCLUSION: Antimicrobial lock treatment using 40 mg/mL(-1) of tetrasodium EDTA for at least 21 hours could significantly reduce or potentially eradicate CVC-associated biofilms of clinically relevant microorganisms.

Statistical assessment of a laboratory method for growing biofilms.

Microbial biofilms have been grown in laboratories using a variety of different approaches. A laboratory biofilm reactor system, called the CDC biofilm reactor (CBR) system, has been devised for growing biofilms under moderate to high fluid shear stress. The reactor incorporates 24 removable biofilm growth surfaces (coupons) for sampling and analysing the biofilm. Following preliminary experiments to verify the utility of the CBR system for growing biofilms of several clinically relevant organisms, a standard operating procedure for growing a Pseudomonas aeruginosa biofilm was created. This paper presents the results of a rigorous, intra-laboratory, statistical evaluation of the repeatability and ruggedness of that procedure as well as the results of the experiments with clinically relevant organisms. For the statistical evaluations, the outcome of interest was the density (c.f.u. cm(-2)) of viable P. aeruginosa. Replicate experiments were conducted to assess the repeatability of the log density outcome. The mean P. aeruginosa log10 density was 7.1, independent of the coupon position within the reactor. The repeatability standard deviation of the log density based on one coupon per experiment was 0.59. Analysis of variance showed that the variability of the log density was 53 % attributable to within-experiment sources and 47 % attributable to between-experiments sources. The ruggedness evaluation applied response-surface design and regression analysis techniques, similar to those often used for sensitivity analyses in other fields of science and engineering. This approach provided a quantitative description of ruggedness; specifically, the amount the log density was altered by small adjustments to four key operational factors--time allowed for initial surface colonization, temperature, nutrient concentration, and fluid shear stress on the biofilm. The small size of the regression coefficient associated with each operational factor showed that the method was rugged; that is, relatively insensitive to minor perturbations of the four factors. These results demonstrate that the CBR system is a reliable experimental tool for growing a standard biofilm in the laboratory and that it can be adapted to study several different micro-organisms.

Chlorine inactivation of bacterial bioterrorism agents.

Seven species of bacterial select agents were tested for susceptibility to free available chlorine (FAC). Under test conditions, the FAC routinely maintained in potable water would be sufficient to reduce six species by 2 orders of magnitude within 10 min. Water contaminated with spores of Bacillus anthracis spores would require further treatment.