Feto-fetal hemorrhage (FFH) through placental vascular anastomoses is believed to be responsible for the death or damage of a "second twin" after the demise of a "first twin (co-twin)" in ...monochorionic twin pregnancies. However, the timing of FFH has been difficult to determine. The resulting anemia in the surviving twin can be suspected by the finding of an elevated middle cerebral artery peak-systolic velocity (MCA-PSV), but this elevation may lag for at least 4 h after the demise of the first twin. Knowledge of the timing of FFH may have important clinical implications, as it may dictate if and when attempts to prevent death or damage to the second twin by delivery or intrauterine fetal transfusion would be warranted. We present a case that supports the notion that FFH occurs before the actual demise of the first twin. A review of the literature was also conducted.
The quantitative lung index: the left lung Kontopoulos, Eftichia V.; Quintero, Luis F.; Chmait, Ramen ...
The journal of maternal-fetal & neonatal medicine,
11/2022, Letnik:
35, Številka:
21
Journal Article
Recenzirano
We have previously described a gestational age-independent sonographic parameter to assess fetal lung growth in the right lung (right quantitative lung index, or QLI-R). The purpose of this study was ...to develop a similar sonographic parameter to assess the growth of the left lung in the fetus, independent of gestational age, or QLI-L.
A new index, the QLI-L was derived using published formulas for the head circumference (HC) and the area of the base of the left lung (LA), with the corresponding percentiles.
Left lung growth can be expressed using the following formula:
The 50th percentile of the QLI-L remained approximately constant at 1.0 for the GA between 16-32 weeks. A small left lung (<1st percentile) was defined as a QLI-L < 0.5.
Fetal left lung growth can be adequately described independent of gestational age using the QLI-L. Further experience is needed to assess the clinical accuracy of the QLI-L in characterizing fetal left lung growth.
Infección Intraabdominal Gustavo A. Quintero Gustavo A. Quintero
Revista colombiana de cirugía,
09/2021, Letnik:
13, Številka:
3
Journal Article
Odprti dostop
La infección intraabdominal es una de las entidades que presentan mayor complejidad en su manejo. La clave para un tratamiento completo y adecuado se basa en cuatro pilares: eliminar la causa, ...extirpar la contaminación, optimizar los mecanismos de defensa, y tratar oportunamente sus consecuencias. Puede originarse en cualquier órgano intraabdominal o pélvico y se clasifica en hematógena, aguda, espontánea y postoperatoria. Se caracteriza por presentar gérmenes aerobios, anaerobios y en un alto porcentaje, crecimiento de hongos, lo cual debe ser tenido en cuenta para el uso adecuado de antibióticos. Es una entidad que puede evolucionar hacia un síndrome de respuesta inflamatoria sistémica y hacia sepsis. El diagnóstico se hace con ayudas paraclínicas e imaginológicas que van desde una simple radiografía del abdomen hasta el uso de RMN, según la patología de base. Idealmente se realizan ECO Y TAC abdominales las cuales no sólo sirven de ayuda diagnóstica sino terapéutica. El tratamiento debe basarse en los cuatro pilares ya enunciados y se logra mediante tres mecanismos: un adecuado, oportuno, pero anticipado inicio de antibióticos; terapia de soporte en cuidado intensivo teniendo en cuenta que mecanismos como la hemodiafiltración además de brindar soporte orgánico, remueve endotoxinas y citoquinas, modulando así la respuesta inflamatoria y, finalmente, la cirugía mediante la cual se extirpa el foco de contaminación y se elimina la causa de ésta. Por tal razón es importante entender todos los aspectos de esta entidad y que su tratamiento debe ser integral utilizando diferentes herramientas que son sinérgicas en el manejo de las mismas.
Fuel ethanol production has become one of the most studied processes in the last two decades because of the need to decrease its production cost and improve its energetic performance. The most ...promising raw material is lignocellulosic biomass because of its negligible cost and high availability. On the other hand, most research has focused on single steps and has not considered the whole process design. Aspen Plus allowed designing this kind of process while considering relevant aspects such as raw material composition and kinetic models of chemical and biological transformation. In this study fuel ethanol from rice hulls has been simulated considering the kinetic parameters for acid pretreatment, detoxification, and fermentation with the aim of assessing the energy performance of the process. In addition, the economic evaluation was accomplished using Aspen Process Economic Analyzer with the objective of calculating the production cost. It was found that the dilute acid pretreatment had a higher ethanol yield (347.25 L/t) and lower energy consumption (86.75 MJ/L) than liquid hot water pretreatment. However, the latter pretreatment had a lower production cost (US$0.4367/L); although when energy cogeneration and electricity sales were included in the analysis, dilute acid pretreatment became the most economic technology with a lower production cost (US$0.1918/L).
Objective We sought to describe stage-specific perinatal outcomes after selective laser photocoagulation of communicating vessels (SLPCV) for twin-twin transfusion syndrome. Study design Patients ...with twin-twin transfusion syndrome underwent SLPCV preferentially using sequential vs standard laser technique. Patient characteristics and outcome data were examined by Quintero stage. Results Of 682 consecutive women studied, the Quintero stage distribution was: 114 stage I (17%), 177 stage II (26%), 328 stage III (48%), and 63 stage IV (9%). Perinatal survival of at least 1 twin did not differ according to stage (I-92%, II-93%, III-88%, IV-92%; P = .30). However, dual twin survival differed by stage (I-79%, II-76%, III-59%, IV-68%; P < .01), primarily because stage III pregnancies were associated with decreased donor twin survival ( P < .01). Sequential SLPCV was associated with improved donor survival, independent of stage (odds ratio, 1.67; 95% confidence interval, 1.16–2.40; P < .01). Conclusion Stage-specific perinatal outcomes after laser therapy may assist physicians in patient counseling and in planning future studies.
During animal cell division, an actin-based ring cleaves the cell into two. Problems with this process can cause chromosome missegregation and defects in cytoplasmic inheritance and the partitioning ...of organelles, which in turn are associated with human diseases 1–3. Although much is known about how chromosome segregation is coupled to cell division, the way organelles coordinate their inheritance during partitioning to daughter cells is less well understood. Here, using a high-content live-imaging small interfering RNA screen, we identify Myosin-XIX (Myo19) as a novel regulator of cell division. Previously, this actin-based motor was shown to control the interphase movement of mitochondria 4. Our analysis shows that Myo19 is indeed localized to mitochondria and that its silencing leads to defects in the distribution of mitochondria within cells and in mitochondrial partitioning at division. Furthermore, many Myo19 RNAi cells undergo stochastic division failure—a phenotype that can be mimicked using a treatment that blocks mitochondrial fission and rescued by decreasing mitochondrial fusion, implying that mitochondria can physically interfere with cytokinesis. Strikingly, using live imaging we also observe the inappropriate movement of mitochondria to the poles of spindles in cells depleted for Myo19 as they enter anaphase. Since this phenocopies the results of an acute loss of actin filaments in anaphase, these data support a model whereby the Myo19 actin-based motor helps to control mitochondrial movement to ensure their faithful segregation during division. The presence of DNA within mitochondria makes their inheritance an especially important aspect of symmetrical cell division.
•RNAi screen identifies Myo19 as novel regulator of cell division•Myo19 ensures fair mitochondrial inheritance at division•Division requires coupled mitochondrial segregation and cytokinesis
It is not known how animal cells partition mitochondria at division. Rohn et al. identify the unconventional myosin Myo19 as a novel actin-based regulator of this process. Myo19 depletion alters the distribution of mitochondria at mitotic exit, leading to unequal mitochondrial segregation at division and, occasionally, to division failure.
The Colombian government has defined the use of bioethanol as a gasoline enhancer to reduce greenhouse gases, gasoline imports, and to boost the rural economy. To meet the projected fuel ethanol ...demand needed to oxygenate the gasoline in the whole country, the construction of about five additional ethanol production plants is required. For this, a comparative analysis of the technological options using different feedstocks should be performed. In this work, a comparison of the economical and environmental performance of the ethanol production process from sugarcane and corn under Colombian conditions has been carried out. Net present value and total output rate of potential environmental impact were used as the economical and environmental indicators, respectively. Through the integration of these indicators into one index by using the analytical hierarchy process (AHP) approach, sugarcane ethanol process was determined as the best choice for Colombian ethanol production facilities. AHP scores obtained in this study for sugarcane and corn ethanol were 0.571 and 0.429, respectively. However, starchy crops like corn, cassava or potatoes used as feedstock for ethanol production could potentially cause a higher impact on the rural communities and boost their economies if social matters are considered.
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