Cannabinoids induce cell death in leukaemic cells through Parthanatos and PARP-related metabolic disruptions

BACKGROUND

Several studies have described a potential anti-tumour effect of cannabinoids (CNB). CNB receptor 2 (CB2) is mostly present in hematopoietic stem cells (HSC). The present study evaluates the anti-leukaemic effect of CNB.

METHODS

Cell lines and primary cells from acute myeloid leukaemia (AML) patients were used and the effect of the CNB derivative WIN-55 was evaluated in vitro, ex vivo and in vivo.

RESULTS

We demonstrate a potent antileukemic effect of WIN-55 which is abolished with CB antagonists. WIN-treated mice, xenografted with AML cells, had better survival as compared to vehicle or cytarabine. DNA damage-related genes were affected upon exposure to WIN. Co-incubation with the PARP inhibitor Olaparib prevented WIN-induced cell death, suggesting PARP-mediated apoptosis which was further confirmed with the translocation of AIF to the nucleus observed in WIN-treated cells. Nicotinamide prevented WIN-related apoptosis, indicating NAD+ depletion. Finally, WIN altered glycolytic enzymes levels as well as the activity of G6PDH. These effects are reversed through PARP1 inhibition.

CONCLUSIONS

WIN-55 exerts an antileukemic effect through Parthanatos, leading to translocation of AIF to the nucleus and depletion of NAD+, which are reversed through PARP1 inhibition. It also induces metabolic disruptions. These effects are not observed in normal HSC.

Magnetoelastic Coupling Evidence by Anisotropic Crossed Thermal Expansion in Magnetocaloric RSrCoFeO6 (R = Sm, Eu) Double Perovskites

Double perovskite oxides, characterized by their tunable magnetic properties and robust interconnection between the lattice and magnetic degrees of freedom, present an enticing foundation for advanced magnetic refrigeration materials. Herein, we delve into the influence of rare-earth elements on RSrCoFeO6 (R = Sm, Eu) disordered double perovskites by examining their structural, electronic, magnetic, and magnetocaloric properties. Temperature-dependent synchrotron X-ray diffraction analysis confirmed the stability of the orthorhombic phase (Pnma) across a wide temperature range. X-ray photoemission spectroscopy revealed that both Sm and Eu are in the 3+ state, whereas multiple states for Co2+/3+ and Fe3+/4+ are identified. The magnetic investigation and magnetocaloric effect (MCE) analysis brought to light the presence of a long-range antiferromagnetic (AFM) order with a second-order phase transition (SOPT) in both samples. The maximum magnetic entropy change ΔSMmax was approximately 0.9 J/kg K for both samples at applied field 0-7 T, manifesting prominently above Neel temperatures TN ≈ 93 K (Sm) and 84 K (Eu). Nevertheless, different relative cooling powers (RCP) of 112.6 J/kg (Sm) and 95.5 J/kg (Eu) were observed. A detailed analysis of the temperature-dependent lattice parameters shed light on a distinct magnetocaloric effect across the magnetic transition temperature, unveiling an anisotropic thermal expansion [αV = 1.41 × 10-5 K-1 (Sm) and αV = 1.54 × 10-5 K-1 (Eu)] wherein the thermal expansion axial ratio αbSm/αbEu = 0.61 became lower with increasing temperature, which suggests that the Eu sample experiences a greater thermal expansion in the b-axis direction. At the atomic bonding level, the evidence for magnetoelastic coupling around the magnetic transition temperatures TN was found through the anomalies along the average Co/Fe-O bond distance, formal valence, octahedral distortion, as well as an anisotropic lattice expansion.

Matrix Cauterization With Silver Nitrate in the Treatment of Ingrown Toenails in Children: Pilot Study

BACKGROUND

Although partial onychectomy with chemical matricectomy has been described asthe treatment of choice, there is sparse evidence in the literature regarding the use of silvernitrate for matricectomy. Our aim is to describe the effectiveness of silver nitrate for matrixcauterization after partial onychectomy.

METHODS

A prospective observational study was performed on patients with ingrown toenailsstage 2-3 who underwent partial onychectomy with silver nitrate chemical matricectomy during 2018-2019 in our institution. All patients were evaluated in the outpatient clinic on the 7th and 30th post-operative day and a telephone evaluation was performed every 6 months afterthe surgical procedure to date.

RESULTS

One hundred and twenty-three patients, who underwent 231 partial onychectomies with silver nitrate chemical matricectomy were included, with a median follow-up of 21 months (interquartile range, 12-29). The procedure had an effectiveness of 95.3%, with only 11 recur-rences (4.7%) reported so far on follow-up. Postoperative infections were observed in 4 patients (1.7%). Adverse effects, such as pain and postoperative drainage, were irrelevant in mostpatients.

CONCLUSIONS

Silver nitrate matricectomy after partial onychectomy is an effective and safealternative for the treatment of ingrown toenail in children, with scarce postoperative morbidityand low recurrence rate.

Incidental appendectomy in surgical treatment of ileocolic intussusception in children. Is it safe to perform?

BACKGROUND

Surgical treatment of ileo-colic intussusception (ICI) has been reported as the second cause of emergency laparotomy in children. The performance of incidental appendectomy after surgical reduction is currently controversial. The aim is to analyse the outcomes of performing incidental appendectomy after surgical ICI reduction with or without associated bowel resection.

MATERIALS AND METHODS

A retrospective study was performed in patients with ICI episodes, who underwent surgical treatment in our institution between 2005-2019. Patients were divided in two groups according to the performance of associated appendectomy (AA group) or not (NA group). Subsequently, a stratified analysis was performed according to the need for bowel resection in both groups. Demographic variables, intraoperative findings, surgical time, hospital stay, postoperative complications and recurrences were analysed.

RESULTS

A total of 101 patients (77 AA group; 24 NA group) were included, without differences in demographics or intraoperative findings. A total of 36 bowel resections were performed (24 group AA; 10 group NA), with no differences in surgical time (55.7 min in group AA vs. 61.2 min in group NA; p = 0.587) or hospital stay (median 5 days in both groups). There were also no differences in postoperative complications or recurrences between the two groups. Stratified analysis showed that bowel resection increases operative time, hospital stay and postoperative complications, regardless of whether associated appendectomy was performed or not.

CONCLUSIONS

Incidental appendectomy during surgical treatment of ICI in children is a safe procedure that does not increase operative time, hospital stay, postoperative complications or recurrence.

P-423 Metabolomic profiles of receptive-phase endometrium in women with different infertility diagnosis

Study question

What is the entire metabolomic profile of receptive-phase human endometrium and does the metabolic composition differ between women with different infertility diagnosis?

Summary answer

Human endometrium contains 925 different metabolites from diverse chemical classes, and the metabolomic signature varies between women with different infertility diagnosis.

What is known already

Different metabolites have been identified in human endometrium, including amino acids, nucleosides/nucleotides, organic acids, lipids, and sugars, with main focus on lipid profiles in endometriosis. Metabolic dysregulation in the uterus has been shown to provoke complex effects in the endometrium, leading to a low rate of embryo implantation and endometriosis. These are the first studies highlighting the importance of metabolites (metabolic routes) in endometrial functions and more research in the field is warranted. Further, the previous studies have focussed on specific metabolite classes, and we lack the knowledge of the whole metabolome composition in human uterus.

Study design, size, duration

This cross-sectional study included in total 47 women (age= 34.7±3.8 years, BMI= 24.5±4.2 kg/m²) who attended the Reproduction Unit at the University Hospital Granada from March 2019 to April 2021. Women with endometriosis (n = 13), unexplained infertility (n = 10), recurrent implantation failure (RIF) (n = 15) and male factor infertility (n = 9) were included. The study was approved by the Ethics Committee of Investigación Biomédica de Andalucia.

Participants/materials, setting, methods

Endometrial biopsies were collected at the mid-secretory phase (LH + 7) of a natural cycle using Pipelle curette. The complete metabolome from endometrial samples was analysed by Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy (UPLC-MS/MS). Raw data were extracted, peak-identified and quality control processed using Metabolon’s hardware and software (metabolon.com). Multiple regression models controlling for age and BMI were applied using R software.

Main results and the role of chance

We provide the whole metabolome profile of endometrium, where 925 different metabolites were identified. Among these metabolites, lipid metabolites comprised the largest percentage (44%), where long chain fatty acids such as myristate (14:0), palmitoleate (16:1n7), nonadecanoate (19:0), arachidate (20:0), and dihomo-linolenate (20:3n3 or n6) prevailed. The endometrial metabolomic profiles differed significantly between women with different infertility diagnosis (p <0.05). Overall, the metabolites of the lipid and protein metabolism were less present, while carbohydrates, nucleotides, and xenobiotics were predominant in the uterus of women with unexplained infertility, endometriosis, and RIF when compared to women with male factor infertility. Specifically, the metabolites linoleate (18:2n6), linolenate (18:3n3 or n6), and dihomo-linolenate (20:3n3 or n6) were less abundant in women with indication of dysfunctional endometrium (endometriosis and RIF) (FDR p -value<0.05).

Limitations, reasons for caution

This is the first study presenting the complete metabolome of human endometrium on a limited sample size, which might have been underpowered to detect all differences in metabolite composition between groups.

Wider implications of the findings

This study identifies a metabolomic profiles associated with infertility diagnoses where altered endometrial functions are suspected (RIF and endometriosis). Our study findings could help to understand the molecular background of female infertility and lead to identification of potential molecular biomarkers of endometrial functions involved in embryo implantation and infertility.

Trial registration number

not applicable

Bottom-up effects of woodland eutrophication: Interacting limiting nutrients determine herbivory frequency in northwestern Patagonia

Nutrient enrichment disrupts plant-animal interactions and ecosystem functioning globally. In woodland systems, the mechanisms of bottom-up turnover on plant-herbivore interactions remain understudied. Here, we performed a full-factorial field experiment to evaluate the interactive effects of nutrient addition (nitrogen, phosphorus, and/or potassium) on the assemblage of foliar herbivores and the interaction frequency with Berberis microphylla, a dominant shrub species in Patagonian woodlands. Additionally, we assessed whether these effects could be mediated by changes in vegetative traits and microhabitat characteristics (i.e., canopy cover) that may ultimately influence the foraging behavior of herbivores. The addition of nitrogen reduced the herbivory frequency by 41%, yet this effect was diluted in the presence of potassium. We found no effects of phosphorus addition. Our results suggest that the impact of multiple nutrient additions (N and K) on herbivory patterns could be mediated by changes in two important foliar traits, leaf size and leaf density. This study shows how multiple nutrient addition can change the magnitude of antagonistic plant-animal interactions in woodlands. Since herbivory by arthropods has a relevant role in net primary productivity, our results highlight the importance of buffering human-driven woodland eutrophication to maintain important ecological functions (e.g., herbivory) associated with antagonistic plant-animal interactions and avoiding ecosystem dysfunction.

Gasdermin-B Pro-Tumor Function in Novel Knock-in Mouse Models Depends on the in vivo Biological Context

Gasdermins (GSDM) genes play complex roles in inflammatory diseases and cancer. Gasdermin-B (GSDMB) is frequently upregulated in human cancers, especially in HER2-amplified breast carcinomas, and can promote diverse pro-tumor functions (invasion, metastasis, therapy-resistance). In particular, the GSDMB shortest translated variant (isoform 2; GSDMB2) increases aggressive behavior in breast cancer cells. Paradoxically, GSDMB can also have tumor suppressor (cell death induction) effects in specific biological contexts. However, whether GSDMB has inherent oncogenic, or tumor suppressor function in vivo has not been demonstrated yet in preclinical mouse models, since mice lack GSDMB orthologue. Therefore, to decipher GSDMB cancer functions in vivo we first generated a novel knock-in mouse model (R26-GB2) ubiquitously expressing human GSDMB2. The comprehensive histopathological analysis of multiple tissues from 75 animals showed that nucleus-cytoplasmic GSDMB2 expression did not clearly affect the overall frequency nor the histology of spontaneous neoplasias (mostly lung carcinomas), but associated with reduced incidence of gastric tumors, compared to wildtype animals. Next, to assess specifically the GSDMB2 roles in breast cancer, we generated two additional double transgenic mouse models, that co-express GSDMB2 with either the HER2/NEU oncogene (R26-GB2/MMTV-NEU mice) or the Polyoma middle-T antigen (R26-GB2/MMTV-PyMT) in breast tumors. Consistent with the pro-tumor effect of GSDMB in HER2+ human breast carcinomas, R26-GB2/MMTV-NEU GSDMB2-positive mice have double breast cancer incidence than wildtype animals. By contrast, in the R26-GB2/MMTV-PyMT model of fast growing and highly metastatic mammary tumors, GSDMB2 expression did not significantly influence cancer development nor metastatic potential. In conclusion, our data prove that GSDMB2 in vivo pro-tumor effect is evidenced only in specific biological contexts (in concert with the HER2 oncogene), while GSDMB2 alone does not have overall intrinsic oncogenic potential in genetically modified mice. Our novel models are useful to identify the precise stimuli and molecular mechanisms governing GSDMB functions in neoplasias and can be the basis for the future development of additional tissue-specific and context-dependent cancer models.

Steering Hydrocarbon Selectivity in CO2 Electroreduction over Soft-Landed CuOx Nanoparticle-Functionalized Gas Diffusion Electrodes

The use of physical vapor deposition methods in the fabrication of catalyst layers holds promise for enhancing the efficiency of future carbon capture and utilization processes such as the CO₂ reduction reaction (CO₂RR). Following that line of research, we report in this work the application of a sputter gas aggregation source (SGAS) and a multiple ion cluster source type apparatus, for the controlled synthesis of CuO_x nanoparticles (NPs) atop gas diffusion electrodes. By varying the mass loading, we achieve control over the balance between methanation and multicarbon formation in a gas-fed CO₂ electrolyzer and obtain peak CH₄ partial current densities of -143 mA cm^-2 (mass activity of 7.2 kA/g) with a Faradaic efficiency (FE) of 48% and multicarbon partial current densities of -231 mA cm^-2 at 76% FE (FE_C2H4 = 56%). Using atomic force microscopy, electron microscopy, and quasi in situ X-ray photoelectron spectroscopy, we trace back the divergence in hydrocarbon selectivity to differences in NP film morphology and rule out the influence of both the NP size (3-15 nm, >20 μg cm^-2) and in situ oxidation state. We show that the combination of the O₂ flow rate to the aggregation zone during NP growth and deposition time, which affect the NP production rate and mass loading, respectively, gives rise to the formation of either densely packed CuO_x NPs or rough three-dimensional networks made from CuO_x NP building blocks, which in turn affects the governing CO₂RR mechanism. This study highlights the potential held by SGAS-generated NP films for future CO₂RR catalyst layer optimization and upscaling, where the NPs' tunable properties, homogeneity, and the complete absence of organic capping agents may prove invaluable.

Photoinduced Charge Transfer and Trapping on Single Gold Metal Nanoparticles on TiO2

We present a study of the effect of gold nanoparticles (Au NPs) on TiO₂ on charge generation and trapping during illumination with photons of energy larger than the substrate band gap. We used a novel characterization technique, photoassisted Kelvin probe force microscopy, to study the process at the single Au NP level. We found that the photoinduced electron transfer from TiO₂ to the Au NP increases logarithmically with light intensity due to the combined contribution of electron-hole pair generation in the space charge region in the TiO₂-air interface and in the metal-semiconductor junction. Our measurements on single particles provide direct evidence for electron trapping that hinders electron-hole recombination, a key factor in the enhancement of photo(electro)catalytic activity.

Response of human cancer cells to simultaneous treatment with sorafenib and radiofrequency current

Due to their alleged analgesic, anti-inflammatory and tissue regenerative effects, capacitive-resistive electrothermal therapy (CRET), which is based on non-invasive exposure to radiofrequency (RF) currents, is often applied to chemotherapeutically treated patients with cancer. Our previous studies have demonstrated that subthermal CRET currents can elicit a number of cell responses, including anti-proliferative effects, in the human liver cancer cell line HepG2. Such effects involve significant changes in the regulation of proteins involved in MAPK signaling pathways, which are also implicated in the cancer cell response to standard anticancer drugs such as sorafenib. This overlap in response pathways may lead to competitive, neutralizing or blocking interactions between the electrical and chemical treatments, thus raising questions on the advisability of CRET treatment for their analgesic, anti-inflammatory or other purposes in patients undergoing chemotherapy. The present study analyzed the effects of simultaneous treatment with sorafenib and 448-kHz, subthermal CRET current on the proliferation and viability of HepG2 cell cultures. Cell viability was assessed through Trypan blue or XTT assays, while flow cytometry was applied for cell cycle and apoptosis analysis. The expression of proteins involved in cell proliferation were assessed by immunoblotting and immunofluorescence. The results revealed no evidence to suggest that the electrical treatment counteracted or neutralized the cellular response to sorafenib at the different conditions evaluated. Furthermore, at the standard pharmacological sorafenib concentration, 5 µM, the combined treatment elicited an anti-proliferative response significantly stronger than that induced by each of the treatments when applied separately in HepG2 cells. These data do not support the hypothesis that CRET exposure may inhibit or diminish the effects of a chemotherapeutic drug used in cancer treatment, and highlights the requirement for further investigation into the cell response to the combined action of electrical and chemical treatments.

Congenital pulmonary airway malformation (cpam) mimicking an spontaneous pneumothorax in a newborn

INTRODUCTION

Patients with congenital pulmonary airway malformation (CPAM) are usually asymptomatic, but some may present with respiratory distress. We report a rare presentation of a CPAM as an image compatible with persistent and localized spontaneous pneumothorax.

CASE REPORT

A 2-month-old male infant without prenatal diagnosis, postnatal distress or barotrauma, was admitted with acute respiratory symptoms and a right tension pneumothorax on chest X-ray. Despite placement of a chest drain, radiological image persisted. CT confirmed the presence of a CPAM. An open surgical approach was decided and a huge bulla depending from the right upper apex lobe was found and resected. Pathological report disclosed type 4 CPAM.

DISCUSSION/CONCLUSION

Despite the negative prenatal screening, the diagnosis of CPAM should be considered in a patient with sudden respiratory distress and suspicion of an spontaneous pneumothorax. Type 4 CPAM may appear like unique lung cyst mimicking a spontaneous bullae or a massive pneumothorax.

Paving the way for the oncological process in patients with schizophrenia

Introduction

Oncologic patients with schizophrenia have a higher mortality, which could be explained by a delayed diagnosis and a poor quality of the oncologic treatment (1). Some of the potential reasons are related with patient’s psychopathology, stigma, and barriers in access to medical care. An structured support during the oncologic treatment has been proposed to solve the difficulties that patients with schizophrenia can experience when handling with an oncologic process. (2).

Objectives

To illustrate two approaches for cancer accompaniment in patients with schizophrenia.

Methods

We present two case-report and literature research of the topic.

Results

Case A. A 49 y.o. woman diagnosed with a schizoaffective disorder. In the last years she had difficulties to manage her selfcare, so her mental health providers linked her to an individualized community nurse, who later played a crucial role in helping the patient during the diagnosis and treatment of a breast cancer. Case B. A 37 y.o. man diagnosed with schizophrenia, who was very integrated in a peer-support organization. After being diagnosed with a Lymphoma, he continued participating in all the group activities (theatre, collaborative radio, painting) until his decease. Sharing the process with other patients not only improved his quality of life but also helped the group to manage the grief.

Conclusions

- Individualized support with a mental health nurse could enhance the communication between the oncologist and mental health providers, improve the symptoms management, and allow psychological support. - Peer-support can prevent social isolation, improve the quality of life and the management of the oncologic treatment.

Disclosure

No significant relationships.

Psychiatric comorbidity in a patient with opsoclonus-myoclonus syndrome. differences in the transition from childhood to adulthood: A case report

Introduction

Opsoclonus-Myoclonus syndrome (OMS), also known as Kinsbourne syndrome, is a paraneoplasic pediatric condition characterized by erratic eye movements and generalized myoclonus. Previous studies have described a wide range of psychiatric comorbidities in children with this syndrome. Cognitive impairment (especially intellectual capacity and language), affective symptoms (irritability, poor mood regulation) and behavioral problems are the most frequent presentations (1). However, there is a lack of literature describing the progression of this symptoms when the patient reaches the adulthood.

Objectives

To illustrate the psychiatric comorbidity of an adult patient with Opsoclonus-Myoclonus syndrome.

Methods

We present one case-report and literature research of the topic.

Results

We present a 18 year old girl diagnosed with OMS and Graves-Basedow hyperthyroidism. During her childhood she started presenting attention and comprehension difficulties. She was diagnosed with an Attention Deficit Hyperactivity Disorder (ADHD) and started treatment with methylphenidate. She completed elementary and secondary education. During the adulthood, the main psychiatric comorbidity was related to affective symptoms. We observed an impaired mood regulation, hypothymia, anhedonia, and frequent episodes of irritability, which persisted after the thyroid regulation. This caused incremented anxious symptoms and insomnia that were treated with mirtazapine and lormetazepam. After some weeks, she fulfilled criteria of a depressive episode and we started antidepressant treatment with vortioxetine.

Conclusions

- Adult patients diagnosed with OMS during childhood can persist presenting ADHD as a comorbidity. - Affective symptoms, and even a major depressive episode, should be considered during the follow-up of this population. Insight of the cognitive limitations could be a risk factor for a depression.

Disclosure

No significant relationships.

Impact of SARS-CoV-2 pandemic on emergency department activity at the pediatric surgery unit of a third-level hospital

INTRODUCTION

As a result of the emergence of the SARS-CoV-2 respiratory virus in Wuhan in December 2019, the Spanish Government declared the state of emergency with restrictions such as stay-at-home lockdown. The objective of this study was to analyze emergency activity at a referral pediatric surgery unit in its territory and determine whether surgical pathologies had decreased or not.

METHODS

A retrospective study of pediatric patients presenting at the emergency department and referred to the pediatric surgery unit from March 14, 2020 to April 20, 2020 was carried out. The results were compared with those from the same dates of the previous year. Demographic variables, pathologies, and management strategies were studied for each case. The number of patients with abdominal pain requiring surgical assessment was also analyzed.

RESULTS

161 patients were included - 91 from 2019 and 70 from 2020. Of the 2020 patients, 62 (88.6%) underwent surgery and 8 (11.4%) were admitted, whereas in 2019, patient distribution was 67 (73.6%) and 24 (26.4%), which means there were fewer admissions in 2020 (p= 0.018). There were no differences in terms of hours to emergency department consultation - just an increase in the case of appendicular pathologies in the 2020 period, with 24 [23-48] hours vs. 24 [12-30] hours (p =  0.045).

CONCLUSION

The current pandemic has not caused emergency surgeries to decrease. It has only increased time to consultation in patients with appendicular pathologies.

INFRA-ICE: An ultra-high vacuum experimental station for laboratory astrochemistry

Laboratory astrochemistry aims at simulating, in the laboratory, some of the chemical and physical processes that operate in different regions of the universe. Amongst the diverse astrochemical problems that can be addressed in the laboratory, the evolution of cosmic dust grains in different regions of the interstellar medium (ISM) and its role in the formation of new chemical species through catalytic processes present significant interest. In particular, the dark clouds of the ISM dust grains are coated by icy mantles and it is thought that the ice-dust interaction plays a crucial role in the development of the chemical complexity observed in space. Here, we present a new ultra-high vacuum experimental station devoted to simulating the complex conditions of the coldest regions of the ISM. The INFRA-ICE machine can be operated as a standing alone setup or incorporated in a larger experimental station called Stardust, which is dedicated to simulate the formation of cosmic dust in evolved stars. As such, INFRA-ICE expands the capabilities of Stardust allowing the simulation of the complete journey of cosmic dust in space, from its formation in asymptotic giant branch stars to its processing and interaction with icy mantles in molecular clouds. To demonstrate some of the capabilities of INFRA-ICE, we present selected results on the ultraviolet photochemistry of undecane (C₁₁H₂₄) at 14 K. Aliphatics are part of the carbonaceous cosmic dust, and recently, aliphatics and short n-alkanes have been detected in situ in the comet 67P/Churyumov-Gerasimenko.

Core-Satellite Gold Nanoparticle Complexes Grown by Inert Gas-Phase Condensation

Spontaneous growth of complexes consisted of a number of individual nanoparticles in a controlled manner, particularly in demanding environments of gas-phase synthesis, is a fascinating opportunity for numerous potential applications. Here, we report the formation of such core-satellite gold nanoparticle structures grown by magnetron sputtering inert gas condensation. Combining high-resolution scanning transmission electron microscopy and computational simulations, we reveal the adhesive and screening role of H2O molecules in formation of stable complexes consisted of one nanoparticle surrounded by smaller satellites. A single layer of H2O molecules, condensed between large and small gold nanoparticles, stabilizes positioning of nanoparticles with respect to one another during milliseconds of the synthesis time. The lack of isolated small gold nanoparticles on the substrate is explained by Brownian motion that is significantly broader for small-size particles. It is inferred that H2O as an admixture in the inert gas condensation opens up possibilities of controlling the final configuration of the different noble metal nanoparticles.

Electrocatalytic Behavior of PtCu Clusters Produced by Nanoparticle Beam Deposition

State-of-the-art electrocatalysts for electrolyzer and fuel cell applications currently rely on platinum group metals, which are costly and subject to supply risks. In recent years, a vast collection of research has explored the possibility of reducing the Pt content in such catalysts by alloying with earth-abundant and cheap metals, enabling co-optimization of cost and activity. Here, using nanoparticle beam deposition, we explore the electrocatalytic performance of PtCu alloy clusters in the hydrogen evolution reaction (HER). Elemental compositions of the produced bimetallic clusters were shown by X-ray photoelectron spectroscopy (XPS) to range from 2 at. % to 38 at. % Pt, while high-angle annular dark field scanning transmission electron microscopy (HAADF-STEM) combined with energy dispersive X-ray (EDX) spectroscopy indicated that the predominant cluster morphologies could be characterized as either a fully mixed alloy or as a mixed core with a Cu-rich shell. In contrast with previous studies, a monotonic decrease in HER activity with increasing Cu content was observed over the composition range studied, with the current density measured at -0.3 V (vs reversible hydrogen electrode) scaling approximately linearly with Pt at. %. This trend opens up the possibility that PtCu could be used as a reference system for comparing the composition-dependent activity of other bimetallic catalysts.

Thoracic outlet syndrome in adolescents: a case series

OBJECTIVE

Thoracic Outlet Syndrome (TOS) is caused by a compression of the brachial plexus and the subclavian vessels in their passage to the upper limb. It mostly occurs in women aged 20-50, so it is infrequent in children. We present our results in the diagnosis and management of pediatric TOS.

MATERIAL AND METHODS

Retrospective study of patients diagnosed with TOS between December 2017 and June 2018. Clinical, radiological, surgical, and evolution variables were assessed.

RESULTS

Five TOS were diagnosed in 4 patients - one TOS was bilateral. Mean age at diagnosis was 12.5 years (7-15), and there was a delay in diagnosis of 153 days (10-36). TOS was either venous (3) or neurogenic (2). Patients presented with pain (5/5), edema (4/5), hypoesthesia (3/5), decreased strength (3/5), and cervical pain (2/5). One patient presented with sport-related pain. Neurophysiological study was normal in three cases. Two patients presented bone anomalies at CT-scan. Three surgeries were performed in two patients using the supraclavicular approach with resection of the anomalous first rib and scalenectomy. One patient refused surgery, and another patient remained expectant without reappearance of symptoms. Postoperative follow-up was 9 months (6-12), with progressive improvement of symptoms.

CONCLUSIONS

TOS may occur in adolescents in the form of upper limb pain and edema. Imaging tests are recommended to detect abnormal anatomical structures. The supraclavicular approach represents a safe and effective technique in decompressing the thoracic outlet.

Raman amplification in the ultra-small limit of Ag nanoparticles on SiO2 and graphene: Size and inter-particle distance effects

Size, shape and hot spots are crucial to optimize Raman amplification from metallic nanoparticle (NPs). The amplification from radius = 1.8 ± 0.4 nm ultra-small silver NPs was explored. Increasing NP density redshifts and widens their plasmon that, according to simulations for NPs arrays, is originated by the reduction of the interparticle distance, d, becoming remarkable for d ≤ R. Inter-particle interaction red-shifts (N130 nm) and widens (N90 nm) the standard plasmon of non-interacting spherical particles. Graphene partly delocalizes the carriers enhancing the NIR spectral weight. Raman amplification of graphene phonons is moderate and depends smoothly on d while that of Rhodamine 6G (R6G) varies almost exponentially due to their location at hotspots that depend strongly on d. The experimental correlation between amplification and plasmon position is well reproduced by simulations. The amplification originated by the ultra-small NPs is compared to that of larger particles, granular silver films with 7 < R < 15 nm grains, with similar extinction values. The amplification is found to be larger for the 1.8nm NPs due to the higher surface/volume ration that allows higher density of hot spots. It is demonstrated that Raman amplification can be efficiently increased by depositing low density layers of ultra-small NPs on top of granular films.

The Chemistry of Cosmic Dust Analogues from C, C2, and C2H2 in C-Rich Circumstellar Envelopes

Interstellar carbonaceous dust is mainly formed in the innermost regions of circumstellar envelopes around carbon-rich asymptotic giant branch (AGB) stars. In these highly chemically stratified regions, atomic and diatomic carbon, along with acetylene are the most abundant species after H2 and CO. In a previous study, we addressed the chemistry of carbon (C and C2) with H2 showing that acetylene and aliphatic species form efficiently in the dust formation region of carbon-rich AGBs whereas aromatics do not. Still, acetylene is known to be a key ingredient in the formation of linear polyacetylenic chains, benzene and polycyclic aromatic hydrocarbons (PAHs), as shown by previous experiments. However, these experiments have not considered the chemistry of carbon (C and C2) with C2H2. In this work, by employing a sufficient amount of acetylene, we investigate its gas-phase interaction with atomic and diatomic carbon. We show that the chemistry involved produces linear polyacetylenic chains, benzene and other PAHs, which are observed with high abundances in the early evolutionary phase of planetary nebulae. More importantly, we have found a non-negligible amount of pure and hydrogenated carbon clusters as well as aromatics with aliphatic substitutions, both being a direct consequence of the addition of atomic carbon. The incorporation of alkyl substituents into aromatics can be rationalized by a mechanism involving hydrogen abstraction followed by methyl addition. All the species detected in gas phase are incorporated into the nanometric sized dust analogues, which consist of a complex mixture of sp, sp2 and sp3 hydrocarbons with amorphous morphology.

Facile synthesis of an aminopropylsilane layer on Si/SiO2 substrates using ethanol as APTES solvent

(3-aminopropyl)triethoxysilane (APTES) is a commonly used organosilane on surface functionalization of silicon oxide surfaces. However, its deposition process from solution-phase usually involves the use of toluene, which has often been identified as crucial for the formation of an aminopropylsilane monolayer. Toluene is ranked as a problematic solvent in the guide developed by a group referred to as the solvent sub-team of CHEM21. In this work, we propose a facile synthetic route for functionalizing a silicon substrate with APTES via solution-phase approach using only solvents that are classified as recommended. The influence of the APTES concentration, reaction times and different post-deposition conditions using acetic acid and methanol were studied in order to evaluate the quality and thickness of the organosilane layers.•

The method uses ethanol as APTES solvent for functionalizing silicon dioxide surfaces and only uses solvents classified as recommended.

•

The method uses a solution phase approach, does not require complicated equipment and can be prepared at room temperature.

Pilonidal sinus in pediatric age: primary vs. secondary closure

INTRODUCTION

Pilonidal sinus (PS) is a highly frequent condition in teenagers. There is no consensus on which type of closure should be carried out following surgical removal. Our objective is to compare primary closure (PC) results with secondary closure (SC) or deferred closure results.

MATERIALS AND METHODS

Patients undergoing surgery for PS between 2013 and 2018 were studied and classified according to the type of closure. Presence of infection at removal, recurrence rate, pre- and postoperative antibiotic treat-ment, number of previous drainages, and sinus size were analyzed.

RESULTS

Of the 57 patients (29 of whom women), 29 were treated using PC and 28 using SC. Mean age was 14±1 years in the PC group, and 16±1 years in the SC group. PC patients presented a postoperative partial dehiscence rate of 26%. No statistically significant differences were found between groups regarding the presence of infection at surgery, recurrence rate, postoperative antibiotic treat-ment, number of previous drainages, and sinus size (p>0.05). The SC group re-quired more postoperative dressings [4 (0-6) vs. 8 (2-11) (p<0.01)] and longer time to healing [60 days (9-240) vs. 98 days (30-450) (p<0.01)].

CONCLUSIONS

1 out of 4 PS patients with PC presents postoperative partial dehiscence. However, PC involves fewer subsequent dressings and shorter heal-ing times as compared to SC.

Does time to antibiotic initiation and surgery have an impact on acute appendicitis results?

OBJECTIVE

Time to treatment initiation is a key element to be considered in infectious pathologies such as acute appendicitis (AA). There are few articles in the literature analyzing the relationship between early pre-surgical antibiotic treatment initiation and complication occurrence in AA. Our objective is to analyze such influence and the effects of late treatment initiation.

MATERIALS AND METHODS

A retrospective, observational study was carried out in children undergoing surgery for AA between 2017 and 2018. Demographic variables, time to antibiotic treatment initiation, time to surgery, and postoperative complications were analyzed.

RESULTS

592 patients with a median 12-month follow-up were included in the study. Antibiotic treatment initiation in the first 8 hours following diagnosis prevents complications [OR 0.24 (95% CI: 0.07-0.80)] and dramatically reduces the occurrence of intra-abdominal abscess from 25.0% to 5.5% (p=0.03). Antibiotic treatment initiation in the first 4 hours following diagnosis significantly reduced wound infection rate in non-overweight patients [2.9% vs. 13.6%; OR 0.19 (95% CI: 0.045-0.793); p=0.042]. Surgery within the first 24 hours following diagnosis reduced the proportion of advanced AA (gangrenous appendicitis and peritonitis) from 100% to 38.6% (p=0.023).

CONCLUSIONS

Antibiotic treatment initiation in the first 4 hours following AA prevented the occurrence of post-surgical complications, especially in non-overweight patients. An adequate clinical approach and an early assessment by the pediatric surgeon are key to reduce the morbidity associated with AA.

PCP analogues in samples of Barcelona from 2009 to 2015

Introduction

Novel psychoactive substances (NPS) use is progressively increasing year on year. The new analogues of phencyclidine are frequently sold as legal dissociative anesthetic drug with hallucinogenic and sedative effects, a legal alternative to ketamine, acting as a high affinity and selective ligand of NMDA receptor antagonists.

Objectives

To describe the presence of 3- and 4-MeO-PCP in samples delivered to Energy Control from 2009 to 2015 in Spain.

Methods

A total of 21,198 samples were analyzed from august 2009 to august 2015. Only those samples containing 4-MeO-PCP or 3-MeO-PCP were studied. They were analyzed by Energy Control, a Spanish harm reduction NGO that offers the possibility of analyzing the substances that users report. Analysis was done by gas chromatography–mass spectrometry.

Results

All the samples resulted to be the acquired drug of the consumer. Three samples were adulterated with substances as tramadol, cocaine, acetone among others.

Conclusions

Three and 4-MeO-PCP consumption is not found to be an emerging issue according to the results of our samples. Even the potential harmful effects of these dissociative drugs, our indirect indicator seems to show that consumption has not increased. A more precise monitoring would make a better approach to the real consumption and the impact of these substances in our society.

Disclosure of interest

The authors declare that they have no competing interest.

25I-NBOMe: The legal LSD

Introduction

Novel psychoactive substances (NPS) use is progressively increasing year on year. A new group of phenethylamines sold as legal stimulants and hallucinogens is being reported increasingly since 2012. Within this group, 25I-NBOMe is an outstanding substance with powerful effects and high affinity with the serotonin 2a (5HT2a) receptor. Several toxicity cases have been reported so far.

Objectives

To describe the presence of 25I-NBOMe and its characteristics in samples delivered to Energy Control from 2009 to 2015 in Spain.

Methods

Among the samples, 21,198 analyzed from august 2009 to august 2015 and only those samples containing 25I-NBOMe were studied (n = 56). Samples were analyzed by Energy Control, a Spanish harm-reduction NGO that offers users the possibility of analyzing the substances they intend to consume. Analysis was done by Gas Chromatography–Mass Spectrometry.

Results

From 56 samples were 25I-NBOMe was found, 24 were bought as LSD (42.8%), 12 as 25I-NBOMe (21.4%), 4 as 25C-NBOMe (7.1%), 4 as 25I-NBOH (7.1%) and 12 as other substances (21.4%), gummy bears included. All samples were received from 2012 on, having the highest peak on 2013 (19 samples).

Conclusions

25I-NBOMe consumption represents an emerging issue with potential harmful effects, especially when the substance used is not the expected. Further pharmacokinetic, pharmacodynamic, clinical and epidemiological researches should be conducted to deepen knowledge about 25I-NBOMe and the management of its possible toxic effects. Physicians should be aware of NPS, their increasing use and the clinical differences between them.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Influence of overweight and obesity on acute appendicitis in children. A cohort study

INTRODUCTION

Overweight and obesity are risk factors for the development of postsurgical complications in acute appendicitis in adults. However, there are few studies that evaluate their effects in pediatric patients. We aim to analyze their influence on the postoperative course of acute appendicitis in children.

MATERIAL AND METHODS

A prospective cohort study was performed in patients undergoing surgery for acute appendicitis in 2017-2018, divided into two cohorts according to BMI adjusted to sex and age, following the WHO criteria: exposed cohort (overweight-obese) and non-exposed cohort (normal weight). Clinical follow-up was performed during hospital admission and one month after surgery. Demographic variables, operating time, average hospital stay, and early postoperative complications (wound infection, wound dehiscence, and intra-abdominal abscess) were assessed.

RESULTS

A total of 403 patients were included (exposed cohort n=97 and non-exposed cohort n=306), with no differences in sex or age. A longer operating time was observed in the exposed cohort (57.6 ± 22.5 vs. 44.6 ± 18.2 min, p<0.001), with no differences found according to the surgical approach (open surgery or laparoscopic surgery) used. This group also had a higher surgical wound infection rate as compared to the non-exposed cohort (10.3% vs. 4.2%; RR: 1.90; CI: 95% [1.15-3.14], p<0.001), as well as a higher surgical wound dehiscence rate (7.2% vs. 2.3%; RR: 2.16; CI: 95% [1.24-3.76], p<0.001). No differences in the development of intra-abdominal abscesses or in hospital stay were observed.

CONCLUSIONS

Obese and overweight children with appendicitis have a higher risk of developing postoperative complications such as wound infection and dehiscence than normal weight patients.

Prevalence of non-aromatic carbonaceous molecules in the inner regions of circumstellar envelopes

Evolved stars are a foundry of chemical complexity, gas and dust that provides the building blocks of planets and life, and dust nucleation first occurs in their photosphere. Despite their importance, the circumstellar regions enveloping these stars remain hidden to many observations, thus dust formation processes are still poorly understood. Laboratory astrophysics provides complementary routes to unveil these chemical processes, but most experiments rely on combustion or plasma decomposition of molecular precursors under physical conditions far removed from those in space. We have built an ultra-high vacuum machine combining atomic gas aggregation with advanced in-situ characterization techniques to reproduce and characterize the bottom-up dust formation process. We show that carbonaceous dust analogues formed from low-pressure gas-phase condensation of C atoms in a hydrogen atmosphere, in a C/H2 ratio similar to that reported for evolved stars, leads to the formation of amorphous C nanograins and aliphatic C-clusters. Aromatic species or fullerenes do not form effectively under these conditions, raising implications for the revision of the chemical mechanisms taking place in circumstellar envelopes.

Broad band high resolution rotational spectroscopy for Laboratory Astrophysics

We present a new experimental setup devoted to the study of gas phase molecules and processes using broad band high spectral resolution rotational spectroscopy. A reactor chamber has been equipped with radio receivers similar to those used by radio astronomers to search for molecular emission in space. The whole Q (31.5-50 GHz) and W bands (72-116.5 GHz) are available for rotational spectroscopy observations. The receivers are equipped with 16×2.5 GHz Fast Fourier Transform spectrometers with a spectral resolution of 38.14 kHz allowing the simultaneous observation of the complete Q band and one third of the W band. The whole W band can be observed in three settings in which the Q band is always observed. Species such as CH3CN, OCS, and SO2 are detected, together with many of their isotopologues and vibrationally excited states, in very short observing times. The system permits automatic overnight observations and integration times as long as 2.4×105 seconds have been reached. The chamber is equipped with a radiofrequency source to produce cold plasmas and with four ultraviolet lamps to study photochemical processes. Plasmas of CH4, N2, CH3CN, NH3, O2, and H2, among other species, have been generated and the molecular products easily identified by their rotational spectrum, and mass spectrometry and optical spectroscopy. Finally, the rotational spectrum of the lowest energy conformer of CH3CH2NHCHO (N-Ethylformamide), a molecule previously characterized in microwave rotational spectroscopy, has been measured up to 116.5 GHz allowing the accurate determination of its rotational and distortion constants and its search in space.

Citric Juice-mediated Synthesis of Tellurium Nanoparticles with Antimicrobial and Anticancer Properties

Bacterial infections and cancer are two of the most significant concerns that the current healthcare system should tackle nowadays. Green nanotechnology is presented as a feasible solution that is able to produce materials with significant anticancer and antibacterial activity, while overcoming the main limitations of traditional synthesis. In the present work, orange, lemon and lime extracts were used as both reducing and capping agents for the green synthesis of tellurium nanoparticles (TeNPs) using a microwave-assisted reaction. TeNPs showed a uniform size distribution, and rod- and cubic-shapes, and were extensively characterized in terms of morphology, structure and composition using TEM, SEM, XPS, XRD, FTIR and EDX analysis. TeNPs showed an important antibacterial activity against both Gram-negative and -positive bacteria in a range concentrations from 5 to 50 μg/mL over a 24-hour time period. Besides, nanoparticles showed anticancer effect towards human melanoma cells over 48 hours at concentrations up to 50 μg/mL. Moreover, the Te nanostructures showed no significant cytotoxic effect towards human dermal fibroblast at concentrations up to 50 μg/mL. Therefore, we present an environmentally-friendly and cost-effective synthesis of TeNPs using only fruit juices and showing enhanced and desirable biomedical properties towards both infectious diseases and cancer.

There Is Great Ignorance About the Brain Death Concept Among the Population in Santiago de Cuba (Cuba)

INTRODUCTION

The knowledge of the brain death (BD) concept is important when determining the attitude toward organ donation.

OBJECTIVE

To analyze the level of knowledge of the BD concept among the population in Santiago de Cuba and determine the factors that condition it.

METHODS

From the Collaborative International Donor Project, we obtained a sample of Cubans living in the area of Santiago de Cuba (n = 455). The attitude was assessed using a validated questionnaire (PCID-DTO-RIOS). The survey was self-administered and completed anonymously. Student t test, χ², Fisher, and logistic regression analysis were used.

RESULTS

Forty percent (n = 180) of the respondents know the BD concept and consider it as the death of an individual. Of the rest, 43% (n = 199) do not know about it, and the remaining 17% (n = 76) consider that it does not mean the death of a patient. The variables significantly related to the correct knowledge of BD in the multivariate analysis and considered as independent are: level of studies; the opinion of the couple toward organ donation; the religion of the respondent; having offspring; and a favorable attitude toward organ donation.

CONCLUSION

There is ignorance about the brain death concept among the population of Santiago de Cuba. This lack of knowledge has a direct relationship with various psychosocial factors.

Attitude Toward Organ Donation in the Population of Cienfuegos, Cuba

INTRODUCTION

The sensitization of the population toward organ donation is fundamental; for that reason, it is important to determine the factors that condition the opinion toward donation on the population scope in order to carry out cost-effective campaigns.

OBJECTIVE

To analyze the attitude toward the donation of the proper organs for transplantation among the population residing in Cienfuegos, Cuba.

METHOD

Population under study: Population who reside in Cienfuegos, Cuba.

INCLUSION CRITERIA

Population over 15 years old as stratified by age and sex. Assessment instrument: The attitude questionnaire for organ donation for transplant-PCID-DTO Ríos. Fieldwork: A random selection based on stratification. The available data from the census were used. The completion was anonymous and self-administered. Verbal consent was requested to collaborate in the study.

STATISTICS

Student t test, χ², Fisher, and a logistic regression analysis.

RESULTS

A sample of 636 respondents was included in the study, of which 71% (n = 453) are in favor of donating their organs after death, 16% (n = 103) are against, and 13% (n = 80) are undecided. This attitude is associated with different psychosocial variables (P < .001): age, marital status, having offspring, level of studies, carrying out prosocial activities, discussing with the family the subject of donation and transplantation, knowledge of the concept of brain death, the attitude toward the manipulation of the corpse, the religion of the respondent, and the attitude of the couple toward organ transplantation. The main independent factors obtained in the multivariate analysis (odds ratio >2.5): knowledge of the brain death concept, attitude toward the manipulation of the corpse, religion, and attitude of the couple toward transplantation.

CONCLUSIONS

The attitude toward organ donation among the population of Cienfuegos, Cuba, is favorable and is conditioned by several psychosocial factors.

Tuning the size, composition and structure of Au and Co50Au50 nanoparticles by high-power impulse magnetron sputtering in gas-phase synthesis

Gas-phase synthesis of nanoparticles with different structural and chemical distribution is reported using a circular magnetron sputtering in an ion cluster source by applying high-power impulses. The influence of the pulse characteristics on the final deposit was evaluated on Au nanoparticles. The results have been compared with the more common direct current approach. In addition, it is shown for the first time that high-power impulses in magnetron based gas aggregation sources allows the growth of binary nanoparticles, CoAu in this case, with a variety of crystalline and chemical arrangements which are analyzed at the atomic level.

[Slipping rib syndrome in paediatrics: report of 4 cases]

AIM OF THE STUDY

The slipping rib syndrome (SRS) is an unknown pathology for the pediatric surgeon due to its low incidence in children. The weakness of the costal ligaments allowing an area of rib hypermobility has been postulated recently as the main etiology. It produces an intermittent pain in the lower thorax or upper abdomen that can affect to the daily activities and can be the origin of unspecific chronic pain.

METHODS

A retrospective review of patients diagnosed with SRS between october 2012 and march 2017 was performed. Data of demographics, symptoms, imaging studies, surgical findings and long-term follow-up were collected.

RESULTS

During this period, 4 patients were diagnosed with SRS. Median age at diagnosis was 13 years (12-15 years) with a mean duration of symptoms of 13 months (12-36 months). In 2 patients the SRS was associated with Costal Dysmorphia (CD). The initial diagnosis was clinical with posterior ultrasound confirmation. Resection of the affected cartilages was performed in 3 patients and after a follow-up of 6 months (3-30 months), they all are painless and refer a good cosmetic result. One patient refused the intervention.

CONCLUSIONS

The SRS is an infrequent cause of thoracic pain with an etiology not well understood. The awareness of this disease and its typical presentation can avoid unnecessary studies. The resection of the affected cartilages is a safe and effective treatment.

Gas-Phase Synthesis of Nanoparticles: present status and perspectives

There is an increasing interest in the generation of well-defined nanoparticles (NPs) not only because of their size-related particular properties, but also because they are promising building blocks for more complex materials in nanotechnology. Here, we will shortly introduce the gas phase synthesis technology that has evolved rapidly in the last years and allows the fabrication of complex NPs with controllable and tuneable chemical composition and structure while keeping very good control over the size distribution. We will also address some limitations of the technology (stability over time, production yield…) and discuss possible solutions.

Direct synthesis of graphene on silicon oxide by low temperature plasma enhanced chemical vapor deposition

Direct graphene growth on silicon with a native oxide using plasma enhanced chemical vapour deposition at low temperatures [550 °C-650 °C] is demonstrated for the first time. It is shown that the fine-tuning of a two-step synthesis with gas mixtures C2H2/H2 yields monolayer and few layer graphene films with a controllable domain size from 50 nm to more than 300 nm and the sheet resistance ranging from 8 kΩ sq-1 to less than 1.8 kΩ sq-1. Differences are understood in terms of the interaction of the plasma species - chiefly atomic H - with the deposited graphene and the native oxide layer. The proposed low temperature direct synthesis on an insulating substrate does not require any transfer processes and improves the compatibility with the current industrial processes.

Anti-oxidants correct disturbance of redox enzymes in the hearts of rat fetuses with congenital diaphragmatic hernia

AIM

To evaluate if the redox system is unbalanced in the hearts of nitrofen-induced congenital diaphragmatic hernia  (CDH) animals and to study the possible preventive effects of two anti-oxidant treatments, apocynin and epigallocatechin-3-gallate (EGCG).

METHODS

Adult rats were divided into four groups. Group 1: rats received only vehicle on day E9.5. Group 2: rats received 100 mg nitrofen on day E9.5. Group 3: 1 month before mating rats received apocynin 1.5 mM and, when pregnant, 100 mg nitrofen on day E9.5. Group 4: same than group 3 but with EGCG 30 mg/kg. All fetuses were recovered at term and the hearts were processed. Nox activity and mRNA levels of Nox1, Nox2, Nox4, SOD1, SOD2, SOD3, catalase, and GPX1 were analyzed. Nox, SOD, and Catalase activity and H2O2 production were also evaluated.

RESULTS

Nox activity, H₂O₂ production and Nox1, Nox2, and Nox4 mRNA levels were increased in the hearts of fetuses with CDH. There were no changes in SOD1 levels, whereas those of SOD2, SOD3, catalase, and GPX1 mRNA were decreased. Apocynin and EGCG treatments attenuated the increment of Nox and SOD activities and H₂O₂ production was only decreased by apocynin.

CONCLUSION

These findings suggest a possible preventive effect on the abnormal redox metabolism of anti-oxidant treatments in the hearts from rat fetuses with CDH. If the same occurs in humans, it could represent a potential tool in future prenatal treatment.

[The role of fetal magnetic resonance imaging in the study of congenital diaphragmatic hernia]

INTRODUCTION AND OBJECTIVES

Different echographic and fetal magnetic resonance (MRI) measurements have been described in the diagnosis of associated malformations and the prognosis of congenital diaphragmatic hernia (CDH). We have reviewed our experience searching for useful isolated or combined parameters and how MRI can complement ultrasound.

MATERIAL AND METHODS

We evaluated 29 fetuses with CDH. We examined ultrasonography: Lung to Head (LHR o/e) and in MRI: ipsilateral lung volume (IPV) and total expressed as percentage of observed / expected lung volume (VPT o/e) and percentage of herniated liver (PHH). We studied: survival, ECMO and associated malformations.

RESULTS

LHR o/e was the measure that best predicted survival (p< 0.05). VPT o/e did not predict survival or the need of ECMO (p> 0.05). PHH ≥19% was related to the need of ECMO. IPV < 2 cc required ECMO more frequently (p< 0.018) and when it was 0 cc in all cases. No combination of MR measurements was superior to LHR o/e in prediction of survival. MRI complemented the ultrasound in 4 cases: diaphragmatic eventration diagnosed with HDC, right HDC with fluid in the sac that suggested thoracic cyst, differentiation between spleen and lung that measured together overestimated the LHR and/or suspicion of Cornelia de Lange due to facial malformations.

CONCLUSIONS

Not a single or combined MRI measurement exceeds LHR o/e in survival prediction. MRI is related to prognosis and can be used to support ultrasound in making decisions. MRI occasionally provides complementary morphological information.