Screening for retinopathy of prematurity: results of a 7-year study of underweight newborns

BACKGROUND: Retinopathy of prematurity (ROP) is a serious complication of treatment and extension of survival in premature infants and leads to blindness unless recognized and treated early. An ROP prospective screening survey was performed, enrolling all premature newborns weighing <2000 g at delivery. METHODS: A total of 2014 infants had a retinal evaluation by indirect ophthalmoscopy at 4-6 weeks of age. If any ROP stage was detected, the patient was followed periodically to assess treatment. All premature infants with threshold retinopathy were treated by transscleral cryotherapy at the time of detection. RESULTS: We found 449 infants (22.2%) with ROP in any stage, and 230 (11.42%) with threshold retinopathy who underwent cryotherapy. In the 500-1000 g group (n = 334), 48.2% had ROP in any stage and 92 (27.5%) had threshold retinopathy. In the 1001-1500 g group (n = 1374), 257 (18.7%) had any ROP stage and 122 (8.8%) had stage 3. In the 1501-2000 g group, 306 neonates were evaluated, 31 (10%) had any ROP stage and 16 (5.2%) underwent cryotherapy. A total of 198/230 infants (86%) with threshold retinopathy who received cryotherapy had complete recovery, but 5% developed unilateral and 9% bilateral retinal detachment. There were no complications related to anesthesia. CONCLUSIONS: Overall ROP rate was 2.68/1000 deliveries and 22.2% of premature infants <2000 g had any ROP stage, 11.42% with retinal detachment risk received cryotherapy with 86% successful results.     

Effect of the size and location of osteochondral defects in degenerative arthritis. A finite element simulation

Physiological studies have shown that focal articular surface defects in the human knee may progress to degenerative arthritis. Although the risk of this evolutive process is multifactorial, defect size is one of the most important factors. In order to determine the influence of osteochondral defect size and location on the stress and strain concentrations around the defect rim, a finite element model of the human knee was developed. From our results, it became clear that the size and location of cartilage defects drastically affect to those variables. No stress concentration appeared around the rim of small defects, being the stress distribution mainly controlled by the meniscus contact. On the contrary, important rim stress concentration was found for large osteochondral defects. This alteration of the stress distribution has important clinical implications regarding the long-term integrity of the cartilage adjacent to osteochondral defects.     

Evaluation of circulating intestinally committed memory B cells in children vaccinated with attenuated human rotavirus vaccine

In a double blind trial, 319 fully immunized children received two doses of either placebo or 10(6.7) focus-forming units of the attenuated RIX4414 human rotavirus (RV) vaccine ("all-in-one" formulation). Plasma RV-specific IgA (RV IgA), stool RV IgA, and circulating total and RV memory B cells (CD19+ IgD+/- CD27+) with an intestinal homing phenotype (alpha4beta7+ CCR9+/-) were measured, after the first and second doses, as potential correlates of protection. After the first and/or second dose, 54% of vaccinees and 13% of placebo recipients had plasma RV IgA. Before vaccination, most (95%) of the children (of both study groups) were breast-fed and had stool RV IgA (68.64%). Coproconversion (4-fold increase) after the first and/or second dose was observed in 32.7% of vaccinees and 17.4% of placebo recipients. No significant difference was seen when comparing the frequencies of any subset of memory B cells between vaccinees and placebo recipients. Statistically significant weak correlations were found between plasma RV IgA titers and coproconversion, and several subsets of memory B cells. The vaccine provided 74.8% protection (95% confidence interval, 30.93-92.62) against any RV gastroenteritis and 100% protection (95% confidence interval, 14.53-100) against severe RV gastroenteritis. When vaccinees and placebo recipients were considered together, a correlation was found between protection from disease and plasma RV IgA measured after dose 2 and RV memory (IgD- CD27+ alpha4beta7+ CCR9+) circulating B cells measured after dose 1. However, the correlation coefficients for both tests were low (<0.2), suggesting that other factors are important in explaining protection from disease.     

“It is just like having a period with back pain”: exploring women’s experiences with community-based distribution of misoprostol for early abortion on the Thailand–Burma border

Introduction

The lack of economic development and longstanding conflict in Burma have led to mass population displacement. Unintended pregnancy and unsafe abortion are common and contribute to maternal death and disability. In 2011, stakeholders operating along the Thailand-Burma border established a community-based distribution program of misoprostol for early abortion, with the aim of providing safe and free abortion care in this low-resource and legally restricted setting.

Mosquito La protein binds to the 3' untranslated region of the positive and negative polarity dengue virus RNAs and relocates to the cytoplasm of infected cells

The untranslated regions (UTRs) of the positive and negative strand RNAs of several viruses are major binding sites for cellular and viral proteins. Human La autoantigen is one of the cellular proteins that interacts with various positive strand RNA viral genomes including that of dengue virus (DEN) within the 5'- and 3'-UTRs of positive (+) and the 3'-UTR of negative strand (-) RNA, and with the nonstructural proteins NS3 and NS5, that form DEN replicase complex. Since DEN replicates in human and mosquito cells, some functional interactions have to be conserved in both hosts. In the present report, we demonstrate that mosquito La protein interacts with the 3'-UTRs of (+) and (-) polarity viral RNAs. The localization of La protein, examined by confocal microscopy, indicates that La protein is redistributed in DEN-infected cells. Furthermore, the presence of La protein in an in vitro replication system inhibited RNA synthesis in a dose-dependent manner, suggesting that La protein plays an important role in dengue virus replicative cycle.     

Retinal degenerations: from cell signaling to cell therapy; pre-clinical and clinical issues

Extracellular signaling molecules have been implicated in the progression of Retinal Degeneration (RD). Gene regulatory events linked to the maintenance of retinal structure and function incorporate signaling cascades that may serve as therapeutic targets for some forms of blindness. This review shall focus on the evidence for non-cell-autonomous mechanisms that affect the pattern of degeneration seen in retinal dystrophies, the types of signals that may influence the course of degeneration and finally with the related prospects for retinal-therapies.     

CD14+ antigen-presenting cells in human dermis are less mature than their CD1a+ counterparts

We recently demonstrated that three antigen-presenting cell (APC) subsets exist in the healthy human dermis, CD14(+) and CD1a(+) dermal APCs and migratory dermal Langerhans cells. Here, we extend these findings by defining CD208 as an exclusive marker of migratory dermal Langerhans cells, confirming that migratory dermal Langerhans cells (CD1a(high) CD207(+) CD208(+)) and CD1a(+) dermal APCs (CD1a(mid) CD207(-) CD208(-)) are two distinct APC populations. Using flow cytometry and multicolor fluorescence immunohistochemistry, we demonstrated that there were striking differences between CD1a(+) and CD14(+) dermal APCs in their expression of pattern recognition receptors and maturation markers. Expression of Toll-like receptor (TLR) 2, CD206 and CD209 was largely restricted to CD14(+) dermal APCs. Consistent with these observations, most CD14(+) dermal APCs expressed an immature phenotype when compared with CD1a(+) dermal APCs, which expressed high levels of the maturation marker CD83 on their cell surface. However, a subset of CD14(+) dermal APCs also expressed cell-surface CD83, associated with a loss of cell-surface TLR2, suggesting that they have the capacity to mature. CD14(+) dermal APCs are therefore the dominant cutaneous APC population capable of sensing ligands recognized by CD206, CD209 and TLR2 and subsequently may have the potential to mature. CD68 expression was largely restricted to a subset of CD14(+) dermal APCs, while both CD14(+) and CD1a(+) dermal APCs expressed CD11b and CD11c. These findings have important implications for understanding cutaneous immune responses in humans and for the optimization of vaccine delivery via the skin.