Higher cord blood levels of mannose-binding lectin-associated serine protease-2 in infants with necrotising enterocolitis

Necrotising enterocolitis (NEC) causes significant morbidity and mortality in premature infants. The role of innate immunity in the pathogenesis of NEC remains unclear. Mannose-binding lectin (MBL) recognizes microorganisms and activates the complement system via MBL-associated serine protease-2 (MASP-2). The aim of this study was to investigate whether MBL and MASP-2 are associated with NEC. This observational case-control study included 32 infants with radiologically confirmed NEC and 64 controls. MBL and MASP-2 were measured in cord blood using ELISA. Multivariate logistic regression was performed. Of the 32 NEC cases (median gestational age, 30.5 wk), 13 (41%) were operated and 5 (16%) died. MASP-2 cord blood concentration ranged from undetectable (<10 ng/mL) to 277 ng/mL. Eighteen of 32 (56%) NEC cases had higher MASP-2 levels (> or =30 ng/mL) compared with 22 of 64 (34%) controls (univariate OR 2.46; 95% CI 1.03-5.85; p = 0.043). Higher cord blood MASP-2 levels were significantly associated with an increased risk of NEC in multivariate analysis (OR 3.00; 95% CI 1.17-7.93; p = 0.027). MBL levels were not associated with NEC (p = 0.64). In conclusion, infants later developing NEC had significantly higher MASP-2 cord blood levels compared with controls. Higher MASP-2 may favor complement-mediated inflammation and could thereby predispose to NEC.

Is there a correlation between venlafaxine therapy during pregnancy and a higher incidence of necrotizing enterocolitis?

BACKGROUND: Novel antidepressant drugs are increasingly used by women of child bearing age. However, potentially harmful effects on fetus and newborn remain unknown. METHODS: Case report and literature review. RESULTS: We present preterm twins whose mother was treated with venlafaxine, a nonselective serotonin reuptake inhibitor, throughout pregnancy until delivery. The twins developed neonatal necrotizing enterocolitis. CONCLUSION: The question whether there might be a correlation between maternal serotonin reuptake inhibitor therapy and neonatal necrotizing enterocolitis is discussed.

M-ficolin in the neonatal period: Associations with need for mechanical ventilation and mortality in premature infants with necrotising enterocolitis

OBJECTIVE: Necrotising enterocolitis (NEC) causes significant mortality in premature infants. The involvement of the innate immune system in the pathogenesis of NEC remains unclear. M-, L- and H-ficolins recognize microorganisms and activate the complement system, but their role in host defense is largely unknown. This study investigated whether ficolin concentrations are associated with NEC. STUDY DESIGN: Case-control study including 30 premature infants with NEC and 60 controls. M-, L- and H-ficolins were measured in cord blood using time-resolved immunofluorometric assays. Multivariate logistic regression was performed. RESULTS: Of the 30 NEC cases (median gestational age, 29.5 weeks), 12 (40%) were operated and 4 (13%) died. No difference regarding ficolin concentration was found when comparing NEC cases versus controls (p>0.05). However, infants who died of NEC had significantly lower M-ficolin cord blood concentrations than NEC survivors (for M-ficolin <300ng/ml; multivariate OR 12.35, CI 1.03-148.59, p=0.048). In the entire study population, M-, L- and H-ficolins were positively correlated with gestational age (p<0.001) and birth weight (p<0.001). Infants with low M-ficolin required significantly more often mechanical ventilation after birth multivariate (OR 10.55, CI 2.01-55.34, p=0.005). CONCLUSIONS: M-, L- and H-ficolins are already present in cord blood and increase with gestational age. Low cord blood concentration of M-ficolin was associated with higher NEC-associated fatality and with increased need for mechanical ventilation. Future studies need to assess whether M-ficolin is involved in multiorgan failure and pulmonary disease.

Omega-3 poly-unsaturated fatty acids for the prevention of severe neutropenic enterocolitis in patients with acute myeloid leukemia

Neutropenic enterocolitis is a potentially fatal complication of myeloablative chemotherapy in patients with acute myeloid leukemia. Omega-3 polyunsaturated fatty acids (PUFA) are precursors of potent anti-inflammatory prostaglandins. Our aim was to explore the safety and effectiveness of omega-3 PUFA added to parenteral nutrition in protecting leukemia patients from severe enterocolitis. Fourteen patients with acute myeloid leukemia who received omega-3 PUFA in a Phase II trial were compared with 66 consecutive control patients not getting this intervention. We performed crude and adjusted comparisons, using inverse probability of treatment weighting for adjusted analysis, and blind outcome assessment to minimize assessor bias. Primary outcome was severe enterocolitis (≥Grade 3). The crude odds ratio of Grade 3 colitis or higher was 1.36 (95% CI 0.37 to 4.96, P = 0.64), and the adjusted odds ratio was 0.79 (95% CI 0.35 to 1.78, P = 0.57). There was little evidence to suggest differences between groups in serious adverse events and overall mortality. Our results provide little evidence that addition of omega-3 PUFA is beneficial in this condition. Routine treatment with omega-3 PUFA is currently not warranted.

A mouse model for S. typhimurium-induced enterocolitis.

Salmonella typhimurium has emerged as a model pathogen that manipulates host cells in a complex fashion, thus causing disease. In humans, S. typhimurium causes acute intestinal inflammation. Intriguingly, type III secreted virulence proteins have a central role in this process. At the cellular level, the functions of these factors are well characterized; at present, animal models are required for elucidating how these factors trigger inflammatory disease in vivo. Calf infection models have been employed successfully and, recently, a mouse model was identified: in streptomycin-pretreated mice, S. typhimurium causes acute colitis. This mouse model provides a new avenue for research into acute intestinal inflammation because it enables the manipulation and dissection of both the bacterial and host contributions to the disease in unsurpassed detail.

Outcome in neonates with necrotizing enterocolitis and patent ductus arteriosus.

BACKGROUND There is no agreement of the influence of patent ductus arteriosus (PDA) on outcomes in patients with necrotizing enterocolitis (NEC). In this study, we assessed the influence of PDA on NEC outcomes. METHODS A retrospective study of 131 infants with established NEC was performed. Outcomes (death, disease severity, need for surgery, hospitalization duration), as well as multiple clinical parameters were compared between NEC patients with no congenital heart disease (n=102) and those with isolated PDA (n=29). Univariate, multivariate and stepwise logistic regression analyses were performed. RESULTS Birth weight and gestational age were significantly lower in patients with PDA [median (95% CI): 1120 g (1009-1562 g), 28.4 wk (27.8-30.5 wk)] than in those without PDA [median (95% CI): 1580 g (1593-1905 g), 32.4 wk (31.8-33.5 wk); P<0.05]. The risk of NEC-attributable fatality was higher in NEC patients with PDA (35%) than in NEC patients without PDA (14%)[univariate odds ratio (OR)=3.3, 95% CI: 1.8-8.6, P<0.05; multivariate OR=2.4, 95% CI: 0.82-2.39, P=0.111]. Significant independent predictors for nonsurvival within the entire cohort were advanced disease severity stage III (OR=27.9, 95% CI: 7.4-105, P<0.001) and birth weight below 1100 g (OR=5.7, 95% CI: 1.7-19.4, P<0.01). CONCLUSIONS In patients with NEC, the presence of PDA is associated with an increased risk of death. However, when important differences between the two study groups are controlled, only birth weight and disease severity may independently predict mortality.

Probiotics and the prevention of necrotizing enterocolitis in preterm infants: A systematic review of the literature

Necrotizing enterocolitis is a common gastrointestinal disease associated with high mortality and morbidity among preterm infants. This was a systematic literature review that evaluated whether the administration of probiotic supplements is of benefit in the prevention of NEC. The search was narrowed to randomized clinical trials identified through The Cochrane Central Register of Controlled Trials, U.S. National Institute of Health clinical trials registry database, Pub Med and OVID MEDLINE databases. Inclusion criteria were: prospective, randomized clinical trials that administered probiotics as a preventive measure against NEC for infants of early gestational age (<35 wks) and/or low birth weight (<1500g), maintained NEC as the primary measured outcome, used Bell’s classification for NEC diagnosis with reports of stage 2 NEC or higher, and began probiotic administration within 10 days of life. Trials were excluded if participant enrollment was fewer than 100 infants, published before the year 2000, or probiotic supplementation was discontinued after less than seven consecutive days. Based on specific study characteristics, each resulting article was then judged by two authors for study quality. The search was further narrowed to studies of either high or moderate quality, which were then summarized in a set of tables based on study characteristics and results. From an initial set of 20 identified studies, five clinical trials met all criteria; each was discussed thoroughly based on trial limitations, strengths and comparisons to other included publications. Based on this review, the weight of evidence appears to support the use of probiotic supplementation in preterm infants as a preventive measure against NEC. Recommendations for future research were also provided.^

Con dos minas de oro, Belén no tiene caminos: Una interpretación ideológica de las investigaciones financiadas por el Banco Mundial

Entre 1998 y 2001 realicé trabajo de campo en el Departamento de Belén, en el Oeste dela provincia de Catamarca (NOA), con el objetivo de caracterizar los cambios sociales y las consecuencias que el aprovechamiento del yacimiento minero Bajo de la Alumbrera produce en la localidad. Esta información fue sistematizada en mi tesis de maestría (Mastrangelo 2004) y me permitió precisar que, para completar la descripción de lo que pasaba localmente, era necesario incluir en el campo empírico además de a los pobladores locales y a la empresa, al Estado (provincial y nacional) y al Banco Mundial que estaban implementando la política de desregulación minera al mismo tiempo que establecían las condiciones para lo que denominan “una minería sustentable”. Así fue que tomando entrevistas a funcionarios del Banco Mundial y el Estado argentino comencé a participar de un proyecto de investigación ejecutado por el Banco Mundial y la República Argentina. El año de participación como “técnica” en el “proyecto del Banco” fue usado para realizar trabajo de campo etnográfico entre los funcionarios estatales y representantes del Banco Mundial. En la tesis presento la información allí recogida interpretada en base a conceptos teóricos sobre la política, la ideología y la hegemonía elaborados por CliffordGeertz (1997), MijailBajtin (1999), Ernesto Laclau (1996) y SlavojZizek (1992). El contenido se presenta en dos grandes secciones temáticas. En la primera de ellas Describo las características y los problemas que los pobladores de Belén atribuyen a la minera y las formas en que la empresa toma relación con ellos e interviene en la realidad local (contratando fuerza de trabajo, generando encadenamientos con la economía local y realizando donaciones). En la segunda me detengo en la descripción y el análisis de cómo esos problemas locales son interpretados por instituciones globalizantes (el Estado –- y el Banco Mundial), haciendo énfasis en las descripción de las prácticas y representacionesque acompañan la entrega de los créditos que el Banco Mundial otorgó al Estado argentino para la modernización de las instituciones públicas relacionadas con la minería (Proyectos PASMA I y II, préstamo de 69,5 millones de dólares desembolsados entre1995 y 2001).

Marcelo D. Boeri. Apariencia y realidad en el pensamiento griego: Investigaciones sobre aspectos epistemológicos, éticos y de teoría de la acción en algunas teorías de la Antigüedad . 1ª ed. Buenos Aires, Colihue, 2007, 384 pp.

El eje temático que orienta la dirección y sentido de este libro es el clásico 'problema' que advierte todo el pensamiento antiguo y que, desde diversas concepciones, ha intentado resolver lo que podríamos denominar el tema de la apariencia-realidad, o tal vez parecer-ser. El Dr. Boeri dirige su mirada hacia los pensadores clásicos griegos y helenísticos y penetra hondo en sus textos no con un interés meramente histórico, sino, como él mismo lo advierte, filosófico y sistemático.

Investigaciones en ciencias humanas y sociales : del ABC disciplinar a la reflexión metodológica

Diversidad de objetos, variedad de enfoques, prácticas disciplinares y multidisciplinares, y ejemplos de ejecución de proyectos de investigación y desarrollo son los rasgos distintivos de los siete capítulos que integran esta obra. En ellos se recoge el material desplegado en los Seminarios-Talleres de Metodología de la Investigación en Humanidades que se realizaron en el marco de las V Jornadas de Investigación de la Facultad de Filosofía y Letras de la Universidad Nacional de Cuyo en setiembre de 2004: estudios sobre procesos sociales, cuestiones educativas, geográficas, históricas, lingüísticas y literarias. Algunos capítulos han mantenido el estilo y formato característicos del contexto de los seminarios-talleres, a veces con ligeras modificaciones; otros han sido enteramente reescritos para la convocatoria de esta publicación. Este libro refleja entonces abordajes disciplinares y pluridisciplinares diversos a problemáticas igualmente variadas. Por tratarse de propuestas orientadas a y/o basadas en seminarios-talleres, está claro que los autores involucrados no pueden abarcar todos los aspectos de los objetos de estudio respectivos. Sin embargo, la idea es al menos brindar algún punto de vista sobre el estadio de desarrollo de algunas de las investigaciones actualmente en ejecución en nuestra Facultad.

Dominique Ionga-Prat, Iglesia y sociedad en la Edad Media, Instituto de Investigaciones Históricas, UNAM, 2010, ISBN: 978- 607-02-1216-1. 73 pp.

Fil: Mendoza, José María Felipe.

Sánchez Cuervo, Antolín y Ambrosio Velasco Gómez (coords.), Filosofía política de las independencias latinoamericanas. Madrid, Biblioteca Nueva / Consejo Superior de Investigaciones Científicas, 2012, 281 págs.

Fil: Ribas, Pedro. Universidad Autónoma de Madrid