IntroductionThe administration of stem cells holds promise as a potential therapy for spinal cord injury (SCI). Mesenchymal stem cells have advantages for clinical applications, since they can be easily obtained, are suitable for autologous transplantation and have been previously shown to induce regeneration of the spinal cord in experimental settings. Here we evaluated the feasibility, safety and potential efficacy of autologous transplantation of mesenchymal stem cells in subjects with chronic complete SCI.MethodWe conducted a phase I, non-controlled study in 14 subjects of both genders aging between 18 to 65 years, with chronic traumatic SCI (>6 months), at thoracic or lumbar levels, classified as American Spinal Injury Association (ASIA) A - complete injury. Baseline somatosensory evoked potentials (SSEP), spinal magnetic resonance imaging (MRI) and urodynamics were assessed before and after treatment. Pain rating was performed using the McGill Pain Questionnaire and a visual analogue score scale. Bone marrow-derived mesenchymal stem cells were cultured and characterized by flow cytometry, cell differentiation assays and G-band karyotyping. Mesenchymal stem cells were injected directly into the lesion following laminectomy and durotomy.ResultsCell transplantation was an overall safe and well-tolerated procedure. All subjects displayed variable improvements in tactile sensitivity and eight subjects developed lower limbs motor functional gains, principally in the hip flexors. Seven subjects presented sacral sparing and improved American Spinal Injury Association impairment scale (AIS) grades to B or C – incomplete injury. Nine subjects had improvements in urologic function. One subject presented changes in SSEP 3 and 6 months after mesenchymal stem cells transplantation. Statistically significant correlations between the improvements in neurological function and both injury size and level were found.ConclusionIntralesional transplantation of autologous mesenchymal stem cells in subjects with chronic, complete spinal cord injury is safe, feasible, and may promote neurological improvements.Trial registrationClinicalTrials.gov NCT01325103 – Registered 28 March 2011

Abstract. Zika virus (ZIKV) is an emerging flavivirus, which has caused a widespread outbreak in the Americas.

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RESUMO -Objetivo: descrever as características clínicas e laboratoriais da meningite piogênica em lactentes. Método: informações obtidas a partir do acompanhamento prospectivo dos lactentes com meningite piogênica, admitidos no Hospital Couto Maia no período de março a dezembro de 1997, foram inseridas em um banco de dados e analisadas com auxílio de programas estatísticos. Resultados: meningite piogênica foi mais prevalente em lactentes com idade entre 6 meses e 1 ano, sendo o agente etiológico mais freqüente o Haemophilus influenzae. A letalidade global foi de 25,9% e, entre os sobreviventes, 39,3% deixaram o hospital apresentando alguma anormalidade compatível com envolvimento encefálico ao exame neurológico. Conclusão: meningite piogênica em lactentes se constitui em enfermidade com taxa de letalidade elevada, sendo, na maioria dos casos, passível de prevenção. Consideramos de grande relevância a adoção de medidas profiláticas de saúde visando redução da incidência desta enfermidade.PALAVRAS-CHAVE: meningite piogênica, meningite bacteriana, lactentes, crianças. Clinical and laboratorial aspects of acute bacterial meningitis in infantsABSTRACT -Objective: to describe clinical and laboratorial characteristics of acute bacterial meningitis in infants. Method: data from the prospective follow-up of infants with acute bacterial meningitis, admitted at the Hospital Couto Maia between March and December 1997, were analyzed with specific statistical software. Results: acute bacterial meningitis was more prevalent in infants with ages varying from 6 months to 1 year. The most frequent etiologic agent was Haemophilus influenzae. The global lethality was 25.9% and among the survivors 39.3% left the hospital with some abnormality in the neurological exam compatible with the brain involvement. Conclusion: acute bacterial meningitis in infants is a high lethality disease that in the majority of cases can be prevented. We consider of great relevance the adoption of health prevention strategies in order to reduce the incidence of this disease.