Search

Introduction Ventriculo-peritoneal shunt (VPS) related ascites is a rare complication of pediatric low grade gliomas (pLGG). Physiopathology of this complication is not fully understood and there is paucity of data regarding the molecular profile of pLGG gliomas complicating with ascites and the optimal management of this unusual event. Methods International multi-institutional retrospective analysis of patients diagnosed with BRAF altered pLGG and ascites arising as a complication of VPS. Demographics, tumor characteristics, therapeutic approaches and outcomes were recorded. Results Nineteen patients were identified. Median age at diagnosis was 14 months (R: 2-144). Most patients (17; 89.4%) presented with lesions involving the optic pathway. Mean tumor standard volume was 34.8 cm(2) (R: 12.5-85.4). Pilocytic Astrocytoma was the most frequent histological diagnosis (14;7 3.7%). Eight (42.1%) tumors harbored BRAF V600-E mutation and seven (36.8%) KIAA1549 fusion. The onset of ascites was documented at a median time of 5 months following VPS insertion. Four (21%) patients were managed with paracentesis only, 7(36.8%) required both paracentesis and shunt diversion, 7(36.8%) required only a shunt diversion and 1 (5.2%) patient was managed conservatively. Chemotherapy regimen was changed in 10 patients following ascites. Eight patients received targeted therapy (4 dabrafenib/4 trametinib) and 5 were radiated. There were eleven survivors with a median OS of 69 months (R: 3-144). Conclusions Ascites is an early feature in the clinical course of young patients with midline BRAF altered pLGG, with high mortality rate observed in our cohort. The hypothesis of ascites as an adverse prognostic factor in pLGG warrants further prospective research.

Study Region: The area of interest comprises 1.6 million km² of the Horn of Africa, extending 60 km offshore the Gulf of Aden and Indian Ocean, and delimited by the Tana River in Kenya and the Rift Valley in Ethiopia. Study Focus: Deep (> 400 m) groundwater resources are virtually unexplored in the Horn of Africa. One of the main challenges in this vast and sparsely documented area, is producing solid geological models. This paper presents a first-order assessment of the deep structure and water resources in the region, based on the integration of data from hydrogeological and Oil & Gas exploration. Public domain cross-sections, geological maps, and satellite data are reinterpreted, defining the extent of formations in the subsurface. The data integration benefits from using a multi-source modelling platform, subsurface mapping software from the Oil & Gas and hydrogeology sectors, and proprietary scripts. New Hydrological Insights: The present study reveals new evidence of the presence of deep aquifer systems in the Horn of Africa. The model outputs include the extent, predicted thickness, salinity, and petrophysical properties of the potential aquifers. The results of this first extensive 3D subsurface model for the region provide new hydrogeological insights into potential transboundary aquifers and can be used as a baseline for further investigations and, ultimately, for quantifying the total water resources in the region.

Complex marine−terrestrial interactions characterize Chilean fjords, where benthic communities influence the distribution of organic matter (OM). We examined spatial and seasonal changes in the hydrography, sediment conditions and soft-bottom macrobenthic

Objective Many low- and middle-income countries (LMICs) are ill equipped to care for the large and growing burden of vascular conditions. We aimed to develop essential vascular care recommendations that would be feasible for implementation at nearly every setting worldwide, regardless of national income. Methods The normative Delphi method was used to achieve consensus on essential vascular care resources among 27 experts in multiple areas of vascular care and public health as well as with experience in LMIC health care. Five anonymous, iterative rounds of survey with controlled feedback and a statistical response were used to reach consensus on essential vascular care resources. Results The matrices provide recommendations for 92 vascular care resources at each of the four levels of care in most LMICs, comprising primary health centers and first-level, referral, and tertiary hospitals. The recommendations include essential and desirable resources and encompass the following categories: screening, counseling, and evaluation; diagnostics; medical care; surgical care; equipment and supplies; and medications. Conclusions The resources recommended have the potential to improve the ability of LMIC health care systems to respond to the large and growing burden of vascular conditions. Many of these resources can be provided with thoughtful planning and organization, without significant increases in cost. However, the resources must be incorporated into a framework that includes surveillance of vascular conditions, monitoring and evaluation of vascular capacity and care, a well functioning prehospital and interhospital transport system, and vascular training for existing and future health care providers. © 2016 Society for Vascular Surgery

Objective: Two clobazam aqueous suspensions for paediatric oral usage (5 mg/ml) were investigated to determinate its physicochemical stability under different storage conditions. Method: Formulations were stored at 4 and 25 ºC and the clobazam content was determined by High Performance Liquid Chromatography. Each sample was analyzed by triplicate at different time points (0, 7, 14, 28 and 56 days). Results: Liquid suspensions were successfully formulated from pure drug and commercially available tablets. In both cases, samples showed suitable physical stability. Clobazam was chemically stable in aqueous suspension during the 56 days of the study at the two storage temperatures. Conclusions: All the tried oral liquid formulations can be conserved at 4 and 25 ºC at least 56-day period. Objetivo: Dos suspensiones orales acuosas de clobazam para uso pediátrico (5 mg/ml) fueron evaluadas para determinar su estabilidad fisicoquimica bajo diferentes condiciones de almacenamiento. Métodos: Las formulaciones fueron conservadas a 4 y 25 ºC y el contenido de clobazam fue determinado mediante Cromatografía Líquida de Alta Performance. Cada una de las muestras fue analizada por triplicado a diferentes tiempos (0, 7, 14, 28 y 56 días). Resultados: Las suspensiones fueron formuladas satisfactoriamente a partir del principio activo puro y de comprimidos disponibles comercialmente. En ambos casos, las muestras presentaron una adecuada estabilidad física. El clobazam fue químicamente estable en las suspensiones acuosas durante los 56 días de duración del estudio a las dos temperaturas elegidas para su conservación. Conclusiones: Todas las formulaciones orales líquidas formuladas y evaluadas en este estudio pueden ser conservadas a 4 y 25 ºC por al menos 56 días.

Dos suspensiones orales acuosas de clobazam para uso pediátrico (5 mg/ml) fueron evaluadas para determinar su estabilidad fisicoquimica bajo diferentes condiciones de almacenamiento. Two clobazam aqueous suspensions for paediatric oral usage (5 mg/ml) were investigated to determinate its physicochemical stability under different storage conditions. Fil: Buontempo, Fabian. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Tecnología Farmacéutica; Argentina; Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina; Fil: Moretton, Marcela Analía. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Tecnología Farmacéutica; Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina; Fil: Quiroga, E.. Colegio de Farmacéuticos de la Provincia de Buenos Aires; Argentina; Fil: Chiappetta, Diego Andrés. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Tecnología Farmacéutica; Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina