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Abstract. The impact of Chagas disease is no longer restricted to endemic areas. The aim of this study is to evaluate a 2-year period of a vertical transmission screening program of Trypanosoma cruzi infection in a tertiary care hospital in Barcelona (Spain). Two enzyme-linked immunosorbent assays (recombinant and crude antigen) were performed in parallel to pregnant women at risk of T. cruzi infection. Discordant results were confirmed by a third diagnostic test. In the case of a positive result, the newborn was tested at birth and after 8 months of life. A total of 1,473 women met the inclusion criteria for the screening program with a resulting seroprevalence for T. cruzi of 3.5% (2.2-5.2% 95% confidence interval [95% CI]). One case of congenital infection was identified. Screening programs for vertically transmitted T. cruzi acute infection are beneficial in non-endemic areas for early detection and treatment of acute infection.

Here we provide updated pregnancy outcomes in alemtuzumab-treated female patients in phase 2 (CAMMS223 [NCT00050778]) and phase 3 (CARE-MS I [NCT00530348], CARE-MS II [NCT00548405]) studies. Patients received annual treatment courses of alemtuzumab and could enter an extension study (NCT00930553), with as-needed alemtuzumab retreatment (≥1 year apart). Pregnant/lactating patients were treatment-ineligible but remained on study for safety follow-up. As of July 1, 2015, 193 pregnancies occurred in 136 of 972 alemtuzumab-treated female patients; 167 were completed, 16 were ongoing, and 10 had unknown outcomes. Of completed pregnancies, 110 (66%) were live births with no congenital abnormalities or birth defects among 94 patients (at conception: mean age, 31.5 years; mean EDSS, 1.7; mean time since initial MS relapse, 6.6 years; mean time since last MS relapse, 3.5 years; mean time from previous alemtuzumab infusion, 27.9 months). There were 37 (22%) spontaneous abortions, 19 (11%) elective abortions, and 1 (0.6%) previously reported stillbirth. In alemtuzumab MS clinical studies, the most common pregnancy outcome was full-term live birth, with no evidence of teratogenicity to date. The rate of spontaneous abortion with alemtuzumab was comparable with rates observed in other MS patients and general populations. Ongoing surveillance is needed.Study supported by Sanofi Genzyme and Bayer Healthcare Pharmaceuticals.

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Desde el añ o 2007 se está n realizando distintos procedimientos en cirugía laparoendoscópica por puerto ú nico (laparoendoscopic single-site surgery), incluyendo nefrectomía, pieloplastia, adenomectomía prostá tica y, con el perfeccionamiento del instrumental laparoscó pico, prostatectomía radical. Presentamos nuestra experiencia inicial en prostatectomía radical laparoscó pica utilizando el dispositivo Single-Incision Laparoscopic Surgery Port s de Covidien y 2 trocares auxiliares de 5 mm colocados lateralmente para triangulació n. El Single-Incision Laparoscopic Surgery Port s permite una inserció n precisa y sencilla a travé s de una incisió n de Hadson. El puerto flexible contiene 3 cá nulas de 5 mm o 2 cá nulas de 5 mm y una de 12 mm para facilitar el intercambio de instrumental a travé s de la incisió n ú nica. Este abordaje disminuye la morbilidad por sangrado, hernias y/o lesió n de los ó rganos internos y mejora los resultados cosmé ticos. El puerto ú nico forma parte del desarrollo natural de la cirugía mínimamente invasiva. Se necesita má s experiencia para determinar los beneficios intra y postoperatorios de la cirugía laparoendoscó pica por puerto ú nico en comparació n con la laparoscopia convencional.