The umbilical cord is a perinatal tissue normally discarded after delivery that can be used as a source of different cell types with promising therapeutic potential. In this chapter, we discuss the use of different cell populations isolated from umbilical cord tissue and blood, which include hematopoietic stem cells/progenitors, mononuclear cells, and mesenchymal stem/stromal cells, as therapeutic agents for neurological disorders. We review the main preclinical studies and clinical trials based on umbilical cord derived cells in optic neuropathies and retinal diseases, stroke, and neurodegenerative diseases such as Parkinson's disease, Alzheimer's disease and amyotrophic lateral sclerosis.

Introduction and importance: Spigelian hernia is a rare abdominal wall hernia, representing 0.1 to 2 % of all ventral hernias. Clinically, the signs and symptoms are nonspecific and unclear.Case presentation: Here, we present a 69-year-old female patient, with abdominal bulging in both iliac fossae. Imaging exams suggested Spigelian hernia and right inguinal hernia. The treatment was surgical, with placement of polypropylene meshes and the patient had an uneventful postoperative evolution.Clinical discussion: The characteristics of this case corroborate the current literature, which points to a greater involvement of adults aged between 40 and 70 years. The treatment of choice is surgery, which can be open or videolaparoscopic, with placement of a mesh or primary suture.Conclusion: The clinical presentation of Spigelian hernia is not characteristic and its diagnosis should be sus-pected during the investigation of an abdominal mass.

The protrusion of adipose tissue, peritoneal sac or abdominal viscera in the anterolateral region of the abdomen can configure the so-called Spigelian hernia. A 53-year-old patient with comorbidities is admitted for reoperation of Spiegel's hernia. Aging and the presence of obesity, multiparity and previous surgery may have predisposed the appearance of this type of hernia. For recurrence, obesity may have been a contributing factor, although factors related to the surgical procedure and the hernia itself should also be considered. Spiegel's hernia is a rare abdominal hernia whose treatment is surgery, bearing in mind the risks of recurrence and the possibilities of mitigating them.

Objective: To assess the profile of patients hospitalized in a public Covid-19 referral center in Rio de Janeiro. Methods: An observational, cross-sectional, retrospective study was conducted at a public hospital during April 2021. 1413 patients with suspected Covid-19 were included in the study and data were collected from electronic medical records. Results: There was a predominance of older patients (59.12 years of age ± 13.79; mean ± SD) being hospitalized, with no significant male/female difference and the majority of patients came from emergency units. 44.09% of patients occupied intensive care beds. Out of those, 74.52% reported dyspnea, 49.68% had more than 50% pulmonary involvement and the most present chest CT finding was ground-glass opacity. 84.27% had some type of comorbidity and systemic arterial hypertension was the most reported one. The median time elapsed from the onset of symptoms to hospital admission was 8 days (IQR 6-11). Conclusion: Most of those hospitalized with Covid-19 in the analyzed period were elderly, of both sexes. The delay between the onset of symptoms and hospitalization, severe pulmonary involvement and the presence of comorbidities were identified in the records of patients with severe evolution.

Spontaneous pneumomediastinum is characterized by the accumulation of air in the mediastinum with no identified cause. It is a rare and self-limiting condition. We report the case of a 32-year-old female patient with controlled bronchial asthma, who presented with spontaneous pneumomediastinum, with no precipitating event. The evolution is generally benign and the treatment is conservative. Symptomatic medication may be instituted.

Ranulas are mucoceles that occur as a result of saliva's leakage from a sublingual gland, due to obstruction or trauma of its duct. Ranulas can either be confined to the floor of the mouth or invade submandibular and submental spaces. In this case, they are called plunging ranulas which are rarely found in children. The aim of this study is to report a case treated by our group and discuss its management.

Retina and/or optic nerve injury may cause irreversible blindness, due to degeneration of retinal ganglion cells. We and others have previously shown that the intravitreal injection of mesenchymal stem cells (MSCs) protects injured retinal ganglion cells and stimulates their regeneration after optic nerve injury, but the long-term effects of this therapy are still unknown. We injected rat MSC (rMSC) intravitreally in adult (3–5 months) Lister Hooded rats of either sex after optic nerve crush. Retinal ganglion cell survival, axonal regeneration, and reconnection were analyzed 60 and 240 days after crush by immunohistochemistry for Tuj1, anterograde labeling with cholera-toxin B and by immunohistochemistry for nerve growth factor-induced gene A (NGFI-A, driven by light stimulation) in the superior colliculus after a cycle of light deprivation-stimulation. Visual behaviors (optokinetic reflex, looming response, and preference for dark) were analyzed 70 days after crush. rMSC treatment doubled the number of surviving retinal ganglion cells, preferentially of a larger subtype, and of axons regenerating up to 0.5 mm. Some axons regenerated to the lateral geniculate nucleus and superior colliculus. NGFI-A+ cells were doubled in rMSC-treated animals 60 days after crush, but equivalent to vehicle-injected animals 240 days after crush, suggesting that newly formed synapses degenerated. Animals did not recover visual behaviors. We conclude that rMSC-induced neuroprotection is sustained at longer time points. Although rMSCs promoted long-term neuroprotection and long-distance axon regeneration, the reconnection of retinal ganglion cells with their targets was transitory, indicating that they need additional stimuli to make stable reconnections.