A metagenomic-based study of two sites from the Barbadian reef system.

We study the microbiome of sea water collected from two locations of the Barbadian coral reefs. The two sites differ in several environmental and ecological variables including their endogenous benthic community and their proximity to urban development and runoffs from inland watersheds. The composition of the microbial communities was estimated using whole genome DNA shotgun sequencing with adjuvant measurements of chemical and environmental qualities. Although both sites exhibit a similar degree of richness, the less urbanized site (Maycocks reef at Hangman's Bay) has a strong concentration of phototrophs whereas the more urbanized location (Bellairs reef at Folkstone) is enriched for copiotrophs, macroalgal symbionts and marine-related disease-bearing organisms from taxa scattered across the tree of life. Our results are concordant with previous profiles of warm ocean surface waters, suggesting our approach captures the state of each coral reef site, setting the stage for longitudinal studies of marine microbiome dynamics in Barbados. Supplementary Information: The online version contains supplementary material available at 10.1007/s00338-022-02330-y.

Incontinencia urinaria de urgencia en mujeres adultas: ¿Qué tratamientos ofrecer en APS? / Emergency Urinary Incontinence in Adult Women: what treatments do we offer at PHC?

La incontinencia urinaria de urgencia corresponde a la pérdida involuntaria de orina, cuya causa es presumida multifactorial: hiperactividad del detrusor, hipersensibilidad vesical y distensibilidad reducida del detrusor. Esta patología es bastante frecuente tanto en Chile como en el mundo, con una prevalencia local entre 10% y 15%, a su vez genera un gran impacto en el bienestar físico, mental y socioeconómico del paciente. El diagnóstico es clínico, con apoyo en el uroanálisis y su tratamiento de primera línea puede ser realizado en APS. En cuanto al tratamiento existen tanto terapias no farmacológicas como farmacológicas; correspondiendo las técnicas de reentrenamiento vesical, los cambios de estilo de vida y los fármacos anticolinérgicos a tratamientos efectivos de primera línea. Existen, además, otros fármacos que pueden ser utilizados para el tratamiento de la IUU, cuya evidencia será igualmente revisada en este artículo.

Urge incontinence is defined as an involuntary leakage of urine, presumably with a multifactorial cause: detrusor overactivity, bladder hypersensibility and a reduced bladder compliance. It's a common disease worldwide, with local studies reporting a prevalence around 10-15%, causing a great impact in the physical, mental and socioeconomic well-being of the affected patients. Diagnosis is mainly based on the clinical history, supporting it with laboratory tests to rule out other conditions, and uncomplicated cases can be treated and followed in a primary care setting. There are pharmacologic and non-pharmacologic therapies, being healthy lifestyles changes, bladder retraining programs and anticholinergic drugs the first line of treatment. Additional pharmacologic treatments will be revised in this article.

Arteritis de Takayasu: informe de un caso con compromiso supraaórtico y tratamiento quirúrgico / Takayasu's arteritis: report of a case with supraaortic compromise and surgical treatment

La arteritis de Takayasu es una vasculitis inflamatoria crónica de grandes vasos. Fue descrita por primera vez por el oftalmólogo japonés Nikito Takayasu, en el año 1908. Presentamos un caso de arteritis de Takayasu, diagnosticada clínicamente de acuerdo a los criterios del American College of Rheumatology de 1990. Se trata de una paciente de 23 años que ingresa al Hospital Regional de Talca por un accidente vascular encefálico hemisférico y sintomatología de robo subclavio. Se realiza un angio TAC que muestra compromiso severo (oclusión total) del tercio medio y distal del tronco braquiocefálico, carótida común derecha e inicio de la subclavia derecha. Además, este examen demuestra un flujo retrógrado en la arteria vertebral derecha, compatible con el síndrome de robo subclavio. Se decide corregir la oclusión subclavia mediante angioplastía, sin éxito tanto en el abordaje anterogrado como retrógrado. Finalmente se opta por un bypass protésico (politetrafluoroetileno expandido) desde la carótida común izquierda a la subclavia derecha a través de un túnel subcutáneo en la cara anterior del cuello.

Takayasu's arteritis is a chronic inflammatory vasculitis of large vessels. It was first identified by Japanese ophthalmologist Nikito Takayasu, in 1908. A case of Takayasu's arteritis is presented, clinically diagnosed according to the criteria of the American College of Rheumatology of 1990. This is a 23 year oíd patient, entering Talca's Regional Hospital for a stroke, also presenting symptoms of subclavian steal. An angio CT was made, showing severe commitment (total occlusion) in the middle and distal third of the brachiocephalic trunk, right common carotid and the beginning of right subclavian artery. In addition, this test shows retrograde flow on the right vertebral artery, compatible with the subclavian steal syndrome. It was decided to correct the subclavian occiusion through angioplasty, without success, in both the anterograde and retrograde approach; finally opting for a prosthetic bypass (expanded polytetrafluoroethylene) from left common carotid to right subclavian artery through a tunnel of the subcutaneous front of the neck.

[Cochlear implants in Aragón]. / Diez años de implantación coclear en Aragón.

Cochlear implants are, actually, one of the major advances in the treatment for profound deafness. His use is, already, a routine in the daily practice of our specialty. Due to its special aspects, cochlear implants have to be done following a protocol that organizes and coordinates the different aspects of the diagnoses and treatment of profound deafness, in the different administrative and geographical fields. The health system in our country and the smale dimension of our area, has taken us to create and follow a special program in which all the available resources are used. Following this protocol, we have performed 63 cochlear implants, in the last 10 years. We show here the results and complications.

[Design and performance of a laboratory of olfactory test. Application of a new evaluation system]. / Diseñio y realización de un laboratorio de olfatometría. Aplicación de un nuevo sistema de valoración.

BACKGROUND: To study and evaluate the factors that may influence on human olfactory sensibility to pyridine, we designed a specific laboratory with a new olfactory test to perform accurate measurements. METHODS: We have chosen pyridine as the test substance in our laboratory, for its frequent use of it in other studies. The special conditions of our laboratory are designed to allow individuals to access to this substance, controlling the different factors and parameters. With this purpose, we have validated the test and we have settled the reference threshold values with the score of thirty voluntary healthy patients between 20 and 40 years of age. RESULTS: We have used four different concentrations of pyridine to study the different factors of olfactory sensibility. 95% of cases detected the highest pyridine concentration and the remaining concentrations allowed us to know the olfactory sensibility of the studied population and the inferior thresholds. CONCLUSIONS: We have designed, performed and endorsed a laboratory for the study of olfaction. We have determined the sensibility of the studied population to different concentrations of pyridine that can be considered as a reference for further studies.

[Laryngeal chondro-radionecrosis]. / Condrorradionecrosis laríngea.

Laryngeal chondroradionecrosis is a complication following radiotherapy for laryngeal tumours that may appear many years after the treatment. We present the case of a 78 year old man, that come to the Accident and Emergency department with a prelaryngeal mass and hemoptysis. He had been treated 17 years before with radiotherapy for a vocal cond carcinoma. Posteriorly the lesion did a cutaneous fistula with complete laryngeal exposition and torpid evolution. Post-radiotherapy necrosis in the larynx is a serious complication though not a common one. A tumour recurrence needs to be excluded and even in this case a total laryngectomy is mandatory as it will end in total loss of laryngeal function.

Human E2F5 gene is oncogenic in primary rodent cells and is amplified in human breast tumors.

E2F transcription factors (E2F1 to 6) are central players in the control of animal cell proliferation as regulators of genes involved in cell cycle progression and in transformation. In this report, we have investigated the potential involvement of the E2F5 gene in tumorigenesis. We show that E2F5 can promote the formation of morphologically transformed foci in primary baby rat kidney cells (BRK) when it is overexpressed in the presence of its heterodimeric partner DP1 and activated RAS. This suggests that E2F5 behaves like a MYC-type cooperating oncogene in functional assays, prompting us to monitor potential amplifications of the E2F5 gene in primary human tumors. We mapped the human E2F5 gene to 8q21.1-21.3 equidistant from the MOS (8q12) and MYC (8q24) oncogenes. Since the long arm of chromosome 8 is frequently the site of increased gene copy number (ICN) in breast cancer, we screened 442 breast tumor DNAs for gains of E2F5, MOS, and MYC genes. The three genes showed ICN, albeit at variable incidence and levels of amplification, with the ICN of E2F5 occurring concomitantly with those of MOS and/or MYC in almost half of the cases. Moreover, a marked increase of the 2. 5-kb E2F5 transcript was also detected in some tumors and tumor cell lines. In conclusion, the evidence that sustained unregulated expression of E2F5 can cooperate with other oncogenes to promote cell transformation in functional assays, together with the detection of chromosomal amplifications and overexpressions of the E2F5 gene in breast tumors, provides the first indications that E2F5 deregulation may have a role in human tumor development.

[An analysis of the tumor growth rate in neuroma of the VIII cranial nerve using a digital image analysis system]. / Análisis de la tasa de crecimiento tumoral en el neurinoma del VIII par mediante la aplicación de un sistema de análisis digital de imágenes.

A digital image analysis system was used in a retrospective analysis of MRI findings in 9 patients with acoustic neuroma. Maximum and minimum tumor diameters and surface area were measured and tumor volume was calculated. All studies included intravenous injection of gadolinium (Gd-DTPA or DOTA) and axial and coronal sections. Tumoral growth rate was analyzed using the increase in tumor size ( T) tumor area doubling time (ADT), and tumor volume doubling time (VDT). The purpose of this study was to document the growth rate of acoustic neuromas with periodic MRI. In an era in which preservation of hearing and the facial nerve is a goal of acoustic neuroma surgery, knowledge of tumor growth rate should improve patient care.

[Evaluation with acoustic rhinometry of surgical results in patients undergoing septoplasty]. / Evaluación mediante rinometría acústica de los resultados quirúrgicos en pacientes intervenidos de septoplastia.

We used acoustic rhinometry to evaluate the surgical results of septoplasty in patients with nasal respiratory insufficiency caused by morphological abnormalities of the nasal septum. Acoustic rhinometry is a relatively new exploration method for the nasal cavity that yields objective spatial measurements. These measurements are the cross sections and volumes of the nasal cavity divided longitudinally into two regions, an anterior region up to 32 mm from the nasal orifices and the posterior region, up to 64 mm from the same point. We studied 45 patients with nasal respiratory insufficiency who had undergone septoplasty. Measurements were made before and after surgery. Our results show a clear increase in nasal sections and volumes after surgery. They confirm the benefits of acoustic rhinometry as a method for quantifying morphological abnormalities of the nasal cavity.

In breast cancer, amplification of the steroid receptor coactivator gene AIB1 is correlated with estrogen and progesterone receptor positivity.

The AIB1 gene was isolated upon microdissection of the homogeneously staining regions observed in breast cancer cell lines. It was subsequently shown to map at a region at 20q12 that is frequently amplified in breast tumors. In a screen of breast tumor cell lines, of all the genes mapping to the region, AIB1 appeared to be the most consistently amplified and overexpressed. AIB1 shares homology with the SRC-1 family of nuclear receptor coactivators. It was found to interact in a ligand-dependent manner with the estrogen receptor (ER) and to result in increased levels of estrogen-dependent transcription. These properties could be of important biological significance in breast and ovarian cancerigenesis, and we were, therefore, interested in determining whether the amplification of the AIB1 gene was associated with a particular phenotype or subgroup in these tumors. We tested a population of 1157 breast and 122 ovarian tumors in which DNA amplification had been determined previously at 15 chromosomal locations. Amplification of the AIB1 gene was observed in 4.8% of breast cancers and 7.4% of ovarian cancers. In breast tumors, AIB1 was correlated with ER and progesterone receptor positivity, as well as with tumor size. Correlation was also observed with the amplification of MDM2 and FGFR1 genes, but interestingly, no correlation was found with the amplification of CCND1, which is known to be strongly associated with ER. Furthermore, analyzing at 20q12-q13 range, we show the existence of three amplification cores, represented by AIB3/AIB4, AIB1, and RMC20C001. AIB1 and CCND1 amplifications may, thus, represent two different subsets of ER-positive breast tumors.

Relaxed cell-cycle arrests and propagation of unrepaired chromosomal damage in cancer cell lines with wild-type p53.

The role of the p53 protein in mediating G1 and G2 cell-cycle arrests after genotoxic insult has been clearly and reproducibly established in primary diploid fibroblasts, but data obtained from p53 wild-type (wt) cancer cell lines are inconsistent. Furthermore, a large proportion of human tumors have p53 wt genotypes but present genetic aberrations that may result from defective cell-cycle checkpoints. We therefore investigated the integrity of G1/S and G2/M cell-cycle arrests in p53 wt cancer cell lines. In the study presented here, we showed that in most cancer cells tested, G1 arrest was relaxed or absent in comparison with arrest in normal diploid fibroblasts, despite seemingly normal p53 and p21 responses. Two cell lines (MCF7 and HCT116) were synchronized in G0/G1 by leucine starvation and subjected to genotoxic stress to determine more precisely the relative proportion of cells arresting in G1 and G2. Whereas the MCF7 cells showed consistent G1 arrest, the HCT116 cells showed none at all. Furthermore, cell-cycle arrests in G1 and G2 in response to gamma irradiation and bleomycin treatment were transient, as the cells resumed cycling after 48-72 h. The cells resuming proliferation suffered massive apoptosis, but a proportion of the cells were rescued and showed normal doubling times. These cells retained a p53 wt genotype but presented gross chromosomal aberrations in 15-20% of the analyzed metaphases. The aberrations were not clonal. These data show that p53 wt cancer cells have relaxed cell-cycle controls after genotoxic insult and tolerate unrepaired chromosomal damage, despite normal p53 function.

[Experimental microsurgery of the facial nerve: end-to-end suture versus approximated ends wrapped with masseter muscle aponeurosis]. / Microcirugía experimental del nervio facial: sutura término-terminal versus envoltura de los extremos aproximados con manguito de aponeurosis de músculo masetero.

As an alternative to end-to-end facial nerve microsurgery, we propose anastomosis of the sectioned nerve ends and wrapping with ipsilateral masseter fascia. This intervention was performed on the right facial nerve of 20 Wistar rats and compared with classical end-to-end anatomosis performed on the left nerve of the same rats. At the end of the experiment, histological studies were made of each nerve removed "en bloc" with the ipsilateral lip orbicular muscle. Five micra-thick sections were stained using conventional and immunohistochemical methods. We analyzed truncal integrity, fibroblast proliferation, demyelination, lymphocyte proliferation, granulomatous reaction, and muscle degeneration in both types of anastomosis. The differences between the two types of anastomosis were statistically non-significant, and both interventions produced similar functional results. Small differences between the techniques might condition the use of one or the other in selected cases.

Short report: one case of nasal human myiasis caused by third stage instar larvae of Oestrus ovis.

This is a report of a case of human nasal myiasis caused by third instar larvae of the sheep nasal bot fly, Oestrus ovis. Female flies rarely deposit first instar larvae in the eye, nostrils, and external auditory canal of humans, where they usually survive only a few days without further development. One human infestation by third instar larvae of O. ovis has been recorded in an patient infected with human immunodeficiency virus (HIV) in the United Kingdom. Our report describes a new case of nasal myiasis caused by the third instar larvae of the sheep bot fly in a patient without HIV or signs of any other disease.

[Perceptive deafness and AIDS]. / Hipoacusia perceptiva y SIDA.

We report a case of a 23 years old woman HIV positive for the past five years with a four year history of right perceptive hypoacusia evolution without tinitus, vertigo or any other otologic symptomatology. After reviewing her personal and family history and conducting imilar tonal audiometry, tympanometry bilateral, contralateral estapedial reflex, auditory evoked brain stem response and a bilateral nasal fiberendoscopy, we analyzed the evolution of her immunal deficiency and the treatments to which she has been submitted with the purpose of determining the risk factors that have coincided in this case to be able to establish some criteria to follow the auditive affect in HIV positive patients.

[Sinus manifestations of the acquired immunodeficiency syndrome]. / Manifestaciones sinusales del síndrome de inmunodeficiencia adquirida.

OBJECTIVE: We decided to review the different disorders which may affect the paranasal sinuses in the course of the acquired immuno-deficiency syndrome, and the most suitable treatment for them. DEVELOPMENT: Involvement of the paranasal sinuses is not particularly common in the acquired immuno-deficiency syndrome. The commonest disorder is sinusitis. Also seen are lymphomas no-Hodgkin, small cell, Burkitt's or no Burkitt and immunoblastic. Cases of Kaposi's sarcoma or malignant tumors such as a schwannoma may appear. In our hospital, an HIV+ patient presented with a frontal cerebral abscess which had developed from sinusitis of the whole left paranasal sphere. We have therefore reviewed 150 histories of HIV+ patients and the relevant literature available. CONCLUSIONS: Only in 3.3% of the HIV+ patients reviewed did sinusitis develop during the course of their illness. In one of these, there was intracranial spread of infection with the appearance of cerebral abscess following infection by Streptococcus milleri. We emphasize the review of the literature dealing with sinus pathology in these patients. On many occasions diagnosis was not made since it was masked by other infections. Cure is difficult and relapses are frequent in spite of suitable treatment and are associated with decline in immunocompetence.

[Current status and clinical experience in the treatment of tracheobronchial stenoses with self-expanding metallic stents]. / Estado actual y experiencia clínica en el tratamiento de las estenosis traqueobronquiales con prótesis metálicas autoexpandibles.

The development of symptomatic stenosis in the bronchial tree can lead to high risk asphyxia. The implantation of metallic prostheses (stents) can provide palliative resolution of stenosis and alleviate the acute symptoms of these patients. We assess the efficacy of expandable metallic stents for treating various types of tracheobronchial stenosis. Sixteen Wallstent type expandable metallic prostheses were implanted in 16 patients with tracheobronchial stenosis (12 malignant and 4 benign) in the interventional radiology unit under fluoroscopic and endoscopic guidance. The prostheses were placed correctly and no complications were observed, such that symptoms improved immediately. Three patients with post-intubation stenosis required additional treatment with laser therapy during follow-up examinations. All the patients with malignancies died from the underlying disease, but with open airways and no tracheal symptoms. Metallic prostheses are a valid alternative for palliative treatment of malignant tracheobronchial stenosis.

[Population-based study of exercise habits in the counties of Alt Camp and Conca de Barvera (Tarragona)]. / Estudio poblacional sobre el hábito de realizar ejercicio físico en las comarcas de Alt Camp y Conca de Barberà (Tarragona).

OBJECTIVE: To find the proportion of the adult population that practice physical exercise habitually. DESIGN: An observational study of a crossover nature. SETTING: The counties of Alt Camp and Conca de Barberà (Tarragona). PATIENTS AND OTHER PARTICIPANTS: A two-stage random sampling (stratified by age, gender and type of town) was performed on the different municipal registers in the counties and a representative sample of 672 people between 15 and 90 was extracted. INTERVENTIONS: By means of a home interview, a questionnaire to determine whether the interviewees practiced regular physical exercise was filled out (physical activity carried out in their free time, three or more days per week). MEASUREMENTS AND MAIN RESULTS: The most notable finding was that 47.3% of the whole sample practiced physical exercise (49.5% of men and 45.3% of women, NS). The youngest (15 to 29) were those who did most physical exercise (58.7%): this was statistically significant in comparison with the other age groups (p < 0.01). CONCLUSIONS: The results are comparable to those recorded in other studies in our country and could also serve as an indicator for those population-groups with similar demographic, socio-economic and cultural characteristics to our own.

[Otomycosis and topical application of thimerosal: study of 152 cases]. / Otomicosis y aplicación tópica de timerosal. Estudio de 152 casos.

PURPOSE: To evaluate the effectiveness of the topical application of Timerosal (merthilate tintura) in mycosis involving the external auditory canal. PATIENTS AND METHODS: The study includes 152 patients with the clinical, otoscopic and microscopic diagnosis of otomycosis. Results were assessed 72 hours and 10 days after the application. RESULTS: Bacteriological study was performed in 83 patients, finding Aspergilly niger in 54.0% of the cases, Candida albicans in 25.4%, Aspergillus fumigatus in 15.8% and Penicillium in 4.8%. Improvement at 72 h. was found in 66.4% and at 10 days in 93.4% of the patients. Bacteriological contamination was found in 6.6% of the total. COMMENTS: In most of the patients, the otomycosis healed after cleaning of the external auditory canal and topical application of timerosal. This method is easy to apply, fast, effective, of low cost and few side effects.

Sinonasal undifferentiated carcinoma invading the orbit.

Sinonasal undifferentiated carcinoma (SNUC) is an infrequent tumor described by Frierson et al. in 1986. Since its initial description, fewer than 100 patients have been reported. We present a case of a SNUC invading the orbit in a 57-year-old woman, for which the findings are documented by CT scan, light and electron microscopy.