Clinical Presentation and Perioperative Management of Pheochromocytomas and Paragangliomas: A 4-Decade Experience.

PURPOSE: Latin American reports on pheochromocytomas and paragangliomas (PPGLs) are scarce. Recent studies demonstrate changes in clinical presentation and management of these patients. Herein, we assessed the main characteristics of PPGL patients in our academic center over the past 4 decades. METHODS: Demographic, clinical, biochemical, and perioperative data from 105 PPGL patients were retrospectively and prospectively collected over the 1980-2019 period. Data were organized into 4 periods by decade. RESULTS: Age at diagnosis, gender, tumor size and percentage of bilaterality, percentage of paragangliomas, and metastases remained stable across the 4 decades. The proportion of genetic testing and incidentalomas increased in recent decades (all P < 0.001). Therefore, we compared PPGLs diagnosed as incidentalomas (36%) with those clinically suspected (64%). Incidentalomas had fewer adrenergic symptoms (38 vs. 62%; P < 0.001) and lower rates of hypertension (64% vs. 80%; P = 0.01) and hypertensive crisis (28% vs. 44%; P = 0.02); also, they had lower functionality (79% vs. 100%; P = 0.01) and lower catecholamines levels (8.4-fold vs. 12.5-fold above upper cutoffs; P = 0.04). Regarding management of all PPGLs over the decades, we observed significant increases in both perioperative doxazosin dose (P = 0.003) and laparoscopic approach rates (P < 0.001), along with a decrease in the length of hospital stays (P = 0.007). CONCLUSIONS: We observed a change in the clinical presentation of PPGL in recent decades, with a marked increase in incidental cases and milder symptoms. The implementation of a multidisciplinary program for adrenal disorders in our institution has translated into more timely diagnoses, more genetic testing, and improvements in perioperative management.

North American matsutake: names clarified and a new species described.

Tricholoma matsutake, known widely as "matsutake," has great commercial and cultural significance in Japan. Because Japanese production is insufficient to meet the high domestic demand, morphologically similar mushrooms, thought by many to belong to T. magnivelare, are imported from western North America. However, molecular data produced since the early 2000s have indicated that more than one species of matsutake occur in North America and this raises the question of correct naming for the different species. To address this question, we assessed the phylogenetic diversity within North American matsutake based on nuc rDNA ITS1-5.8S-ITS2 (internal transcribed spacer [ITS] barcode) sequences, including newly obtained sequences from the type collections for Agaricus ponderosus and Armillaria arenicola, and morphological characters. Our results agree with earlier indications that three matsutake species occur in North America and allow us to clarify the correct application of names-T. magnivelare from the eastern USA and Canada, T. murrillianum from the western USA and Canada, and T. mesoamericanum from Mexico, newly described here. The existence of the three North American species is further supported by the results of evolutionary divergence analysis, geographical distributions, and morphological characters.

The importance of molecular analyses for understanding the genetic diversity of Histoplasma capsulatum: an overview.

Advances in the classification of the human pathogen Histoplasma capsulatum (H. capsulatum) (ascomycete) are sustained by the results of several genetic analyses that support the high diversity of this dimorphic fungus. The present mini-review highlights the great genetic plasticity of H. capsulatum. Important records with different molecular tools, mainly single- or multi-locus sequence analyses developed with this fungus, are discussed. Recent phylogenetic data with a multi-locus sequence analysis using 5 polymorphic loci support a new clade and/or phylogenetic species of H. capsulatum for the Americas, which was associated with fungal isolates obtained from the migratory bat Tadarida brasiliensis. This manuscript is part of the series of works presented at the "V International Workshop: Molecular genetic approaches to the study of human pathogenic fungi" (Oaxaca, Mexico, 2012).

Evolutionary consequences of putative intra-and interspecific hybridization in agaric fungi.

Agaric fungi of the southern Appalachian Mountains including Great Smoky Mountains National Park are often heterozygous for the rDNA internal transcribed spacer region (ITS) with >42% of collections showing some heterozygosity for indels and/or base-pair substitutions. For these collections, intra-individual haplotype divergence is typically less than 2%, but for 3% of these collections intra-individual haplotype divergence exceeds that figure. We hypothesize that high intra-individual haplotype divergence is due to hybridization between agaric fungi with divergent haplotypes, possibly migrants from geographically isolated glacial refugia. Four species with relatively high haplotype divergence were examined: Armillaria mellea, Amanita citrina f. lavendula, Gymnopus dichrous and the Hygrocybe flavescens/chlorophana complex. The ITS region was sequenced, haplotypes of heterozygotes were resolved through cloning, and phylogenetic analyses were used to determine the outcome of hybridization events. Within Armillaria mellea and Amanita citrina f. lavendula, we found evidence of interbreeding and recombination. Within G. dichrous and H. flavescens/chlorophana, hybrids were identified but there was no evidence for F2 or higher progeny in natural populations suggesting that the hybrid fruitbodies might be an evolutionary dead end and that the genetically divergent Mendelian populations from which they were derived are, in fact, different species. The association between ITS haplotype divergence of less than 5% (Armillaria mellea = 2.6% excluding gaps; Amanita citrina f. lavendula = 3.3%) with the presence of putative recombinants and greater than 5% (Gymnopus dichrous = 5.7%; Hygrocybe flavescens/chlorophana = 14.1%) with apparent failure of F1 hybrids to produce F2 or higher progeny in populations may suggest a correlation between genetic distance and reproductive isolation.

Evaluation of the degree of mycophilia-mycophobia among highland and lowland inhabitants from Chiapas, Mexico.

BACKGROUND: Mushrooms generate strong and contrasting feelings ranging from extreme aversion to intense liking. To categorize these attitudes, Wasson and Wasson coined the dichotomic terms "mycophilia" and "mycophobia" in 1957. In Mesoamerica these categories have been associated to ecological regions. Highland peoples are viewed as mycophiles, whereas lowland inhabitants are considered mycophobes. However, this division is based on little empirical evidence and few indicators. This study questioned whether mycophilia and mycophobia are indeed related to ecological regions through the evaluation of 19 indicators tested in the highlands and lowlands of Chiapas, Mexico. METHODS: The heterogeneity of attitudes toward mushrooms was explored in terms of ecological region and sociocultural variables. Information was obtained through structured interviews in 10 communities in Los Altos de Chiapas (highlands) and the Selva Lacandona (lowlands). We analyzed indicators separately through χ2 tests and multivariate techniques. The Mycophilia-Mycophobia Index was also used in the analysis. To assess which factors better explain the distribution of attitudes, we built 11 models using the Beta probability-density function and compared them with the Akaike Information Criterion. RESULTS: Most people had positive attitudes in both ecological regions. The classification and ordination analyses found two large groups comprising both highland and lowland towns. Contrary to expectation if mycophilia and mycophobia were mutually exclusive, all the fitted probability distributions were bell-shaped; indicating these attitudes behave as a continuous variable. The model best supported by data included occupation and ethnicity. Indigenous peasants had the highest degree of mycophilia. DISCUSSION: Results suggest the studied populations tend to be mycophilic and that their attitudes are not dichotomic, but rather a gradient. Most people occupied intermediate degrees of mycophilia. Despite there markable similarity in the degree of mycophilia between ecological regions, the Principle-Coordinates Analysis shows differences in the specific way in which people from either region establishes a cultural relationship with mushrooms. The comparison of models suggests that sociocultural variables explains the differences better than ecological regions do. The obtained results are evidence of mycophilia among lowlands inhabitants in the Mayan region and of the fact that the mycophilia-mycophobia phenomenon is not expressed as a bimodal frequency distribution.

Understanding cultural significance, the edible mushrooms case.

BACKGROUND: Cultural significance is a keystone in quantitative ethnobiology, which offers the possibility to make inferences about traditional nomenclature systems, use, appropriation and valuing of natural resources. In the present work, using as model the traditional mycological knowledge of Zapotecs from Oaxaca, Mexico, we analyze the cultural significance of wild edible resources. METHODS: In 2003 we applied 95 questionnaires to a random sample of informants. With this data we integrated the Edible Mushroom Cultural Significance Index. This index included eight variables: frequency of mention, perceived abundance, use frequency, taste, multifunctional food use, knowledge transmission, health and economy. Data were analyzed in an inductive perspective using ordination and grouping techniques to reveal the behavior of species in a cultural multivariate dimension. RESULTS: In each variable the species had different conducts. Cantharellus cibarius s.l. was the species with most frequency of mention. Pleurotus sp. had the highest perceived abundance. C. cibarius s.l. was the most frequently consumed species. Gomphus clavatus was the most palatable species and also ranked highest in the multifunctional food index. Cortinarius secc. Malacii sp. had the highest traditional importance. Only Tricholoma magnivelare was identified as a health enhancer. It also had the most economic importance. According to the compound index, C. cibarius s.l., the Amanita caesarea complex, Ramaria spp. and Neolentinus lepideus were the mushrooms with highest cultural significance. Multivariate analysis showed that interviewees identify three main groups of mushrooms: species with high traditional values, frequent consumption and known by the majority; species that are less known, infrequently consumed and without salient characteristics; and species with low traditional values, with high economic value and health enhancers. CONCLUSION: The compound index divided the cultural significance into several cultural domains and showed the causes that underlie this phenomenon. This approach can be used in cross-cultural studies because it brings a list with the relative position of species among a cultural significance gradient. This list is suitable for comparisons and also it is flexible because cultural variables can be included or removed to adjust it to the nature of the different cultures or resources under study.

Process and dynamics of traditional selling wild edible mushrooms in tropical Mexico.

BACKGROUND: More than twelve temperate-inhabitant Mexican ethnic groups are considered to be mycophilic and to have extensive traditional mycological knowledge. In contrast, inhabitants of tropical lands have been studied only superficially and their mycological knowledge is less well known. In this paper, we report the results of an ethnomycological research in markets of a wide area of the Mexican tropics. Our aims were to describe the dynamics related to the traditional selling process of wild mushrooms and to determine the tendencies of informants toward mushrooms (mycophily vs. mycophoby). METHODS: We visited 25 markets of 12 different settlements in the states of Oaxaca, Tabasco and Veracruz and collected information by participant observation as well as by 291 non-structured and semi-structured interviews. RESULTS: Mushroom selling was observed in four towns in Oaxaca and in two in Tabasco. Women represented 81.82% of sellers, while indigenous people (Chinantecos, Chontales, Ch'oles and Zoques) comprised 68.18%. Mushroom commercialization took place in secondary mobile markets and only in peasant stands. Mushroom collectors gather the resource in places with secondary vegetation, farmed areas and cattle fields. Because of land tenure restrictions mushroom sellers did not normally collect mushrooms themselves. In Oaxaca, we observed economic dynamics not based on capitalism, such as exchange, reciprocity and barter. CONCLUSION: The sale of some wild edible mushrooms, the large amounts of commercialization of Schizophyllum commune, the complicated intermediary process, as well as the insertion of mushrooms into different informal economic practices are all evidence of an existent mycophily in a sector of the population of this region of the Mexican tropics. Among our informants, urban mestizo people were mycophobic, rural mestizo people were non-mycophilic and indigenous people were true mycophilic.

Traditional infrageneric classification of Gymnopilus is not supported by ribosomal DNA sequence data.

The traditional classification of Gymnopilus (Agaricales) recognizes two primary groups, Annulati and Gymnopilus, based on the presence or absence of a membranous partial veil. While our analyses of DNA sequence data from the nuclear ribosomal ITS1-5.8S-ITS2 (ITS) gene supports the monophyly of the genus, these traditional subgroups were not recovered. Five well-supported clades within the genus were identified through these analyses: 1) the spectabilis-imperialis group; 2) nevadensis-penetrans group; 3) a clade formed by G. underwoodii, G. validipes and G. cf. flavidellus; 4) aeruginosus-luteofolius group; and 5) lepidotus-subearlei group. Relationships among these subgroups were not resolved.

Primer registro de Collybia cookei (Tricholomataceae, Agaricales) en México / First record of Collybia cookei (Tricholomataceae, Agaricales) from Mexico

Se registra por primera vez para la micobiota mexicana a Collybia cookei (Bres.) Arnold, recolectada de un bosque de abeto, en el Estado de México

Contribución al estudio taxonómico de los hongos tremeloides (Heterobasidiomycetes) de México / Contribution to the taxonomic study of tremelloid fungi (Heterobasidiomycetes), in Mexico

Se presenta el estudio taxónomico de 26 especies de hongos tremeloides (Heterobasidiomycetes). Dos son nuevos registros para la micobiota Mexicana: Guepiniopsis alpina (Tracy & Earle) Bras. y Tremella reticulata (Berk.) Farlow, de los que se incluyen sus descriptores completas. Se presentan también claves para las especies mexicanas del género Guepiniopsis y Tremella, y se amplia la información sobre la distribución geográfica de 19 especies

Nuevos registros del género Collybia (Tricholomataceae) y descripción de especies poco estudiadas en México / New records of genus collybia (Tricholomataceae) and description of the species less studied in Mexico

Se presenta la descripción taxonómica de ocho especies pertenecientes al género Collybia (Fr.) Staude, cinco de las cuales han sido poco estudiadas (C. alkaliverens Sing., C. confluens (Pers. : Fr.) Kumm., C. maculata Smith, C. polyphylla (Pk.) Sing. : Halling y C. subnuda (Ellis : Pk.) Gill.) y las tres restantes representan nuevos registros para el país (C: butyracea var. asema Fr., C. maculata var. occidentalis Smith y C. maculata var. scorzonerea (Fr. Gill.). Además se contribuye al conocimiento de la distribución geográfica de C. butyracea Fr., C. dryophila (Bull. : Fr. ) Kumm. sensu lato y C. tabular para las secciones del género a las que pertenecen las especies estudiadas

Revisión de algunas especies del genero Ramaria subgenero Lentoramaria en México / Revision of some species of genus Ramaria subgenus Lentoramaria in Mexico

En este trabajo se hace una revisión de 11 taxa del género Ramaria subgénero Lentoramaria de México, de los cuales R. acris (Pk.) Corner, R. concolor f. tsugina (Pk.) Petersen, R. flavula (Atk.) Petersen, R. gracilis (Pers. per Fr.) Quél., R. mollelriana (Bres. & Rom.) Corner, R. pseudogracilis Petersen, R. rainieriensis Marr & Stuntz y R suecica (Fr.) Donk se registran por primera vez para la micoflora mexicana. Ampliándose además, los datos de distribución para R. apiculata (Fr.) Donk, R. stricta (Pers. per Fr.) Quél. y R. concoclor (Corner) Petersen, en México. Se presenta también, una clave sinóptica de los taxa estudiados