Gamma Knife radiosurgery for the management of glomus jugulare tumors: A systematic review and report of the experience of a radioneurosurgery unit in Latin America.

Background: Glomus jugulare tumors (GJTs) are rare and mainly affect women between the 5th and 6th decades of life. Its localization and anatomic relationships make conventional surgical treatment difficult and with a considerable risk of complications. This manuscript aims to describe the results of Gamma Knife radiosurgery (GKR) in patients with GJT treated in a single center in Latin America, as well as to systematically review the literature to determine the clinical and radiological effectiveness of this technique. Methods: A search of information from January 1995 to June 2023 was performed. Twenty-two articles reporting 721 GJT patients treated with GKR were included in the study. Variables such as symptomatic control, control of tumor size, and complications were evaluated. These variables were described using measures of central tendency and proportions. For the institutional experience, 77 patients with GJT tumors were included in the study. Pre-treatment clinical variables and follow-up data were collected from medical charts and phone interviews. The Short Form-36 scale was applied to assess the quality of life. The data were analyzed using the statistical program STATA17.0. Results: A total of 721 patients were considered. The median of patients included in these studies was 18.5. The mean age was 58.4 years. The median of symptom control was 89%, and the median of imaging control was 95.7%. In our institution, 77 patients were included in the study. The mean age was 53.2 years. The median hospital stay was 4.92 hours. For the clinical follow-up, information on 47 patients was obtained. An improvement in pre-treatment symptoms was described in 58%, with general symptomatic control of 97%. The tumor-control rate was 95%, and there were statistically significant differences in six of the nine Short Form-36 scale domains. Conclusion: GKR is an effective, safe, and cost-effective technique that offers a high degree of symptomatic and tumor size control in patients with GJT.

miR-21, miR-221, miR-29 and miR-34 are distinguishable molecular features of a metabolically unhealthy phenotype in young adults.

Discrepancies between the measurement of body mass index (BMI) and metabolic health status have been described for the onset of metabolic diseases. Studying novel biomarkers, some of which are associated with metabolic syndrome, can help us to understand the differences between metabolic health (MetH) and BMI. A group of 1469 young adults with pre-specified anthropometric and blood biochemical parameters were selected. Of these, 80 subjects were included in the downstream analysis that considered their BMI and MetH parameters for selection as follows: norm weight metabolically healthy (MHNW) or metabolically unhealthy (MUNW); overweight/obese metabolically healthy (MHOW) or metabolically unhealthy (MUOW). Our results showed for the first time the differences when the MetH status and the BMI are considered as global MetH statures. First, all the evaluated miRNAs presented a higher expression in the metabolically unhealthy group than the metabolically healthy group. The higher levels of leptin, IL-1b, IL-8, IL-17A, miR-221, miR-21, and miR-29 are directly associated with metabolic unhealthy and OW/OB phenotypes (MUOW group). In contrast, high levels of miR34 were detected only in the MUNW group. We found differences in the SIRT1-PGC1α pathway with increased levels of SIRT1+ cells and diminished mRNA levels of PGCa in the metabolically unhealthy compared to metabolically healthy subjects. Our results demonstrate that even when metabolic diseases are not apparent in young adult populations, MetH and BMI have a distinguishable phenotype print that signals the potential to develop major metabolic diseases.

Age-related loss of Notch3 underlies brain vascular contractility deficiencies, glymphatic dysfunction, and neurodegeneration in mice.

Vascular aging affects multiple organ systems, including the brain, where it can lead to vascular dementia. However, a concrete understanding of how aging specifically affects the brain vasculature, along with molecular readouts, remains vastly incomplete. Here, we demonstrate that aging is associated with a marked decline in Notch3 signaling in both murine and human brain vessels. To clarify the consequences of Notch3 loss in the brain vasculature, we used single-cell transcriptomics and found that Notch3 inactivation alters regulation of calcium and contractile function and promotes a notable increase in extracellular matrix. These alterations adversely impact vascular reactivity, manifesting as dilation, tortuosity, microaneurysms, and decreased cerebral blood flow, as observed by MRI. Combined, these vascular impairments hinder glymphatic flow and result in buildup of glycosaminoglycans within the brain parenchyma. Remarkably, this phenomenon mirrors a key pathological feature found in brains of patients with CADASIL, a hereditary vascular dementia associated with NOTCH3 missense mutations. Additionally, single-cell RNA sequencing of the neuronal compartment in aging Notch3-null mice unveiled patterns reminiscent of those observed in neurodegenerative diseases. These findings offer direct evidence that age-related NOTCH3 deficiencies trigger a progressive decline in vascular function, subsequently affecting glymphatic flow and culminating in neurodegeneration.

Propofol-Related Infusion Syndrome in a Child With Refractory Status Epilepticus: Successful Resuscitation With Veno-Arterial Extracorporeal Membrane Oxygenation, Continuous Renal Replacement Therapy, and Therapeutic Plasma Exchange.

Propofol is used for sedation, anxiolysis, anesthesia induction, and as an anticonvulsant. In cases of refractory status epilepticus (RSE), propofol is more efficient than barbiturates. We present a case of a 3-year-old female with RSE who developed propofol-related infusion syndrome (PRIS) despite low dosage after failed attempts with multiple anti-epileptic drips and bolus therapies. Careful consideration must be made before initiating propofol administration for RSE. We discuss our PRIS treatment approach with extracorporeal membrane oxygenation, therapeutic plasma exchange, and continuous renal replacement therapy leading to our patient recovering to baseline and being discharged home from the hospital.

Fungal Alcohol Dehydrogenases: Physiological Function, Molecular Properties, Regulation of Their Production, and Biotechnological Potential.

Fungal alcohol dehydrogenases (ADHs) participate in growth under aerobic or anaerobic conditions, morphogenetic processes, and pathogenesis of diverse fungal genera. These processes are associated with metabolic operation routes related to alcohol, aldehyde, and acid production. The number of ADH enzymes, their metabolic roles, and their functions vary within fungal species. The most studied ADHs are associated with ethanol metabolism, either as fermentative enzymes involved in the production of this alcohol or as oxidative enzymes necessary for the use of ethanol as a carbon source; other enzymes participate in survival under microaerobic conditions. The fast generation of data using genome sequencing provides an excellent opportunity to determine a correlation between the number of ADHs and fungal lifestyle. Therefore, this review aims to summarize the latest knowledge about the importance of ADH enzymes in the physiology and metabolism of fungal cells, as well as their structure, regulation, evolutionary relationships, and biotechnological potential.

Hyphal Growth and Conidia Germination Are Induced by Phytohormones in the Root Colonizing and Plant Growth Promoting Fungus Metarhizium guizhouense.

Beneficial associations are very important for plants and soil-dwelling microorganisms in different ecological niches, where communication by chemical signals is relevant. Among the chemical signals, the release of phytohormones by plants is important to establish beneficial associations with fungi, and a recently described association is that of the entomopathogenic ascomycete fungus Metarhizium with plants. Here, we evaluated the effect of four different phytohormones, synthetic strigolactone (GR24), sorgolactone (SorL), 3-indolacetic acid (IAA) and gibberellic acid (GA3), on the fungus Metarhizium guizhouense strain HA11-2, where the germination rate and hyphal elongation were determined at three different times. All phytohormones had a positive effect on germination, with GA3 showing the greatest effect, and for hyphal length, on average, the group treated with synthetic strigolactone GR24 showed greater average hyphal length at 10 h of induction. This work expands the knowledge of the effect of phytohormones on the fungus M. guizhouense, as possible chemical signals for the rapid establishment of the fungus-plant association.

Analysis of the photocatalytic activity of La0.9Sr0.1Fe0.8Co0.2O3±Î´ perovskite as a catalyst in the degradation of RB-5 dye.

The photocatalytic efficiency of some semiconductors depends mainly on their morphological, optical, and structural properties, which can be modified by varying the calcination temperature. In order to evaluate how these properties change, as a function of temperature in a AA'BB'O3 perovskite material, La0.9Sr0.1Fe0.8Co0.2O3±Î´ (LSFC) was synthesized by the Pechini method and calcined at different temperatures (600 °C, 700 °C, 800 °C, and 900 °C). All the samples were characterized structurally, morphologically, and optically by XRD, SEM, and UV-Vis spectroscopy. Additionally, specific surface area and pore size distribution were calculated by BET and BHJ methods. LSFC was evaluated as photocatalyst material, estimating the degradation of reactive black 5 (RB5), employing as irradiation source UV light and sunlight. The obtained results display a clear tendency between the photoactivity and the heat treatment: degradation percentage decreases as the calcination temperature increases mainly due to the crystal and grain size and, furthermore, loss of porosity and the decrease in surface area, affecting the photocatalytic activity (98%, 95%, 74%, and 50% degradation, respectively). All the ceramic samples follow a pseudo-first-order reaction.

Recurrence quantification analysis during a mental calculation task.

The identification of brain dynamical changes under different cognitive conditions with noninvasive techniques such as electroencephalography (EEG) is relevant for the understanding of their underlying neural mechanisms. The comprehension of these mechanisms has applications in the early diagnosis of neurological disorders and asynchronous brain computer interfaces. In both cases, there are no reported features that could describe intersubject and intra subject dynamics behavior accurately enough to be applied on a daily basis. The present work proposes the use of three nonlinear features (recurrence rate, determinism, and recurrence times) extracted from recurrence quantification analysis (RQA) to describe central and parietal EEG power series complexity in continuous alternating episodes of mental calculation and rest state. Our results demonstrate a consistent mean directional change of determinism, recurrence rate, and recurrence times between conditions. Increasing values of determinism and recurrence rate were present from the rest state to mental calculation, whereas recurrence times showed the opposite pattern. The analyzed features in the present study showed statistically significant changes between rest and mental calculation states in both individual and population analysis. In general, our study described mental calculation EEG power series as less complex systems in comparison to the rest state. Moreover, ANOVA showed stability of RQA features along time.

Digital tomosynthesis improves chest radiograph accuracy and reduces microbiological false negatives in COVID-19 diagnosis.

PURPOSE: Diagnosing pneumonia by radiograph is improvable. We aimed (a) to compare radiograph and digital thoracic tomosynthesis (DTT) performances and agreement for COVID-19 pneumonia diagnosis, and (b) to assess the DTT ability for COVID-19 diagnosis when polymerase chain reaction (PCR) and radiograph are negative. METHODS: Two emergency radiologists with 11 (ER1) and 14 experience-years (ER2) retrospectively evaluated radiograph and DTT images acquired simultaneously in consecutively clinically suspected COVID-19 pneumonia patients in March 2020-January 2021. Considering PCR and/or serology as reference standard, DTT and radiograph diagnostic performance and interobserver agreement, and DTT contributions in unequivocal, equivocal, and absent radiograph opacities were analysed by the area under the curve (AUC), Cohen's Kappa, Mc-Nemar's and Wilcoxon tests. RESULTS: We recruited 480 patients (49 ± 15 years, 277 female). DTT increased ER1 (from 0.76, CI95% 0.7-0.8 to 0.79, CI95% 0.7-0.8; P=.04) and ER2 (from 0.77 CI95% 0.7-0.8 to 0.80 CI95% 0.8-0.8, P=.02) radiograph-AUCs, sensitivity, specificity, predictive values, and positive likelihood ratio. In false negative microbiological cases, DTT suggested COVID-19 pneumonia in 13% (4/30; P=.052, ER1) and 20% (6/30; P=.020, ER2) more than radiograph. DTT showed new or larger opacities in 33-47% of cases with unequivocal opacities in radiograph, new opacities in 2-6% of normal radiographs and reduced equivocal opacities by 13-16%. Kappa increased from 0.64 (CI95% 0.6-0.8) to 0.7 (CI95% 0.7-0.8) for COVID-19 pneumonia probability, and from 0.69 (CI95% 0.6-0.7) to 0.76 (CI95% 0.7-0.8) for pneumonic extension. CONCLUSION: DTT improves radiograph performance and agreement for COVID-19 pneumonia diagnosis and reduces PCR false negatives.

Influence of Hospital Environmental Variables on Thermometric Measurements and Level of Concordance: A Cross-Sectional Descriptive Study.

During a pandemic, and given the need to quickly screen febrile and non-febrile humans, it is necessary to know the concordance between different thermometers (TMs) and understand how environmental factors influence the measurements made by these instruments. OBJECTIVE: The objective of this study is to identify the potential influence of environmental factors on the measurements made by four different TMs and the concordance between these instruments in a hospital setting. METHOD: The study employed a cross-sectional observational methodology. The participants were patients who had been hospitalised in the traumatology unit. The variables were body temperature, room temperature, room relative humidity, light, and noise. The instruments used were a Non Contract Infrared TM, Axillary Electronic TM, Gallium TM, and Tympanic TM. A lux meter, a sound level meter, and a thermohygrometer measured the ambient variables. RESULTS: The study sample included 288 participants. Weak significant relationships were found between noise and body temperature measured with Tympanic Infrared TM, r = -0.146 (p < 0.01) and likewise between environmental temperature and this same TM, r = 0.133 (p < 0.05). The concordance between the measurements made by the four different TMs showed an Intraclass Correlation Coefficient (ICC) of 0.479. CONCLUSIONS: The concordance between the four TMs was considered "fair".

Intralesional Treatments for Invasive Cutaneous Squamous Cell Carcinoma.

Cutaneous squamous cell carcinoma (cSCC) is the second most frequent cancer in humans and has the potential to progress locally, metastasize, and cause death in a subset of patients. cSCC is especially common in the elderly, and it will probably represent a major health concern in the near future. Surgery is the standard treatment for cSCC, but intralesional therapies can sometimes be considered for certain patients and under certain circumstances. The choice of intralesional treatment depends on the patient's characteristics and the clinician's previous experience and expertise. Here we are reviewing intralesional treatments for cSCC and keratoacanthoma (KA). We have started with some classic drugs, such as methotrexate and 5-fluorouracil, bleomycin, interferon, and cryosurgery, but also comment on electrochemotherapy. Finally, we have focused on novel therapies, some of which are under development, and future perspectives, including intralesional immunotherapy and oncolytic viruses.

Neuroinvasive Onchocerca lupi Infection in a Ten-Year-Old Girl.

The nematode Onchocerca lupi is an emerging human pathogen. Though its life cycle is not well studied, it likely infects humans after a bite from a black fly vector, which in turn acquires infective microfilariae from an infected canid. These microfilariae mature into an infective larval stage within the fly. Among six reported cases in the United States, five involved children, and all occurred in the southwest. In this report, we present a case of O. lupi infection with cervical spine invasion in a healthy 10-year-old girl. She presented with five months of neurological symptoms from a rural and medically underserved area, highlighting a need for clinical vigilance in such settings for this emerging infectious threat in the American southwest.