Blood Test Increases Colorectal Cancer Screening in Persons Who Declined Colonoscopy and Fecal Immunochemical Test: A Randomized Controlled Trial.

BACKGROUND & AIMS: The septin 9 blood test is indicated for colorectal cancer screening in individuals who decline first-line tests, but participation in this context is unclear. We conducted a randomized controlled trial to compare reoffering colonoscopy and fecal immunochemical test (FIT) alone versus also offering the blood test among individuals who declined colonoscopy and FIT. METHODS: Screen-eligible Veterans aged 50-75 years who declined colonoscopy and FIT within the previous 6 months were randomized to letter and telephone outreach to reoffer screening with colonoscopy/FIT only (control), or additionally offering the blood test as a second-line option (intervention). The primary outcome was completion of any screening test within 6 months. The secondary outcome was completion of a full screening strategy within 6 months, including colonoscopy for those with a positive noninvasive test. RESULTS: Of 359 participants who completed follow-up, 9.6% in the control group and 17.1% in the intervention group completed any screening (7.5% difference; P = .035). Uptake of colonoscopy and FIT was similar in the 2 groups. The full screening strategy was completed in 9.0% and 14.9% in the control and intervention groups, respectively (5.9% difference; P = .084). CONCLUSIONS: Among individuals who previously declined colonoscopy and FIT, offering a blood test as a secondary option increased screening by 7.5% without decreasing uptake of first-line screening options. However, completion of a full screening strategy did not increase. These findings indicate that a blood test is a promising method to improve colorectal cancer screening, but obtaining a timely colonoscopy after a positive noninvasive test remains a challenge (ClincialTrials.gov number, NCT03598166).

Use, Yield, and Risk of Device-assisted Enteroscopy in the United States: Results From a Large Retrospective Multicenter Cohort.

INTRODUCTION: Since 2001, device-assisted enteroscopy (DAE) has revolutionized the diagnostic and therapeutic capabilities for managing small bowel pathology. Though commonly performed, there have been no recent large studies to assess the use, yield, and risks of DAE and none that include all 3 DAE modalities. We hypothesized that DAE is safe with high diagnostic and therapeutic yields achieved within reasonable procedure duration and here we present a large retrospective multicenter US study evaluating the use, yield, and complications of DAE. METHODS: After obtaining institutional review board approval, electronic records were used to identify all DAE's performed for luminal small bowel evaluation in adult patients at 4 US referral centers (Duke University Medical Center, New York University Langone Medical Center, Louisiana State University Health Sciences Center, and University of Massachusetts Medical Center) from January 1, 2014 to January 1, 2019. Electronic medical records were reviewed to collect and analyze a variety of procedure-related outcomes. Using the data pooled across centers, descriptive statistics were generated for the patient and procedure-related characteristics and outcomes; relationships between characteristics and outcomes were explored. RESULTS: A total of 1787 DAE's were performed over this 5-year period (392 at Duke University Medical Center, 887 at Louisiana State University Health Sciences Center, 312 at New York University Langone Medical Center, and 195 at University of Massachusetts Medical Center). Of these, there were 1017 (57%) double-balloon, 391 (29%) single-balloon, and 378 (21%) spiral enteroscopies. The mean age of patients undergoing DAE was 66 years and 53% of examinations were performed on women; 18% of patients in the cohort underwent >1 DAE over this time span. A total of 53% of examinations were performed for suspected small bowel bleeding, 31% were directly guided by video capsule endoscopy findings and 8% were performed for abnormal imaging. A total of 85% of examinations used an antegrade approach and DAE took a mean of 45 minutes to complete; 76% of examinations revealed abnormal findings, with vascular, inflammatory, and neoplastic findings seen in 49%, 17%, and 15% of the cohort, respectively. Older age was significantly associated with any abnormal finding, including arteriovenous malformations (P<0.0001); 50% of examinations included a therapeutic maneuver, most commonly argon plasma coagulation/cautery (43%). There were complications in 16 examinations (0.9%) including 2 perforations (0.1%), 6 cases with bleeding (0.3%) and 1 episode of pancreatitis (0.1%). CONCLUSIONS: DAE is most commonly performed to evaluate suspected small bowel bleeding and is commonly directed by video capsule findings. DAE is safe, has a high diagnostic yield, with 76% of examinations showing abnormal findings, and frequently features therapeutic maneuvers. Advancing age is associated with abnormal findings on DAE.

Abnormal distraction and load-specific connectivity during working memory in cognitively normal Parkinson's disease.

Visuospatial working memory impairments are common in Parkinson's disease (PD), yet the underlying neural mechanisms are poorly understood. The present study investigated abnormalities in context-dependent functional connectivity of working memory hubs in PD. Cognitively normal PD and control participants underwent fMRI while performing a visuospatial working memory task. To identify sources of dysfunction, distraction, and load-modulated connectivity were disentangled for encoding and retrieval phases of the task. Despite normal working memory performance in PD, two features of abnormal connectivity were observed, one due to a loss in normal context-related connectivity and another related to upregulated connectivity of hubs for which the controls did not exhibit context-dependent connectivity. During encoding, striatal-prefrontal coupling was lost in PD, both during distraction and high memory loads. However, long-range connectivity of prefrontal, medial temporal and occipital hubs was upregulated in a context-specific manner. Memory retrieval was characterized by different aberrant connectivity patterns, wherein precuneus connectivity was upregulated during distraction, whereas prefrontal couplings were lost as memory load approached capacity limits. Features of abnormal functional connectivity in PD had pathological and compensatory influences as they correlated with poorer working memory or better visuospatial skills. The results offer new insights into working memory-related signatures of aberrant cortico-cortical and corticostriatal functional connections, which may portend future declines in different facets of working memory.

Initial Experience in Chile with Stent Implantation in the Right Ventricle Outflow Tract in High-Risk Patients with Tetralogy of Fallot.

Tetralogy of Fallot (ToF) treatment is difficult in patients with surgical risk factors or unfavorable anatomy. Stent implantation in the right ventricular outflow tract (RVOT) is an option for these patients. We report our initial experience in Chile with RVOT stenting in patients with ToF. Retrospective and descriptive study conducted in three pediatric cardiovascular centers in Chile between 2012 and 2015, including all ToF patients with stent in the RVOT as first procedure. Clinical records, echocardiographic, interventional, and surgical reports were reviewed for demographics and information of RVOT and pulmonary arteries. 12 newborns with ToF were included (75% female). Median age was 20 days (1-70) and mean weight was 2178 g (1400-3414). Saturations increased after the procedure from 74.3% (55-88) to 88.5% (80-98%), (p < 0.01). No complications or mortality were related to interventions. Follow-up was 11 months (7-36). Median right and left pulmonary arteries Z-score increased from - 4.0 (- 5.2 to - 0.3) and - 1.5 (- 4.8 to - 0.26) to + 0.53 (0.0 to 2.2) and + 1.1 (0.5 to 2.9), (p < 0.05), respectively. Nakata index increased from 63 mm2/mm2 (35 to 143) to 162 mm2/mm2 (107 to 197), (p < 0.05). Surgical repair was performed at a median of 4 months (2-7). Transannular patch repair was necessary in all patients and there was no surgical mortality. RVOT stenting is a safe and useful option for patients with ToF and surgical risk factors or unfavorable anatomy. It increases the pulmonary blood flow, improving saturation and pulmonary artery growth as a bridge for surgical repair.

Microstructure of starch-based meals with either palm or soybean oils alter in vitro starch digestibility with no major effects on glycaemic responses.

Glycaemic response (GR) to starch-based meals depends on their food composition and microstructure. We studied the effect of palm and soybean oils on the microstructure of a solid starch-oil-gluten matrix, on the starch gelatinisation and in vitro digestibility. Additionally, a pilot cross-over study was carried out to assess GR after eating gelatinised starch/gluten-based foods with the addition of either palm or soybean oil in 8 young non-diabetic female volunteers (ISRCTN39636850). Both types of foods generated similar starch gelatinisation temperature. Starch/gluten-based food with soybean oil had rougher microstructure compared to food with palm oil, showing a higher initial and lower final in vitro digestion. Administration of starch/gluten-based meals with either palm or soybean oils to volunteers show very similar postprandial glucose or insulin responses. In conclusion, differences in fatty acid composition changes food microstructure and in vitro starch digestibility, with no major effects on glycaemic responses in female volunteers.

Description of Ornithodoros montensis n. sp. (Acari, Ixodida: Argasidae), a parasite of the toad Rhinella arenarum (Amphibia, Anura: Bufonidae) in the Monte Desert of Argentina.

A new tick species of the genus Ornithodoros (Acari: Argasidae) was described from larvae collected on the toad Rhinella arenarum in a locality from Argentina belonging to the Monte Biogeographic Province. Ornithodoros montensis n. sp. was described based on morphological traits and sequences of the mitochondrial 16S rRNA gene. The diagnostic characters for this species are a combination of idiosoma oval, dorsal plate pyriform with posterior margin slightly concave, dorsal surface with 17 pairs of setae (7 anterolateral, 4 to 5 central and 5 to 6 posterolateral), ventral surface with 6 pairs of setae and 1 pair on anal valves, three pairs of sternal setae, postcoxal setae absent, and hypostome pointed apically with dental formula 3/3 in the anterior half and 2/2 posteriorly almost to base. Phylogenetic analysis of 16S rDNA sequences and a principal component analysis based on morphometric characters provided additional support to the description of O. montensis as an independent lineage within the genus Ornithodoros. Larvae of O. montensis are phylogenetically closely related to O. puertoricensis, O. rioplatensis, O. talaje s.s., O. guaporensis, O. hasei and O. atacamensis, all of them belonging to the "O. talaje group".

[Parsonage-Turner syndrome. Report of one case]. / Síndrome de Parsonage-Turner en paciente sometido a cirugía de revascularización miocárdica. Caso clínico.

We report a 59-year-old male who, three weeks after a coronary revascularization surgery, reported a sudden intense burning pain in his left upper limb. Two weeks later, he reports a paresis with difficulty to extend his left wrist and fingers. The electromyography showed a severe axonal damage of the radial nerve with distal denervation signs. This clinical picture probably corresponds to a neuralgic amyotrophy, an inflammatory disorder of the brachial plexus known by a number of terms, including Parsonage-Turner syndrome.

Codon usage revisited: Lack of correlation between codon usage and the number of tRNA genes in enterobacteria.

It is widely believed that if a high number of genes are found for any tRNA in a rapidly replicating bacteria, then the cytoplasmic levels of that tRNA will be high and an open reading frame containing a higher frequency of the complementary codon will be translated faster. This idea is based on correlations between the number of tRNA genes, tRNA concentration and the frequency of codon usage observed in a limited number of strains as well as from the fact that artificially changing the number of tRNA genes alters translation efficiency and consequently the amount of properly folded protein synthesized. tRNA gene number may greatly vary in a genome due to duplications, deletions and lateral transfer which in turn would alter the levels and functionality of many proteins. Such changes are potentially deleterious for fitness and as a result it is expected that changes in tRNA gene numbers should be accompanied by a modification of the frequency of codon usage. In contrast to this model, when comparing the number of tRNA genes and the frequency of codon usage of several Salmonella enterica and Escherichia coli strains we found that changes in the number of tRNA genes are not correlated to changes in codon usage. Furthermore, these changes are not correlated with a change in the efficiency of codon translation. These results suggest that once a genome gains or loses tRNA genes, it responds by modulating the concentrations of tRNAs rather than modifying its frequency of codon usage.

[Thromboelastography and classical coagulation tests in the preoperative period of liver transplantation]. / Comparación preoperatoria entre pruebas de coagulación y tromboelastografía en pacientes con cirrosis hepática sometidos a trasplante hepático.

BACKGROUND: Compared to standard coagulation essays (SCE), such as international normalized ratio (INR), prothrombin activated partial thromboplastin time (aPTT), or platelet count, thromboelastograhy (TEG) offers precise and real-time information about hemostasis. TEG tests both platelet function and coagulation by assaying several parameters of clot formation dynamically in whole blood. AIM: To evaluate hemostasis in cirrhotic patients undergoing liver transplantation and determine the positive and negative predictive values of SCE for alterations of TEG. MATERIAL AND METHODS: Preoperative SCE and TEG were prospectively analyzed in 25 patients. Results were categorized as normal, laboratory alteration or clinical alteration. SCE results were compared with TEG parameters to determine positive (PPV) and negative predictive values (NPV). RESULTS: Hemostasis was abnormal and laboratory abnormalities were observed in all patients. One patient had clinical signs of excessive bleeding. SCE were abnormal in all patients and TEG was normal in nine patients. The most common alteration in TEG was hypocoagulability, in some cases associated with hypercoagulability and hyperfibrinolysis. Two patients had solely hypercoagulability. PPV of INR, aPTT, platelet count and fibrinogenemia were 0, 0, 0.5 and 0.17 respectively. NPV of the same tests were 1, 1, 0.34 and 1 respectively. CONCLUSIONS: Hypocoagulability was the most common laboratory alteration, however, clinical signs of coagulopathy were rarely present. SCE had a poor predictive value to diagnose o discard hemostatic abnormalities.

Removal of Two Neonicotinoid Insecticides and Mineralization of 14C-Imidacloprid in Biomixtures.

Environmental contamination with neonicotinoid insecticides represents an issue of wide concern due to their negative effects on pollinators. The goal of this work was to evaluate the potential use of biomixtures employed in biopurification systems (BPS) to remove two neonicotinoid pesticides, imidacloprid and thiamethoxam, from wastewater of agricultural origin. The removal was assayed by quantification of the parent compounds and the detection of putative transformation products of imidacloprid by means of LC-MS/MS, and mineralization of radiolabeled imidacloprid. Two biomixtures (B1, B2) were prepared using coconut fiber, compost and two soils pre-exposed to imidacloprid (volumetric composition 50:25:25). After spiking of neonicotinoids and 228 days of treatment, the removal ranged from 22.3%-30.3% and 38.6%-43.7% for imidacloprid and thiamethoxam, respectively. Transformation products imidacloprid-urea, desnitro-imidacloprid and desnitro-olefin-imidacloprid were detected in both biomixtures. The mineralization of 14C-imidacloprid revealed DT50 (mineralization half-lives) values of 3466 and 7702 days in the biomixtures B1 and B2, respectively, markedly lower than those in the soil used in their preparation (8667 and 9902 days, respectively). As demonstrated by these findings, the high persistence of these compounds in the BPS suggests that additional biological (or physicochemical) approaches should be explored in order to decrease the impact of neonicotinoid-containing wastewater of agricultural origin.

Thubunaea eleodori sp. nov. (Nematoda: Physalopteridae) from Liolaemus eleodori (Sauria: Liolaemidae) from Argentina.

Thubunaea eleodori sp. nov. is described from the stomach of Liolaemus eleodori (Sauria: Liolaemidae) from San Guillermo National Park, Province of San Juan, Argentina. T. eleodori is most similar to those species lacking spicules, T. cnemidophorus, T. fitsimonsi, T. parkeri, T. schukurovi, and T. smogorzhewskii. T. eleodori is separated from these species based on the papilla pattern. T. eleodori has 12 pedunculate papillae and 14 sessile papillae, T. smogorzhewskii lacks pedunculate papillae, T. fitsimonsi and T. parkeri lack sessile papillae, and T. cnemidophorus has14-16 pedunculate papillae and 12 sessile papillae. T. eleodori represents the first member of the genus to be reported from Argentina.

Multilocus, DNA-based phylogenetic analyses reveal three new species lineages in the Phellinus gabonensis-P. caribaeo-quercicola species complex, including P. amazonicus sp. nov.

Species complexes in the poroid Hymenochaetaceae are well documented in the temperate areas. Potential species complexes are less known in tropical areas, however. In the last ten years, four phylogenetically and morphologically closely related species of Phellinus (Hymenochaetaceae) were described from various tropical/subtropical areas viz. P. caribaeo-quercicola, P. gabonensis, P. ellipsoideus, and P. castanopsidis They are characterized by cushion-shaped basidiomata, ventricose, commonly hamate hymenial setae, and broadly ellipsoid, thick-walled, pale yellowish basidiospores. Pursuing the studies of this complex, a phylogenetic approach based on DNA sequence data from the nuc rDNA regions ITS1-5.8S-ITS2 (ITS) and partial 28S (including the domains D1, D2, D3) and on part of the translation elongation factor 1-α (tef1, region between exons 4 and 8) revealed three new lineages or phylogenetic species. Two of these phylogenetic species are composed of exclusively on Neotropical specimens. One of them, described below as Phellinus amazonicus sp. nov., is represented by multiple collections originating from Neotropical, lowland, dense, moist forest at the western edge of the Amazon Basin in Ecuador, the Guiana Shield in French Guiana and (more likely) Trinidad. The second Neotropical phylogenetic species is represented in our phylogenetic analyses by a single collection from northeastern Argentina. It is also potentially known from two herbarium specimens originating from southern Brazil, for which no sequence data is available. It is left for now as Phellinus sp. 1, waiting to gather more specimens and DNA sequences data. The third new phylogenetic species is known by a single collection (pure culture) of uncertain origin. It is thought to represent Phellinus setulosus, a Southeast Asian taxa. From an evolutionary perspective, tree species occurring in the Neotropics (P. amazonicus, P. caribaeo-quercicola, and Phellinus sp. 1) have a closely related genetic background and form a well supported Neotropical lineage.

Recessive mutations in the INS gene result in neonatal diabetes through reduced insulin biosynthesis.

Heterozygous coding mutations in the INS gene that encodes preproinsulin were recently shown to be an important cause of permanent neonatal diabetes. These dominantly acting mutations prevent normal folding of proinsulin, which leads to beta-cell death through endoplasmic reticulum stress and apoptosis. We now report 10 different recessive INS mutations in 15 probands with neonatal diabetes. Functional studies showed that recessive mutations resulted in diabetes because of decreased insulin biosynthesis through distinct mechanisms, including gene deletion, lack of the translation initiation signal, and altered mRNA stability because of the disruption of a polyadenylation signal. A subset of recessive mutations caused abnormal INS transcription, including the deletion of the C1 and E1 cis regulatory elements, or three different single base-pair substitutions in a CC dinucleotide sequence located between E1 and A1 elements. In keeping with an earlier and more severe beta-cell defect, patients with recessive INS mutations had a lower birth weight (-3.2 SD score vs. -2.0 SD score) and were diagnosed earlier (median 1 week vs. 10 weeks) compared to those with dominant INS mutations. Mutations in the insulin gene can therefore result in neonatal diabetes as a result of two contrasting pathogenic mechanisms. Moreover, the recessively inherited mutations provide a genetic demonstration of the essential role of multiple sequence elements that regulate the biosynthesis of insulin in man.

[Giant Amyand hernia]. / Hernia de Amyand gigante.

The finding of the appendix inside an hernial sac is called "Amyand hernia": The global incidence is 0.28 to 1%. Clinical manifestations are the presence of an inflamed inguinal mass, tense, hypersensitivensible, with variable size, non-reducible, and associated to abdominal pain, vomit and very rarely true appendicitis manifestations. Surgical treatment depends on the case presentation and the intraoperative findings. We present a case of a giant Amyand's hernia successfully treated with surgery by performing the hernia repair with Bassini technique and transherniotomy appendectomy.

Skrjabinodon castillensis (Nematode: Pharyngodonidae) parasitizing Liolaemus gracielae lizard (Squamata: Iguania: Liolaemidae) from Argentina.

Skrjabinodon castillensis is mentioned and illustrated here, based on specimens found in the large intestines of Liolaemus gracielae (Squamata: Liolaemidae) collected in San Juan province, Argentina. The species found is assigned to Skrjabinodon based lateral alae present in males. Lateral alae beginning midway between lips and nerve ring and ending just posterior to first pair of caudal papillae. In males, caudal alae absent, paired caudal papillae present. The species recorded in this study differs from all other species assigned to Skrjabinodon by morphology and number of tail filament spines. Skrjabinodon castillensis is the ninth species from the Neotropical realm and the only species of this genus known from Argentina.

The Effects of Fatigue on Muscle Synergies in the Shoulders of Baseball Players.

BACKGROUND: Muscle synergies are defined as the central nervous system's organizational structure for movement. Muscle synergies change after muscular fatigue, with certain synergies assuming the primary role to compensate for fatigue within another muscle synergy. Owing to the high eccentric forces imposed upon the external rotators (ie, posterior rotator cuff), pitchers that continue to throw while fatigued are at a significantly higher risk of shoulder and/or elbow injury; however, the neuromuscular compensation strategies of baseball players in response to fatigue are currently unknown. HYPOTHESIS: Players would utilize the same muscle synergy structure following external rotation (ER) fatigue; however, muscle coefficients of nonfatigued muscles would increase (ie, compensate for the external rotators) after fatigue. STUDY DESIGN: Cross-sectional study conducted in a controlled, laboratory setting. METHODS: Nine players from an intercollegiate competitive club baseball team voluntarily participated in this study. Surface electromyography was used on 14 muscles of the glenohumeral and scapulothoracic joints of the dominant arm during a reaching protocol. Players completed a baseline reaching protocol (prefatigue), then an ER fatigue protocol until maximum concentric ER was reduced by 40%, and finally repeated the same reaching protocol (postfatigue). Principal component analysis was used to extract muscle synergies, the variance accounted for (VAF) of each synergy, and muscle coefficients. Prefatigue was compared with postfatigue using paired t tests for all dependent variables. RESULTS: Four muscle synergies were extracted for both pre- and postfatigue. The VAF for the ER/abduction synergy decreased significantly (prefatigue, 34.6%; postfatigue, 32.4%; P = 0.03), showing a decreased reliance on ER/abduction during the reaching task after fatigue. Within synergy 1, the pectoralis major muscle coefficient (-0.489 vs -0.552; P = 0.01; effect size = 1.68) decreased significantly from prefatigue to postfatigue, indicating that the pectoralis major assumed more of an antagonist role during ER/abduction. Within synergy 2 (forward reaching), there were no significant changes in VAF or muscle coefficients observed. For the third synergy, muscle coefficients increased for the serratus anterior (P = 0.02) and middle deltoid (P = 0.01), whereas in the fourth synergy, the pectoralis major (P = 0.01) increased and teres major (P = 0.01) and biceps brachii (P = 0.05) muscle coefficients decreased. CONCLUSION: The decreased VAF of the ER/abduction synergy after fatigue indicate that other muscles within that synergy could not fully compensate to maintain function. Interestingly, the changes in muscle coefficients suggest that players relied less on the internal rotation (IR) synergy and more on the cross-body synergy following fatigue. This may be due to imbalances between ER and IR while maintaining balance between cross-abduction and adduction. CLINICAL RELEVANCE: Clinicians may consider implementing low-load, high-repetition training programs to develop posterior shoulder endurance and prolong the onset of muscular fatigue.

Video Consent for Upper Endoscopy and Colonoscopy Improves Patient Comprehension in a Safety-net, Multi-lingual Population.

The challenges of consenting for procedures are well documented and are compounded when patients have limited English proficiency (LEP). Standardized video consent has been studied, but research in gastroenterology is limited. We created educational videos in English and Spanish covering the elements of traditional consent for colonoscopy and upper endoscopy. All participants underwent traditional verbal consent and a subset viewed the language and procedure specific video. Participants from a multilingual, safety-net hospital patient population were then given a questionnaire to assess their comprehension and satisfaction. Participants who watched the video had higher comprehension scores than those who received traditional verbal consent alone. This difference persisted when data was stratified by language and procedure, and when controlled for educational level and prior procedure. Video consent improves comprehension and satisfaction for endoscopy and may mitigate some of the challenges encountered when consenting patients with LEP.

Skrjabinodon castillensis n. sp. (Nematoda:Pharyngodonidae) from the Homonota horrida and H.darwinii (Squamata: Phyllodactylidae) from Argentina and key for the Neotropical species of the genus Skrjabinodon.

Skrjabinodon castillensis n. sp. is described and illustrated here, based on specimens found in the large intestines of Homonota horrida (province San Juan) and Homonota darwinii (province Neuquén) (Squamata: Phyllodactylidae) from Argentina. The new species is assigned to Skrjabinodon based lateral alae present in males, absent in females. Lateral alae beginning midway between lips and nerve ring and ending just posterior to first pair of caudal papillae. Females with vulva near esophageal bulb. In males, caudal alae absent, paired caudal papillae present. Skrjabinodon castillensis n. sp. represents the 9th species from the Neotropical realm. The new species differs from all other species assigned to Skrjabinodon by morphology of tail filament and number of tail filament spines. Skrjabinodon castillensis n. sp. is the only species of this genus known from Argentina. A key to the species of Skrjabinodon in the Neotropical realm is provided.

Screening of Antibacterial Activity of Some Resupinate Fungi, Reveal Gloeocystidiellum lojanense sp. nov. (Russulales) against E. coli from Ecuador.

Bacterial resistance to antibiotics is a serious public health problem that needs new antibacterial compounds for control. Fungi, including resupinated fungi, are a potential source to discover new bioactive compounds efficient again to bacteria resistant to antibiotics. The inhibitory capacity against the bacterial species was statistically evaluated. All the species (basidiomata and strains) were molecularly characterized with the ITS1-5.8S-ITS2 barcoding marker. The strains Ceraceomyces sp., Fuscoporia sp., Gloeocystidiellum sp., Oliveonia sp., Phanerochaete sp., and Xenasmatella sp. correspond to resupinate Basidiomycetes, and only the strain Hypocrea sp. is an Ascomycete, suggesting contamination to the basidiome of Tulasnella sp. According to the antagonistic test, only the Gloeocystidiellum sp. strain had antibacterial activity against the bacterial species Escherichia coli of clinical interest. Statistically, Gloeocystidiellum sp. was significantly (<0.001) active against two E. coli pathotypes (O157:H7 and ATCC 25922). Contrarily, the antibacterial activity of fungi against other pathotypes of E. coli and other strains such as Serratia sp. was not significant. The antibacterial activity between 48 and 72 h increased according to the measurement of the inhibition halos. Because of this antibacterial activity, Gloeocystidiellum sp. was taxonomically studied in deep combined morphological and molecular characterization (ITS1-5.8S-ITS2; partial LSU D1/D2 of nrDNA). A new species Gloeocystidiellum lojanense, a resupinate and corticioid fungus from a tropical montane rainforest of southern Ecuador, with antibacterial potential against E. coli, is proposed to the science.

The nature and time course of cortical activation following subthalamic stimulation in Parkinson's disease.

We studied the time course and nature of interactions between the subthalamic nucleus (STN) and the motor cortex in 8 Parkinson disease (PD) patients with chronically implanted STN deep-brain stimulation (DBS) electrodes. We first identified the cortical evoked potentials following STN stimulation. The most consistent potential was positive wave with peak latency of 22.2 +/- 1.2 ms from stimulation of clinically effective contacts. We then stimulated the motor cortex with transcranial magnetic stimulation (TMS) at 2-15 ms and at the latency of the evoked potential ( approximately 23 ms) following STN DBS. TMS induced currents in 3 directions: lateral-medial (LM) direction activated corticospinal axons directly, posterior-anterior (PA), and anterior-posterior (AP) directions activated corticospinal neurons transynaptically. Motor-evoked potentials (MEP) elicited by AP and PA TMS were facilitated at short (2-4 ms) and medium latencies (21-24 ms). However, MEPs elicited by LM TMS were not modified by STN DBS. Short-latency antidromic stimulation of the corticosubthalamic projections and medium latency transmission likely through the basal ganglia-thalamocortical circuit led to cortical evoked potentials and increased motor cortex excitability at specific intervals following STN stimulation at clinically effective contacts. Cortical activation may be related to the clinical effects of STN DBS in PD.