Genetic identity in genebanks: application of the SolCAP 12K SNP array in fingerprinting and diversity analysis in the global in trust potato collection.

Breeders rely on genetic integrity of material from genebanks; however, admixture, mislabeling, and errors in original data can occur and be detrimental. Two hundred and fifty accessions, representing paired samples consisting of original mother plants and their in vitro counterparts from the cultivated potato collection at the International Potato Center (CIP) were fingerprinted using the Infinium 12K V2 Potato Array to confirm genetic identity of the accessions and evaluate genetic diversity of the potato collection. Diploid, triploid, and tetraploid accessions were included, representing seven cultivated potato taxa (based on Hawkes, 1990). Fingerprints between voucher mother plants maintained in the field and in vitro clones of the same accession were used to evaluate identity, relatedness, and ancestry using hierarchal clustering and model-based Bayesian admixture analyses. Generally, in vitro and field clones of the same accession grouped together; however, 11 (4.4%) accessions were mismatches genetically, and in some cases the SNP data revealed the identity of the mixed accession. SNP genotypes were used to assess genetic diversity and to evaluate inter- and intraspecific relationships along with determining population structure and hybrid origins. Phylogenetic analyses suggest that the triploids included in this study are genetically similar. Further, some genetic redundancies among individual accessions were also identified along with some putative misclassified accessions. Accessions generally clustered together based on taxonomic classification and ploidy level with some deviations. STRUCTURE analysis identified six populations with significant gene flow among the populations, as well as revealed hybrid taxa and accessions. Overall, the Infinium 12K V2 Potato Array proved useful in confirming identity and highlighting the diversity in this subset of the CIP collection, providing new insights into the accessions evaluated. This study provides a model for genetic identity of plant genetic resources collections as mistakes in conservation of these collections and in genebanks is a reality. For breeders and other users of these collections, confirmed identity is critical, as well as for quality management programs and to provide insights into the accessions evaluated.

Unilateral Stimulation of Prelemniscal Radiations for the Treatment of Acral Symptoms of Parkinson's Disease: Long-Term Results.

BACKGROUND: Prelemniscal radiations (Raprl) have been proposed as a target for the treatment of Parkinson's disease. We evaluated effectiveness of this target through UPDRS-III in patients treated with Raprl deep brain stimulation (Raprl-DBS) and followed from 24 to 48 months. METHODS: Nineteen patients in Hoehn-Yahr stages II-III were implanted with tetrapolar deep brain stimulation electrodes in Raprl contralateral to the extremities with more prominent symptoms. Placement was assisted by MRI/CT/anatomical atlas fusion, microelectrode recording, and micro- and macro-stimulation. The effect on motor symptoms was evaluated in an open label protocol through specific items of the UPDRS-III score, applied pre-operatively and 6, 12, 24, and 48 months after the onset of stimulation in an OFF-medication/ON-stimulation condition. Changes in scores with regard to pre-operative condition were obtained for each symptom in both sides and statistical significance determined through double-tail Wilcoxon test. Influence of demographic variables on outcome was analyzed using linear regression testing. RESULTS: A greater than 80% decrease in UPDRS score for contralateral symptoms (classified as excellent results) occurred in 14 patients (73.7%), while in the other 5 it decreased from 33 to 79% (considered suboptimal results). These changes remained statistically significant up to 48 months (p < 0.01), while ipsilateral symptoms progressively increased. Suboptimal results were associated with selective improvement of only one symptom. CONCLUSION: Raprl-DBS induces a long-term, significant improvement of contralateral acral symptoms of Parkinson's disease.

Optimizing Prelemniscal Radiations as a Target for Motor Symptoms in Parkinson's Disease Treatment.

OBJECTIVE: To better define prelemniscal radiations (Raprl) as a target for the control of tremor and rigidity in Parkinson's disease (PD). METHODS: A total of 36 deep brain stimulation (DBS) electrodes were stereotactically implanted in Raprl contralateral to the extremities to be treated. Effects on symptoms were evaluated using UPDRS-III before and after DBS, and significance was determined using the Wilcoxon test. The location of DBS contacts in cases with optimum versus suboptimum results was evaluated using Student's t test and percentage improvement correlated through a bivariable Pearson test. The power and percentage of spike components for microelectrode recordings were statistically compared between the target point and structures located above and below. RESULTS: Raprl-DBS improved tremor and rigidity (p < 0.01). The potency of microelectrode recordings indicated that the target was formed by fibers. There was no correlation between demographic characteristics and clinical outcome, and there were no significant differences in stereotactic placement between cases with optimum and suboptimum results. Tremor and rigidity were selectively improved in cases with suboptimum results. CONCLUSION: Raprl-DBS is an effective treatment for the motor symptoms of PD. Selective improvement of symptoms suggests that the target has different fiber components related to either tremor or rigidity, and variations in improvement between cases may derive from individual variations of the location of these fibers.

Metabolic Changes Induced by Electrical Stimulation of Prelemniscal Radiations for the Treatment of Parkinson Disease.

OBJECTIVE: The aim of this work was to study mechanisms of action of electrical stimulation of prelemniscal radiations (Raprl) in the treatment of Parkinson disease, using 2-deoxy-2-fluoro-D-glucose (18F-FDG) Positron Emission Tomography (PET/CT). Materialand Methods: Five patients with PD and predominant unilateral tremor, rigidity and bradykinesia underwent deep brain stimulation (DBS) in contralateral Raprl that improved symptoms from 82.4 to 94.5%. 18F-FDG PET studies were performed before electrode implantation and after DBS therapy. Changes in metabolic activity in PET were evaluated by the maximal standardized uptake value (MSUV) and statistical parametric mapping (SPM) for regions of interest (ROIs) ipsilateral and contralateral to the stimulation site. ROIs were derived from a preoperative probabilistic tractography and included primary motor, supplementary motor and orbitofrontal cortices: Raprl, ventrolateral thalamus, putamen and cerebellum. RESULTS: No significant MSUV changes occurred in ROIs contralateral to Raprl-DBS. In contrast, MSUV decreased ipsilateral to DBS in Raprl, the thalamus, and the primary and supplementary motor cortices. SPM analysis showed metabolic changes which were significantly different after DBS therapy in all ROIs ipsilateral to DBS compared to those in the contralateral side. CONCLUSION: Raprl-DBS decreases the metabolic activity of areas anatomically related to its fiber composition. Improvement of symptoms may result from a decrease in pathological overactivity of circuits related to the ROIs.

Bilateral cingulotomy and anterior capsulotomy applied to patients with aggressiveness.

OBJECTIVE: To perform a preliminary study on the effects and safety of bilateral cingulotomy and anterior capsulotomy in patients with aggressive behavior. PATIENTS AND METHODS: Twenty-three psychiatric patients showing aggressive behavior refractory to conventional treatment were initially evaluated. The subjects were clinically selected using the Overt Aggression Scale (OAS) and the Global Assessment of Functioning Scale (GAF). Each case was carefully reviewed by the Ethics Committee of Mexico's General Hospital. Once selection criteria were met, stereotactic lesions were made using radiofrequency on the anterior limb of the internal capsule and supragenual cingulum. Statistical differences were evaluated with a Wilcoxon test at 6 months and at 4 years. RESULTS: Ten patients underwent surgery. Their OAS and GAF scores decreased after the procedure at the 6-month (p < 0.05) and at the 4-year (p = 0.068) follow-up. Four patients showed mild and transitory postsurgical complications (hyperphagia and somnolence). CONCLUSIONS: Bilateral anterior capsulotomy in combination with cingulotomy may reduce aggressive behavior and improve clinical evaluations. Very strict clinical and ethical evaluations were applied prior to considering patients for this treatment.

Tratamiento de la fractura diafisaria de húmero con clavo intramedular "Telegraph®"

Introducción: El enclavado intramedular acerrojado por vía anterógrada es uno de los métodos quirúrgicos para el tratamiento de la fractura diafisaria de húmero y tiene como ventaja ser una técnica por mínimo acceso. Objetivo: Evaluar los resultados del tratamiento de la fractura diafisaria de húmero con el clavo intramedular acerrojado anterógrado "Telegraph®". Métodos: Se realizó un estudio prospectivo, longitudinal y descriptivo en 16 pacientes con fractura diafisaria de húmero; intervenidos quirúrgicamente con el sistema intramedular "Telegraph®" en el Hospital Ortopédico Docente "Fructuoso Rodríguez". Se evaluaron los resultados según la escala QuickDASH. Resultados: Predominaron los pacientes entre 40 y 60 años y del sexo femenino. El tiempo medio de seguimiento estuvo entre 27,25 ± 4,5 meses. El tipo de fractura A2a (trazo simple, oblicuo, del tercio medio) fue la más frecuente. Hubo pocas complicaciones y no afectaron el resultado final. A los 6 meses de la operación, el 75 % de los pacientes presentó un grado de dificultad nulo o incipiente. Conclusiones: Con el uso del clavo intramedular acerrojado "Telegraph®" se obtienen resultados funcionales satisfactorios por lo que constituye una opción válida de tratamiento.

Introduction: Locked intramedullary nailing by antegrade approach is one of the surgical methods for the treatment of humeral diaphyseal fracture and has the advantage of being a minimal access technique. Objective: To evaluate the results of the treatment of the diaphyseal fracture of the humerus with the Telegraph® antegrade locked intramedullary nail. Methods: A prospective, longitudinal, descriptive study was carried out in 16 patients with diaphyseal fracture of the humerus; underwent surgery with the Telegraph® intramedullary system at Fructuoso Rodríguez Orthopedic Hospital. The results were evaluated according to the QuickDASH scale. Results: There was a predominance of patients between 40 and 60 years of age and of the female sex. The mean follow-up time was 27.25 ± 4.5 months. The type of A2a fracture (simple, oblique line, of the middle third) was the most frequent. There were few complications and they did not affect the final result. Six months after the operation, 75% of the patients had no or incipient degree of difficulty. Conclusions: The use of Telegraph® locked intramedullary nail, satisfactory functional results are obtained, establishing a valid treatment option.

Tratamiento de las fracturas del antebrazo con placas de compresión dinámica

Introducción: Las fracturas del antebrazo comprometen la diáfisis del radio y el cúbito. Su relación anatómica desempeña un papel importante porque el antebrazo se vincula con los movimientos de la mano para garantizar la función de la extremidad y de los tejidos blandos. Objetivo: Evaluar los resultados del tratamiento de la fractura diafisiarias de antebrazo con placa de compresión dinámica. Métodos: Se realizó un estudio prospectivo, longitudinal y descriptivo en 28 pacientes con fractura diafisaria de antebrazo, intervenidos quirúrgicamente con placa de compresión dinámica en el Hospital Ortopédico Docente "Fructuoso Rodríguez". Los resultados fueron evaluados según la escala funcional de Grace-Eversmann. Resultados: La edad media fue de 38 años, con una proporción entre sexos de 2,1:1. Predominaron las fracturas del tercio medio del radio y del cúbito. Se afectó más el lado izquierdo, pero en el 75 % de los casos hubo un excelente resultado. No se registraron fallas con la técnica quirúrgica aplicada. Conclusiones: La osteosíntesis con placa de compresión dinámica en las fracturas diafisarias de antebrazo es una alternativa adecuada para garantizar tasas de consolidación elevadas y resultados funcionales excelentes.

Introduction: Fractures of the forearm compromise the diaphysis of the radius and ulna. Their anatomical relationship plays an important role because the forearm is linked to hand movements to ensure limb and soft tissue function. Objective: To evaluate the results of treating diaphyseal forearm fracture with dynamic compression plate. Methods: A prospective, longitudinal and descriptive study was carried out in 28 patients with diaphyseal fracture of the forearm. They underwent surgery with a dynamic compression plate at Fructuoso Rodríguez Teaching Orthopedic Hospital. The results were evaluated according to Grace-Eversmann functional scale. Results: The mean age was 38 years, with a gender ratio of 2.1:1. Fractures of the middle third of the radius and ulna predominated. The left side was affected more, but 75% of the cases had excellent result. No failures were recorded with the applied surgical technique. Conclusions: Osteosynthesis with dynamic compression plating in diaphyseal fractures of the forearm is a suitable alternative to guarantee high consolidation rates and excellent functional results.

Fractura compleja del húmero asociada a parálisis radial / Complex Fracture of the Humerus Associated with Radial Paralysis

Las fracturas de la diáfisis humeral son lesiones que se producen con frecuencia como parte de caídas o de accidentes de alta energía y se asocian con parálisis del nervio radial. Se presenta paciente de 43 años de edad, masculino, que sufre accidente automovilístico que le produce fractura diafisaria del húmero derecho multifragmentaria, por lo cual se le realiza reducción cerrada y osteosíntesis con clavo intramedular acerrojado y tratamiento conservador para la parálisis radial. La evolución fue satisfactoria, el paciente se recuperó de la parálisis a los 4 meses y logró la consolidación completa a los 5 meses. Tras un año de evolución no presenta dolor en el hombro, y tiene movilidad completa del hombro, muñeca y dedos a la extensión(AU)

Diaphyseal fracture of humerus are frequent lesions, resulting from falls or high energy accidents; they are associated to radial nerve palsy. We report the case of a 43 years old male patient, who suffered a multifragment diaphyseal fracture of his right humerus, as a result of a car accident. He underwent a closed reduction and osteosynthesis using a locking intramedullary nail for the radial paralysis. His evolution was satisfactory; this patient recovered from the paralysis after four months and he managed full consolidation five months later. After a year, he did not have any pain in his shoulder, he has full mobility of his shoulder, wrist and fingers when extendind(AU)

Resultados del tratamiento de la fractura del húmero distal con placas perpendiculares

Introducción: La fractura del extremo distal del húmero constituye un verdadero reto para los traumatólogos. Se han diseñado numerosos métodos de tratamiento quirúrgico para restaurar anatómicamente la superficie articular y lograr una estabilidad que permita la movilidad y la pronta incorporación del paciente a sus actividades diarias. Objetivo: Evaluar los resultados del tratamiento quirúrgico de la fractura del húmero distal con placas perpendiculares Métodos: Se realizó un estudio prospectivo, longitudinal, descriptivo en 18 pacientes con fractura del húmero distal, intervenidos quirúrgicamente con el sistema de placas perpendiculares en el Hospital Ortopédico Docente "Fructuoso Rodríguez" en el período 2017-2020. Los resultados se evaluaron según la escala de la clínica Mayo para la función del codo. Resultados: Se estudiaron 18 casos con un promedio de edad de 49 años. El tipo de fractura más frecuente fue la simple articular. Al año la flexoextensión media fue de 1120/160 y la pronosupinación de 810/800. La complicación más común fue la rigidez articular. El 50 % de los resultados fueron excelentes. Conclusiones: El tratamiento de la fractura de húmero distal con placas perpendiculares ofreció buenos resultados clínicos y funcionales por lo que constituye una opción válida en el Hospital Ortopédico Docente "Fructuoso Rodríguez".

Introduction: The fracture of the distal end of the humerus is a real challenge for traumatologists. Numerous surgical treatment methods have been designed to anatomically restore the joint surface and achieve stability that allows mobility and prompt return of the patient to daily activities. Objective: To evaluate the results of the surgical treatment of the distal humerus fracture with perpendicular plates. Methods: A prospective, longitudinal, descriptive study was carried out in 18 patients with fractures of the distal humerus, who underwent surgery with the perpendicular plate system. The results were evaluated according to Mayo Clinic scale for elbow function. Results: Eighteen cases with an average age of 49 years were studied. The most frequent type of fracture was simple joint. At one year, mean flexoextension was 1120/160 and pronosupination 810/800. The most common complication was joint stiffness. 50% of the results were excellent. Conclusions: The treatment of the distal humerus fracture with perpendicular plates offered good clinical and functional results, in consequence it constitutes a valid option at Fructuoso Rodríguez Orthopedic Teaching Hospital.

Biopsia transrectal ecodirigida de la próstata: estado del arte y guía práctica de consejos y trucos / Transrectal Ultrasound Biopsy of the Prostate: State of the Art and Practical Guide of Tip and Tricks

Zoom Image Resumen Introducción y Objetivos La biopsia transrectal de la próstata (BTRP), fue propuesta por primera vez en 1937 y hasta 1981 se realizó la primera biopsia ecodirigida, actualmente es la vía de acceso a la próstata más utilizada por su fácil curva de aprendizaje como por el alto rendimiento diagnóstico, sin embargo, en el Reino Unido, el 68% de los urólogos no realizan BTRP porque consideran que no han recibido suficiente entrenamiento. El objetivo de este estudio es describir las diferentes técnicas utilizadas en la actualidad, las complicaciones del procedimiento y aportar una guía de consejos y trucos implementada en varios centros de referencia a la hora de realizar una BTRP para prevenir complicaciones, mejorar el desempeño de la prueba y del urólogo y estandarizar el método de toma de la BTRP. Materiales y Métodos Realizamos una búsqueda en las bases de datos de PubMed, MEDLINE, SciELO utilizando las palabras claves "Transrectal ultrasound biopsy of the prostate" "tips and tricks" "Transperineal biopsy of the prostate" "Magnetic resonance imaging targeted biopsy" "MRI/US fusion biopsy", basados en la literatura y en la experiencia de los autores de más de 1100 biopsias anuales entre los diferentes centros de referencia. Brindamos una guía práctica de consejos y trucos para facilitar el desempeño del urólogo en la BTRP. Resultados La biopsia transrectal de próstata ecodirigida continúa siendo la primera opción para el abordaje diagnóstico del paciente con sospecha clínica de cáncer de próstata, es de gran importancia estandarizar el esquema de toma de la biopsia, y en nuestro caso recomendamos utilizar un esquema de 12 cores, definir la profilaxis antibióticas y la duración del tratamiento, y el uso de analgesia o anestesia local. Presentamos los consejos y trucos que hemos utilizado en nuestra práctica clínica en varios centros de referencia.

Introduction Transrectal biopsy of the prostate was described for the first time in 1937, and it was not until 1981 the first transrectal biopsy of the prostate was done using transrectal ultrasound to guide the procedure. Nowadays it is the most popular technique to obtain prostatic tissue when suspecting adenocarcinoma of the prostate, this due to its easy learning curve and to its excellent diagnostic performance. Up to 68% of urologist in the UK do not do prostate biopsy arguing they have not received enough training The aim of this article is to describe the different techniques, the physics of ultrasonography and a practical guide of tips and tricks from a center where we performed up to 1100 transrectal ultrasound biopsies annually, aiming to improve the diagnostic performance and lower the complicacion rates of the biopsy. Methods We performed a search in PubMed, MEDLINE, SciELO using the keywords "Transrectal ultrasound biopsy of the prostate" "tips and tricks" "Transperineal biopsy of the prostate""Magnetic resonance imaging targeted biopsy" "MRI/US fusion biopsy," and base on the literature review and our experience of more than a thousand biopsies annually we wrote this article. Results TRUS biopsy of the prostate continue to be the first choice in the urologist armamentarium to diagnose the patient with clinical suspicion of prostate cáncer, with a low complication rate, a good diagnostic performance and an easy learning curve. It is necessary to standardized the procedure, perform a doble sextant biopsy, define the best antibiotic prophylaxis, the technique for anesthesia/analgesia. Here we present our practical guide of tips and tricks.

Prostatectomía radical y calidad de vida: resultados en un centro de alta complejidad / Radical Prostatectomy and Quality of Life: Results in a Center of High Complexity

La prostatectomía radical (PR), es el procedimiento quirúrgico de elección cuando se trata de dar manejo con intención curativa al cáncer de próstata localizado. Fue el primer tratamiento quirúrgico descrito para el cáncer de próstata y ha sido realizado por más de 100 años. Tiene como ventaja importante frente a la radioterapia el permitir la estadificación precisa con el estudio patológico del espécimen quirúrgico; sin embargo, tiene algunas desventajas como la necesidad de hospitalización y recuperación post operatoria intrahospitalaria, la posibilidad de una resección incompleta y el riesgo de incontinencia urinaria y de disfunción eréctil, entre otras.1­3 La frecuencia de complicaciones y secuelas descrita en la literatura es variable, con amplios rangos según las diferentes series y autores disponibles.

Radical prostatectomy (PR) is the surgical procedure of choice when it comes to managing localized prostate cancer with curative intent. It was the first surgical treatment described for prostate cancer and has been performed for over 100 years. However, it has some disadvantages such as the need for hospitalization and in-hospital post-operative recovery, the possibility of incomplete resection and the risk of urinary incontinence and erectile dysfunction, among others.1-3 The frequency of complications and sequelae described in the literature is variable, with wide ranges according to the different series and authors available.

Prostatectomía paliativa en cáncer de próstata localmente avanzado y metastásico con uropatía obstructiva / Palliative Prostatectomy of Locally Advanced and Metastatic Prostate Cancer with Obstructive Uropathy Julián Chavarriaga Soto

La queja más frecuente en pacientes con cáncer de próstata localmente avanzado, son los síntomas urinarios bajos (SUOB), secundarios a la obstrucción al tracto de salida dela vejiga,lo que puede llevar a la retención urinaria, residuo postmiccional elevado, cistolitiasis e inclusive hidronefrosis bilateral secundaria a la uropatía obstructiva asociada al adenocarcinoma prostático. Una de las limitaciones más grandes de esos pacientes con estadio avanzado del cáncer de próstata, es que no tiene opciones curativas de tratamiento; por lo que las conductas a seguir son netamente paliativas con la finalidad de mejorar la calidad de vida que no inciden en la mortalidad especifica asociada al cáncer, ni tampoco en la sobrevida libre de enfermedad. Bajo esas circunstancias, las opciones de tratamiento son: terapia de privación androgénica y derivación de la vía urinaria, procedimientos mínimamente invasivos (Laser, Stent), resección transuretral prostática paliativa (pRTUP), prostatectomía con láser de diodo, y HPS 120 W Green laser.

The Most Frequent Complaint in Prostate Cancer Patients locally advanced, are the lower urinary symptoms (SUOB), secondary to the obstruction to the bladder outlet tract, which in turn may lead to urinary retention, postmictional residue high, cystolithiasis and even bilateral hydronephrosis secondary to obstructive uropathy associated with prostatic adenocarcinoma. One of the most important large of those patients with advanced stage cancer prostate, it is that it does not have curative options of treatment; for what the behaviors to follow are purely palliative with the to improve the quality of life that do not affect the quality of life. specific mortality associated with cancer, nor in the case of disease-free survival. Under these circumstances, the treatment options are: deprivation therapy androgenic and urinary tract bypass, procedures minimally invasive (Laser, Stent), transurethral resection palliative prostatics (pRTUP), laser prostatectomy of diode, and HPS 120 W Green laser.

Effects of rTMS on Parkinson's disease: a longitudinal fMRI study.

Parkinson's disease is a movement disorder whose principal symptoms are tremor, rigidity, bradykinesia and postural instability. Initially, drugs like L: -dopa or dopaminergic agonists are able to control these symptoms, but with the progress of the disease these drugs become less effective. Previous studies have reported that repetitive transcranial magnetic stimulation (rTMS) can improve these motor symptoms. The objective of this study was to investigate the neural mechanisms through which 25 Hz rTMS may improve motor symptoms in Parkinson's disease. In a double-blind placebo-controlled study, we evaluated the effects of 25 Hz. rTMS in 10 Parkinson's disease patients. Fifteen rTMS sessions were performed over the primary cortex on both hemispheres (one after the other) during a 12-week period. The patients were studied using functional magnetic resonance imaging during performance of a simple tapping and a complex tapping task, 1 week before the administration of the first rTMS session and just after the last session. rTMS improved bradykinesia, while functional magnetic resonance imaging showed different cortical patterns in prefrontal cortex when patients performed the complex tapping test. Furthermore, the improvement in bradykinesia is associated with caudate nucleus activity increases in simple tapping. Finally, we observed a relative change in functional connectivity between the prefrontal areas and the supplementary motor area after rTMS. These results show a potential beneficial effect of repetitive transcranial magnetic stimulation on bradykinesia in Parkinson's disease which is substantiated by neural changes observed in functional magnetic resonance imaging.