RESUMO
Phylogenies for Octopoda have, until now, been based on morphological characters or a few genes. Here we provide the complete mitogenomes and the nuclear 18S and 28S ribosomal genes of twenty Octopoda specimens, comprising 18 species of Cirrata and Incirrata, representing 13 genera and all five putative families of Cirrata (Cirroctopodidae, Cirroteuthidae, Grimpoteuthidae, Opisthoteuthidae and Stauroteuthidae) and six families of Incirrata (Amphitretidae, Argonautidae, Bathypolypodidae, Eledonidae, Enteroctopodidae, and Megaleledonidae) which were assembled using genome skimming. Phylogenetic trees were built using Maximum Likelihood and Bayesian Inference with several alignment matrices. All mitochondrial genomes had the 'typical' genome composition and gene order previously reported for octopodiforms, except Bathypolypus ergasticus, which appears to lack ND5, two tRNA genes that flank ND5 and two other tRNA genes. Argonautoidea was revealed as sister to Octopodidae by the mitochondrial protein-coding gene dataset, however, it was recovered as sister to all other incirrate octopods with strong support in an analysis using nuclear rRNA genes. Within Cirrata, our study supports two existing classifications suggesting neither is likely in conflict with the true evolutionary history of the suborder. Genome skimming is useful in the analysis of phylogenetic relationships within Octopoda; inclusion of both mitochondrial and nuclear data may be key.
Assuntos
Genoma Mitocondrial , Octopodiformes , Animais , Octopodiformes/genética , Filogenia , Teorema de Bayes , Mitocôndrias/genética , RNA de TransferênciaRESUMO
Comparative population genetics in asexual vs. sexual species offers the opportunity to investigate the impact of asexuality on genome evolution. Here, we analyse coding sequence polymorphism and divergence patterns in the fascinating Lineus ribbon worms, a group of marine, carnivorous nemerteans with unusual regeneration abilities, and in which asexual reproduction by fissiparity is documented. The population genomics of the fissiparous L. pseudolacteus is characterized by an extremely high level of heterozygosity and unexpectedly elevated πN /πS ratio, in apparent agreement with theoretical expectations under clonal evolution. Analysis of among-species allele sharing and read-count distribution, however, reveals that L. pseudolacteus is a triploid hybrid between Atlantic populations of L. sanguineus and L. lacteus. We model and quantify the relative impact of hybridity, polyploidy and asexuality on molecular variation patterns in L. pseudolacteus and conclude that (i) the peculiarities of L. pseudolacteus population genomics result in the first place from hybridization and (ii) the accumulation of new mutations through the Meselson effect is more than compensated by processes of heterozygosity erosion, such as gene conversion or gene copy loss. This study illustrates the complexity of the evolutionary processes associated with asexuality and identifies L. pseudolacteus as a promising model to study the first steps of polyploid genome evolution in an asexual context.
Assuntos
Evolução Biológica , Genética Populacional , Invertebrados/genética , Poliploidia , Transcriptoma , Animais , DNA Mitocondrial/genética , Genótipo , Heterozigoto , Hibridização Genética , Filogenia , Reprodução/genética , Reprodução Assexuada/genéticaRESUMO
BACKGROUND: In patients undergoing two-stage hepatectomy (TSH) for colorectal liver metastases (CRLM), chemotherapy is discontinued before portal vein occlusion and restarted after curative resection. Long chemotherapy-free intervals (CFI) may lead to tumor progression and poor oncological outcomes. OBJECTIVE: The aim of this study was to investigate the impact of the length of CFI on oncological outcome in patients undergoing TSH for CRLM. PATIENTS AND METHODS: Overall, 74 patients suffering from bilobar CRLM who underwent ALPPS (associating liver partition with portal vein ligation for staged hepatectomy; n = 43) or conventional TSH (n = 31) at two tertiary centers were investigated. The impact of CFI on long-term outcomes was analyzed by univariable and multivariable analysis. RESULTS: Preoperative chemotherapy was administered in 91 % (67/74) of patients, and chemotherapy was resumed postoperatively in 69 % (44/64) of patients who completed TSH. The use of postoperative chemotherapy was significantly associated with improved mean overall survival (36 ± 3 vs. 13 ± 3 months; p < 0.001). Overall, the median CFI from surgery to postoperative chemotherapy was 16 weeks (interquartile range 11-31) and was significantly shorter in the ALPPS group when compared with the conventional TSH group (10 vs. 21 weeks; p < 0.001). Multivariable analysis revealed a CFI ≤ 10 weeks as an independent factor associated with improved overall survival (p = 0.006) and disease-free survival (p = 0.010). CONCLUSION: A short CFI is associated with improved oncological outcome in patients undergoing TSH for CRLM. Decreased interstage intervals after ALPPS may facilitate the timely resumption of chemotherapy.
Assuntos
Antineoplásicos/administração & dosagem , Neoplasias Colorretais/patologia , Hepatectomia/métodos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Suspensão de Tratamento , Idoso , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Período Pré-Operatório , Critérios de Avaliação de Resposta em Tumores Sólidos , Taxa de Sobrevida , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: The role of intraoperative cholangiography (IOC) in the diagnosis, prevention and management of bile duct injury (BDI) remains controversial. The aim of the present study was to determine the value of routine IOC in the diagnosis and management of BDI sustained during laparoscopic cholecystectomy (LC) at a high-volume centre. METHODS: A retrospective analysis of a single-institution database was performed. Patients who underwent LC with routine IOC between October 1991 and May 2012 were included. RESULTS: Among 11,423 consecutive LCs IOC was performed successfully in 95.7 per cent of patients. No patient had IOC-related complications. Twenty patients (0.17 per cent) sustained a BDI during LC, and the diagnosis was made during surgery in 18 patients. Most BDIs were type D according to the Strasberg classification. The sensitivity of IOC for the detection of BDI was 79 per cent; specificity was 100 per cent. All injuries diagnosed during surgery were repaired during the same surgical procedure. Two patients developed early biliary strictures that were treated by percutaneous dilatation and a Roux-en-Y hepaticojejunostomy with satisfactory long-term results. CONCLUSION: The routine use of IOC during LC in a high-volume teaching centre was associated with a low incidence of BDI, and facilitated detection and repair during the same surgical procedure with a good outcome.
Assuntos
Ductos Biliares/lesões , Colangiografia/métodos , Colecistectomia Laparoscópica/efeitos adversos , Complicações Intraoperatórias/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Biliares/cirurgia , Feminino , Humanos , Cuidados Intraoperatórios/métodos , Complicações Intraoperatórias/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
OBJECTIVE: Knowledge of urophatogens and antibiotic susceptibility should be used to assist with empirical urinary tract infection treatment. METHODS: We retrospectively analysed local bacterial pattern and antimicrobial susceptibility in positive urinary isolates from paediatric patients collected in the period 2009-2013. Results were compared with a previous study carried out in the same sanitary area between 1995 and 1999. RESULTS: We identified 2,762 urinary isolates. Escherichia coli was the most common uropathogen (58.9%), followed by Enterococcus sp. (11.6%) and Proteus mirabilis (10.9%). More than 95% of non extended-spectrum beta-lactamase (ESBL)-producing E. coli were susceptible to nitrofurantoin, fosfomycin, cefotaxime and aminoglycosides. However, 56%, 49%, and 22% of the E. coli isolates were resistant to ampicillin, oral first-generation cephalosporins, and trimethoprim-sulfamethoxazole, respectively. Ampicillin and amoxicillin-clavulanate were the most effective antibiotics to treat Enterococcus sp. and P. mirabilis, respectively. Not significant modifications were found compared to results published at the same area in the 90´s. CONCLUSIONS: E. coli was the mostly isolated uropathogen, with a high percentage of resistance to ampicillin, oral first-generation cephalosporins, and trimethoprim-sulfamethoxazole. These urinary isolates and antimicrobial susceptibility patterns were similar to those reported in other paediatric studies and did not show significant changes compared to local previously published results. Thus, it can be considered that the current recommendations about empiric antibiotic therapy in paediatric urinary tract infections remain applicable nowadays.
Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Bacteriúria/microbiologia , Infecções Urinárias/microbiologia , Adolescente , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Enterococcus , Escherichia coli , Feminino , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Proteus mirabilis , Estudos Retrospectivos , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/urinaRESUMO
BACKGROUND: Acute appendicitis (AA) has a prevalence of 8% in the general population with a rate of complicated (perforated) appendicitis (CA) up to 40%. Serum fibrinogen may serve as an indicator for CA. PATIENTS AND METHODS: 115 patients were included from January 2012 to December 2012 using a positive pathology report for AA as a gold standard diagnostic method. We divided the patients into two groups accordingly to the pathology report: Complicated Appendicitis and Uncomplicated Appendicitis (UA). Our primary endpoint was to compare the levels of serum fibrinogen between the two groups and find if there is a relationship between fibrinogen level and CA. RESULTS: 68 patients were diagnosed with UA and 47 with CA. Using a fibrinogen value of 885 mg/dl we found to be the best cut-off for predicting complicated appendicitis with a sensitivity of 86.77% (76.87-93.71 IC 95%), a specificity of 91.49 (83.51-99.46 IC 95%), a positive predictive value of 93.65 (95% CI 86.81-99.64) and, a negative predictive value of 82.69 (95% CI 65.73-87.84). CONCLUSION: In the setting of a patient with a clinical diagnosis of AA, this study demonstrates fibrinogen as a good predictor factor for appendiceal perforation.
Assuntos
Apendicite/diagnóstico , Fibrinogênio/análise , Doença Aguda , Adolescente , Adulto , Apendicite/sangue , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Adulto JovemRESUMO
The congenital abnormalities of kidney and urinary tract (CAKUT) are disorders with a high prevalence in the general population, with urinary tract dilations being the most frequent. CAKUT also account for the most important cause of chronic kidney disease in childhood. This paper focuses on the role of the primary care paediatrician in the diagnosis, assessment, and follow-up of children with CAKUT, with special emphasis on the associated urinary tract infections, the progression toward chronic renal failure, and the genetic basis.
Assuntos
Nefropatias/congênito , Nefropatias/diagnóstico , Anormalidades Urogenitais/diagnóstico , Humanos , Pediatras , PrevalênciaRESUMO
The bacteriological profile in children with culture-positive bacteriuria was analyzed during a 5-year period. Escherichia coli was the most common cause of urinary tract infections (57%), followed by Streptococcus faecalis (11%), Pseudomonas aeruginosa (8%), and Proteus mirabilis (6%). Results of antimicrobial susceptibility testing indicated that cephalosporins (first, second and third generation) and nitrofurantoin are the best empirical oral treatment for urinary infections in children. Fosfomycin is a valid option in some cases. In hospitalized children treatment must be initiated with a third-generation cephalosporin, and gentamicin can be added in severely ill inpatients. These treatments can be modified when microbiological results become available.
Assuntos
Antibacterianos/farmacologia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Adolescente , Antibacterianos/uso terapêutico , Criança , Enterococcus faecalis/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Feminino , Humanos , Klebsiella pneumoniae/efeitos dos fármacos , Masculino , Testes de Sensibilidade Microbiana , Proteus mirabilis/efeitos dos fármacos , Pseudomonas aeruginosa/efeitos dos fármacos , Staphylococcus/efeitos dos fármacosRESUMO
OBJECTIVE: To evaluate blood pressure in a group of patients with multicystic dysplastic kidney (MDK) disease through ambulatory blood pressure (ABP) monitoring. PATIENTS AND METHODS: ABP monitoring was performed in 16 patients with MDK disease using a Spacelabs 90207 monitor and an appropriately sized armband. The patients performed their normal daily activities except physical exercise. The activity period was 8:00 am to 8:00 pm and the resting period was midnight to 6:00 am. Patients with a percentage of correct readings of less than 70 % were excluded. The mean systolic and diastolic blood pressures for each period were calculated. Circadian variability was determined by the ratio between mean systolic and diastolic values in the active and resting periods, respectively. The results were compared with ABP values in healthy children. RESULTS: Fourteen patients (mean age 16 3.1 years, range: 6-27.6) were included. No patients with hypertension were found through casual measurement. One patient had daytime systolic hypertension. Five patients presented an abnormal drop in blood pressure during sleep. CONCLUSION: Blood pressure should be monitored in patients with MDK disease. ABP monitoring may detect alterations that can go unnoticed in casual determinations. Further studies with large samples are needed to establish the real prevalence of hypertension in these patients.
Assuntos
Monitorização Ambulatorial da Pressão Arterial/métodos , Hipertensão/diagnóstico , Hipertensão/etiologia , Rim Displásico Multicístico/complicações , Adolescente , Feminino , Humanos , MasculinoRESUMO
The Argentine hemorrhagic fever (AHF) is an infectious disease, endemo-epidemical, of viral etiology, produced by the Junin virus and limited to the Buenos Aires Province, South of Córdoba, East of La Pampa, and South of Santa Fe. It generally assails rural workers at harvest-time, especially during corn-harvest. The incubation period of the disease does not exceed 12 days. A feverish syndrome with asthenia, adynamia, myalgias, migraine, photophobia, epigastralgia etc., appear. The patient has a facial erythema, petechias on the skin, enantema on the palate, conjunctive micropolyadenopaty injection. The laboratory shows a low erytro, leukopenia with aneosinophilia, thrombopenia and a urine with albuminuria and virous cells. After the fourth day, hemorrhage and a neurological case appears. The laboratory tends to normalize and cast appears in the urine. The most striking neurological signs are the following: muscular hypotonia, proprioceptive hyporreflexia or arreflexia, marinesco reflex, shakings, difficulty to stand and walk, oscillations in consciousness level, and ocular disturbances. The cytochemical test of the C.L. Rachis in the usual ways of the AHF is within its normal characteristics; on the other hand there are modifications in the nervous cases: the total proteins are nearly always increased and the cells augmented with a great predominance of mononuclear cells. The electroencephalogrammes were always abnormal, varying from a brief disorganization up to a diffusive and permanent slowness. The half of which additionally presented paroxisms generalized by slow waves. The pathological anatomy over the central nervous system makes us think that the lesion would not primitively neuronal but that the action of the virus would be indirectly done through the capillar wall. This capillar lesion is produced by multiple focuses. The neuronal destruction with necrosis by microinfarcts is minimum. The symptoms and neurological signs are present in 10% of the clinical cases; the death-rate in the nervous clinical cases having reached 50% of them. The premature treatment allows the death-rate to diminish and the cases that survive have not many after effects.
Assuntos
Doenças do Sistema Nervoso Central/etiologia , Febre Hemorrágica Americana/complicações , Adulto , Arenavirus do Novo Mundo/isolamento & purificação , Doenças do Sistema Nervoso Central/fisiopatologia , Líquido Cefalorraquidiano/citologia , Proteínas do Líquido Cefalorraquidiano/análise , Criança , Diagnóstico Diferencial , Eletroencefalografia , Febre Hemorrágica Americana/líquido cefalorraquidiano , Febre Hemorrágica Americana/microbiologia , Febre Hemorrágica Americana/fisiopatologia , Febre Hemorrágica Americana/transmissão , Humanos , Músculos/patologia , Nistagmo Patológico/etiologia , ReflexoRESUMO
The effectiveness of a commercial drug containing fibrinogen, thrombin and factor XIL (Tissucol, Immuno) was assessed in 127 patients receiving oral anticoagulant treatment with acenocoumarin who were subjected to 183 minor surgical procedures: 107 exodontia, 53 periodontal procedures, 17 combinations of the former, 4 liver biopsies and 2 skin biopsies. All but the liver biopsies were performed in the outpatient clinic. Mild haemorrhage appeared in 21 instances. None of the patients required systemic administration of coagulation factors, and the maneuvers did not take any longer than in patients with integrity of the coagulation mechanisms. The outstanding benefits of this technique are: less discomfort for patients, who can be subjected to a single procedure while otherwise requiring several sessions; anticoagulation needs not be discontinued, subcutaneous heparin being otherwise necessary; low risk of complications and avoidance of substitutive therapy; lesser economic burden, as no hospital admission is needed.