Larvae trypanorhynch (Cestoda) infecting the dusky flounder, Syacium papillosum (Paralichthyidae: Pleuronectiformes) in the continental shelf of the Yucatan Peninsula, Mexico.

Trypanorhynch cestode larvae were found parasitizing specimens of dusky flounder Syacium papillosum (Linnaeus, 1758) in the Southeastern Gulf of Mexico (s-GoM). Plerocercoids were recovered from a total of 194 flatfish, embedded in the intestine and stomach wall. Trypanorhynch were identified using morphology and a molecular phylogeny using newly sequenced partial 28S (region D1-D3) ribosomal DNA in combination with data derived from other species of trypanorhynchs available from GenBank. Larvae representing three genera of trypanorhynch cestodes, Nybelinia Poche, 1926; Kotorella Euzet & Radujkovic, 1989 and Oncomegas Dollfus, 1929 were found in dusky flounder specimens in the s-GoM. These plerocercoids represent six species: Nybelinia sp. 1, Nybelinia sp. 2, Nybelinia sp. 3, Nybelinia sp. 4, Kotorella pronosoma (Stossich, 1901) and Oncomegas wageneri (Linton, 1890) Dollfus, 1929. All cestode specimens in this study represent new locality records for their respective species.

Stephanostomum minankisi n. sp. (Digenea: Acanthocolpidae) from dusky flounder Syacium papillosum (Paralichthydae) from southern Gulf of Mexico: A new species without spines?

A new species of the genus Stephanostomum is described for the southeastern Gulf of Mexico based on morphological and nucleotide evidence. Stephanostomum minankisi n. sp. infects the intestine of the dusky flounder Syacium papillosum in the Yucatan Continental Shelf, Mexico (Yucatan Peninsula). Sequences of the 28S ribosomal gene were obtained and compared with available sequences of the other species and genera of the families Acanthocolpidae and Brachycladiidae from GenBank. A phylogenetic analysis was conducted, including 39 sequences, 26 of which represented 21 species and six genera of the family Acanthocolpidae. The new species is characterized by the absence of circumoral spines and spines on the tegument. Nonetheless, scanning electron microscopy consistently revealed the pits of 52 circumoral spines distributed in a double row with 26 spines each, and forebody spined. Other distinctive features of this species are testes in contact (sometimes overlapping), the vitellaria running along the body lateral fields to the mid-level of the cirrus-sac, pars prostatica and ejaculatory duct similar in length, and uroproct present. The phylogenetic tree showed that the three species found as parasites of dusky flounder (the new adult species and two in metacercaria stages) were grouped into two different clades. S. minankisi n. sp. was the sister species of Stephanostomum sp. 1 (Bt = 56) and formed a clade with S. tantabiddii, supported by high bootstrap values (100).

Discovery of a new species of Homalometron Stafford, 1904 (Digenea: Apocreadiidae) from the stripped mojarra, Eugerres plumieri in a coastal lagoon of the Gulf of Mexico.

To date, 34 species of the genus Homalometron (Apocreadiidae) have been described; five of them in Mexican fresh or brackish water fish, whereas five have been reported as parasites of members of the fish family Gerreidae. While sampling wildlife vertebrates during a field course of parasitology at the Los Tuxtlas Biological Station (Instituto de Biología, Universidad Nacional Autónoma de México) in Veracruz, specimens of digeneans were collected from the intestine of the stripped mojarra, Eugerres plumeri in Sontecomapan Lagoon. Specimens were studied morphologically and molecularly, and we discovered that they represented a new species of Homalometron. The new species is morphologically like the other four congeners in having three pairs of well-developed oral papillae on the oral sucker: Homalometron elongatum; Homalometron lesliorum; Homalometron carapavae; and Homalometron papilliferum. Here, we describe the newly discovered species, increasing our understanding about the parasite diversity of brackish water fishes of Mexico.

Occurrence of Ancylostoma Caninum from a Gray Fox Urocyon Cinereoargenteus in Southeastern Mexico.

The hookworm Ancylostoma caninum is a common nematode of wild and domestic canids worldwide. In Mexico, there are few records of helminths in wild canids, especially in the southeastern region. The aim of the present study was to examine the helminths from a gray fox Urocyon cinereoargenteus in southeastern Mexico. A road-killed female gray fox found in Merida, Yucatan, Mexico, was examined for helminths. Only nematodes were found in the intestine of the gray fox and identified using morphological studies and molecular analysis of 28S rRNA gene fragments. The characteristics exhibited by the nematode specimens were in accordance with descriptions of A. caninum: e. g. oral opening with a pair of prominent chitinous plates bearing three pairs of ventral teeth, lateral rays with a common trunk, dorsal ray divided into two branches with each branch terminating in three digitations. BLAST analysis of the 28S sequence showed similarity and coverage values of 99.8 % and 100 %, respectively, with a sequence of A. caninum from the domestic dog Canis familiaris in Australia. The genetic distance between the Australian specimen and the Yucatan specimen of A. caninum was 0.1 %, that is, they were only different in a single nucleotide. The gray fox examined in this study was found close to a rural community where A. caninum has been recorded from domestic dogs, which could be the source of infection. Our study increases the distribution of this nematode parasitizing the gray fox in Mexico and provides the first nucleotide sequence of A. caninum from the gray fox.

Discovery of a New Genus and Species of Allocreadiidae (Trematoda) in Mexico: Mesoamericatrema Magnisacculus n. Gen. n. Sp.

The trematodes of Allocreadiidae are mainly parasites of freshwater fish and the family contains 18 valid genera. Since 2004, 4 genera have been described in the Americas: Paracreptotrema, Paracreptotrematoides, Pseudoparacreptotrema and Auriculostoma, of which the latter was recently synonymized with Creptotrema by Franceschini et al., (2021). During a study in 2018 on fish parasites of Lacantún River, Chiapas, Mexico, allocreadiids were collected from the intestine of Atherinella alvarezi and morphological differences with other genera of the family were immediately noted. These differences were corroborated with molecular data and phylogenetic analyses, which indicated that it was a new genus and species. The objective of this study is to describe the new taxon, which we name Mesoamericatrema magnisacculus n. gen., n. sp. as well as to clarify its phylogenetic relationships, host specificity, and geographical distribution. For this, we carried out a meticulous study of the morphology and compared the new taxon with its congeners. We also obtained sequences of the 28S and ITS from the ribosomal RNA region that were used in generating molecular phylogenies and in calculating genetic distances with sequences of other species of Allocreadiidae available in the Genbank. The new genus is mainly characterized by having a very large cirrus sac in relation to the length of its body and nests in a clade that groups Creptotrema, Creptotrematina, Paracreptotrema, Paracreptotrematoides, Pseudoparacreptotrema and Wallinia, all of which have a Neotropical affinity in terms of their geographic and host distribution. Mesoamericatrema n. gen. is the fifth genus of Allocreadiidae to be described in the Americas since 2004, the third discovered in Mexico since 2016, and the first to be described as parasitizing Atheriniformes, which indicates that Middle America is a region where important speciation events have occurred in freshwater fish parasites.

Morphological and Molecular Identification of Nematodes in The Tayra Eira Barbara from Campeche, Mexico.

The tayra Eira barbara is a Neotropical mustelid considered as an endangered species by Mexican environmental authorities. Despite the considerable information available on the biology and ecology of E. barbara, little is known about its helminth fauna. Here, we provided new records of nematodes from a road-killed tayra in Calakmul, Campeche, Mexico. The species identification of nematodes was based on morphological studies and molecular analysis of fragments of the 28S gene. The tayra specimen was infected by three nematodes: Molineus sp., Physalopterinae gen. sp. and Angiostrongylus vasosum. To our knowledge, this study is the first to report the natural infection of E. barbara with Molineus sp. and Physalopterinae gen. sp. Our study provides the first nucleotide sequences of nematodes parasitizing E. barbara providing a starting point against which future studies may be compared.

Disentangling the evolutionary and biogeographical history of the freshwater fish trematode genus Creptotrema (Digenea: Allocreadiidae) using an integrative taxonomy approach: the case of Creptotrema agonostomi in Middle American mountain mullets.

Species of the allocreadiid genus Creptotrema are parasites of freshwater fishes in the Americas. Species in the genus possess one pair of muscular oral lobes on the oral sucker. Currently, the genus contains eight species, six distributed in South America, one in Middle America and one in North America. Genetic data are only available for the North American species, Creptotrema funduli, a parasite of fundulids originally described from Oneida Lake, New York State. In this study, we obtained 28S ribosomal DNA sequences of trematodes morphologically similar to Creptotrema agonostomi from the mountain mullet, Dajaus monticola, across a wide geographical range in Middle America. Our molecular phylogenetic analyses showed that (1) the genus Creptotrema, as currently conceived, is not monophyletic; (2) the allocreadiids in mountain mullets should be re-allocated in the genus Pseudoparacreptotrema; and (3) the allocreadiid trematodes from D. monticola across Middle America represent four morphologically similar species, three of which can be distinguished genetically. These three new species are described herein using an integrative taxonomy approach. We contend that accurate estimates of species diversity and phylogenetic relationships among allocreadiids, and most likely other species of trematodes, necessarily require an integrative taxonomy approach that should consider at least DNA sequences and scanning electron microscopy.

Testing the higher-level phylogenetic classification of Digenea (Platyhelminthes, Trematoda) based on nuclear rDNA sequences before entering the age of the 'next-generation' Tree of Life.

Digenea Carus, 1863 represent a highly diverse group of parasitic platyhelminths that infect all major vertebrate groups as definitive hosts. Morphology is the cornerstone of digenean systematics, but molecular markers have been instrumental in searching for a stable classification system of the subclass and in establishing more accurate species limits. The first comprehensive molecular phylogenetic tree of Digenea published in 2003 used two nuclear rRNA genes (ssrDNA = 18S rDNA and lsrDNA = 28S rDNA) and was based on 163 taxa representing 77 nominal families, resulting in a widely accepted phylogenetic classification. The genetic library for the 28S rRNA gene has increased steadily over the last 15 years because this marker possesses a strong phylogenetic signal to resolve sister-group relationships among species and to infer phylogenetic relationships at higher levels of the taxonomic hierarchy. Here, we have updated the database of 18S and 28S rRNA genes until December 2017, we have added newly generated 28S rDNA sequences and we have reassessed phylogenetic relationships to test the current higher-level classification of digeneans (at the subordinal and subfamilial levels). The new dataset consisted of 1077 digenean taxa allocated to 106 nominal families for 28S and 419 taxa in 98 families for 18S. Overall, the results were consistent with previous higher-level classification schemes, and most superfamilies and suborders were recovered as monophyletic assemblages. With the advancement of next-generation sequencing (NGS) technologies, new phylogenetic hypotheses from complete mitochondrial genomes have been proposed, although their power to resolve deep levels of trees remains controversial. Since data from NGS methods are replacing other widely used markers for phylogenetic analyses, it is timely to reassess the phylogenetic relationships of digeneans with conventional nuclear rRNA genes, and to use the new analysis to test the performance of genomic information gathered from NGS, e.g. mitogenomes, to infer higher-level relationships of this group of parasitic platyhelminths.

Morphological and molecular characterization of an enigmatic clinostomid trematode (Digenea: Clinostomidae) parasitic as metacercariae in the body cavity of freshwater fishes (Cichlidae) across Middle America.

The family Clinostomidae Lühe, 1901 contains 29 species allocated to seven genera, of which Clinostomum Leidy, 1856 is the most diverse, with c. 14 valid species. The diversity of Clinostomum has been assessed, combining morphological and molecular data. The genetic library for species in this genus has increased steadily, although there is little or no information for the other genera included in the family. Molecular phylogenetic relationships among the genera of clinostomids have not been assessed, and their classification is still based on morphological traits. The monotypic Ithyoclinostomum was described from a fish-eating bird in Brazil, and its metacercariae have been found in several locations in South America, parasitizing erythrinid freshwater fishes. We collected unusually large metacercariae from the body cavity of cichlids in several locations across Middle America. These metacercariae exhibited some resemblance to Ithyoclinostomum, although several differences prevent their inclusion in Ithyoclinostomum dimorphum, casting doubt on their taxonomic identification. The main objective of this paper was to characterize the metacercariae collected in cichlids using both morphology and molecular data from three molecular markers, and to assess the molecular phylogenetic relationships among the genera of Clinostomidae to establish the position of the newly generated sequences. We took a conservative position and tentatively placed the metacercariae as belonging to Ithyoclinostomum.

Increased plasma levels of N-terminal pro-B-type natriuretic peptide as biomarker for the diagnosis of cardioembolic ischaemic stroke.

BACKGROUND: Despite comprehensive study, the aetiology of stroke is not identified in 35% of cases. AIMS: We conducted a study to assess the diagnostic capacity of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the identification of ischaemic stroke of cardioembolic origin. The secondary purpose of the study was to evaluate the prognostic value of NT-proBNP for predicting 90-day all-cause mortality. METHODS: We designed a prospective observational study including patients hospitalised due to stroke between March 2019 and March 2020. Blood samples were collected on admission to the emergency department and serum NT-proBNP levels were determined. Statistical analysis was performed using a bivariate logistic regression model and receiver operating characteristic (ROC) and Kaplan-Meier curves. Statistical significance was established at p<.05. RESULTS: The study included 207 patients with first ischaemic stroke. Plasma NT-proBNP levels were significantly higher (p<.001) in the cardioembolic stroke group (2069pg/mL±488.5). ROC curves showed that NT-proBNP>499pg/mL was the optimum value for diagnosing cardioembolic ischaemic stroke (sensitivity, 82%; specificity, 80%). Moreover, plasma NT-proBNP levels>499pg/mL were independently associated with cardioembolic stroke (OR: 9.881; p=.001). Finally, NT-proBNP>1500pg/mL was useful for predicting 90-day mortality (sensitivity, 70%; specificity, 93%). CONCLUSIONS: NT-proBNP was independently associated with cardioembolic stroke and should be quantified in blood tests within 24h of stroke onset. High plasma levels (>499pg/mL) may indicate an underlying cardioembolic cause, which should be further studied, while NT-proBNP >1500pg/mL was associated with increased 90-day mortality.

Guidelines for the management of coagulation disorders in patients with cirrhosis.

Coagulation management in the patient with cirrhosis has undergone a significant transformation since the beginning of this century, with the concept of a rebalancing between procoagulant and anticoagulant factors. The paradigm that patients with cirrhosis have a greater bleeding tendency has changed, as a result of this rebalancing. In addition, it has brought to light the presence of complications related to thrombotic events in this group of patients. These guidelines detail aspects related to pathophysiologic mechanisms that intervene in the maintenance of hemostasis in the patient with cirrhosis, the relevance of portal hypertension, mechanical factors for the development of bleeding, modifications in the hepatic synthesis of coagulation factors, and the changes in the reticuloendothelial system in acute hepatic decompensation and acute-on-chronic liver failure. They address new aspects related to the hemorrhagic complications in patients with cirrhosis, considering the risk for bleeding during diagnostic or therapeutic procedures, as well as the usefulness of different tools for diagnosing coagulation and recommendations on the pharmacologic treatment and blood-product transfusion in the context of hemorrhage. These guidelines also update the knowledge regarding hypercoagulability in the patient with cirrhosis, as well as the efficacy and safety of treatment with the different anticoagulation regimens. Lastly, they provide recommendations on coagulation management in the context of acute-on-chronic liver failure, acute liver decompensation, and specific aspects related to the patient undergoing liver transplantation.

[Habituation deficit study in patients with episodic migraine thru nociceptive blink reflex]. / Estudio del déficit de habituación en pacientes con migraña episódica mediante reflejo de parpadeo nociceptivo.

INTRODUCTION: Lack of habituation is the most reproducible interictal neurophysiological phenomenon in episodic migraine. The aim of this study is to evaluate the habituation phenomenon by examining the nociceptive blink reflex in patients with episodic migraine. SUBJECTS AND METHODS: We conducted a cross-sectional observational case-control study. Patients with episodic migraine were selected consecutively and studied during the interictal phase. The nociceptive blink reflex was examined and a study was conducted comparing symmetry, analysis of the Euclidean distances and assessment of latency prolongation between stimulation blocks. RESULTS: Thirty-one patients and 16 healthy controls were included, their mean ages being 32.25 and 32.35 years, respectively. The controls displayed left-right symmetry. The Euclidean and Manhattan distances showed that the means of the block latencies of the groups are different and increase according to the number of blocks being compared. The means of the block latencies do not differ significantly in the migraine patient group, in contrast to what is seen in the healthy group. CONCLUSION: Habituation deficit was observed in the interictal phase in patients with episodic migraine compared to controls, as measured by the absence of latency prolongation in the nociceptive blink reflex.

TITLE: Estudio del déficit de habituación en pacientes con migraña episódica mediante reflejo de parpadeo nociceptivo.Introducción. La falta de habituación es el fenómeno neurofisiológico interictal más reproducible en la migraña episódica. El objetivo de este estudio es evaluar el fenómeno de habituación mediante el estudio del reflejo de parpadeo nociceptivo en pacientes con migraña episódica. Sujetos y métodos. Estudio observacional transversal de casos y controles. Los pacientes con migraña episódica fueron seleccionados de manera consecutiva, estudiados durante la fase interictal. Se estudió el reflejo de parpadeo nociceptivo, y se realizó un estudio comparativo de simetría, análisis de distancias euclidianas y valoración de prolongación de latencias entre bloques de estimulación. Resultados. Se incluyó a 31 pacientes y 16 controles sanos, con una edad media de 32,25 y 32,35 años, respectivamente. Los controles mostraron simetría izquierda-derecha. Las distancias euclidiana y Manhattan demostraron que las medias de las latencias por bloque de los grupos son diferentes y se incrementan según el número de bloques que se comparen. Las medias de las latencias de los bloques no difieren significativamente en el grupo de pacientes con migraña, a diferencia del grupo de sanos. Conclusión. Se observó un déficit de habituación en la fase intercrítica en pacientes con migraña episódica frente a controles, medido por la ausencia de prolongación de latencias en el reflejo de parpadeo nociceptivo.

Prevalence of esophageal inlet patch and clinical characteristics of the patients. / Prevalencia y características clínicas de pacientes con parche de mucosa gástrica ectópica en esófago.

INTRODUCTION AND AIMS: An inlet patch (IP) is the presence of gastric columnar epithelium outside of the stomach. No studies have been conducted in Mexico on that pathology. The aim of the present study was to determine the prevalence of esophageal IP and the clinical characteristics of the patients that present it. MATERIALS AND METHODS: A cross-sectional study was conducted that included consecutive patients referred for endoscopy within the time frame of September 2015 to May 2016. The patients answered a questionnaire, and high-definition endoscopy with digital chromoendoscopy was performed. The prevalence of IP was identified. The chi-square test was used to compare the clinical characteristics between patients that presented with esophageal IP and those without it. RESULTS: A total of 239 patients were included in the study. Their mean age was 53 years, and 130 (54.4%) were women. IP was found in 26 patients (10.9%), 15 of whom were men (57.7%). The main reason for referral to endoscopy was gastroesophageal reflux disease, present in 69.2% of the patients with IP and in 55.9% without IP (p=.19). The most common symptoms were heartburn and regurgitation. The former was present in 69.2% of the patients with IP and in 59.1% without IP (p=.32), and the latter was present in 65.4% of the patients with IP and 69.1% without IP (p=.7). Extraesophageal manifestation distribution was: cough in 46.2% of the patients with IP and 38% without IP (p=.45) and dysphonia in 54% with IP and 47% without IP (p=.53). Twenty-three percent of the patients with IP had Barrett's esophagus, as did 23% without IP (p=.99). CONCLUSIONS: The prevalence of IP was high. The primary referral diagnosis was gastroesophageal reflux disease. No differences were found in relation to symptoms or the presence of Barrett's esophagus between the patients with and without IP.

Radionecrosis versus disease progression in brain metastasis. Value of (18)F-DOPA PET/CT/MRI. / Radionecrosis versus progresión de la enfermedad en metástasis cerebrales: valor del (18)F-DOPA PET/TC/RM.

The use of (18)F-DOPA PET/CT with magnetic resonance imaging fusion and the use of visual methods and quantitative analysis helps to differentiate between changes post-radiosurgery vs. suspicion of disease progression in a patient with brain metastases from melanoma, thus facilitating taking early surgical action.

Amniotic membrane transplantation for persistent corneal epithelial defects in eyes after penetrating keratoplasty.

PURPOSE: To determine the primary success and recurrence rate of amniotic membrane transplantation (AMT) for the treatment of persistent corneal epithelial defects (PEDs) in eyes after penetrating keratoplasty (PK). DESIGN: Retrospective, non-randomized, observational case series. METHOD: AMT was performed in 24 eyes of 24 patients with erosions (n=6) or ulcers (n=18), which were resistant to medical therapy. All eyes had undergone one (42%) or more PKs before AMT. After the removal of epithelium and pannus (if present), one or more layers of AM ('graft' (n=3), 'patch' (n=5), 'sandwich'=combination of graft/patch (n=16)) were transplanted. Main outcome measures included 'surgical success' (epithelium closed within 4 weeks after AMT), and 'recurrence' (new epithelial defect developing during follow-up after surgical success). RESULTS: The rate of surgical success was 70% and was found to be inversely proportional to the number of previous PKs. Defects limited only to the centre of the graft had a higher success rate (central: 100%, non-central: 61%). A total of 44% successful eyes (erosions: 75% vs ulcers: 33%) had a recurrence after a mean follow-up of 16+/-13 months. The rate of surgical success was highest (81 vs 67 vs 25%) and the rate of recurrence was lowest (38 vs 90 vs 100%) with the sandwich technique in contrast to the graft or patch techniques used alone. CONCLUSIONS: AMT may be beneficial in the treatment of PEDs after PK, especially when applying the sandwich technique. Recurrences seem to be more frequent, if PK preceded AMT.

Prótesis de resuperficialización mediante luxación quirúrgica de la cadera con la técnica de Ganz / Ganz technique to resurfacing hip arthroplasty

El abordaje posterolateral para realizar las prótesis de resuperficialización es el estándar de oro para la mayoría de los autores. Este abordaje sacrifica la circulación extraósea de la cadera. Aún está por definirse qué tanto influye esta pérdida de la circulación en el desarrollo de las complicaciones más frecuentes en este tipo de prótesis como la fractura del cuello femoral y el aflojamiento aséptico. Existe la posibilidad de preservar la circulación extraósea a través de la luxación quirúrgica de la cadera descrita por Ganz. El objetivo de este artículo es describir la luxación quirúrgica de la cadera en los pacientes a los cuales se les realizó prótesis de resuperficialización.