Is resilience a unifying concept for the biological sciences?

There is increasing interest in applying resilience concepts at different scales of biological organization to address major interdisciplinary challenges from cancer to climate change. It is unclear, however, whether resilience can be a unifying concept consistently applied across the breadth of the biological sciences, or whether there is limited capacity for integration. In this review, we draw on literature from molecular biology to community ecology to ascertain commonalities and shortcomings in how resilience is measured and interpreted. Resilience is studied at all levels of biological organization, although the term is often not used. There is a suite of resilience mechanisms conserved across biological scales, and there are tradeoffs that affect resilience. Resilience is conceptually useful to help diverse researchers think about how biological systems respond to perturbations, but we need a richer lexicon to describe the diversity of perturbations, and we lack widely applicable metrics of resilience.

House sparrows prioritize skin repair over constitutive innate immunity during long-term chronic stress.

The reactive scope model was created to address two major unanswered questions in stress physiology: how and when does the adaptive acute stress response turn into harmful chronic stress? Previous studies suggest that immunoenhancement should occur in reactive homeostasis (acute stress) and immunosuppression should occur in homeostatic overload (chronic stress). We used this dichotomy of immune function to further elucidate the transition from acute to chronic stress by treating house sparrows (Passer domesticus) with different intensities of chronic stress and then monitoring their immune function. By varying the number of stressors given per day and the length of chronic stress bouts over a period of 6 months, we produced four treatment groups: high, medium, and low stress, and captivity-only. We tracked immunity through the bacterial killing assay and monitored healing of a 4 mm skin biopsy punch. We hypothesized that higher-stress birds would repair their skin more slowly and have lower bacterial killing capacity. The opposite was true-high-stress birds initially repaired their skin fastest. Additionally, all birds dramatically reduced bacterial killing capacity after the biopsy and increased food-derived uric acid, suggesting increased energy acquisition and a shift in immune resources to a more immediate concern (healing). Once healing finished, only the high-stress birds were unable to recover circulating immune function, suggesting that the combination of high stress and an immune challenge pushed these birds into homeostatic overload. Prioritizing healing over other immunological processes might be the best defense for a bird in its natural habitat.

Dual effect of the presence of fruits on leaf gas exchange and water relations of olive trees.

The presence of fruits provokes significant modifications in plant water relations and leaf gas exchange. The underlying processes driving these modifications are still uncertain and likely depend on the water deficit level. Our objective was to explain and track the modification of leaf-water relations by the presence of fruits and water deficit. With this aim, net photosynthesis rate (AN), stomatal conductance (gs), leaf osmotic potential (Ψπ), leaf soluble sugars and daily changes in a variable related to leaf turgor (leaf patch pressure) were measured in olive trees with and without fruits at the same time, under well-watered (WW) and water stress (WS) conditions. Leaf gas exchange was increased by the presence of fruits, this effect being observed mainly in WW trees, likely because under severe water stress, the dominant process is the response of the plant to the water stress and the presence of fruits has less impact on the leaf gas exchange. Ψπ was also higher for WW trees with fruits than for WW trees without fruits. Moreover, leaves from trees without fruits presented higher concentrations of soluble sugars and starch than leaves from trees with fruits for both WW and WS, these differences matching those found in Ψπ. Thus, the sugar accumulation would have had a dual effect because on one hand, it decreased Ψπ, and on the other hand, it would have downregulated AN, and finally gs in WW trees. Interestingly, the modification of Ψπ by the presence of fruits affected turgor in WW trees, the change in which can be identified with leaf turgor sensors. We conclude that plant water relationships and leaf gas exchange are modified by the presence of fruits through their effect on the export of sugars from leaves to fruits. The possibility of automatically identifying the onset of sugar demand by the fruit through the use of sensors, in addition to the water stress produced by soil water deficit and atmosphere drought, could be of great help for fruit orchard management in the future.

Cellular Toxicity Mechanisms and the Role of Autophagy in Pt(IV) Prodrug-Loaded Ultrasmall Iron Oxide Nanoparticles Used for Enhanced Drug Delivery.

Ultrasmall iron oxide nanoparticles (<10 nm) were loaded with cis-diamminetetrachloroplatinum (IV), a cisplatin (II) prodrug, and used as an efficient nanodelivery system in cell models. To gain further insight into their behavior in ovarian cancer cells, the level of cellular incorporation as well as the platination of mitochondrial and nuclear DNA were measured using inductively coupled plasma mass spectrometry (ICP-MS) strategies. Quantitative Pt results revealed that after 24 h exposure to 20 µM Pt in the form of the Pt(IV)-loaded nanoparticles, approximately 10% of the incorporated Pt was associated with nuclear DNA. This concentration increased up to 60% when cells were left to stand in drug-free media for 3 h. These results indicated that the intracellular reducing conditions permitted the slow release of cisplatin (II) from the cisplatin (IV)-loaded nanoparticles. Similar results were obtained for the platination of mitochondrial DNA, which reached levels up to 17,400 ± 75 ng Pt/ mg DNA when cells were left in drug-free media for 3 h, proving that this organelle was also a target for the action of the released cisplatin (II). The time-dependent formation of Pt-DNA adducts could be correlated with the time-dependent decrease in cell viability. Such a decrease in cell viability was correlated with the induction of apoptosis as the main route of cell death. The formation of autophagosomes, although observed upon exposure in treated cells, does not seem to have played an important role as a means for cells to overcome nanoparticles' toxicity. Thus, the designed nanosystem demonstrated high cellular penetration and the "in situ" production of the intracellularly active cisplatin (II), which is able to induce cell death, in a sustained manner.

Effect of Materials For Interim Restoration on Estimation of Working Length Using Electronic Apex Locator: in vitro Study / Efecto de Materiales Para Restauración Intermedia sobre la Estimación de la Longitud de Trabajo Endodóntico Utilizando Localizador Electrónico de Foramen: Estudio in vitro

ABSTRACT: The aim of this in vitro study was to evaluate measurement accordance using an electronic apex locator for estimation of working length in endodontics when different restorative materials for interim crown restoration are utilized. For this study, 13 single-rooted premolars with endodontic occlusal access cavity were prepared. To establish the working length of each tooth, these were mounted in alginate and with the help of an electronic foramen locator and endodontic file K-file # 15, the working length was established. This length was later compared to the estimated working lengths using different intermediate restoration materials. These materials were: Superior Chemfil, Ketac ™ Molar Easymix and Filtek z350 resin. In the electronic measurements, an acceptable tolerance range of variation up to ± 0.5 mm was considered. Highest discrepancies were considered erroneous. For these measurements, central tendency and dispersion were analyzed. The Bland-Altman method was used, and the ANOVA test with a significance level of p <0,05 for statistic difference. Regarding measurements' acceptability and the type of interim restoration material utilized, 7 were acceptable, and 6 were unacceptable for ChemFil Superior, 12 were acceptable and 1 unacceptable for Ketac™ Molar Easymix, and 11 were acceptable and 2 were unacceptable for Filtek Z350 composite resin. The average difference between all electronic measurements was 0.29 (± 0.44). Chemfill Superior showed the most prominent variation between measurements 0.58 (± 0.45). When using an electronic apex locator, measurements showed statistically significant differences depending on the interim restoration material of choice (p<0.05). In conclusion, the measurement accordance using electronic apex locator to estimation the working length is higher, however the electronic estimation of working length can be significatively affected by the material chosen for interim temporary restoration.

RESUMEN: El objetivo de este estudio in vitro, fue evaluar la concordancia de las estimaciones de longitud de trabajo mediante localizador electrónico de foramen, utilizando diferentes materiales de restauración intermedia coronaria. Para tales fines fueron preparados 13 premolares uniradiculares con cavidad de acceso oclusal endodóntico. Para establecer la a longitud de trabajo de cada diente, estos fueron montados en alginato y con la ayuda de un localizador electrónico de foramen y lima de endodoncia K-file #15 fue establecida la longitud de trabajo. Esta longitud fue comparada posteriormente con las longitudes de trabajo estimadas utilizando diferentes materiales de restauración in- termedia. Estos materiales fueron: Chemfil superior, Ketac™ Molar Easymix y resina Filtek z350. En las mediciones electrónicas, se consideró un rango de tolerancia aceptable de variación hasta ± 0,5 mm. Las discrepancias mayores se consideraron erróneas. Se calcularon medidas de tendencia central y la dispersión. Se utilizó el método de Bland- Altman y la prueba ANOVA con un nivel de significancia de p <0,05. Con respecto a la aceptabilidad de las mediciones y el tipo de material de restauración intermedia, 7 fueron aceptables y 6 fueron inaceptables para ChemFil Superior, 12 fueron aceptables y 1 inaceptable para Ketac ™ Molar Easymix, y 11 fueron aceptables y 2 fueron inaceptables para el compuesto Filtek Z350 resina. La diferencia promedio entre todas las mediciones electrónicas fue de 0,29 (± 0,44). Chemfil Superior mostró la mayor variación entre medicio- nes 0,58 (± 0,45). Las mediciones mostraron diferencias estadísticamente significativas dependiendo del material de restauración intermedio elegido (p <0,05). En conclusión, la concordancia en la estimación de la longitud de trabajo usando localizador electrónico de foramen es alta, sin embargo, puede verse afectada significativamente por el material de obturación intermedio.

Ultrasmall iron oxide nanoparticles cisplatin (IV) prodrug nanoconjugate: ICP-MS based strategies to evaluate the formation and drug delivery capabilities in single cells.

Ultrasmall iron oxide nanoparticles (<10 nm) were explored here as nanotransporters of cis-diamminetetrachloroplatinum (IV) (a cisplatin prodrug) in cellular models. The coating of the particles containing reactive carboxylic acid groups enabled the formation of a stable conjugate between the prodrug and the nanoparticles using one pot reaction. The nanoconjugate was characterized by different techniques exhibiting diameters of about 6.6 ± 1.0 nm. The use of a hyphenated strategy based on high performance liquid chromatography (HPLC) coupled to inductively coupled plasma mass spectrometry (ICP-MS) permitted the quantitative evaluation of Fe and Pt in the nanoconjugate. Furthermore, the cellular uptake of the synthetic nanoconjugate was explored by single cell-ICP-MS (SC-ICP) which was used for the first time in this type of studies. The experiments in A2780 and A2780cis, sensitive and resistant ovarian cancer cell models respectively, revealed intracellular platinum concentrations of 12 fg/cell and 4 fg/cell, respectively which were 4-fold higher with respect to the uptake of cisplatin in both models. Intracellular drug release from the nanoconjugate was proved by measuring DNA platination in the same cells. In this case, levels of about 250 ng Pt/mg DNA were observed, about 5-fold higher when the nanoconjugate was used in comparison to cisplatin. Furthermore, the differences between the two lines turned to be significantly smaller than in the case of using cisplatin. The quantitative analytical tools developed here provided essential information required to fully characterize the developed nanoplatforms particularly important to overcome drug resistance.

SUPERIOR GLUTEAL ARTERY PSEUDOANEURYSM: TWO CASES REPORT AND REVIEW OF THE LITERATURE.

INTRODUCTION: Gluteal pseudoaneurysms are extremely rare and respond to pelvic trauma, penetrating wounds, inflammation or infection in the gluteal region. CLINICAL CASES: Two men, 73 and 82 years respectively, who presented gluteal pseudoanerysm after drainage of perianal abscess the first one and after trauma the second one. In both cases the diagnosis was made by imaging tests (doppler ultrasound that was completed with computed tomographic angiography). The first one was successfully treated by ultrasound-guided injection of thrombin at the pseudoaneurysm sac. However, secondary treatment with thrombin injection and coil embolization was performed due to pseudoaneurysm reperfusion. The second one was successfully treated by embolization with hydrocoils through contralateral percutaneous femoral access as well as thrombin injection by direct ultrasound-guided puncture. DISCUSSION: The incidence, presentation and surgical strategy are discussed. Current literature is also reviewed. CONCLUSION: Ultrasound scan is the first diagnostic test, computed tomographic angiography can give more topographic information. We found selective percutaneous embolization to be the treatment of choice. Open surgical treatment should be reserved for selected cases.

Evaluation of long-term hard tissue relapse following surgical-orthodontic treatment in skeletal class II patients: A systematic review and meta-analysis.

This systematic review and meta-analysis was performed to evaluate the long-term hard tissue stability and relapse factors following surgical-orthodontic treatment in skeletal class II patients. A literature search was conducted using Embase, Cochrane Central, Web of Science, and PubMed, yielding 3184 articles published up to January 2019. Risk of bias was assessed following the Cochrane handbook. Ten articles met the inclusion criteria. A total of 1079 patients were followed up for 5-13 years. The qualitative findings showed a variety of extrinsic and intrinsic factors affecting long-term stability. Meta-analysis for the amount and direction of cephalometric landmark displacement in the vertical and sagittal planes showed significant angular increases of ANB and backward relapse of SNB, however within the clinically acceptable range of 4°. In relation to linear measurements, the mean differences in all landmarks were within the clinically acceptable range of 2mm except for gonion. In conclusion, this systematic review showed multiple intrinsic and extrinsic factors responsible for relapse. However, the outcomes of the meta-analysis are limited due to the heterogeneity of data, small number of studies, and inconsistent methods of evaluation. Further high-quality studies utilising standardised three-dimensional methodologies are required to improve the level of evidence.

Opsoclonus-myoclonus-ataxia syndrome associated with central nervous system HIV-1 escape phenomenon. / Síndrome opsoclono-mioclono-ataxia asociado a fenómeno de escape viral por virus de la inmunodeficiencia humana en el sistema nervioso central.

INTRODUCTION: Opsoclonus-myoclonus-ataxia (OMA) syndrome is a rare neurological disorder characterized by involuntary conjugate saccadic eye movements, myoclonus, and ataxia. Few reports exist on patients with HIV and OMA. CASE REPORT: A 41-year-old man diagnosed with HIV-1 infection in 1997 coursed with multiple anti-retroviral schemes as a consequence of poor adherence. In 2008 he presented an HIV-1 viral load of 100,000 copies/mL and a CD4+ T cell count of 10 cells/mm3. In 2013 our patient arrived with an 11-month history of progressive opsoclonus and ataxia. He had undetectable plasma HIV-1 RNA load and CD4+ of 606 cells/mm3. No opportunistic infections were found. Cerebrospinal fluid analysis showed mildly elevated protein concentration and HIV-1 viral load of 534 copies/mL. Cerebrospinal fluid co-receptor tropism test showed selective CCR5 usage. A brain magnetic resonance imaging showed hippocampal atrophy and T2-weighted hyperintensities. Our patient exhibited a dramatic recovery and cerebrospinal fluid HIV clearance after adjustment of anti-retroviral treatment based on genotyping resistance and tropism analyses. CONCLUSIONS: In patients with HIV presenting cengral nervous system dysfunction without opportunistic infections, cerebro-spinal fluid and plasma HIV-1 viral load, resistance and tropism tests should be performed to assess a potential viral escape and to design the appropriate anti-retroviral therapy in an individual patient basis.

TITLE: Síndrome opsoclono-mioclono-ataxia asociado a fenómeno de escape viral por virus de la inmunodeficiencia humana en el sistema nervioso central.Introducción. El síndrome opsoclono-mioclono-ataxia (OMA) es un trastorno neurológico infrecuente caracterizado por movimientos oculares conjugados sacádicos involuntarios, mioclonías y ataxia. Existen pocos casos en la bibliografía de pacientes con virus de la inmunodeficiencia humana (VIH) y OMA. Caso clínico. Varón de 41 años y diagnóstico de infección por el VIH-1 desde 1997, que cursó con múltiples esquemas antirretrovirales debido a una pobre adhesión al tratamiento. En 2008 presentó una carga viral de 100.000 copias/mL y una cuenta linfocitaria CD4+ de 10 células/mm3. En 2013 sufrió un cuadro progresivo de 11 meses de evolución caracterizado por opsoclonía y ataxia. En ese momento, su carga viral era indetectable, y la cuenta de CD4+, de 606 células/mm3. Se descartaron infecciones oportunistas. El examen del líquido cefalorraquídeo demostró hiperproteinorraquia leve y una carga viral de 534 copias/mL. El examen del tropismo de correceptor en el líquido cefalorraquídeo demostró un uso selectivo de CCR5. La resonancia magnética cerebral objetivó atrofia hipocámpica e hiperintensidades en las secuencias ponderadas en T2. El paciente mostró una recuperación clínica franca y un aclaramiento de la carga viral en el líquido cefalorraquídeo tras el ajuste de antirretrovirales basado en la resistencia de genotipo y el análisis de tropismo. Conclusiones. En pacientes con infección por el VIH y disfunción del sistema nervioso central sin infecciones oportunistas, debería llevarse a cabo una determinación de la carga viral en el plasma y el líquido cefalorraquídeo para descartar un potencial fenómeno de escape viral, así como exámenes de resistencia y tropismo para diseñar el tratamiento antirretroviral adecuado.

Evaluation of long-term hard tissue remodelling after skeletal class III orthognathic surgery: a systematic review.

This systematic review was performed to investigate the long-term hard tissue stability in orthognathic surgery patients with skeletal class III malocclusion. A literature search was conducted using the Embase, Cochrane Central, Web of Science, and PubMed databases, yielding 3690 articles published up to June 2018. Nine articles met the inclusion criteria; these reported skeletal changes in 886 patients with between 5 and 12.7 years of follow-up. Risk of bias was assessed according to the Cochrane Handbook. Results showed variations in stability based on age, facial pattern, surgical procedure, and fixation type. Young patients showed a greater increase in mandibular length and higher A-point stability after bimaxillary surgery than older patients. Dolichofacial patients showed skeletal relapse with a facial clockwise rotation, whereas counterclockwise rotation was observed in brachyfacial patients. Single mandibular setback surgery was linked to stability loss with decreased mandibular ramus and gonion angle; meanwhile, genioplasty fell into the highly stable surgery category. The hyoid bone relapsed significantly postero-inferiorly, which correlated with suprahyoid muscle changes but little to no mandibular position changes. Fixation with monocortical miniplates showed higher patient satisfaction and better stability compared to bicortical screw fixation. These conclusions should be regarded with caution because of the lack of current evidence from three-dimensional imaging.

Synergies, radiation and kinetics in photo-Fenton process with UVA-LEDs.

The photo-Fenton process, with UV-A LED (λ = 380-390, 390-400 and 380-400 nm) has demonstrated to be effective in the abatement of a target micropollutant, such as diphenhydramine hydrochloride (DPH). Different concentrations of iron (Fe2+) and H2O2 were tested and monitored, and the best results in DPH removal were obtained for the highest concentrations of both iron (II) and H2O2 (10 mg Fe2+/L - 150 mg H2O2/L). The evolution of iron and peroxide concentration was also monitored. Kinetic studies showed that dark Fenton process prevails at the beginning of the experiment, when Fe2+ concentration is higher. However, after these initial moments, the prevailing process is photo-Fenton and, in addition, wavelength radiation plays an important role. Concerning the effect of radiation, four LEDs (4.2 W total power) were used, emitting radiation in the wavelength range between 380-390 or 390-400 nm. Similar results were obtained in both cases in DPH removal by photo-Fenton (30 min for total elimination). However, a synergistic effect was observed when two LEDs of 380-390 nm and two LEDs of 390-400 nm were used. Total power was the same (4.2 W) in each experimental condition, but the increase in the wavelength range to 20 nm (380-400 nm) produces an increase in the rate of DPH removal, achieving its total elimination at 15 min. This fact, with the use of a simple radiation model, reveals the important role that radiation plays in the photo-Fenton process. Finally, the formed intermediates were determined and some reaction pathways were proposed.

[Paraganglioma of Zuckerkandl's organ. Report of two pediatric cases]. / Paraganglioma del órgano de Zuckerkandl: reporte de dos casos pediátricos.

INTRODUCTION: Pheochromocytoma is an infrequent neuroendocrine tumor, originated from neural crest cells. 10% of them are extra adrenal, located at sympathetic nodules and are known as paragangliomas. The most common place is the Zuckerkandl organ, 10 to 26% are malign and has a mortality around de 26% of the cases. CASE REPORT: We present two cases of teenagers with Zuckerkandl's organ paraganglioma, who debut with high blood pressure, diaphoresis and dyspnea. Complete tumor resection was performed in both cases, during which they presented hipertensive crisis and, after vascular pedicle ligation, hypotension. CONCLUSIONS: Zuckerkandl's organ paraganglioma is a rare pathology in pediatric population, therefore represents an important diagnostic and therapeutic challenge. Surgery differs from other tumors because of catecholamine secretion that produces hemodynamic changes and demands prompt and accurate management from surgeon and anesthetist.

INTRODUCCION: El feocromocitoma es un tumor neuroendocrino infrecuente. El 10% son extraadrenales en los ganglios simpáticos, conocidos como paragangliomas. El sitio más común es el órgano de Zuckerkandl. Son malignos en un 10 a 26% con una mortalidad del 26%. REPORTE DE CASOS: Presentamos dos casos de paraganglioma del órgano de Zuckerkandl en adolescentes, que debutan con hipertensión arterial, diaforesis y disnea. Se realizó resección completa del tumor; durante ambas cirugías presentaron crisis hipertensiva y posterior a la ligadura del pedículo vascular del tumor presentaron hipotensión, con normalización progresiva de las cifras tensionales en el postoperatorio. CONCLUSIONES: El paraganglioma del órgano de Zuckerkandl es una patología infrecuente en la población pediátrica, representa un importante reto diagnóstico y terapéutico. La cirugía difiere de las de otros tumores ya que la secreción de catecolaminas genera cambios hemodinámicos transoperatorios que exigen al cirujano y anestesiólogo un manejo rápido, eficaz y oportuno.

Prevalence of abdominal aortic aneurysm in patients with high cardiovascular risk. / Prevalencia de aneurisma de aorta abdominal en pacientes con alto riesgo cardiovascular.

BACKGROUND: To determine the prevalence of abdominal aortic aneurysm (AAA) (arterial diameter ≥30mm), in patients with high or very high cardiovascular risk (CVR) and to evaluate their clinical features. PATIENTS AND METHODS: Observational, cross-sectional and multicentric study conducted in Spanish Internal Medicine Services. We enrolled men with age >55years and women >65years who had a high or very high CVR. RESULTS: The study included 659 patients. The prevalence of AAA was 8% (53 patients). 76.9% were male with a mean age of 71±8.7years. The multivariate analysis showed an association between AAA and age (OR: 1.06; 95%CI: 1.02-1.1; P<.01), male sex (OR: 5.6; 95%CI: 1.6-18.8; P=.01), active smoking (OR: 3.22; 95%CI: 1.16-8.93; P=.024) and peripheral arterial disease (OR: 3.51; 95%CI: 1.73-7.09; P<.01). Diabetes mellitus was an independent protective factor (OR: 0.41; 95%CI: 0.22-0.78; P=.06). Those with subaneurysmal dilatation of the abdominal aorta (diameter 25-29.9mm) presented similar features as patients with AAA. CONCLUSIONS: The prevalence of AAA in patients with high CVR is high. Ultrasound screening can be performed by general practitioners. Men >65years with elevated CVR could benefit, particularly in the presence of active smoking or peripheral arterial disease.

3D Models of Female Pelvis Structures Reconstructed and Represented in Combination with Anatomical and Radiological Sections.

We present a computer program designed to visualize and interact with three-dimensional models of the main anatomical structures of the female pelvis. They are reconstructed from serial sections of corpse, from the Visible Human project of the Medical Library of the United States and from serial sections of high-resolution magnetic resonance. It is possible to represent these three-dimensional structures in any spatial orientation, together with sectional images of corpse and magnetic resonance imaging, in the three planes of space (axial, coronal and sagittal) that facilitates the anatomical understanding and the identification of the set of visceral structures of this body region. Actually, there are few studies that analysze in detail the radiological anatomy of the female pelvis using three-dimensional models together with sectional images, making use of open applications for the representation of virtual scenes on low cost Windows® platforms. Our technological development allows the observation of the main female pelvis viscera in three dimensions with a very intuitive graphic interface. This computer application represents an important training tool for both medical students and specialists in gynecology and as a preliminary step in the planning of pelvic floor surgery.

Interferon-free treatments in patients with hepatitis C genotype 3 infection in a tertiary hospital.

OBJECTIVE: Hepatitis C virus genotype 3 represents a unique entity within HCV treatment and multiple studies have documented that HCV genotype 3 infection is associated with more rapid disease progression than other genotypes, resulting in increased risk of cirrhosis, hepatocellular carcinoma, and all-cause mortality. In the current study, we further evaluated the real-world effectiveness of 12 weeks of ledipasvir/sofosbuvir ± ribavirin (LDV/SOF ± RBV) and sofosbuvir + daclatasvir (SOF + DCV) for treatment-naive or treatment-experienced patients infected with HCV genotype 3, with or without cirrhosis. METHODS: Retrospective and observational study carried out in a third level hospital. Study period: April 2015 to January 2016. Inclusion criteria: Patients with HCV genotype-3 infection treated either with LDV/SOF ± RBV or with SOF + DCV during study period treated for 12 weeks. The patients that were treated during 24 weeks were excluded and those treated with peg-interferon. The main endpoint measured was the sustained virologic response (SVR) at 12 weeks (SVR12) and the secondary endpoint was SVR at 24 weeks (SVR24). RESULTS: During the study period, 603 patients were treated in our hospital: 71 with genotype 3. We included 46 patients who were treated with LDV/SOF ± RBV or SOF + DCV for 12 weeks. A 43.75% (7/16) of all patients treated with LDV/SOF achieved SVR12, 90% (9/10) of the patients treated with LDV/SOF+RBV achieved SVR12 and 95% (19/20) of the patients treated with SOF+DCV achieved SVR12. There was statistically significant difference (p=0.001) between LDV/SOF respect to SOF+DCV and between LDV/SOF with regard to LDV/SOF +RBV (p=0.018) used to treat HCV genotype 3 infection. CONCLUSIONS: In conclusion, in our cohort of patients, the combination of SOF + DCV followed by LDV/SOF + RBV 12 weeks were the most effective in patients with HCV genotype 3 and with cirrhosis (SVR12 90% and 80%, respectively) and in those without cirrhosis (SVR12 100% in both combinations). All patients who achieved SVR12 also achieved SVR24, regardless of the regimen received.

Epidemiology and Risk Factors for Cancer After Lung Transplantation.

Cancer is the third most common cause of death among lung transplant (LT) recipients who survive for more than 1 year. The purpose of this study was to analyze the incidence and risk factors for cancer after LT in a Spanish cohort. The epidemiology and risk factors for cancer were retrospectively analyzed in LT recipients from 2 cities in Spain, Madrid and Barcelona. Of the 1353 LT patients initially included in the study, 125 (9.2%) developed cancer after a mean of 3.7 years. This frequency was 5-fold higher than in the general population. The most prevalent tumors were skin cancer (32%), lymphoproliferative disease (18%), and lung cancer (16.5%). In 4 patients, lung cancer was diagnosed on the day of the operation. The risk of cancer increased with age >55 year (hazard ratio [HR] 2.89 [1.64-5.09]; P < .001), in men (HR 2.8 [1.4-5.6]; P = .004), and in heavy smokers (>20 pack-years) (HR 2.94 [1.64-5.27]; P < .001). Other factors such as sun exposure were not found to be risk factors. In conclusion, prevalence of cancer is high in LT recipients in a Mediterranean country. Skin tumors, lymphoproliferative disease, and lung cancer are the most prevalent cancers. Age, male sex, and smoking were the main risk factors for cancer in this population.

Assessment of pre and postoperative anxiety in patients undergoing ambulatory oral surgery in primary care.

BACKGROUND: To analyze the pre- and postoperative anxiety level in patients undergoing ambulatory oral surgery (AOS) in a primary healthcare center (PHC). MATERIAL AND METHODS: Prospective and descriptive clinical study on 45 patients who underwent AOS procedures in the dental clinic of a public PHC of Spain between April and September 2015. Anxiety analysis was carried out with pre- and postoperative anxiety-state (STAI-S), anxiety-trait (STAI-T) and dental anxiety (MDAS) questionnaires. A descriptive, inferential and binary logistic regression analysis were performed for the variables age, sex, educational level, previous experience of oral treatment, type of oral surgery, degree of third molar impaction, surgical time, intraoperative complications, postoperative complications, and pain score with a visual analogue scale (VAS). RESULTS: The majority were female (57.8%) with a mean age of 33.5±9.6 years. The most frequent procedure was the lower third molar removal (82.2%). The mean pain score on the VAS was 1.6±1.8. The incidence of complications was low (7.8%). There was a statistically significant association between post- and preoperative anxiety (r=0.56, p<0.001) and a correlation between pain score and postoperative anxiety (Rho= -0.35, p=0.02). The likelihood of postoperative anxiety was related to preoperative anxiety (OR=1.3, p=0.03). CONCLUSIONS: AOS in a PHC is safe and should be more encouraged in the public primary care. The emotional impact on users was relatively low, highlighting that the preoperative anxiety levels were higher than the postoperative ones. Psychological factors related to pre- and postoperative anxiety should be considered in the AOS carried out in PC.

The malate sensing two-component system MaeKR is a non-canonical class of sensory complex for C4-dicarboxylates.

Microbial colonization of different environments is enabled to a great extent by the plasticity of their sensory mechanisms, among them, the two-component signal transduction systems (TCS). Here, an example of TCS plasticity is presented: the regulation of L-malate catabolism via malic enzyme by MaeRK in Lactobacillales. MaeKR belongs to the citrate family of TCS as the Escherichia coli DcuSR system. We show that the Lactobacillus casei histidine-kinase MaeK is defective in autophosphorylation activity as it lacks a functional catalytic and ATP binding domain. The cognate response regulator MaeR was poorly phosphorylated at its phosphoacceptor Asp in vitro. This phosphorylation, however, enhanced MaeR binding in vitro to its target sites and it was required for induction of regulated genes in vivo. Elucidation of the MaeR structure revealed that response regulator dimerization is accomplished by the swapping of α4-ß5-α5 elements between two monomers, generating a phosphoacceptor competent conformation. Sequence and phylogenetic analyses showed that the MaeKR peculiarities are not exclusive to L. casei as they are shared by the rest of orthologous systems of Lactobacillales. Our results reveal MaeKR as a non-canonical TCS displaying distinctive features: a swapped response regulator and a sensor histidine kinase lacking ATP-dependent kinase activity.

Mercury correlates with altered corticosterone but not testosterone or estradiol concentrations in common loons.

We investigated the relation between environmental mercury exposure and corticosterone concentrations in free-living adult common loons (Gavia immer). We determined blood and feather mercury concentrations and compared them to testosterone, estradiol, and stress-induced plasma corticosterone concentrations. Although neither testosterone nor estradiol correlated with Hg levels, there was a robust positive relation between blood Hg and stress-induced corticosterone concentrations in males, but not in females. The lack of an effect in females may have been due to overall less contamination in females. There were no significant correlations between feather Hg and stress-induced corticosterone in either sex. To help determine whether Hg had a causal effect on corticosterone, we investigated the impact of experimental Hg intake on the corticosterone stress response in captive juvenile loons. Juveniles were subjected to three different feeding regimes: 0, 0.4 and 1.2µg Hg (as MeHgCL)/g wet weight (ww) fish. We then measured baseline and 30min post-solitary confinement stressor corticosterone concentrations. The Hg fed chicks exhibited a decreased ability to mount a stress response. From these data, we conclude that Hg contamination does appear to alter the corticosterone response to stress, but not in a consistent predictable pattern. Regardless of the direction of change, however, exposure to mercury contamination and the resulting impact on the corticosterone stress response in common loons may substantially impact health, fitness and survival.