Perioperative outcome and female sexual function after laparoscopic transvaginal NOTES-assisted nephrectomy.

PURPOSE: There is a concern about the impact that this surgery could have on a patient's sexuality, although this has not been well documented. The objective of our study is to describe the surgical results and assess sexual function and patient satisfaction after transvaginal NOTES-assisted laparoscopic radical and living donor nephrectomy. METHODS: Between March 2008 and October 2014, 100 women underwent transvaginal NOTES-assisted nephrectomy (78 living donor and 22 radical nephrectomy) in our centre. The procedure was performed using two different techniques depending on the indication as described previously, but using the same vaginal approach. Variables evaluated were operative time, blood loss, intra-operative complications, hospital stay, satisfaction, first-month creatinine and warm ischaemia time in donors. Sexual function was assessed with the Female Sexual Function Index questionnaire before and after surgery. All variables were accrued in a prospective database. RESULTS: The procedure was completed in all cases. Mean age and body mass index was higher in the radical nephrectomy group. Mean operative time and hospital stay were similar for both techniques. All sexually active women reported unaltered sexual function after surgery and satisfaction with the results. The pre- and post-FSFI scores for living donor (n = 54) and radical nephrectomy (n = 4) were 27.47 ± 1.02/27.27 ± 1.10 (p > 0.05) and 31.17 ± 0.81/31.87 ± 0.97 (p > 0.05). CONCLUSIONS: Transvaginal NOTES-assisted or hybrid NOTES nephrectomy offers a safe technique with excellent cosmetic results and no sexual effect. Despite promising results, randomized controlled studies with longer follow-up are warranted to further elucidate the potential of this novel technique.

Spatial Analysis of Metal Profiles in Sediments in a Tropical Estuary: A Geostatistical Approach.

The spatial structure and distribution of heavy metals [cadmium (Cd), copper (Cu), iron (Fe), lead (Pb), and nickel (Ni)] in sediments were geostatistically analyzed along the estuarine ecosystem of Tigre River-San Andres Lagoon (Tamaulipas, Mexico). In most cases, heavy-metal concentrations exhibited a strong spatial autocorrelation along the estuary as indicated by variogram analysis. Heavy-metal concentrations were found to be higher in the middle estuary, close to the mouth of the Tigre River, and declined as distance from the mouth increased. Metal mean levels at the middle estuary were 2.41 mg/kg Cd, 4.80 mg/kg Cu, 172.36 mg/kg Fe, 5.22 mg/kg Pb, and 2.10 mg/kg Ni. The spatial distribution of heavy metals suggests the existence of a common heavy-metal source located in this area of the estuary. The importance of wastewater discharges and open dumping in the town of El Moron, adjacent to the mouth of the Tigre River, is highlighted; these are believed to be the anthropogenic sources for heavy metals in this estuarine ecosystem.

Regional-Scale Spatio-Temporal Analysis of Anastrepha ludens (Diptera: Tephritidae) Populations in the Citrus Region of Santa Engracia, Tamaulipas, Mexico.

Large citrus areas in Tamaulipas are affected by Anastrepha ludens (Loew) populations. Here we report the findings of a spatio-temporal analysis of A. ludens on an extended citrus area from 2008-2011 aimed at analyzing the probabilities of A. ludens infestation and developing an infestation risk classification for citrus production. A Geographic Information System combined with the indicator kriging geostatistics technique was used to assess A. ludens adult densities in the spring and fall. During the spring, our models predicted higher probabilities of infestation in the western region, close to the Sierra Madre Oriental, than in the east. Although a patchy distribution of probabilities was observed in the fall, there was a trend toward higher probabilities of infestation in the west than east. The final raster models summarized the probability maps using a three-tiered infestation risk classification (low-, medium-, and high risk). These models confirmed the greater infestation risk in the west in both seasons. These risk classification data support arguments for the use of the sterile insect technique and biological control in this extended citrus area and will have practical implications for the area-wide integrated pest management carried out by the National Program Against Fruit Flies in Tamaulipas, Mexico.

Marked testosterone deficiency-related symptoms may be associated to higher metabolic risk in men with low testosterone levels.

INTRODUCTION: Testosterone deficiency syndrome (TDS) is usually suspected on the basis of signs/symptoms. However, some men with low testosterone levels (low T) are asymptomatic or present mild, unnoticed symptoms. Would they have the same cardiovascular risk as symptomatic men? AIMS: This study aims to assess the relationship between presence/severity of low T-related symptoms and the likelihood of metabolic syndrome (MetS). METHODS: Data were taken from a multicenter, cross-sectional study conducted in Spain among men visiting men's healthcare offices aged ≥45 with low T (total T <8 nmol/L or <12 nmol/L and calculated free T <250 nmol/L). Only subjects whose MetS components and symptoms had been assessed were selected. Data available included anthropometrics, toxic habits, comorbidities, and total testosterone (TT) levels. MAIN OUTCOME MEASURES: MetS was defined using the harmonized definition. Erectile dysfunction was classified using the International Index of Erectile Function questionnaire. The Ageing Male Symptoms (AMS) scale assessed symptoms. Symptom severity was classified as "none/mild" and "moderate/severe." Bivariate and multivariate logistic regression analyses were performed to calculate the effect of moderate/severe symptoms on the odds ratio (OR) for MetS. RESULTS: Mean age (SD) was 61.2 (8.1) years. Erectile dysfunction (ED), AMS, and MetS prevalence were 97.4%, 94.9%, and 69.6%. Prevalence of MetS was higher in men with moderate/severe symptoms vs. men with no/mild ones (75.3% vs. 57.9%, P < 0.001). Age and prevalence of TT <8 nmol/L, moderate/severe ED, and obesity were significantly higher in men with moderate/severe symptoms. Multivariate analysis showed that besides obesity and moderate/severe ED, moderate/severe symptoms increased the likelihood of MetS. This effect disappeared in men with severe ED and in the nonobese. Three symptoms showed relationship with MetS after adjusting for all confounding factors. CONCLUSION: Severity of TDS symptoms may indicate higher cardiovascular risk in men with low T.

Cadmium and lead levels along the estuarine ecosystem of Tigre River-San Andres Lagoon, Tamaulipas, Mexico.

Cadmium and lead levels were evaluated in water and sediment along the estuarine ecosystem of Tigre River-San Andres Lagoon (Gulf of Mexico) during September to December 2009. Significant highest metal concentration in water (0.45 mg L(-1) Cd and 3.94 mg L(-1) Pb) and sediment (2.83 mg kg(-1) Cd and 6.61 mg kg(-1) Pb) were found at the mouth of the Tigre River, where the fishing town of El Moron is located. Cadmium levels in sediment were above limits associated with adverse biological effects on aquatic fauna, so negative impacts on natural populations of aquatic organisms would be expected to occur. This in turn could affect the fishery resources inhabiting this ecosystem.

Density-dependent condition of juvenile penaeid shrimps in seagrass-dominated aquatic vegetation beds located at different distance from a tidal inlet.

Seagrasses are critical habitats for the recruitment and growth of juvenile penaeid shrimps within estuaries and coastal lagoons. The location of a seagrass bed within the lagoon can determine the value of a particular bed for shrimp populations. Consequently, differences in the abundance of shrimp can be found in seagrasses depending on their location. As shrimp density increases, density-dependent effects on biological parameters are more likely to occur. However, knowledge about density-dependent processes on shrimp populations in nursery habitats remains limited. The present investigation was undertaken to examine the effects of population density on shrimp condition in two selected seagrass beds, located at different distance from a tidal inlet, one 25 km away (distant) and the other 1 km away (nearby), in a subtropical coastal lagoon. The study was based on monthly samplings during one year in Laguna Madre (Mexico), performing a total of 36 shrimp trawls (100 m2 each one) within each seagrass bed (n = 3 trawls per bed per month for 12 months). Shrimp density was related to the proximity to the tidal inlet (higher density was consistently observed in the nearby seagrass bed), which in turn adversely affected the condition of both species studied (Penaeus aztecus and P. duorarum). In this regard, the present study provides the first evidence of density-dependent effects on shrimp condition inhabiting a nursery habitat. Both shrimp species exhibited a negative relationship between condition and shrimp density. However, this pattern differed depending on the proximity to the tidal inlet, suggesting that shrimp populations inhabiting the nearby seagrass bed are exposed to density-dependent effects on condition; whereas, such effects were not detected in the distant seagrass bed. Shrimp density within the distant seagrass bed was probably below carrying capacity, which is suggested by the better shrimp condition observed in that area of the lagoon. Intra and interspecific competition for food items is surmised to occur, predominantly within seagrass beds near the tidal inlet. However, this hypothesis needs to be tested in future studies.

Effect of Propolis, a Honeybee Product, Against a Parasite (Ligictaluridus floridanus) from Catfish (Ictalurus punctatus) Gills.

PURPOSE: The aim of this study was to evaluate the in vitro and in vivo efficacy of propolis against Ligictaluridus floridanus on Ictalurus punctatus gills. METHODS: This study used an ethanol extract of propolis at a concentration of 300 mg mL-1, with a total polyphenol concentration of 2.77 mg mL-1 as determined by chromatography. In vitro trial used propolis concentrations at 5, 30 as well as 60 mg L-1 and a 70% ethanol control group to treat naturally infected catfish. The in vivo experiment was 16 weeks in duration, consisting of seventy-two fish infected by cohabitation and subjected to one-hour baths every 72 h during the trial. RESULTS: In vitro studies showed that parasites exposed to 60 mg L-1 of propolis displayed a significant reduction (p < 0.05) in their survival time. In vivo studies confirmed the reduction of intensity and abundance of Ligictaluridus floridanus on the gills of channel catfish. CONCLUSION: This study has provided the first challenge of propolis against L. floridanus on I. punctatus gills and shows that propolis has an anthelmintic effect.

Cooperative energetic effects elicited by the yeast Shwachman-Diamond syndrome protein (Sdo1) and guanine nucleotides modulate the complex conformational landscape of the elongation factor-like 1 (Efl1) GTPase.

One of the final maturation steps of the large ribosomal subunit requires the joint action of the elongation factor-like 1 (human EFL1, yeast Efl1) GTPase and the Shwachman-Diamond syndrome protein (human SBDS, yeast Sdo1) to release the eukaryotic translation initiation factor 6 (human eIF6, yeast Tif6) and allow the assembly of mature ribosomes. EFL1 function is driven by conformational changes. However, the nature of such conformational changes or the mechanism by which they are prompted are still largely unknown. In previous studies, it has been established that this GTPase interacts with its cofactor in solution in an inverted orientation with respect to the binding mode derived from 60S ribosome subunit cryo-EM data. To shed new light on this conundrum, we characterized calorimetrically the energetic basis describing the recognition of Efl1 to GT(D)P, Sdo1 and their intercommunication in solution. A structural-based analysis of the binding signatures indicates that Efl1 has a large structural flexibility. The mutual effects of Sdo1 and nucleotides on Efl1 modulate in a very specific and robust way the complex conformational landscape of Efl1, resembling the behavior observed with other GTPases and their cofactors.

[ Segmental ostial ablation to interrupt electrical conduction in a single pulmonary vein for the prevention of idiopathic paroxysmal atrial fibrillation]. / Ablación segmentaria del ostium de la vena pulmonar superior izquierda para eliminar actividad eléctrica anormal generadora de fibrilación atrial paroxística idiopática.

Several studies have shown the role of focal trigers in the pulmonary veins initiating episodes of atrial fibrillation. Radiofrequency catheter ablation of this foci is a curative therapy for paroxysmal atrial fibrillation. We report a case of idiopathic paroxysmal atrial fibrillation triggered by abnormal electrical activity in a single pulmonary vein. Mapping was performed during sinus rhythm with a 4F decapolar catheter (Spiral Supreme, Daig, St. Jude Medical) positioned near the ostium by a transseptal approach. Pulmonary vein potentials were only identified in the left superior pulmonary vein. Segmental ostial ablation (30 W) performed during left atrial pacing resulted in complete cesation of conduction in the pulmonary vein. There were no complications. The clinical response (suppression of the paroxysms of atrial fibrillation in a 9-month follow-up) observed in this patient imply that atrial fibrillation was triggered by this pulmonary vein. This case report illustrates several aspects of catheter-based ablation of pulmonary vein foci for the treatment of paroxysmal atrial fibrillation and demonstrates its efficacy.

Restorative Rehabilitation of a Patient with Generalized Non-Carious Cervical Lesions: Case Report / Rehabilitación restaurativa de un paciente con lesiones cervicales no-cariosas generalizadas: Reporte de un caso

ABSTRACT Non-Carious Cervical Lesions (NCCL) are a current problem of multifactorial origin that is associated with the loss of vertical occlusal dimension, hypersensitivity, loss of teeth, fractures, and many other pathologies that affect the masticatory function of the oral cavity. Identification of the etiological factors of NCCL comprises a key piece for the solution of the problem. Based on clinical scientific evidence related with the diagnosis, a restorative treatment must be planned according to the loss of dental structure in order to return function and aesthetics. The purpose of this case report was to describe a 54-year-old male patient who was diagnosed with generalized NCCL combined with occlusal vertical dimension loss. The protocol of the treatment process is described.

RESUMEN Las lesiones cervicales no cariosas (LCNC) son una problemática actual de origen multifactorial, la cual se ve asociada a la pérdida de dimensión vertical oclusal, hipersensibilidad, pérdida de dientes, fracturas y muchas otras patologías que afectan la función masticatoria de la cavidad bucal. La identificación de los factores etiológicos de las LCNC son piezas claves para la solución del problema. Basados en la evidencia científica clínica relacionado con el diagnóstico, se debe planificar un plan de tratamiento restaurativo que depende de la pérdida de la estructura dentaria para devolver la función y estética. El objetivo de este reporte de caso es describir a un paciente masculino de 54 años a quien se le diagnosticó LCNC generalizadas combinado con una pérdida de dimensión vertical oclusal. El protocolo de plan de tratamiento es descrito paso a paso.

Brucellosis and polyneuroradiculomyeloencephalitis: a case report

Reports on simultaneous central and peripheral nervous system involvement in a patient with brucellosis are very rare. We report of one young female patient with a long history of consumption of non-pasteurized dairy products in which clinical and laboratory findings confirmed the existence of an active brucellosis with nervous system impairment. Cerebrospinal fluid were negative. Elctrophysiology and positive findings on sural nerve biopsy complemented the diagnosis of polyneuroradiculomyelo encephalitis. Treatment with a combination of doxycycline and rifampin for 2 months was successfully applied. No relapse or sequelae occurred in the patient after 12 monts of follow up

Event related brain potentials to semantically incongruent words in children of different ages

In this study, developmental changes of N400 elicited by a simple paradigm to semantic incongruity were examined. Subjects were divided in three different age groups and education levels: Group I (first grade) = 7-8 years, n=10; Group II (third grade) = 9-10 years, n=10; and Group III (sith grade)= 11-12 years, n=10. EEG activity was recorded from 8 monopolar sites referred to linked earlobes. Data showed that the amplitude of the N400 like component did not change significantly from first to sith grade, although the onset latency appeared to be shorter in older children. No significant latency and amplitude changes were found among groups