Plasticity of haemoglobin concentration and thermoregulation in a mountain lizard.

The plastic capability of species to cope with the new conditions created by climate change is poorly understood. This is particularly relevant for organisms restricted to high elevations because they are adapted to cold temperatures and low oxygen availability. Therefore, evaluating trait plasticity of mountain specialists is fundamental to understand their vulnerability to environmental change. We transplanted mountain lizards, Iberolacerta cyreni, 800 m downhill to evaluate the plastic response in body condition, thermoregulation traits, haemoglobin level, and haemoparasite load. Initial measurements of body mass, total haemoglobin concentration ([Hb]), hematic parasite intensities, dorsal luminance, and thermoregulatory behaviour were resampled after two and four weeks of acclimation. We also tested whether an anti-parasitic drug reduced haemoparasite intensity. After only two weeks of acclimation to a lower elevation, lizards decreased 42% in [Hb], had 17% less parasite intensities, increased body condition by 25%, and raised by ~3% their mean preferred temperatures and their voluntary thermal maximum. The anti-parasitic treatment had no significant effect on the intensity of hematic parasites, but our results suggest that negative effects of haemoparasites on [Hb] are relaxed at lower elevation. The rapid plastic changes observed in thermal preferences, body condition, [Hb], and parasite intensity of I. cyreni demonstrate a potential plastic response of a mountain specialist. This may be adaptive under the climatic extremes typical of mountain habitats. However, there is uncertainty in whether the observed plasticity can also help overcome long term environmental changes.

Paleoenvironments shaped the exchange of terrestrial vertebrates across Wallace's Line.

Faunal turnover in Indo-Australia across Wallace's Line is one of the most recognizable patterns in biogeography and has catalyzed debate about the role of evolutionary and geoclimatic history in biotic interchanges. Here, analysis of more than 20,000 vertebrate species with a model of geoclimate and biological diversification shows that broad precipitation tolerance and dispersal ability were key for exchange across the deep-time precipitation gradient spanning the region. Sundanian (Southeast Asian) lineages evolved in a climate similar to the humid "stepping stones" of Wallacea, facilitating colonization of the Sahulian (Australian) continental shelf. By contrast, Sahulian lineages predominantly evolved in drier conditions, hampering establishment in Sunda and shaping faunal distinctiveness. We demonstrate how the history of adaptation to past environmental conditions shapes asymmetrical colonization and global biogeographic structure.

New definitions of susceptibility categories EUCAST 2019: clinic application.

In January 2019, the European Committee for the Study of Antimicrobial Susceptibility (EUCAST) introduced some changes in the definitions of clinical categories for antibiotic susceptibility. The objective of these changes was to improve the credibility of category "I", optimizing and lengthening the survival and use of available antibiotics in the face of increasing antimicrobial resistance. This article aims to describe and explain these changes in the EUCAST criteria as well as make a short review about the factors on which the antibiotic susceptibility criteria depend.

Benign familial macrocephaly in a mother-son pair.

Macrocephaly can be found isolated or associated with other anomalies as a part of specific syndrome. Benign Familial Macrocephaly (BFM) is a primary macrocephaly and autosomal dominant and multifactorial inheritances had been proposed. Cole and Hughes (5), described clinically seven patients. We report two BFM cases, a boy and his mother. The male propositus showed macrocephaly with dolicocephaly shape, frontal bossing, narrowing biparietal and a square-shaped face. Neurological examination was normal. He had two computed tomography (CT) scans of the skull, one at 7 months of age showing extracerebral fluid collection in the anterior convexity and increased interhemispheric subarachnoid space and a second normal CT scan at 3 years of age. The mother showed macrocephaly with dolycocephaly shape and dished-out mid-face. This family exhibited the full clinical spectrum of BFM, with an autosomal dominant inheritance.

Reversal of cardiac cirrhosis following orthotopic heart transplantation.

Irreversible hepatic cirrhosis greatly increases the risks attending heart transplantation (HT), and is accordingly considered to be an absolute contraindication for HT unless combined heart and liver transplantation can be performed. It is now recognized that hepatic cirrhosis can undergo regression if the source of insult is removed, but no cases of post-HT regression of cirrhosis of cardiac origin have hitherto been reported. Here we report a case of cardiac cirrhosis that underwent complete regression following orthotopic HT, and we discuss the implications of this case.

Neuropsychological functioning in adolescents with first episode psychosis: a two-year follow-up study.

Cognitive deficits are a core feature of psychotic disorders. Both in adult and adolescent populations, studies have shown that patients with psychosis have poorer cognitive functioning than controls. The cognitive domains that seem to be affected are mainly attention, working memory, learning and memory, and executive function. However, with regard to the trajectory of cognitive function throughout the illness, there is still a dearth of prospective data in patients who develop psychosis during adolescence. In this article, neuropsychological functioning was assessed in a sample of 24 first episodes of early onset psychosis (EOP) and 29 healthy adolescents at baseline and after a two-year follow-up. Patients with EOP showed lower scores than controls in overall cognitive functioning and in all specific domains assessed (attention, working memory, executive function, and learning and memory) both at baseline and the two-year follow-up. When changes in cognitive functioning over two years were assessed, patients and controls showed significant improvement in almost all cognitive domains. However, this improvement disappeared in the patient group after controlling for improvement in symptomatology. Our findings support a neurodevelopmental pathological process in this sample of adolescents with psychosis.

Population structure of Pseudomonas aeruginosa through a MLST approach and antibiotic resistance profiling of a Mexican clinical collection.

Pseudomonas aeruginosa is one of the most important pathogens worldwide. Population genetics studies have shown that the P. aeruginosa population has an epidemic structure with highly conserved clonal complexes. Nonetheless, epidemiological studies of P. aeruginosa have been historically absent or infrequent in developing countries, in which different medical treatments, conditions and infrastructure may have an impact in population dynamics and evolutionary outcomes, including antibiotic resistance profiles. In this study we contribute to fill this gap by analyzing 158 P. aeruginosa isolates from the most extensive nosocomial collection in Mexico City. We investigated the population genetic structure through a MLST approach together with a classical microbiology antibiotic resistance profiling, one of the associated concerns in the evolution of this pathogen. On the one hand, our results are in accordance with previous studies on the epidemic structure of P. aeruginosa, as well as the existence of three main phylogroups, that are not related to environmental parameters. On the other hand, antibiotic resistance profiles indicate higher prevalence in our sample of multi drug resistant (75.15%), extremely drug resistant (17.72%) and pan-drug resistant (9.49%) than resistance reported in developed countries. It is important to reflect on the causes that make less developed countries hotspots of antibiotic resistance, considering the multifactorial aspects of the socio-political context of such countries that include, but are not restricted to, public policy implementation and enforcement regarding access to antibiotics, as well as health care personnel education and other obstacles related to poverty and unequal access to health services and information.

Developmental impairment of auditory evoked N1/P2 component in rats undernourished in utero: its relation to brain serotonin activity.

In utero undernourishment produces an elevation of L-tryptophan and serotonin in the brain, including the auditory cortex (A1), such changes seem to be related to an increase in the free fraction (FFT) of plasma L-tryptophan that is transported into the brain through the blood-brain barrier, where it is taken up by serotonergic neurons for serotonin synthesis. Our observations support that FFT has a positive correlation with L-tryptophan (L-Trp) and serotonin levels in the auditory cortex (r=0.95 and 0.82, respectively). Interestingly, a decreased intensity dependence of the auditory evoked N1/P2 component was found in gestationally undernourished animals during their postnatal development. The N1/P2 component had a negative correlation (r=0.81) with A1 serotonin, such that it reflects changes in the neurotransmitter concentration. The present observations suggest a relevant role of serotonin in modulating the activity of the auditory cortex. Since the N1/P2 component is mainly associated with the activity of A1 neurons, it may well be that perception of auditory information is impaired during this developmental period, in the early undernourished animals, possibly affecting cognitive processes. This may be relevant to humans since low birth weight babies that also suffered gestational undernourishment (fetal-placental insufficiency) present an increase in plasma FFT from birth up to 3 months of age. These findings support that the plasma FFT and the intensity dependence of the auditory evoked N1/P2 component relate one another and may be markers of changes of the brain serotonergic activity.

[Lichenoid drug eruption induced by olanzapine]. / Erupción liquenoide inducida por olanzapina.

Lichenoid drug eruptions can mimic idiopathic lichen planus and other dermatoses. The list of drugs that can cause them is long and growing steadily. Although cutaneous side effects of antipsychotics are rare, various cutaneous manifestations have been reported in association with olanzapine. We present the case of a patient who developed an atypical lichenoid eruption due to olanzapine. A review of the literature in Medline from 1951 to 2007 and in the Indice Médico Español (Spanish Medical Index) revealed no previous cases of lichenoid eruptions associated with the use of this drug.

[Development of human resources]. / El desarrollo de recursos humanos.

The purposes, objectives and strategies of WHO for the development of human resources are described and commented. The implication of this programme were emphasized in relation to the strategy of primary health care. The mediate and longterm plans are analyzed, underlining the fellowship activities and the training of academic personnel.

[Geriatric digestive pathology]. / Patología digestiva geriátrica.

This study shows the digestive diseases frequency, in 438 patients older than 60 years. Gastroduodenal pathology was more frequent (53%) followed by colonic diseases (34%) intestine (25.7%), intestinal parasitosis (24%) anus-rectum (19%), esophagus (17%), biliary Tract (12%) liver (7%) and pancreas (2%).

Tuberculosis intestinal: aspectos clinicos, diagnosticos y terapeuticos / Intestinal tuberculosis: clinical, diagnostic and therapeutical aspects

Presentamos el estudio de 351 pacientes de TBC intestinal observados en el Hospital Regional Honorio Delgado de Arequipa-Peru, entre 1960 y 1983. Se analizan los problemas etiopatogenicos, clinicos, diagnosticos y terapeuticos, llegandose a la conclusion que, en nuestro medio la TBC intestinal sigue constituyendo un importante problema medico-social, que debe ser encarado adecuadamente por nuestras autoridades de salud

Hepatocarcinoma: alternativas terapéuticas / Hepatocarcinoma: therapeutic alternatives

Esta patología poco común es causa de 1 millón de muertes al año con un pronóstico vital a 5 años de 5.7 por ciento. El marcador biológico más útil para su diagnóstico es la elevación de la Alfa Feto Proteína (AFP) además de servir como un marcador pronóstico. para determinar los pacientes candidatos a procedimientos quirúrgicos, así como la severidad de la enfermedad se utiliza la clasificación de child´s-Pugh y la de Okuda. El tratamiento se basa principalmente en el acto quirúrgico en aquellos pacientes que tienen la enfermedad localizada y en quimioterapia sistémica inmunoterapia, embolización o ligadura de la arteria hepática, inyección percutánea de etanol, ablación con radiofrecuencia, crioterapia y anticuerpos marcados...

Tuberculosis peritoneal y cirugía / Peritoneal tuberculosis and surgery

La TBC peritoneal es una enfermedad poco frecuente y la relación entre ésta y la cirugía abdominal es aún menos conocida y no existe mucha información respecto a la conducta frente al hallazgo de TBC peritoneal durante una cirugía abdominal. El objetivo es mostrar nuestra experiencia frente a los pacientes sometidos a cirugía abdominal y pelviana y que concomitantemente presentaban TBC peritoneal. Para esto se revisan 14 fichas de pacientes operados en el Servicio, por distintas patologías abdominales y pelvianas y con TBC peritoneal asociada. Se efectuó cirugía abdominal electiva en 11 casos; 4 fueron de urgencia; 25 porciento de los pacientes tenían linfopenia y 33 porciento hipoalbuminemia preoperatoria. Al momento de la cirugía, en todos los pacientes se pesquisó TBC peritoneal, 3 tuvieron líquido libre intraperitoneal (28 porciento). Trece pacientes fueron intervenidos de acuerdo a lo planificado; 1 no se operó frente al hallazgo de TBC peritoneal. Once casos evolucionaron satisfactoriamente de su patología abdominal quirúrgica. Concluimos que el hallazgo de TBC peritoneal no contraindica realizar la cirugía planificada, ya que la morbilidad estaría dada fundamentalmente por las condiciones generales del enfermo y por su patología abdominal quirúrgica, no teniendo relevancia el hecho de encontrar como hallazgo siembra peritoneal de origen tuberculoso