Regulation of lactate dehydrogenase in response to WSSV infection in the shrimp Litopenaeus vannamei.

Lactate dehydrogenase (LDH) is key for anaerobic glycolysis. LDH is induced by the hypoxia inducible factor -1 (HIF-1). HIF-1 induces genes involved in glucose metabolism and regulates cellular oxygen homeostasis. HIF-1 is formed by a regulatory α-subunit (HIF-1α) and a constitutive ß-subunit (HIF-1ß). The white spot syndrome virus (WSSV) induces anaerobic glycolysis in shrimp hemocytes, associated with lactate accumulation. Although infection and lactate production are associated, the LDH role in WSSV-infected shrimp has not been examined. In this work, the effects of HIF-1 silencing on the expression of two LDH subunits (LDHvan-1 and LDHvan-2) in shrimp infected with the WSSV were studied. HIF-1α transcripts increased in gills, hepatopancreas, and muscle after WSSV infection, while HIF-1ß remained constitutively expressed. The expression for both LDH subunits increased in each tissue evaluated during the WSSV infection, translating into increased enzyme activity. Glucose concentration increased in each tissue evaluated, while lactate increased in gills and hepatopancreas, but not in muscle. Silencing of HIF-1α blocked the increase of LDH expression and enzyme activity, along with glucose (all tissues) and lactate (gills and hepatopancreas) concentrations produced by WSSV infection. These results demonstrate that HIF-1 up regulates the expression of LDH subunits during WSSV infection, and that this induction contributes to substrate metabolism in energetically active tissues of infected shrimp.

Use of an experimental model to evaluate infection resistance of meshes in abdominal wall surgery.

BACKGROUND: Staphylococcal species are the most common organisms causing prosthetic mesh infections, however, infections due to rapidly growing mycobacteria are increasing. This study evaluates the resistance of biomaterial for abdominal wall prostheses against the development of postoperative infection in a rat model. MATERIAL AND METHODS: In 75 rats, we intramuscularly implanted three different types of prostheses: (1) low-density polypropylene monofilament mesh (PMM), (2) high-density PMM, and (3) a composite prosthesis composed of low-density PMM and a nonporous hydrophilic film. Meshes were inoculated with a suspension containing 108 colony-forming units of Staphylococcus aureus, Staphylococcus epidermidis, Mycobacterium fortuitum, or Mycobacterium abscessus before wound closure. Animals were sacrificed on the eighth day postoperatively for clinical evaluation, and the implants were removed for bacteriologic analyses. RESULTS: Prostheses infected with S aureus showed a higher bacterial viability, worse integration, and clinical outcome compared with infection by other bacteria. Composite prostheses showed a higher number of viable colonies of both M fortuitum and Staphylococcus spp., with poorer integration in host tissue. However, when the composite prosthesis was infected with M abscessus, a lower number of viable bacteria were isolated and a better integration was observed compared with infection by other bacteria. CONCLUSIONS: Considering M abscessus, a smaller collagen-free contact surface shows better resistance to infection, however, depending on the type of bacteria, prostheses with a large surface, and covered with collagen shows reduced resistance to infection, worse integration, and worse clinical outcome.

"Low-field" intraoperative MRI: a new scenario, a new adaptation.

AIM: To describe the adaptation of Cruces University Hospital to the use of intraoperative magnetic resonance imaging (ioMRI), and how the acquisition and use of this technology would impact the day-to-day running of the neurosurgical suite. MATERIALS AND METHODS: With the approval of the ethics committee, an observational, prospective study was performed from June 2012 to April 2014, which included 109 neurosurgical procedures with the assistance of ioMRI. These were performed using the Polestar N-30 system (PSN30; Medtronic Navigation, Louisville, CO), which was integrated into the operating room. RESULTS: A total of 159 procedures were included: 109 cranial surgeries assisted with ioMRI and 50 control cases (no ioMRI use). There were no statistical significant differences when anaesthetic time (p=0.587) and surgical time (p=0.792) were compared; however, an important difference was shown in duration of patient positioning (p<0.0009) and total duration of the procedure (p<0.0009) between both groups. CONCLUSIONS: The introduction of ioMRI is necessary for most neurosurgical suites; however, a few things need to be taken into consideration when adapting to it. Increase procedure time, the use of specific MRI-safe devices, as well as a checklist for each patient to minimise risks, should be taken into consideration.

Fructose 6-phosphate phosphoketolase activity in wild-type strains of Lactobacillus, isolated from the intestinal tract of pigs.

Phosphoketolases are key enzymes of the phosphoketolase pathway of heterofermentative lactic acid bacteria, which include lactobacilli. In heterofermentative lactobacilli xylulose 5-phosphate phosphoketolase (X5PPK) is the main enzyme of the phosphoketolase pathway. However, activity of fructose 6-phosphate phosphoketolase (F6PPK) has always been considered absent in lactic acid bacteria. In this study, the F6PPK activity was detected in 24 porcine wild-type strains of Lactobacillus reuteri and Lactobacillus mucosae, but not in the Lactobacillus salivarius or in L. reuteri ATCC strains. The activity of F6PPK increased after treatment of the culture at low-pH and diminished after porcine bile-salts stress conditions in wild-type strains of L. reuteri. Colorimetric quantification at 505 nm allowed to differentiate between microbial strains with low activity and without the activity of F6PPK. Additionally, activity of F6PPK and the X5PPK gene expression levels were evaluated by real time PCR, under stress and nonstress conditions, in 3 L. reuteri strains. Although an exact correlation, between enzyme activity and gene expression was not obtained, it remains possible that the xpk gene codes for a phosphoketolase with dual substrate, at least in the analyzed strains of L. reuteri.

[Perioperative considerations in vagal nerve stimulator implantation]. / Aspectos perioperatorios de la implantación de un estimulador vagal.

Vagal nerve stimulation has become an a important tool in the treatment of refractory epilepsy, which continues to be the main indication for this technique. Other therapeutic indications are emerging, however, and vagal nerve stimulation has now been approved for major depression. Additional possible uses under study include morbid obesity, Alzheimer disease, chronic pain syndromes, and certain neuropsychologic disorders. This review considers perioperative aspects relevant to using this therapeutic procedure with a view to facilitating better and more integrated management of its application.

Simulating the migration of drifters deployed in the Bay of Biscay, during the Prestige crisis.

A main conclusion following the oil spill from the Prestige tanker was that improvements in ocean circulation models were necessary; this was in order to predict, more accurately, the trajectories followed by the oil slicks and hence assist in fight against oil pollution operations. In this contribution, the results of the validation of a semi-empirical ocean circulation model, parameterised for the Bay of Biscay and forced with operational oceano-meteorological remote sensing observations, are shown. The model results have been validated with observations from drifting buoys, deployed in the Bay of Biscay during the crisis. The results show that the model explains a relatively large percentage of the current variability. The comparisons between the real and the estimated drifter trajectories indicate that for 3, 5 and 7 day-long trajectories, the drifter position is estimated with errors of approximately 23, 35 and 46km, respectively. The model reproduces relatively well the trajectory followed by the drifter with the shortest period (23 days).

Canine versus human epilepsy: are we up to date?

In this paper we analyse and compare features of canine and human epilepsy and we suggest new tools for better future understanding of canine epilepsy. The prevalence of epileptic seizures in dogs ranges between 0.5% and 5.7% and between 1% and 3% in the human population. Studies on human epilepsy provide a ready-made format for classification, diagnosis and treatment in veterinary epilepsy. Human studies highlight the value of a thorough seizure classification. Nevertheless, a matter of concern in canine epilepsy is the limited information regarding seizure description and classification because of the lack of EEG-video recording. Establishment of a consensus protocol for ambulatory home video-recording in dogs who suffer from epilepsy, mainly considering indications, duration of monitoring, the sufficient essential training for an optimal interpretation of ictal semiology and the methodology of recordings is needed. The ultimate goal is that the information gathered by these videos will be analysed to describe the epileptic seizures thoroughly, recognize patterns and move towards a better understanding and therefore classification of canine epileptic seizures.

Use of BIS VISTA bilateral monitor for diagnosis of intraoperative seizures, a case report.

Changes in BIS (bispectral index) VISTA bilateral monitoring system associated with intraoperative episodes of generalized and focal seizures, during total intravenous anesthesia for resection of a left frontal parasagittal meningioma, are herein described.

Glycolipids as the major autoantigens of cytoplasmatic islet cell antibodies.

It has been recently suggested that pancreatic glycolipidic extracts and acidic glycolipid fractions are able to block the binding of ICA to frozen sections of human pancreas. We study the prevalence of blocking effect by the upper-phase from human pancreatic glycolipid extracts (PGE) in thirty-eight sera ICA positive from seventeen IDDM patients and twenty-one first relatives of type 1 diabetics. Total inhibition was found in 82% and 76% insulin dependent diabetes mellitus patients and first relatives of type 1 diabetics respectively. Partial and no inhibition of ICA+ sera was seen in 6%, 12% of type 1 diabetics and 19%, 5% of the first degree relatives of type 1 diabetics respectively. Our study suggests that there is heterogeneity of cytoplasmatic islet cell antibodies and that glycolipids are the major autoantigen of ICA.

Losartan inhibits in vitro platelet activation: comparison with candesartan and valsartan.

A recent study has shown that losartan, an AT(1)-receptor antagonist, interacts with thromboxane A(2) (TxA(2))/prostaglandin H(2) (PGH(2)) receptors in human platelets. The aim of the present study was to analyse the ability of different angiotensin II (Ang II) AT(1)-receptor antagonists to inhibit TxA(2)-dependent human platelet activation. Platelets were obtained from healthy volunteers and were stimulated with the thromboxane A(2) analogue, U46619 (10(-6) mol/L). U46619-stimulated platelet activation was significantly reduced by losartan in a dose-dependent manner. Only maximal doses of valsartan (5x10(-6) mol/L), reduced U46619-induced platelet activation. The active form of candesartan cilexetil, candesartan (CV-11974), failed to modify platelet activation. Losartan reduced the binding of [(3)H]-U46619 to platelets, an effect that was observed to a lesser extent with valsartan but not with CV-11974. These results suggest that, whilst some AT(1)-receptor antagonists reduce TxA(2)-dependent human platelet activation, it is not a feature common to all AT(1) antagonists.

Caroli's disease: study of six cases, including one with epithelial dysplasia.

Six cases of Caroli's Disease are reviewed. Three of the patients had an associated form of the disease, one of which had a congenital hepatic fibrosis, another a cystic dilatation of extrahepatic bile duct and the last one suffered both the above mentioned associated anomalies. Three patients presented with the simple form which was initially described by Caroli. The distribution of the biliary lesions was a bilobar one in four cases and monolobar in two. One patient presented areas of biliary ectasia partially lined by dysplastic epithelium. Surgical treatment was used in four cases, a left hepatectomy being carried out in two of them and an internal biliary drainage by Roux-Y hepaticojejunostomy in the other two. This is a rare disease, frequently associated with congenital hepatic fibrosis, possibly pre-malignant and whose treatment of choice is hepatic resection.

[Primary gallbladder carcinoma. A review of 41 cases]. / Carcinoma primario de vesícula biliar. Revisión de 41 casos.

We present a retrospective study of primary carcinoma of the gallbladder with a total of 41 cases over a period of 11 years. In the majority of cases the clinical presentation (cholelithiasis, choledocholithiasis); there were only 7 cases of suspected diagnosis, mainly through the use of new diagnostic techniques (echography, computerized tomography). The classification used is that described by Nevin (1976) of affection of gallbladder wall and adjacent tissues. The conclusions of our study are as follows: a) primary neoplasias of the gallbladder are aggressive tumours carrying a poor prognosis aggravated usually late diagnosis due to the scarce symptomatology, b) given the high incidence of cholelithiasis, it is advisable to perform routine cholecystectomy, c) survival is related to the histological grading of the tissues.

[Cystic mucinous tumor of the pancreas . A new case]. / Tumores quísticos mucinosos de páncreas. Un nuevo caso.

The case of a woman with a mucinous cystadenoma of the pancreas is presented. Caudal pancreatectomy was performed. Post-operative course was uneventful.

[Ogilvie syndrome treated with endoscopic decompression]. / Síndrome de Ogilvie tratado mediante descompresión endoscópica.

An elderly woman with multiple myeloma was admitted to the hospital because of colonic obstruction due to Ogilvie's syndrome. Successful decompression was obtained by colonoscopy.

[Melanoma of the small intestine and adenocarcinoma of the colon]. / Melanoma de intestino delgado y adenocarcinoma de colon.

The clinical case of a 73-years old male who was admitted for diarrhea and loss of weight is presented. Barium enema and colonoscopy demonstrated small size polyps in the sigmoid colon, one of which had a histologic diagnosis of adenocarcinoma. Abdominal examination detected a mass in the mesohypogastrium which did not appear to be related to the previous findings. CAT and intestinal transit confirmed a second tumor in the small bowel with the histologic diagnosis of a resected specimen being melanoma.

[Prophylactic use of icatibant before tracheal intubation of a patient with hereditary angioedema type III. (A literature review of perioperative management of patients with hereditary angioedema type III)]. / Uso profiláctico de icatibant en un caso de angioedema hereditario tipo III. (Revisión de la literatura sobre manejo perioperatorio en pacientes con angioedema hereditario tipo III).

Type III hereditary angioedema is a rare familial disorder that has recently been described as a separate condition. Triggers for episodes of angioedema include surgery, dental procedures, and tracheal intubation maneuvers. Since episodes affecting the upper airway are potentially life-threatening, prophylactic treatment is recommended in these situations. The use of icatibant (Firazyr(®)), for prevention of angioedema prior to tracheal intubation, is reported in a patient with type iii hereditary angioedema. A literature review on the anesthetic management of this condition was conducted.

Personalised iron supply for prophylaxis and treatment of pregnant women as a way to ensure normal iron levels in their breast milk.

RATIONALE: Because the characteristics of all body fluids depends on patient's health status, is it possible that disadvantaged and socially vulnerable mothers may have lower amounts of iron in their breast milk, and that their babies receive lower content of the mineral for their normal growth and development. Assuring a preventive treatment of the mother might solve this problem. OBJECTIVE: To demonstrate breast milk iron content from disadvantaged mothers and impact of personalized iron supplementation program. MATERIALS AND METHODS: cross-sectional study. Breast milk samples were obtained for ferritin analysis. Health's services usually provides free folic acid and iron treatment however, treatment compliance is low. Patients were random in two groups: "A: Controls" that had free iron tablets available from Health Centre; and "B: Intervention" group where patients accepted to be periodically contacted at home by health's team for personalized iron dispensation. RESULTS: 360 patients were included. Profilaxis and treatment compliance were 100% and 97,6% for B group while for "Control" one was 63% and 34%(p0.0001). Higher breast milk iron levels were detected in Intervention's mothers compared with control's patients (p0.007). CONCLUSION: Personalized iron prophylaxis and treatment increased breast milk iron levels. Public health policy must ensure iron dispensation for each underserved mother in order to reduce children problems associate to iron deficiency during the first year of their life.

Stroke in young people: the increasing role of advanced imaging.

Ischemic stroke in young people is an unexpected event due to a wider variety of causes compared to the older population. This study highlights the increasing role of neuroimaging in the diagnosis, prognosis and treatment of young stroke patients. Thirty young adult patients (age range, 15-45 years) with acute ischemic stroke diagnosis were retrospectively included and studied at our institution during 2009. The mean age of patients was 35 years and 50% were men. The stroke etiology was established in 86% of cases (n=26), 7% (n=2) were due to atherosclerosis of the main vessels, 10% (n=3) were related to cardioembolism, 27% (n=8) were due to arterial dissection and 43% (n=13) responded to miscellaneous etiologies. The cause remained unexplained in 14% (n=4) of cases. The aims of neuroimaging in the challenging study of young stroke patients are to confirm the ischemic nature of the lesion, to determine its location, and to verify the patency of major neck and intracranial arteries. Both MRI and MSCT offer the best sensitivity and spatial resolution.