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We present the first joint analysis of cluster abundances and auto or cross-correlations of three cosmic tracer fields: galaxy density, weak gravitational lensing shear, and cluster density split by optical richness. From a joint analysis (4×2pt+N) of cluster abundances, three cluster cross-correlations, and the auto correlations of the galaxy density measured from the first year data of the Dark Energy Survey, we obtain Ω_{m}=0.305_{-0.038}^{+0.055} and σ_{8}=0.783_{-0.054}^{+0.064}. This result is consistent with constraints from the DES-Y1 galaxy clustering and weak lensing two-point correlation functions for the flat νΛCDM model. Consequently, we combine cluster abundances and all two-point correlations from across all three cosmic tracer fields (6×2pt+N) and find improved constraints on cosmological parameters as well as on the cluster observable-mass scaling relation. This analysis is an important advance in both optical cluster cosmology and multiprobe analyses of upcoming wide imaging surveys.
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OBJECTIVES: In gastroschisis pregnancies, a) to correlate prenatal ultrasound variables with postnatal outcome and b) to determine the ideal time for setting the delivery in order to achieve the best neonatal outcome. MATERIAL AND METHODS: Retrospective review (2000-2015) of all available gastroschisis whose prenatal findings could be correlated with the neonatal outcome. Two study groups have been defined according to the complications present after birth: favorable gastrosquisis and complicated. Prenatal variables were compared by groups using McWhitney or Chi tests as needed. RESULTS: Twenty-two gastroschisis fulfilled the requirement. Twelve cases had uneventful outcomes. Ten patients experienced complications, including death in five. In the complicated group there were 15 episodes of sepsis and 17 reoperations. Any single ultrasound parameter could predict a bad follow up. In thirteen cases, delivery was forced due to sudden changes on ultrasound bowel appearance. Nine of these patients had very good neonatal outcome. CONCLUSIONS: Finishing pregnancy when sudden changes on the fetal bowel were identified was the only strategy that leaded us to diminish the complication rate in gastroschisis.
OBJETIVOS: En las gestaciones con gastrosquisis, a) valorar la presencia de algún dato ecográfico prenatal que pueda predecir la evolución postnatal de la gastrosquisis, y b) determinar el momento ideal del nacimiento de los pacientes con gastrosquisis que se relacione con una mejor evolución postnatal. MATERIAL Y METODOS: Revisión retrospectiva (2000-2015) de las gastrosquisis cuyos datos ecográficos prenatales hemos podido relacionar con las características de los pacientes y su evolución clínica posterior. Se han determinado dos grupos en función de la evolución favorable o complicada de la gastrosquisis. Todas las variables ecográficas prenatales se han comparado entre grupos según los test de McWitney o Chi cuadrado. RESULTADOS: Veintidós gastrosquisis cumplieron el requisito anterior. Doce casos tuvieron una evolución sin incidencias significativas. Diez pacientes tuvieron una evolución complicada, de los cuales cinco fueron exitus. En este grupo hubo 15 episodios de sepsis y 17 reintervenciones. Ningún parámetro ecográfico prenatal predijo con fiabilidad una evolución desfavorable. En 13 casos se finalizó la gestación porque aparecieron cambios súbitos en la ecografía. Nueve de estos pacientes evolucionaron sin ninguna complicación. CONCLUSIONES: Terminar la gestación cuando se produce un cambio súbito de la apariencia ecográfica de los intestinos fetales es la única estrategia que nos ha permitido disminuir la incidencia de complicaciones en los pacientes con gastrosquisis.
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Doenças Fetais/diagnóstico por imagem , Gastrosquise/diagnóstico por imagem , Resultado da Gravidez , Ultrassonografia Pré-Natal/métodos , Parto Obstétrico/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Recém-Nascido , Masculino , Gravidez , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Sepse/epidemiologia , Fatores de TempoRESUMO
The interaction between a peptide sequence from GB virus C E1 protein (E1P8) and its structural analogs (E1P8-12), (E1P8-13), and (E1P8-21) with anionic lipid membranes (POPG vesicles and POPG, DPPG or DPPC/DPPG (2:1) monolayers) and their association with HIV-1 fusion peptide (HIV-1 FP) inhibition at the membrane level were studied using biophysical methods. All peptides showed surface activity but leakage experiments in vesicles as well as insertion kinetics in monolayers and lipid/peptide miscibility indicated a low level of interaction: neither E1P8 nor its analogs induced the release of vesicular content and the exclusion pressure values (πe) were clearly lower than the biological membrane pressure (24-30 mN m(-1)) and the HIV-1 FP (35 mN m(-1)). Miscibility was elucidated in terms of the additivity rule and excess free energy of mixing (GE). E1P8, E1P8-12 and E1P8-21 (but not E1P8-13) induced expansion of the POPG monolayer. The mixing process is not thermodynamically favored as the positive GE values indicate. To determine how E1 peptides interfere in the action of HIV-1 FP at the membrane level, mixed monolayers of HIV-1 FP/E1 peptides (2:1) and POPG were obtained. E1P8 and its derivative E1P8-21 showed the greatest HIV-1 FP inhibition. The LC-LE phase lipid behavior was morphologically examined via fluorescence microscopy (FM) and atomic force microscopy (AFM). Images revealed that the E1 peptides modify HIV-1 FP-lipid interaction. This fact may be attributed to a peptide/peptide interaction as indicated by AFM results. Finally, hemolysis assay demonstrated that E1 peptides inhibit HIV-1 FP activity.
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Vírus GB C/química , HIV-1/química , Bicamadas Lipídicas/química , Proteínas do Envelope Viral/química , Proteínas Virais de Fusão/química , Materiais Biomiméticos , Eritrócitos/citologia , Eritrócitos/efeitos dos fármacos , Hemólise/efeitos dos fármacos , Humanos , Cinética , Membranas Artificiais , Fosfatidilgliceróis/química , Termodinâmica , Proteínas do Envelope Viral/farmacologia , Proteínas Virais de Fusão/antagonistas & inibidores , Proteínas Virais de Fusão/farmacologiaRESUMO
The incidence of Mediterranean spotted fever (MSF) in Catalonia (Spain) has decreased in the last two decades. The prevalence of antibodies to Rickettsia conorii in human beings and dogs in the region of Vallès Occidental (Catalonia) was assessed by indirect immunofluorescence, and the results compared with those obtained in a similar study from 1987. Nineteen (5·0%) out of 383 human serum samples had antibodies to R. conorii. This seroprevalence was significantly lower (11·5%) (P = 0·003) than that recorded in the 1987 survey. Forty-two out (42·0%) of 100 canine serum samples had antibodies to R. conorii. A high proportion of the studied dogs (91·0%) were receiving anti-tick treatment, mainly with permethrin-imidacloprid spot-on (Advantix, Bayer, Germany). The current canine seroprevalence was not significantly different from that recorded in the 1987 survey (36.9%). In conclusion, this study shows a significant decrease in the prevalence of antibodies to R. conorii in the human population of Catalonia in the last 20 years, which corresponds with a decrease in the number of cases of MSF. We suggest that the widespread use of anti-tick treatment in dogs could limit the introduction of ticks to humans due to a reduction of infestation duration in dogs, thus contributing to the decrease in MSF incidence.
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Anticorpos Antibacterianos/sangue , Febre Botonosa/epidemiologia , Febre Botonosa/veterinária , Doenças do Cão/epidemiologia , Rickettsia conorii/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Cães , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Espanha/epidemiologia , Adulto JovemRESUMO
Three synthetic peptide sequences of 18 amino acid each, corresponding to different fragments of the E2 capsid protein of GB virus C (GBV-C): SDRDTVVELSEWGVPCAT (P45), GSVRFPFHRCGAGPKLTK (P58) and RFPFHRCGAGPKLTKDLE (P59) have been characterized in order to find a relationship between their physicochemical properties and the results obtained in cellular models. Experiments were performed in presence and absence of the HIV fusion peptide (FP-HIV) due to the evidences that GBV-C inhibits AIDS progression. P45 peptide showed lower surface activity and less extent of penetration into 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and 1,2-dimyristoyl-sn-glycero-3-phospho-L-serine (DMPS) (3:2, mol/mol) lipid monolayers than P58 and P59. However, P45 peptide presented higher capacity to inhibit FP-HIV induced cell-cell fusion than the other two sequences. These results were supported by fluorescence anisotropy measurements which indicated that P45 had a significant effect on the inhibition of FP-HIV perturbation of liposomes of the same lipid composition. Finally, atomic force microscopy (AFM) studies have evidenced the modification of the changes induced by the FP-HIV in the morphology of lipid bilayers when P45 was present in the medium.
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Vírus GB C/química , Proteína gp41 do Envelope de HIV/química , HIV/química , Bicamadas Lipídicas/química , Peptídeos/química , Proteínas do Envelope Viral/química , Sequência de Aminoácidos , Biofísica , Vírus GB C/metabolismo , HIV/metabolismo , Proteína gp41 do Envelope de HIV/metabolismo , Bicamadas Lipídicas/metabolismo , Lipossomos/química , Lipossomos/metabolismo , Lipídeos de Membrana/química , Lipídeos de Membrana/metabolismo , Modelos Moleculares , Dados de Sequência Molecular , Peptídeos/metabolismo , Proteínas do Envelope Viral/metabolismoAssuntos
Oncologia/normas , Neoplasias Embrionárias de Células Germinativas/terapia , Neoplasias Ovarianas/terapia , Assistência ao Convalescente/métodos , Assistência ao Convalescente/normas , Protocolos de Quimioterapia Combinada Antineoplásica/normas , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia , Europa (Continente) , Feminino , Humanos , Incidência , Assistência de Longa Duração/métodos , Assistência de Longa Duração/normas , Oncologia/métodos , Estadiamento de Neoplasias , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Embrionárias de Células Germinativas/patologia , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/patologia , Ovariectomia/métodos , Ovariectomia/normas , Ovário/patologia , Ovário/cirurgia , Sociedades Médicas/normas , Sobrevivência , Resultado do TratamentoRESUMO
BACKGROUND AND AIMS: Atherosclerosis prevention in small laboratory models has been used as a preclinical stage in the development of functional foods with claimed antiatherogenic properties. However, a high heterogeneity of experimental atherosclerosis models as well as species-specific differences in lipoprotein metabolism could limit the usefulness of these developments. To solve this, we have performed a meta-analysis on the effects of nutritional complements (i.e. less than 2% of diet) with potential antiatherogenic properties in mice, rabbits and hamsters, and compared the outcomes with those obtained in humans. METHODS AND RESULTS: A meta-analysis comprising works dealing with dietary prevention of experimental atherosclerosis (i.e. macroscopic and/or pathological evidences of atheromatosis in aorta) has been performed (n = 110 works). Quality criteria were applied resulting in selection of 16 works comprising 511 animals. Despite high heterogeneity, there is a significant effect of nutritional interventions reducing atheroma globally (mean effect 24.38% (95% CI: 13.24-35.51%) of prevention). In mouse studies (20.64% (95% CI: 8.38-32.90%)) and in rabbits (40.48% (95% CI: 6.73-74.23%)) this effect was significant, in contrast with hamster-based works (95% CI: 13.66-49.48%). Meta-regression showed that reduction of atheroma plaque formation was not linked to changes either in total circulating cholesterol or LDL cholesterol levels. CONCLUSION: Nutritional addition of selected compounds significantly prevents experimental atheromatosis, but the reproduction of positive effects observed in humans was very limited. These analyses reinforce the need for adequate standardization of atherosclerosis studies in preclinical models and for human intervention trials.
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Aterosclerose/dietoterapia , Aterosclerose/prevenção & controle , Modelos Animais de Doenças , Animais , Colesterol/sangue , LDL-Colesterol/sangue , Cricetinae , Bases de Dados Factuais , Alimento Funcional , Humanos , Camundongos , CoelhosRESUMO
OBJECTIVE: Congenital high airway obstruction syndrome (CHAOS) normally has a dire prognosis due to laryngeal atresia and association with other anomalies. However, rare cases with an isolated tracheal membrane have been described. We assessed systematically the larynx and vocal cords in fetuses with CHAOS, with the goal of identifying such cases and attempting fetoscopic deobstruction. METHODS: Between 2008 and 2012, 7 cases of CHAOS were referred to our institution. The ultrasonographic aspect of the larynx and trachea was assessed. We report the ultrasound findings, necropsy findings of 6 cases and perinatal outcome in 1 case undergoing therapy. RESULTS: In 6 cases, laryngeal atresia was presumed by ultrasound and confirmed by necropsy after termination of pregnancy. In 1 case, normal appearance of the vocal cords led to suspicion of a possible isolated tracheal web completely occluding the trachea. Fetoscopy confirmed the finding, thus the membrane was perforated. Lung size normalized and hydrops resolved. A normal fetus was delivered at term, requiring no respiratory support. At 9 months of age, the infant showed a normal laryngoscopy and was developing well. CONCLUSIONS: Systematic ultrasound assessment of the vocal cords can be performed in fetuses with CHAOS. We report the first case of long-term intact survival after fetoscopic airway deobstruction.
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Obstrução das Vias Respiratórias/cirurgia , Prega Vocal/diagnóstico por imagem , Adulto , Obstrução das Vias Respiratórias/congênito , Obstrução das Vias Respiratórias/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Fetoscopia , Humanos , Masculino , Gravidez , Diagnóstico Pré-Natal , Prognóstico , Síndrome , UltrassonografiaRESUMO
This is the first report of fetoscopy to successfully treat a case of bilobar bronchial atresia presenting in the form of a massive right lung tumor causing severe thoracic compression with mediastinal shift, pulmonary hypoplasia and eventually fetal hydrops. The presence of an echolucent tubular structure in the pulmonary hilum was identified as the intrapulmonary continuation of the interrupted main bronchus, and led to the diagnosis of main bronchial atresia. After extensive discussion and counseling, a fetoscopic operation was designed and indicated. The procedure consisted of a fetal tracheoscopy and access to the right main bronchus, which was perforated with a diode laser until a communication with the dead end of the intrapulmonary main bronchus was achieved. After the operation a significant reduction in size was observed, hydrops and mediastinal shift disappeared and O/E LHR increased to 85%. The fetus was born at term and lobectomy of two dysplastic pulmonary lobes was performed. The infant is developing well at 14 months of age. This report demonstrates that fetoscopic airway decompression can achieve fetal survival in the rare event of main bronchus atresia.
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Doenças Fetais/cirurgia , Neoplasias Pulmonares/cirurgia , Broncoscopia , Descompressão Cirúrgica , Feminino , Fetoscopia , Humanos , Hidropisia Fetal/etiologia , Hidropisia Fetal/cirurgia , Recém-Nascido , Neoplasias Pulmonares/complicações , Gravidez , Adulto JovemRESUMO
The peptide sequence (175-192) RFPFHRCGAGPKLTKDLE (P59) of the E2 envelope protein of GB virus C (GBV-C) has been proved to decrease cellular membrane fusion and interfere with the HIV-1 infectivity in a dose-dependent manner. Based on these previous results, the main objective of this study was to deepen in the physicochemical aspects involved in this interaction. First, we analyzed the surface activity of P59 at the air-water interface as well as its interaction with zwitterionic or negatively charged lipid monolayers. Then we performed the same experiments with mixtures of P59/gp41-FP. Studies on lipid monolayers helped us to understand the lipid-peptide interaction and the influence of phospholipids on peptide penetration into lipid media. On another hand, studies with lipid bilayers showed that P59 decreased gp41-FP binding to anionic Large Unilamellar Vesicles. Results can be attributed to the differences in morphology of the peptides, as observed by Atomic Force Microscopy. When P59 and gp41-FP were incubated together, annular structures of about 200 nm in diameter appeared on the mica surface, thus indicating a peptide-peptide interaction. All these results confirm the gp41-FP-P59 interaction and thus support the hypothesis that gp41-FP is inhibited by P59.
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Vírus GB C/metabolismo , Proteína gp41 do Envelope de HIV/antagonistas & inibidores , HIV-1/efeitos dos fármacos , Peptídeos/farmacologia , Algoritmos , Sequência de Aminoácidos , Proteína gp41 do Envelope de HIV/química , Proteína gp41 do Envelope de HIV/metabolismo , HIV-1/crescimento & desenvolvimento , HIV-1/metabolismo , Humanos , Cinética , Bicamadas Lipídicas/química , Bicamadas Lipídicas/metabolismo , Microscopia de Força Atômica , Dados de Sequência Molecular , Peptídeos/química , Peptídeos/metabolismo , Fosfolipídeos/química , Fosfolipídeos/metabolismo , Ligação Proteica , Espectrometria de Fluorescência , Proteínas Virais/químicaRESUMO
Malignant epithelial tumors (carcinomas) are the most common ovarian cancers and also the most lethal gynecological malignancies. Based on histopathology and molecular genetic alterations, ovarian carcinomas are divided into five main types [high-grade serous (70%), endometrioid (10%), clear-cell (10%), mucinous (3%), and low-grade serous carcinomas (<5%)] that account for over 95% of cases. These types are essentially distinct diseases, as indicated by differences in epidemiological and genetic risk factors, precursor lesions, patterns of spread, and molecular events during oncogenesis, response to chemotherapy, and prognosis. For a successful specific treatment, reproducible histopathological diagnosis of the tumor cell type is critical. The five tumor types are morphologically diverse and resemble carcinomas of the uterus. Actually, recent investigations have demonstrated that a substantial number of cancers, traditionally thought to be primary ovarian tumors (particularly serous, endometrioid, and clear-cell carcinomas), originate in the fallopian tube and the endometrium and involve the ovary secondarily. This presentation summarizes recent advances in the molecular pathology which have greatly improved our understanding of the biology of ovarian carcinoma and are also relevant to patient management.
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Carcinoma , Neoplasias Epiteliais e Glandulares , Neoplasias Ovarianas , Patologia Molecular , Proteína BRCA1/genética , Proteína BRCA2/genética , Carcinoma/classificação , Carcinoma/genética , Carcinoma/patologia , Carcinoma Epitelial do Ovário , Instabilidade Cromossômica , Feminino , Mutação em Linhagem Germinativa , Humanos , Estadiamento de Neoplasias , Neoplasias Epiteliais e Glandulares/classificação , Neoplasias Epiteliais e Glandulares/genética , Neoplasias Epiteliais e Glandulares/patologia , Neoplasias Ovarianas/classificação , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologiaRESUMO
A simple and low cost method for wavelength control of economical random non-preselected independent ONU sources is shown to increase the number of users in an OFDMA-PON. The method is based on OLT monitoring and thermal tuning control; it has been validated through Monte-Carlo simulations and a probabilistic model. The minimum optical spectral gap between the ONUs wavelengths that guarantees a tolerable amount of optical beat interference has been determined through an experiment.
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Desenho Assistido por Computador , Modelos Teóricos , Dispositivos Ópticos , Simulação por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , Luz , Espalhamento de RadiaçãoRESUMO
We compared the sensitivity of closely related Pacific salmon and steelhead (Oncorhynchus spp.) to untreated urban stormwater runoff across three storm events. Juvenile coho, sockeye, steelhead, and Chinook were exposed for 24 h to untreated urban runoff and then transferred to clean water for 48 h. As anticipated from previous studies, coho were highly susceptible to runoff toxicity, with cumulative mortality rates ranging from 92%-100% across the three storms. By contrast, juvenile sockeye were unaffected (100% survival), and cumulative mortality rates were intermediate for steelhead (4%-42%) and Chinook (0%-13%). Furthermore, coho died rapidly following the onset of stormwater exposure (generally <4 h), whereas mortality in Chinook and steelhead was delayed by 1-2 days. Similar to previous findings for coho, steelhead and Chinook did not recover when transferred to clean water. Lastly, significant mortality occurred in coho even when roadway runoff was diluted by 95% in clean water. Our findings extend the urban runoff mortality syndrome in salmonids and point to a near-term need for sublethal studies in steelhead and Chinook to more precisely understand stormwater risks to threatened species recovery efforts in the western United States.
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The aim of this study was to address whether NP might be a predictive factor for severity of CF. The authors collected data from the literature on NP as a unique or associated sign in CF and reviewed the clinical and molecular aspects of CF associated with NP. CF genotypes and clinical severity in NP(+) vs. NP(-) patients were reviewed, taking into account pulmonary function, frequency of P. aeruginosa lung infection, frequency of allergy, nutritional status, and exocrine pancreatic function. The CFTR gene was also analyzed in a patient with isolated severe NP as the unique feature of CF. This review of the literature showed a `milder` phenotype in `NP+` vs. `NP-` CF patients, contrasting with a marked association between NP and `severe` CF mutations. In addition, a complex genotype was identified, associating four heterozygous variants, namely p.Q493X (a severe mutation) on the paternal allele, and p.V562I, p.A1006E, and (TG)11(T)5 (IVS8-5T) on the maternal allele, in a case of CF presenting as isolated NP. The authors speculate that genetic/environmental factors associated with NP might attenuate the functional impact of `severe` CF mutations. The overrepresentation of CF carriers among patients with isolated NP also advocates the need for CFTR molecular screening in such populations for genetic counselling purposes.
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Fibrose Cística/epidemiologia , Pólipos Nasais/epidemiologia , Adulto , Fibrose Cística/genética , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Análise Mutacional de DNA , Humanos , Masculino , Pólipos Nasais/genética , Fatores de Risco , Índice de Gravidade de DoençaRESUMO
Full-duplex bidirectional transmission at 10 Gb/s is demonstrated for extended wavelength division multiplexed passive optical network (WDM-PON) applications, achieving transmission distances up to 25 km of standard single mode fiber (SSMF) when using a low-bandwidth (approximately 1.2 GHz) reflective semiconductor optical amplifier (RSOA) for signal re-modulation at the optical network unit (ONU). The system is assisted by optimum offset filtering at the optical line terminal (OLT)-receiver and the performance is further improved with the use of decision-feedback equalization (DFE). Chromatic dispersion (CD) and Rayleigh Backscattering (RB) effects are considered and analyzed.
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Filtração/instrumentação , Dispositivos Ópticos , Refratometria/instrumentação , Processamento de Sinais Assistido por Computador/instrumentação , Telecomunicações/instrumentação , Desenho Assistido por Computador , Desenho de Equipamento , Análise de Falha de Equipamento , Retroalimentação , Micro-Ondas , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: The surgical correction of proximal severe hypospadias, especially those with penoscrotal transposition (penis buried in scrotum), represents a true challenge for paediatric surgeons. A sequential approach to their repair is widely accepted, to preserve the vascularization of the neourethra and to avoid injuries in penis covering. In our experience, we believe that all hypospadias, even those associated with penoscrotal transposition, can be repaired in one surgical time by using a vascularized flap from dorsal prepuce in one or two layers (mucosal portion for urethra and skin face for ventral island). MATERIALS AND METHODS: From 1997 until 2007, 88 patients with proximal severe hypospadias have been operated. 35 patients associated penoscrotal transposition. Since 2005, we introduced a modification consisting in drawing the incisions following the own cutaneous folds resulting from the fusion of the lateral folds in penis skin. RESULTS: We performed Duckett type urethroplasty in 10 patients, Onlay type flap in 74, Onlay with oral mucosa in 2 and vesical mucosa urethroplasty in 2 of them. The fistula rate needing surgical closure was 17% (15/88), urethral stenosis was present in 5 patients (5.7%, 1 vesical mucosa, 2 Duckett urethrolpasties and 2 Onlay flaps). Severe complications were represented by partial necrosis of the skin flap in 3 patients (3.4%) needing a reurethroplasty. 1 patient presented surgical wound infection without later problems. Before 2005, among the 22 patients with penoscrotal transposition, 5 needed a new cutaneoplasty, associated in 2 occasions to a dorsal Nesbitt plicature to obtain the complete penis alignment. From 2005 until now, None of the 13 patients presenting with penoscrotal transposition needed any posterior cutaneoplasty. The follow up goes from 1 month until 10 years (median 45 months). At present time, urine spurt shows a correct range in all cases and the penis is located out of scrotal bag except in one patient, waiting for a new plasty. DISCUSSION: In our experience, we believe that all of the hypospadias may be repaired in a unique surgical time, including those of them associated with buried penis. Modification on skin incisions design following penoscrotal lateral folds with mucocutaneous preputial flap is an excellent option both for urethroplasty and correcting penis transposition.
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Hipospadia/cirurgia , Pré-Escolar , Humanos , Lactente , Masculino , Procedimentos Cirúrgicos Urológicos Masculinos/métodosRESUMO
OBJECTIVES: Nocardia, a Gram-positive bacterium, is responsible for rare and severe infections. Accurate microbiological data are essential to guide antibiotic treatment. Our primary objective was to describe species identification and results of antimicrobial susceptibility testing (AST) for Nocardia isolates analysed over a 6-year period. Secondary objectives were to study temporal trends in species distribution and AST results. METHODS: We retrospectively analysed results from Nocardia isolates sent between January 2010 and December 2015 to a French laboratory dedicated to Nocardia (Observatoire Français des Nocardioses). Species identification was obtained by amplification and sequencing of a 600-bp fragment of the 16S rRNA gene (for all isolates) and of hsp65 (when required). AST was performed using disk diffusion. RESULTS: We included 793 Nocardia isolates, mostly from the lungs (53.8%). The most frequent species were Nocardia farcinica (20.2%), Nocardia abscessus complex (19.9%) and Nocardia nova complex (19.5%). The proportion of N. farcinica increased significantly over time from 13% in 2010 to 27.6% in 2014. Linezolid, amikacin, trimethoprim-sulfamethoxazole, minocycline and imipenem were the most frequently identified active antibiotics with, respectively, 0% (0/734), 2.9% (21/730), 5.4% (40/734), 9.4% (69/734) and 19.5% (143/732) of isolates not susceptible. Nocardia farcinica was frequently not susceptible to cefotaxime (118/148, 79.7% of the isolates), but only about 5% of Nocardia cyriacigeorgica and N. abscessus complex isolates were not susceptible to cefotaxime. CONCLUSIONS: In this first epidemiological study of Nocardia isolated from human samples in France, N. farcinica was the species most frequently identified and its prevalence increased over time.