Bloqueo de las ramas terminales del plexo lumbar, una alternativa segura para el implante valvular aórtico transcatéter por vía transfemoral. Caso clínico / Lumbar plexus terminal branch block, a safe alternative for transfemoral aortic valve implantation. Case report

El implante de la válvula aórtica transcatéter es una alternativa al tratamiento de pacientes con estenosis aórtica severa, se realiza convencionalmente en anestesia general o anestesia local más sedación. Presentamos el primer caso de implante valvular aórtico transcatéter por vía transfemoral realizado en nuestro hospital en un paciente con estenosis aórtica severa con riesgo quirúrgico alto. La anestesia consistió en la combinación de bloqueo bilateral selectivo de los nervios iliohipogástrico, ilioinguinal y genitofemoral con el paciente despierto sin sedación, mediante el abordaje guiado por ecografía. El implante valvular aórtico transcatéter fue exitoso y transcurrió sin incidencias, el paciente se mantuvo inmóvil, tranquilo, no refirió dolor y no fue necesario suministrar sedantes/hipnóticos durante la dilatación de los accesos vasculares con los introductores. La monitorización estándar mostró estabilidad hemodinámica sin repercusión cardiovascular y no requirió apoyo de fármacos vasopresores o inotropos. Tras la intervención el paciente fue enviado a la Unidad de Cuidados Intensivos Cardiológicos, donde se mantuvo asintomático y estable. Posteriormente el paciente ingresó en la sala de cardiología de la que fue dado de alta sin complicaciones.(AU)

Transcatheter aortic valve implantation is an alternative treatment for patients with severe aortic stenosis, it is conventionally performed under general anaesthesia or local anaesthesia plus sedation. We present the first case of trans-femoral, trans-catheter aortic valve implantation, performed in our hospital in a patient with severe aortic stenosis, who was a high surgical risk. Anaesthesia consisted of a combination of bilateral selective blockade of the iliohypogastric, ilioinguinal and genitofemoral nerves with the patient awake without sedation, using an ultrasound-guided approach. Transcatheter aortic valve implantation was successful and passed without incident, the patient remained immobile, calm, did not report pain, and sedation or hypnotics were not necessary during dilation of the vascular accesses with the introducer. Standard monitoring demonstrated haemodynamic stability, without cardiovascular repercussions and did not necessitate vasopressor or inotropic drug support. After the intervention, the patient was sent to the Cardiac Intensive Care Unit, where he remained asymptomatic and stable. Subsequently, the patient was admitted to the cardiology ward from where he was discharged without complications.(AU)

Lumbar plexus terminal branch block, a safe alternative for transfemoral aortic valve implantation. Case report.

Transcatheter aortic valve implantation is an alternative treatment for patients with severe aortic stenosis, it is conventionally performed under general anaesthesia or local anaesthesia plus sedation. We present the first case of trans-femoral, trans-catheter aortic valve implantation, performed in our hospital in a patient with severe aortic stenosis, who was a high surgical risk. Anaesthesia consisted of a combination of bilateral selective blockade of the iliohypogastric, ilioinguinal and genitofemoral nerves with the patient awake without sedation, using an ultrasound-guided approach. Transcatheter aortic valve implantation was successful and passed without incident, the patient remained immobile, calm, did not report pain, and sedation or hypnotics were not necessary during dilation of the vascular accesses with the introducer. Standard monitoring demonstrated haemodynamic stability, without cardiovascular repercussions and did not necessitate vasopressor or inotropic drug support. After the intervention, the patient was sent to the Cardiac Intensive Care Unit, where he remained asymptomatic and stable. Subsequently, the patient was admitted to the cardiology ward from where he was discharged without complications.

Gongylolepis martiana, an Asteraceae pollinated by bats in the Amazon.

Most Asteraceae species are pollinated by insects, mainly bees and butterflies, although pollination by birds has been documented and pollination by bats has been suggested for some species. Here, we investigated the pollination of Gongylolepis martiana, a species supposedly pollinated by bats. We assessed floral traits and visitors in a population of G. martiana in the Brazilian Amazon, measuring pollen removal from anthers and deposition on stigmas by diurnal and nocturnal visitors. Florets opened at dusk and lasted for 4 days, with the male phase starting on the first night and the female phase on the third night. Accumulated nectar per capitulum was 69.6 µl per night and sugar concentration was 15%. Nectar-feeding bats and hummingbirds contacted the sexual parts, but pollen removal and deposition were greater throughout the night than during the day, when Meliponini bees considerably reduced pollen availability. Other nocturnal visitors of G. martiana were rare, including nocturnal bees and moths that foraged for pollen and nectar, respectively. Our results support that nectarivorous bats are the main pollinators of G. martiana, confirming Vogel's hypothesis of bat pollination in Asteraceae, particularly in the genus Gongylolepis. Since anthesis and each sexual floral phase started in the evening, nectarivorous bats and diurnal bees caused additive priority effects, preventing hummingbirds from being efficient pollinators. The high density of flowering individuals of G. martiana in patches from white-sand forests likely increases bat attraction, while the small amount of nectar per plant favours cross-pollination.

Adaptability and Comparative Biology of Fall Armyworm on Maize and Perennial Forage Species and Relation with Chemical-Bromatological Composition.

This study compared the development of fall armyworm, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae), on forage species of different genera (Arachis, Axonopus, and Cynodon) in relation to maize (preferred host) as well as its adaptability on these forage species, which are the main cultivated forages in southern Brazil. The biological performance of S. frugiperda fed on host plants studied showed the highest adaptation index (AI) in maize (26.89), followed by bermudagrass (22.02), suggesting that bermudagrass is the most suitable alternative host for the development of S. frugiperda. In contrast, the giant missionary grass (18.80) and Pinto peanut (13.81) showed lower adequacy, with a relative adaptation index (RAI) 69.93 and 51.35%, respectively, using maize as standard. The cluster analysis based on similarity of the chemical-bromatological parameters showed that maize has a richer composition than the other plant species studied. The multivariate correlation analysis between AI and chemical-bromatological composition showed a positive correlation between AI and contents of ashes, ethereal extract, potassium, phosphorus, and magnesium and, to a lesser extent, with contents of nitrogen, crude protein, and copper. In this context, complexity of host composition and balance between components could explain the biological fitness of S. frugiperda on host plant species. Pasture diversification with giant missionary grass, or especially with Pinto peanut, may be an interesting strategy for integrated pest management of fall armyworm in pasturelands in a regional context.

Morphological specialization of heterantherous Rhynchanthera grandiflora (Melastomataceae) accommodates pollinator diversity.

The tropical Melastomataceae are characterized by poricidal anthers which constitute a floral filter selecting for buzz-pollinating bees. Stamens are often dimorphic, sometimes with discernible feeding and pollinating functions. Rhynchanthera grandiflora produces nectarless flowers with four short stamens and one long stamen; all anthers feature a narrow elongation with an upwards facing pore. We tested pollen transfer by diverse foraging bees and viability of pollen from both stamen types. The impact of anther morphology on pollen release direction and scattering angle was studied to determine the plant's reproductive strategy. Medium-sized to large bees sonicated flowers in a specific position, and the probability of pollen transfer correlated with bee size even among these legitimate visitors. Small bees acted as pollen thieves or robbers. Anther rostrum and pore morphology serve to direct and focus the pollen jet released by floral sonication towards the pollinator's body. Resulting from the ventral and dorsal positioning of the short and long stamens, respectively, the pollinator's body was widely covered with pollen. This improves the plant's chances of outcrossing, irrespective of which bee body part contacts the stigma. Consequently, R. grandiflora is also able to employ bee species of various sizes as pollen vectors. The strategy of spreading pollen all over the pollinator's body is rather cost-intensive but counterbalanced by ensuring that most of the released pollen is in fact transferred to the bee. Thus, flowers of R. grandiflora illustrate how specialized morphology may serve to improve pollination by a functional group of pollinators.

Evidences that maternal swimming exercise improves antioxidant defenses and induces mitochondrial biogenesis in the brain of young Wistar rats.

Physical exercise during pregnancy has been considered beneficial to mother and child. Recent studies showed that maternal swimming improves memory in the offspring, increases hippocampal neurogenesis and levels of neurotrophic factors. The objective of this work was to investigate the effect of maternal swimming during pregnancy on redox status and mitochondrial parameters in brain structures from the offspring. Adult female Wistar rats were submitted to five swimming sessions (30 min/day) prior to mating with adult male Wistar rats, and then trained during the pregnancy (five sessions of 30-min swimming/week). The litter was sacrificed when 7 days old, when cerebellum, parietal cortex, hippocampus, and striatum were dissected. We evaluated the production of reactive species and antioxidant status, measuring the activities of superoxide-dismutase (SOD), catalase (CAT) and glutathione-peroxidase (GPx), as well as non-enzymatic antioxidants. We also investigated a potential mitochondrial biogenesis regarding mitochondrion mass and membrane potential, through cytometric approaches. Our results showed that maternal swimming exercise promoted an increase in reactive species levels in cerebellum, parietal cortex, and hippocampus, demonstrated by an increase in dichlorofluorescein oxidation. Mitochondrial superoxide was reduced in cerebellum and parietal cortex, while nitrite levels were increased in cerebellum, parietal cortex, hippocampus, and striatum. Antioxidant status was improved in cerebellum, parietal cortex, and hippocampus. SOD activity was increased in parietal cortex, and was not altered in the remaining brain structures. CAT and GPx activities, as well as non-enzymatic antioxidant potential, were increased in cerebellum, parietal cortex, and hippocampus of rats whose mothers were exercised. Finally, we observed an increased mitochondrial mass and membrane potential, suggesting mitochondriogenesis, in cerebellum and parietal cortex of pups subjected to maternal swimming. In conclusion, maternal swimming exercise induced neurometabolic programing in the offspring that could be of benefit to the rats against future cerebral insults.

Two cases of autochthonous Plasmodium falciparum malaria in Germany with evidence for local transmission by indigenous Anopheles plumbeus.

Autochthonous Plasmodium falciparum malaria (PFM) in Central Europe has been reported repeatedly, transmission of the parasite being attributed to blood transfusion or imported P. falciparum-infected vectors. We report two cases of PFM in German children without travel history to malaria-endemic areas. Both infections occurred during a stay in a hospital where a child from Angola with chronic P. falciparum infection was hospitalized at the time. Known routes of transmission, such as imported mosquitoes or blood transfusion, were very unlikely or could be excluded, whereas evidence was obtained for transmission by the indigenous mosquito species Anopheles plumbeus.

Bilateral ablation of auditory cortex in Mongolian gerbil affects discrimination of frequency modulated tones but not of pure tones.

This study examines the role of auditory cortex in the Mongolian gerbil in differential conditioning to pure tones and to linearly frequency-modulated (FM) tones by analyzing the effects of bilateral auditory cortex ablation. Learning behavior and performance were studied in a GO/NO-GO task aiming at avoidance of a mild foot shock by crossing a hurdle in a two-way shuttle box. Hurdle crossing as the conditioned response to the reinforced stimulus (CR+), as false alarm in response to the unreinforced stimulus (CR-), intertrial activity, and reaction times were monitored. The analysis revealed no effects of lesion on pure tone discrimination but impairment of FM tone discrimination. In the latter case lesion effects were dependent on timing of lesion relative to FM tone discrimination training. Lesions before training in naive animals led to a reduced CR+ rate and had no effect on CR- rate. Lesions in pretrained animals led to an increased CR- rate without effects on the CR+ rate. The results suggest that auditory cortex plays a more critical role in discrimination of FM tones than in discrimination of pure tones. The different lesion effects on FM tone discrimination before and after training are compatible with both the hypothesis of a purely sensory deficit in FM tone processing and the hypothesis of a differential involvement of auditory cortex in acquisition and retention, respectively.

[Clinical manifestations of schizencephaly and its sonographic diagnosis]. / Klinische Manifestationen der Schizenzephalie und ihre sonographische Diagnostik.

Schizencephaly is defined as a cerebral malformation of the CNS with various clefts of the cerebral cortex. We report on two patients referred to our department with neurological abnormalities. In both cases the cranial sonography already provided for the clinical picture of schizencephaly. A MR-scan confirmed the diagnosis. In addition one of the patients proved to have a migrational disorder. The analysis of these cases and the relevant literature point out how difficult the etiologic differentiation is and, on the other hand, how various the manifestations of the malformation can be. The important role of cranial sonography as a screening method is shown.