Ecological interactions of Triatoma sanguisuga (Hemiptera: Reduviidae) and risk for human infection with Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) in Illinois and Louisiana.

Triatoma sanguisuga (Leconte) is one of the most widely distributed kissing bugs in the United States, associated with an extensive zoonotic circulation of Trypanosoma cruzi, the agent of Chagas disease, in a large part of the country. However, the actual risk for human infection in the United States is poorly understood. Here, we further assessed the ecology of T. sanguisuga bugs collected in residents' houses in Illinois and Louisiana, using a metagenomic approach to identify their blood-feeding sources, T. cruzi parasites and gut microbiota. Blood meal analysis revealed feeding on domestic animals (dogs, cats, pigs, goats, and turkeys), synanthropic species (raccoons, opossums, and squirrels), as well as the more sylvatic white-tail deer. Human blood was identified in 11/14 (78%) of bugs, highlighting a frequent vector-human contact. The infection rate with T. cruzi was 53% (8/15), and most infected bugs (6/8) had fed on humans. A total of 41 bacterial families were identified, with significant differences in microbiota alpha and beta diversity between bugs from Louisiana and Illinois. However, predicted metabolic functions remained highly conserved, suggesting important constraints to fulfill their role in bug biology. These results confirmed a significant risk for vector-borne transmission of T. cruzi to humans in Louisiana and Illinois, which warrants more active screening for human infections. Also, while there is broad plasticity in the bacterial composition of T. sanguisuga microbiota, there are strong constraints to preserve metabolic profile and function, making it a good target for novel vector control strategies.

MOLECULAR PHYLOGENETIC ANALYSIS OF GYRINICOLA BATRACHIENSIS (NEMATODA: OXYUROIDEA) LENDS SUPPORT TO THE MONOPHYLY OF THE GENUS AND THE RESURRECTION OF GYRINICOLINAE.

Gyrinicola Yamaguti, 1938, includes 6 species of oxyurid found within the intestinal tract of numerous, larval, anuran species in Europe, Asia, South America, and North America. The systematic placement and hierarchical treatment of the genus has shifted at least 5 times since its discovery; the group was first considered as its own family (Gyrinicolidae), then treated as a subfamily (Gyrinicolinae) of Cosmocercidae, then as a member of the Pharyngodonidae, followed by movement back to the Cosmocercidae, and finally a recent proposal suggested the resurrection of the Gyrinicolidae. Species in the genus vary widely in the morphology of the uterine tract, a characteristic often used to indicate membership in the genus, as it is tied to the reproductive mode. However, until recently very few genetic data were available to aid in the placement of this unique group of worms, and before this study to the best of our knowledge none existed for the North American species. To examine the monophyly and placement of the Gyrinicola we sampled populations of Gyrinicola batrachiensis across North America and screened them for genetic diversity using nuclear markers 18S and 28S. Phylogenies suggest at least 3 clades exist among the nematodes from North America and that these clades, alongside Gyrinicola japonica, form a well-supported group within Oxyuroidea. Further representation of Pharyngodonidae from other vertebrate classes may help clarify the relationship of this historical grouping to other members of the Oxyuroidea.

CLINICAL AND SUBCLINICAL CYTAUXZOON FELIS INFECTIONS IN DOMESTIC CATS FROM A RECENTLY IDENTIFIED ENDEMIC REGION.

Cytauxzoon felis is a tick-transmitted intraerythrocytic apicomplexan infecting felids in the southeastern and midwestern United States. Bobcats (Lynx rufus) are the natural wildlife reservoir of C. felis, where in enzootic areas prevalence can reach 100%. Domestic cats can be subclinically infected with C. felis or can develop cytauxzoonosis. Two studies have documented the presence of C. felis in domestic cats in Illinois; these studies have shown a limited number of cases submitted to specialty labs. During 2014-2018, we obtained blood samples collected by veterinary staff from 514 cats that were apparently healthy and 74 cats that were suspected of cytauxzoonosis. These samples were screened using a sensitive, nested PCR to detect the presence of C. felis DNA. We herein document frequent occurrences of cytauxzoonosis (8-15 cases/year from 4 veterinary clinics) and 12.5% prevalence of subclinical infections in southern Illinois, a locality showing a sharp increase in cases of cytauxzoonosis. Our results suggest a high risk of cytauxzoonosis in southern Illinois, despite only recently being recognized in the area. We found no specific risk factors for cytauxzoonosis or subclinical infections in this location. In addition, cases of cytauxzoonosis occur every month of the year (with the highest frequency in summer) and therefore tick prevention should be used in domestic cats in enzootic regions throughout the year.

Design of more efficient luminescent solar concentrators by using peripherally dye-doped stacked optical fibers.

Ways of improving the optical efficiency of luminescent solar concentrators based on multiple poly(methyl methacrylate) plastic optical fibers peripherally doped with two promising types of dyes are analyzed by means of a Monte-Carlo computational model developed by us. By comparing the performance of optical fibers doped with lumogen red and lumogen yellow, or combinations of them at several concentrations, this work clarifies how to achieve a better compromise between the trapping efficiency of the sunlight and the reabsorption of the light emitted by the mixture in stacked optical fibers connected to a photovoltaic solar cell.

Reliability of a Battery of cognitive tests in Young, healthy people / Fiabilidad de una batería de pruebas cognitivas en personas jóvenes y sanas

Cognitive performance is an essential aspect of sports. Still, few studies provide reliable cognitive tests for training and evaluating cognitive aspects related to sports, particularly in a healthy and/or youthful population. This study assessed the intraday and interday reliability of a cognitive test battery related to sports performance. In the research, seventeen healthy volunteers participated. DynavisionTMD2, Bassin Anticipation Timer, Go/No-Go, Eriksen Flanker, and the Trail Making Test (TMT) were analyzed. TMT-A and TMT-B (intraday), as well as the following variables in the interday analysis, exhibited significant differences: "Physical RT - Fastest" (Test 1), "Visual RT - Fastest" and "Physical RT - Fastest" (Test 2), "Visual RT - Fastest" (Test 4) and TMT-A. Thirteen of the thirty-one variables analyzed on the intraday exam had moderate Intraclass Correlation Coefficients (ICC), six were good, and one was exceptional. In the interday analysis, 15 variables with moderate ICC and 5 variables with excellent ICC were identified. Reliable tests include "Reaction Time" (Tests 5 and 6) and "Red and Green Lights" of the DynavisionTMD2, the 15 mph speed of the Bassin Anticipation Timer, and the Go/No-Go, Eriksen Flanker, and TMT tests.(AU)

Laser capture microdissection as a method for investigating the human hair follicle microbiome reveals region-specific differences in the bacteriome profile.

OBJECTIVE: Human hair follicles (HFs) are populated by a rich and diverse microbiome, traditionally evaluated by methods that inadvertently sample the skin microbiome and/or miss microbiota located in deeper HF regions. Thereby, these methods capture the human HF microbiome in a skewed and incomplete manner. This pilot study aimed to use laser-capture microdissection of human scalp HFs, coupled with 16S rRNA gene sequencing to sample the HF microbiome and overcome these methodological limitations. RESULTS: HFs were laser-capture microdissected (LCM) into three anatomically distinct regions. All main known core HF bacterial colonisers, including Cutibacterium, Corynebacterium and Staphylococcus, were identified, in all three HF regions. Interestingly, region-specific variations in α-diversity and microbial abundance of the core microbiome genera and Reyranella were identified, suggestive of variations in microbiologically relevant microenvironment characteristics. This pilot study therefore shows that LCM-coupled with metagenomics is a powerful tool for analysing the microbiome of defined biological niches. Refining and complementing this method with broader metagenomic techniques will facilitate the mapping of dysbiotic events associated with HF diseases and targeted therapeutic interventions.

Self-perception of primary health-care staff about physical activity on prescription: A qualitative semi-structured interview / Autopercepción de los profesionales sanitarios de Atención Primaria sobre la promoción y prescripción de ejercicio físico: entrevista cualitativa semiestructurada

Objective This study aimed to analyze the self-perception at primary health-care (PHC) nurses and general practitioners (GPs) toward PAP implementation in PHC centers. Material and methods Two semi-structured group interviews were performed separately, with five GPs and nurses working in the PHC system in the region of Madrid (Spain). An expert psychologist guided each semi-structured session. The interviews were transcribed verbatim and consensually analyzed using a content analysis. Results Half of the PHC staff considered themselves physically active and were convinced that physically active staff behavior could facilitate PAP with patients. Both GPs and nurses showed a lack of knowledge of exercise prescription but were interested in PAP and motivational training courses, as well as leadership or to collaborate under a multidisciplinary or interdisciplinary PAP approach. Some of the most relevant self-perceived PAP barriers were a confident method to measure sedentary and physical activity levels. Besides lack of staff awareness, time of consultation, and improving local community relationships and PAP policies strategies. Conclusions There are some common self-perceptions, barriers, and facilitators among PHC nurses and GPs for PAP implementation. Following a socio-ecologic approach, this organizational data provides further insight to design a future cost-effective policy strategy to improve patient health and health-care system sustainability. (AU)

Objetivo Este estudio tiene como objetivo analizar la autopercepción de las enfermeras y médicos de Atención Primaria para implementar la promoción y prescripción de ejercicio físico en sus centros. Material y métodos Dos entrevistas grupales semiestructuradas, con cinco enfermeras y cinco médicos que se encontraban trabajando en ese momento en el Sistema de Salud de la Comunidad de Madrid (España), fueron desarrolladas de forma independiente. Un psicólogo experto guio cada una de las sesiones. Las entrevistas grabadas, fueron transcritas y analizado su contenido de forma consensuada. Resultados La mitad de los profesionales sanitarios entrevistados se consideraron a sí mismos físicamente activos y convencidos de que dicho comportamiento podría facilitar la promoción y prescripción de ejercicio físico hacía sus pacientes. Ambos grupos mostraron una falta de conocimiento para prescribir ejercicio físico, pero se sentían interesados en adquirir la formación mediante cursos, así como de recibir formación para entrevistar de forma motivacional a sus pacientes. También mostraron liderazgo o colaboración para implementar la promoción y prescripción de ejercicio físico bajo un enfoque multi o interdisciplinar con otros profesionales. Algunas de las barreras sugeridas por ambos profesionales fue la falta de un método seguro para comprobar los niveles de actividad física y sedentarismo de sus pacientes. Además, de la falta de concienciación de sus compañeros de profesión, el limitado tiempo de consulta que poseen con cada paciente, y mejorar la colaboración con otros recursos comunitarios y desarrollar estrategias políticas adecuadas. Conclusiones Existen autopercepciones, barreras y facilitadores comunes entre los médicos y enfermeras de Atención Primaria para implementar la promoción y prescripción de ejercicio físico... (AU)

Endocarditis infecciosa con compromiso bivalvular por Erysipelothrix rhusiopathiae / Infective endocarditis with bivalvular involvement due to Erysipelothrix rhusiopathiae. Report of one case

The microbiology of infective endocarditis (IE) varies in different populations and depends on public health conditions and socioeconomic status. In low-income countries, oral Streptococci affect hearts with rheumatic valve disease in patients with poor dentition. In high-income countries, Staphylococci are the most common cause, affecting elderly and immunocompromised patients, or those with invasive devices. Gram - positive bacili as IE pathogens are unusual. Erysipelothrix rhusiopathiae is a Gram positive bacili. It causes skin diseases in domestic and farm animals, but in humans, is a very unusual pathogen. This infection is considered a zoonosis, since most cases are linked to direct contact with vector animals. We report a 62 year-old male patient with a history of exposure to animals, who developed an infective endocarditis with severe bivalve regurgitation and septic shock, requiring antimicrobials and surgical resolution. Erysipelothrix rhusiopathiae was isolated from blood and valve vegetation cultures. The patient had a successful evolution and was discharged from the hospital.

Self-perception of primary health-care staff about physical activity on prescription: A qualitative semi-structured interview.

OBJECTIVE: This study aimed to analyze the self-perception at primary health-care (PHC) nurses and general practitioners (GPs) toward PAP implementation in PHC centers. MATERIAL AND METHODS: Two semi-structured group interviews were performed separately, with five GPs and nurses working in the PHC system in the region of Madrid (Spain). An expert psychologist guided each semi-structured session. The interviews were transcribed verbatim and consensually analyzed using a content analysis. RESULTS: Half of the PHC staff considered themselves physically active and were convinced that physically active staff behavior could facilitate PAP with patients. Both GPs and nurses showed a lack of knowledge of exercise prescription but were interested in PAP and motivational training courses, as well as leadership or to collaborate under a multidisciplinary or interdisciplinary PAP approach. Some of the most relevant self-perceived PAP barriers were a confident method to measure sedentary and physical activity levels. Besides lack of staff awareness, time of consultation, and improving local community relationships and PAP policies strategies. CONCLUSIONS: There are some common self-perceptions, barriers, and facilitators among PHC nurses and GPs for PAP implementation. Following a socio-ecologic approach, this organizational data provides further insight to design a future cost-effective policy strategy to improve patient health and health-care system sustainability.

[Infective endocarditis with bivalvular involvement due to Erysipelothrix rhusiopathiae. Report of one case]. / Endocarditis infecciosa con compromiso bivalvular por Erysipelothrix rhusiopathiae.

The microbiology of infective endocarditis (IE) varies in different populations and depends on public health conditions and socioeconomic status. In low-income countries, oral Streptococci affect hearts with rheumatic valve disease in patients with poor dentition. In high-income countries, Staphylococci are the most common cause, affecting elderly and immunocompromised patients, or those with invasive devices. Gram - positive bacili as IE pathogens are unusual. Erysipelothrix rhusiopathiae is a Gram positive bacili. It causes skin diseases in domestic and farm animals, but in humans, is a very unusual pathogen. This infection is considered a zoonosis, since most cases are linked to direct contact with vector animals. We report a 62 year-old male patient with a history of exposure to animals, who developed an infective endocarditis with severe bivalve regurgitation and septic shock, requiring antimicrobials and surgical resolution. Erysipelothrix rhusiopathiae was isolated from blood and valve vegetation cultures. The patient had a successful evolution and was discharged from the hospital.

Changes in electromyographic activity of latent trigger points after a dry needling intervention: a randomised controlled trial.

OBJECTIVE: To analyse the effects of dry needling (DN) in upper trapezius latent trigger points (LTrPs) on pressure pain threshold (PPT) and surface electromyography (sEMG). DESIGN: Randomized, double-blind, placebo controlled clinical trial. SETTINGS: Sports Rehabilitation Laboratory, University of Castilla-La Mancha. PARTICIPANTS: Forty-six participants (18-35 years old) with LTrP in the upper trapezius were divided into two groups: DN-group and Sham-DN-group. INTERVENTIONS: In the DN-group, the needle was inserted 10-times through the skin, and it was manipulated up and down using a "fast in and out" technique. In the Sham-DN-group, non-penetrating needles were used. MAIN OUTCOME MEASURES: PPT, sEMG at rest, and sEMG in isometric contraction of the LTrP of the upper trapezius muscle were evaluated at baseline, 30 min after treatment, and after 24 h, and 72 h of follow-up. RESULTS: The mean change in sEMG at rest between baseline and 30 min was - 0.38 (0.38) %refRMS for the DN group and - 0.05 (0.31) %refRMS for the Sham-DN group (mean difference -0.34, 95% confidence interval (CI) of the difference: - 0.54 to - 0.13), and between baseline and 24 h was - 0.35 (0.35) %refRMS for the DN group and - 0.06 (0.58) %refRMS for the Sham-DN group (mean difference -0.29, 95% CI: -0.57 to -0.01). In addition, the DN-group showed higher values of PPT than the Sham-DN group at 72 h (5.22 (1.23) to 4.65 (1.03) kg/cm2; p < 0.05). CONCLUSIONS: A single session of DN intervention was effective in reducing the electromyographic activity, muscle fatigue and pain of the upper trapezius muscle in LTrP. CONTRIBUTION OF PAPER: In healthy volunteers dry needling is effective.

NEW SPECIES OF ALIPPISTRONGYLUS (TRICHOSTRONGYLINA: NIPPOSTRONGYLINAE) FROM THE ELEGANT RICE RAT, EURYORYZOMYS NITIDUS, OF LA CONVENCIÓN, PERU.

A new species of AlippistrongylusDigiani and Kinsella, 2014, was found in the intestines of the elegant rice rat, Euryoryzomys nitidus, collected in the Amazon rainforest. These mammals were preserved in alcohol and archived in the Colección Científica de Mamíferos del Museo de Historia Natural de la Universidad Mayor de San Marcos and accessed for the observation and investigation for the diversity of their endo-parasites. A total of 857 worms were recovered from the 3 individuals examined. Morphological investigations and comparisons with the only known species of the genus indicate that this is an undescribed species. These nematodes feature the diagnostic characteristic of the genus, being a bifurcated posterior end that consists of a tail and a conical appendage near the level of the vulva and uninterrupted ridges in the synlophe of unequal size. However, the orientation of this conical appendage on the female tail, features of the synlophe, and shape of the copulatory bursa warrant the proposal of an amended diagnosis to include character variability detected in the new species.

Assessment of a computed tomography imaging spectrometer using an optimized expectation-maximization algorithm.

We designed and built a homemade computed tomography imaging spectrometer (CTIS) of 250×250pixels of spatial resolution and 2 nm spectral resolution. The optical design considers a CTIS optical array coupled to a digital reflex camera. We reconstructed the intensity spectra of a fluorescent source, the diffuse reflectance of a ColorChecker, and samples of Capsicum annuum of three different colors, using the expectation-maximization sequential algorithm, optimized utilizing an array of indices to reduce the reconstruction time. The results obtained with a ColorChecker indicate a high positive correlation of 0.9745 with an average residual difference of 1.31% concerning the spectra obtained with a commercial integrating sphere spectrometer. The feasibility of the proposed CTIS system shows how to detect and evaluate the physiological changes resulting from the decomposition of the green fruit of the Capsicum annuum in a range from 500 to 650 nm.

Características del tendón rotuliano y de Aquiles en jugadores senior de bádminton / Characteristics of the patellar and Achilles tendon in senior badminton players

Los objetivos del estudio fueron describir las propiedades estructurales y mecánicas de los tendones rotuliano y de Aquiles en jugadores senior (>35 años) de bádminton y detectar posibles asimetrías entre el lado dominante y no dominante. La muestra estuvo compuesta por 206 jugadores senior de bádminton (Edad: 52.2±9.6 años) que participaron en el campeonato de Europa Senior en 2018. Se evaluaron las propiedades estructurales (grosor, anchura y área de sección transversal) por medio de un ecógrafo Logiq® S8 y las propiedades mecánicas (elasticidad, tono, rigidez e índice de elastografía) con miotonometría y sonoelastografía de los tendones rotuliano y de Aquiles. Los resultados mostraron que fueron mayores el grosor (5.34±19.90%, p = 0.027) y la anchura (1.57±8.52%, p=0.036) en el tendón de Aquiles no dominante mientras que el tendón rotuliano dominante mostró unos valores mayores para el tono (2.09±12.96%, p=0.002) y para la rigidez (4.41±21.11%, p=0.002) respecto al no dominante. (AU)

The purposes of the study were to describe the structural and mechanical properties of the patellar and Achilles tendons in senior badminton players (>35 years) and to detect possible asymmetries between dominant and non-dominant lower limb. Two hundred and six senior badminton players (52.2±9.6 years old) who participated in the 2018 Senior European Championship volunteered to participate in the study. The structural properties (thickness, width and cross-sectional area) by a Logiq® S8 ultrasound system and the mechanical properties (elasticity, tone, stiffness and elastography index) with myotonometry and sonoelastography of the patellar and Achilles tendons were assessed. Non-dominant Achilles tendon showed greater values for the thickness (5.34±19.90%, p=0.027) and width (1.57±8.52%, p=0.036) than those of the dominant tendon, while the dominant patellar tendon showed higher values for tone (2.09±12.96%, p=0.002) and stiffness (4.41±21.11%, p=0.002) compared to the non-dominant one. (AU)

Síndrome compartimental agudo en la baja de combate: una revisión narrativa / Acute compartment syndrome in combat casualties: a narrative review

Introducción: El síndrome compartimental agudo (SCA) es una complicación frecuente y potencialmente devastadora en las heridas de guerra que afectan a las extremidades, debido principalmente a las lesiones vasculares, óseas y de tejidos blandos frecuentemente asociadas, y a la dificultad para reevaluar a la baja durante su evacuación. El objetivo de esta revisión es analizar la evidencia científica disponible y actualizada sobre el manejo diagnóstico-terapéutico del SCA en la baja de combate.Material y métodos:Para la elaboración de este trabajo se ha realizado una búsqueda bibliográfica exhaustiva en las bases de datos: PubMed, Google Scholar, Scopus, ScienceDirect, Scielo y Latindex. Para la selección de artículos, se han establecido como criterios de inclusión que fueran realizados en entornos militares o sobre poblaciones de bajas de combate, escritos en castellano o inglés, y publicados durante los últimos quince años.Resultados y conclusiones:En el entorno operativo, el diagnóstico del SCA será fundamentalmente clínico y el tratamiento consistirá en una fasciotomía precoz y completa de todos los compartimentos del miembro afectado, ya que la fasciotomía tardía o incompleta se ha asociado con peores resultados y a un aumento de la morbimortalidad. La formación continuada en cirugía de guerra ha disminuido las tasas de fasciotomías de revisión. (AU)

Introduction: Acute compartment syndrome (ACS) is a frequent and potentially devastating complication of extremity war wounds, mainly due to the frequently associated vascular, bone and soft tissue injuries, and the limit close monitoring during casualty evacuation. The objective of this review is to analyze the available and updated scientific evidence on the diagnostic-therapeutic management of ACS in combat casualty.Material and Methods:For the preparation of this work, an exhaustive bibliographic search was carried out in the databases: PubMed, Google Scholar, Scopus, ScienceDirect, Scielo and Latindex. For the selection of articles, inclusion criteria have been established: carried out in military environments or on combat casualties populations, written in Spanish or English, and published during the last fifteen years.Results and Conclusions:In the combat zone, the diagnosis is even more heavily weighted toward clinical evaluation and the treatment will consist of a prompt and complete fasciotomy of all compartments of the affected limb, inasmuch as delayed or incomplete fasciotomy has been associated with worse outcomes and increased morbidity and mortality. Pre-deployment training of surgeons has decreased the rate of revision fasciotomies. (AU)

Update of the PANCCO clinical practice guidelines for the treatment of ulcerative colitis in the adult population.

Ulcerative colitis (US) is a chronic disease of unknown etiology. It is incurable and its clinical course is intermittent, characterized by periods of remission and relapse. The prevalence and incidence of the disease has been increasing worldwide. The update presented herein includes the participation of healthcare professionals, decision-makers, and a representative of the patients, all of whom declared their conflicts of interest. Answerable clinical questions were formulated, and the outcomes were graded. The information search was conducted on the Medline/PubMed, Embase, Epistemonikos, and LILACS databases, and covered grey literature sources, as well. The search was updated on November 30, 2020, with no restrictions regarding date or language. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification system was implemented to establish the strength of the recommendation and quality of evidence. A formal consensus was developed, based on the RAND/UCLA methodology and the document was peer reviewed. The short version of the Clinical Practice Guidelines for the Treatment of Ulcerative Colitis in the Adult Population is presented herein, together with the supporting evidence and respective recommendations. In mild-to-moderate UC, budesonide MMX is an option when treatment with 5-ASA fails, and before using systemic steroids. In moderate-to-severe UC, infliximab, adalimumab, vedolizumab, ustekinumab, and tofacitinib can be used as first-line therapy. If there is anti-TNF therapy failure, ustekinumab and tofacitinib provide the best results. In patients with antibiotic-refractory pouchitis, anti-TNFs are the treatment of choice.

[Cadmium polyneuropathy: a rare, but not less important, cause of peripheral neuropathy]. / Polineuropatía por cadmio: una causa infrecuente, pero no menos importante, de neuropatía periférica.

INTRODUCTION: Cadmium is an important heavy metal in neurobiology, with potential neurotoxic effects, often in the form of polyneuropathy (PNP). CASE REPORT: We present an exceptional case of PNP due to cadmium of toxic-occupational origin, specifically a 47-year-old man, aeronautical mechanic, with a 5-year clinical picture, consisting of a tingling sensation having a 'glove and stocking' distribution of symptoms and bimanual manipulative clumsiness. The neurological examination revealed bilateral achilles hyporeflexia and protopathic-thermal-algesic exteroceptive hypoesthesia in hands and feet. The following complementary rests were requested: toxic-metabolic-infectious-vitamin profile, full craniospinal MRI, electroneurographic-electromyographic study (ENG-EMG) of the upper and lower limbs, PET-CT body and 24-hour video-electroencephalogram. The results were consistent with an axonal, distal, symmetric sensory-motor PNP, of moderate intensity, chronic evolution, with active denervation, of toxic-occupational origin due to cadmium. The patient continued on sick leave to cease exposure to cadmium, initiating intensive multimodal neurorehabilitation program, with serial analytical determinations of toxins and new ENG-EMG studies every 6 months. With normalization of the altered values ??and complete clinical restitution at one-year follow-up. CONCLUSIONS: This case highlights the importance of including the toxicological determination of cadmium in case of suspicion of a PNP of toxic-occupational origin, once ruled out other etiologies, in order to early interrupt occupational exposure, as it is a potentially reversible cause of peripheral neuropathy. Currently there is no specific pharmacological treatment against cadmium tested in humans. Randomized clinical trials carried out in these patients are warranted to develop an anti-cadmium drug in refractory cases despite the end of exposure.

TITLE: Polineuropatía por cadmio: una causa infrecuente, pero no menos importante, de neuropatía periférica.Introducción. El cadmio es un metal pesado importante en neurobiología, con potenciales efectos neurotóxicos, frecuentemente en forma de polineuropatía. Caso clínico. Presentamos un caso excepcional de polineuropatía por cadmio de origen tóxico-ocupacional, en concreto, un varón de 47 años, mecánico aeronáutico, con un cuadro de cinco años de evolución, consistente en sensación de hormigueo 'en guante y calcetín' y torpeza manipulativa bimanual. En la exploración destacaba una hiporreflexia aquílea bilateral, y una hipoestesia exteroceptiva protopático-térmico-algésica en las manos y los pies. Se solicitó analítica general completa con perfil tóxico-metabólico-infeccioso-vitamínico, resonancia magnética craneomedular completa, estudio electroneurográfico-electromiográfico de los miembros superiores e inferiores, tomografía por emisión de positrones-tomografía axial computarizada body y videoelectroencefalograma de 24 horas. Los resultados fueron compatibles con una polineuropatía sensitivomotora axonal, distal, simétrica, de intensidad moderada, de evolución crónica y desnervación activa, de origen tóxico-ocupacional por cadmio. El paciente prosiguió la baja laboral para cesar la exposición al cadmio, iniciando neurorrehabilitación intensiva multimodal, y determinaciones analíticas seriadas de tóxicos y nuevos estudios electroneurográficos-electromiográficos cada seis meses, con normalización de los valores alterados y restitución clínica ad integrum al año. Conclusiones. Este caso enfatiza la importancia de incluir la determinación toxicológica del cadmio ante la sospecha de una polineuropatía de origen tóxico-ocupacional, descartadas otras etiologías, para interrumpir precozmente dicha exposición laboral, al ser una causa potencialmente reversible de neuropatía periférica. Actualmente no existe un tratamiento farmacológico específico frente al cadmio demostrado en seres humanos. Urgen ensayos clínicos aleatorizados en estos pacientes, para desarrollar un fármaco frente al cadmio en casos refractarios pese a finalizar la exposición.

Oocyte quality and in vivo embryo survival after ovarian stimulation in nulliparous and multiparous rabbit does.

Superovulation treatments aim to stimulate multifollicular recruitment, maximizing the number of oocytes or transferable embryos produced. Factors associated with the superovulation protocol, female characteristics and many other factors are determinants in the number and quality of oocytes obtained. An accurate way to assess oocyte quality more precise than morphological appearance is genetic expression. The present study aims to compare the response of nulliparous and multiparous females to superovulatory stimulation, studying its effect on the expression of some genes associated with the activation, growth, development and oocyte-embryo transition of oocytes, as well as its impact on in vivo embryonic development and viability rate at birth. In a first experiment, the effect of stimulation treatment on the ovulation response and the expression of the MSY2, MATER, ITPR1, ITPR2, ITPR3, eIF4E, PAR1, PAPOL-A, PAPOL-G, ZAR1 and YY1 genes in nulliparous and multiparous females were determined. In a second experiment, the implantation and viability at birth of embryos from superovulated nulliparous and multiparous females were analysed. The ovulation rate was significantly higher in the superovulation groups than in the control groups. The ovulation rate was significantly increased in nulliparous females compared with multiparous does. From the eleven genes analysed, only the expression of MATER, PAPOL-A, PAPOL-G and ZAR-1 genes was shown to be different among experimental groups. Finally, in terms of implantation rate and viability at birth, the nulliparous control group showed better results than the rest of the groups. Both hyperstimulation treatment and reproductive female's history seem to alter the transcriptome of important genes related to oocyte maturation and competence acquisition, affecting in vivo embryo viability.

Polineuropatía por cadmio: una causa infrecuente, pero no menos importante, de neuropatía periférica / Cadmium polyneuropathy: a rare, but not less important, cause of peripheral neuropathy

Introducción: El cadmio es un metal pesado importante en neurobiología, con potenciales efectos neurotóxicos, frecuentemente en forma de polineuropatía. Caso clínico: Presentamos un caso excepcional de polineuropatía por cadmio de origen tóxico-ocupacional, en concreto, un varón de 47 años, mecánico aeronáutico, con un cuadro de cinco años de evolución, consistente en sensación de hormigueo ‘en guante y calcetín’ y torpeza manipulativa bimanual. En la exploración destacaba una hiporreflexia aquílea bilateral, y una hipoestesia exteroceptiva protopático-térmico-algésica en las manos y los pies. Se solicitó analítica general completa con perfil tóxico-metabólico-infeccioso-vitamínico, resonancia magnética craneomedular completa, estudio electroneurográfico-electromiográfico de los miembros superiores e inferiores, tomografía por emisión de positrones-tomografía axial computarizada body y videoelectroencefalograma de 24 horas. Los resultados fueron compatibles con una polineuropatía sensitivomotora axonal, distal, simétrica, de intensidad moderada, de evolución crónica y desnervación activa, de origen tóxico-ocupacional por cadmio. El paciente prosiguió la baja laboral para cesar la exposición al cadmio, iniciando neurorrehabilitación intensiva multimodal, y determinaciones analíticas seriadas de tóxicos y nuevos estudios electroneurográficos-electromiográficos cada seis meses, con normalización de los valores alterados y restitución clínica ad integrum al año. Conclusiones: Este caso enfatiza la importancia de incluir la determinación toxicológica del cadmio ante la sospecha de una polineuropatía de origen tóxico-ocupacional, descartadas otras etiologías, para interrumpir precozmente dicha exposición laboral, al ser una causa potencialmente reversible de neuropatía periférica. Actualmente no existe un tratamiento farmacológico específico frente al cadmio demostrado en seres humanos.(AU)

Introduction: Cadmium is an important heavy metal in neurobiology, with potential neurotoxic effects, often in the form of polyneuropathy (PNP). Case report: We present an exceptional case of PNP due to cadmium of toxic-occupational origin, specifically a 47-year-old man, aeronautical mechanic, with a 5-year clinical picture, consisting of a tingling sensation having a ‘glove and stocking’ distribution of symptoms and bimanual manipulative clumsiness. The neurological examination revealed bilateral achilles hyporeflexia and protopathic-thermal-algesic exteroceptive hypoesthesia in hands and feet. The following complementary rests were requested: toxic-metabolic-infectious-vitamin profile, full craniospinal MRI, electroneurographic-electromyographic study (ENG-EMG) of the upper and lower limbs, PET-CT body and 24-hour video-electroencephalogram. The results were consistent with an axonal, distal, symmetric sensory-motor PNP, of moderate intensity, chronic evolution, with active denervation, of toxic-occupational origin due to cadmium. The patient continued on sick leave to cease exposure to cadmium, initiating intensive multimodal neurorehabilitation program, with serial analytical determinations of toxins and new ENG-EMG studies every 6 months. With normalization of the altered values ​​and complete clinical restitution at one-year follow-up. Conclusions: This case highlights the importance of including the toxicological determination of cadmium in case of suspicion of a PNP of toxic-occupational origin, once ruled out other etiologies, in order to early interrupt occupational exposure, as it is a potentially reversible cause of peripheral neuropathy. Currently there is no specific pharmacological treatment against cadmium tested in humans. Randomized clinical trials carried out in these patients are warranted to develop an anti-cadmium drug in refractory cases despite the end of exposure.(AU)