Moss establishment success is determined by the interaction between propagule size and species identity.

Colonization of new habitat patches is a key aspect of metacommunity dynamics, particularly for sessile organisms. Mosses can establish in new patches through fragmentation, with different vegetative structures acting as propagules. Despite the importance of these propagules for successful colonization the specific aspects that favour moss colonization by vegetative propagules remain poorly understood, including the effect of propagule size. We examine the intra- and interspecific variation of establishment and colonization success in culture of propagules of different sizes in six widespread soil moss species of contrasting growth form (Dicranum scoparium, Homalothecium aureum, Hypnum cupressiforme, Ptychostomum capillare, Syntrichia ruralis and Tortella squarrosa). We obtained three different size classes of propagules from artificially fragmented vegetative material, and assessed their establishment under controlled light and temperature conditions. We characterize the size, shape, apparent viability, morphological type and size changes due to hydration states of the propagules, all of them traits with potentially significant influence in their dispersal pattern and establishment. Then we assess the effect of these traits on moss establishment, using indicators of surface establishment (number of established shoots and colonized surface) and biomass production (viable biomass) as proxies of colonization success. The establishment indicators related to colonization surface and biomass production differ among species and propagule sizes. The magnitude of the interspecific differences of all indicators of establishment success was larger at the smaller propagule size class. T. squarrosa was the most successful species, and D. scoparium showed the lowest performance. We also found interspecific differences in the hydration dynamics of the propagules. The process of establishment by vegetative fragments operates differently among moss species. Besides, differences between hydration states in propagules of some species could be part of syndromes for both dispersal and establishment. This study unveils several functional traits relevant for moss colonization, such as wet versus dry area and length of fragments, which may improve our understanding of their spatial dynamics.

Conversion from Duodenal Switch to Single Anastomosis Duodenal Switch to Deal with Postoperative Malnutrition.

BACKGROUND: Duodenal switch (DS) is considered one of the most effective bariatric techniques for long-term weight and comorbidity control. After these operations, some patients may get severe complications related to malnutrition and a few of them may need surgical revision. Lengthening the common channel (CC) is usually the solution: changing the Roux anastomosis or with a side-to-side anastomosis (kissing X). We propose that when simplified construction of the DS is used, conversion to single anastomosis DS (SADI-S/OADS) is an easy and safe choice. OBJECTIVES: To evaluate the safety and effectiveness of conversion from DS to SADI-S in cases of malnutrition. METHODS: We report three patients with severe malnutrition after a DS at 9, 74, and 84 months. One of them had also liver failure related to alcohol abuse and malnutrition. Laparoscopic reoperations included a new ileo-ileal anastomosis and takedown of the Roux-en-Y anastomosis with the aim of lengthening the CC. RESULTS: All three patients were successfully converted by laparoscopy. After a median follow-up of 54.6 months [32-76 months], all of them had moderate weight regain and returned to normal biochemical nutritional parameters. Two patients with type 2 diabetes (T2DM) before DS had complete remission before conversion; one of them had recurrence of T2DM after conversion. The patient with liver failure improved significantly after conversion. CONCLUSIONS: Conversion from DS to SADI-S/OADS is a simple operation with excellent results in resolving malnutrition in those patients. However, weight regain and recurrence of comorbidities may arise.

Liver transplantation for neuroendocrine tumors in Europe-results and trends in patient selection: a 213-case European liver transplant registry study.

OBJECTIVE: The purpose of this study was to assess outcomes and indications in a large cohort of patients who underwent liver transplantation (LT) for liver metastases (LM) from neuroendocrine tumors (NET) over a 27-year period. BACKGROUND: LT for NET remains controversial due to the absence of clear selection criteria and the scarcity and heterogeneity of reported cases. METHODS: This retrospective multicentric study included 213 patients who underwent LT for NET performed in 35 centers in 11 European countries between 1982 and 2009. One hundred seven patients underwent transplantation before 2000 and 106 after 2000. Mean age at the time of LT was 46 years. Half of the patients presented hormone secretion and 55% had hepatomegaly. Before LT, 83% of patients had undergone surgical treatment of the primary tumor and/or LM and 76% had received chemotherapy. The median interval between diagnosis of LM and LT was 25 months (range, 1-149 months). In addition to LT, 24 patients underwent major resection procedures and 30 patients underwent minor resection procedures. RESULTS: Three-month postoperative mortality was 10%. At 5 years after LT, overall survival (OS) was 52% and disease-free survival was 30%. At 5 years from diagnosis of LM, OS was 73%. Multivariate analysis identified 3 predictors of poor outcome, that is, major resection in addition to LT, poor tumor differentiation, and hepatomegaly. Since 2000, 5-year OS has increased to 59% in relation with fewer patients presenting poor prognostic factors. Multivariate analysis of the 106 cases treated since 2000 identified the following predictors of poor outcome: hepatomegaly, age more than 45 years, and any amount of resection concurrent with LT. CONCLUSIONS: LT is an effective treatment of unresectable LM from NET. Patient selection based on the aforementioned predictors can achieve a 5-year OS between 60% and 80%. However, use of overly restrictive criteria may deny LT to some patients who could benefit. Optimal timing for LT in patients with stable versus progressive disease remains unclear.

Revisión de vías venosas centrales: anatomía quirúrgica y sus complicaciones / Central venous lines: surgical anatomy and its complications

Los registros de canalización de venas centrales datande 1927, principios de siglo X, cuando se logró abordarel bulbo superior de la vena yugular interna. Actualmente, es una heramienta que se ha expandido y utilza enuna gran variedad de procedimientos terapéuticos y diagnósticos dentro de los que se destacan la monitorización de parámetros hemodinámicas. En Estados Unios se colocan anualmente 5 milones de catéteresvenosos centrales (CVC), de los cuales aproximadamente15%presenta complicaciones, lo que signifca un riesgopara la vida del paciente. La experiencia del personalmédico en la instalación y manejo de los catéteres, esfundamental en pos de disminuir la tasa de complicaciones. En el presente trabajo se realiza una revisiónbibliográfica sobre los riesgos y complicaciones de lacitada intervención, abordando las relaciones anatómicas de los sitos de punción más frecuentes y la técnicaa emplear, conocimientos que consideramos básicospara el éxito del procedimiento. Resultados: las principales complicaciones encontradas con respecto al abordajeYugular son las siguientes, la Trombosis en un 7,6 a12%, siendo la más frecuente; seguida de la Punciónarterial con un 6.3 û 9.4% y la colocación incorecta delcatéter (5%), entre otras. En la Subclavia, el riesgo principal está referido a la incorecta colocación de la vía(9%) y en menor medida la Trombosis (1,9 a 8%). Porotro lado, la realización de la vía Femoral produjo unaTrombosis del 12- 21,5% seguida de la Punción arterial(9- 15%). La Vena Femoral, presentó una mayor incidencia de bacteriemias, siendo la Vena Subclavia la queprodujo menor cantidad de casos. Hubo mayor cantidadde complicaciones en la V. Yugular Interna pero de mayorgravedad en la V. Subclavia. Conclusiones: Llevar lafrecuencia de complicaciones a cero es imposible, peroel adecuado conocimiento de la anatomía normal y latécnica de punción es una condición elemental paradisminuir al mínimo las complicaciones.(AU)

Central veins chaneling records date back to 1927,begining of 20th century, when was adresing the uperbulb of the vein, internal jugular. Curently, it is a tol thathas expanded and used in a variety of therapeuticprocedures and diagnoses within which stand monitoringhemodynamic parameters. United States 5 milon centralvenous catheters (CVCS) are placed anualy, of them15% aproximately presents complications, thusrepresenting a risk to the life of the patient. The experienceof the medical personel in the instalation andmanagement of catheters, is esential in order to reducethe rate of complications.In this paper is a literature review on the risks andcomplications of the abovementioned intervention,adresing the anatomical relations of requent puncturesites and the technique to be used, knowledge which weconsider basic to the suces of the procedure.Results: the main complications were found with respectto the aproach to jugular are as folows, thrombosis in a7.6 to 12%, being the most common; folowed by thearterial puncture with a 6.3 - 9.4% and the incorectplacement of the catheter (5%), among others. Insubclavian, the main risk is refering to the incorectplacement of the via (9%) and to a leser extentthrombosis (1.9-8%). On the other hand, the completionof the via Femoral produced a 12-21.5% folowed by arterial puncture thrombosis (9-15%).The Femoral veins, was which presented higherincidence of bacteraemia, being it subclavian vein whichdid les. There were many complications in the V. internaljugular but more serious in the V. subclavian.Conclusions: The frequency of complications zero isimposible, but the adequate knowledge of normalAnatomy and puncture technique is a basic conditon tominimize complications.(AU)

Revisión de vías venosas centrales: anatomía quirúrgica y sus complicaciones / Central venous lines: surgical anatomy and its complications

Los registros de canalización de venas centrales datande 1927, principios de siglo X, cuando se logró abordarel bulbo superior de la vena yugular interna. Actualmente, es una heramienta que se ha expandido y utilza enuna gran variedad de procedimientos terapéuticos y diagnósticos dentro de los que se destacan la monitorización de parámetros hemodinámicas. En Estados Unios se colocan anualmente 5 milones de catéteresvenosos centrales (CVC), de los cuales aproximadamente15%presenta complicaciones, lo que signifca un riesgopara la vida del paciente. La experiencia del personalmédico en la instalación y manejo de los catéteres, esfundamental en pos de disminuir la tasa de complicaciones. En el presente trabajo se realiza una revisiónbibliográfica sobre los riesgos y complicaciones de lacitada intervención, abordando las relaciones anatómicas de los sitos de punción más frecuentes y la técnicaa emplear, conocimientos que consideramos básicospara el éxito del procedimiento. Resultados: las principales complicaciones encontradas con respecto al abordajeYugular son las siguientes, la Trombosis en un 7,6 a12%, siendo la más frecuente; seguida de la Punciónarterial con un 6.3 – 9.4% y la colocación incorecta delcatéter (5%), entre otras. En la Subclavia, el riesgo principal está referido a la incorecta colocación de la vía(9%) y en menor medida la Trombosis (1,9 a 8%). Porotro lado, la realización de la vía Femoral produjo unaTrombosis del 12- 21,5% seguida de la Punción arterial(9- 15%). La Vena Femoral, presentó una mayor incidencia de bacteriemias, siendo la Vena Subclavia la queprodujo menor cantidad de casos. Hubo mayor cantidadde complicaciones en la V. Yugular Interna pero de mayorgravedad en la V. Subclavia. Conclusiones: Llevar lafrecuencia de complicaciones a cero es imposible, peroel adecuado conocimiento de la anatomía normal y latécnica de punción es una condición elemental paradisminuir al mínimo las complicaciones.

Central veins chaneling records date back to 1927,begining of 20th century, when was adresing the uperbulb of the vein, internal jugular. Curently, it is a tol thathas expanded and used in a variety of therapeuticprocedures and diagnoses within which stand monitoringhemodynamic parameters. United States 5 milon centralvenous catheters (CVCS) are placed anualy, of them15% aproximately presents complications, thusrepresenting a risk to the life of the patient. The experienceof the medical personel in the instalation andmanagement of catheters, is esential in order to reducethe rate of complications.In this paper is a literature review on the risks andcomplications of the abovementioned intervention,adresing the anatomical relations of requent puncturesites and the technique to be used, knowledge which weconsider basic to the suces of the procedure.Results: the main complications were found with respectto the aproach to jugular are as folows, thrombosis in a7.6 to 12%, being the most common; folowed by thearterial puncture with a 6.3 - 9.4% and the incorectplacement of the catheter (5%), among others. Insubclavian, the main risk is refering to the incorectplacement of the via (9%) and to a leser extentthrombosis (1.9-8%). On the other hand, the completionof the via Femoral produced a 12-21.5% folowed by arterial puncture thrombosis (9-15%).The Femoral veins, was which presented higherincidence of bacteraemia, being it subclavian vein whichdid les. There were many complications in the V. internaljugular but more serious in the V. subclavian.Conclusions: The frequency of complications zero isimposible, but the adequate knowledge of normalAnatomy and puncture technique is a basic conditon tominimize complications.

El pretratamiento con alopurinol disminuye la translocación bacteriana y atenúa los cambios morfológicos de la mucosa intestinal en un modelo de isquemia-reperfusión intestinal en ratas / Pretreatment with allopurinol reduces bacterial translocation and ameliorates the morphological changes of the intestinal mucosa in an intestinal ischemia-reperfusion rat model

Objetivo. Evaluar el efecto protector contra la lesión por isquemia-reperfusión intestinal del pretratamiento con alopurinol en ratas. Materiales y métodos. Se llevó a cabo un experimento controlado en animales. Un grupo de 10 ratas Wistar de características morfométricas comparables se mantuvo en bioterio bajo condiciones controladas por tres días. A cinco animales se les administró 50 mg/kg diarios de alopurinol por vía oral durante los tres días y, una dosis adicional, antes de inducir isquemia intestinal por ligadura quirúrgica durante 60 minutos seguida de 60 minutos de reperfusión. El otro grupo de cinco ratas no recibió el medicamento. Se hizo el análisis histológico de la mucosa intestinal al final del experimento por medio de la clasificación de Chou y se tomaron hemocultivos de la cavidad cardiaca. Resultados. Se encontraron hemocultivos positivos en 20 % de los animales pretratados con alopurinol, en comparación con el 100 % de las ratas control (p<0,0001). Se evidenció lesión profunda en la mucosa intestinal en todos los casos. La administración previa a la injuria de alopurinol redujo significativamente la lesión por isquemia-reperfusión (p<0,001). Conclusiones. La administración de alopurinol antes de la isquemia intestinal, reduce los cambios morfológicos ocasionados por isquemia-reperfusión. El efecto benéfico se demostró con el pretratamiento por tres días.

Objective: To evaluate the protective effect of pretreatment with allopurinol in an intestinal ischemia-reperfusion injury rat model. Materials and methods: A controlled animal trial was conducted; 10 Wistar rats were kept under controlled conditions for three days. One group (n=5) received allopurinol 50 mg/kg per day for the 3-day period and an additional dose immediately prior to surgical mesenteric artery clamping (60 minutes) and reperfusion (60 minutes). The other group (n=5) did not receive the medication. Hystologic analysis of intestinal mucosa by means of Chou grading system was performed, and blood cultures from the heart were withdrawn. Results: Positive blood cultures were found in 20% of the allopurinol group as compared with 100% in the control group (p<0.0001). Deep mucosal lesion was evidence in all cases. Allopurinol pretreatment reduced significantly the ischemia-reperfusion injury (p<0.001). Conclusions: Allopurinol administration prior to intestinal ischemia ameliorated morphologic changes related to the ischemia-reperfusion process. The beneficial effect of allopurinol was demonstrated with pretreatment for three days.

Meningitis sifilítica aguda / Acute syphilitic meningitis

Se trata de un paciente de 28 años de sexo femenino, que presentó un cuadro clínico rápidamente progresivo de cambios en el comportamiento y deterioro del estado de conciencia. Ingresó con puntaje de Glasgow de 8/15 y requirió intubación traqueal. Tenía respuesta plantar extensora bilateral, pupila izquierda midriática de 5 mm, sin respuesta a la luz, ptosis palpebral del mismo lado y nistagmo con componente rápido hacia la izquierda. El contenido de proteínas del líquido cefalorraquídeo fue de 0,86 g/l con pleocitosis moderada de predominio linfocitario. Tres semanas antes del ingreso, presentó parto vaginal eutócico; no tuvo control prenatal durante el embarazo. En el recién nacido se demostró serología reactiva para sífilis y FTA-ABS positivo. La paciente también fue hallada reactiva para serología de sífilis en el líquido cefalorraquídeo, con diagnóstico de meningitis sifilítica aguda. La prueba ELISA para VIH fue negativa.

A 28 year-old woman presented with a rapidly progressive clinical picture of behavioral changes and altered level of consciousness. She was admitted with Glasgow Coma Score 8/15, 5 mm dilated non-reactive left pupil, right ptosis and nystagmus with left lateral gaze. Protein content at cerebrospinal fluid was 0,86 g/L with pleocytosis. Three weeks earlier, the patient underwent vaginal delivery of a pregnancy without prenatal care, and the newborn was found to be reactive to syphilis serology and positive on FTA-ABS test. The patient was found positive as well for syphilis on serologic tests for syphilis, corresponding yhe picture to neurosyphilis.HIV testing was negative in the patient.

Qualitative study of substituent effects on NMR (15)N and (17)O chemical shifts.

A qualitative approach to analyze the electronic origin of substituent effects on the paramagnetic part of chemical shifts is described and applied to few model systems, where its potentiality can be appreciated. The formulation of this approach is based on the following grounds. The influence of different inter- or intramolecular interactions on a second-order property can be qualitatively predicted if it can be known how they affect the main virtual excitations entering into that second-order property. A set of consistent approximations are introduced in order to analyze the behavior of occupied and virtual orbitals that define some experimental trends of magnetic shielding constants. This approach is applied first to study the electronic origin of methyl-beta substituent effects on both (15)N and (17)O chemical shifts, and afterward it is applied to a couple of examples of long-range substituent effects originated in charge transfer interactions such as the conjugative effect in aromatic compounds and sigma-hyperconjugative interactions in saturated multicyclic compounds.

The association of Streptococcus bovis bacteremia and gastrointestinal diseases: a retrospective analysis.

There is a well-established association between Streptococcus bovis bacteremia (SBB) and colorectal cancer. However, SBB is also frequently associated with chronic liver disease and has been described with other gastrointestinal disorders. The aim of the study was to evaluate the prevalence of gastrointestinal disease in patients with SBB. Retrospective analysis of the microbiology database at Jackson Memorial Medical Center, Miami, Florida, between 1992 and 2002, was performed. Patients' clinical records were reviewed, with special focus on underlying gastrointestinal disease or other major comorbidities. Thirty-eight patients (83%) were adults and eight (17%) were pediatric patients. Nineteen patients presented with gastrointestinal disorders associated with SBB (41%). Nine adult patients (19%) had end-stage liver disease (five female). Six patients had alcohol-induced liver disease (one with concomitant chronic hepatitis C), with the remaining three cases related to autoimmune hepatitis, primary biliary cirrhosis, and nonalcoholic steatohepatitis. Colonic neoplasms (adenocarcinoma in 3 and adenomatous polyps in 3) were found in 6 of 10 adult patients in whom colonoscopic evaluation was performed. Seven adult patients had acquired immunodeficiency syndrome (AIDS) (18%). Mortality in the patients with AIDS and SBB was high (71%). No significant association with gastrointestinal diseases was found in the pediatric population. Bacteremia due to S. bovis in adults is frequently associated with hepatic dysfunction (1:4), colonic neoplasms (1:6), and AIDS (1:6). This association was valid for our adult population only. SBB is an early clue to the likely presence of these serious underlying conditions and warrants rigorous investigation when recognized.

Effect of transdermal nitroglycerin on inflammatory mediators in patients with peripheral atherosclerotic vascular disease.

OBJECTIVE: To demonstrate that nitroglycerin improves biological markers of arterial inflammation in patients with peripheral vascular disease. BACKGROUND: Atherosclerosis is an inflammatory disease in which there is an increase in active inflammation markers such as C-reactive protein and other factors released by endothelial cells. Nitroglycerin acts by a chemical liberation of nitric oxide. We have previously published the results from several controlled clinical trials confirming an anti-inflammatory action of nitroglycerin. METHODS: Forty patients with peripheral vascular disease entered a randomized, double-blind, placebo-controlled pilot study for 6 weeks. Twenty-one patients were treated with continuous application of a transdermal nitroglycerin patch (15 mg/24 hours) on the anterior face of the thigh. Venous blood samples were obtained before treatment and 2 and 6 weeks after. We measured plasma levels of C-reactive protein, cGMP (also intraplatelet cGMP), E-selectin, ICAM, VCAM-1, IL-6, and nitrites/nitrates. RESULTS: No biological parameter was modified in the placebo group. On the contrary, nitroglycerin significantly reduced plasma levels of C-reactive protein and sE-selectin and increased the levels of intraplatelet cGMP. CONCLUSIONS: The results of this preliminary study show that nitroglycerin has an anti-inflammatory action in patients with peripheral vascular disease. This may provide a new therapeutic approach to understanding the efficacy of nitrovasodilators in the improvement of atherosclerotic syndromes.

Influence of superimposed alcoholic hepatitis on the outcome of liver transplantation for end-stage alcoholic liver disease.

BACKGROUND/AIMS: Alcoholic cirrhosis is a common indication for liver transplantation. The present study was aimed to assess the influence of superimposed alcoholic hepatitis on the outcome of liver transplantation in patients with alcoholic cirrhosis. METHODS: Survival rates of 68 patients transplanted for alcoholic cirrhosis were compared with those of 101 patients transplanted for miscellaneous causes. Within the alcoholic group, explanted livers were searched for data of acute alcoholic hepatitis. The survival rate of patients with alcoholic hepatitis superimposed on liver cirrhosis was compared to that of patients with liver cirrhosis alone. Clinical severity of alcoholic hepatitis was assessed with Maddrey's score. RESULTS: Survival was similar in alcoholics and patients with other causes of liver disease. Among patients transplanted for alcoholic cirrhosis, survival was similar in patients with superimposed alcoholic hepatitis (n=36) and in cases with liver cirrhosis alone (n=32). There was no difference in survival between patients with mild (n=26) and severe (n=10) alcoholic hepatitis. Seven alcoholics (10%) returned to ethanol consumption. Recidivism was not associated with either alcoholic hepatitis in the explanted liver or graft loss. CONCLUSIONS: Survival after liver transplantation in patients with alcoholic cirrhosis plus alcoholic hepatitis detected in the explanted liver is similar to that of patients transplanted for other reasons. Even the presence of severe alcoholic hepatitis does not worsen the outcome of liver transplantation for end-stage alcoholic liver disease.

Segunda prospección biológico pesquera de tiburones frente al Callao y Pisco, Mayo de 1996 / The second exploration biological fishing of sharks opposite to the Callao and Grappa, May, 1996

Between May 14 and 17 1996 on the surface 100 miles off coast between Callao and Pisco were caught two species of the blue sharks that belong to the families "Blue Shark" Prionace glauca (Carcharhinidae) and "Diamond Shark" Isurus oxyrinchus (Lamnnidae). The 21 caught specimen weighed 80kg 15 blue sharks 202 kg/h and 3 individuals/100 fishhooks.

Entre el 14 y 17 de mayo de 1996 utilizando un espinel de superficie a 100 millas mar afuera frente a Callao y Pisco, se capturó 2 especies de tiburones pertenecientes a 2 familias distintas "tiburón azul" Priomace glauca (Carcharhinidae) y "tiburón diamante" Isurus oxirinchus (Lamnidae). Un total de 21 especímenes capturados pesaron 808 kg. destacando el "tiburon azul" con 15 individuos (504kg) que representó el 63% de la captura total. Los índices de abundancia relativa expresado en valores de captura por unidad de esfuerzo (CPUE) obtenidos para el recurso "tiburón" fueron 202 kg/h y 3 ind/100 anzuelos.

Sombras intratorácicas pseudotumorales de origen cardiovascular / Pseudotumorlike intratorácicas shades of cardiovascular origin

Reportamos cinco pacientes con imágenes intratorácicas de aspecto tumoral, referidos al ION-SOLCA para valoración diagnóstica; ésta reveló que las imágenes pseudotumorales eran de origen cardiovascular: una fístula arteriovenosa pulmonar un aneurisma aorto-torácico con fístula aorto-bronquial, un tumor evanescente de colección pleural (tumor fantasma) y dos casos de arteria pulmonar dilatada por hipertensión pulmonar. Destacamos las principales características clínicas útiles para el diagnóstico y analizamos la importancia del reconocimiento de estas entidades, ante imágenes radiológicas aparentemente tumorales...