La formación en entrenamiento de fuerza dirigida a médicos aumenta su prescripción / Strength training education for physicians increases its prescription

Introducción: Tradicionalmente la prescripción médica se centra en el ejercicio aeróbico, pero son cada vez más los autores que señalan al entrenamiento de fuerza como la modalidad de ejercicio más saludable. El objetivo del presente trabajo es evaluar los cambios en los conocimientos y la seguridad para la prescripción de ejercicio de fuerza tras haber realizado un curso teórico-práctico de ejercicio físico dirigido a médicos, con respecto a no haberlo realizado. Material y métodos: Se realizó un estudio de intervención en 160 médicos con 2 cohortes, 80 realizaron un curso sobre ejercicio (grupo de intervención) y 80 no lo realizaron (grupo comparativo). Se recogieron datos personales, profesionales, sobre el ejercicio físico en general y de fuerza que practicaban o prescribían, y seguridad y conocimientos para su prescripción. Se analizaron las diferencias entre los grupos y la repercusión de haber realizado o no el curso. Resultados: Los 2 grupos eran homogéneos en sexo, edad, especialidad y realización de ejercicio físico, destacando la baja tasa de práctica y prescripción del entrenamiento de fuerza en ambos grupos. Se objetivó que el grupo que había realizado el curso adquirió conocimientos y seguridad para la prescripción de ejercicio de fuerza y consideraba que era la odalidad que debía ser potenciada (p<0,001). Conclusiones: La formación en entrenamiento de fuerza dirigida a médicos mediante un curso teórico-práctico aumenta los conocimientos y la seguridad para su prescripción.(AU)

Introduction: Medical prescriptions have traditionally been focused on aerobic exercise. However, an increasing number of authors are pointing towards strength training as the healthiest exercise modality. The purpose of this study is to assess whether physicians increase their knowledge as well as their confidence to prescribe strength training after attending a physical training course. Materials and methods: A prospective cohort study of 160 physicians was conducted, 80 physicians out of the 160 attended a physical training course, whereas the remaining 80 physicians did not. Personal and professional data was collected, as well as data regarding the type of exercise they were practising or prescribing and the confidence and knowledge for their prescription. Finally, differences between the two groups and the impact of attending the course where analysed. Results: Both groups were homogeneous in gender, age, medical speciality and practice of physical exercise, with very low rates of strength training and prescription for both groups. It was established that the group attending the course acquired knowledge and confidence for prescribing strength training. Moreover, this group considered that strength training was the exercise modality which should be encouraged (P<.001). Conclusions: Education in strength training for physicians by means of a theoretical-practical course increases knowledge and confidence for its prescription.(AU)

Realidad virtual de bajo coste. Una nueva aplicación para rehabilitación motora de los miembros superiores en patología neurológica: Estudio piloto / Low-cost virtual reality. A new application for upper extremity motor rehabilitation in neurological pathology: Pilot study

Antecedentes y objetivo: El objetivo de este estudio es presentar una nueva aplicación de realidad virtual (RV) de bajo coste basada en el dispositivo Leap Motion Controller (LMC) desarrollada para la rehabilitación motora de miembros superiores tras patología neurológica y mostrar su viabilidad clínica realizando una experiencia piloto. Material y métodos: El LMC permite la interacción con las aplicaciones virtuales mediante la captación de los movimientos de la mano. Se realizó una prueba piloto con cuatro pacientes con afectación de miembros superiores con Upper Extremity Motor Score (UEMS) mayor de 10. Se les valoró con los test Box and Block (BBT) y tarea de escritura del Jebsen-Taylor Hand Function (JTHF) antes y después de la intervención. Resultados: Los pacientes completaron el protocolo de nueve sesiones de 30 minutos de duración dividido en tres sesiones por semana. En el BBT pasaron de 38 (DE 20) cubos antes de la intervención a 44 (DE 21,72) cubos tras finalizarla. En el JTHF pasaron de 28,25 s (DE 8,61) a 26, 75 s (DE 21,72). No hubo diferencias estadísticamente significativas. La usabilidad del dispositivo se valoró con la escala Quebec User Evaluation of Satisfaction with assistive Technology, versión 2.0 (QUEST) siendo la seguridad, efectividad y facilidad de uso los aspectos prioritarios. Conclusión: Se presenta un nuevo desarrollo de RV basado en el dispositivo LMC y se ha comprobado su viabilidad clínica en pacientes neurológicos con afectación de los miembros superiores. Es preciso realizar un estudio clínico con una muestra amplia para valorar su posible efectividad clínica como elemento de tratamiento.(AU)

Background and objectives: The aim of this study is to present a new virtual reality (VR) low cost application based on Leap Motion Controller (LMC) device for upper extremity motor rehabilitation after neurological pathology and to demonstrate its clinical feasibility by carrying out a pilot experience. Material and methods: The LMC allows the interaction with virtual applications by capturing the patient's hand movements. A pilot study was carried out with 4 patients with upper limb impairment reflected with Upper Extremity Motor Score (UEMS) greater than 10. They were assessed using the Box and Block (BBT) and the writing task within the Jebsen-Taylor Hand Function (JTHF) before and after the intervention. Results: All patients completed the 9-session, 30-min protocol divided into 3 sessions per week. They went from an average result of 38 (SD 20) blocks in BBT before the intervention to 44 (SD 21.72) after it. They went from 28.25 s (SD 8.61) to 26.75 s (SD 21.72) in the JTHF. Statistically significant differences were no found. The device usability was assessed by the QUEST scale, being the security, effectiveness and ease to use the aspects that patients considered to be a priority. Conclusión: A new VR development based on the LMC device is presented and the clinical feasibility of its application in neurological patients with upper limb involvement has been proven. A clinical study with a large sample size is needed to assess its potential clinical effectiveness as a treatment element.(AU)

[Strength training education for physicians increases its prescription]. / La formación en entrenamiento de fuerza dirigida a médicos aumenta su prescripción.

INTRODUCTION: Medical prescriptions have traditionally been focused on aerobic exercise. However, an increasing number of authors are pointing towards strength training as the healthiest exercise modality. The purpose of this study is to assess whether physicians increase their knowledge as well as their confidence to prescribe strength training after attending a physical training course. MATERIALS AND METHODS: A prospective cohort study of 160 physicians was conducted, 80 physicians out of the 160 attended a physical training course, whereas the remaining 80 physicians did not. Personal and professional data was collected, as well as data regarding the type of exercise they were practising or prescribing and the confidence and knowledge for their prescription. Finally, differences between the two groups and the impact of attending the course where analysed. RESULTS: Both groups were homogeneous in gender, age, medical speciality and practice of physical exercise, with very low rates of strength training and prescription for both groups. It was established that the group attending the course acquired knowledge and confidence for prescribing strength training. Moreover, this group considered that strength training was the exercise modality which should be encouraged (P<.001). CONCLUSIONS: Education in strength training for physicians by means of a theoretical-practical course increases knowledge and confidence for its prescription.

Development of an Anti-Acinetobacter baumannii Biofilm Phage Cocktail: Genomic Adaptation to the Host.

The need for alternatives to antibiotic therapy due to the emergence of multidrug resistant bacteria (MDR), such as the nosocomial pathogen Acinetobacter baumannii, has led to the recovery of phage therapy. In addition, phages can be combined in cocktails to increase the host range. In this study, the evolutionary mechanism of adaptation was utilized in order to develop a phage adapted to A. baumannii, named phage Ab105-2phiΔCI404ad, from a mutant lytic phage, Ab105-2phiΔCI, previously developed by our group. The whole genome sequence of phage Ab105-2phiΔCI404ad was determined, showing that four genomic rearrangements events occurred in the tail morphogenesis module affecting the ORFs encoding the host receptor binding sites. As a consequence of the genomic rearrangements, 10 ORFs were lost and four new ORFs were obtained, all encoding tail proteins; two inverted regions were also derived from these events. The adaptation process increased the host range of the adapted phage by almost 3-fold. In addition, a depolymerase-expressing phenotype, indicated by formation of a halo, which was not observed in the ancestral phage, was obtained in 81% of the infected strains. A phage cocktail was formed by combining this phage with the A. baumannii phage vB_AbaP_B3, known to express a depolymerase. Both the individual phages and the phage cocktail showed strong antimicrobial activity against 5 clinical strains and 1 reference strain of A. baumannii tested. However, in all cases resistance to the bacterial strains was also observed. The antibiofilm activity of the individual phages and the cocktail was assayed. The phage cocktail displayed strong antibiofilm activity.

[Low-cost virtual reality. A new application for upper extremity motor rehabilitation in neurological pathology: Pilot study]. / Realidad virtual de bajo coste. Una nueva aplicación para rehabilitación motora de los miembros superiores en patología neurológica: Estudio piloto.

BACKGROUND AND OBJECTIVES: The aim of this study is to present a new virtual reality (VR) low cost application based on Leap Motion Controller (LMC) device for upper extremity motor rehabilitation after neurological pathology and to demonstrate its clinical feasibility by carrying out a pilot experience. MATERIAL AND METHODS: The LMC allows the interaction with virtual applications by capturing the patient's hand movements. A pilot study was carried out with 4 patients with upper limb impairment reflected with Upper Extremity Motor Score (UEMS) greater than 10. They were assessed using the Box and Block (BBT) and the writing task within the Jebsen-Taylor Hand Function (JTHF) before and after the intervention. RESULTS: All patients completed the 9-session, 30-min protocol divided into 3 sessions per week. They went from an average result of 38 (SD 20) blocks in BBT before the intervention to 44 (SD 21.72) after it. They went from 28.25 s (SD 8.61) to 26.75 s (SD 21.72) in the JTHF. Statistically significant differences were no found. The device usability was assessed by the QUEST scale, being the security, effectiveness and ease to use the aspects that patients considered to be a priority. CONCLUSIóN: A new VR development based on the LMC device is presented and the clinical feasibility of its application in neurological patients with upper limb involvement has been proven. A clinical study with a large sample size is needed to assess its potential clinical effectiveness as a treatment element.

Síndrome del trefinado / Syndrome of the trephined

El síndrome del trefinado (ST) consiste en el deterioro neurológico que se produce tras la realización de una craniectomía descompresiva en la que no se lleva a cabo reposición ósea. Su incidencia es variable, aunque se cree que esta entidad está infradiagnosticada. Se caracteriza por la reversión de los síntomas tras dicha reposición del hueso, por lo que este es el único tratamiento definitivo. Mostramos el caso de un paciente valorado por el servicio de rehabilitación en la unidad de cuidados intensivos tras sufrir un accidente cerebrovascular, que presenta alteración del nivel de consciencia y deterioro motor abrupto, siendo diagnosticado de ST. La intervención rehabilitadora, con cambios posturales precoces del paciente ayudó a mitigar los síntomas hasta que se realizó el tratamiento resolutivo final (AU)

Syndrome of the trephined (SoT) is the neurological deterioration that occurs after the performance of decompressive craniectomy in which bone is not replaced. The incidence of SoT varies, but this entity seems to be underdiagnosed. It is characterized by symptom reversal after bone replacement, which is the only definitive treatment. We report the case of a patient assessed by the Rehabilitation Service in the Critical Care Unit after a stroke, who had altered level of consciousness and abrupt motor impairment. The patient was diagnosed with SoT. Rehabilitation, with early postural changes, helped to ameliorate the symptoms until the provision of definitive treatment (AU)

Unveiling the Atomic and Electronic Structure of Stacked-Cup Carbon Nanofibers.

We report results of comprehensive experimental exploration (X-ray photoemission, Raman and optical spectroscopy) of carbon nanofibers (CNFs) in combination with first-principles modeling. Core-level spectra demonstrate prevalence of sp2 hybridization of carbon atoms in CNF with a trace amount of carbon-oxygen bonds. The density functional theory (DFT)-based calculations demonstrated no visible difference between mono- and bilayers because σ-orbitals are related to in-plane covalent bonds. The influence of the distortions on π-peak is found to be significant only for bilayers as a result of π-π interlayer bonds formation. These results are supported by both experimental Raman and XPS valence band spectra. The combination of optical measurements with a theoretical modeling indicates the formation of optically active graphene quantum dots (GQDs) in the CNF matrix, with a radiative relaxation of the excited π* state. The calculated electronic structure of these GQDs is in quantitative agreement with the measured optical transitions and provides an explanation of the absence of visible contribution from these GQDs to the measured valence bands spectra.

[Syndrome of the trephined]. / Síndrome del trefinado.

Syndrome of the trephined (SoT) is the neurological deterioration that occurs after the performance of decompressive craniectomy in which bone is not replaced. The incidence of SoT varies, but this entity seems to be underdiagnosed. It is characterized by symptom reversal after bone replacement, which is the only definitive treatment. We report the case of a patient assessed by the Rehabilitation Service in the Critical Care Unit after a stroke, who had altered level of consciousness and abrupt motor impairment. The patient was diagnosed with SoT. Rehabilitation, with early postural changes, helped to ameliorate the symptoms until the provision of definitive treatment.

Luchando contra la COVID-19: labor asistencial de los médicos rehabilitadores españoles. Estudio transversal / Fighting against COVID-19: clinical activities of spanish rehabilitation physicians: a cross-sectional study

OBJETIVO: El objetivo de este estudio es analizar el impacto y la organización tanto asistencial como docente en los Servicios de Medicina Física y Rehabilitación de España ante el nuevo y cambiante escenario debido a la pandemia por la COVID-19. MÉTODOS: Se realiza una encuesta dirigida a los tutores de los Servicios de Rehabilitación. Un total de 31 preguntas divididas en 6 apartados: información general de los Servicios, adaptación del Servicio durante el periodo COVID, labor asistencial de los médicos rehabilitadores, abordaje rehabilitador de pacientes COVID, consecuencia de la pandemia sobre la salud de los rehabilitadores y labores de tutoría durante ese periodo. RESULTADOS: Se recibieron un total de 54 encuestas. Casi la mitad de los Servicios cancelaron todas las consultas presenciales (40%) y las salas de terapias se destinaron a camas de pacientes COVID (48%). En 30 hospitales (55,6%) los facultativos han trabajado en plantas COVID. La gran mayoría de los Servicios han elaborado material gráfico y audiovisual con ejercicios, así como protocolos de derivación y tratamiento rehabilitador de pacientes COVID ingresados. Casi la mitad de los Servicios encuestados han tenido algún caso de ansiedad en el personal médico. Las labores de tutoría se han anulado (40,7%) o disminuido (35,2%). CONCLUSIONES: La organización de los Servicios de Rehabilitación para hacer frente a la pandemia ha sido similar en todo el territorio español. La respuesta de los Servicios a la crisis sanitaria ha visualizado la versatilidad de trabajo de los médicos rehabilitadores

OBJECTIVE: The aim of this study was to analyse both the impact of the pandemic and clinical and teaching organisation in Spanish Physical Medicine and Rehabilitation Departments during the COVID-19 pandemic. METHODS: A survey was conducted of the tutors of rehabilitation departments. The questionnaire contained 31 questions divided into 6 parts about the following: general information on the department, adaptation of rehabilitation departments to the COVID pandemic, clinical work of rehabilitation physicians, the approach to rehabilitation in COVID patients, and the effects of the pandemic on the health and teaching activity of rehabilitation physicians during this period. RESULTS: A total of 54 responses were obtained. Almost half of the departments cancelled face-to-face medical consultations (40%) and 48% of the treatment rooms were turned into COVID beds. In 30 hospitals (55.6%), the physicians worked in COVID units. Most of the rehabilitation departments developed both graphic and audiovisual material with exercises, referral protocols and guidelines for the rehabilitation management and treatment of COVID 19 patients. Half of the departments reported some anxiety symptoms in medical staff. Tutorial work has been cancelled (40.7%) or reduced (35.2%). CONCLUSIONS: The organisation of Spanish rehabilitation departments in response to the COVID pandemic has been very similar throughout the country. The response of these departments to the healthcare crisis has revealed the versatility of rehabilitation physicians

[Fighting against COVID-19: clinical activities of spanish rehabilitation physicians: A cross-sectional study]. / Luchando contra la COVID-19: labor asistencial de los médicos rehabilitadores españoles. Estudio transversal.

OBJECTIVE: The aim of this study was to analyse both the impact of the pandemic and clinical and teaching organisation in Spanish Physical Medicine and Rehabilitation Departments during the COVID-19 pandemic. METHODS: A survey was conducted of the tutors of rehabilitation departments. The questionnaire contained 31 questions divided into 6 parts about the following: general information on the department, adaptation of rehabilitation departments to the COVID pandemic, clinical work of rehabilitation physicians, the approach to rehabilitation in COVID patients, and the effects of the pandemic on the health and teaching activity of rehabilitation physicians during this period. RESULTS: A total of 54 responses were obtained. Almost half of the departments cancelled face-to-face medical consultations (40%) and 48% of the treatment rooms were turned into COVID beds. In 30 hospitals (55.6%), the physicians worked in COVID units. Most of the rehabilitation departments developed both graphic and audiovisual material with exercises, referral protocols and guidelines for the rehabilitation management and treatment of COVID 19 patients. Half of the departments reported some anxiety symptoms in medical staff. Tutorial work has been cancelled (40.7%) or reduced (35.2%). CONCLUSIONS: The organisation of Spanish rehabilitation departments in response to the COVID pandemic has been very similar throughout the country. The response of these departments to the healthcare crisis has revealed the versatility of rehabilitation physicians.

Toxins of toxin/antitoxin systems are inactivated primarily through promoter mutations.

AIMS: Given the extreme toxicity of some of the toxins of toxin-antitoxin (TA) systems, we were curious how the cell silences toxins, if the antitoxin is inactivated or independent toxins are obtained via horizontal gene transfer. METHODS AND RESULTS: Growth curves of Escherichia coli K12 BW25113 harbouring plasmid pCA24N to produce RalR, MqsR, GhoT or Hha toxins, showed toxin inactivation after 3 h. Sequencing plasmids from these cultures revealed toxin inactivation occurred primarily due to consistent deletions in the promoter. The lack of mutation in the structural genes was corroborated by a bioinformatics analysis of 1000 E. coli genomes which showed both conservation and little variability in the four toxin genes. For those strains that lacked a mutation in the plasmid, single nucleotide polymorphism analysis was performed to identify that chromosomal mutations iraM and mhpR inactivate the toxins GhoT and MqsR/GhoT respectively. CONCLUSION: We find that the RalR (type I), MqsR (type II), GhoT (type V) and Hha (type VII) toxins are inactivated primarily by a mutation that inactivates the toxin promoter or via the chromosomal mutations iraM and mhpR. SIGNIFICANCE AND IMPACT OF THE STUDY: This study demonstrates toxins of TA systems may be inactivated by mutations that primarily affect the toxin gene promoter instead of the toxin structural gene.

Anomalías vasculares / Vascular malformations

Las anomalías vasculares, a pesar de ser un motivo frecuente de consulta en la edad pediátrica, son un tipo de patología poco conocida en la práctica clínica. esto dificulta la realización de un diagnóstico correcto y, por lo tanto, impide aplicar el tratamiento preciso en cada caso. la nomenclatura ha sido sin duda el mayor obstáculo para el conocimiento de estas lesiones, ya que hasta hace pocos años se utilizaba una terminología puramente descriptiva y errónea, lo que puede dar lugar a errores muy importantes de conceptos. a lo largo de este capítulo abordaremos de manera actualizada los dos grandes grupos de anomalías vasculares: los tumores y las malformaciones. Nos centraremos en aquellos que consideramos más importantes, bien por su frecuencia o por la posibilidad de provocar complicaciones más o menos graves. describiremos las principales características clínicas de cada uno de ellas, las pruebas complementarias que se necesitan en cada caso para realizar un diagnóstico diferencial correcto y las distintas posibilidades terapéuticas con las que contamos actualmente

Despite the fact that vascular anomalies being a frequent cause for consultation in paediatric patients, little is known about this type of pathology in clinical practice. this means it is difficult to ensure a correct diagnosis and hence apply the precise treatment in each case. the nomenclature has undoubtedly been the biggest obstacle to our knowledge of these injuries. Until recently, purely descriptive and erroneous terminology was employed, which may give rise to very important conceptual errors. throughout this chapter, we shall approach two major groups of vascular anomalies, tumours and malformations, from a more current perspective. We shall focus on those we consider the most important, either because of their frequency or because they may lead to more or less serious complications. We shall describe the main clinical characteristics of each of these anomalies, the complementary tests needed in each case to make a correct differential diagnosis, and the different therapeutic possibilities that are currently available

[Conservative management of traumatic priapism in paediatric patients]. / Manejo conservador del priapismo traumático en la edad pediátrica.

INTRODUCTION: High-flow priapism is infrequent in pediatric patients. It is mostly secondary to perineal trauma resulting in laceration of a penile artery and the formation of an arterio-cavernous fistula. It does not constitute a medical emergency in itself, and allows conservative management awaiting spontaneous resolution. CLINICAL CASE: A six-year-old boy with painless persistent erection preceded by perineal trauma. Ultrasound imaging confirmed the clinical suspicion of high flow priapism secondary to arterio-cavernous fistula. After adopting a conservative approach, the patient presented progressive detumescence, as well as ultrasound resolution one month after the episode. COMMENTS: In high-flow priapism, venous drainage of the penis is preserved. The classical approach in adults is based on therapeutic angiography, which presents greater technical complexity and the risk of iatrogenic hypoxia in pediatric patients.

INTRODUCCION: El priapismo de alto flujo es una entidad infrecuente en la edad pediátrica. Es, en su mayoría, secundario a traumatismo perineal que provoca la laceración de una arteria peneana y formación de una fístula arterio-cavernosa. No constituye una emergencia médica, permitiendo un manejo conservador a la espera de su resolución espontánea. CASO CLINICO: Niño de seis años con erección persistente e indolora tras traumatismo perineal. El diagnóstico ecográfico confirma la sospecha de priapismo de alto flujo secundario a fístula arteria-cavernosa. Tras manejo conservador, presenta detumescencia progresiva y resolución ecográfica al mes del episodio. COMENTARIOS: En el priapismo de alto flujo el drenaje venoso del pene se encuentra conservado. El manejo clásico en adultos se fundamenta en la angiografía terapéutica, de mayor complejidad técnica y riesgo de hipoxia iatrogénica en el paciente pediátrico.

Manejo conservador del priapismo traumático en la edad pediátrica / No disponible

Introducción: El priapismo de alto flujo es una entidad infrecuente en la edad pediátrica. Es, en su mayoría, secundario a traumatismo perineal que provoca la laceración de una arteria peneana y formación de una fístula arterio-cavernosa. No constituye una emergencia médica, permitiendo un manejo conservador a la espera de su resolución espontánea. Caso clínico: Niño de seis años con erección persistente e indolora tras traumatismo perineal. El diagnóstico ecográfico confirma la sospecha de priapismo de alto flujo secundario a fístula arteria-cavernosa. Tras manejo conservador, presenta detumescencia progresiva y resolución ecográfica al mes del episodio. Comentarios: En el priapismo de alto flujo el drenaje venoso del pene se encuentra conservado. El manejo clásico en adultos se fundamenta en la angiografía terapéutica, de mayor complejidad técnica y riesgo de hipoxia iatrogénica en el paciente pediátrico

Introduction: High-flow priapism is infrequent in pediatric patients. It is mostly secondary to perineal trauma resulting in laceration of a penile artery and the formation of an arterio-cavernous fistula. It does not constitute a medical emergency in itself, and allows conservative management awaiting spontaneous resolution. Clinical case: A six-year-old boy with painless persistent erection preceded by perineal trauma. Ultrasound imaging confirmed the clinical suspicion of high flow priapism secondary to arterio-cavernous fistula. After adopting a conservative approach, the patient presented progressive detumescence, as well as ultrasound resolution one month after the episode. Comments: In high-flow priapism, venous drainage of the penis is preserved. The classical approach in adults is based on therapeutic angiography, which presents greater technical complexity and the risk of iatrogenic hypoxia in pediatric patients

Mechanisms of Bacterial Tolerance and Persistence in the Gastrointestinal and Respiratory Environments.

Pathogens that infect the gastrointestinal and respiratory tracts are subjected to intense pressure due to the environmental conditions of the surroundings. This pressure has led to the development of mechanisms of bacterial tolerance or persistence which enable microorganisms to survive in these locations. In this review, we analyze the general stress response (RpoS mediated), reactive oxygen species (ROS) tolerance, energy metabolism, drug efflux pumps, SOS response, quorum sensing (QS) bacterial communication, (p)ppGpp signaling, and toxin-antitoxin (TA) systems of pathogens, such as Escherichia coli, Salmonella spp., Vibrio spp., Helicobacter spp., Campylobacter jejuni, Enterococcus spp., Shigella spp., Yersinia spp., and Clostridium difficile, all of which inhabit the gastrointestinal tract. The following respiratory tract pathogens are also considered: Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, Burkholderia cenocepacia, and Mycobacterium tuberculosis Knowledge of the molecular mechanisms regulating the bacterial tolerance and persistence phenotypes is essential in the fight against multiresistant pathogens, as it will enable the identification of new targets for developing innovative anti-infective treatments.

Evolution of the Quorum network and the mobilome (plasmids and bacteriophages) in clinical strains of Acinetobacter baumannii during a decade.

In this study, we compared eighteen clinical strains of A. baumannii belonging to the ST-2 clone and isolated from patients in the same intensive care unit (ICU) in 2000 (9 strains referred to collectively as Ab_GEIH-2000) and 2010 (9 strains referred to collectively as Ab_GEIH-2010), during the GEIH-REIPI project (Umbrella BioProject PRJNA422585). We observed two main molecular differences between the Ab_GEIH-2010 and the Ab_GEIH-2000 collections, acquired over the course of the decade long sampling interval and involving the mobilome: i) a plasmid harbouring genes for blaOXA 24/40 ß-lactamase and abKA/abkB proteins of a toxin-antitoxin system; and ii) two temperate bacteriophages, Ab105-1ϕ (63 proteins) and Ab105-2ϕ (93 proteins), containing important viral defence proteins. Moreover, all Ab_GEIH-2010 strains contained a Quorum functional network of Quorum Sensing (QS) and Quorum Quenching (QQ) mechanisms, including a new QQ enzyme, AidA, which acts as a bacterial defence mechanism against the exogenous 3-oxo-C12-HSL. Interestingly, the infective capacity of the bacteriophages isolated in this study (Ab105-1ϕ and Ab105-2ϕ) was higher in the Ab_GEIH-2010 strains (carrying a functional Quorum network) than in the Ab_GEIH-2000 strains (carrying a deficient Quorum network), in which the bacteriophages showed little or no infectivity. This is the first study about the evolution of the Quorum network and the mobilome in clinical strains of Acinetobacter baumannii during a decade.

Anomalías congénitas cervicales / Congenital cervical anomalies

Las anomalías cervicales congénitas son un grupo heterogéneo de enfermedades que pueden presentarse desde el nacimiento hasta la edad adulta. Para lograr un manejo óptimo de este tipo de lesiones y así evitar posibles complicaciones derivadas de las mismas es de suma importancia que tanto pediatras como cirujanos pediátricos conozcan el origen embriológico, así como las principales manifestaciones clínicas de cada una de las distintas entidades patológicas que pueden presentarse en localización cervical. Para realizar un correcto diagnóstico diferencial de este conjunto de malformaciones habitualmente es necesaria la realización de estudios de imagen complementarios, estos nos ayudarán a tipificar la lesión y a conocer las relaciones anatómicas más importantes de la misma de cara a diseñar una adecuada estrategia terapéutica que, en la mayoría de las ocasiones, incluirá su exéresis quirúrgica. En este artículo se abordará resumidamente el manejo actual de las anomalías congénitas del cuello de mayor relevancia en el paciente pediátrico

Congenital cervical anomalies are a heterogeneous group of diseases that can be present from birth up to the adult age. To achieve an optimum management of this type of lesions and thus avoid possible complications derived from them, it is extremely important for both pediatricians and pediatric surgeons to know the embryological origin and the main clinical manifestations of each one of the different pathological entities that can be found in the cervical location. To make a correct differential diagnosis of this collection of malformations, it us usually necessary to perform complementary imaging studies. these will help us to typify the lesion and to know their most important anatomical relations in order to design an adequate therapeutic strategy which, most of the time, will include surgical exeresis. This article will briefly approach the current management of congenital cervical anomalies having the greatest relevance in the pediatric patient

Genomic Evolution of Two Acinetobacter baumannii Clinical Strains from ST-2 Clones Isolated in 2000 and 2010 (ST-2_clon_2000 and ST-2_clon_2010).

Acinetobacter baumannii is a successful nosocomial pathogen due to its ability to persist in hospital environments by acquiring mobile elements such as transposons, plasmids, and phages. In this study, we compared two genomes of A. baumannii clinical strains isolated in 2000 (ST-2_clon_2000) and 2010 (ST-2_clon_2010) from GenBank project PRJNA308422.