Remarkable clinical improvement with oral nucleoside treatment in a patient with adult-onset TK2 deficiency: A case report.

OBJECTIVES: Thymidine kinase 2 deficiency (TK2d) is a rare autosomal recessive mitochondrial disorder. It manifests as a continuous clinical spectrum, from fatal infantile mitochondrial DNA depletion syndromes to adult-onset mitochondrial myopathies characterized by ophthalmoplegia-plus phenotypes with early respiratory involvement. Treatment with pyrimidine nucleosides has recently shown striking effects on survival and motor outcomes in the more severe infantile-onset clinical forms. We present the response to treatment in a patient with adult-onset TK2d. METHODS: An adult with ptosis, ophthalmoplegia, facial, neck, and proximal muscle weakness, non-invasive nocturnal mechanical ventilation, and dysphagia due to biallelic pathogenic variants in TK2 received treatment with 260 mg/kg/day of deoxycytidine (dC) and deoxythymidine (dT) under a Compassionate Use Program. Prospective motor and respiratory assessments are presented. RESULTS: After 27 months of follow-up, the North Star Ambulatory Assessment improved by 11 points, he walked 195 m more in the 6 Minute-Walking-Test, ran 10 s faster in the 100-meter time velocity test, and the Forced Vital Capacity stabilized. Growth Differentiation Factor-15 (GDF15) levels, a biomarker of respiratory chain dysfunction, normalized. The only reported side effect was dose-dependent diarrhea. DISCUSSION: Treatment with dC and dT can significantly improve motor performance and stabilize respiratory function safely in patients with adult-onset TK2d.

Distal hereditary motor neuronopathy as a new phenotype associated with variants in BAG3.

OBJECTIVE: To describe a new phenotype associated with a novel variant in BAG3: autosomal dominant adult-onset distal hereditary motor neuronopathy. METHODS: This study enrolled eight affected individuals from a single family and included a comprehensive evaluation of the clinical phenotype, neurophysiologic testing, muscle MRI, muscle biopsy and western blot of BAG3 protein in skeletal muscle. Genetic workup included whole exome sequencing and segregation analysis of the detected variant in BAG3. RESULTS: Seven patients developed slowly progressive and symmetric distal weakness and atrophy of lower limb muscles, along with absent Achilles reflexes. The mean age of onset was 46 years. The neurophysiological examination was consistent with the diagnosis of distal motor neuronopathy. One 57-year-old female patient was minimally symptomatic. The pattern of inheritance was autosomal dominant, with one caveat: one female patient who was an obligate carrier of the variant died at the age of 73 years without exhibiting any muscle weakness. The muscle biopsies revealed neurogenic changes. A novel heterozygous truncating variant c.1513_1514insGGAC (p.Val505GlyfsTer6) in the gene BAG3 was identified in all affected family members. CONCLUSIONS: We report an autosomal dominant adult-onset distal hereditary motor neuronopathy with incomplete penetrance in women as a new phenotype related to a truncating variant in the BAG3 gene. Our findings expand the phenotypic spectrum of BAG3-related disorders, which previously included dilated cardiomyopathy, myofibrillar myopathy and adult-onset Charcot-Marie-Tooth type 2 neuropathy. Variants in BAG3 should be considered in the differential diagnosis of distal hereditary motor neuronopathies.

Distal myopathy due to digenic inheritance of TIA1 and SQSTM1 variants in two unrelated Spanish patients.

Welander distal myopathy typically manifests in late adulthood and is caused by the founder TIA1 c.1150G>A (p.Glu384Lys) variant in families of Swedish and Finnish descent. Recently, a similar phenotype has been attributed to the digenic inheritance of TIA1 c.1070A>G (p.Asn357Ser) and SQSTM1 c.1175C>T (p.Pro392Leu) variants. We describe two unrelated Spanish patients presenting with slowly progressive gait disturbance, distal-predominant weakness, and mildly elevated creatine kinase (CK) levels since their 6th decade. Electromyography revealed abnormal spontaneous activity and a myopathic pattern. Muscle magnetic resonance imaging (MRI) showed marked fatty replacement in distal leg muscles. A muscle biopsy, performed on one patient, revealed myopathic changes with rimmed vacuoles. Both patients carried the TIA1 p.Asn357Ser and SQSTM1 p.Pro392Leu variants. Digenic inheritance is supported by evidence from unrelated pedigrees and a plausible biological interaction between both proteins in protein quality control processes. Recent functional studies and additional case descriptions further support this. Clinical suspicion is necessary to seek both variants.

Use of Tenecteplase in Acute Ischemic Stroke in the Time of SARS-CoV-2.

Tenecteplase (TNK) is a fibrinolytic drug that is administrated in a single bolus, recommended in eligible patients with acute ischemic stroke prior to mechanical thrombectomy. This study explores its usefulness in adverse situations, such as the SARS-CoV-2 pandemic. We conducted a retrospective study involving consecutive patients with suspected acute ischemic stroke treated either with intravenous fibrinolysis with alteplase during 2019 or with TNK (.25 mg/kg) between March 2020 and February 2021. A comparative analysis was made to compare patient treatment times and prognosis. A total of 117 patients treated with alteplase and 92 with TNK were included. No significant differences were observed in age, main vascular risk factors or previous treatments. The median National Institutes of Health Stroke Scale was 8 in the alteplase group and 10 in those treated with TNK (P = .13). Combined treatment with mechanical thrombectomy was performed in 47% in the alteplase group and 46.7% in the TNK group; Thrombolysis In Cerebral Infarction scale 2b-3 recanalization was achieved in 83% and 90.7%, respectively (P = .30). There was a decrease in onset-to-needle median time (165 min vs 140 min, P < .01) and no significant variations in door-needle median time. There was no significant difference in the incidence of symptomatic hemorrhagic transformation in mortality or functional independence at 3 months. The easier administration of TNK has improved the accessibility of fibrinolytic therapy, even in adverse circumstances, such as the COVID-19 pandemic. Its use appears to be safe and effective, even in patients who are not candidates for mechanical thrombectomy.

Serum GDF-15 Levels Accurately Differentiate Patients with Primary Mitochondrial Myopathy, Manifesting with Exercise Intolerance and Fatigue, from Patients with Chronic Fatigue Syndrome.

Primary mitochondrial myopathies (PMM) are a clinically and genetically highly heterogeneous group that, in some cases, may manifest exclusively as fatigue and exercise intolerance, with minimal or no signs on examination. On these occasions, the symptoms can be confused with the much more common chronic fatigue syndrome (CFS). Nonetheless, other possibilities must be excluded for the final diagnosis of CFS, with PMM being one of the primary differential diagnoses. For this reason, many patients with CFS undergo extensive studies, including extensive genetic testing and muscle biopsies, to rule out this possibility. This study evaluated the diagnostic performance of growth differentiation factor-15 (GDF-15) as a potential biomarker to distinguish which patient with chronic fatigue has a mitochondrial disorder. We studied 34 adult patients with symptoms of fatigue and exercise intolerance with a definitive diagnosis of PMM (7), CFS (22), or other non-mitochondrial disorders (5). The results indicate that GDF-15 can accurately discriminate between patients with PMM and CFS (AUC = 0.95) and between PMM and patients with fatigue due to other non-mitochondrial disorders (AUC = 0.94). Therefore, GDF-15 emerges as a promising biomarker to select which patients with fatigue should undergo further studies to exclude mitochondrial disease.

Longer intervals between SARS-CoV-2 infection and mRNA-1273 doses improve the neutralization of different variants of concern.

The humoral immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern elicited by vaccination was evaluated in COVID-19 recovered individuals (Rec) separated 1-3 months (Rec2m) or 4-12 months (Rec9m) postinfection and compared to the response in naïve participants. Antibody-mediated immune responses were assessed in 66 participants by three commercial immunoassays and a SARS-CoV-2 lentiviral-based pseudovirus neutralization assay. Immunoglobulin (Ig) levels against SARS-CoV-2 spike were lower in naïve participants after two doses than in Rec after a single dose (p < 0.05). After two doses in Rec, levels of total Ig to receptor-binding domain were significantly increased in Rec9m compared to Rec2m (p < 0.001). The neutralizing potency observed in Rec9m was consistently higher than in Rec2m against variants of concern (VOCs) Alpha, Beta, Delta, and BA.1 sublineage of Omicron with 2.2-2.8-fold increases. Increasing the interval between SARS-CoV-2 infection and the vaccination with messenger RNA-based vaccines to more than 3 months generates a more efficient heterologous humoral immune response against VOCs by allowing enough time to mount a strong recall memory B cell response.

Home calligraphic exercises as manual dexterity training in patients with Parkinson's disease: a pilot feasibility study.

PURPOSE: To assess the feasibility and effects on manual dexterity and the quality of life (QoL) of a 12-week home calligraphic training program in patients with Parkinson's disease (PD). METHODS: A pilot study with participants recruited from the Movement Disorders consultation at the Hospital 12 de Octubre (Madrid). The main outcome, manual dexterity, was assessed using the Purdue Pegboard Test (PPT). Secondary outcomes included clinical rating scales that contemplate aspects related to manual dexterity (DextQ-24, UPDRSII, UPDRSIII), and QoL (PDQ-39 and EuroQoL-5D). RESULTS: Thirty PD patients (57% males) with a mean age of 66.11 (9.76) years and 93% adherence rate. The PPT scores improved significantly (p < 0.0001) from T0 (start of the study) to T1 (after 24 weeks). No statistically significant change was found in DextQ-24, UPDRS-II and UPDRS-III, but a clear improvement was observed in the QoL measurement: EuroQoL-5D (p < 0.0001), PDQ-39 (p < 0.0001) and modified PDQ-39 (p = 0.022). CONCLUSIONS: This is the first study to demonstrate the feasibility and improvement in hand dexterity assessed by the PPT for patients diagnosed with PD after a 12-week home calligraphic training program. A significant improvement was noted in the QoL measurements, such as the PDQ-39, modified PDQ-39, and EuroQoL-5D.Implications for RehabilitationMost patients with Parkinson's disease suffer from impaired manual dexterity, making it difficult to perform activities of daily living such as eating, buttoning, or shaving.A 12-week home calligraphic training program could improve hand dexterity in these patients.The advantage of this home calligraphic trainingis is that it is an easy-to-perform, low-cost and no side effects.This training also improves their quality of life.

Treatment with integrase inhibitors alters SARS-CoV-2 neutralization levels measured with HIV-based pseudotypes in people living with HIV.

The presence of neutralizing antibodies (NAbs) is a major correlate of protection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Thus, different in vitro pseudoviruses-based assays have been described to detect NAbs against SARS-CoV-2. However, the determination of NAbs against SARS-CoV-2 in people living with HIV (PLWH) through HIV-based pseudoparticles could be influenced by cross-neutralization activity or treatment, impeding accurate titration of NAbs. Two assays were compared using replication-defective HIV or VSV-based particles pseudotyped with SARS-CoV-2 spike to measure NAbs in COVID-19-recovered and COVID-19-naïve PLWH. The assay based on HIV-pseudoparticles displayed neutralization activity in all COVID-19-recovered PLWH with a median neutralizing titer 50 (NT50) of 1417.0 (interquartile range [IQR]: 450.3-3284.0), but also in 67% of COVID-19-naïve PLWH (NT50: 631.5, IQR: 16.0-1535.0). Regarding VSV-pseudoparticles system, no neutralization was observed in COVID-19-naïve PLWH as expected, whereas in comparison with HIV-pseudoparticles assay lower neutralization titers were measured in 75% COVID-19-recovered PLWH (NT50: 100.5; IQR: 20.5-1353.0). Treatment with integrase inhibitors was associated with inaccurate increase in neutralization titers when HIV-based pseudoparticles were used. IgG purification and consequent elimination of drugs from samples avoided the interference with retroviral cycle and corrected the lack of specificity observed in HIV-pseudotyped assay. This study shows methodological alternatives based on pseudoviruses systems to determine specific SARS-CoV-2 neutralization titers in PLWH.

Differences in Dietary Habits, Physical Exercise, and Quality of Life between Patients with Obesity and Overweight.

BACKGROUND: Overweight and obesity differ in their repercussions on the health and health-related quality of life (HRQoL) of patients. The objective of this study was to compare physical activity levels and dietary habits before admission and HRQoL at discharge between patients with obesity and overweight. METHODS: A cross-sectional study was undertaken among participants in a clinical trial on education for healthy eating and physical activity, enrolling non-diabetic patients admitted to Internal Medicine Departments. These were classified by body mass index (BMI) as having overweight (25-29.9 Kg/m2) or obesity (≥30 kg/m2). Data were gathered on sociodemographic characteristics, clinical variables (medication for anxiety/depression, Charlson Comorbidity Index, length of hospital stay), physical exercise and diet (International Physical Activity and Pardo Questionnaires), and HRQoL (EQ-5D-5L). The study included 98 patients with overweight (58.2% males) and 177 with obesity (52% males). RESULTS: In comparison to patients with obesity, those with overweight obtained better results for regular physical exercise (p = 0.007), healthy diet (p = 0.004), and "emotional eating" (p = 0.017). No between-group difference was found in HqoL scores. CONCLUSION: Patients with overweight and obesity differ in healthy dietary and physical exercise behaviors. Greater efforts are warranted to prevent an increase in the BMI of patients, paying special attention to their state of mind.

Fisheries management tools to support coastal and marine spatial planning: A case study from the Northern Gulf of California, Mexico.

A management approach was developed that combined spatial and non-spatial tools to inform a Coastal and Marine Spatial Planning Process (CMSP) in the Puerto Peñasco-Puerto Lobos Coastal Corridor, Northern Gulf of California, Sonora, Mexico. Four fisheries management tools were applied with an emphasis on ecosystem level management for eleven small-scale fisheries. Two spatial management tools, using a spatial prioritization approach, were combined with a permit regularization process, a non-spatial quota prioritization, and a tradeoff analysis in a novel way: • Locally Managed Marine Areas were developed, these are spatial areas where individual community fishermen are assigned the rights to harvest and manage specific fisheries within defined geographic areas. • Fishery refuges that incorporate information on fisheries, ecological importance, and connectivity. • A non-spatial quota prioritization process using a framework for the integrated assessment of stocks, encompassing a vulnerability analysis, a sustainability analysis, and a management framework analysis. • A trade-off analysis of the combination of these different management tools, using an Atlantis ecosystem model for the northern Gulf of California, that tested the ecosystem effects of alternative scenarios to assess benefits in support of ecosystem-based management.

Cognitive Impairment Is a Common Comorbidity in Deceased COVID-19 Patients: A Hospital-Based Retrospective Cohort Study.

We analyzed the frequency of cognitive impairment (CI) in deceased COVID-19 patients at a tertiary hospital in Spain. Among the 477 adult cases who died after admission from March 1 to March 31, 2020, 281 had confirmed COVID-19. CI (21.1% dementia and 8.9% mild cognitive impairment) was a common comorbidity. Subjects with CI were older, tended to live in nursing homes, had shorter time from symptom onset to death, and were rarely admitted to the ICU, receiving palliative care more often. CI is a frequent comorbidity in deceased COVID-19 subjects and is associated with differences in care.

"Intrasellar Balloon Technique" in intraoperative MRI guided transsphenoidal endoscopic surgery for sellar region tumors. Usefulness on image interpretation and extent of resection evaluation. Technical note.

BACKGROUND: Intraoperative magnetic resonance imaging (iMRI) is an effective and proven tool in transsphenoidal endoscopic surgery. However, image interpretation is not always easy and can be hindered by the presence of blood, tumor remains or the displacement of surrounding structures. In this article we present a novel technique based on using intrasellar ballons to reduce these difficulties and facilitate the surgeon's intraoperative assessment by iMRI. METHODS: Eighteen patients with pituitary macroadenomas underwent transsphenoidal surgery during 2013-2014 under low-field iMRI control (PoleStar N20, 0.15 T). Intrasellar balloons were used in all of them to assess the presence of tumoral remnants. We compared the findings in iMRI and postoperative high-field MRI control scans and also analyzed the number of intermediate imaging controls needed during surgery using this technique. RESULTS: In total, of the 18 patients, 14 underwent a complete resection. In the remaining four patients, a safe maximal resection was performed, leaving a remnant because of cavernous sinus invasion. In all cases, the balloons were a major help in distinguishing the anatomical structures from the tumoral remnants. Fewer imaging controls were required, and there were no false-positives or negative intraoperative findings. No complications related to the technique were registered. CONCLUSION: The "intrasellar balloon technique" is a useful tool that facilitates surgeons' intraoperative decision making. It is an important contribution to overcome the limitations of low-field iMRI as it provides a precise delineation of the resection margins, reduces false-positives and -negatives, and decreases the number of intermediate imaging controls required.

Afectación psicológica y calidad de vida del paciente ostomizado temporal y definitivo. Estudio Stoma Feeling / Psychological impact and quality of life in patients with temporary and definitive ostomy. Stoma Feeling Study

OBJETIVO: evaluar la afectación psicológica o impacto emocional que tiene la creación de un estoma para el paciente y si existen diferencias en dicha afectación y en la calidad de vida entre personas con estomas temporales y aquellas que son portadoras de estomas definitivos. MÉTODO: estudio observacional controlado y OBJETIVO: evaluar la afectación psicológica o impacto emocional que tiene la creación de un estoma para el paciente y si existen diferencias en dicha afectación y en la calidad de vida entre personas con estomas temporales y aquellas que son portadoras de estomas definitivos. MÉTODO: estudio observacional controlado y multicéntrico. La población incluida en el estudio está formada por personas recién intervenidas y portadoras de una colostomía o una ileostomía. El estudio consta de una visita de inclusión en el postoperatorio inmediato y una visita final a los tres meses de la inclusión. Se desarrolló en consultas de centros públicos y privados de España, en las condiciones asistenciales habituales y de acuerdo a la práctica clínica. Las herramientas utilizadas para el análisis de las variables del estudio son el Cuestionario de Calidad de Vida (Stoma-QoL) y las taxonomías NANDA, NIC y NOC. RESULTADOS: de los 814 pacientes del estudio, el 61,5% eran hombres, con una edad media de 62,5 años. En cuanto al tipo de ostomías, el 57% eran colostomías frente a un 43% de ileostomías. En cuanto al análisis comparativo entre pacientes con ostomías temporales y definitivas, encontramos que la media de indicadores de los resultados NOC seleccionados es de 7,8 enostomías temporales y 7,2 en ostomías definitivas, pero sin ser estadísticamente significativos (p= 0,1809). En cuanto a la valoración de los indicadores seleccionados dentro de cada NOC propuesto, los resultados fueron muy similares, sin encontrar en ningún parámetro diferencias significativas entre pacientes con con ostomía temporal o definitiva. DISCUSIÓN Y CONCLUSIONES: la evaluación de los resultados desvela que no existen diferencias significativas en los resultados de los indicadores NOC entre pacientes portadores de un estoma temporal o definitivo tres meses después de una cirugía. En cuanto a la evaluación de la calidad de vida mediante el cuestionario validado Stoma QoL, si bien se ha registrado una puntuación mayor en los pacientes con ostomías definitivas, esta diferencia no ha sido estadísticamente significativa

OBJECTIVE: to assess the psychological or emotional impact of stoma creation on patients, and if there are differences in the psychological impact and quality of life between persons with a temporary stoma and those with a definitive stoma. METHOD: an observational, controlled and multicentre study. The population included in this study were persons who had recently undergone surgery to create an ileostomy or colostomy. The study consisted of an inclusion visit immediately after surgery and a final visit three months after inclusion. It was conducted in public and private health centres in Spain, under regular care conditions, and according to clinical practice. The tools used for the analysis of the study variables were the Quality of Life Questionnaire (Stoma-QoL) and the NANDA, NIC and NOC taxonomies. RESULTS: out of the 814 patients in the study, 61.5% were male, with a mean 62.5 years of age. Regarding the type ofostomy, 57% were colostomies vs. 43% of ileostomies. In terms of the comparative analysis between patients with temporary and definitive ostomy, the results regarding the number of indicators of NOC outcomes selected were a mean 7.8 in temporary ostomy and 7.2 in definitive ostomy, but these were not statistically significant (p= 0.1809). Regarding the assessment of the indicators selected within each suggested NOC, outcomes were very similar, and no significant differences were found in any parameter between patients with temporary or definitive ostomy. DISCUSSION AND CONCLUSIONS: the assessment of the outcomes reveals that there are no significant differences in the outcomes for NOC indicators between patients with a temporary or definitive stoma three months after the ostomy procedure. Regarding the assessment of quality of life through the validated Stoma QoL questionnaire, a higher score has been recorded in patients with definitive ostomy, but this difference has not been statistically significant

Susceptibilidad antimicrobiana de aislamientos de Escherichia coli procedentes de ecosistemas dulceacuícolas / Antimicrobial susceptibility of Escherichia coli isolates from river water ecosystems

Introducción: la resistencia antimicrobiana constituye uno de los mayores problemas que afronta la salud pública mundial. La aparición de cepas resistentes no solo de origen clínico sino también ambiental agrava la situación. Entre los microorganismos que presentan esta característica se destaca la especie bacteriana Escherichia coli debido a su doble papel como indicador de contaminación fecal y como patógeno. Objetivos: aislar e identificar hasta especie aislamientos de Escherichia coli a partir de muestras de agua procedentes de ríos contaminados de La Habana y determinar la susceptibilidad antimicrobiana in vitro de estos aislados. Métodos: se estudiaron 113 aislamientos de bacterias coliformes aislados de 10 estaciones de muestreo ubicadas en la zona urbana de los ríos capitalinos Almendares, Quibú y Luyanó en el período comprendido de febrero de 2008 hasta junio de 2010. La identificación de los aislados, la determinación de la susceptibilidad antimicrobiana y la búsqueda de b-lactamasas de espectro extendido se realizó mediante el método automatizado VITEK. Resultados: se identificaron 113 cepas ambientales de Escherichia coli. Se demostró que 23 por ciento de los aislamientos resultaron resistentes al menos a uno de los antimicrobianos evaluados. Los mayores porcentajes de resistencia se observaron frente a ampicilina, sulfametoxazol-trimetropin y ciprofloxacina. Conclusiones: la presencia de aislados de E. coli con multirresistencia antimicrobiana en estos ríos indica claramente el riesgo biológico que implica el uso de sus aguas(AU)

Introduction: antimicrobial resistance is one of the biggest problems facing global public health. The emergence of resistant clinical and environmental strains worsens the situation. Among the microorganisms with antimicrobial resistance, Escherichia coli species stands out due to its dual role as fecal contamination indicator and pathogen. Objectives: to isolate and identify Escherichia coli isolates from water samples from polluted rivers located in La Habana, and to determine their antimicrobial in vitro susceptibility. Methods: one hundred thirteen isolates of coliform bacteria isolated from 10 sampling stations in the capital´s urban areas near Almendares, Quibú and Luyanó rivers were studied in the period of February 2008 to June 2010. The identification of isolates, the determination of antimicrobial susceptibility and the search for extended-spectrum b-lactamase were all performed using VITEK automated method. Results: one hundred thirteen environmental strains of Escherichia coli were identified. It showed that 23 percent of the isolates were resistant to at least one of the tested antimicrobials. The highest percentages of resistance were observed to ampicilline, sulfamethoxazole-trimethoprim and ciprofloxacin. Conclusions: the presence of E. coli isolates with multiple antimicrobial resistances in these rivers clearly indicates the biological risk involving the use of their waters(AU)

Susceptibilidad antimicrobiana de aislamientos de Escherichia coli procedentes de ecosistemas dulceacuícolas / Antimicrobial susceptibility of Escherichia coli isolates from river water ecosystems

Introducción: la resistencia antimicrobiana constituye uno de los mayores problemas que afronta la salud pública mundial. La aparición de cepas resistentes no solo de origen clínico sino también ambiental agrava la situación. Entre los microorganismos que presentan esta característica se destaca la especie bacteriana Escherichia coli debido a su doble papel como indicador de contaminación fecal y como patógeno. Objetivos: aislar e identificar hasta especie aislamientos de Escherichia coli a partir de muestras de agua procedentes de ríos contaminados de La Habana y determinar la susceptibilidad antimicrobiana in vitro de estos aislados. Métodos: se estudiaron 113 aislamientos de bacterias coliformes aislados de 10 estaciones de muestreo ubicadas en la zona urbana de los ríos capitalinos Almendares, Quibú y Luyanó en el período comprendido de febrero de 2008 hasta junio de 2010. La identificación de los aislados, la determinación de la susceptibilidad antimicrobiana y la búsqueda de b-lactamasas de espectro extendido se realizó mediante el método automatizado VITEK. Resultados: se identificaron 113 cepas ambientales de Escherichia coli. Se demostró que 23 % de los aislamientos resultaron resistentes al menos a uno de los antimicrobianos evaluados. Los mayores porcentajes de resistencia se observaron frente a ampicilina, sulfametoxazol-trimetropin y ciprofloxacina. Conclusiones: la presencia de aislados de E. coli con multirresistencia antimicrobiana en estos ríos indica claramente el riesgo biológico que implica el uso de sus aguas.

Introduction: antimicrobial resistance is one of the biggest problems facing global public health. The emergence of resistant clinical and environmental strains worsens the situation. Among the microorganisms with antimicrobial resistance, Escherichia coli species stands out due to its dual role as fecal contamination indicator and pathogen. Objectives: to isolate and identify Escherichia coli isolates from water samples from polluted rivers located in La Habana, and to determine their antimicrobial in vitro susceptibility. Methods: one hundred thirteen isolates of coliform bacteria isolated from 10 sampling stations in the capital´s urban areas near Almendares, Quibú and Luyanó rivers were studied in the period of February 2008 to June 2010. The identification of isolates, the determination of antimicrobial susceptibility and the search for extended-spectrum b-lactamase were all performed using VITEK automated method. Results: one hundred thirteen environmental strains of Escherichia coli were identified. It showed that 23 % of the isolates were resistant to at least one of the tested antimicrobials. The highest percentages of resistance were observed to ampicilline, sulfamethoxazole-trimethoprim and ciprofloxacin. Conclusions: the presence of E. coli isolates with multiple antimicrobial resistances in these rivers clearly indicates the biological risk involving the use of their waters.

CsRAV1 induces sylleptic branching in hybrid poplar.

• Sylleptic branching in trees may increase significantly branch number, leaf area and the general growth of the tree, particularly in its early years. Although this is a very important trait, so far little is known about the genes that control this process. • This article characterizes the Castanea sativa RAV1 gene, homologous to Arabidopsis TEM genes, by analyzing its circadian behavior and examining its winter expression in chestnut stems and buds. Transgenic hybrid poplars over-expressing CsRAV1 or showing RNA interference down-regulated PtaRAV1 and PtaRAV2 expression were produced and analyzed. • Over-expression of the CsRAV1 gene induces the early formation of sylleptic branches in hybrid poplar plantlets during the same growing season in which the lateral buds form. Only minor growth differences and no changes in wood anatomy are produced. • The possibility of generating trees with a greater biomass by manipulating the CsRAV1 gene makes CsRAV1 transgenic plants promising candidates for bioenergy production.

[Antimicrobial susceptibility of Escherichia coli isolates from river water ecosystems]. / Susceptibilidad antimicrobiana de aislamientos de Escherichia coli procedentes de ecosistemas dulceacuícolas.

INTRODUCTION: Antimicrobial resistance is one of the biggest problems facing global public health. The emergence of resistant clinical and environmental strains worsens the situation. Among the microorganisms with antimicrobial resistance, Escherichia coil species stands out due to its dual role as fecal contamination indicator and pathogen. OBJECTIVES: To isolate and identify Escherichia coil isolates from water samples from polluted rivers located in La Habana, and to determine their antimicrobial in vitro susceptibility. METHODS: One hundred thirteen isolates of coliform bacteria isolated from 10 sampling stations in the capital's urban areas near Almendares, Quibú and Luyanó rivers were studied in the period of February 2008 to June 2010. The identification of isolates, the determination of antimicrobial susceptibility and the search for extended-spectrum beta-lactamase were all performed using VITEK automated method. RESULTS: One hundred thirteen environmental strains of Escherichia coli were identified. It showed that 23% of the isolates were resistant to at least one of the tested antimicrobials. The highest percentages of resistance were observed to ampicilline, sulfamethoxazole-trimethoprim and ciprofloxacin. CONCLUSIONS: The presence of E. coil isolates with multiple antimicrobial resistances in these rivers clearly indicates the biological risk involving the use of their waters.

Endosymbiotic bacteria nodulating a new endemic lupine Lupinus mariae-josephi from alkaline soils in Eastern Spain represent a new lineage within the Bradyrhizobium genus.

Lupinus mariae-josephi is a recently described endemic Lupinus species from a small area in Eastern Spain where it thrives in soils with active lime and high pH. The L. mariae-josephi root symbionts were shown to be very slow-growing bacteria with different phenotypic and symbiotic characteristics from those of Bradyrhizobium strains nodulating other Lupinus. Their phylogenetic status was examined by multilocus sequence analyses of four housekeeping genes (16S rRNA, glnII, recA, and atpD) and showed the existence of a distinct evolutionary lineage for L. mariae-josephi that also included Bradyrhizobium jicamae. Within this lineage, the tested isolates clustered in three different sub-groups that might correspond to novel sister Bradyrhizobium species. These core gene analyses consistently showed that all the endosymbiotic bacteria isolated from other Lupinus species of the Iberian Peninsula were related to strains of the B. canariense or B. japonicum lineages and were separate from the L. mariae-josephi isolates. Phylogenetic analysis based on nodC symbiotic gene sequences showed that L. mariae-josephi bacteria also constituted a new symbiotic lineage distant from those previously defined in the genus Bradyrhizobium. In contrast, the nodC genes of isolates from other Lupinus spp. from the Iberian Peninsula were again clearly related to the B. canariense and B. japonicum bv. genistearum lineages. Speciation of L. mariae-josephi bradyrhizobia may result from the colonization of a singular habitat by their unique legume host.