A PCR Test Using the Mini-PCR Platform and Simplified Product Detection Methods Is Highly Sensitive and Specific to Detect Fasciola hepatica DNA Mixed in Human Stool, Snail Tissue, and Water DNA Specimens.

Fasciola hepatica has a complex lifecycle with multiple intermediate and definitive hosts and influenced by environmental factors. The disease causes significant morbidity in children and its prevalent worldwide. There is lack of data about distribution and burden of the disease in endemic regions, owing to poor efficacy of the different diagnostic methods used. A novel PCR-based test was developed by using a portable mini-PCR® platform to detect Fasciola sp. DNA and interpret the results via a fluorescence viewer and smartphone image analyzer application. Human stool, snail tissue, and water samples were used to extract DNA. Primers targeting the ITS-1 of the 18S rDNA gene of Fasciola sp. were used. The limit of detection of the mini-PCR test was 1 fg/µL for DNA samples diluted in water, 10 fg/µL for Fasciola/snail DNA scramble, and 100 fg/µL for Fasciola/stool DNA scramble. The product detection by agarose gel, direct visualization, and image analyses showed the same sensitivity. The Fh mini-PCR had a sensitivity and specificity equivalent to real-time PCR using the same specimens. Testing was also done on infected human stool and snail tissue successfully. These experiments demonstrated that Fh mini-PCR is as sensitive and specific as real time PCR but without the use of expensive equipment and laboratory facilities. Further testing of multiple specimens with natural infection will provide evidence for feasibility of deployment to resource constrained laboratories.

Substituting meat for mycoprotein reduces genotoxicity and increases the abundance of beneficial microbes in the gut: Mycomeat, a randomised crossover control trial.

PURPOSE: The high-meat, low-fibre Western diet is strongly associated with colorectal cancer risk. Mycoprotein, produced from Fusarium venanatum, has been sold as a high-fibre alternative to meat for decades. Hitherto, the effects of mycoprotein in the human bowel have not been well considered. Here, we explored the effects of replacing a high red and processed meat intake with mycoprotein on markers of intestinal genotoxicity and gut health. METHODS: Mycomeat (clinicaltrials.gov NCT03944421) was an investigator-blind, randomised, crossover dietary intervention trial. Twenty healthy male adults were randomised to consume 240 g day-1 red and processed meat for 2 weeks, with crossover to 2 weeks 240 g day-1 mycoprotein, separated by a 4-week washout period. Primary end points were faecal genotoxicity and genotoxins, while secondary end points comprised changes in gut microbiome composition and activity. RESULTS: The meat diet increased faecal genotoxicity and nitroso compound excretion, whereas the weight-matched consumption of mycoprotein decreased faecal genotoxicity and nitroso compounds. In addition, meat intake increased the abundance of Oscillobacter and Alistipes, whereas mycoprotein consumption increased Lactobacilli, Roseburia and Akkermansia, as well as the excretion of short chain fatty acids. CONCLUSION: Replacing red and processed meat with the Fusarium-based meat alternative, mycoprotein, significantly reduces faecal genotoxicity and genotoxin excretion and increases the abundance of microbial genera with putative health benefits in the gut. This work demonstrates that mycoprotein may be a beneficial alternative to meat within the context of gut health and colorectal cancer prevention.

Reliability and Validity of the Polar V800 Sports Watch for Estimating Vertical Jump Height.

This study aimed to assess the reliability and validity of the Polar V800 to measure vertical jump height. Twenty-two physically active healthy men (age: 22.89 ± 4.23 years; body mass: 70.74 ± 8.04 kg; height: 1.74 ± 0.76 m) were recruited for the study. The reliability was evaluated by comparing measurements acquired by the Polar V800 in two identical testing sessions one week apart. Validity was assessed by comparing measurements simultaneously obtained using a force platform (gold standard), high-speed camera and the Polar V800 during squat jump (SJ) and countermovement jump (CMJ) tests. In the test-retest reliability, high intraclass correlation coefficients (ICCs) were observed (mean: 0.90, SJ and CMJ) in the Polar V800. There was no significant systematic bias ± random errors (p > 0.05) between test-retest. Low coefficients of variation (<5%) were detected in both jumps in the Polar V800. In the validity assessment, similar jump height was detected among devices (p > 0.05). There was almost perfect agreement between the Polar V800 compared to a force platform for the SJ and CMJ tests (Mean ICCs = 0.95; no systematic bias ± random errors in SJ mean: -0.38 ± 2.10 cm, p > 0.05). Mean ICC between the Polar V800 versus high-speed camera was 0.91 for the SJ and CMJ tests, however, a significant systematic bias ± random error (0.97 ± 2.60 cm; p = 0.01) was detected in CMJ test. The Polar V800 offers valid, compared to force platform, and reliable information about vertical jump height performance in physically active healthy young men.

Study of tyrosine and dopa enantiomers as tyrosinase substrates initiating l- and d-melanogenesis pathways.

Tyrosinase starts melanogenesis and determines its course, catalyzing the oxidation by molecular oxygen of tyrosine to dopa, and that of dopa to dopaquinone. Then, nonenzymatic coupling reactions lead to dopachrome, which evolves toward melanin. Recently, it has been reported that d-tyrosine acts as tyrosinase inhibitor and depigmenting agent. The action of tyrosinase on the enantiomers of tyrosine (l-tyrosine and d-tyrosine) and dopa (l-dopa and d-dopa) was studied for the first time focusing on quantitative transient phase kinetics. Post-steady-state transient phase studies revealed that l-dopachrome is formed more rapidly than d-dopachrome. This is due to the lower values of Michaelis constants for l-enantiomers than for d-enantiomers, although the maximum rates are equal for both enantiomers. A deeper analysis of the inter-steady-state transient phase of monophenols demonstrated that the enantiomer d-tyrosine causes a longer lag period and a lower steady-state rate, than l-tyrosine at the same concentration. Therefore, d-melanogenesis from d-tyrosine occurs more slowly than does l-melanogenesis from l-tyrosine, which suggests the apparent inhibition of melanin biosynthesis by d-tyrosine. As conclusion, d-tyrosine acts as a real substrate of tyrosinase, with low catalytic efficiency and, therefore, delays the formation of d-melanin.

Factores relacionados con el control de la hipertensión arterial en Cienfuegos / Factors related to the control of hypertension in Cienfuegos

Introducción: El control de la presión arterial es un desafío global y uno de los principales problemas de salud pública en la actualidad. Objetivos: Describir los factores relacionados con la evolución, detección y control de la hipertensión arterial en Cienfuegos en el periodo de 2001 a 2011, en un contexto de acceso universal a los servicios de salud. Métodos: Estudio poblacional desarrollado en el año 2011, con una muestra representativa probabilística de 1276 adultos entre 25-74 años, residentes en la ciudad de Cienfuegos, Cuba. Resultados: De los hipertensos, el 32,8 por ciento desconocía su condición, el 90 por ciento de los que conocían su condición llevaban tratamiento y el 29,8 por ciento estaban controlados. El riesgo de no control fue significativamente superior en las personas con más de 65 años, en las de raza negra o mestiza y en las que tenían más de un año sin ir a su médico o controlarse la presión arterial. Con relación al 2001, el porcentaje de hipertensos que desconocían su condición se incrementó en 11,3 por ciento; se redujo el número de tratados en un 3,4 por ciento y el nivel de control en un 10 por ciento. Conclusiones: Existe un grupo de factores como la edad, la raza, y la falta de seguimiento de las personas en los servicios de salud para la detección y control de la HTA que afectan su comportamiento. Los resultados, aunque superan los reportados por otros países de la región, sugieren brechas en la detección, el seguimiento de los casos y la gestión del sistema en el 2011, si se compara con la década precedente(AU)

Introduction: The control of blood pressure is a global challenge and one of the main public health problems nowadays. Objectives: To describe the factors related to the evolution, detection and control of hypertension in Cienfuegos from 2001 to 2011 in a scenario of universal access to health services. Methods: Population study developed during 2011, with a representative, probabilistic sample of 1276 adults in the ages from 25 to 74 years old whom lived in the city of Cienfuegos, Cuba. Results: From the hypertensive patients, 32,8 percent were unaware of their condition, 90 percent of those who knew their condition had treatment, and 29,8 percent were controlled. Uncontrolled hypertension's risk was significantly higher in people with age ≥ 65 years, the ones of black race or mixed race, in the ones not attending to the doctor's consultation or not controlling the blood pressure for more than one year. In relation to 2001, the percentage of hypertensive patients who did not know their condition increased by 11,3 percent; the number of treated patients was reduced by 3,4 percent and the level of control by 10 percent. Conclusions: There are a group of factors as age, race, and the lack of follow up to these patients in the health care services in order to detect and control hypertension that affect its behavior. The results, although better than those observed in other countries in the region, show a gap in terms of detection and control of hypertension, the follow up of the patients and management of the system in the year 2011 in comparison with the previous decade(AU)

Cardiometabolic and Muscular Fatigue Responses to Different CrossFit® Workouts.

CrossFit® consists of workouts of the day (WODs) in which different exercises are conducted at high intensity with minimal or no rest periods. This study sought to quantify exercise intensity and muscular fatigue in the three CrossFit® session modalities: gymnastics (G), metabolic conditioning (M) and weightlifting (W). Thirty two, young, strength-trained, healthy men completed the three WODs: G ("Cindy"), M (double skip rope jumps) and W (power cleans). The variables measured in the sessions were: mean heart rate (HR), rate of perceived exertion (RPE), blood lactate [lactate], and jump height (H), average power (AP) and maximum take-off velocity (Vmax) in a counter movement jump test. In all three WODs, elevated HR values (≥90% of the theoretical HRmax) were recorded at the time points mid-session and end-session. Mean RPEs were 17.6 ± 1.6 (G WOD), 16.0 ± 2.3 (M WOD), and 15.7 ± 2.0 (W WOD). Postexercise [lactate] was higher than 10 mmol·L-1 for the three WODs. Following the G ("Cindy") and W (power cleans) WODs, respectively, significant muscular power losses were observed in H (7.3% and 8.1%), Vmax (13.8% and 3.3%), AP relative (4.6% and 8.3%) and AP total (4.2% and 8.2%) while losses in the M WOD were not significant (p > 0.05). A vigorous intensity of exercise was noted in all three WODs, with greater mean HRs detected in the "Cindy" and skip rope WODs than power clean WOD. Muscular fatigue was produced in response to the "Cindy" and power clean WODs but not the skip rope WOD.

Psychological Safety and Support: Assessing Resident Perceptions of the Clinical Learning Environment.

BACKGROUND: Assessments of the clinical learning environment could allow early interventions to improve graduate medical education. To date, measurement tools for this have not been identified. OBJECTIVE: We established the concurrent validity of 2 instruments that assess cultural facets of the clinical learning environment by correlating them with external program evaluation data. METHODS: In 2017 we surveyed residents across 19 training programs on their perceptions of organizational support by using the Short Survey of Perceived Organizational Support (SPOS), and psychological safety by using the Psychological Safety Scale (PSS). Data were aggregated to the program level and correlated with results from the Accreditation Council for Graduate Medical Education (ACGME) Resident Survey. RESULTS: Of 511 residents, 322 (63%) completed the survey, and 496 of 516 residents (96%) completed the ACGME Resident Survey. Perceived organizational support correlated positively with overall program evaluation score (r = 0.75, P < .001); faculty (r = 0.72, P < .001); evaluation (r = 0.73, P < .001); educational content (r = 0.52, P = .022); and resources domains (r = 0.55, P = .014). Psychological safety had a positive correlation with overall program evaluation (r = 0.57, P = .011); faculty (r = 0.50, P = .028); and evaluation (r = 0.62, P < .005). CONCLUSIONS: The SPOS and PSS correlated with key ACGME Resident Survey domains. Programs showing greater support of residents were likely to show more positive ratings on program evaluation metrics. Teaching institutions may benefit from actively monitoring and improving aspects of their learning environment through internal assessments.

Circadian rhythm effect on physical tennis performance in trained male players.

To determine the effect of circadian rhythm on neuromuscular responses and kinematics related to physical tennis performance, after a standardised warm-up, 13 highly competitive male tennis players were tested twice for serve velocity/accuracy (SVA), countermovement vertical jump (CMJ), isometric handgrip strength (IS), agility T-test (AGIL) and a 10-m sprint (10-m RUN). In a randomised, counter-balance order, tennis players underwent the test battery twice, either in the morning (i.e., AM; 9:00 h) and in the afternoon (i.e., PM; 16:30 h). Paired t-tests were used to analyse differences due to time-of-day in performance variables. Comparison of morning versus afternoon testing revealed that SVA (168.5 ± 6.5 vs. 175.2 ± 6.1 km · h-1; P = 0.003; effect size [ES] = 1.07), CMJ (32.2 ± 0.9 vs. 33.7 ± 1.1 cm; P = 0.018; ES = 1.46), AGIL (10.14 ± 0.1 vs. 9.91 ± 0.2 s; P = 0.007; ES = 1.23) and 10-m RUN time (1.74 ± 0.1 vs. 1.69 ± 0.1 s; P = 0.021; ES = 0.67) were significantly blunted during the morning testing. However, IS was not affected by time-of-day (P = 0.891). Thus, tennis performance may be reduced when competing in the morning in comparison to early evening. Therefore, coaches and tennis players should focus on schedule the SVA, power, speed and agility training sessions in the afternoon.

Implementation of the Spanish National Enhanced Recovery Program (ERAS) in Bariatric Surgery: A Pilot Study.

INTRODUCTION: The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish fast track group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery. PATIENTS AND METHODS: A multicentric prospective pilot study was performed, including 125 consecutive patients undergoing bariatric surgery at 3 Spanish hospitals between January and June 2015, after the Spanish National ERAS protocol in bariatric surgery. Compliance with the protocol, morbidity, mortality, hospital stay, and readmission were evaluated. RESULTS: Bariatric techniques performed included 68 Roux-en-Y gastric bypass (54.4%) and 57 laparoscopic sleeve gastrectomy (45.6%) cases. All surgeries were laparoscopically performed with conversion in only 1 case (0.8%). Median postoperative pain evaluated by visual analogic scale 24 hours after surgery was 2 (range, 0 to 5). Postoperative nausea or vomiting appeared in 7 patients (5.6%). Complications appeared in 6 patients (4.8%). The reoperation rate was 4%. The mortality rate was 0.8%. The median hospital stay was 2 days (range, 2 to 10 d) and readmission rate was 2.4%. The compliance of all the items of the protocol was achieved in 78.4% of the patients. CONCLUSIONS: The Spanish National ERAS protocol is a safe issue with a high implementation rate. It can be recommended to establish this protocol to other institutions.

Metodología de determinación de la transición aeróbica-anaeróbica en la evaluación funcional / Methodology to elucidate the aerobic-anaerobic transition in functional Assessment

El consumo de oxígeno máximo (VO2max) es considerado el parámetro más importante en la determinación de la capacidad funcional de una persona. Como consecuencia del gran estres que supone la realizacion de pruebas de esfuerzo con un carácter máximo, se ha buscado la valoración de la capacidad funcional a traves de pruebas con un carácter submaximo, siendo el umbral láctico (UL) el parámetro mas estudiado. Se han propuesto diversas metodologías en la determinación del UL, si bien, aquellas metodologías que asocian el UL a unas determinadas concentraciones fijas de lactato sanguíneo no parecen adecuadas, siendo la metodología mas adecuada la del ajuste algorítmico. El UL indica el comienzo de una participación progresivamente mayor de la glucolisis anaeróbica al metabolismo energético, siendo conocida dicha intensidad de ejercicio como transición aerobica-anaerobica. El inicio de la transición aeróbica anaeróbica, además de caracterizarse por un incremento de las concentraciones de lactato con respecto a los valores de reposo, se acompaña de un incremento desproporcional de la respuesta ventilatoria, electromiografía y de activación del sistema nervioso simpático, en relación a los incrementos de la intensidad de ejercicio, que hasta ese momento habian mantenido una relación proporcional. De este modo, en el inicio de la transición aerobica-anaerobica se puede observar una respuesta de tipo umbral a nivel electromiografico, que se conoce umbral de electromiografía (UE), en los niveles de catecolaminas en plasma, umbral de catecolaminas (UC), y de la ventilacion pulmonar, umbral ventilatorio (VT1). A pesar de que la transición aerobica-anaerobica se ha estudiado ampliamente en ejercicios empleados para el desarrollo de la resistencia cardiorrespiratorio, recientemente se esta estudiando en ejercicios empleados en el entrenamiento contrarresistencias, como la media sentadilla, donde las respuestas son similares a las observadas en cicloergometro (AU)

The maximum oxygen consumption (VO2max) is considered the most important parameter to determine the functional ability of a person. Due to the large stress involved in the maximum effort testing, the submaximal effort test have achieved a relevant role in the capacity functional assessment, being lactic threshold (UL) the parameter most studied. They have proposed different methodologies in determining the UL, although those who associate UL methodologies to certain fixed blood lactate concentrations considered inadequate, the most appropriate methodology of the algorithmic adjustment. The UL marks the beginning of a progressively greater share of the anaerobic glycolysis energy metabolism, being known that as exercise intensity aerobic-anaerobic transition. The onset of transition aerobic anaerobic also characterized by an increase in lactate concentrations over resting values, is accompanied by a disproportionate increase in ventilatory, electromyographic response and activation of the sympathetic nervous system in relation to increases the intensity of exercise, which until then had maintained a proportional relationship. Thus, at the start of the aerobic-anaerobic transition can observe a response threshold type to electromyographic level, the threshold for electromyography (EU) is known, in levels of plasma catecholamines, threshold catecholamines (UC), and pulmonary ventilation, ventilatory threshold (VT1). Although the aerobic-anaerobic transition has been studied extensively in exercises employed for the development of cardiorespiratory endurance, recently it is you studying exercises employed in contrarresistencias training, as the half-squat, where the responses are similar to those observed in I cycle ergometer (AU)

Acute Physiological and Mechanical Responses During Resistance Exercise at the Lactate Threshold Intensity.

The purpose of this study was to examine acute metabolic, mechanical, and cardiac responses to half-squat (HS) resistance exercise performed at a workload corresponding to the lactate threshold (LT). Thirteen healthy subjects completed 3 HS exercise tests separated by 48-hour rest periods: a maximal strength or 1 repetition maximum (1RM) test, an incremental load test to establish the % 1RM at which the LT was reached, and a constant load test at the LT intensity. During the last test, metabolic, mechanical, and cardiac responses were monitored respectively through blood lactate concentrations, height (H), average power (AP) and peak power (PP) recorded in a countermovement jump test, and heart rate (HR). During the constant load test, lactate concentrations and HR remained stable whereas significant reductions were detected in H, AP, and PP (p ≤ 0.05). Only low correlation was observed between lactate concentrations and the H (r = 0.028), AP (r = 0.072), and PP (r = 0.359) losses produced. Half-squat exercise at the LT elicits stable HR and blood lactate responses within a predominantly aerobic metabolism, although this exercise modality induces significant mechanical fatigue.

Reliability and validity assessment of a linear position transducer.

The objectives of the study were to determine the validity and reliability of peak velocity (PV), average velocity (AV), peak power (PP) and average power (AP) measurements were made using a linear position transducer. Validity was assessed by comparing measurements simultaneously obtained using the Tendo Weightlifting Analyzer Systemi and T-Force Dynamic Measurement Systemr (Ergotech, Murcia, Spain) during two resistance exercises, bench press (BP) and full back squat (BS), performed by 71 trained male subjects. For the reliability study, a further 32 men completed both lifts using the Tendo Weightlifting Analyzer Systemz in two identical testing sessions one week apart (session 1 vs. session 2). Intraclass correlation coefficients (ICCs) indicating the validity of the Tendo Weightlifting Analyzer Systemi were high, with values ranging from 0.853 to 0.989. Systematic biases and random errors were low to moderate for almost all variables, being higher in the case of PP (bias ±157.56 W; error ±131.84 W). Proportional biases were identified for almost all variables. Test-retest reliability was strong with ICCs ranging from 0.922 to 0.988. Reliability results also showed minimal systematic biases and random errors, which were only significant for PP (bias -19.19 W; error ±67.57 W). Only PV recorded in the BS showed no significant proportional bias. The Tendo Weightlifting Analyzer Systemi emerged as a reliable system for measuring movement velocity and estimating power in resistance exercises. The low biases and random errors observed here (mainly AV, AP) make this device a useful tool for monitoring resistance training. Key pointsThis study determined the validity and reliability of peak velocity, average velocity, peak power and average power measurements made using a linear position transducerThe Tendo Weight-lifting Analyzer Systemi emerged as a reliable system for measuring movement velocity and power.

Human gut Bacteroidetes can utilize yeast mannan through a selfish mechanism.

Yeasts, which have been a component of the human diet for at least 7,000 years, possess an elaborate cell wall α-mannan. The influence of yeast mannan on the ecology of the human microbiota is unknown. Here we show that yeast α-mannan is a viable food source for the Gram-negative bacterium Bacteroides thetaiotaomicron, a dominant member of the microbiota. Detailed biochemical analysis and targeted gene disruption studies support a model whereby limited cleavage of α-mannan on the surface generates large oligosaccharides that are subsequently depolymerized to mannose by the action of periplasmic enzymes. Co-culturing studies showed that metabolism of yeast mannan by B. thetaiotaomicron presents a 'selfish' model for the catabolism of this difficult to breakdown polysaccharide. Genomic comparison with B. thetaiotaomicron in conjunction with cell culture studies show that a cohort of highly successful members of the microbiota has evolved to consume sterically-restricted yeast glycans, an adaptation that may reflect the incorporation of eukaryotic microorganisms into the human diet.

Gait-cycle characteristics and running economy in elite Eritrean and European runners.

PURPOSE: This study aimed to determine whether biomechanical characteristics such as ground-contact time, swing time, and stride length and frequency contribute to the exceptional running economy of East African runners. METHODS: Seventeen elite long-distance runners (9 Eritrean, 8 European) performed an incremental maximal running test and 3 submaximal running bouts at 17, 19, and 21 km/h. During the tests, gas-exchange parameters were measured to determine maximal oxygen uptake (VO2max) and running economy (RE). In addition, ground-contact time, swing time, stride length, and stride frequency were measured. RESULTS: The European runners had higher VO2max values than the Eritrean runners (77.2 ± 5.2 vs 73.5 ± 6.0 mL · kg-1 · min-1, P = .011, effect sizes [ES] = 0.65), although Eritrean runners were more economical at 19 km/h (191.4 ± 10.4 vs 205.9 ± 13.3 mL · kg-1 · min-1, P = .026, ES = 1.21). There were no differences between groups for ground-contact time, swing time, stride length, or stride frequency at any speed. Swing time was associated with running economy at 21 km/h in the Eritrean runners (r = .71, P = .033), but no other significant association was found between RE and biomechanical variables. Finally, best 10-km performance was significantly correlated with RE (r = -.57; P = .013). CONCLUSIONS: Eritrean runners have superior RE compared with elite European runners. This appears to offset their inferior VO2max. However, the current data suggest that their better RE does not have a biomechanical basis. Other factors, not measured in the current study, may contribute to this RE advantage.

Lesiones de la vía biliar en colecistectomías laparoscópicas / Bile duct injures from laparoscopic cholecystectomy

Introducción: en febrero de 1991, se realizó la primera colecistectomía laparoscópica en Cuba. No obstante sus beneficios, las lesiones de la vía biliar parecen ser más frecuentes. Objetivo: describir el comportamiento de las lesiones de la vía biliar en 6 centros de 5 provincias del país, a fin de detectar deficiencias al ser corregidas. Métodos: se realizó un estudio multicentros, descriptivo y retrospectivo de 27 lesiones de la vía biliar ocurridas en 17 288 colecistectomías laparoscópicas realizadas en 6 hospitales universitarios. Se colectó el dato primario a través de un cuestionario de 13 puntos, aplicado a cada paciente lesionado, y común para todos los centros. Resultados: el porcentaje de lesiones de la vía biliar en esta serie fue bajo (0,15 por ciento). En 59,2 por ciento, el diagnóstico fue posoperatorio y casi el 63 por ciento fueron graves lesiones tipo E de Strasberg. Las técnicas de reparación más empleadas fueron las derivaciones biliodigestivas, pero las lesiones diagnosticadas durante el transoperatorio fueron en la mayoría de los casos tratados con reparación sobre sonda. Se presentaron complicaciones mayores en 25,9 por ciento. Conclusiones: el porcentaje de lesiones en nuestro estudio es bajo, pero predominan las de caracter grave. Las estenosis posquirúrgicas, estuvieron predominantemente relacionadas con la elección errónea de la técnica primaria de reparación(AU)

Introduction: On February 1991 the first laparoscopic cholecistectomy (LC) was performed in Cuba. Despite the benefits of this approach, bile ducts injuries (BDI) seem to be more frequent. Objective: To describe the behavior of the bile duct injuries in six hospitals located in 5 provinces throughout the country so as to detect deficiencies to be corrected. Methods: A retrospective, multicenter and descriptive study of 27 bile duct injuries on 17288 LC performed in 6 university hospitals throughout the country. The primary data was collected through a 13 point-questionnaire applied to every injured patient, and equal for all the centers. Results: The percentage of BDI in this series was low (0.15 percent). In 59.2 percent of cases, the diagnosis was made postoperatively and almost 63 percent were severe Strasberg's type E lesions. The most used repair techniques were bile digestive derivations, but lesions identified transoperatively were in most of the cases treated with T tube repairs. Major complications occurred in 25.9 percent of patients. Conclusions: The percentage of lesions in our study is low, but they were mostly severe. The postsurgical stenosis was mainly related with the wrong selection of the primary repair technique(AU)

Lesiones de la vía biliar en colecistectomías laparoscópicas / Bile duct injures from laparoscopic cholecystectomy

Introducción: en febrero de 1991, se realizó la primera colecistectomía laparoscópica en Cuba. No obstante sus beneficios, las lesiones de la vía biliar parecen ser más frecuentes. Objetivo: describir el comportamiento de las lesiones de la vía biliar en 6 centros de 5 provincias del país, a fin de detectar deficiencias al ser corregidas. Métodos: se realizó un estudio multicentros, descriptivo y retrospectivo de 27 lesiones de la vía biliar ocurridas en 17 288 colecistectomías laparoscópicas realizadas en 6 hospitales universitarios. Se colectó el dato primario a través de un cuestionario de 13 puntos, aplicado a cada paciente lesionado, y común para todos los centros. Resultados: el porcentaje de lesiones de la vía biliar en esta serie fue bajo (0,15 por ciento). En 59,2 por ciento, el diagnóstico fue posoperatorio y casi el 63 por ciento fueron graves lesiones tipo E de Strasberg. Las técnicas de reparación más empleadas fueron las derivaciones biliodigestivas, pero las lesiones diagnosticadas durante el transoperatorio fueron en la mayoría de los casos tratados con reparación sobre sonda. Se presentaron complicaciones mayores en 25,9 por ciento. Conclusiones: el porcentaje de lesiones en nuestro estudio es bajo, pero predominan las de caracter grave. Las estenosis posquirúrgicas, estuvieron predominantemente relacionadas con la elección errónea de la técnica primaria de reparación(AU)

Introduction: On February 1991 the first laparoscopic cholecistectomy (LC) was performed in Cuba. Despite the benefits of this approach, bile ducts injuries (BDI) seem to be more frequent. Objective: To describe the behavior of the bile duct injuries in six hospitals located in 5 provinces throughout the country so as to detect deficiencies to be corrected. Methods: A retrospective, multicenter and descriptive study of 27 bile duct injuries on 17288 LC performed in 6 university hospitals throughout the country. The primary data was collected through a 13 point-questionnaire applied to every injured patient, and equal for all the centers. Results: The percentage of BDI in this series was low (0.15 percent). In 59.2 percent of cases, the diagnosis was made postoperatively and almost 63 percent were severe Strasberg's type E lesions. The most used repair techniques were bile digestive derivations, but lesions identified transoperatively were in most of the cases treated with T tube repairs. Major complications occurred in 25.9 percent of patients. Conclusions: The percentage of lesions in our study is low, but they were mostly severe. The postsurgical stenosis was mainly related with the wrong selection of the primary repair technique(AU)

Rectosigmoid deep infiltrating endometriosis and ureteral involvement with loss of renal function.

UNLABELLED: Endometriosis is a complex disease with unclear pathogenesis, defined as the presence of endometrial tissue (glands and stroma) outside its usual location in the uterine cavity. Ureteral involvement is rare, with an estimated frequency of 10-14% in cases of deep endometriosis with nodules of 3 cm or larger. An important complication of ureteral involvement is asymptomatic loss of renal function. In a patient with asymptomatic renal failure the relevance of extrinsic ureteral involvement by deep endometriosis has been taken to account. CASE REPORT: A 32-year-old nulliparous woman presented with chronic pelvic pain associated with severe dysmenorrhea, dyspareunia and digestive problems including diarrhea, occasional constipation and rectal bleeding. She reported no urological symptoms. Magnetic resonance imaging (MRI) identified a 4 cm nodule in the recto-vaginal septum, compressing and infiltrating the rectal wall, and chronic left hydronephrosis. Isotope renogram revealed 91% function in the right kidney and 9% in the left kidney. A multidisciplinary surgical team including consultants from the departments of digestive surgery and urology assessed the patient. The treatment recommended was a joint approach of laparoscopic surgery to perform adhesiolysis, ureterolysis, freeing of the uterus and appendages, resection of the rectovaginal septum nodule, and left nephrectomy. COMMENT: Diagnosis and treatment of deep endometriosis should be performed in specialized centers and in the context of multidisciplinary collaboration. We must be aware of the potential risk of ureteral involvement and the asymptomatic loss of renal function in any patient with endometriosis nodules of 3 cm or larger.

Melatonin in octopus (Octopus vulgaris): tissue distribution, daily changes and relation with serotonin and its acid metabolite.

Information regarding melatonin production in molluscs is very limited. In this study the presence and daily fluctuations of melatonin levels were investigated in hemolymph, retina and nervous system-related structures in the cephalopod Octopus vulgaris. Adult animals were maintained in captivity under natural photoperiod and killed at different times in a regular daily cycle. Levels of melatonin, serotonin (5-HT) and its acid metabolite (5-hydroxyindole acetic acid, 5-HIAA) in the hemolymph, retina, optic lobe, and cerebral ganglion were assayed by HPLC. Melatonin content fluctuated rhythmically in the retina and hemolymph, peaking at night. In the retina, but not in the other neural tissues, the rhythm was opposite to that of 5-HT, which displayed basal levels at night. Also, 5-HIAA levels in the retina were higher during the night, supporting that rhythmic melatonin production could be linked to diurnal changes in 5-HT degradation. The high levels of melatonin found in the retina point to it as the major source of melatonin in octopus; in addition, a large variation of melatonin content was found in the optic lobe with maximal values at night. All these data suggest that melatonin might play a role in the transduction of the light-dark cycle information for adjustment of rhythmic physiological events in cephalopods.

Ontogenetic stage-dependent effect of temperature on developmental and metabolic rates in a holometabolous insect.

Different hypotheses attempt to explain how different stages of organisms with complex life cycles respond to environmental changes. Most studies have focused at the among-species level showing similar responses to temperature throughout ontogeny. However, there is no agreement about the pattern expected at the intraspecific scale where a strong selective effect is expected. In this paper, we studied the effects of thermal treatments on a life history trait (developmental rate) and a physiological trait (metabolic rate) during development in the fruitfly Drosophila buzzatii. First, we estimated the rate of development during larval life (LDR) and the pupal stage (PDR) in flies derived from two natural populations exposed to several thermal treatments. Our results showed that the developmental rate ratio, LDR/PDR, did not vary between populations, and that the effects of thermal treatments were stage specific. Second, we studied the relationship between developmental rate (DR) and metabolic rate (MR) in each life cycle stage. We found that allometric relationships between DR and MR varied throughout ontogeny, a pattern that shed light on the mechanisms responsible for thermal plasticity. We conclude that, although different populations may show developmental rate isomorphy; larvae and pupae may choose alternative "decisions" in terms of life-history evolution and physiological traits when confronted to different thermal environments.