Impact of Bariatric Surgery on the Incidence of Various Cancers. Narrative Review

Obesity is a global epidemic. According to the World Health Organization (WHO), it is an abnormal or excessive accumulation of fat that can harm health. Its incidence is increasing alarmingly in developing countries. It is also a significant risk factor for developing chronic diseases such as type 2 diabetes mellitus, arterial hypertension, coronary disease, non-alcoholic fatty liver disease, and musculoskeletal disorders such as osteoarthritis. Furthermore, associations have been found between obesity and the development of prostate, liver, gallbladder, kidney, colon, endometrial, breast, and ovarian cancer. Bariatric and metabolic surgery is the most effective treatment for morbid obesity and its comorbidities. This surgery can reduce general mortality by 40% at ten years due to cardiovascular outcomes, diabetes, or cancer and improve metabolic diseases such as type 2 diabetes.

La obesidad es una epidemia global, según la Organización Mundial de la Salud (OMS) se define como una acumulación anormal o excesiva de grasa que puede ser perjudicial para la salud, su incidencia está aumentando de forma alarmante en los países en desarrollo. Asimismo, es un factor de riesgo importante para el desarrollo de enfermedades crónicas como la diabetes mellitus tipo 2, hipertensión arterial, enfermedad coronaria, enfermedad del hígado graso no alcohólico y trastornos musculoesqueléticos como la osteoartritis; además, se han encontrado asociaciones entre la obesidad y el desarrollo del cáncer de próstata, hígado, vesícula biliar, riñón, colon, endometrio, mama y ovarios. La cirugía bariátrica y metabólica es el tratamiento más eficaz para la obesidad mórbida y sus comorbilidades, esta cirugía puede reducir la mortalidad general en un 40% a los diez años por desenlaces cardiovasculares, diabetes o cáncer, como también mejorar enfermedades metabólicas como la diabetes tipo 2.

Whole Sequencing and Detailed Analysis of SARS-CoV-2 Genomes in Southeast Spain: Identification of Recurrent Mutations in the 20E (EU1) Variant with Some Clinical Implications.

During the COVID-19 pandemic caused by SARS-CoV-2, new waves have been associated with new variants and have the potential to escape vaccinations. Therefore, it is useful to conduct retrospective genomic surveillance research. Herein, we present a detailed analysis of 88 SARS-CoV-2 genomes belonging to samples taken from COVID-19 patients from October 2020 to April 2021 at the "Reina Sofía" Hospital (Murcia, Spain) focused to variant appeared later. The results at the mentioned stage show the turning point since the 20E (EU1) variant was still prevalent (71.6%), but Alpha was bursting to 14.8%. Concern mutations have been found in 5 genomes classified as 20E (EU1), which were not characteristic of this still little evolved variant. Most of those mutations are found in the spike protein, namely Δ69-70, E484K, Q675H and P681H. However, a relevant deletion in ORF1a at positions 3675-3677 was also identified. These mutations have been reported in many later SARS-CoV-2 lineages, including Omicron. Taken together, our data suggest that preferential emergence mutations could already be present in the early converging evolution. Aside from this, the molecular information has been contrasted with clinical data. Statistical analyses suggest that the correlation between age and severity criteria is significantly higher in the viral samples with more accumulated changes.

PAHs and trace metals in marine surficial sediments from the Porcupine Bank (NE Atlantic): A contribution to establishing background concentrations.

Little is known about pollutant concentrations in marine remote areas such as the Porcupine Bank in the NE Atlantic Ocean. Remote locations are much less studied than the more readily accessible coastal areas, nevertheless, are of great importance both to unveil how far human influence has reached and, are more challenging, to infer background concentrations (BCs) of naturally occurring and/or anthropogenic pollutants. Knowledge of contaminant background levels are critical for establishing remediation and management strategies; in addition, background assessment is heavily emphasised in legislative monitoring requirements. Obtaining suitable sampling locations to assess background concentrations can be challenging, as samples should match characteristics to the target area and not be impacted by historical or current inputs of the chemical substances of study. Anthropogenic impacts generally deem local-based sampling to be unsuitable to infer background pollution values. Sampling in remote areas such as the Porcupine Bank better fulfils low impact and pressure requirements making them more suitable for the derivation of background concentration estimates for organic compounds and metals. The total concentrations of polycyclic aromatic hydrocarbons (PAHs) and metal(loid)s in deep sea sediments were evaluated and both an environmental status and a set of concentration data were adequate to derive BCs concentrations is presented. Concentration data indicated, in comparison with previous published data, trace level presence of PAHs and metal(loids) in sediments from the Porcupine Bank. These values will provide a valuable tool to identify the natural presence of organic and inorganic compounds and be the basis to perform a sound environmental assessment.

Interaction fidelity is less common than expected in plant-pollinator communities.

Pairs of plants and pollinators species sometimes consistently interact throughout time and across space. Such consistency can be interpreted as a sign of interaction fidelity, that is a consistent interaction between two species when they co-occur in the same place. But how common interaction fidelity is and what determines interaction fidelity in plant-pollinator communities remain open questions. We aim to assess how frequent is interaction fidelity between plants and their pollinators and what drives interaction fidelity across plant-pollinator communities. Using a dataset of 141 networks around the world, we quantify whether the interaction between pairs of plant and pollinator species happens more ('interaction fidelity') or less ('interaction avoidance') often than expected by chance given the structure of the networks in which they co-occur. We also explore the relationship between interaction fidelity and species' degree (i.e. number of interactions), and the taxonomy of the species involved in the interaction. Our findings reveal that most plant-pollinator interactions do not differ from random expectations, in other words show neither fidelity nor avoidance. Out of the total 44,814 co-occurring species pairs we found 7,877 unique pair interactions (18%). Only 551 (7%) of the 7,877 plant-pollinator interactions did show significant interaction fidelity, meaning that these pairs interact in a consistent and non-random way across networks. We also find that 39 (0.09%) out of 44,814 plant-pollinator pairs showed significant interaction avoidance. Our results suggest that interactions involving specialist species have a high probability to show interaction fidelity and a low probability of interaction avoidance. In addition, we find that particular associations between plant and insect orders, as for example interactions between Hymenoptera and Fabales, showed high fidelity and low avoidance. Although niche and neutral processes simultaneously influence patterns of interaction in ecological communities, our findings suggest that it is rather neutral processes that are shaping the patterns of interactions in plant-pollinator networks.

Atypical Kaposi's sarcoma in young inmunocompetent patient.

Kaposi´s sarcoma is a rare tumor associated with human herpes virus 8 (HHV-8) infection. Four main clinical subtypes have been described. This study reports on a form of KS in an HIV negative and immunocompetent middle-aged man. The only remarkable factor is that he has sex with other men. This form of Kaposi´s sarcoma is rare. It occurs more in younger patients than in the classic form, is limited to the skin, and is associated with a good prognosis. The means of transmission of the virus is through saliva in oroanal or orogenital sexual practices. Mechanisms of tumor development are still not well known. Given the possible increased number of this variant, it would be interesting to extend this study.

High prevalence and diversity of HIV-1 non-B genetic forms due to immigration in southern Spain: A phylogeographic approach.

Phylogenetic studies are a valuable tool to understand viral transmission patterns and the role of immigration in HIV-1 spread. We analyzed the spatio-temporal relationship of different HIV-1 non-B subtype variants over time using phylogenetic analysis techniques. We collected 693 pol (PR+RT) sequences that were sampled from 2005 to 2012 from naïve patients in different hospitals in southern Spain. We used REGA v3.0 to classify them into subtypes and recombinant forms, which were confirmed by phylogenetic analysis through maximum likelihood (ML) using RAxML. For the main HIV-1 non-B variants, publicly available, genetically similar sequences were sought using HIV-BLAST. The presence of HIV-1 lineages circulating in our study population was established using ML and Bayesian inference (BEAST v1.7.5) and transmission networks were identified. We detected 165 (23.4%) patients infected with HIV-1 non-B variants: 104 (63%) with recombinant viruses in pol: CRF02_AG (71, 43%), CRF14_BG (8, 4.8%), CRF06_cpx (5, 3%) and nine other recombinant forms (11, 6.7%) and unique recombinants (9, 5.5%). The rest (61, 37%) were infected with non-recombinant subtypes: A1 (30, 18.2%), C (7, [4.2%]), D (3, [1.8%]), F1 (9, 5.5%) and G (12, 7.3%). Most patients infected with HIV-1 non-B variants were men (63%, p < 0.001) aged over 35 (73.5%, p < 0.001), heterosexuals (92.2%, p < 0.001), from Africa (59.5%, p < 0.001) and living in the El Ejido area (62.4%, p<0.001). We found lineages of epidemiological relevance (mainly within Subtype A1), imported primarily through female sex workers from East Europe. We detected 11 transmission clusters of HIV-1 non-B Subtypes, which included patients born in Spain in half of them. We present the phylogenetic profiles of the HIV-1 non-B variants detected in southern Spain, and explore their putative geographical origins. Our data reveals a high HIV-1 genetic diversity likely due to the import of viral lineages that circulate in other countries. The highly immigrated El Ejido area acts as a gateway through which different subtypes are introduced into other regions, hence the importance of setting up epidemiological control measures to prevent future outbreaks.

Actividad comparativa de tedizolid frente a Staphylococcus coagulasa negativos resistentes a linezolid y Staphylococcus aureus resistentes a meticilina / Comparative activity of tedizolid against clinical isolates of linezolid-resistant coagulase-negative staphylococci and methicillin-resistant Staphylococcus aureus

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Biterapia inmunosupresora efectiva e innovadora en un síndrome opsoclono-mioclono-ataxia paraneoplásico e inusual del adulto / Innovative and effective immunosuppressive bitherapy for an unusual paraneoplastic opsoclonus-myoclonus-ataxia syndrome of the adult

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Dyslipidemia: Genetics, lipoprotein lipase and HindIII polymorphism.

The direct link between lipid metabolism alterations and the increase of cardiovascular risk are well documented. Dyslipidemias, including isolated high LDL-c or mixed dyslipidemia, such as those seen in diabetes (hypertriglyceridemia, high LDL-c or low HDL-c), correlate with a significant risk of cardiovascular and cerebrovascular disease worldwide.  This review analyzes the current knowledge concerning the genetic basis of lipid metabolism alterations, emphasizing lipoprotein lipase gene mutations and the HindIII polymorphism, which are associated with decreased levels of triglycerides and LDL-c, as well as higher levels of HDL-c. These patterns would be associated with decreased global morbidity and mortality, providing protection against cardiovascular and cerebrovascular diseases.

Disfunción tiroidea subclínica / Subclinical thyroid dysfunction

La disfunción tiroidea subclínica es una alteración funcional de alta prevalencia en las consultas médicas de los centros de salud, observable solo mediante la realización de pruebas complementarias de laboratorios, caracterizadas por una elevación de la TSH mayor a 4.0mU/L ó menor a 0.4mU/L con valores normales de T3 y T4 libres, aunque existe la tendencia actual a la disminución de estos rangos de referencia según estudios epidemiológicos en cada población en particular; su tratamiento y control por el especialista son mandatorios en aquellos individuos con valores séricos de TSH superiores a 10mU/L ó menores de 0.1mU/L. La presente revisión bibliográfica tiene como propósito resumir los conocimientos actuales con relación a la prevalencia, factores de riesgo, diagnóstico, clasificación, tratamiento y seguimiento de las patologías incluidas en la disfunción tiroidea subclínica (hipotiroidismo e hipertiroidismo) y sus consecuencias sistémicas(AU)

Thyroid dysfunction is highly prevalent in the health consultation and it is only proven by laboratory essays, were TSH is higher than 4 mU/L, with a normal T3 and free T4; although there is a current tendency to take in account lower values depending of the epidemiological studies of each population. The diagnosis and treatment are mandatory in subjects with a TSH higher than 10 mU/L or lower than 0,1mU/L. This review has the purpose of summarizing the current knowledge of prevalence, risk factors, diagnosis, treatment and follow-up of hypo and hyperthyroidism, as well as their sistemic consequences(AU)

Atypical Kaposi's sarcoma in young inmunocompetent patient

Abstract: Kaposi´s sarcoma is a rare tumor associated with human herpes virus 8 (HHV-8) infection. Four main clinical subtypes have been described. This study reports on a form of KS in an HIV negative and immunocompetent middle-aged man. The only remarkable factor is that he has sex with other men. This form of Kaposi´s sarcoma is rare. It occurs more in younger patients than in the classic form, is limited to the skin, and is associated with a good prognosis. The means of transmission of the virus is through saliva in oroanal or orogenital sexual practices. Mechanisms of tumor development are still not well known. Given the possible increased number of this variant, it would be interesting to extend this study.

Phylodynamic and Phylogeographic Profiles of Subtype B HIV-1 Epidemics in South Spain.

BACKGROUND: Since 1982, HIV-1 epidemics have evolved to different scenarios in terms of transmission routes, subtype distribution and characteristics of transmission clusters. We investigated the evolutionary history of HIV-1 subtype B in south Spain. PATIENTS & METHODS: We studied all newly diagnosed HIV-1 subtype B patients in East Andalusia during the 2005-2012 period. For the analysis, we used the reverse transcriptase and protease sequences from baseline resistance, and the Trugene® HIV Genotyping kit (Siemens, Barcelona, Spain). Subtyping was done with REGA v3.0. The maximum likelihood trees constructed with RAxML were used to study HIV-1 clustering. Phylogeographic and phylodynamic profiles were studied by Bayesian inference methods with BEAST v1.7.5 and SPREAD v1.0.6. RESULTS: Of the 493 patients infected with HIV-1 subtype B, 234 grouped into 55 clusters, most of which were small (44 clusters ≤ 5 patients, 31 with 2 patients, 13 with 3). The rest (133/234) were grouped into 11 clusters with ≥ 5 patients, and most (82%, 109/133) were men who have sex with men (MSM) grouped into 8 clusters. The association with clusters was more frequent in Spanish (p = 0.02) men (p< 0.001), MSM (p<0.001) younger than 35 years (p = 0.001) and with a CD4+ T-cell count above 350 cells/ul (p<0.001). We estimated the date of HIV-1 subtype B regional epidemic diversification around 1970 (95% CI: 1965-1987), with an evolutionary rate of 2.4 (95%CI: 1.7-3.1) x 10-3 substitutions/site/year. Most clusters originated in the 1990s in MSMs. We observed exponential subtype B HIV-1 growth in 1980-1990 and 2005-2008. The most significant migration routes for subtype B went from inland cities to seaside locations. CONCLUSIONS: We provide the first data on the phylodynamic and phylogeographic profiles of HIV-1 subtype B in south Spain. Our findings of transmission clustering among MSMs should alert healthcare managers to enhance preventive measures in this risk group in order to prevent future outbreaks.

Diplopía vertical binocular tras laberintectomía química con gentamicina. A propósito de un caso y revisión de la literatura / Binocular vertical diplopia following chemical labyrinthectomy with gentamicin: A case report and review of literature

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[Letal endocarditis due to Corynebacterium pseudodiphtheriticum]. / Endocarditis infecciosa fatal por Corynebacterium pseudodiphtheriticum.

We present a case report of a infective endocarditis by Corynebacterium pseudodiphtheriticum in a young patient eight years old with bicuspid aortic valve that led to a severe neurological embolism and death. Corynebacterium pseudodiphtheriticum is part of the nasopharyngeal and skin flora. However, there are cases reported of endocarditis usually associated with immunocompromised patients that mostly presented a poor clinical outcome.

Endocarditis infecciosa fatal por Corynebacterium pseudodiphtheriticum / Letal endocarditis due to Corynebacterium pseudodiphtheriticum

We present a case report of a infective endocarditis by Corynebacterium pseudodiphtheriticum in a young patient eight years old with bicuspid aortic valve that led to a severe neurological embolism and death. Corynebacterium pseudodiphtheriticum is part of the nasopharyngeal and skin flora. However, there are cases reported of endocarditis usually associated with immunocompromised patients that mostly presented a poor clinical outcome.

Se presenta el caso clínico de una endocarditis infecciosa por Corynebacterium pseudodiphtheriticum en un niño de 8 años, portador de una valvulopatía aórtica bicúspide, que falleció por una embolia cerebral grave. Corynebacterium pseudodiphtheriticum forma parte de la microbiota de la piel y nasofaringe. Sin embargo, se han descrito casos de endocarditis en pacientes inmunocomprometidos, asociados, en su mayoría, a una mala evolución clínica.

Los estudios de resistencias a antirretrovirales como herramienta para el análisis de los clusters de transmisión del virus de la inmunodeficiencia humana / Study of human immunodeficiency virus transmission chains in Andalusia: Analysis from baseline antiretroviral resistance sequences

INTRODUCCIÓN Y OBJETIVO: Las secuencias de proteasa y transcriptasa reversa del VIH-1 aportan una información muy valiosa para el manejo de la infección por VIH, más allá de la información de resistencias a los antirretrovirales. En nuestro estudio la hemos utilizado para evaluar las cadenas de transmisión, la transmisión de resistencias entre ellos, y para conocer la distribución espacial de los diferentes subtipos utilizando técnicas de georreferenciación. MÉTODOS: Hemos estudiado 693 pacientes diagnosticados de VIH-1 durante el periodo 2005-2012, todos ellos residentes en Andalucía Oriental. La secuencia del gen pol (transcriptasa reversa y proteasa) se generó utilizando Trugene® HIV Genotyping Kit (Siemens, NAD). La historia evolutiva fue inferida a través de MEGA 5.2 mediante el método de Neighbor-Joining. Para la filogeografía y el estudio de resistencias utilizamos ArcGIS y REGA. RESULTADOS: Doscientos noventa y ocho pacientes se asociaron en 77 clusters diferentes. La mayoría de los cluster estaban formados por parejas (n = 49), de hombres que practican sexo con hombres (n = 26), de nacionalidad española (n = 37), con una edad menor a 45 años (73,5%). Las áreas de mayor heterogeneidad de subtipos fueron el área metropolitana de Granada y las zonas de costa de Almería y Granada. Hemos encontrado 5 cluster con más de 10 individuos. En 15 cluster detectamos mutaciones de resistencia. CONCLUSIONES: Presentamos datos que demuestran que el estudio epidemiológico de los diferentes clusters de transmisión de VIH mediante análisis filogenético se presenta como una herramienta potente y de gran utilidad para la vigilancia y control epidemiológico de la propagación del VIH, que puede ayudar a diseñar actuaciones eficaces para prevenir la diseminación del VIH

INTRODUCTION AND OBJECTIVE: Protease and reverse transcriptase HIV-1 sequences provide useful information for patient clinical management, as well as information on resistance to antiretrovirals. The aim of this study is to evaluate transmission events, transmitted drug resistance, and to georeference subtypes among newly diagnosed patients referred to our center. METHODS: A study was conducted on 693 patients diagnosed between 2005 and 2012 in Southern Spain. Protease and reverse transcriptase sequences were obtained for resistance to cART analysis with Trugene® HIV Genotyping Kit (Siemens, NAD). MEGA 5.2, Neighbor-Joining, ArcGIS and REGA were used for subsequent analysis. RESULTS: The results showed 298 patients clustered into 77 different transmission events. Most of the clusters were formed by pairs (n = 49), of men having sex with men (n = 26), Spanish (n = 37), and below 45 years of age (73.5%). Urban areas from Granada, and the coastal areas of Almeria and Granada showed the greatest subtype heterogeneity. Five clusters were formed by more than 10 patients, and 15 clusters had transmitted drug resistance. CONCLUSIONS: The study data demonstrate how the phylogenetic characterization of transmission clusters is a powerful tool to monitor the spread of HIV, and may contribute to design correct preventive measures to minimize it

Sensibilidad in vitro a ceftarolina de Staphylococcus aureus / In vitro sensitivity to ceftaroline of Staphylococcus aureus

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