Early diverting stoma closure is feasible and safe: results from a before-and-after study on the implementation of an early closure protocol at a tertiary referral center.

BACKGROUND: Evidence on early closure (EC) of defunctioning stoma (DS) after colorectal surgery shows a favorable effect when patients are carefully selected. Therefore, a clinical pathway adapted to the implementation of an EC strategy was developed in our center. The aim of this study was to carry out a comparative analysis of time until DS closure and DS-related morbidity before and after the implementation of an EC protocol (ECP). METHODS: This study is a before-and-after comparative analysis. Patients were divided into two cohorts according to the observational period: patients from the period before the ECP implementation (January 2015-December 2019) [Period 1] and those from the period after that (January 2020-December 2022) [Period 2]. All consecutive patients subjected to elective DS closure within both periods were eligible. Early closure was defined as the reversal within 30 days from DS creation. Patients excluded from EC or those not closed within 30 days since primary surgery were analyzed as late closure (LC). Baseline characteristics and DS-related morbidity were recorded. RESULTS: A total of 145 patients were analyzed. Median time with DS was shorter in patients after ECP implementation [42 (21-193) days versus 233 (137-382) days, p < 0.001]. This reduction in time to closure did not impact the DS closure morbidity and resulted in less DS morbidity (68.8% versus 49.2%, p = 0.017) and fewer stoma nurse visits (p = 0.029). CONCLUSIONS: The ECP was able to significantly reduce intervals to restoration of bowel continuity in patients with DS, which in turn resulted in a direct impact on the reduction of DS morbidity without negatively affecting DS closure morbidity.

Surgical treatment trends and outcomes for anal fistula: fistulotomy is still accurate and safe. Results from a nationwide observational study.

PURPOSE: The aim of the present study was to analyse current surgical treatment preferences for anal fistula (AF) and its subtypes and nationwide results in terms of success and complications. METHODS: A retrospective multicentre observational cohort study was conducted. The study period was 1 year (2019), with a follow-up period of at least 1 year. A descriptive analysis of patient characteristics and trends regarding technical options was performed. Univariate and multivariate Cox regression models were used to analyse factors associated with healing and faecal incontinence (FI). RESULTS: Fifty-one hospitals were involved, providing data on 1628 patients with AF. At a median follow-up of 18.3 (9.9-28.3) months, 1231 (75.9%) patients achieved healing, while 390 (24.1%) did not; failure was catalogued as persistence in 279 (17.2.0%) patients and as recurrence in 111 (6.8%). On multivariate analysis, factors associated with healing were fistulotomy (OR 5.5; 95% CI 3.8-7.9; p < 0.001), simple fistula (OR 2.1; 95% CI 1.5-2.8; p < 0.001), single tract (HR 1.9; 95% CI 1.3-2.8; p < 0.001) and number of preparatory surgeries (none vs. 3; HR 1.8; 95% CI 1.2-2.8; p = 0.006). Regarding de novo FI, in the multivariate analysis previous anal surgery (OR 1.5, 95% CI 1.0-2.4, p = 0.037), age (OR 1.02, 95% CI 1.00-1.04, p = 0.002) and being female (OR 1.7, 95% CI 1.1-2.5, p = 0.008) were statistically related. CONCLUSIONS: Anal fistulotomy is the most used procedure for AF, especially for simple AF, with a favourable overall balance between healing and continence impairment. Sphincter-sparing or minimally invasive sphincter-sparing techniques resulted in lower rates of healing. In spite of their intended sphincter-sparing design, a certain degree of FI was observed for several of these techniques.

Epidemiology, oncologic results and risk stratification model for metachronous peritoneal metastases after surgery for pT4 colon cancers: results from an observational retrospective multicentre long-term follow-up study.

PURPOSE: Metachronous peritoneal metastases (MPM) following a curative surgery procedure for pT4 colon cancer is a challenging condition. Current epidemiological studies on this topic are scarce. METHODS: A retrospective multicentre trial was designed. All consecutive patients who underwent operations to treat pT4 cancers between 2015 and 2017 were reviewed. Demographic, clinical, operative, pathological and oncological follow-up variables were included. MPM were described as any oncological disease at the peritoneum, clearly different from a local recurrence. Univariate and multivariate Cox regression models were constructed. A risk stratification model was created on a cumulative factor basis. According to the calculated hazard ratio (HR), a scoring system was designed (HR < 3, 1 point; HR > 3, 2 points) and a scale from 0 to 6 was calculated for peritoneal disease-free rate (PDF-R). A risk stratification model was also created on the basis of these calculations. RESULTS: Fifty different hospitals were involved, which included a total of 1356 patients. Incidence of MPM was 13.6% at 50 months median follow-up. The strongest independent risk factors for MPM were positive pN stage [HR 3.72 (95% CI 2.56-5.41; p < 0.01) for stage III disease], tumour perforation [HR 1.91 (95% CI 1.26-2.87; p < 0.01)], mucinous or signet ring cell histology [HR 1.68 (95% CI 1.1-2.58; p = 0.02)], poorly differentiated tumours [HR 1.54 (95% CI 1.1-2.2; p = 0.02)] and emergency surgery [HR 1.42 (95% CI 1.01-2.01; p = 0.049)]. In the absence of additional risk factors, pT4 tumours showed 98% and 96% PDF-R in 1-year and 5-year periods based on Kaplan-Meier curves. CONCLUSIONS: Cumulative MPM incidence was 13.6% at 5-year follow-up. The sole presence of a pT4 tumour resulted in high rates of PDF-R at 1-year and 5-year follow-up (98% and 96% respectively). Five additional risk factors different from pT4 status itself were identified as possible MPM indicators during follow-up.

Local tumor regrowth after clinical complete response following neoadjuvant therapy for rectal cancer: what happens when organ preservation falls short.

Organ preservation strategies, especially watch and wait, after neoadjuvant treatment in locally advanced rectal cancer, have become topics that generate significant interest, for both patients and clinicians. The obvious advantage of these strategies is the avoidance of surgery with its associated risks and functional consequences. Over time, it has become evident that these strategies offer acceptable safety in oncological terms and, in most patients, allows preservation of the rectum without harming patients in terms of distant metastasis or survival. However, there is a small group of patients in whom the tumor returns after an initially diagnosed clinical complete response; patients with local tumor regrowth. The main threat in these patients is not simply local disease, which can be successfully managed in most cases, but the possible effects it may have on distant metastases. The pathophysiology of the phenomenon of local tumor regrowth is not well known and, therefore, strategies to minimize possible impact on survival are not well defined. Our aim is to review key issues in this subgroup that pose a substantial threat to the safety and viability of organ-preserving and watch-and-wait strategies. We also explore possible pathophysiologic explanations and future directions and perspectives that may improve both local and systemic disease control.

Ratio de sexo en la descendencia de futbolistas profesionales: estudio preliminar / Sex ratio in the offspring of professional soccer players: preliminary study / Proporção sexual em filhos de jogadores profissionais de futebol: estudo preliminar

OBJETIVO: Analizar si el entrenamiento de alta carga de los deportistas masculinos de élite puede influir en la proporción de sexo de sus descendientes. MÉTODO: Diseño observacional, descriptivo y transversal. Participaron 15 futbolistas, siendo condición necesaria que en el momento del estudio se encontrasen deportivamente activos, sin problemas de fertilidad y con descendencia. Las variables de estudio fueron el sexo de la descendencia, el número de hijos y el orden de nacimiento, y cargas de volumen e intensidad. El análisis estadístico consistió en relacionar las variables de carga, volumen e intensidad de ejercicio físico, con el sexo de los hijos, a través de la prueba de Ji cuadrado, teniendo en cuenta un nivel de significación p < 0.05. RESULTADOS: La descendencia fue de 28 hijos (13 niños, 15 niñas). El análisis de volumen e intensidad no reflejó diferencias significativas en la proporción niño/niña (p = 0.935; p = 0.296 respectivamente). En cambio, dentro de la población de niñas nacidas se observaron más nacimientos como consecuencia del entrenamiento de alta intensidad (p = 0.037). CONCLUSIONES: Este es el primer artículo hasta la fecha que evalúa la influencia del ejercicio físico de alta carga sobre el sexo de la descendencia de varones deportistas. Pese a que el número de niñas no ha sido significativamente mayor al de niños, se observa mayor número de niñas nacidas cuando el entrenamiento es de alta intensidad

OBJECTIVE: To analyze whether the high load training of elite male athletes can influence the sex ratio of their offspring. METHOD: Observational, descriptive cross-sectional study. Fifteen male soccer players participated from the study according to the following criteria at the time of the study: being engaged in sports practice and competition, no fertility issues and live offspring. The study variables were the sex of the offspring, the number of children and the order of birth, and volume and intensity loads. The statistical analysis consisted in relating the variables of volume and intensity load with frequency tables by means of the Chi square test, with margin of error p <0.05. RESULTS: The offspring was 28 children (13 boys, 15 girls). Volume and intensity analysis did not show significant differences in the boy/girl ratio (p = 0.935, p = 0.296 respectively). In contrast, within the population of girls, more births were observed as a consequence of high intensity training (p = 0.037). CONCLUSIONS: This is the first article to date that assesses the influence of high-load physical exercise on the sex of the offspring of male athletes. Although the number of girls has not been significantly greater than that of boys, there is a greater number of girls born when the training is of high intensity

OBJETIVO: Analisar se o treinamento de alta carga de atletas de elite do sexo masculino pode influenciar na proporção sexual de seus descendentes. MÉTODO: Estudo observacional, transversal e descritivo. Quinze jogadores de futebol do sexo masculino participaram do estudo de acordo com os seguintes critérios na época do estudo: estar envolvido na prática de esportes e competição, sem problemas de fertilidade e prole viva. As variáveis de estudo foram o sexo da prole, o número de filhos e a ordem de nascimento e as cargas de volume e intensidade. A análise estatística consistiu em relacionar as variáveis de volume e intensidade da carga com tabelas de frequência por meio do teste Qui-quadrado, com margem de erro p <0,05. RESULTADOS: A prole foi de 28 crianças (13 meninos e 15 meninas). A análise de volume e intensidade não mostrou diferenças significativas na relação menino / menina (p = 0,935, p = 0,296 respectivamente). Por outro lado, na população de meninas, mais nascimentos foram observados como consequência do treinamento de alta intensidade (p = 0,037). CONCLUSÕES: Este é o primeiro artigo até o momento que avalia a influência do exercício físico de alta carga sobre o sexo de filhos de atletas do sexo masculino. Embora o número de meninas não tenha sido significativamente maior que o de meninos, há um maior número de meninas nascidas quando o treinamento é de alta intensidade

Sperm DNA fragmentation as a result of ultra-endurance exercise training in male athletes.

Intensive sports practice seems to exert negative effects on semen parameters; in order to assess these effects, the objective of this study was to assess semen, including DNA fragmentation, and hormone parameters in elite triathletes. Twelve high-level triathletes preparing for a National Triathlon Championship participated in the study. The qualitative sperm parameters analysed were volume, sperm count, motility, morphology and DNA fragmentation; when needed, additional testing was performed. Assessed hormones were testosterone (T), cortisol (C) and testosterone-cortisol ratio (T/C). Maximum oxygen consumption and training characteristics were also assessed. Hormonal values and physical semen parameters were within normal ranges. DNA fragmentation showed high values (20.4 ± 6.1%). Round cells in semen were higher than normal (2.8 ± 1.5 million/ml), with the presence of macrophages. Correlations were found for several parameters: concentration of round cells positively correlated with progressive sperm motility (p = .01) and sperm morphology (p = .02); contrarily, the correlation found with DNA fragmentation was negative (p = .04). Sperm DNA fragmentation and the T/C ratio, however, were correlated in a positive manner (p = .03). As evidenced by the observed results, sperm DNA fragmentation is affected by high-level sports practice; therefore, high loads of endurance training could potentially interfere with the athlete's fertility potential.

Intraepithelial lymphocytes subsets in different forms of celiac disease.

AIM: The enumeration of intraepithelial lymphocytes subsets (total, γδ, and CD3(-) IELs) by flow cytometry (FCM), named as IEL lymphogram, constitutes a useful tool for celiac disease (CD) diagnosis. The aim of this study was to quantify IELs by FCM and their diagnostic value to differentiate active, silent and potential CD. METHODS: Prospective study of 60 active and 20 silent CD patients, and 161 controls in which duodenal biopsy and IEL quantification by FCM was performed. RESULTS: Active and silent CD patients had significant higher levels of both total and γδ IELs than absent CD patients (P < 0.0001 and P < 0.0001, P = 0.012 and P < 0.011; respectively). Active and silent CD patients had significant lower levels of CD3(-) IELs than absent CD patients (P < 0.047 and P < 0.009, respectively). Moreover, they were lower in silent than in active CD patients (P = 0.002). Changes of IELs subsets were more marked in children than adults active CD. The optimal IEL lymphogram cut off values for active CD diagnosis were: ≥10, ≥15 and ≤9 %, and with better performance characteristics for silent CD: ≥ 11, ≥10 and ≤5 %. CONCLUSION: The evaluation of IELs subsets by FCM is useful to confirm diagnosis of active and silent CD.

Findings on sperm alterations and DNA fragmentation, nutritional, hormonal and antioxidant status in an elite triathlete. Case report / Hallazgo de alteraciones en semen, nutricionales, hormonales, del estado antioxidante y fragmentación de ADN en un triatleta de élite. Caso clínico / Descoberta das alterações no sêmen, nutricionais, hormonais, o antioxidante status e fragmentação de DNA em triatleta de elite. Relato do caso

Objective. The present case study analyzes semen quality, nutritional patterns, and hormonal and oxidative status of an international high-level triathlete with a low-volume, high-intensity training load. Method. The athlete was 26 years old, having participated in competitions since he was 13 years old, and practiced professional triathlon for the last five years. The qualitative sperm parameters analyzed were volume, sperm count, motility, morphology, and DNA fragmentation (additional testing performed as needed). Salivary hormones measured were T, C, and T/C. Seminal plasma total antioxidant capacity was measured. Maximum oxygen consumption and training characteristics were assessed. To determine habitual food intake and its possible repercussion on oxidative status, a quali-quantitative frequency questionnaire of 136 different foods was used and subsequently analyzed using specific software. Results. Hormonal and physical semen parameters were within normal ranges. Sperm morphology and DNA fragmentation showed abnormal values (3.9% and 38.33%). Round cells in semen were higher than normal (2.3 million/ml), with presence of macrophages. Apoptotic and necrotic events were observed. Total antioxidant capacity, although not compromised, was low. Dietetic intake was characterized by excess protein and appropriate overall antioxidant intake (with slight deficit and excess of some specific nutrients) according to recommended values. Conclusions. In this high-intensity endurance athlete, sperm parameters, mainly sperm morphology and DNA fragmentation, are altered. Further knowledge is needed with regards nutritional antioxidant intake and other dietetic strategies oriented toward avoiding oxidative damage in semen of high-performance triathletes. Moreover, adequate nutritional strategies must be found and nutritional advice given to athletes so as to palliate or dampen the effects of exercise on semen quality (AU)

Objetivo. El presente estudio de caso analiza la calidad de semen, patrones nutricionales y status hormonal y oxidativo de un triatleta internacional de alto nivel con carga de entrenamiento de bajo volumen y alta intensidad. Método. Atleta de 26 años de edad, con una práctica deportiva competitiva desde los 13 años, y cinco años de triatlón profesional. Los parámetros cualitativos analizados en semen fueron: volumen, contaje espermático, motilidad, morfología, y fragmentación de ADN, con pruebas adicionales según necesidad. Las hormonas salivares cuantificadas fueron: T, C, y T/C. La capacidad antioxidante total fue medida en plasma seminal. También se analizó el consumo máximo de oxígeno y características de entrenamiento. Para determinar la ingesta alimentaria habitual y su posible repercusión sobre el estado oxidativo, se utilizó un cuestionario de frecuencia de consumo cuali-cuantitativa, de 136 alimentos, analizado mediante software informático. Resultados. Los valores hormonales y parámetros físicos seminales estaban dentro de la normalidad. La morfología y fragmentación de ADN espermático mostraron valores anormales (3.9% y 38.33%). Aparecía un elevado número de células redondas (2.3 millones/mL), con presencia de macrófagos. Se observaron eventos apoptóticos y necróticos. La capacidad antioxidante total, aunque no alterada, estaba baja. La ingesta dietética se caracterizó por un exceso proteico y consumo adecuado de antioxidantes (con ligero déficit y exceso de algunos nutrientes específicos), según valores recomendados. Conclusiones. El ejercicio de resistencia de alta intensidad altera los parámetros espermáticos, principalmente morfología y fragmentación de ADN. Es necesario obtener mayor información sobre el efecto de antioxidantes y otras estrategias dietéticas con relación al daño oxidativo en el semen de triatletas de alto rendimiento, al igual que hallar estrategias nutricionales adecuadas para paliar o amortiguar los efectos del ejercicio sobre la calidad del semen (AU)

Objetivo: O presente estudo de caso analisa a qualidade de sêmen, padrões nutricionais, estado hormonal e oxidativo de um triatleta internacional de alto nível com carga de treinamento de baixo volume e alta intensidade. Método: Atleta de 26 anos de idade, com uma pratica esportiva desde os 13 anos e cinco anos de triátlon profissional. Os parâmetros qualitativos analisados no sêmen foram: volume, contagem espermática, motilidade, morfologia, e fragmentação de DNA com testes adicionais dada necessidade. Os testes hormonais salivares foram: Testosterona, Cortisol e a razão testosterona/cortisol. A capacidade antioxidante total foi medida no plasma seminal. Também foi analisado o consumo máximo de oxigênio e características do treinamento. Para determinar a ingesta alimentar habitual e sua possível repercussão sobre o estado oxidativo, foi utilizado um questionário de frequência de consumo quali-quantitativo de 136 alimentos, a partir do uso de um software especifico. Resultados: os valores e parâmetros hormonais e físicos seminais estavam dentro da normalidade. A morfologia e fragmentação do DNA espermático mostraram valores anormais (3,9% e 38,33%). Apresentando um elevado número de células redondas (2,3 milhoes/mL), com presença de macrófagos. Se observaram eventos apoptóticos e necróticos. A capacidade antioxidante total, ainda que não alterada, estava baixa. A ingesta dietética foi caracterizada por um excesso proteico e consumo adequado de antioxidantes (com ligeiro déficit excesso de alguns nutrientes específicos) segundo valores recomendados. Conclusões: o exercício de resistência de alta intensidade altera os parâmetros espermáticos, principalmente morfologia e fragmentação do DNA. Faz-se necessário obter maiores informações sobre o efeito de antioxidantes e outras estratégias dietéticas com relação ao dano oxidativo no sêmen de triatletas de alto rendimento, e traçar estratégias nutricionais adequadas para atenuar os efeitos do exercício sobre a qualidade do sêmen

Peri-ileostomy pyoderma gangrenosum. Case report.

Pyoderma gangrenosum is one of the most severe complications that can occur following stoma placement. Despite few cases reported in the literature, it is considered an underdiagnosed entity. We present a case of peri-ileostomy pyoderma gangrenosum (PPG) in a patient who underwent a pancoloproctectomy and permanent ileostomy due to ulcerative colitis (UC). Treatment was based on local cures, proper fitting of ostomy devices, topical tacrolimus and systemic corticosteroids, adalimumab and antibiotics. Satisfactory resolution was achieved in eight weeks.

Colloids for fluid resuscitation: what is their role in patients with shock?

BACKGROUND: Fluid therapy is widely used in critically ill patients to restore effective intravascular volume and improve organ perfusion. Recent studies have questioned the administration of colloid-based solutions, especially if containing hydroxyethyl starch (HES), in different ICU populations; however, there is still uncertainty on the use of colloids as initial fluid therapy for early resuscitation. METHODS: The aim of this study was to investigate the effect of two different resuscitation fluid strategies on the mortality of patients with shock. In a multicentric (57 ICUs), controlled, open-label trial (from February 2003 to August 2012), the authors randomized patients with signs of acute hypovolemia, defined by the combination of hypotension, evidence of low filling pressures or cardiac index and at least two signs of tissue hypoperfusion (such as altered consciousness, mottled skin, oliguria, lactate levels > 2 mmol/L), to received either a colloid- or crystalloid-based therapy. Both cohorts received maintenance fluids consisting in isotonic crystalloids and albumin in case of severe hypoalbuminemia (<2 g/dL). Exclusion criteria included previous fluid therapy, pregnancy, brain death, extended burns, chronic hemodialysis or liver disease, known coagulopathy, acute anaphylaxis, dehydration and hypotension due to sedative drugs. RESULTS: Among the 6498 eligible patients, 2857 were eventually randomized in one of the two groups. The 28-day mortality was 25.4% in the colloid and 27.0% in the crystalloid group (P=0.26). In the sub-group analysis, similar mortality rates were reported for shock due to hypovolemia, sepsis or trauma. Also, the use of continuous renal replacement therapy was similar between groups (11.0% vs. 12.5%, P=0.19). There were more days alive without mechanical ventilation or vasopressors during the first 7 and 28 days and a lower 90-day mortality in the colloid group. CONCLUSION: These data suggest that mortality was not increased and probably decreased with the use of colloids in different forms of shock requiring early fluid resuscitation. We discussed herein some methodological issues that may explain the discrepancies of this trial with the other studies developed in the same field.

An imbalance between frequency of CD4+CD25+FOXP3+ regulatory T cells and CCR4+ and CCR9+ circulating helper T cells is associated with active perennial allergic conjunctivitis.

Allergic conjunctivitis (AC) is one of the most common eye disorders in ophthalmology. In mice models, it has been suggested that control of allergic conjunctivitis is a delicate balance between Tregs and inflammatory migrating effector cells. Our aim was to evaluate the frequency of Tregs and the frequency of homing receptors expressing cells in peripheral blood mononuclear cells (PBMC) from patients with perennial allergic conjunctivitis (PAC). The analyses of phenotypic markers on CD4+ T cells and both soluble or intracellular cytokines were performed by flow cytometry. CD4+CD25+ cells were 15 times more frequent in PBMC from patients than HC; the vast majority of these CD4+CD25+ cells were FOXP3-, and most of CD4+ T cells were CCR4+ and CCR9+ cells. Upon allergen-stimulation, no significant changes were observed in frequency of Treg; however, an increased frequency of CD4+CCR4+CCR9+ cells, CD4+CD103+ cells and CD4+CD108+ cells with increased IL-5, IL-6, and IL-8 production was observed. These findings suggest an immune dysregulation in PAC, characterized by diminished frequency of Tregs and increased frequency of circulating activated CD4+ T cells; upon allergen-stimulation, these cells were expressing cell-surface molecules related to mucosa homing and were able to trigger an inflammatory microenvironment.

A constant-momentum/energy-selector time-of-flight mass spectrometer.

A matrix assisted laser desorption/ionization time-of-flight mass spectrometer has been built with an ion source that can be operated in either constant-energy or constant-momentum acceleration modes. A decreasing electric field distribution in the ion-accelerating region makes it possible to direct ions onto a space-focal plane in either modes of operation. Ions produced in the constant-momentum mode have velocities and, thus, flight times that are linearly dependent on mass and kinetic energies that are inversely dependent on mass. The linear mass dispersion doubles mass resolving power of ions accelerated with space-focusing conditions in constant-momentum mode. The mass-dependent kinetic energy is exploited to disperse ions according to mass in a simple kinetic energy filter constructed from two closely spaced, oblique ion reflectors. Focusing velocity of ions of the same mass can substantially improve ion selection for subsequent post source decay or tandem time-of-flight analyses.

[Expression of B7 molecules and TLR-9 on corneal epithelial cells infected with adenovirus: clinico-pathological implications in viral keratoconjunctivitis]. / Expresión de moléculas B7 y TLR:9 en células epiteliales corneales infectadas con adenovirus: implicaciones clínico-patológicas en la queratoconjuntivitis viral.

PURPOSE: B7 molecules are a family of proteins that co-stimulate T cells during immune activation. Normally the corneal epithelial cells (CEC) do not express these molecules on their cell surface. Toll-like receptors play an important role in the innate immune response to invading pathogens and recently have been demonstrated to be expressed on mice cornea. The objective of this study was to determine whether adenoviral infection induces B7 molecules and TLR9 on human CEC. METHODS: CEC were isolated from human corneas treated with dispase-II, and grown in the presence of supplemented hormonal epithelial medium until confluence. Then CEC were then infected with adenovirus 5 (Ad5) and cultured for different times. The CEC were then recovered and stained against human CD80, CD86, TLR-9 and cytokeratin. All cells were analyzed by flow cytometry. RESULTS: Ad5 infection of CEC induced the expression of B7 molecules and TLR-9 after 24 hours in culture, rising to maximum levels at 72 hours. B7 expression at 72 hours was as follows: CD80 expression on infected CEC was 62% (standard error [SE] 2.6) versus 3% (SE 1.2) on non-infected CEC (p<0.001); CD86 expression on infected CEC was 95% (SE 2.1) versus 5% (SE 1.2) on non-infected CEC (p<0.001). TLR-9 expression at 72 hours was 80% (SE 1.2) on infected CEC versus 5% (SE 1) on non-infected CEC (p<0.001). CONCLUSIONS: Ad5 infection induced the expression of B7 molecules and TLR-9 on CEC.

Expresión de moléculas B7 y TLR:9 en células epiteliales corneales infectadas con adenovirus: implicaciones clínico-patológicas en la queratoconjuntivitis viral / Expression of B7 molecules and TLR-9 on corneal epithelial cells infected with adenovirus: clinico-pathological implications in viral keratoconjunctivitis

Objetivo: Las moléculas B7 son una familia deproteínas que coestimulan al linfocito T durante laactivación inmunitaria, normalmente las célulasepiteliales corneales (CEC) no expresan estas moléculasen superficie. Los receptores tipo Toll jueganun papel importante en la respuesta inmune innatahacia patógenos invasores y recientemente sedemostró su expresión en córneas de ratón. El objetivodel presente estudio fue determinar si la infecciónviral induce moléculas B7 y TLR9 en CEChumanas.Métodos: Las CEC fueron obtenidas de corneashumanas tratadas con dispasa II y crecidas en presenciade medio hormonal epitelial suplementadohasta su confluencia. Posteriormente las células fueron infectadas con adenovirus 5 (Ad5) y cultivadasa diferentes tiempos. Las CEC fueron recuperadasy marcadas contra CD80, CD86, TLR-9 y citoqueratina.Todas las células fueron analizadas porcitometría de flujo.Resultados: La infección de CEC con Ad5 indujola expresión de moléculas B7 y TLR-9 desde las 24h, alcanzando su máximo nivel a las 72 h. La expresiónde moléculas B7 a las 72 h fue como sigue,expresión de CD80 en CEC infectadas 62% errorestándar (ES) 2.6 versus 3 ES 1.2 (p < 0,001) enCEC no infectadas; expresión de CD86 en CECinfectadas 95% ES 2.1 versus 5% ES 1.2 (p <0,001) en CEC no infectadas. La expresión de TLR-9 a las 72 h fue de 80% ES 1.2 en CEC infectadasversus 5% ES 1 en CEC no infectadas (p < 0,001).Conclusiones: La infección por Ad5 induce laexpresión de moléculas B7 y TLR-9 en CEC

Purpose: B7 molecules are a family of proteins that co-stimulate T cells during immune activation. Normally the corneal epithelial cells (CEC) do not express these molecules on their cell surface. Tolllike receptors play an important role in the innate immune response to invading pathogens and recently have been demonstrated to be expressed on mice cornea. The objective of this study was to determine whether adenoviral infection induces B7 molecules and TLR9 on human CEC. Methods: CEC were isolated from human corneas treated with dispase-II, and grown in the presence of supplemented hormonal epithelial medium until confluence. Then CEC were then infected with adenovirus 5 (Ad5) and cultured for different times. The CEC were then recovered and stained against human CD80, CD86, TLR-9 and cytokeratin. All cells were analyzed by flow cytometry. Results: Ad5 infection of CEC induced the expression of B7 molecules and TLR-9 after 24 hours in culture, rising to maximum levels at 72 hours. B7 expression at 72 hours was as follows: CD80 expression on infected CEC was 62% (standard error [SE] 2.6) versus 3% (SE 1.2) on non-infected CEC (p<0.001); CD86 expression on infected CEC was 95% (SE 2.1) versus 5% (SE 1.2) on non-infected CEC (p<0.001). TLR-9 expression at 72 hours was 80% (SE 1.2) on infected CEC versus 5% (SE 1) on non-infected CEC (p<0.001). Conclusions: Ad5 infection induced the expression of B7 molecules and TLR-9 on CEC

Crystallization, data collection and phasing of the molybdate-binding protein of the phytopathogen Xanthomonas axonopodis pv. citri.

Xanthomonas axonopodis pv. citri ModA protein is the ABC periplasmic binding component responsible for the capture of molybdate. The protein was crystallized with sodium molybdate using the hanging-drop vapour-diffusion method in the presence of PEG or sulfate. X-ray diffraction data were collected to a maximum resolution of 1.7 A using synchrotron radiation. The crystal belongs to the orthorhombic space group C222(1), with unit-cell parameters a = 68.15, b = 172.14, c = 112.04 A. The crystal structure was solved by molecular-replacement methods and structure refinement is in progress.

[Small-cell laryngeal neuroendocrine carcinoma. A case report and review of literature]. / Carcinoma neuroendocrino de células pequeñas localizadas en la laringe. Presentación de un caso clínico y revisión de la literatura.

A case of small-cell carcinoma of larynx was diagnosed in a 48-year-old man. This is an unusual laryngeal carcinoma (the incidence is lower than 1% of all carcinomata in this location). We analyzed some clinical and histopathological aspects of these carcinomata and some prognostic and therapeutic factors. A bibliographic review was made.

[Dermatophytes isolated in our clinics. 5-year-study in Zaragoza]. / Dermatófitos aislados en muestras clínicas. Estudio de 5 años en Zaragoza.

BACKGROUND: This review summarizes the different species of dermatophytes isolates in our laboratory between 1991 and 1995. We describe the clinical forms and establish the distribution over this period of time. METHODS: Retrospective survey of samples from outpatients of the Dermatology Service in Miguel Servet Hospital where mycologic cultures are required. The extraction of samples is made by scrapes with a carpet or scalpel and they are cultured on Saboureaud agar with chloramphenicol and dermatophytes agar for 3 weeks. All plates were incubated at 28 degrees C. The identification of isolated strains is made by means of morphologic and physiologic criteria; the doubtful strains were identified in national referral center of Majadahonda CNMVISS. RESULTS: 4004 samples were analyzed from 3934 patients and 543 strains of dermatophytes were isolated. The frequencies were as follow: Microsporum canis (44%), Trichophyton mentagrophytes (31.4%), Trichophyton rubrum (18.6%), Epidermophyton floccosum (2.6%), Microsporum gypseum (1.4%), Trichophyton tonsurans (0.7%), Trichophyton verrucosum (0.7%), Trichophyton violaceum (0.2%) y Microsporum audouinii (0.2%). The most frequently observed dermatophytoses were Tinea corporis (54.8%), followed by Tinea unguium (12.6%), Tinea capitis (12.5%), Tinea pedis (8.3%), Tinea manuum (6.3%), Tinea cruris (4.7%) and Tinea barbae (0.7%). CONCLUSIONS: The zoophylic species are the most prevalent in our area and we have observed a raise of Microsporum canis in recent years. It is important to perform mycologic survey in every suspected lesion in older to determinate the true incidence of human dermatophytoses.