Synergistic effect of the coculture of Leuconostoc pseudomesenteroides and Lactococcus lactis, isolated from honeybees, on the generation of plant-based dairy alternatives based on soy, pea, oat, and potato drinks.

The production of plant-based dairy alternatives has been majorly focused on the improvement of sensorial, technological and nutritional properties, to be able to mimic and replace milk-based fermented products. The presence of off-flavours and antinutrients, the lack of production of dairy-like flavours or the metabolic inaccessibility of plant proteins are some of the challenges to overcome to generate plant-based dairy alternatives. However, in the present study, it is demonstrated how the synergistic effect of two LAB strains, when cocultured, can simultaneously solve those challenges when fermenting in four different plant-based raw materials: soy, pea, oat, and potato drinks (SPOP). The fermentation was performed through the mono- and co-culture of the two LAB strains isolated from Apis mellifera (honeybee): Leuconostoc pseudomesenteroides NFICC 2004 and Lactococcus lactis NFICC 2005. Firstly, the coculture of both strains demonstrated to increase the acidification rate of the four plant matrices. Moreover, L. pseudomesenteroides (LP) demonstrated to in situ produce high concentrations of mannitol when fructose was present as C-source. Furthermore, L. pseudomesenteroides, which encoded for PII-proteinase, demonstrated to break down SPOP proteins, releasing free amino acids that were used by L.lactis (LL) for growth and metabolism. Lastly, the analysis of their co-metabolic volatile performance showed the principal ability of removal of the main off-flavours found in SPOP, such as hexanal, 1-octen-3-ol, 2-pentylfuran, pentanal, octanal, heptanal, and nonanal, mainly led by L. pseudomesenteroides, as well as the production of dairy-like flavours, such as diacetyl and 3-methyl-1-butanol, triggered by L. lactis metabolism. Overall, these findings endorsed the use of honeybee isolated strains as starter cultures, demonstrated the potential of coupling genotypes and phenotypes of multiple strains to improve the organoleptic properties suggesting a potential of combining plant-based matrices for the generation of future high-quality plant-based dairy alternatives.

Anakinra versus Baricitinib: Different Strategies for Patients Hospitalized with COVID-19.

BACKGROUND: Immunomodulatory drugs have been used in patients with severe COVID-19. The objective of this study was to evaluate the effects of two different strategies, based either on an interleukin-1 inhibitor, anakinra, or on a JAK inhibitor, such as baricitinib, on the survival of patients hospitalized with COVID-19 pneumonia. METHODS: Individuals admitted to two hospitals because of COVID-19 were included if they fulfilled the clinical, radiological, and laboratory criteria for moderate-to-severe disease. Patients were classified according to the first immunomodulatory drug prescribed: anakinra or baricitinib. All subjects were concomitantly treated with corticosteroids, in addition to standard care. The main outcomes were the need for invasive mechanical ventilation (IMV) and in-hospital death. Statistical analysis included propensity score matching and Cox regression model. RESULTS: The study subjects included 125 and 217 individuals in the anakinra and baricitinib groups, respectively. IMV was required in 13 (10.4%) and 10 (4.6%) patients, respectively (p = 0.039). During this period, 22 (17.6%) and 36 (16.6%) individuals died in both groups (p = 0.811). Older age, low functional status, high comorbidity, need for IMV, elevated lactate dehydrogenase, and use of a high flow of oxygen at initially were found to be associated with worse clinical outcomes. No differences according to the immunomodulatory therapy used were observed. For most of the deceased individuals, early interruption of anakinra or baricitinib had occurred at the time of their admission to the intensive care unit. CONCLUSIONS: Similar mortality is observed in patients treated with anakinra or baricitinib plus corticosteroids.

Results from a large cross-sectional study assessing Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis urogenital infections in patients with primary infertility.

Female and male infertility have been associated to Chlamydia trachomatis, Ureaplasma spp. and Mycoplasma hominis urogenital infections. However, evidence from large studies assessing their prevalence and putative associations in patients with infertility is still scarce. The study design was a cross-sectional study including 5464 patients with a recent diagnosis of couple's primary infertility and 404 healthy control individuals from Cordoba, Argentina. Overall, the prevalence of C. trachomatis, Ureaplasma spp. and M. hominis urogenital infection was significantly higher in patients than in control individuals (5.3%, 22.8% and 7.4% vs. 2.0%, 17.8% and 1.7%, respectively). C. trachomatis and M. hominis infections were significantly more prevalent in male patients whereas Ureaplasma spp. and M. hominis infections were more prevalent in female patients. Of clinical importance, C. trachomatis and Ureaplasma spp. infections were significantly higher in patients younger than 25 years. Moreover, Ureaplasma spp. and M. hominis infections were associated to each other in either female or male patients being reciprocal risk factors of their co-infection. Our data revealed that C. trachomatis, Ureaplasma spp. and M. hominis are prevalent uropathogens in patients with couple's primary infertility. These results highlight the importance of including the screening of urogenital infections in the diagnostic workup of infertility.

Macroligadura como tratamiento para hemorroides / Macro-ligation as a hemorrhoid treatment

Introducción: Las hemorroides constituyen una dilatación varicosa de los plexos hemorroidales que involucran la mucosa del recto y ano. Estas constituyen la enfermedad anorrectal más frecuente en el mundo occidental, con una alta prevalencia que suele representar el 50 % de las consultas con el proctólogo. Se pueden describir dos grandes grupos de hemorroides, los internos que son aquellos situados por encima de la línea pectínea y los externos que son los que se encuentran por debajo de esta línea, se tendrán en cuenta los internos. A estos últimos se los clasifica por Goligher en relación con el grado de prolapso de la mucosa rectal y la posibilidad de reducción del prolapso. Para las hemorroides grado II y III se han diseñados diferentes métodos quirúrgicos de tratamiento desde la electrocoagulación, la crioterapia, la terapia fotodinámica y RBL El presente trabajo plantea como objetivo describir nuestros resultados iniciales en el tratamiento de patología hemorroidal por medio de la técnica de macroligadura alta por aspiración RBL. Materiales y Métodos: Se incluyeron 40 pacientes a los que se le realizo RBL, comprendidos desde el mes de octubre de 2016 a marzo de 2018, que presenten patología hemorroidal grado II III y IV, técnica de macroligadura alta por succión. Resultados: Del 63% de femenino y un 37% de masculino, la distribución por grados fue de la siguiente manera, grado 2: 75%, grado 3: 17.5% y grado 4: 7.5%, el dolor posterior al procedimiento en forma inmediata fue de 3.78±2.63, a las 48 hs 2.10±2.31 y a los 7 postquirúrgicos 1.10±1.86. Tuvimos un total de 7 (18%) pacientes con recidivas dentro de los 18 meses de seguimiento, tenesmo se presentó 27.59% en los grados 2, un 57,14% en los grados 3 y un 66,67% en los grados 4. Solo reportamos un 23% de sangrado posquirúrgico. Conclusión: Podemos afirmar que la técnica de macro ligadura alta como variante de la RBL, es una técnica segura, aplicable en forma ambulatoria, con un beneficio importante por sobre el resto de las técnicas resectivas que solo requiere una sedación para el procedimiento, con bajos umbrales de dolor postquirúrgicos, pronta recuperación y reinserción laboral; presenta bajos índices de complicaciones. Además, representa una excelente opción para el tratamiento de las hemorroides grado 2 y 3. (AU)

Introduction: Hemorrhoids are a varicose dilatation of the hemorrhoidal plexuses that involve the mucosa of the rectum and anus. These constitute the most frequent anorectal disease in the western world, with a high prevalence that usually represents 50% of consultations with the proctologist. Two large groups of hemorrhoids can be described; the internal ones that are those located above the pectineal line and the external ones that are those below this line, the internal ones will be taken into account. The latter are classified by Goligher in relation to the degree of prolapse of the rectal mucosa and the possibility of prolapse reduction. For the grade II and III hemorrhoids, different surgical methods of treatment have been designed from electrocoagulation, cryotherapy, photodynamic therapy and RBL. The present work aims to describe our initial results in the treatment of hemorrhoidal pathology by means of the macro-adherence technique. High by RBL aspiration. Materials and Methods: Forty patients were included, who underwent RBL, from October 2016 to March 2018, who presented grade II III and IV hemorrhoidal pathology, high suction macroligation technique. Results: Of 63% of female and 37% of male, the distribution by grades was as follows, grade 2: 75%, grade 3: 17.5% and grade 4: 7.5%, pain after the procedure immediately it was 3.78 ± 2.63, at 48 hours 2.10 ± 2.31 and at 7 postsurgical 1.10 ± 1.86. We had 7 (18%) patients with recurrences within 18 months of follow-up; tenesmo presented 27.59% in grades 2, 57.14% in grades 3 and 66.67% in grades 4. We only reported 23% of postoperative bleeding. Conclusion: We can affirm that the high macro ligature technique as a variant of the RBL is a safe technique, applicable in ambulatory form, with an important benefit over the rest of the resection techniques that only requires a sedation for the procedure, with low postoperative pain thresholds, early recovery and re-employment; It presents low rates of complications. In addition, it represents an excellent option for the treatment of grade 2 and 3 hemorrhoids. (AU)

Modulation of stress- and cocaine prime-induced reinstatement of conditioned place preference after memory extinction through dopamine D3 receptor.

Accumulating evidence indicates that dopamine (DA) D3 receptor (DAD3R) antagonists appear highly promising in attenuating cocaine reward and relapse in preclinical models of addiction. In the present study, we investigated the effects of the selective DAD3R antagonist SB-277011-A on the reinstatement of cocaine-induced conditioned place preference (CPP) produced by a priming dose of cocaine, by social defeat stress and by two kinds of physiological stressors (restraint and tail pinch) in male adult mice. We also explored reinstatement-related plasma corticosterone levels (as marker of stress response) and the effects of blocking DAD3R. Administration of SB-277011-A (24 or 48 mg/kg i.p.) did not modify conditioned reinstatement of cocaine seeking triggered by cocaine prime. By contrast, we found that the vulnerability to reinstatement of the CPP of defeated animals that have undergone CPP extinction was abolished by the DAD3R antagonist (24 mg/kg) given 30 min before the test session. Reactivation of the CPP response produced by physiological stress stimuli was also attenuated by SB-277011-A (48 mg/kg i.p.). On the other hand, the blockade of DAD3R significantly prevented the increased corticosterone release during reinstatement of cocaine-induced CPP that was seen in social defeated animals, in mice suffering physiological stress and after cocaine prime. Present results demonstrate a modulation by DAD3R of the reactivation of the incentive value of cocaine-associated cues induced by social and physiological stress stimuli, which was associated to a glucocorticoid-dependent mechanism. Our results also point to a possible potential therapeutic use of selective DAD3R antagonists for the prevention of stress-induced cocaine-seeking and relapse.

Results of Cryoenergy and Radiofrequency-Based Catheter Ablation for Treating Ventricular Arrhythmias Arising From the Papillary Muscles of the Left Ventricle, Guided by Intracardiac Echocardiography and Image Integration.

BACKGROUND: Catheter radiofrequency ablation of ventricular arrhythmias (VAs) arising from the left ventricle's papillary muscles has been associated with inconsistent results. The use of cryoenergy versus radiofrequency has not been compared yet. This study compares outcomes and complications of catheter ablation of VA from the papillary muscles of the left ventricle with either cryoenergy or radiofrequency. METHODS AND RESULTS: Twenty-one patients (40±12 years old; 47% males; median ejection fraction 59±7.3%) with drug refractory premature ventricular contractions or ventricular tachycardia underwent catheter cryoablation or radiofrequency ablation. VAs were localized using 3-dimensional mapping, multidetector computed tomography, and intracardiac echocardiography, with arrhythmia foci being mapped at either the anterolateral papillary muscle or posteromedial papillary muscles of the left ventricle. Focal ablation was performed using an 8-mm cryoablation catheter or a 4-mm open-irrigated radiofrequency catheter, via transmitral approach. Acute success rate was 100% for cryoenergy (n=12) and 78% for radiofrequency (n=9; P=0.08). Catheter stability was achieved in all patients (100%) treated with cryoenergy, and only in 2 (25%) patients treated with radiofrequency (P=0.001). Incidence of multiple VA morphologies was observed in 7 patients treated with radiofrequency (77.7%), whereas none was observed in those treated with cryoenergy (P=0.001). VA recurrence at 6 months follow-up was 0% for cryoablation and 44% for radiofrequency (P=0.03). CONCLUSIONS: Cryoablation was associated with higher success rates and lower recurrence rates than radiofrequency catheter ablation, better catheter stability, and lesser incidence of polymorphic arrhythmias.

Neuroendoscopic management of middle fossa arachnoid cysts.

OBJECTIVE: The purpose of this study is to analyze symptomatic middle fossa arachnoid cysts and describe the advantages of the endoscopic technique to manage those cases that should be resolved surgically. METHODS: The physiopathology is described, and the clinical manifestations are analyzed. The diagnostic methodology and the surgical indications are presented. The endoscopic surgical technique is described thoroughly, and the advantages of the method are stated based on a series of 28 operated cases. The endoscope of choice has been a rigid endoscope with a 0° lens. RESULTS: All the cases in our series were solved by means of the endoscopic technique. One patient developed meningitis, recovering with antibiotic treatment, and 3 patients developed subdural hygromas: 2 were treated by means of subdural-peritoneal shunting, and the remaining subdural hematoma required surgical drainage. All of the complications reported occurred in patients affected by cysts classified as Galassi type III. There was no mortality. CONCLUSIONS: The effectiveness of neuroendoscopic management of middle fossa arachnoid cysts has not yet been superseded by any other surgical treatment. It has been shown to be a simple, reliable, and fast procedure, with a low rate of complications and shorter hospital stay. In general, patients can resume their usual daily activities quite soon.

A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up.

BACKGROUND: Immediate-function implants have become an accepted alternative for fixed restoration protocols in edentulous mandibles on the basis of documented high success rates. The All-on-4 concept (Nobel Biocare, Göteborg, Sweden), a surgical and prosthetic protocol for immediate function involving the use of four implants to support a fixed prosthesis in patients with completely edentulous mandibles, represents one of these protocols. The authors conducted a study to document long-term follow-up of the All-on-4 concept. METHODS: This longitudinal study included 245 patients with a total of 980 immediate-function implants (four per patient), all placed in the anterior region, to support fixed full-arch mandibular prostheses. The inclusion criterion was having an edentulous mandible, or a mandible with hopeless teeth, in need of fixed implant restorations. RESULTS: A total of 21 implants failed in 13 patients, giving cumulative patient-related and implant-related success rates of 94.8 percent and 98.1 percent, respectively, at five years, and 93.8 percent and 94.8 percent, respectively, with up to 10 years of follow-up. The prostheses' survival rate was 99.2 percent with up to 10 years of follow up. CONCLUSIONS: The results support the conclusion that use of the All-on-4 immediate-function implant concept in completely edentulous mandibles is viable in the long term. CLINICAL IMPLICATIONS: High prosthesis survival rates can be achieved by the use of four implants to support a full-arch fixed prosthesis in the mandible.

Kyphoplasty in the treatment of osteoporotic Vertebral Compression Fractures (VCF) : procedure description and analysis of the outcomes in 128 patients.

In recent years, the advent of percutaneous techniques in the management of osteoporotic vertebral compression fractures has proven to be a great step forward in the evolution of patients suffering from this pathology.Vertebroplasty, which was developed in 1984 by Galibert and Deramond, presents the disadvantage of leakage of the cementation material and the impossibility to restore spinal deformity. Kyphoplasty has shown to be almost a definite solution to these problems. The description of the technique, its indications, and the outcomes resulting from our series of 200 vertebral fractures in 128 patients are presented in this paper.

Tratamiento endoscopico de los quistes aracnoideos supratentoriales de linea media / Endoscopic treatment of supratentorial midline arachnoid cysts

Objetivo: el proposito de esta presentacion es analizar el rol de la neuroendoscopia en el tratamiento de los quistes aracnoideos supratentoriales de linea media. Descripcion: se han utilizado neuroendoscopios rigidos Wolf, Storz o Aesculap segun los casos. El instrumental auxiliar utilizado ha consistido en pinza de biopsia, tijera, electrodo mono y/o bipolar y cateter balon tipo Fogarty 3F. El equipamiento complementario lo constituyen una videocamara de alta resolucion, una fuente de luz fria y un monitor de alta definicion, de acuerdo a su disponibilidad. Las imagenes han sido registradas por medio de un capturador fotografico digital y de un videograbador. Resultados: la tecnica neuroendoscopica ha permitido el tratamiento quirurgico de los quistes aracnoideos supratentoriales de linea media en forma minimamente invasiva comunicando estas lesiones con las cisternas basales y/o el sistema ventricular. Conclusion: la vecindad de estas lesiones con el sistema ventricular resulta ideal para su fenestracion endoscopica y comunicacion con las vias de circulacion del liquido cefalorraquideo

Tratamiento endoscopico de los quistes aracnoideos supratentoriales de linea media / Endoscopic treatment of supratentorial midline arachnoid cysts

Objetivo: el proposito de esta presentacion es analizar el rol de la neuroendoscopia en el tratamiento de los quistes aracnoideos supratentoriales de linea media. Descripcion: se han utilizado neuroendoscopios rigidos Wolf, Storz o Aesculap segun los casos. El instrumental auxiliar utilizado ha consistido en pinza de biopsia, tijera, electrodo mono y/o bipolar y cateter balon tipo Fogarty 3F. El equipamiento complementario lo constituyen una videocamara de alta resolucion, una fuente de luz fria y un monitor de alta definicion, de acuerdo a su disponibilidad. Las imagenes han sido registradas por medio de un capturador fotografico digital y de un videograbador. Resultados: la tecnica neuroendoscopica ha permitido el tratamiento quirurgico de los quistes aracnoideos supratentoriales de linea media en forma minimamente invasiva comunicando estas lesiones con las cisternas basales y/o el sistema ventricular. Conclusion: la vecindad de estas lesiones con el sistema ventricular resulta ideal para su fenestracion endoscopica y comunicacion con las vias de circulacion del liquido cefalorraquideo (AU)

Abordaje neuroendoscópico a la patología expansiva del III ventrículo: nuestra experiencia en 16 pacientes / Approach neuroendoscopic expansive patology third ventriculo: our experience in 16 patients

Los autores reportan una serie de 16 pacientes portadores de procesos expansivos del III ventrículo tratados con técnicas endoscópicas. Se discuten los procedimientos clínicos, radiológicos y quirúrgicos utilizados, la evolución y los hallazgos histológicos. Material y métodos: entre agosto de 1995 y noviembre de 1999, hemos tratados 16 pacientes con patología expansiva del tercer ventrículo, utilizando técnicas endoscópicas, el promedio de edad fue de 32,63 años (rango entre 1 mes y 76 años), en diez pacientes se realizó tercer ventriculostomía. En nuestros tres pacientes portadores de quistes coloides del III ventrículo, la extirpación fue completa, con seguimiento entre 6 y 18 meses. En 12 pacientes se realizaron extirpaciones parciales o biopsia tumoral. Resultados: en 15 pacientes se realizó diagnóstico histológico y en 3 de ellos fue posible la resección del tumor. En 10 pacientes se realizó III ventriculostomía como tratamiento ...

Abordaje neuroendoscópico a la patología expansiva del III ventrículo: nuestra experiencia en 16 pacientes / Approach neuroendoscopic expansive patology third ventriculo: our experience in 16 patients

Los autores reportan una serie de 16 pacientes portadores de procesos expansivos del III ventrículo tratados con técnicas endoscópicas. Se discuten los procedimientos clínicos, radiológicos y quirúrgicos utilizados, la evolución y los hallazgos histológicos. Material y métodos: entre agosto de 1995 y noviembre de 1999, hemos tratados 16 pacientes con patología expansiva del tercer ventrículo, utilizando técnicas endoscópicas, el promedio de edad fue de 32,63 años (rango entre 1 mes y 76 años), en diez pacientes se realizó tercer ventriculostomía. En nuestros tres pacientes portadores de quistes coloides del III ventrículo, la extirpación fue completa, con seguimiento entre 6 y 18 meses. En 12 pacientes se realizaron extirpaciones parciales o biopsia tumoral. Resultados: en 15 pacientes se realizó diagnóstico histológico y en 3 de ellos fue posible la resección del tumor. En 10 pacientes se realizó III ventriculostomía como tratamiento ... (AU)