Sinonasal anatomy variations on CT scans of a sample of Filipino adults with chronic rhinosinusitis

Objective@#To determine the prevalence of sinonasal anatomic variations seen on paranasal sinus (PNS) CT scans of a sample of Filipino adults with chronic rhinosinusitis.@*Methods@#Design: Cross-sectional study Setting: Tertiary Government Training Hospital Participants: The PNS CT scans of 51 Filipino patients with chronic rhinosinusitis with and without nasal polyposis diagnosed at our outpatien Department of Otorhinolaryngology-Head and Neck Surgery between October 2015 to December 2020 were reviewed for the presence of sinonasal anatomic variants. The prevalence of the identified variants was calculated.@*Results@#The CT scans of 51 patients, 41 (80.4%) men and 10 (19.6%) women, were included. The median age was 48 years (Q25: 35, Q75: 56, IQR:21). The median Lund Mackay Score (LMS) was 15 (Q25: 12, Q75: 20, IQR:8). Majority (94%) had an LMS of ≥5. The most common anatomic variant in the study population was agger nasi (n=46/51, 90.2% present bilaterally) followed by uncinate process attachment to the lamina papyracea (n=90/102, 88.24%). The third to sixth most common findings were Keros type II classification (n=76/102, 74.51%), nasal septal deviation (n=35/51, 68.62%), optic nerve canal type 1 (n=67/102, 65.69%) and anterior ethmoid artery grade 1 (n=46/102, 45.1%), respectively. Less common variants were Onodi cell (n=13/51, 25.49% unilateral and n=10/51, 19.61% bilateral), Haller cell (n=8/51, 15.69% unilateral and n=1/51, 1.96% bilateral), supraorbital cell (n=4/51, 7.84% unilateral and n=4/51, 7.84% bilateral), middle turbinate concha bullosa (n=3/51, 5.88% unilateral and n=6/51, 11.76% bilateral), superior turbinate concha bullosa (n=2/51, 3.92% unilateral and n=1/51, 1.96% bilateral), pneumatized crista galli (n=2/51, 3.92%) and optic nerve dehiscence (n=1/51, 1.96% bilateral). @*Conclusion@#In the adult Filipino population with CRS sampled in this study, the six most common sinonasal anatomic variants were agger nasi, superior attachment of the uncinate process to the lamina papyracea, Keros type II classification, septal deviation, optic nerve canal type 1 and anterior ethmoid artery grade 1. Pre-operatively, the PNS CT scan of every patient must be meticulously evaluated for the sinonasal anatomic variants to avoid surgical complications.

Generalidades de las principales urgencias en el paciente oncológico: revisión de tema / Overview of the main emergencies in cancer patients: Review / Generalidades das principais urgências no paciente oncológico: revisão de tema

Las urgencias oncológicas son complicaciones comunes de la evolución natural del tumor o de su manejo. Algunas pueden presentarse de manera sutil y ser pasadas por alto, lo que aumenta la morbimortalidad. El objetivo de esta revisión narrativa es recopilar información actualizada de las principales complicaciones oncológicas, para ello se realizó una revisión de artículos originales, revisiones sistemáticas y narrativas en bases de datos como Scopus, SciELO, PubMed, ScienceDirect y en el buscador Google Scholar. Se seleccionaron 63 referencias que mostraran información relevante acerca de las urgencias oncológicas planteadas para el desarrollo del artículo. En la revisión se discute que las complicaciones pueden clasificarse de acuerdo con su origen en infecciosas (neutropenia febril), metabólicas (síndrome de lisis tumoral e hipercalcemia maligna) y obstructivas (síndrome de vena cava superior, obstrucción intestinal, compresión medular y taponamiento cardiaco). El diagnóstico requiere un alto índice de sospecha, el médico debe tener la capacidad resolutiva y el conocimiento necesarios para el manejo y hacer uso racional de los recursos diagnósticos. Es necesario adoptar medidas terapéuticas que impacten positivamente en el pronóstico y que reduzcan la morbimortalidad.

Oncological emergencies are common complications resulting from the natural evolution of the tumor or its management; however, some of them may be subtle or even overlooked, which contributes to greater morbidity and mortality. Our aim was to gather updated information on the main oncological complications. A narrative literatura review was performed by searching for original articles, systematic reviews and narratives, in databases such as Scopus, SciELO, PubMed, ScienceDirect and in the Google Scholar search engine. 63 references were selected that addressed relevant information about the oncological emergencies raised for the development of the article. According to their origin, complications can be classified into infectious (febrile neutropenia), metabolic (tumor lysis syndrome and malignant hypercalcemia) and obstructive (superior vena cava syndrome, intestinal obstruction, spinal cord compression and cardiac tamponade). Facing these complications requires a high level of suspicion; the physician must be able to resolve each complication and have the necessary knowledge to approach each case, with a rational use of diagnostic resources. It is also necessary to adopt therapeutic measures that positively impact patients. patient prognosis, decreasing morbidity and death.

As urgências oncológicas são complicações comuns da evolução natural do tumor ou do seu manejo. Algumas podem apresentar-se de maneira sutil e ser passadaspor encima, o que aumenta a morbimortalidade. O objetivo desta revisão narrativa é recopilar informação atualizada das principais complicações oncológicas, para isso se realizou uma revisão de artigos originais, revisões sistemáticas e narrativas em bases de dados como Scopus, SciELO, PubMed, ScienceDirect e no buscador Google Scholar. Se selecionaram 63 referências que mostraram informação relevante sobre às urgências oncológicas apresentadas para o desenvolvimento do artigo. Na revisão se discuteque as complicações podem classificar-se de acordo com a sua origem em infecciosas (neutropenia febril), metabólicas (síndrome de lise tumoral e hipercalcemia maligna) e obstrutivas (síndrome de veia cava superior, obstrução intestinal, compressão medular e entupimento cardíaco). O diagnóstico requere um alto índice de suspeita, o médico deve ter a capacidade resolutiva e o conhecimento necessário para o manejo e fazer uso racional dos recursos diagnósticos. É necessário adotar medidas terapêuticas que impactem positivamente no prognóstico e que reduzam a morbimortalidade.

Cyanide metabolism of Pseudomonas pseudoalcaligenes CECT5344: role of siderophores.

Cyanide is one of the most potent and toxic chemicals produced by industry. The jewelry industry of Córdoba (Spain) generates a wastewater (residue) that contains free cyanide, as well as large amounts of cyano-metal complexes. Cyanide is highly toxic to living systems because it forms very stable complexes with transition metals that are essential for protein function. In spite of its extreme toxicity, some organisms have acquired mechanisms to avoid cyanide poisoning. The biological assimilation of cyanide needs the concurrence of three separate processes: (i) a cyanide-insensitive respiratory chain, (ii) a system for iron acquisition (siderophores) and (iii) a cyanide assimilation pathway. Siderophores are low-molecular-mass compounds (600-1500 Da) that scavenge iron (Fe(3+)) ions (usually with extremely high affinity) from the environment under iron-limiting conditions. There are two main classes of siderophores: catechol and hydroxamate types. The catechol-type siderophores chelate ferric ion via a hydroxy group, whereas the hydroxamate-type siderophores bind iron via a carbonyl group with the adjacent nitrogen. In the presence of cyanide, bacterial proliferation requires this specific metal uptake system because siderophores are able to break down cyano-metal complexes. Pseudomonas pseudoalcaligenes CECT5344 is able to use free cyanide or cyano-metal complexes as nitrogen source. A proteomic approach was used for the isolation and identification, in this strain, of a protein that was induced in the presence of cyanide, namely CN0, that is involved in siderophore biosynthesis in response to cyanide. An overview of bacterial cyanide degradation pathways and the involvement of siderophores in this process are presented.

Molecular and Regulatory Properties of the Nitrate Reducing Systems of Rhodobacter

Phototrophic bacteria of the genus Rhodobacter possess several forms of nitrate reductase including assimilatory and dissimilatory enzymes. Assimilatory nitrate reductase from Rhodobacter capsulatus E1F1 is cytoplasmic, it uses NADH as the physiological electron donor and reduced viologens as artificial electron donors, and it is coupled to an ammonium-producing nitrite reductase. Nitrate reductase induction requires a high C/N balance and the presence of nitrate, nitrite, or nitroarenes. A periplasmic 47-kDa protein facilitates nitrate uptake, thus increasing nitrate reductase activity. Two types of dissimilatory nitrate reductases have been found in strains from Rhodobacter sphaeroides. One of them is coupled to a complete denitrifying pathway, and the other is a periplasmic protein whose physiological role seems to be the dissipation of excess reducing power, thus improving photoanaerobic growth. Periplasmic nitrate reductase does not use NADH as the physiological electron donor and is a 100-kDa heterodimeric hemoprotein that receives electrons through an electron transport chain spanning the plasma membrane. This nitrate reductase is regulated neither by the intracellular C/N balance nor by O2 pressure. The enzyme also exhibits chlorate reductase activity, and both reaction products, nitrite and chlorite, are released almost stoichiometrically into the medium; this accounts for the high resistance to chlorate or nitrite exhibited by this bacterium. Nitrate reductases from both strains seem to be coded by genes located on megaplasmids.