Clinical practice guideline on the management of vestibular schwannoma.

INTRODUCTION: Vestibular schwannoma (VS) is the most common tumour of the cerebellopontine angle. The greater accessibility to radiological tests has increased its diagnosis. Taking into account the characteristics of the tumour, the symptoms and the age of the patient, three therapeutic strategies have been proposed: observation, surgery or radiotherapy. Choosing the most appropriate for each patient is a frequent source of controversy. MATERIAL AND METHODS: This paper includes an exhaustive literature review of issues related to VS that can serve as a clinical guide in the management of patients with these lesions. The presentation has been oriented in the form of questions that the clinician usually asks himself and the answers have been written and/or reviewed by a panel of national and international experts consulted by the Otology Commission of the SEORL-CCC. RESULTS: A list has been compiled containing the 13 most controversial thematic blocks on the management of VS in the form of 50 questions, and answers to all of them have been sought through a systematic literature review (articles published on PubMed and Cochrane Library between 1992 and 2023 related to each thematic area). Thirty-three experts, led by the Otology Committee of SEORL-CCC, have analyzed and discussed all the answers. In Annex 1, 14 additional questions divided into 4 thematic areas can be found. CONCLUSIONS: This clinical practice guideline on the management of VS offers agreed answers to the most common questions that are asked about this tumour. The absence of sufficient prospective studies means that the levels of evidence on the subject are generally medium or low. This fact increases the interest of this type of clinical practice guidelines prepared by experts.

Role of Hologic® Panther Aptima™ SARS-CoV-2 assay in the detection of SARS-CoV-2: screening or diagnostic technique? / Papel del ensayo Hologic® Panther Aptima™ SARS-CoV-2 en la detección del SARS-CoV-2: ¿técnica de cribado o de diagnóstico?

During the multiple waves of COVID-19 suffered all over the world, having a rapid and sensitive diagnostic test has be come a priority for microbiology laboratories. The AptimaTM SARS-CoV-2 transcription-mediated amplification (TMA) assay running on the Panther system (Hologic) was presented as a very good option to cover this need. To evaluate this system, 570 respiratory samples were included in the study and were processed both by the Panther (Hologic) system and by qRT PCR (Thermo Fisher Science, Waltham, USA), current assay for the diagnosis of severe acute respiratory syndrome coronavi rus 2 (SARS-CoV-2). A high number of false positives (n=76) was obtained with Panther system (Hologic), but the number of false positives decreases as the relative light units (RLU) val ue increases. These results show that this technique can be a good option for sample screening but checking for positive results should be mandatory, especially those with low RLU values (AU)

Durante las múltiples oleadas de COVID-19 sufridas en todo el mundo, disponer de una prueba diagnóstica rápida y sensible se ha convertido en una prioridad para los laborato transcripción (TMA) AptimaTM SARS-CoV-2 que se ejecuta en el sistema Panther (Hologic) se presentó como una muy bue na opción para cubrir esta necesidad. Para evaluar este sis tema, se incluyeron en el estudio 570 muestras respiratorias y se procesaron tanto por el sistema Panther (Hologic) como por qRT-PCR (Thermo Fisher Science, Waltham, EE. UU.), téc nica utilizada actualmente para el diagnóstico del síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2). Se obtuvo un alto número de falsos positivos (n=76) con el sistema Panther (Hologic), pero el número de falsos positivos disminuye a medida que aumenta el valor de las unidades re lativas de luz (RLU). Estos resultados muestran que esta técnica puede ser una buena opción como técnica de screening, pero la verificación de resultados positivos debería ser obligatoria, especialmente aquellos con valores bajos de RLU (AU)

RP-HPLC Separation and 1H NMR Identification of a Yellow Fluorescent Compound-Riboflavin (Vitamin B2)-Produced by the Yeast Hyphopichia wangnamkhiaoensis.

The yeast Hyphopichia wangnamkhiaoensis excretes a brilliant yellow fluorescent compound into its growth culture. In this study, we isolated and identified this compound using reverse-phase high-performance liquid chromatography-diode array detector (RP-HPLC-DAD) as well as 1H NMR and UV-Vis spectroscopy. Two of the three RP-HPLC-DAD methods used successfully separated the fluorescent compound and involved (1) a double separation step with isocratic flow elution, first on a C18 column and later on a cyano column, and (2) a separation with a linear gradient elution on a phenyl column. The wavelengths of maximum absorption of the fluorescent compound-containing HPLC fractions (~224, 268, 372, and 446 nm) are in good agreement with those exhibited by flavins. The 1H NMR spectra revealed methyl (δ 2.30 and 2.40) and aromatic proton (δ 7.79 and 7.77) signals of riboflavin. The 1H NMR spectra of the samples spiked with riboflavin confirmed that the brilliant yellow fluorescent compound is riboflavin. The maximum excitation and emission wavelengths of the fluorescent compound were 448 and 528 nm, respectively, which are identical to those of riboflavin.

High performance of the automated ADVIA Centaur Systems SARS-CoV-2 Antigen Assay in nasopharyngeal samples with high viral load / Alto rendimiento del ensayo de antígeno ADVIA Centaur Systems SARS-CoV-2 automatizado en muestras nasofaríngeas con alta carga viral

ADVIA Centaur SARS-CoV-2 Antigen (COV2Ag) Assay (Siemens Healthineers) was evaluated for SARS-CoV-2 detection. A total of 141 nasopharyngeal samples were analyzed by this technique and results were compared with those obtained by quantitative reverse-transcription polymerase chain reaction (RT-PCR). The overall sensitivity and specificity of the test were 68.70% and 70%, respectively. Regarding cycle threshold (Ct) values, the COV2Ag test showed a sensitivity of 93.75% and 100% for nasopharyngeal samples with Ct < 25 and < 20, respectively. ADVIA Centaur COV2Ag Assay is a useful, automated, and rapid technique for early SARS-CoV-2 diagnosis and isolation of the infected individuals, avoiding its transmission.(AU)

[Development of the INSABI educational strategy: a lesson learned from the COVID-19 epidemic]. / Desarrollo de la estrategia educativa del INSABI: una lección aprendida a partir de la epidemia de COVID-19.

The Institute for Health for Well-being (INSABI according to its initials in Spanish), in collaboration with the National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), instituted the Continuous Training on clinical management "Mexico against COVID-19" in 2020, with the purpose of training the frontline health personnel in the care for patients with COVID-19 in the context of hospital reconversion through the COVIDUTI platform. Virtual conferences were held for medical personnel from all over the country with the possibility of interacting with various specialists. In 2020, 215 sessions were held and 158 in 2021. That year educational content was expanded and included topics for other health categories, such as nursing and social work. In October 2021, it was established the Health Educational System for Well-being (SIESABI), with the aim of promoting continuous and permanent education for health workers. It currently offers face-to-face and virtual courses, permanent seminars, and telementoring, with the possibility of providing academic follow-up to its subscribers and linking priority courses that are on other platforms. The educational platform is an opportunity to unify the efforts of the health system in Mexico in the continuous and permanent education of professionals who care for people without social security and thereby contribute to the implementation of a model of care based on primary health care (PHC).

El Instituto de Salud para el Bienestar (INSABI), en colaboración con el Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), instituyó el entrenamiento continuo sobre manejo clínico "México contra COVID-19" en 2020, con el propósito de capacitar al personal de salud de primera línea en la atención de pacientes con COVID-19 en el contexto de la reconversión hospitalaria mediante la plataforma COVIDUTI. Se realizaron conferencias virtuales dirigidas a personal médico de todo el país con la posibilidad de interactuar con diversos especialistas. En 2020 se realizaron 215 sesiones y 158 en 2021. Ese año se ampliaron contenidos educativos y se incluyeron temas para otras categorías de salud, como enfermería y trabajo social. En octubre de 2021 se estableció el Sistema Educativo de Salud para el Bienestar (SIESABI), con el objetivo de promover la educación continua y permanente para los trabajadores de la salud. Actualmente ofrece cursos presenciales, virtuales, seminarios permanentes y telementorías, con la posibilidad de dar seguimiento académico a sus suscriptores y vincular cursos prioritarios que están en otras plataformas. La plataforma educativa es una oportunidad para unificar los esfuerzos del sistema de salud en México en la educación continua y permanente de los profesionales que atienden a personas sin seguridad social y, con ello, contribuir en la implementación de un modelo de atención basado en Atención Primaria de Salud (APS).

High performance of the automated ADVIA Centaur Systems SARS-CoV-2 Antigen Assay in nasopharyngeal samples with high viral load.

ADVIA Centaur SARS-CoV-2 Antigen (COV2Ag) Assay (Siemens Healthineers) was evaluated for SARS-CoV-2 detection. A total of 141 nasopharyngeal samples were analyzed by this technique and results were compared with those obtained by quantitative reverse-transcription polymerase chain reaction (RT-PCR). The overall sensitivity and specificity of the test were 68.70% and 70%, respectively. Regarding cycle threshold (Ct) values, the COV2Ag test showed a sensitivity of 93.75% and 100% for nasopharyngeal samples with Ct < 25 and < 20, respectively. ADVIA Centaur COV2Ag Assay is a useful, automated, and rapid technique for early SARS-CoV-2 diagnosis and isolation of the infected individuals, avoiding its transmission.

Valoración de dos pruebas inmunocromatográficas para la detección de anticuerpos frente a SARS-CoV-2 / Evaluation of two immunocromatographic tests for the detection of antibodies against SARS-CoV-2

Introducción. Las pruebas serológicas han resultado una herramienta de gran valor en el transcurso de la pandemia por SARS-CoV-2, tanto en la detección, apoyando a los métodos moleculares, como en el seguimiento de la respuesta inmune, provocada por la vacunación o por la infección natural. Dentro de todas estas técnicas, las pruebas rápidas resultan interesantes por su fácil uso, rápida respuesta y bajo coste económico. Material y métodos. Se evaluaron dos técnicas inmunológicas diferentes: Realy Tech y Mikrogen Diagnostik recomLine SARS-CoV-2 IgG. Como técnicas de referencia se utilizaron pruebas automatizadas: SARS-CoV-2 IgG II Quant antibody test y SARS-CoV-IgG assay, ambos de Abbott Diagnostics. Resultados. Mikrogen Diagnostik fue el que, en conjunto, ofreció mejores resultados (S=0,985; E=0,839). Las dos técnicas mostraron buenos valores predictivos positivos, pero los valores predictivos negativos de Realy Tech estuvieron lejos de lo deseable. Conclusiones. Mikrogen Diagnostik recomLine SARS-CoV-2 IgG ofreció muy buenos resultados en la detección de anticuerpos frente a SARS-CoV-2 y podría ser utilizada como alternativa a las técnicas automatizadas. (AU)

Introduction. Serological tests have been a valuable tool during the SARS-CoV-2 pandemic, supporting molecular methods for detection, and monitoring the immune response, caused by vaccination or by natural infection. Within all these techniques, rapid tests are interesting due to their ease of use, rapid response and low cost. Methods. Two different immunological techniques were evaluated: Realy Tech and Mikrogen Diagnostik recomLine SARS-CoV-2 IgG. SARS-CoV-2 IgG II Quant antibody test and SARS-CoV-IgG assay, both from Abbott Diagnostics, were used as reference techniques. Results. Mikrogen Diagnostik recomLine SARS-CoV-2 IgG shows the best results (S=0.985; E=0.839). Three techniques offered good positive predictive values, but Realy Tech and Healgen negative predictive values left to be desired. Conclusions. Mikrogen Diagnostik recomLine SARS-CoV-2 IgG showed good results in the detection of antibodies against SARS-CoV-2 and could be used as an alternative to automated techniques. (AU)

Extraction of Acetogenins Using Thermosonication-Assisted Extraction from Annona muricata Seeds and Their Antifungal Activity.

The objective of this work was to find the optimal conditions by thermosonication-assisted extraction (TSAE) of the total acetogenin content (TAC) and yield from A. muricata seeds, assessing the effect of the temperature (40, 50, and 60 °C), sonication amplitude (80, 90, and 100%), and pulse-cycle (0.5, 0.7, and 1 s). In addition, optimal TSAE conditions of acetogenins (ACGs) were compared with extraction by ultrasound at 25 °C and the soxhlet method measuring TAC and antioxidant capacity. Moreover, solubility and identification of isolated ACGs were performed. Furthermore, the antifungal activity of ACGs crude extract and isolated ACGs was evaluated. Optimal TSAE conditions to extract the highest TAC (35.89 mg/g) and yield (3.6%) were 50 °C, 100% amplitude, and 0.5 s pulse-cycle. TSAE was 2.17-fold and 15.60-fold more effective than ultrasound at 25 °C and the Soxhlet method to extract ACGs with antioxidant capacity. Isolated ACGs were mostly soluble in acetone and methanol. Seven ACGs were identified, and pseudoannonacin was the most abundant. The inhibition of Candida albicans, Candida krusei, and Candida tropicalis was higher from isolated ACGs than crude extract. TSAE was effective to increase the yield in the ACGs extraction from A. muricata seeds and these ACGs have important antifungal activity.

Treatment of melasma with platelet-rich plasma: A self-controlled clinical trial.

Melasma is a common circumscribed hypermelanosis of sun-exposed areas of the skin. Platelet-Rich Plasma therapy has been evidenced to inhibit melanin synthesis in animals and humans. To determine the effectiveness of platelet-rich plasma as a treatment for melasma. Twenty female patient with melasma were involved in this study. The intervention included three Platelet-Rich Plasma application sessions at 15-day intervals. Patients were evaluated before and after treatment. Variables measured included the facial melanin concentration using the melasma area and severity index score, melasma quality of life scale satisfaction grade, and histologic changes. Mean age was 41 ± 7 years. An initial MELASQOL score of 42 ± 14.8 and final score of 16.6 ± 7.2 (p = 0.008) were reported; the initial and final MASI score were 15.5 ± 8.4 and 9.5 ± 7.2 (p = 0.001), respectively. The dermatoscopy examination revealed a decrease in pigmentation after intervention (p = 0.001). Histopathologic improvement was detected in reductions in cutaneous atrophy (14 [70%] vs. 11 [55%]), solar elastosis (15 [75%] vs.11 [55%]), and inflammatory infiltrate (9 [45%] vs. 6 [30%]), before and after treatment, respectively. The intervention was associated with decreased intensity of the melasma patch and improved skin quality, shown by the MELASQOL and MASI scores.

Neoplastic degeneration of chronic sacrococcygeal pilonidal sinus: report of seven cases and literature review.

INTRODUCTION: Neoplastic degeneration is an uncommon but extremely serious complication of pilonidal sinus (PS) disease. We pretend to determine the factors that influence in the prognosis of the neoplastic disease assessing clinical features and histological findings. MATERIALS AND METHODS: We retrospectively studied the patients diagnosed of malignization of PS in our institution from 2000 to 2019. RESULTS: Seven male patients with a mean age at diagnosis of 64.8 years old were collected. Average time between the initial symptoms of PS disease and the tumor diagnosis was 33.7 years. The patients presenting an ulcerative pattern in the primary tumor showed in all the cases perineural invasion, local deep structures infiltration, and neoplastic dissemination to the regional lymph nodes. All these patients died in an average time of 7 months. On the other hand, patients with exophytic patterns in the primary tumor did not present local invasion or regional nodes affectation. All the cases survive with an average follow-up of 70.5 months. CONCLUSIONS: Ulcerated lesions clearly show a worse prognosis than tumors with exophytic morphology. Factors as perineural infiltration, local deep structures infiltration, or regional lymph node involvement dramatically decrease survival rates.

OBJETIVO: La cancerificación es una complicación infrecuente pero grave de la enfermedad por sinus pilonidal. Intentaremos determinar los factores que influyen en el pronóstico de la enfermedad neoplásica basándonos en hallazgos clínicos e histopatológicos. MATERIAL Y MÉTODOS: retrospectivamente se revisan pacientes diagnosticados de malignización de sinus pilonidal en nuestra institución del 2000 a 2019. RESULTADOS: fueron recopilados los casos de siete varones con una media de edad al diagnóstico de 64.8 años. El promedio entre el inicio de los síntomas de sinus pilonidal y el diagnóstico del tumor fue de 33.7 años. Los pacientes con un patrón ulcerativo en el tumor primario presentaron todos invasión perineural, infiltración de estructuras profundas y diseminación a linfáticos regionales. Todos estos pacientes fallecieron en una media de 7 meses. Por el contrario, los pacientes que mostraban un patrón exofítico, no presentaron invasión local o afectación de los linfáticos regionales. Todos estos casos sobrevivieron, con una media de seguimiento de 70.5 meses. CONCLUSIONES: tumores primarios ulcerativos claramente presentan un peor pronóstico que los casos de morfología exofítica. Factores como la infiltración perineural, la invasión local de estructuras profundas o la afectación de los ganglios linfáticos regionales van ligados a una disminución dramática en la supervivencia.

Hibiscus Acid from Hibiscus sabdariffa L. Inhibits Flagellar Motility and Cell Invasion in Salmonella enterica.

Extracts of Hibiscus sabdariffa L. (commonly called Rosselle or "Jamaica flower" in Mexico) have been shown to have antibiotic and antivirulence properties in several bacteria. Here, an organic extract of H. sabdariffa L. is shown to inhibit motility in Salmonella enterica serovars Typhi and Typhimurium. The compound responsible for this effect was purified and found to be the hibiscus acid. When tested, this compound also inhibited motility and reduced the secretion of both flagellin and type III secretion effectors. Purified hibiscus acid was not toxic in tissue-cultured eukaryotic cells, and it was able to reduce the invasion of Salmonella Typhimurium in epithelial cells. Initial steps to understand its mode of action showed it might affect membrane proton balance.

Full-duplex transmission of multi-Gb/s subcarrier multiplexing and 5G NR signals in 39 GHz band over fiber and space.

We propose a stable full-duplex transmission of millimeter-wave signals over a hybrid single-mode fiber (SMF) and free-space optics (FSO) link for the fifth-generation (5G) radio access networks to accelerate the Industry 4.0 transformation. For the downlink (DL), we transmit 39 GHz subcarrier multiplexing (SCM) signals using variable quadrature amplitude modulation (QAM) allocations for multi-user services. As a proof of operation, we experimentally demonstrate the transmission of 3 Gb/s SCM signals (1 Gb/s per user) over a hybrid system consisting of a 10 km SMF and 1.2 m FSO link. For the uplink (UL), satisfactory performance for the transmission of 2.4 Gb/s 5G new radio (NR) signal at 37 GHz over the hybrid system is experimentally confirmed for the first time, to the best of our knowledge. The measured error vector magnitudes for both DL and UL signals using 4/16/64-QAM formats are well below the third generation partnership project (3GPP) requirements. We also further evaluate by simulation the full-duplex transmission over the system in terms of received optical and RF powers and bit error rate performance. A wireless radio distance of approximately 200 m, which is sufficient for 5G small-cell networks, is estimated for both DL and UL direction under the heavy rain condition, based on the available data from Spain. Furthermore, simulation for the DL direction is conducted to verify the superior performance of the system using variable QAM allocation over uniform QAM allocation. Using a variable modulation allocation, up to five users (2 Gb/s per user) can be transmitted over a hybrid 10 km SMF and 150 m FSO link.

Quality attributes of partially hydrolyzed collagen in a liquid formulation used for skin care.

BACKGROUND: The deterioration of the skin accentuates over time, affecting its aesthetic appearance. This is characterized by the weakening of the mechanisms involved in the regeneration and repair of the dermal matrix. Consequently, the skin losses elasticity and smoothness resulting in the formation of wrinkles. The alternatives for facial rejuvenation include surgery, injection of botulinum toxin, and the application of masks. Topic products are less invasive, can be self-applied, and have an increased benefit/risk relationship. AIM: We developed a liquid formulation containing collagen hydrolyzed and evaluated the product by cutting-edge technology in order to define proper its quality attributes. METHODS: We employed nuclear magnetic resonance (NMR), size-exclusion chromatography (SEC), and mass spectrometry (MS). Additionally, we analyzed its cosmetical effect in five volunteers and we demonstrate the product safety. RESULTS: Our results demonstrate the following: (a) a stable secondary structure identity associated to the known triple helix arrangement in liquid and solid states; (b) a typical conformational flexibility depending on its hydration state; (c) thermal stability confirmed by liquid- and solid-state nuclear magnetic resonance schemes; and (d) a molecular mass distribution of peptides between 0.5 and 19.5 kDa. The product faded wrinkles in the forehead, an effect that remained after removing the mask. The formula was non-irritating and hypoallergenic. CONCLUSION: We characterized, using state-of-the-art methodologies, the quality attributes that are critical for the safety and beneficial effect of a new collagen-containing formula.

M-QAM signal transmission at the photonically generated K-band over thermal-induced turbulent FSO links with different turbulence distributions.

We present a theoretical and experimental study on the impact of different thermal-induced free-space turbulence distributions on the M-quadrature amplitude modulation (M-QAM) signal transmission in radio frequency K-band over hybrid optical links of standard single mode fiber (SSMF) and free-space optics (FSO). Frequency multiplication using an external intensity modulator biased at the null transmission point has been employed to photonically generate radio signals at a frequency of 25 GHz , included for the frequency bands for fifth-generation (5G) mobile networks. Moreover, extensive simulations have been performed for 10Gb/s with 4-, 16-, and 64-QAM over 5 km of SSMF and 500 m long FSO channels under scenarios with different turbulence levels and distributions. Proof-of-concept experiments have been conducted for 20 MHz with 4- and 64-QAM over 5 km of SSMF and 2 m long FSO channels under turbulence conditions. Both theoretical and experimental systems have been analyzed in terms of error vector magnitude (EVM) performance showing feasible transmission over the hybrid links in the received optical power range. Non-uniform turbulence distributions are shown to have a different impact on M-QAM modulation formats, i.e., turbulence distributions with higher strength in the middle of the FSO link reveal a 1.9 dB penalty when using 64-QAM signals compared to a 1.3 dB penalty using 4-QAM signals, whereas higher penalties have been measured when 4-QAM format is transmitted over turbulence distributions with larger magnitude in the second half of the FSO link. The results have been validated by theoretical predictions and lead to practical consequences on future networks' deployment.

Parálisis facial: guía de práctica clínica de la Sociedad Española de ORL / Facial paralysis: Clinical practice guideline of the Spanish Society of Otolaryngology

La parálisis de Bell es la forma más común de paresia o parálisis facial. Sin embargo, no todos los pacientes con parálisis facial tienen una parálisis de Bell. Otras causas frecuentes incluyen las secuelas del tratamiento del neurinoma del VIII par, el cáncer de cabeza y cuello, la iatrogenia, el zóster ótico y los traumatismos. El abordaje de cada una de estas situaciones es totalmente diferente. El objetivo de esta guía es servir de consejo para el tratamiento y el seguimiento de los pacientes con parálisis facial. Nuestra idea es que la guía sea práctica, haciendo hincapié en recomendaciones efectivas y útiles en el manejo diario de los pacientes. Esta guía ha sido promovida por la Sociedad Española de ORL y escrita por médicos con experiencia en la enfermedad del nervio facial, incluyendo al menos un especialista de cada comunidad autónoma. Redactada en un formato de preguntas y respuestas, incluye 56 cuestiones relevantes relacionadas con el nervio facial

Bell's palsy is the most common diagnosis associated with facial nerve weakness or paralysis. However, not all patients with facial paresis/paralysis have Bell's palsy. Other common causes include treatment of vestibular schwannoma, head and neck tumours, iatrogenic injuries, Herpes zoster, or trauma. The approach to each of these conditions varies widely. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of patients with different causes of facial paralysis. We intend to draft a practical guideline, focusing on operationalised recommendations deemed to be useful in the daily management of patients. This guideline was promoted by the Spanish Society of Otolaryngology and developed by a group of physicians with an interest in facial nerve disorders, including at least one physician from each Autonomous Community. In a question and answer format, it includes 56 relevant topics related to the facial nerve

1 H-NMR metabolomics profiling of recombinant tobacco plants holding a promoter of a sesquiterpene cyclase.

INTRODUCTION: Nicotiana tabacum is a plant model intensively used in the bio-engineering pharmaceutical industry as a platform to produce drugs and therapeutic agents. Currently, no information regarding the non-targeted metabolome of transgenic tobacco containing recombinant regulatory sequences is available. OBJECTIVE: To compare the proton nuclear magnetic resonance (1 H-NMR) metabolomics profiling of a recombinant Nicotiana tabacum strain containing a promoter of a sesquiterpene cyclase from Capsicum annuum driving GUS expression, versus wild-type samples. Methodology The non-targeted 1 H-NMR metabolome was obtained and processed by principal component analysis (PCA) and orthogonal projection to latent structures discriminant analysis (OPLS-DA). The differential metabolites were quantified by quantitative NMR. RESULTS: PCA and OPLS-DA revealed 37 metabolites including 16 discriminant compounds for transgenic samples. Ethanol (0.4 mg g-1 ), the main differential compound, was exclusively detected in transgenic tobacco; however, high levels of formate (0.28 mg g-1 ) and acetate (0.3 mg g-1 ) were simultaneously observed in the same group of samples. Cembratriene-4,6-diol, an antitumour and neuroprotective compound, and capsidiol, a known phytoalexin, increased by about 30% in transgenic samples. In addition, the endogenous levels of the antioxidant caffeoylquinic acid isomers increased by 50% in comparison to those of wild-type tobaccos. CONCLUSION: Our results support the occurrence of metabolic differences between wild type and transgenic tobacco containing a promoter of a Capsicum sesquiterpene cyclase gene. Interestingly, the recombinant transgenic strain studied accumulated high amounts of added value compounds with biological activity.

Facial paralysis: Clinical practice guideline of the Spanish Society of Otolaryngology. / Parálisis facial: guía de práctica clínica de la Sociedad Española de ORL.

Bell's palsy is the most common diagnosis associated with facial nerve weakness or paralysis. However, not all patients with facial paresis/paralysis have Bell's palsy. Other common causes include treatment of vestibular schwannoma, head and neck tumours, iatrogenic injuries, Herpes zoster, or trauma. The approach to each of these conditions varies widely. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of patients with different causes of facial paralysis. We intend to draft a practical guideline, focusing on operationalised recommendations deemed to be useful in the daily management of patients. This guideline was promoted by the Spanish Society of Otolaryngology and developed by a group of physicians with an interest in facial nerve disorders, including at least one physician from each Autonomous Community. In a question and answer format, it includes 56 relevant topics related to the facial nerve.

Pielopastia Laparoscópica: Técnica Robótica / Laparoscopic pyeloplasty: Robotic Technique

Múltiples series de pieloplastia laparoscópica han demostrado altos niveles de éxito y escasas complicaciones para población adulta. El uso de robótica facilita la reconstrucción pieloureteral debido a la superioridad en cuanto a visión estereoscópica, precisión de movimientos y filtros anti temblor . Lo que permite además del éxito quirúrgico, una ventaja en términos de técnica mínimamente invasiva y consecuentemente menor estadía hospitalaria. El objetivo del presente video es demostrar la técnica utilizada en nuestro centro para pieloplastia robótica y mostrar una sistematización que simplifica el procedimiento.AU

Multiple series of laparoscopic pyeloplasty have demonstrated high success levels and few complications in the adult population. The use of robotics facilitates pyeloureteral reconstruction due to the superiority in stereoscopic vision, movement precision and anti-tremor filters. The previous provides not only surgical success but also an advantage in terms of minimally invasive technique and consequently less hospital stay. The objective of this video is to demonstrate the technique used in our facilities in robotic pyeloplasty and to show a systematization that simplifies the procedure.

Análisis experimental mediante vibrometría láser doppler en huesos temporales de cadáver fresco de una nueva prótesis de maleovestibulopexia / A new malleostapedotomy prosthesis. Experimental analysis by laser doppler vibrometer in fresh cadaver temporal bones

Introducción y objetivos. Confirmar en temporales frescos de cadáver el comportamiento óptimo teórico (previamente determinado en un modelo computadorizado del oído medio humano) de una nueva prótesis de sustitución osicular total así como objetivar la facilidad de colocación de la misma. Finalmente comprobamos su estabilidad tras ser colocada puesto que el diseño de esta nueva prótesis evita, teóricamente, su movilización o extrusión al anclarse directamente en el mango del martillo. Material y métodos. En el estudio analizamos, mediante vibrometría láser doppler, el comportamiento mecanoacústico de una nueva prótesis de recambio osicular total en el oído medio humano utilizando 10 huesos temporales de cadáver fresco. Resultados. El diseño de la prótesis impide su desplazamiento o extensión y facilita su colocación en el oído medio. La función de transferencia de los temporales a quienes se implantó la nueva prótesis se superpone con la del oído medio intacto antes de la colocación de la prótesis lo que sugiere un comportamiento mecanoacústico óptimo de la misma. Conclusiones. La prótesis de titanio evaluada en este estudio presenta un comportamiento mecanoacústico superponible al del oído medio intacto, lo que se suma a la facilidad de colocación y estabilidad posquirúrgica conviertiéndola en un diseño de prótesis a tener en cuenta ante una reconstrucción osicular total (AU)

Introduction and objectives. One of the problems with total ossicular replacement prostheses is their stability. Prosthesis dislocations and extrusions are common in middle ear surgery. This is due to variations in endo-tympanic pressure as well as design defects. The design of this new prosthesis reduces this problem by being joined directly to the malleus handle. The aim of this study is to confirm adequate acoustic-mechanical behaviour in fresh cadaver middle ear of a new total ossicular replacement prosthesis, designed using the finite elements method. Methods. Using the doppler vibrometer laser, we analysed the acoustic-mechanical behaviour of a new total ossicular replacement prosthesis in the human middle ear using 10 temporal bones from fresh cadavers. Results. The transfer function of the ears in which we implanted the new prosthesis was superimposed over the non-manipulated ear. This suggests optimum acoustic-mechanical behaviour. Conclusions. The titanium prosthesis analysed in this study demonstrated optimum acoustic-mechanical behaviour. Together with its ease of implantation and post-surgical stability, these factors make it a prosthesis to be kept in mind in ossicular reconstruction (AU)