Temporal-spectral signaling of sensory information and expectations in the cerebral processing of pain.

The perception of pain is shaped by somatosensory information about threat. However, pain is also influenced by an individual's expectations. Such expectations can result in clinically relevant modulations and abnormalities of pain. In the brain, sensory information, expectations (predictions), and discrepancies thereof (prediction errors) are signaled by an extended network of brain areas which generate evoked potentials and oscillatory responses at different latencies and frequencies. However, a comprehensive picture of how evoked and oscillatory brain responses signal sensory information, predictions, and prediction errors in the processing of pain is lacking so far. Here, we therefore applied brief painful stimuli to 48 healthy human participants and independently modulated sensory information (stimulus intensity) and expectations of pain intensity while measuring brain activity using electroencephalography (EEG). Pain ratings confirmed that pain intensity was shaped by both sensory information and expectations. In contrast, Bayesian analyses revealed that stimulus-induced EEG responses at different latencies (the N1, N2, and P2 components) and frequencies (alpha, beta, and gamma oscillations) were shaped by sensory information but not by expectations. Expectations, however, shaped alpha and beta oscillations before the painful stimuli. These findings indicate that commonly analyzed EEG responses to painful stimuli are more involved in signaling sensory information than in signaling expectations or mismatches of sensory information and expectations. Moreover, they indicate that the effects of expectations on pain are served by brain mechanisms which differ from those conveying effects of sensory information on pain.

Acute Nonruptured Expansion of Extracranial Carotid Artery Aneurysm. An Infrequent Clinical Presentation.

The extracranial carotid artery aneurysms are a rare disease, representing a low percentage of peripheral aneurysms (0.4-4%). Their main symptoms are derived from cerebral events and local compression, with rupture being rare. We report the case of a 79-year-old woman who presented with a right Common Carotid Artery aneurysm with pain and local symptoms. The expansion of the aneurysm is documented with images and the surgical treatment consisting of bypass from Common Carotid artery to Internal Carotid artery with Dacron prosthesis and reimplantation of External Carotid artery is described and discussed. To the best of our knowledge, this is the first case of expansion directly documented in the literature.

Physical activity and amyloid beta in middle-aged and older adults: A systematic review and meta-analysis.

BACKGROUND: One of the pathological hallmarks distinguishing Alzheimer's disease from other dementias is the accumulation of amyloid beta (Aß). Higher physical activity is associated with decreased dementia risk, and one potential path could be through Aß levels modulation. We aimed to explore the relationship between physical activity and Aß in middle-aged and older adults. METHODS: A systematic search of PubMed, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trials, and SPORTDiscus was performed from inception to April 28, 2022. Studies were eligible if they included physical activity and Aß data in adults aged 45 years or older. Multi-level meta-analyses of intervention and observational studies were performed to examine the role of physical activity in modulating Aß levels. RESULTS: In total, 37 articles were included (8 randomized controlled trials, 3 non-randomized controlled trials, 4 prospective longitudinal studies, and 22 cross-sectional studies). The overall effect size of physical activity interventions on changes in blood Aß was medium (pooled standardized mean difference = -0.69, 95% confidence interval (95%CI): -1.41 to 0.03; I2 = 74.6%). However, these results were not statistically significant, and there were not enough studies to explore the effects of physical activity on cerebrospinal fluid (CSF) and brain Aß. Data from observational studies were examined based on measurements of Aß in the brain using positron emission tomography scans, CSF, and blood. Higher physical activity was positively associated with Aß only in the CSF (Estimate r = 0.12; 95%CI: 0.05-0.18; I2 = 38.00%). CONCLUSION: Physical activity might moderately reduce blood Aß in middle-aged and older adults. However, results were only near statistical significance and might be interpreted with caution given the methodological limitations observed in some of the included studies. In observational studies, higher levels of physical activity were positively associated with Aß only in CSF. Therefore, further research is needed to understand the modulating role of physical activity in the brain, CSF, and blood Aß, as well as its implication for cognitive health.

DISCOVER-EEG: an open, fully automated EEG pipeline for biomarker discovery in clinical neuroscience.

Biomarker discovery in neurological and psychiatric disorders critically depends on reproducible and transparent methods applied to large-scale datasets. Electroencephalography (EEG) is a promising tool for identifying biomarkers. However, recording, preprocessing, and analysis of EEG data is time-consuming and researcher-dependent. Therefore, we developed DISCOVER-EEG, an open and fully automated pipeline that enables easy and fast preprocessing, analysis, and visualization of resting state EEG data. Data in the Brain Imaging Data Structure (BIDS) standard are automatically preprocessed, and physiologically meaningful features of brain function (including oscillatory power, connectivity, and network characteristics) are extracted and visualized using two open-source and widely used Matlab toolboxes (EEGLAB and FieldTrip). We tested the pipeline in two large, openly available datasets containing EEG recordings of healthy participants and patients with a psychiatric condition. Additionally, we performed an exploratory analysis that could inspire the development of biomarkers for healthy aging. Thus, the DISCOVER-EEG pipeline facilitates the aggregation, reuse, and analysis of large EEG datasets, promoting open and reproducible research on brain function.

Local brain oscillations and interregional connectivity differentially serve sensory and expectation effects on pain.

Pain emerges from the integration of sensory information about threats and contextual information such as an individual's expectations. However, how sensory and contextual effects on pain are served by the brain is not fully understood so far. To address this question, we applied brief painful stimuli to 40 healthy human participants and independently varied stimulus intensity and expectations. Concurrently, we recorded electroencephalography. We assessed local oscillatory brain activity and interregional functional connectivity in a network of six brain regions playing key roles in the processing of pain. We found that sensory information predominantly influenced local brain oscillations. In contrast, expectations exclusively influenced interregional connectivity. Specifically, expectations altered connectivity at alpha (8 to 12 hertz) frequencies from prefrontal to somatosensory cortex. Moreover, discrepancies between sensory information and expectations, i.e., prediction errors, influenced connectivity at gamma (60 to 100 hertz) frequencies. These findings reveal how fundamentally different brain mechanisms serve sensory and contextual effects on pain.

Berlin statement on legacy and emerging contaminants in polar regions.

Polar regions should be given greater consideration with respect to the monitoring, risk assessment, and management of potentially harmful chemicals, consistent with requirements of the precautionary principle. Protecting the vulnerable polar environments requires (i) raising political and public awareness and (ii) restricting and preventing global emissions of harmful chemicals at their sources. The Berlin Statement is the outcome of an international workshop with representatives of the European Commission, the Arctic Council, the Antarctic Treaty Consultative Meeting, the Stockholm Convention on Persistent Organic Pollutants (POPs), environmental specimen banks, and data centers, as well as scientists from various international research institutions. The statement addresses urgent chemical pollution issues in the polar regions and provides recommendations for improving screening, monitoring, risk assessment, research cooperation, and open data sharing to provide environmental policy makers and chemicals management decision-makers with relevant and reliable contaminant data to better protect the polar environments. The consensus reached at the workshop can be summarized in just two words: "Act now!" Specifically, "Act now!" to reduce the presence and impact of anthropogenic chemical pollution in polar regions by. •Establishing participatory co-development frameworks in a permanent multi-disciplinary platform for Arctic-Antarctic collaborations and establishing exchanges between the Arctic Monitoring and Assessment Program (AMAP) of the Arctic Council and the Antarctic Monitoring and Assessment Program (AnMAP) of the Scientific Committee on Antarctic Research (SCAR) to increase the visibility and exchange of contaminant data and to support the development of harmonized monitoring programs. •Integrating environmental specimen banking, innovative screening approaches and archiving systems, to provide opportunities for improved assessment of contaminants to protect polar regions.

Physical Performance and Amyloid-ß in Humans: A Systematic Review and Meta-Analysis of Observational Studies.

BACKGROUND: Accumulation of amyloid-ß (Aß) plaques is one of the main features of Alzheimer's disease (AD). Physical performance has been related to dementia risk and Aß, and it has been hypothesized as one of the mechanisms leading to greater accumulation of Aß. Yet, no evidence synthesis has been performed in humans. OBJECTIVE: To investigate the association of physical performance with Aß in humans, including Aß accumulation on brain, and Aß abnormalities measured in cerebrospinal fluid (CSF) and blood. METHODS: A systematic review with multilevel meta-analysis was performed from inception to June 16th, 2022. Studies were eligible if they examined the association of physical performance with Aß levels, including the measure of physical performance as a predictor and the measure of Aß as an outcome in humans. RESULTS: 7 articles including 2,619 participants were included in the meta-analysis. The results showed that physical performance was not associated with accumulation of Aß in the brain (ES = 0.01; 95% CI -0.21 to 0.24; I2 = 69.9%), in the CSF (ES = -0.28; 95% CI -0.98 to 0.41; I2 = 91.0%) or in the blood (ES = -0.19; 95% CI -0.61 to 0.24; I2 = 99.75%). Significant heterogeneity was found across the results , which posed challenges in arriving at consistent conclusions; and the limited number of studies hindered the opportunity to conduct a moderation analysis. CONCLUSIONS: The association between physical performance and Aß is inconclusive. This uncertainly arises from the limited number of studies, study design limitations, and heterogeneity of measurement approaches. More studies are needed to determine whether physical performance is related to Aß levels in humans.

Longitudinal resting-state electroencephalography in patients with chronic pain undergoing interdisciplinary multimodal pain therapy.

ABSTRACT: Chronic pain is a major healthcare issue posing a large burden on individuals and society. Converging lines of evidence indicate that chronic pain is associated with substantial changes of brain structure and function. However, it remains unclear which neuronal measures relate to changes of clinical parameters over time and could thus monitor chronic pain and treatment responses. We therefore performed a longitudinal study in which we assessed clinical characteristics and resting-state electroencephalography data of 41 patients with chronic pain before and 6 months after interdisciplinary multimodal pain therapy. We specifically assessed electroencephalography measures that have previously been shown to differ between patients with chronic pain and healthy people. These included the dominant peak frequency; the amplitudes of neuronal oscillations at theta, alpha, beta, and gamma frequencies; as well as graph theory-based measures of brain network organization. The results show that pain intensity, pain-related disability, and depression were significantly improved after interdisciplinary multimodal pain therapy. Bayesian hypothesis testing indicated that these clinical changes were not related to changes of the dominant peak frequency or amplitudes of oscillations at any frequency band. Clinical changes were, however, associated with an increase in global network efficiency at theta frequencies. Thus, changes in chronic pain might be reflected by global network changes in the theta band. These longitudinal insights further the understanding of the brain mechanisms of chronic pain. Beyond, they might help to identify biomarkers for the monitoring of chronic pain.

Implementation of a Palliative Hospital-Centered Spiritual and Psychological Telehealth System During COVID-19 Pandemic.

BACKGROUND: The severity of the COVID-19 pandemic has resulted in limited provision of palliative care and hospital teams have had to rise to the challenge of how to deliver care safely to people with palliative needs. Telehealth interventions have been seen as a useful resource with potential to improve clinical effectiveness. OBJECTIVE: To describe the implementation of a spiritual and psychological palliative telehealth system during the pandemic. METHODS: Pilot study based on the implementation of a telehealth system designed to support hospitalized patients referred to a mobile palliative care team, through synchronic videoconferences, and including patients' relatives. The implementation included protocol development, physical infrastructure, and training. The intervention consisted of spiritual and psychological telehealth sessions performed remotely by the chaplain and psychologist of a palliative care team. RESULTS: During the study period 59 patients were recruited, median age of 70 years, 57.6% females. The primary diagnosis was severe COVID-19 (50.8%), advanced cancer (32.2%) and advanced chronic illness (16.9%). A total of 211 telehealth sessions were carried out, 82% psychological and 18% spiritual. The main criteria for psychological sessions were being related to seriously ill patients with withdrawal or withholding of life-support treatment (60.1%). The main criteria for spiritual sessions were being a patient with spiritual suffering or requesting spiritual assistance (73.6%). An electronic user satisfaction survey indicated high satisfaction rates. CONCLUSION: This report demonstrates that it is possible to provide spiritual and psychological palliative care to hospitalized patients and families during pandemic restrictions through interdisciplinary telehealth delivery.

Boosting pharmaceutical removal through aeration in constructed wetlands.

This work evaluated the removal efficiency of 13 wastewater-borne pharmaceuticals in a pilot constructed wetland (CW) operated under different aeration strategies (no aeration, intermittent and continuous). Aeration improved the removal of conventional wastewater parameters and the targeted micropollutants, compared to the non-aerated treatment. Reduction of chemical oxygen demand (COD) and total nitrogen (TN) was slightly higher applying intermittent aeration than applying continuous aeration, the opposite was observed for the investigated pharmaceuticals. Seven targeted compounds were found in influent wastewater, and five of them (acetaminophen, diclofenac, ketoprofen, bezafibrate and gemfibrozil) were efficiently removed (> 83%) in the aerated systems. The overall risk of the investigated samples against aquatic ecosystems was moderate, decreasing in the order influent > no aeration > intermittent aeration > continuous aeration, based on the hazard quotient approach. Lorazepam, diclofenac and ketoprofen were the pharmaceuticals that could contribute the most to this potential environmental impact of the CW effluents after discharge. To the authors' knowledge this is the first sound study on the removal and fate of ketoprofen, bezafibrate, and lorazepam in aerated CWs, and provides additional evidence on the removal and fate of acetaminophen, diclofenac, gemfibrozil, and carbamazepine in this type of bioremediation systems at pilot plant scale.

Modulating Brain Rhythms of Pain Using Transcranial Alternating Current Stimulation (tACS) - A Sham-Controlled Study in Healthy Human Participants.

Chronic pain is a major health care problem. A better mechanistic understanding and new treatment approaches are urgently needed. In the brain, pain has been associated with neural oscillations at alpha and gamma frequencies, which can be targeted using transcranial alternating current stimulation (tACS). Thus, we investigated the potential of tACS to modulate pain and pain-related autonomic activity in an experimental model of chronic pain in 29 healthy participants. In 6 recording sessions, participants completed a tonic heat pain paradigm and simultaneously received tACS over prefrontal or somatosensory cortices at alpha or gamma frequencies or sham tACS. Concurrently, pain ratings and autonomic responses were collected. Using the present setup, tACS did not modulate pain or autonomic responses. Bayesian statistics confirmed a lack of tACS effects in most conditions. The only exception was alpha tACS over somatosensory cortex where evidence was inconclusive. Taken together, we did not find significant tACS effects on tonic experimental pain in healthy humans. Based on our present and previous findings, further studies might apply refined stimulation protocols targeting somatosensory alpha oscillations. TRIAL REGISTRATION: The study protocol was pre-registered at ClinicalTrials.gov (NCT03805854). PERSPECTIVE: Modulating brain oscillations is a promising approach for the treatment of pain. We therefore applied transcranial alternating current stimulation (tACS) to modulate experimental pain in healthy participants. However, tACS did not modulate pain, autonomic responses, or EEG oscillations. These findings help to shape future tACS studies for the treatment of pain.

New insights on the combined removal of antibiotics and ARGs in urban wastewater through the use of two configurations of vertical subsurface flow constructed wetlands.

The occurrence and removal of 49 antibiotics and 11 selected antibiotic resistance genes (ARGs) were investigated in 2 vertical subsurface flow (VF) constructed wetlands (1.5 m2 each): an unsaturated (UVF) unit and a partially saturated (SVF) unit (0.35 m saturated out of 0.8 m) operating in parallel and treating urban wastewater. Thirteen antibiotics were detected in influent wastewater, 6 of which were present in all samples. The SVF showed statistical significance on the removal of 4 compounds (namely ciprofloxacin, ofloxacin, pipemidic acid and azithromycin), suggesting that the wider range of pH and/or redox conditions of this configuration might promote the microbial degradation of some antibiotics. In contrast, the concentration of the latter (except pipemidic acid) and also clindamycin was higher in the effluent than in the influent of the UVF. Five ARGs were detected in influent wastewater, sul1 and sul2, blaTEM, ermB and qnrS. All of them were detected also in the biofilm of both wetlands, except qnrS. Average removal rates of ARGs showed no statistical differences between both wetland units, and ranged between 46 and 97% for sul1, 33 and 97% for sul2, 9 and 99% for ermB, 18 and 97% for qnrS and 11 and 98% for blaTEM.

Dynamics of brain function in patients with chronic pain assessed by microstate analysis of resting-state electroencephalography.

ABSTRACT: Chronic pain is a highly prevalent and severely disabling disease that is associated with substantial changes of brain function. Such changes have mostly been observed when analyzing static measures of resting-state brain activity. However, brain activity varies over time, and it is increasingly recognized that the temporal dynamics of brain activity provide behaviorally relevant information in different neuropsychiatric disorders. Here, we therefore investigated whether the temporal dynamics of brain function are altered in chronic pain. To this end, we applied microstate analysis to eyes-open and eyes-closed resting-state electroencephalography data of 101 patients suffering from chronic pain and 88 age- and sex-matched healthy controls. Microstate analysis describes electroencephalography activity as a sequence of a limited number of topographies termed microstates that remain stable for tens of milliseconds. Our results revealed that sequences of 5 microstates, labelled with the letters A to E, consistently described resting-state brain activity in both groups in the eyes-closed condition. Bayesian analysis of the temporal characteristics of microstates revealed that microstate D has a less predominant role in patients than in controls. As microstate D has previously been related to attentional networks and functions, these abnormalities might relate to dysfunctional attentional processes in chronic pain. Subgroup analyses replicated microstate D changes in patients with chronic back pain, while patients with chronic widespread pain did not show microstates alterations. Together, these findings add to the understanding of the pathophysiology of chronic pain and point to changes of brain dynamics specific to certain types of chronic pain.

Nighttime Kidney Transplant From Donor With Controlled Cardiac Death: Greater Functionality at the Cost of More Complications?

BACKGROUND: Kidney transplantation surgery from controlled cardiac death donor (Maastricht III) is frequently performed at night, without taking into account the accumulated fatigue that the surgical team may experience. The objective of the study is to assess whether surgical complications and the functionality of the graft in the short and long term are affected by the time of day in which kidney transplantation from controlled cardiac death donors is performed. METHODS: A retrospective observational study was carried out. Patient were classified according to the start of surgery, daytime hours (8:00 AM to 7:59 PM), and nighttime hours (8:00 PM to 7:59 AM). Baseline and intraoperative parameters, postoperative complications, and parameters related to graft functionality were analyzed. RESULTS: A total of 77 patients were included: 37 patients had kidney transplantations performed during the daytime (48.05%), and 40 patients had kidney transplantations performed at nighttime (51.95%). No statistically significant differences were found between the baseline characteristics of both groups except for sex (55.0% men in daytime vs 78.4% men in nighttime, P = .03) and time on pretransplant dialysis (33.1 months in daytime vs 13.8 months in nighttime, P = .008). The incidence of surgical complications and the functionality of the graft was similar in both groups; however, the surgical time was shorter in night transplants (163.2 minutes in daytime vs 136.5 minutes at nighttime, P = .0006) CONCLUSION: The performance of kidney transplants at night is not associated, either in the short or long term, with an increase in surgical complications or conditions leading to the deterioration in the functionality of the graft.

[Living-donor renal transplant. State of the art.] / Trasplante renal de donante vivo. Estado actual.

Living donor kidney transplantation is the best therapeutic option in a patient with end-stage renal failure, because it provides excellent functionality and graft survival. Laparoscopic living donor nephrectomyis the gold-standard for obtaining the graft. In exper thands, different minimally invasive surgeries can be offered with the main advantage of improving the a esthetic results. Although there may be controversy regarding laparoscopic devices for vascular ligation during living donor nephrectomy, both endostaplers and locking clips have proven to be safe as long as the proper techniqueis performed. Living donor nephrectomy has minimal morbidity and mortality. Age and glomerular filtration rate of the donor candidate are prognostic factor of long-term renal failure. In relation to the implant surgery,robotic kidney transplantation is now probably at the beginning of its development. Published series still do not allow to clearly establish its role compared to conventional open surgery.

El trasplante renal de donante vivo suponela mejor opción terapéutica en un paciente con insuficiencia renal terminal, por su excelente funcionalidad y supervivencia del injerto. La nefrectomía laparoscópica de donante vivo es la técnica de elección para la obtención del injerto. En manos expertas, distintas variantes mínimamente invasivas pueden ofrecerse con la principal ventaja de mejorar los resultados estéticos del donante. Aunque pueda existir controversia en relación a los dispositivos laparoscópicos para la ligadura vascular durante la nefrectomía de donante vivo, tanto las endograpadoras como los clips con cierre tipo Hem-olokhan demostrado ser seguros siempre que se respete la técnica adecuada en su empleo. La nefrectomía de donante vivo no está exenta de una mínima morbi-mortalidad.La edad y el filtrado glomerular del candidato a donante son orientativas del riesgo de enfermedad renal a largo plazo. En relación a la cirugía del implante, el trasplante renal robótico se encuentra en los albores de su desarrollo. Las series publicadas no permiten aún establecer claramente su papel frente a la cirugía abierta convencional.

Review of REACH Annex IV--establishing the minimum risk of a substance based on its intrinsic properties.

Registration is the main mechanism in REACH that ensures the safety of substances. However, some substances are exempted from Registration, such as those included in Annex IV. Annex IV lists substances that are exempted from Registration on the basis that 'sufficient information is known about these substances that they are considered to cause minimum risk because of their intrinsic properties'. As part of the follow up to the co-decision process on REACH, the Commission was mandated to review Annex IV. To enable consideration of whether additional substances should be added to Annex IV and whether substances currently in the Annex should remain, the Commission, together with stakeholders, operationalized the core concepts of minimum risk and sufficient information in the form of criteria. These criteria consider the intrinsic properties of the substance and are based on the classification criteria in Annex VI of Directive 67/548/EEC but were set at a level 'well below' the classification criteria to correspond with a minimum risk level. As a result of the review, Annex IV has been recently amended. This paper looks at how the agreed criteria demonstrate minimum risk and concludes that, although developed in the frame of REACH registration, they could be more widely used in the sound management of chemicals.

Properties and Skin Compatibility of Films Based on Poly(Lactic Acid) (PLA) Bionanocomposites Incorporating Chitin Nanofibrils (CN).

Nanobiocomposites suitable for preparing skin compatible films by flat die extrusion were prepared by using plasticized poly(lactic acid) (PLA), poly(butylene succinate-co-adipate) (PBSA), and Chitin nanofibrils as functional filler. Chitin nanofibrils (CNs) were dispersed in the blends thanks to the preparation of pre-nanocomposites containing poly(ethylene glycol). Thanks to the use of a melt strength enhancer (Plastistrength) and calcium carbonate, the processability and thermal properties of bionanocomposites films containing CNs could be tuned in a wide range. Moreover, the resultant films were flexible and highly resistant. The addition of CNs in the presence of starch proved not advantageous because of an extensive chain scission resulting in low values of melt viscosity. The films containing CNs or CNs and calcium carbonate resulted biocompatible and enabled the production of cells defensins, acting as indirect anti-microbial. Nevertheless, tests made with Staphylococcus aureus and Enterobacter spp. (Gram positive and negative respectively) by the qualitative agar diffusion test did not show any direct anti-microbial activity of the films. The results are explained considering the morphology of the film and the different mechanisms of direct and indirect anti-microbial action generated by the nanobiocomposite based films.

Gene expression profiling of intestinal regeneration in the sea cucumber.

BACKGROUND: Among deuterostomes, the regenerative potential is maximally expressed in echinoderms, animals that can quickly replace most injured organs. In particular, sea cucumbers are excellent models for studying organ regeneration since they regenerate their digestive tract after evisceration. However, echinoderms have been sidelined in modern regeneration studies partially because of the lack of genome-wide profiling approaches afforded by modern genomic tools.For the last decade, our laboratory has been using the sea cucumber Holothuria glaberrima to dissect the cellular and molecular events that allow for such amazing regenerative processes. We have already established an EST database obtained from cDNA libraries of normal and regenerating intestine at two different regeneration stages. This database now has over 7000 sequences. RESULTS: In the present work we used a custom-made microchip from Agilent with 60-mer probes for these ESTs, to determine the gene expression profile during intestinal regeneration. Here we compared the expression profile of animals at three different intestinal regeneration stages (3-, 7- and 14-days post evisceration) against the profile from normal (uneviscerated) intestines. The number of differentially expressed probes ranged from 70% at p < 0.05 to 39% at p < 0.001. Clustering analyses show specific profiles of expression for early (first week) and late (second week) regeneration stages. We used semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR) to validate the expression profile of fifteen microarray detected differentially expressed genes which resulted in over 86% concordance between both techniques. Most of the differentially expressed ESTs showed no clear similarity to sequences in the databases and might represent novel genes associated with regeneration. However, other ESTs were similar to genes known to be involved in regeneration-related processes, wound healing, cell proliferation, differentiation, morphological plasticity, cell survival, stress response, immune challenge, and neoplastic transformation. Among those that have been validated, cytoskeletal genes, such as actins, and developmental genes, such as Wnt and Hox genes, show interesting expression profiles during regeneration. CONCLUSION: Our findings set the base for future studies into the molecular basis of intestinal regeneration. Moreover, it advances the use of echinoderms in regenerative biology, animals that because of their amazing properties and their key evolutionary position, might provide important clues to the genetic basis of regenerative processes.

Functional results in the treatment of localized prostate cancer. An updated literature review.

Prostate cancer is the second most frequently diagnosed cancer in men. The initial diagnosis is made in increasingly younger patients, so it seems to be essential to guarantee optimal functional results. We carried out a systematic search to define the functional results of each of the therapeutic options for localized prostate cancer. Radical prostatectomy generates a greater negative effect on urinary continence and erectile function compared to active surveillance and radiotherapy. Robotic surgery seems to offer better functional results, especially at the level of erectile function. Urinary and bowel symptoms are more pronounced after radiotherapy compared to other options. Patients must be warned of the possible functional results prior to choice of treatment.