Phrenic Nerve Block for Diaphragmatic Pain: Case Report.

Referred chronic shoulder pain may arise from diaphragmatic irritation. It can potentially be alleviated by blockade of the phrenic nerve. There is literature describing its use in acute pain conditions; yet for chronic pain, there are no reports. We present 2 cases of chronic diaphragmatic irritation causing ipsilateral referred shoulder pain. Patients experienced significant pain relief and a reduction in opioid consumption after receiving an ultrasound-guided phrenic nerve block. While the phrenic nerve block shows promise for pain relief, carefully evaluating its benefits and risks is recommended before considering its application in selected cases.

Two draft genomes of fungal leaf endophytes from tropical gymnosperms.

Two ascomycetes, Neofusicoccum sp. and Xylaria sp., were isolated from healthy leaves of the tropical gymnosperms Zamia pseudoparasitica (Z2) and Zamia nana (Z50) from Panama. The two draft genomes possess a broad predicted repertoire of carbohydrate-degrading CAZymes, peptidases, and secondary metabolites, with more secondary metabolite clusters in the Xylaria isolate.

A high-quality genome for the slender anole (Anolis apletophallus): an emerging model for field studies of tropical ecology and evolution.

The slender anole, Anolis apletophallus, is a small arboreal lizard of the rainforest understory of central and eastern Panama. This species has been the subject of numerous ecological and evolutionary studies over the past 60 years as a result of attributes that make it especially amenable to field and laboratory science. Slender anoles are highly abundant, short-lived (nearly 100% annual turnover), easy to manipulate in both the lab and field, and are ubiquitous in the forests surrounding the Smithsonian Tropical Research Institute in Panama, where researchers have access to high-quality laboratory facilities. Here, we present a high-quality genome for the slender anole, which is an important new resource for studying this model species. We assembled and annotated the slender anole genome by combining 3 technologies: Oxford Nanopore, 10× Genomics Linked-Reads, and Dovetail Omni-C. We compared this genome with the recently published brown anole (Anolis sagrei) and the canonical green anole (Anolis carolinensis) genomes. Our genome is the first assembled for an Anolis lizard from mainland Central or South America, the regions that host the majority of diversity in the genus. This new reference genome is one of the most complete genomes of any anole assembled to date and should facilitate deeper studies of slender anole evolution, as well as broader scale comparative genomic studies of both mainland and island species. In turn, such studies will further our understanding of the well-known adaptive radiation of Anolis lizards.

Effect of process parameters and surfactant additives on the obtained activity of recombinant tryptophan hydroxylase (TPH1) for enzymatic synthesis of 5-hydroxytryptophan (5-HTP).

5-hydroxytryptophan (5-HTP) is an intermediate molecule in the biosynthesis of serotonin, an important neurotransmitter, regulating a series of metabolic and psychological functions in humans. In this work, we studied the heterologous production of Human tryptophan hydroxylase (TPH1) in Escherichia coli, for the synthesis of 5-hydroxytryptophan (5-HTP) from Tryptophan (Trp). To quantify TPH1 activity, a simple fluorescence-based microtiter plate assay was established, based on the changes in fluorescence emission at 340 nm between substrate and product when excited at 310 nm, allowing quick and reliable quantification of released 5-HTP. To increase enzyme production, heterologous TPH1 production was studied in stirred tank bioreactor scale. The effect of rate of aeration (0.25, 0.50 and 0.75 vvm) and agitation (150, 250 and 500 rpm) was evaluated for biomass production, pH, volumetric oxygen transfer coefficient (kLa) and volumetric TPH1 activity. We determined that high agitation and low aeration allowed reaching the maximum measured enzyme activity. Under such conditions, we observed a 90% substrate conversion, obtaining 90 µM (~0.02 g/L) 5-HTP from a 100 µM Tryptophan substrate solution. Finally, we observed that the addition of Tween 20 (0.1%) in the culture broth under production conditions expanded the pH operation range of TPH1. Our results establish a base for a biocatalytic approach as a potential alternative process for the synthesis of 5-HTP using recombinant TPH1.

Effect of the Central American Isthmus on gene flow and divergence of the American crocodile (Crocodylus acutus).

The final formation of the Central American Isthmus (CAI) about 3.5 million years ago altered global ocean circulation, connected North and South America terrestrial biotas, and established the Caribbean Sea. The nature of this event creates a natural scenario to test vicariance, divergence, and speciation by allopatry. Studies have shown the effect of the CAI on marine and terrestrial species, but none have examined a large-bodied amphibious taxon. We used RAD sequencing on populations of the American crocodile (Crocodylus acutus) to study the genomic variation of C. acutus on both sides of the CAI, infer its demographic history, and measure the effect of the opening of the Panama Canal. Our results showed three genomic clusters: (1) Caribbean and the Panama Canal, (2) Pacific coast, and (3) Coiba island. The estimated divergence times between the Caribbean and Pacific populations are about 20,000 years ago, which is younger than the formation of the CAI, coinciding with the Last Glacial Maximum. We hypothesize the glacial/interglacial cycles facilitated gene flow between the Caribbean and Pacific crocodile populations after the formation of the CAI, masking any genomic divergence the CAI may have caused. There is no evidence of gene flow associated with the opening of the Panama Canal.

Inter-chromosomal coupling between vision and pigmentation genes during genomic divergence.

Recombination between loci underlying mate choice and ecological traits is a major evolutionary force acting against speciation with gene flow. The evolution of linkage disequilibrium between such loci is therefore a fundamental step in the origin of species. Here, we show that this process can take place in the absence of physical linkage in hamlets-a group of closely related reef fishes from the wider Caribbean that differ essentially in colour pattern and are reproductively isolated through strong visually-based assortative mating. Using full-genome analysis, we identify four narrow genomic intervals that are consistently differentiated among sympatric species in a backdrop of extremely low genomic divergence. These four intervals include genes involved in pigmentation (sox10), axial patterning (hoxc13a), photoreceptor development (casz1) and visual sensitivity (SWS and LWS opsins) that develop islands of long-distance and inter-chromosomal linkage disequilibrium as species diverge. The relatively simple genomic architecture of species differences facilitates the evolution of linkage disequilibrium in the presence of gene flow.

Interplay between Developmental Flexibility and Determinism in the Evolution of Mimetic Heliconius Wing Patterns.

To what extent can we predict how evolution occurs? Do genetic architectures and developmental processes canalize the evolution of similar outcomes in a predictable manner? Or do historical contingencies impose alternative pathways to answer the same challenge? Examples of Müllerian mimicry between distantly related butterfly species provide natural replicates of evolution, allowing us to test whether identical wing patterns followed parallel or novel trajectories. Here, we explore the role that the signaling ligand WntA plays in generating mimetic wing patterns in Heliconius butterflies, a group with extraordinary mimicry-related wing pattern diversity. The radiation is relatively young, and numerous cases of wing pattern mimicry have evolved within the last 2.5-4.5 Ma. WntA is an important target of natural selection and is one of four major effect loci that underlie much of the pattern variation in the group. We used CRISPR/Cas9 targeted mutagenesis to generate WntA-deficient wings in 12 species and a further 10 intraspecific variants, including three co-mimetic pairs. In all tested butterflies, WntA knockouts affect pattern broadly and cause a shift among every possible scale cell type. Interestingly, the co-mimics lacking WntA were very different, suggesting that the gene networks that pattern a wing have diverged considerably among different lineages. Thus, although natural selection channeled phenotypic convergence, divergent developmental contexts between the two major Heliconius lineages opened different developmental routes to evolve resemblance. Consequently, even under very deterministic evolutionary scenarios, our results underscore a surprising unpredictability in the developmental paths underlying convergence in a recent radiation.

Multilocus molecular systematics of the circumtropical reef-fish genus Abudefduf (Pomacentridae): history, geography and ecology of speciation.

We investigated a pantropical sub-family and genus of damselfishes, the sergeant-majors (Pomacentridae: Abudefdufinae: Abudefduf), to identify the tempo and mechanisms of speciation in the lineage. We examined sequence capture data from 500 loci and 20 species, with multiple individuals sampled from across the geographic ranges of widespread species. Utilizing a maximum likelihood framework, as well as a time-calibrated Bayesian phylogeny, the following key questions are addressed: What is the historical tempo of speciation? What are the relative contributions of vicariant, peripatric and parapatric speciation to sergeant-major diversity? How is speciation related to major variation in trophic ecology? The approximately 20 species of sergeant-majors fall into three main lineages. The ancestral condition appears to be benthivory, which is predominant in two lineages comprising six species. The remaining species of sergeant-majors, of which there are at least 15, fall within a clade composed entirely of planktivores. This clade is sister to a benthivore clade that included one species, Abudefduf notatus, in transition to planktivory. Most speciation of sergeant-majors, which appeared ∼24 million years ago, occurred in the last 10 million years. Present distributional patterns indicate vicariant speciation precipitated by the closure of land barriers between both sides of the Atlantic and the Pacific, and the emergence of land between the Indian and Pacific Oceans. Within this backdrop, frequent oscillations in sea level over the last 10 million years also appear to have generated conditions suitable for both peripatric and vicariant speciation, and most speciation within the genus appears linked to these changes in sea level. Diversification within the genus has been concentrated in planktivorous seargeant-majors rather than benthivores. The root cause is unclear, but does not appear to be related to differences in dispersal potential, which is greater in the planktivorous species, due to the ability of their post-larval juveniles to raft with floating debris. This elevated speciation rate in planktivores and their propensity to form local endemics may reflect relaxation of selective pressures (e.g., on crypticity) that limit speciation in benthivorous sergeant-majors. Finally, our data allow us to clarify relationships of geminate sergeant-major species, indicating that there are subdivisions within the Atlantic for both benthivore and planktivore geminate pairs that may have misled previous studies.

Carrion fly-derived DNA metabarcoding is an effective tool for mammal surveys: Evidence from a known tropical mammal community.

Metabarcoding of vertebrate DNA derived from carrion flies has been proposed as a promising tool for biodiversity monitoring. To evaluate its efficacy, we conducted metabarcoding surveys of carrion flies on Barro Colorado Island (BCI), Panama, which has a well-known mammal community, and compared our results against diurnal transect counts and camera trapping. We collected 1,084 flies in 29 sampling days, conducted metabarcoding with mammal-specific (16S) and vertebrate-specific (12S) primers, and sequenced amplicons on Illumina MiSeq. For taxonomic assignment, we compared blast with the new program protax, and we found that protax improved species identifications. We detected 20 mammal, four bird, and one lizard species from carrion fly metabarcoding, all but one of which are known from BCI. Fly metabarcoding detected more mammal species than concurrent transect counts (29 sampling days, 13 species) and concurrent camera trapping (84 sampling days, 17 species), and detected 67% of the number of mammal species documented by 8 years of transect counts and camera trapping combined, although fly metabarcoding missed several abundant species. This study demonstrates that carrion fly metabarcoding is a powerful tool for mammal biodiversity surveys and has the potential to detect a broader range of species than more commonly used methods.

Características neuroanatômicas e linguísticas na dislexia adquirida / Neuroanatomical and linguistic characteristics of acquired dyslexia / Características neuroatómicas y linguísticas en la dyslexia adquirida

Introdução: a dislexia adquirida caracteriza-se pela perda da capacidade de compreender o significado de palavras escritas desenvolvida previamente. Esta afecção pode ter origem em acidentes vasculares, traumatismos e outras doenças cerebrais. Objetivo: investigar as características da dislexia adquirida, explorando as correlações neuroanatômicas nas encefalopatias que as produzem, por meio de uma revisão de literatura. Método: Para a realização do estudo, os autores seguiram os critérios sugeridos pela Cochrane Handbook. Primeiramente, formulou-se uma pergunta, seguida da localização e seleção criteriosa dos artigos. Em seguida, ocorreu a avaliação crítica de cada estudo, finalizando com a análise, interpretação e apresentação dos resultados encontrados. Foram consultadas as bases de dados Science Direct, Pubmed/Medline e Scopus, com a utilização dos descritores "brain diseases", "brain injuries", "traumatic brain injuries" e "stroke" com o operador booleano OR, associado aos descritores "alexia" e "acquired dyslexia" por meio do operador booleano AND. Revisão de Literatura: A primeira busca eletrônica contabilizou 137 artigos científicos, dos quais 11 foram eleitos por se tratar de estudos contendo a relação anatômica das lesões e/ou sinais clínicos e linguísticos da dislexia adquirida. Conclusão: A principal causa da dislexia adquirida foi o acidente vascular cerebral, sobretudo no lobo occipital, em ambos os hemisférios, repercutindo na percepção e, posteriormente, no reconhecimento visual da palavra. Faz-se necessário ampliar as pesquisas sobre a dislexia adquirida, a fim de aprofundar o conhecimento sobre a mesma, instrumentalizando os clínicos para o processo de reabilitação.

Introduction: acquired dyslexia is characterized by the loss of the capacity to understand the meaning of written words previously developed. This condition can be caused by strokes, trauma and other brain diseases. Objective: to investigate the characteristics of acquired dyslexia, exploring the neuroanatomical correlations in the encephalopathies that produce them, through a literature review. Method: For the study, the authors followed the criteria suggested by the Cochrane Handbook. Firstly, a question was asked, followed by the location and careful selection of the articles. Then, the critical evaluation of each study occurred, ending with the analysis, interpretation and presentation of the results found. The databases Science Direct, Pubmed / Medline and Scopus, using the descriptors "brain diseases", "brain injuries", "traumatic brain injuries" and "stroke" with the Boolean operator OR, associated with the descriptors "alexia" and "acquired dyslexia" through the Boolean operator AND. Literature Review: The first electronic search counted 137 scientific articles, of which 11 were chosen because they were studies containing the anatomical relationship of lesions and/or clinical and linguistic signs of acquired dyslexia. Conclusion: The main cause of acquired dyslexia was stroke, especially in the occipital lobe, in both hemispheres, affecting the perception and subsequent visual recognition of the word. It is necessary to broaden the research on acquired dyslexia in order to deepen the knowledge about it, instrumentalizing the clinicians for the rehabilitation process.

Introducción: la dislexia adquirida se caracteriza por la pérdida de la capacidad en comprender el significado de palabras escritas desarrollada previamente. Esta afección puede originarse en accidentes vasculares, traumatismos y otras enfermedades cerebrales. Objetivo: investigar las características de la dislexia adquirida, explorando las correlaciones neuroanatómicas en las encefalopatías que las producen, por medio de una revisión de literatura. Metodos: Para la realización del estudio, los autores siguieron los criterios sugeridos por la Cochrane Handbook. Primero, se formuló una pregunta, seguida de la localización y selección criteriosa de los artículos. A continuación, ocurrió la evaluación crítica de cada estudio, finalizando con el análisis, interpretación y presentación de los resultados encontrados. Se han consultado las bases de datos Science Direct, Pubmed / Medline y Scopus, con la utilización de los descriptores "brain diseases", "brain cura", "traumatismo cerebrovascular" y "stroke" con el operador booleano OR, asociado a los descriptores "alexia" y "adquirido dyslexia" a través del operador booleano AND. Revisión de Literatura: La primera búsqueda electrónica contabilizó 137 artículos científicos, de los cuales 11 fueron elegidos por tratarse de estudios que contenían la relación anatómica de las lesiones y/o signos clínicos y lingüísticos de la dislexia adquirida. Conclusión: La principal causa de la dislexia adquirida fue el accidente cerebrovascular, sobre todo en el lobo occipital, en ambos hemisferios, repercutiendo en la percepción y posterior reconocimiento visual de la palabra. Se hace necesario ampliar las investigaciones sobre la dislexia adquirida, a fin de profundizar el conocimiento sobre la misma, instrumentalizando a los clínicos para el proceso de rehabilitación.

Avaliação da força adesiva de restaurações em dentes clareados através do teste de microtração após o processo de desoxigenação com metabisulfito de sódio / Evaluation of adhesive strength of restorations in teeth bleached through microtensile test after desoxygenation process with sodium metabisulfite

Objetivo: O objetivo deste estudo é demonstrar a capacidade do metabissulfito de sódio em desoxigenar e devolver imediatamente a resistência de união adequada entre sistema adesivo e estrutura dental. Metodologia: 18 molares hígidos foram divididos em seis grupos de três dentes cada, o grupo controle, grupo 1, não recebeu tratamento clareador nem agente neutralizador, o grupo 5 foi clareado e recebeu tratamento com hidróxido de cálcio durante 15 dias, o grupo 6 recebeu tratamento clareador, porém não recebeu tratamento com nenhum agente neutralizador, já os grupos 2, 3 e 4 receberam tratamento clareador e usou-se como agente neutralizador o metabisulfito de sódio, diferindo o tempo de uso, grupo 2, 10 minutos, grupo 3, uma hora, grupo 4 setenta e duas horas. Todos os corpos de prova foram restaurados com sistema adesivo Scotch Bond Multiuso e resina composta Z250 e após cortados em palitos para serem submetidos a teste de microtração. Resultados: O teste Kruskal-Wallis indicou que houve diferença estatisticamente significante entre os grupos 1 e 3, assim como este grupo se mostrou diferente do grupo 4 e do grupo 5. Conclusão: o metabisulfito de sódio, utilizado por uma hora, determina uma resistência adesiva significativamente maior que as demais variáveis testadas.

Objective: The objective of this study is to demonstrate the ability of sodium metabisulfite in deoxygenate and return immediately to adequate bond strength between adhesive system and tooth structure. Methods: 18 molars were divided into six groups of three teeth each, the control group, group 1 received no treatment or bleach neutralizing agent, group 5 was bleached and treated with calcium hydroxide for 15 days, the group 6 received bleaching, but not treated with any neutralizing agent and the groups 2, 3 and.4 received bleaching treatment was used as the neutralizing agent sodium metabisulfite, deferring the time of use, group 2, 10 minutes, group 3, one hour, group 4 seventy-two hours. All specimens were restored with a bonding system Scotch Bond Multipurpose and Z250 composite resin and after cut in sticks for subjected to the microtensile test. Results: The Kruskal-Wallis test indicated that there was a statistically significant difference between groups 1 and 3, as well as this group was different from group 4 and group 5. Conclusion: sodium metabisulfite, used for an hour, provides a bond strength significantly higher than the other variables tested.

Cirugia mucogingival / Gingival surgery

La cirugía mucogingival engloba una serie de técnicas tendientes a solucionar problemas periodontales vinculados con una alteración en la normal relación topoghráfica entre encía insertada y mucosa alveolar.

Relaciones ortodoncia periodoncia / Periodontics and orthodontics relations

Es innegable que la terapia ortodóntica puede producir una mejor oclusión y un complejo dento facial más estético. Sin embargo, cabe preguntarnos: Es la salud periodontal mejor o peor como consecuencia de la terapia ortodóntica?, Qué efecto tiene sobre el periodonto la fuerza odontológica ejercida?, Una vez realizada la terapia ortodóntica, cómo influye sobre el periodonto la recidiva?.

Influencia de vehículos de disolución sobre el hidróxido de calcio / Influence of dissolution vehicles on calcium hydroxide

El uso del hidróxido de calcio es habitual en la práctica endodóntica, atribuyéndose propiedades reparativas a su elevado pH. El objetivo de este trabajo es de verificar el pH del hidróxido de calcio al ser mezclado con seis solventes diferentes. Se procedió a determinar colorimétrica y potenciométricamente el pH de los solventes y de sus mezclas resultantes. Los resultados determinaron que el paramonoclorofenol alcanforado baja el pH del hidróxido de calcio significativamente, comparación con el resto de los solventes. Es posible que el mecanismo de acción del hidróxido de calcio no sea debido exclusivamente a su elevado pH, sino que sea multifactorial

Manual de ensenanza para paciente con insuficiencia renal cronica del Hospital Universitario Ramon Gonzalez Valencia / Teching manual for patient with chronic renal failure from Hospital Universitario Ramonon Gonzalez Valencia

Manual de instruccion programada para el paciente que sufre insuficiencia renal cronica, disenado para ayudarlo a enfrentarse a las nuevas situaciones derivadas de la enfermedad. Contiene 9 secciones antecedidas de las instrucciones para desarrollarlarlas. Cada una se refiere a: rinon normal, insuficiencia renal cronica, dieta, medicamentos, productividad, diferentes metodos de dialisis, trasplante renal y descripcion de actitudes y sentimientos frente a la enfermedad, el tratamiento y las nuevas limitaciones

Manual de ensenanza para la familia del paciente con insuficiencia renal cronica / Teaching manual for the family for the family of the patient with chronik renal failure

Material de instruccion programada dirigido a la ensenanza a los familiares de la persona con insuficiencia renal cronica para capacitarlos en el cuidado del enfermo. Incluye la cooperacion en el seguimiento , la dieta por parte del paciente, la farmacoterapia, las actividades de la vida diaria, en diferentes modalidades de dialisis y el soporte afectivo que requiere el paciente