Persistent mycotic superficial femoral artery pseudoaneurysm after endovascular treatment: a case report.

Mycotic pseudoaneurysms of the superficial femoral artery (SFA) are rare and are usually secondary to colonization of an atherosclerotic plaque during an episode of bacteremia. We describe the case of a 68 year-old diabetic male who presented to the Emergency Department with pyrexia and a painful expanding mass in the left thigh. He had a history of diarrhea and had been treated 16 days earlier for an SFA pseudoaneurysm that had been excluded with a covered stent with no adjunctive antibiotic therapy. Angio CT showed an abscess surrounding femoral vessels and stent thrombosis. Under general anesthesia, we performed extensive debridement, removal of the endovascular material, SFA ligation, and empirical antibiotic therapy. Blood and tissue cultures were positive for Escherichia coli. At the 3-months follow up visit, the patient reported he had no claudication. In selected patients, mycotic pseudoaneurysms can be treated by SFA ligation.

Pseudoaneurismas micóticos da artéria femoral superficial (AFS) são raros, e geralmente são secundários à colonização de uma placa aterosclerótica durante bacteremia. Relatamos o caso de um paciente masculino diabético de 68 anos que chegou ao Serviço de Emergência com pirexia e massa expansiva dolorosa na coxa esquerda. Apresentava histórico de diarreia e havia sido tratado 16 dias antes para pseudoaneurisma da AFS, que foi excluído com stent coberto e sem antibioticoterapia adjuvante. A angiotomografia computadorizada demonstrou um abscesso ao redor dos vasos femorais e trombose do stent. Sob anestesia geral, realizamos desbridamento extenso, remoção do material endovascular, ligadura de AFS e antibioticoterapia empírica. Culturas de sangue e tecidos foram positivas para Escherichia coli. Na consulta de seguimento aos 3 meses, o paciente negou claudicação. Em pacientes selecionados, pseudoaneurismas micóticos podem ser tratados com ligadura de AFS.

[Usefulness of upper gastrointestinal series to detect leaks in the early postoperative period of bariatric surgery]. / Utilidad del estudio contrastado precoz del tracto digestivo superior después de cirugía bariátrica: ¿se justifica su uso rutinario?

BACKGROUND: Postoperative leaks are the most undesirable complication of bariatric surgery and upper gastrointestinal (GI) series are routinely ordered to rule them out. Despite the published literature recommending against its routine use, it is still being customarily used in Chile. AIM: To examine the usefulness of routine upper GI series using water-soluble iodinated contrast media for the detection of early postoperative leaks in patients undergoing bariatric surgery. MATERIAL AND METHODS: A cohort of 328 patients subjected to bariatric surgery was followed from October 2012 to October 2013. Most of them underwent sleeve gastrectomy. RESULTS: Upper GI series on the first postoperative day were ordered to 308 (94%) patients. Postoperative leaks were observed in two patients, with an incidence of 0.6%. The sensitivity for upper GI series detection of leak was 0% and the negative predictive value was 99%. CONCLUSIONS: Routine upper GI series after bariatric surgery is not useful for the diagnosis of postoperative leak, given the low incidence of this complication and the low sensitivity of the technique.

Nucleolin is required for DNA methylation state and the expression of rRNA gene variants in Arabidopsis thaliana.

In eukaryotes, 45S rRNA genes are arranged in tandem arrays in copy numbers ranging from several hundred to several thousand in plants. Although it is clear that not all copies are transcribed under normal growth conditions, the molecular basis controlling the expression of specific sets of rRNA genes remains unclear. Here, we report four major rRNA gene variants in Arabidopsis thaliana. Interestingly, while transcription of one of these rRNA variants is induced, the others are either repressed or remain unaltered in A. thaliana plants with a disrupted nucleolin-like protein gene (Atnuc-L1). Remarkably, the most highly represented rRNA gene variant, which is inactive in WT plants, is reactivated in Atnuc-L1 mutants. We show that accumulated pre-rRNAs originate from RNA Pol I transcription and are processed accurately. Moreover, we show that disruption of the AtNUC-L1 gene induces loss of symmetrical DNA methylation without affecting histone epigenetic marks at rRNA genes. Collectively, these data reveal a novel mechanism for rRNA gene transcriptional regulation in which the nucleolin protein plays a major role in controlling active and repressed rRNA gene variants in Arabidopsis.

"To be, or not be satisfied in NPOs": a serial multiple mediation and clustering analysis of paid staff and volunteers' profiles.

Introduction: Non-profit organizations (NPOs) are a complex working context whose main characteristic resides in the dichotomy between paid staff and volunteers. Despite its benefits for goal achievement, this circumstance can be also a challenge, for both groups' interaction, for their comprehension of their own role and to HR management. The aim of this study was to explore factors that may contribute to promote job satisfaction among NPOs' members. Methods: Combining two different data analyses, serial multiple mediation analyses and cluster analyses, first we analyze whether there are differences between paid staff and volunteers in perceived intrapersonal conflict and performance and its effect on job satisfaction, and second, we analyze whether there is an additional profiles distribution that reflects more adequately the reality of NPOs, despite the formal roles that coexist in these organizations (paid staff and volunteers). Results: Results confirm that paid staff and volunteers differ on their perceived job satisfaction level, with volunteers being more satisfied. This relationship is serially mediated by role conflict, role ambiguity, and performance. Another characteristic of the NPOs is that the dichotomy between paid staff and volunteers does not capture well the reality of the labor relations between members of both groups and the organization. To explore this phenomenon, we perform a cluster analysis based on paid staff and volunteers' perceptions. Cluster analyses demonstrate the existence of three rather homogenous profiles. Discussion: Additionally, practical implications for HR management in NPOs and future research lines to understand this organizational context dynamics are also discussed.

Prediction of asymptomatic abdominal aortic aneurysm expansion by means of rate of variation of C-reactive protein plasma levels.

OBJECTIVE: C-reactive protein (CRP) is an independent risk factor for arteriosclerosis, but its role in abdominal aortic aneurysm (AAA) expansion remains not completely verified. There are no data about the prognostic significance of rates of variation of the CRP levels in asymptomatic AAAs. This study investigated the association between plasma CRP levels and AAA diameter and assessed the relationship between the gradient of CRP levels and rates of expansion in asymptomatic AAAs. METHODS: Plasma levels of high-sensitive CRP (hs-CRP) were measured using a high-sensitivity technique and AAA size was determined by computed tomography in 435 patients with asymptomatic AAAs followed up in our outpatient department. RESULTS: The median hs-CRP level was 4.23 mg/L. The aorta diameter increased in the four groups of patients determined according to hs-CRP quartiles (35 ± 2, 40 ± 3, 49 ± 4, and 58 ± 5 mm; P = .01). The median rate of CRP level variation per year was 1.4 mg/L. Patients with an elevation >1.4 mg/L had an expansion rate of 4.8 mm vs 3.9 mm in those <1.4 mg/L (P < .01). The multivariate age-adjusted logistic model confirmed initial diameter and variation of CRP level were the only factors associated with expansion, with odds ratios (95% confidence intervals) of 6.3 (3.1-7.5) and 3.4 (2.1-5.6). CONCLUSIONS: These results confirm a statistical association between AAA diameter and hs-CRP plasma levels. This cohort study corroborates this potential causal association and contributes information about the value of the hs-CRP plasma level gradient as a marker of disease progression and rate of expansion.

Linear and non-linear relationships between job demands-resources and psychological and physical symptoms of service sector employees. When is the midpoint a good choice?

Related to the research of working conditions, the link between organizational factors and health was traditionally analyzed using linear models. However, the literature analysis suggests inconsistencies in linear models predicting workers' health levels. To clarify this issue, this exploratory research compares the linear and non-linear relationships between job demands-resources (task complexity, time pressure, contact with users, and job autonomy), and the psychological and physical symptoms of employees working in the main five service subsectors: commerce, horeca (hotels, restaurants, and cafés), public administration, education, and healthcare. With a final sample of 4,047 participants, our study data were extracted from the II Andalusian Working Conditions Survey. Following the theoretical framework of JD-R Model and considering the Vitamin Model theoretical approach for non-linear relationships, our results showed that there were significant differences among the five subsectors analyzed regarding the linear and non-linear relationships between job demands-resources and psychological and physical symptoms of employees. Furthermore, task complexity generated non-linear relationships in higher proportion than time pressure and contact with users. Likewise, non-linear relationships found showed a U-shape. Moreover, the findings of non-linear relationships suggested that medium levels of task complexity should not be exceeded to avoid further negative impact on psychological and physical symptoms for service sector employees, preserving their health. Finally, some general practical implications of work environment interventions are suggested.

Opponent or allied? An European analysis of the union presence and human resource practices.

Human Resources Practices (HRPs) and unions coexist in some organisations to manage the employment relationships of the workers. In this study, we analyse how the presence/absence of unions and HRPs are combined in private European organisations, and which of these combinations are related to higher levels of wellbeing and the quality of labor relations. Data come from 24,503 workers of private organisations, obtained from the Sixth European Working Conditions Survey. Latent profiles analysis and different analyses of the variance suggested four different profiles. The profile with the greatest presence of HRPs and union presence is related to the highest levels of employees' wellbeing and quality of labor relations in organisations, whereas those organisations with a low level of union presence or HRPs reached the worst levels in employees' wellbeing and quality of labor relations indicators. The results and their practical implications are discussed.

Mechanisms Involved in Neuroprotective Effects of Transcranial Magnetic Stimulation.

Transcranial Magnetic Stimulation (TMS) is widely used in neurophysiology to study cortical excitability. Research over the last few decades has highlighted its added value as a potential therapeutic tool in the treatment of a broad range of psychiatric disorders. More recently, a number of studies have reported beneficial and therapeutic effects for TMS in neurodegenerative conditions and strokes. Yet, despite its recognised clinical applications and considerable research using animal models, the molecular and physiological mechanisms through which TMS exerts its beneficial and therapeutic effects remain unclear. They are thought to involve biochemical-molecular events affecting membrane potential and gene expression. In this aspect, the dopaminergic system plays a special role. This is the most directly and selectively modulated neurotransmitter system, producing an increase in the flux of dopamine (DA) in various areas of the brain after the application of repetitive TMS (rTMS). Other neurotransmitters, such as glutamate and gamma-aminobutyric acid (GABA) have shown a paradoxical response to rTMS. In this way, their levels increased in the hippocampus and striatum but decreased in the hypothalamus and remained unchanged in the mesencephalon. Similarly, there are sufficient evidence that TMS up-regulates the gene expression of BDNF (one of the main brain neurotrophins). Something similar occurs with the expression of genes such as c-Fos and zif268 that encode trophic and regenerative action neuropeptides. Consequently, the application of TMS can promote the release of molecules involved in neuronal genesis and maintenance. This capacity may mean that TMS becomes a useful therapeutic resource to antagonize processes that underlie the previously mentioned neurodegenerative conditions.

Effective behaviors to de-escalate organizational conflicts in the process of escalation.

The goal of the present study was to determine what behaviors negotiators can use to help to quell an escalating conflict. In doing so, we formed a sample of professionals who took on the role of negotiator when we provoked an organizational conflict between a superior and subordinate that escalates due to the intervention of research confederates. Trained judges analyzed the negotiators' behaviors that most effectively mitigated the intensity of the conflict in which they were involved. The results demonstrate that the behaviors most effective at de-escalating an escalating conflict are problem-solving and accommodation, especially when said conflict has escalated considerably. Similarly, jointly employing problem-solving and direct fighting behaviors also seems to help de-escalate conflict. The results do not, however, consistently support using a forceful behavioral strategy to de-escalate a conflict in the early stages of escalation.

Increasing Integrative Negotiation in European Organizations Through Trustworthiness and Trust.

Integrative negotiation in which employers and employees create value is a major necessity in the current challenging context. Collective labor negotiations in organizations are traditionally focused on mostly distributive issues, such as pay, working hours, and holidays. However, the current situation demands the inclusion of other issues of a potentially more integrative nature, such as telework, sustainability, and risk prevention, the enhancement of which is a major challenge for organizations. In this study, we explore the negotiation process between management and employee representatives (ERs), analyzing the roles of trust and trustworthiness. We collected data from 614 human resources managers from different organizations in 11 European countries. The results confirm that ERs who management perceive to be trustworthy have a greater influence on negotiation, particularly with regard to integrative as opposed to distributive issues, and that trust partially mediates this relationship.

Interpersonal Conflicts in the Unit Impact the Service Quality Rated by Customers: The Mediating Role of Work-Unit Well-Being.

Social dynamics at work are crucial for understanding how internal processes in an organization are related to their performance and productivity. Following the Service-Profit Chain (SPC) theory, this study analyses, at the work-unit level, how interpersonal conflicts are related to service quality in the hospitality and tourism industry through the shared experience of well-being in the work unit. In other words, we examine the mediating role of two main aspects of work-related well-being in the unit (job satisfaction and burnout) on the relationship between interpersonal conflicts in the unit and customers' perceptions of service quality. To do so, we conducted a cross-sectional survey study that collected data from 398 service employees (91 work units) and 1233 customers from three and four-star hotels with restaurant in Spain. Using path analysis in Structural Equation Models, our results supported a full mediation model at the work-unit level: interpersonal conflicts in the work unit are related to customers' service quality perceptions through the work-unit's well-being (job satisfaction and burnout). Therefore, our findings extend the SPC theory by integrating group dynamics and employees' experiences, which should be enhanced through occupational health-oriented policies and practices to increase service quality. In this sense, this study has implications for the development of intervention programs aiming at improving the occupational well-being and quality of service in hospitality and tourism settings.

Characterization of AtNUC-L1 reveals a central role of nucleolin in nucleolus organization and silencing of AtNUC-L2 gene in Arabidopsis.

Nucleolin is one of the most abundant protein in the nucleolus and is a multifunctional protein involved in different steps of ribosome biogenesis. In contrast to animals and yeast, the genome of the model plant Arabidopsis thaliana encodes two nucleolin-like proteins, AtNUC-L1 and AtNUC-L2. However, only the AtNUC-L1 gene is ubiquitously expressed in normal growth conditions. Disruption of this AtNUC-L1 gene leads to severe plant growth and development defects. AtNUC-L1 is localized in the nucleolus, mainly in the dense fibrillar component. Absence of this protein in Atnuc-L1 plants induces nucleolar disorganization, nucleolus organizer region decondensation, and affects the accumulation levels of pre-rRNA precursors. Remarkably, in Atnuc-L1 plants the AtNUC-L2 gene is activated, suggesting that AtNUC-L2 might rescue, at least partially, the loss of AtNUC-L1. This work is the first description of a higher eukaryotic organism with a disrupted nucleolin-like gene and defines a new role for nucleolin in nucleolus structure and rDNA chromatin organization.

Inside "Pandora's Box" of Solidarity: Conflicts Between Paid Staff and Volunteers in the Non-profit Sector.

Non-profit organizations (NPOs) are quite complex in terms of organizational structure, diversity at the workplace, as well as motivational mechanisms and value rationality. Nevertheless, from the perspective of organizational psychology, the systematic analysis of this context is scarce in the literature, particularly regarding conflicts. This qualitative study analyzes types, prevalence, and consequences of conflicts in a large NPO considering as theoretical framework several consolidated organizational psychology theories: conflict theory, social comparison theory, and equity theory. Conflicts were analyzed taking into account volunteers' perspective, who have been the consistent protagonist in NPO research, but also considering paid staff's perspective as one of the main stakeholders in these organizations, whose relative power has increased in the past decade due to the professionalization of the NPO's sector. Results confirmed the existence of four types of conflicts: task, process, status, and relationship conflicts. Relationship conflict is the least reported type, revealing the protection factor that values and engagement with a social aim have on this organizational context. The most relevant finding is the strong difference between paid staff and volunteers in conflict perceptions, showing paid staff, overall, higher levels of conflicts than volunteers. Findings also show stronger negative consequences for paid staff compared to volunteers. Theoretical and practical implications are discussed.

Relative roles of photoperiodic and nutritional cues in modulating ovarian activity in goats.

The objective of the current study was to evaluate the influence of nutrition and its interaction with the photoperiod on the ovarian activity of Criollo goats. In early February (22 degrees NL, anestrous season) goats were randomly assigned to the two experimental groups: high (HN; n=10) and low (LN; n=10) nutrition goats. The HN group was fed in mixed prairies with grass and clover (17.3-/+7.5% of crude protein, CP; 66.3-/+5.7% dry organic matter, DOM) and received 150 g of concentrate (12% CP) per goat and day. The LN group received only corn stubble (6.2-/+0.7% CP, 53.7-/+1.9% DOM). Serum progesterone (P(4)) and triiodothyronine (T(3)) concentrations were measured (RIA) at three selected periods of seasonal anestrous: early (8-24(th) March), mid (13(th) April - 3(rd) May) and late (26(th) May - 14(th) June) anestrous. Body weight, body condition and body condition index were determined at the beginning of the study and every 14 days. Body weight was positively correlated with serum T(3) (r=0.704; p<0.05). The percentage of cycling does during the three examined periods was higher (p<0.05) in the HN group than in the LN group (80 vs. 30%, 80 vs. 20%, and 60 vs. 10%, respectively). The high nutrition level increased reproductive activity of Criollo goats during all three periods of the anestrous season including deep anestrous.

Learning strategies scale: adaptation to Portuguese and factor structure.

Since learning strategies seem to be an important set of variables to explain the effectiveness of training and e-learning in organizations is here to stay, this paper aimed to analyze the factor structure and psychometric properties of a Learning Strategies Scale (LSS) and its relationship with the training transfer in an e-learning corporate context. A total of 3600 employees of a Brazilian bank participated in this study by responding to the LSS after taking part in an online course. We measured training transfer with self-evaluation and hetero-evaluation scales. Internal consistency, confirmatory factor analysis, and multiple regressions were conducted. A four-factor structure and an acceptable level of fit for the model were found. All types of learning strategies were related to training transfer in self-evaluation, and the cognitive and help-seeking strategies contributed to explain training transfer in hetero-evaluation. As a reliable and valid measure that predicts the effectiveness of training and job performance, participants should be advised about the learning strategies that produce better performance results at the workplace. Future research should use it in different contexts and samples, analyzing its relationships with other workplace variables.

Effect of testosterone on oxidative stress and cell damage induced by 3-nitropropionic acid in striatum of ovariectomized rats.

This paper evaluates the effects of testosterone (0.5 mg/kg subcutaneously (s.c.) for 8 days) on oxidative stress and cell damage induced by 3-nitropropionic acid (20 mg/kg intraperitoneally (i.p.) for 4 days) in ovariectomized rats. Gonadectomy triggered oxidative damage and cell loss, evaluated by the detection of caspase-3, whereas 3-nitropropionic acid increased the levels of oxidative stress induced by ovariectomy and prompted cell damage characterized by enhanced levels of lactate dehydrogenase. These changes were blocked by testosterone administration. Our results support the following conclusions: i) ovariectomy triggers oxidative and cell damage via caspase-3 in the striatum; ii) 3-nitropropionic acid exacerbates oxidative stress induced by ovariectomy and leads to cell damage characterized by increased levels of lactate dehydrogenase; iii) testosterone administration decreases oxidative stress and cell damage. Additionally, these data support the hypothesis that testosterone might play an important role in the onset and development of neurodegenerative diseases.

17 beta-Estradiol may affect vulnerability of striatum in a 3-nitropropionic acid-induced experimental model of Huntington's disease in ovariectomized rats.

The aim of present study was to clarify the role of female sex hormones in the development and course of neurodegenerative disease in an experimental model of Huntington's disease induced by 3-nitropropionic acid (NPA) (30 mg/kg intraperitoneally (i.p.)/day for 4 days) in ovariectomized rat. Gonadectomy prompted oxidative stress and cell death evaluated by the detection of caspase-3, whereas 3-nitropropionic acid enhanced the oxidative stress induced by ovariectomy and it triggered cell damage characterized by increases of LDH levels. These changes were prevented by administration of 17 beta-estradiol. Our findings suggested that: (i) ovariectomy induced oxidative stress and apoptosis in the brain; (ii) 3-nitropropionic acid exacerbated oxidative stress induced by ovariectomy and shifting cell to cell death; and (iii) 17 beta-estradiol administration decreased oxidative stress and cell death induced by ovariectomy and 3-nitropropionic acid. These results revealed that sex ovarian hormones play a important role in onset and development of neurodegenerative diseases, as well as neuroprotective effects of 17 beta-estradiol against the changes induced ovariectomy and ovariectomy plus 3-nitropropionic acid.

Effect of transcranial magnetic stimulation on oxidative stress induced by 3-nitropropionic acid in cortical synaptosomes.

This study evaluates the effect of transcranial magnetic stimulation (TMS; 60 Hz and 0.7 mT) treatment on 3-nitropropionic acid (20 mg/kg i.p./day for 4 days)-induced oxidative stress in cortical synaptosomes of Wistar rats. The oxidative derangement was confirmed by a high level of lipid peroxidation products and protein carbonyls, together with a decreased in reduced glutathione (GSH) content, catalase and GSH-peroxidase (GSH-Px) activities. Additionally, it was observed a reduction in succinate dehydrogenase (SDH) activity. All changes were partially prevented or reversed by administration of TMS. These results show that TMS reduces oxidative stress in cortical synaptosomes, and suggest that TMS may protect neuronal and maintain synaptic integrity.

Persistent mycotic superficial femoral artery pseudoaneurysm after endovascular treatment: a case report / Pseudoaneurisma micótico persistente da artéria femoral superficial após tratamento endovascular: relato de caso

Abstract Mycotic pseudoaneurysms of the superficial femoral artery (SFA) are rare and are usually secondary to colonization of an atherosclerotic plaque during an episode of bacteremia. We describe the case of a 68 year-old diabetic male who presented to the Emergency Department with pyrexia and a painful expanding mass in the left thigh. He had a history of diarrhea and had been treated 16 days earlier for an SFA pseudoaneurysm that had been excluded with a covered stent with no adjunctive antibiotic therapy. Angio CT showed an abscess surrounding femoral vessels and stent thrombosis. Under general anesthesia, we performed extensive debridement, removal of the endovascular material, SFA ligation, and empirical antibiotic therapy. Blood and tissue cultures were positive for Escherichia coli. At the 3-months follow up visit, the patient reported he had no claudication. In selected patients, mycotic pseudoaneurysms can be treated by SFA ligation.

Resumo Pseudoaneurismas micóticos da artéria femoral superficial (AFS) são raros, e geralmente são secundários à colonização de uma placa aterosclerótica durante bacteremia. Relatamos o caso de um paciente masculino diabético de 68 anos que chegou ao Serviço de Emergência com pirexia e massa expansiva dolorosa na coxa esquerda. Apresentava histórico de diarreia e havia sido tratado 16 dias antes para pseudoaneurisma da AFS, que foi excluído com stent coberto e sem antibioticoterapia adjuvante. A angiotomografia computadorizada demonstrou um abscesso ao redor dos vasos femorais e trombose do stent. Sob anestesia geral, realizamos desbridamento extenso, remoção do material endovascular, ligadura de AFS e antibioticoterapia empírica. Culturas de sangue e tecidos foram positivas para Escherichia coli. Na consulta de seguimento aos 3 meses, o paciente negou claudicação. Em pacientes selecionados, pseudoaneurismas micóticos podem ser tratados com ligadura de AFS.

Effect of alpha-tocopherol on the metabolic control and oxidative stress in female type 2 diabetics.

In this study we evaluate the effects of alpha-tocopherol on the metabolic control and oxidative stress in female patients with type 2 diabetes mellitus. Thirty-four female type 2 diabetics 40-70 years old up to 14 years with diabetes, under medical treatment, were randomly divided in two groups. One group received placebo (Control group, n = 21) and the other received alpha-tocopherol (800 IU/day, n = 13) during 6 weeks. Blood samples were collected at the beginning and at the end of the study to measure malondialdehyde production, glycated hemoglobin, selenium dependent-glutathione peroxidase, Cu,Zn-superoxide dismutase in erythrocytes and total antioxidant status, glucose, lipid and lipoproteins in serum. Erythrocyte malondialdehyde decreased and serum-total antioxidant status increased after alpha-tocopherol treatment (P < 0.0001). However, an unexpected increase on cholesterol levels and a reduced erythrocyte-Cu,Zn-superoxide dismutase activity was observed after alpha-tocopherol treatment. alpha-Tocopherol administration did not affect glucose, glycated hemoglobin, triacylglycerides, lipoprotein levels and serum malondialdehyde. A minor oxidative stress was observed in female type 2 diabetic patients after alpha-tocopherol treatment inferred from the reduced levels of erythrocyte malondialdehyde and the increased values of total antioxidant status. On the other hand, no beneficial changes were observed on glycemic control or lipid metabolism.