Elevation provenance affects photosynthesis and its acclimation to temperature in the high-Andes alpine herb Phacelia secunda.

We analysed whether Phacelia secunda populations from different elevations exhibit intrinsic traits associated with diffusive and biochemical components of photosynthesis, and if they differ in acclimation of photosynthesis to warmer temperatures. We hypothesized that P. secunda will have similar photosynthetic performance regardless of altitudinal provenance and that plants from high elevations will have a lower photosynthetic acclimation capacity to higher temperature than plants from low elevations. Plants from 1600, 2800 and 3600 m a.s.l. in the central Chilean Andes were collected and grown under two temperature regimes (20/16 °C and 30/26 °C day/night). The following photosynthetic traits were measured in each plant for the two temperature regimes: AN , gs , gm , Jmax , Vcmax , Rubisco carboxylation kcat c . Under a common growth environment, plants from the highest elevation had slightly lower CO2 assimilation rates compared to lower elevation plants. While diffusive components of photosynthesis increased with elevation provenance, the biochemical component decreased, suggesting compensation that explains the similar rates of photosynthesis among elevation provenances. Plants from high elevations had lower photosynthetic acclimation to warmer temperatures compared to plants from lower elevations, and these responses were related to elevational changes in diffusional and biochemical components of photosynthesis. Plants of P. secunda from different elevations maintain photosynthetic traits when grown in a common environment, suggesting low plasticity to respond to future climate changes. The fact that high elevation plants had lower photosynthetic acclimation to warmer temperature suggests higher susceptibility to increases in temperature associated with global warming.

Human papillomavirus infections in low-grade squamous intraepithelial lesion in Peruvian pregnant woman: A cross-sectional cytology-based study.

Background and Aims: Low-risk human papillomaviruses (HPV) are important in pregnant women because they are risk factors for Condyloma acuminatum and recurrent respiratory papillomatosis in the newborn. On the other hand, HPV may contribute to the development of preneoplastic lesions such as LSIL in pregnant women. We aimed to assess the frequency of HPV infections in low-grade squamous intraepithelial lesion (LSIL) in Peruvian pregnant women. Methods: A cross-sectional study was conducted from 2011 to 2015 in 84 primiparous- and multiparous pregnant women (mean age: 27 ± 6.3 years). Pregnant women of 18-45 years attending gynecology outpatient department were included for the study. LSIL and HPV (nuclear irregularities, koilocytosis, and cytopathic effect) cellular alterations were reported using the Bethesda System guidelines. Results: Sixty-four percent had cytological HPV infection (koilocytes and/or pathognomonic signs of infection) and more than a half of pregnant women had a previous Pap test. LSIL was more frequent in multiparous (increased by 12%, p = 0.008), in the second and third trimester (60.7%, p = 0.002), and between the ages of 18 and 30 (42 cases (50%), p = 0.110). This proportion was significatively increased in women with ≥2 sexual partners (39.3%), with an early onset of first intercourse, and from the Rímac Municipality (14.3%) (p < 0.05). The rate of pregnant women with HPV infection increased by 39% between 2011 and 2015 (p = 0.001). Conclusion: Peruvian pregnant women with LSIL have a high frequency of HPV infections. These young pregnant women (≤30 years of age), with multiple pregnancy, ≥2 sexual partners, and early onset of sexual intercourse were mainly associated with the third trimester HPV infection and LSIL. To detect early lesions of the cervix, it is key to continue monitoring HPV infections with molecular techniques and screening in pregnant women.

The Absence of Caspase-8 in the Dopaminergic System Leads to Mild Autism-like Behavior.

In the last decade, new non-apoptotic roles have been ascribed to apoptotic caspases. This family of proteins plays an important role in the sculpting of the brain in the early stages of development by eliminating excessive and nonfunctional synapses and extra cells. Consequently, impairments in this process can underlie many neurological and mental illnesses. This view is particularly relevant to dopamine because it plays a pleiotropic role in motor control, motivation, and reward processing. In this study, we analyze the effects of the elimination of caspase-8 (CASP8) on the development of catecholaminergic neurons using neurochemical, ultrastructural, and behavioral tests. To do this, we selectively delete the CASP8 gene in cells that express tyrosine hydroxylase with the help of recombination through the Cre-loxP system. Our results show that the number of dopaminergic neurons increases in the substantia nigra. In the striatum, the basal extracellular level of dopamine and potassium-evoked dopamine release decreased significantly in mice lacking CASP8, clearly showing the low dopamine functioning in tissues innervated by this neurotransmitter. This view is supported by electron microscopy analysis of striatal synapses. Interestingly, behavioral analysis demonstrates that mice lacking CASP8 show changes reminiscent of autism spectrum disorders (ASD). Our research reactivates the possible role of dopamine transmission in the pathogenesis of ASD and provides a mild model of autism.

Impact of the Management and Proportion of Lost to Follow-Up Cases on Cancer Survival Estimates for Small Population-Based Cancer Registries.

BACKGROUND: Estimation of survival requires follow-up of patients from diagnosis until death ensuring complete and good quality data. Many population-based cancer registries in low- and middle-income countries have difficulties linking registry data with regional or national vital statistics, increasing the chances of cases lost to follow-up. The impact of lost to follow-up cases on survival estimates from small population-based cancer registries (<500 cases) has been understudied, and bias could be larger than in larger registries. METHODS: We simulated scenarios based on idealized real data from three population-based cancer registries to assess the impact of loss to follow-up on 1-5-year overall and net survival for stomach, colon, and thyroid cancers-cancer types with very different prognosis. Multiple scenarios with varying of lost to follow-up proportions (1-20%) and sample sizes of (100-500 cases) were carried out. We investigated the impact of excluding versus censoring lost to follow-up cases; punctual and bootstrap confidence intervals for the average bias are presented. RESULTS: Censoring of lost to follow-up cases lead to overestimation of the overall survival, this effect was strongest for cancers with a poor prognosis and increased with follow-up time and higher proportion of lost to follow-up cases; these effects were slightly larger for net survival than overall survival. Excluding cases lost to follow-up did not generate a bias on survival estimates on average, but in individual cases, there were under- and overestimating survival. For gastric, colon, and thyroid cancer, relative bias on 5-year cancer survival with 1% of lost to follow-up varied between 6% and 125%, 2% and 40%, and 0.1% and 1.0%, respectively. CONCLUSION: Estimation of cancer survival from small population-based registries must be interpreted with caution: even small proportions of censoring, or excluding lost to follow-up cases can inflate survival, making it hard to interpret comparison across regions or countries.

Programa de coordinación en la transición asistencial para la mejora de la farmacoterapia entre un Servicio de Urgencias y un Centro Sociosanitario / Coordination program in the care transition for the improvement of pharmacotherapy between an Emergency Service and a Center Socio-sanitary

Objetivos: Describir un programa de colaboración entre farmacéuticos de un Servicio de Urgencias y un Centro Sociosanitario, así como evaluar su impacto sobre la frecuencia de reconsulta al Servicio de Urgencias.Material y métodos: Estudio observacional retrospectivo en el cual se describieron las intervenciones realizadas por un programa de colaboración multidisciplinar en pacientes dados de alta desde un Servicio de Urgencias a un Centro Sociosanitario durante 9 meses. Para evaluar el impacto asistencial del programa, se comparó el número de reconsultas al Servicio de Urgencias a los 30 días de los pacientes derivados al Centro Sociosanitario con el mismo periodo del año previo a la intervención. Resultados: De los 627 pacientes dados de alta desde el Servicio de Urgencias hasta al centro de sociosanitario, se comunicaron modificaciones de tratamiento en 233 pacientes (edad media: 87,1 (SD:7,7) años). El principal motivo de asistencia a Urgencias fue infección respiratoria/broncoaspiaración (74; 31,8%), seguida de infección urinaria (33; 14,2%). Se realizaron intervenciones en 48 (20,6%) de los pacientes al ingreso por parte de los farmacéuticos del centro sociosanitario, siendo mayoritario el ajuste de antibioterapia (13; 27,1%). Se observó una tendencia no significativa a la reducción en el número de reconsultas al Servicio de Urgencias (6,6% vs. 4,9%; p=0,258).Conclusiones: La comunicación entre los farmacéuticos responsables del Servicio de Urgencias y de los Centros Sociosanitarios permite optimizar de forma precoz el tratamiento farmacoterapéutico de los pacientes, con un potencial impacto sobre las reconsultas a los Servicios de Urgencias. (AU)

Objectives: To describe a collaborative program between pharmacists from an Emergency Department and a long-term Health Care Center, and to evaluate its impact on the frequency of visits to the emergency department.Material and methods: Retrospective observational study in which the interventions performed by a multidisciplinary collaboration team in patients discharged from an Emergency Service to a long-term Health Care Center for 9 months were described. To evaluate the health-care impact of this intervention, the number of re-visits to the emergency department at 30 days of patient’s dischrge to long-term Health Care Center was compared with the same period of the previous year.Results: 627 patients discharged from the Emergency Department to the long-term Health Care Center, being treatment modifications reported in 233 patients (mean age: 87.1 (SD: 7.7) years). The main reason for attending the emergency room was respiratory infection (74; 31.8%), followed by urinary infection (33; 14.2%). Interventions were performed in 48 (20.6%) of the patients upon admission by pharmacists of the the long-term Health Care Center, being the adjustment of antibiotic therapy the most frequent intervention (13; 27.1%). There was a non-significant trend towards a reduction in the number of re-visits to the Emergency Department during the intervention period (6.6% vs. 4.9%; p=0.258).Conclusions: Communication between the pharmacists responsible for the Emergency Service and long-term Health Care Centers allows a comprehensive action on the patient’s pharmacotherapy, with a potential impact on the healthcare system. (AU)

Bioconversion of polyphenols and organic acids by gut microbiota of predigested Hibiscus sabdariffa L. calyces and Agave (A. tequilana Weber) fructans assessed in a dynamic in vitro model (TIM-2) of the human colon.

The present work aimed at understanding gut microbiota bioconversion of phenolic compounds (PC) and organic acids in predigested Hibiscus sabdariffa (Hb) calyces and the mixture of Hb and Agave (Agave tequilana Weber) fructans (AF). With this purpose, dried Hb and Hb/AF were predigested with enzymatic treatment, and then fermented in a dynamic in vitro model of the human colon (TIM-2). After HPLC-ESI-QToF-MS analysis of samples taken at 0, 24, 48 and 72 h of fermentation, it was observed that hydroxycinnamic acids, flavanols, flavonols, and anthocyanins were mainly transformed into derivatives of hydroxyphenylpropionic, hydroxyphenylacetic and hydroxybenzoic acids. Moreover, organic acids, such as hydroxycitric and hibiscus acids, were formed along with unidentified lactones and reduced compounds. Interestingly, no differences were observed between microbial-derived metabolites formed after the fermentation of Hb and Hb/AF. In conclusion, colonic fermentation of polyphenol-rich Hb yields a wide range of microbial phenolic metabolites with potential effects on health.

Tratamiento quirúrgico de la gangrena de Fournier / Surgical management of Fournier's gangrene

Resumen Objetivo: Describir el manejo quirúrgico realizado para la reconstrucción genitoperineal (RGP) en pacientes con secuelas de Gangrena de Fournier (GF). Materiales y Método: Corresponde a una serie de casos retrospectiva de pacientes con secuelas de GF a los que se les realizó RGP entre los años 2011 y 2019. Se realizó un análisis descriptivo con las variables de técnica quirúrgica, edad, sexo, comorbilidades, subunidades anatómicas afectadas, origen anatómico de la gangrena de Fournier, número de procedimientos quirúrgicos, procedimiento de colostomía, terapia de presión negativa, Flexi-Seal®, bacterias aisladas, duración de estancia hospitalaria, tipo de procedimientos reconstructivos y complicaciones. Resultados: Se realizó RGP a 43 pacientes (81,1% hombres), con un promedio de edad de 59,1 (17-86 años), 72,7% eran diabéticos. El número de subunidades involucradas se asocia directamente y significativamente en relación al número de intervenciones quirúrgicas. Las técnicas utilizadas para la reconstrucción en orden de frecuencia fueron: colgajos (23%), cierre parcial más injerto dermoepidérmico de grosor parcial (IPP) (20%), cierre parcial (16%) e IPP (16%), cierre por segunda intención (10%), colgajo más IPP (7%) y cierre parcial para cierre por segunda intención de zona restante (5%). Discusión: La elección de reconstrucción se basa en las características del defecto, es decir, el tamaño, la ubicación y profundidad, así como la disponibilidad de tejido local. De preferencia optar por cierres primarios sin tensión, seguido de colgajos y de IPP. Conclusión: La RGP es un desafío para el cirujano plástico. Las técnicas descritas han demostrado ser seguras y reproducibles para el tratamiento quirúrgico de la gangrena de Fournier.

Aim: To describe the surgical management performed for genital-perineal reconstruction (GPR) in patients with sequelae of Fournier gangrene (FG). Materials and Method: It is based on a retroactive series of cases of patients with effects of FG who were given GPR between 2011 and 2019. We performed a descriptive analysis using the variables surgical technique, age, sex, comorbidities, anatomical subunits affected, anatomic origin of the Fournier's gangrene, number of surgical procedures, colostomy procedure, negative pressure therapy, Flexi-Seal®, bacteria isolated, hospital stay, type of reconstructive procedures and complications. We performed GPR on 43 patients (81.1% male), with a mean age of 59.1 (17-86 years); 72% were diabetic. The number of subunits involved was directly and significantly associated with the number of surgical interventions. Results: The reconstruction techniques most used were, in descending order: flaps (23.2%), wound closure and split-thickness skin graft (STSG) (23.2%), primary closure (16.2%), STSG (16.2%), secondary closure (9.3%), flap and STSG (6.9%) and partial wound closure for healing of the remaining area for a second intention (4.6%). Discussion: The reconstruction choice is based on the characteristics of the defect, that is, the size, location and depth, as well as the availability of local tissue. Preferably opt for primary closures without tension, followed by flaps and IPP. Conclusion: The RGP is a challenge for the plastic surgeon. The techniques described have proven safe and reproducible for the surgical treatment of Fournier Gangrene.

Bioconversion by gut microbiota of predigested mango (Mangifera indica L) 'Ataulfo' peel polyphenols assessed in a dynamic (TIM-2) in vitro model of the human colon.

Gut microbiota bioconversion of polyphenols in predigested mango 'Ataulfo' peel was studied using a validated, dynamic in vitro human colon model (TIM-2) with faecal microbial inoculum. Dried peels were predigested with enzymatic treatment, followed by TIM-2 fermentation (72 h). Samples were taken at 0, 24, 48 and 72 h and analyzed by HPLC-QToF. Derivatives of hydroxyphenylpropionic, hydroxyphenylacetic and hydroxybenzoic acids, as well as, pyrogallol were the main polyphenols identified. These metabolites might derivate from flavonoid (flavanols and flavonols), gallate and gallotannin biotransformation. Despite the high content of ellagic acid in mango peel, low amounts were detected in TIM-2 samples due to transformation into urolythins A and C, mainly. Xanthone and benzophenone derivatives, specific to mango, remained after the colonic biotransformation, contrary to flavonoids, which completely disappeared. In conclusion, microbial-derived metabolites, such as xanthone and benzophenone derivatives, among others, are partially stable after colonic fermentation, and thus have the potential to contribute to mango peel bioactivity.