Confirmed mixed bird-insect pollination system of Scrophularia trifoliata L., a Tyrrhenian species with corolla spots.

Both bird and mixed vertebrate-insect (MVI) pollination systems are very rare in Europe and the Mediterranean region. Because MVI can ensure reproduction over a wider range of environmental conditions than when insects are the sole pollinators, under certain circumstances such systems are highly advantageous to plants. Here, we investigated the pollination and some reproductive traits of the Tyrrhenian Scrophularia trifoliata, the only species of the genus possessing two showy dark spots inside the corolla, for which MVI pollination system had been inferred on the basis of limited censuses. We conducted field experiments to study MVI pollination and some reproductive traits and elucidate the role of corolla spots, analysing their ultraviolet pattern, histology and pigments versus the rest of the corolla. The primary pollinators were wasps and passerine birds. Corolla spots absorb UV light, present abundant anthocyanins and are histologically identical to the rest of the corolla. Control flowers had higher visitation frequency than flowers without spots. S. trifoliata is self-compatible, with efficient intrafloral protogyny and herkogamy that prevent self-pollination but not geitonogamy. We confirmed the existence of a mixed bird-insect pollination system in S. trifoliata. This system is found in three other Scrophularia species with large, showy flowers - two Mediterranean (S. grandiflora and S. sambucifolia) and one Macaronesian (S. calliantha). Unlike those species, S. trifoliata has two large spots inside the corolla. These likely operate as nectar guides and their dark colouration is related to abundant anthocyanin content.

Surgical Options for the Refractive Correction of Keratoconus: Myth or Reality.

Keratoconus provides a decrease of quality of life to the patients who suffer from it. The treatment used as well as the method to correct the refractive error of these patients may influence on the impact of the disease on their quality of life. The purpose of this review is to describe the evidence about the conservative surgical treatment for keratoconus aiming to therapeutic and refractive effect. The visual rehabilitation for keratoconic corneas requires addressing three concerns: halting the ectatic process, improving corneal shape, and minimizing the residual refractive error. Cross-linking can halt the disease progression, intrastromal corneal ring segments can improve the corneal shape and hence the visual quality and reduce the refractive error, PRK can correct mild-moderate refractive error, and intraocular lenses can correct from low to high refractive error associated with keratoconus. Any of these surgical options can be performed alone or combined with the other techniques depending on what the case requires. Although it could be considered that the surgical option for the refracto-therapeutic treatment of the keratoconus is a reality, controlled, randomized studies with larger cohorts and longer follow-up periods are needed to determine which refractive procedure and/or sequence are most suitable for each case.

Poroqueratosis pruriginosa diseminada inflamatoria. Buena respuesta a ciclosporina / Inflammatory Disseminated Pruritic Porokeratosis With a Good Response to Ciclosporin

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Sirolimus, una opción terapéutica en la linfangioleiomiomatosis / No disponible

La linfangioleiomiomatosis (LAM) es una enfermedad rara que se caracteriza por la proliferación anormal de células musculares lisas atípicas (células LAM) que condicionan la destrucción del parénquima pulmonar con formación de quistes. A pesar de que el trasplante pulmonar se considera la única opción terapéutica cuando la enfermedad progresa, ensayos clínicos recientes muestran que el tratamiento con sirolimus, fármaco inhibidor de mTOR (mammalian target of rapamycin), puede tener un efecto beneficioso sobre la función pulmonar y la reducción del tamaño de los angiomiolipomas renales que se asocian a la LAM. Presentamos el caso de una mujer de 20 años, diagnosticada de linfangioleiomiomatosis asociada a esclerosis tuberosa, en tratamiento con sirolimus

Lymphangioleiomyomatosis (LAM) is a rare disease that affects young females in their reproductive years. It is characterized by proliferation of abnormal smooth muscle-like cells (LAM cells) leading to progressive cystic destruction of the lung. Even though lung transplantation is considered the only treatment for severe LAM, some recent trials of sirolimus (mTOR inhibitor) showed that there was an improvement in lung function and a reduction in the size of renal angiomyolipomas. We report the case of a twenty years old woman with LAM associated to the tuberous sclerosis complex, who is being treated with sirolimus

Paquidermodactilia en un paciente con trastorno de ansiedad generalizada asociado a tics / Pachydermodactyly in a Patient With Generalized Anxiety Disorder and Tics

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Gangrena de fournier / Fournier's gangrene

La Gangrena de Fournier es una enfermedad caracterizada por una fasceitis necrotizante de las regiones perineal y genital siendo una patología potencialmente letal. Usualmente la infección comienza a nivel perianal o genital y rápidamente se expande por los planos fasciales del periné. Esta expansión se produce rápidamente calculándose que avanza 2.5 cm por hora. Es una entidad de etiología polimicrobiana y en promedio se aíslan cuatro microorganismos diferentes, aerobios y anaerobios. El diagnóstico se basa principalmente en la evaluación clínica y es de gran importancia que se lo haga de forma temprana lo cual disminuirá de manera significativa la morbi-mortalidad de estos pacientes .. El manejo estará encaminado inicialmente hacia la estabilización del paciente desde el punto de vista hemodinámico y metabólico, la iniciación de un antibiótico de amplio espectro, seguido de un pronto manejo quirúrgico agresivo consistente en el desbridamiento amplio de la piel y tejido celular subcutáneo del área comprometida. Cuando el defecto se encuentre en proceso de granulación su resolución es generalmente por segunda intención, sin embargo en los casos en que el desbridamiento es muy extenso se realizará cirugía reconstructiva.

Experiencia inicial en el Hospital Vozandes Quito con la técnica de pph para el tratamiento de hemorroides / Initial experience at the Hospital Vozandes Quito with the technique tph for the treatment of hemorrhoids

El presente artículo tiene como objetivo evaluar la experiencia inicial en el Servicio de Cirugía General del Hospital Vozandes Quito con el procedimiento para prolapso y hemorroides (PPH); para lo cual se realizó un estudio retrospectivo longitudinal, en el que se seleccionaron todos los pacientes intervenidos con dicha técnica entre septiembre del 2005 hasta junio 2007 y se evaluó el tiempo quirúrgico, tipo de analgesia, estadía hospitalaria y complicaciones postoperatorias. Un total de 31 pacientes fueron intervenidos con la técnica de PPH. El tiempo quirúrgico promedio fue de 38.3 minutos. El tipo de analgesia en el postoperatorio fue AINES en el 68 por ciento de los casos, opiodes en el 6 por ciento y combinados en el 26 por ciento; se utilizó analgesia de rescate en el 32 por ciento de pacientes, quienes refirieron dolor intenso. El promedio en cuanto al tiempo de hospitalización fue de 1.8 días. No hubo complicaciones en el postoperatorio inmediato. En la primera semana postoperatoria se evidenció que en 3 casos (9.6 por ciento) existió la presencia de un pequeño paquete hemorroidal residual los mismos que no requirieron reintervención quirúrgica. En un solo caso (3.2 por ciento) recidivó un paquete hemorroidal importante que requirió ser reintervenido por técnica convencional.

Antimony distribution and mobility in topsoils and plants (Cytisus striatus, Cistus ladanifer and Dittrichia viscosa) from polluted Sb-mining areas in Extremadura (Spain).

A study about topsoil antimony distribution and mobility from the soils to the biomass has been afforded in three abandoned Sb mining areas located at Extremadura. Physico-chemical characteristics of the soils and total antimony levels were measured in soils and autochthonous plant species (Cytisus striatus, Cistus ladanifer and Dittrichia viscosa). Comparison with corresponding values in reference areas isolated from the mining activities is discussed. Antimony mobility in the soils was estimated by measuring the water extractable fraction; low results were obtained for the three soil areas, with no statistical differences. Plant ability to accumulate antimony was estimated by use of plant accumulation coefficients (PAC). Seasonal (spring vs. autumn) effects on the antimony content in the plant species. Cytisus striatus from Mari Rosa mine presented antimony excluder characteristics, whereas Dittrichia viscosa specimens growing in San Antonio mine showed a significant antimony bioaccumulation.

[Serum concentrations of estradiol and testosterone in patients with oligoasthenozoospermia and asthenozoospermia]. / Concentraciones séricas de estradiol y testosterona en pacientes con oligoastenozoospermia y astenozoospermia.

In order to study the possible influence of circulating concentrations of estradiol (E2) and testosterone (T) on the spermatogenesis, 43 subjects, 21 to 43 years of age; 16 of them with oligoasthenozoospermia; 16 with "pure" asthenozoospermia, and 11 with normal semen study, were studied. This last group was taken as control for results evaluation and comparison. In all the cases, the presence of genitourinary infection, as well as testicular lesions and varicocele, was previously discarded. Serum concentrations of estradiol, testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin (PRL), were determined by radio-analysis, in fasting blood samples. The results are shown as average values +/- standard error (mean +/- SE). Statistical analysis of differences between the groups, was done by "t" Student test in paired samples. Patients with oligoasthenozoospermia showed a significant increase (56.9%) (less than 0.001) in estradiol circulating levels, while T, FSH, LH and PRL concentrations were below normal band, and there were not significant differences between the three groups. These results suggest that the excess of estradiol or of some of its metabolites could affect normal production of spermatozoa, maybe due to a direct effect on germinal epithelium of testicle.

Occurrence of human papillomavirus type 16 DNA sequences and c-myc oncogene alterations in uterine-cervix carcinoma.

Using genetic engineering and molecular biology techniques, we have examined sixteen human carcinomas in the uterine-cervix tumors (the most frequent tumor in México, representing 34% of malignant tumors in women), for the presence of Human Papillomavirus type 16 (HPV-16) DNA sequences and possible alterations of the cellular myc (c-myc) proto-oncogene. In this study we have analyzed cervical carcinomas from patient with clinical stage II. We detected in 31% of these samples, the presence of HPV-16 sequences (2-100 copies). In addition, an elevated amplification (up to 80-fold in one tumor) and/or rearrangement of the c-myc oncogene was detected in most tumors (more than 90% of the samples). These results suggest that either c-myc oncogene and/or HPV-16 could play an important role in the development of uterine-cervix carcinoma.