Bacterial Strains Isolated from Stingless Bee Workers Inhibit the Growth of Apis mellifera Pathogens.

Apis mellifera bees are an important resource for the local economy of various regions in Argentina and the maintenance of natural ecosystems. In recent years, different alternatives have been investigated to avoid the reduction or loss of colonies caused by pathogens and parasites such as Ascosphaera apis, Aspergillus flavus, and Paenibacillus larvae. We focused on bacterial strains isolated from the intestine of native stingless bees, to elucidate their antagonistic effect on diseases of A. mellifera colonies. For this purpose, worker bees of the species Tetragonisca fiebrigi, Plebeia spp., and Scaptotrigona jujuyensis were captured from the entrance to tree hives and transported to the laboratory, where their intestines were extracted. Twenty bacterial colonies were isolated from the intestines, and those capable of inhibiting enterobacteria in vitro and producing organic acids, proteases, and chitinases were selected. Four genera, Levilactobacillus, Acetobacter, Lactiplantibacillus, and Pantoea, were selected and identified by the molecular marker that codes for the 16S rRNA gene. For inhibition assays, cell suspensions and cell-free suspensions were performed. All treatments showed significant antibacterial effects, in comparison with the controls, against P. larvae and antifungal effects against A. apis and A. flavus. However, the mechanisms by which these bacteria inhibit the growth of these pathogens were not studied.

Economic evaluation of percutaneous cryoablation vs conventional surgery in extra-abdominal desmoid tumours in the Spanish healthcare system.

BACKGROUND: Desmoid tumours (DTs) or deep fibromatosis are benign soft-tissue tumours, sometimes locally aggressive, requiring intervention on some cases. Surgery has been the gold standard, but new less invasive techniques such as percutaneous cryoablation have proved their effectiveness, reducing health resources and complications. The study aimed to compare the total cost of percutaneous cryoablation and conventional surgery for patients with extra-abdominal and/or abdominal wall DTs, candidates for local ablative treatment in Spain. METHODS: A cost-analysis model was developed. An expert panel provided data about resource consumption for the percutaneous cryoablation technique and validated the epidemiology used for target population estimation. Unitary resources cost (€ 2022) derived from local cost databases. A retrospective analysis of 54 surgical cases in 3 Spanish hospitals was performed to estimate the cost of conventional surgery based on the cost of the Diagnosis-Related group (DRG) codes identified on this patient sample, weighted by each DRG proportion. The total cost for each alternative included intervention cost and complications cost, considering debridement required in 4.5% of cases with percutaneous cryoablation and minor surgery for surgical site infection in 18.0% for conventional surgery. RESULTS: The total cost for percutaneous cryoablation (€ 5774.78/patient-year) was lower than the total cost for conventional surgery (€ 6780.98/patient-year), yielding cost savings up to € 80,002 in 1 year for the entire cohort of 80 patients with DTs eligible for intervention estimated in Spain. One-way sensitivity analyses confirmed the results' robustness. CONCLUSION: Percutaneous cryoablation versus conventional surgery would yield cost savings for the management of DT patients in Spain. CRITICAL RELEVANCE STATEMENT: This manuscript provides insight into the economic impact derived from the savings related to the use of percutaneous cryoablation for desmoid-type tumours from the perspective of the Spanish National Healthcare System, providing useful information for the health decision-making process. KEY POINTS: • Desmoid tumours are locally aggressive and may require local therapy. • Percutaneous cryoablation procedure is less invasive than the conventional surgery. • Cost comparison shows savings associated to percutaneous cryoablation use.

Fungal microbiota isolated from native stingless bee species inhibited pathogens of Apis mellifera.

Social bees can establish interactions with microorganisms to keep their colonies free of pathogens and parasites by developing different protection strategies. We explored the fungal microbiota isolated from three species of stingless bees, Tetragonisca fiebrigi, Plebeias sp., and Scaptotrigona jujuyensis, and its potential ability to suppress pathogenic microorganisms of A. mellifera, namely Paenibacillus larvae, Ascosphaera apis and Aspergillus flavus, which were tested and evaluated. Six filamentous fungal strains, Trametes hirsuta, Alternaria alternata, Curvularia spicifera, Skeletocutis sp., Alternaria tenuissima, Monascus spp., as well as the yeast Wickerhamomyces anomalus, were selected for trials and isolated from the heads of foraging bees. The fungal strains were identified by macroscopic and microscopic taxonomic characteristics and by sequencing of the ITS1-5.8S-ITS2 region of ribosomal DNA. All fungal strains inhibited these pathogens of A. mellifera. We also evaluated the effect of the secondary metabolites extracted with and without ethanol. Both metabolites showed antimicrobial properties, and our results suggest that fungi isolated from stingless bees produce bioactive compounds with antibacterial and antifungal effects that could be used to treat Apis mellifera colony diseases and maintain colony health.

Functional outcomes after arthroscopic double button fixation of distal clavicular fractures in athletes.

Distal third clavicle fractures are a frequent pathology in young, active patients, accounting for 30% of all clavicle fractures. There are several treatments available, which range from orthopedic management to surgical treatment with various options including: locking plates, tension bands and button fixation. The aim of this study was to evaluate the clinical and radiologic results of a group of patients treated with the arthroscopic double button fixation technique and, secondly, to analyze the complications and the rate of return to sports. METHODS: Nineteen patients (15 male and 4 Female) with a mean age of 38.2 years (21-64) were included. In all cases, an arthroscopic surgery with double button fixation of the distal third of the clavicle was performed. Functional Outcomes were evaluated with the visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons scale (ASES) for functional outcomes. Range of Motion (ROM) was also assessed. RESULTS: The mean follow up was 27.3 months (12 to 54 months). The mean VAS was 0.63 and the mean ASES score was 94.1. The ROM was fully recovered in 17 patients (89,4%). All patients returned to regular sports practice at 3.5 months. Finally, a total of 2 complications were registered (11,6%). CONCLUSION: The arthroscopic double button fixation of distal clavicular fractures is a safety and reliable procedure, and it is associated with favorable functional and radiological outcomes in most patients.

Feasibility and outcomes of transjugular intrahepatic portosystemic shunts in infants.

BACKGROUND: Experience with transjugular intrahepatic portosystemic shunts (TIPS) in the pediatric population, especially in infants, is limited. OBJECTIVE: To evaluate the feasibility, efficacy and safety of TIPS placement in infants. MATERIALS AND METHODS: This retrospective non-comparative observational cohort study analyzed all pediatric patients < 12 months of age treated with TIPS while waiting for liver transplant between October 2018 and April 2021. The sample consisted of 10 infants with chronic liver disease. All had refractory ascites and decreased portal vein size. Their mean age ± standard deviation was 5 ± 1 months and their mean weight was 5.4 ± 1.0 kg. We calculated the pediatric end-stage liver disease score and portosystemic gradients before and after TIPS placement. We used ultrasound to check for complications and to assess the presence of ascites. We used paired-sample t-test for the mean comparison of paired variables. RESULTS: Ten TIPS procedures were performed that were technically and hemodynamically successful except for one, in which an extrahepatic portal puncture required surgical repair. Ascites resolved in three infants and was reduced in six. The portal vein size remained stable after TIPS placement. Four infants had early stent thrombosis and two had late stent thrombosis treated with angioplasty or covered stents. CONCLUSION: TIPS placement in infants is a feasible, safe and effective procedure.

[Septic hip arthritis after a closed acetabulum fracture treated conservatively. Case report]. / Artritis séptica de cadera luego de una fractura cerrada de acetábulo tratada en forma conservadora. Reporte de caso.

Necrotizing fasciitis is a life-threatening infection. Inmediate diagnosis and treatment are essential. Acetabulum fractures are a frequent identity in older adults today, associated with low-energy trauma. The indication for surgical or conservative treatment depends on multiple factors such as the age and comorbidities of the patient, the type and location of the fracture, and the socio-economic environment. We described an unusual case of infected hematoma, secondary to a closed acetabulum fracture, which led to septic arthritis of the hip joint.

Las fracturas de acetábulo asociadas a traumatismos de baja energía, son una identidad frecuente hoy en día en los adultos mayores. La indicación del tratamiento quirúrgico o conservador, depende de múltiples factores como la edad y las comorbilidades del paciente, el tipo y localización de la fractura, y el medio socio-económico. Independientemente del tratamiento elegido, ninguno está exento de complicaciones. Se describe a continuación un paciente con una fractura de acetábulo cerrada, de tratamiento conservador, que derivó en artritis séptica de la articulación coxofemoral.

Strains of Lactobacillus spp. reduce chalkbrood in Apis mellifera.

Beekeeping activities have increased recently in Argentina, a country that is a major consumer of honey and other products from hives. With the advancement of monoculture areas in Argentina and worldwide, beekeepers move from one area to another in search of floral resources, thus spreading diseases such as chalkbrood, caused by the fungus Ascosphaera apis. Although there are few effective antifungals for the control of chalkbrood, different natural products have been investigated in recent years. Current research is focusing on the intestinal microbiota for the prevention of different pathogens and parasites. In this work, we analyzed the in vivo probiotic effect of three lactic acid bacteria (genus Lactobacillus spp.) isolated from pollen bread from apiaries of Jujuy province on A. apis strains from Spanish and Argentine provinces. Special hives were made for the assays, and a protective effect was observed in larvae of bees fed lactic acid bacteria added to sugar syrup at 105 CFU/mL concentrations, administered from May to September in two consecutive years. The results showed that the three lactic acid bacteria reduced larval mummification by percentages greater than 80%. Therefore, this work brings a first approximation of the in vivo probiotic effect of lactic bacteria against A. apis.

Luxación periastragalina medial pura: reporte de casos y revisión bibliográfica / Pure medial subtalar dislocation: case report and literature review

Las luxaciones subastragalinas (periastragalinas) sin fractura asociada son un cuadro poco frecuente. Representan solo el 1% de las luxaciones en el ser humano. Presentamos tres casos de luxaciones mediales puras en pacientes que sufrieron un traumatismo de alta energía. En todos los casos, el tratamiento consistió en la reducción cerrada bajo anestesia y posterior inmovilización; la evolución fue satisfactoria. Las luxaciones subastragalinas requieren de un diagnóstico temprano y una rápida resolución. Con estos casos se quiere demostrar la importancia de la sospecha diagnóstica y el beneficio de un tratamiento precoz y acertado. Nivel de evidencia: IV

Isolated subtalar dislocations without associated fracture are a rare entity. They represent only 1% of dislocations in humans. We present a series of 3 cases of pure medial dislocations in patients who suffered high-energy trauma. In all cases, the treatment was closed reduction under anesthesia and subsequent immobilization; all with good results. Subtalar dislocations require early diagnosis and rapid resolution. The aim of this presentation is to demonstrate the importance of diagnostic suspicion and the benefit of early treatment for successful outcome. Level of evidence: IV

Lactobacillus salivarius A3iob Reduces the Incidence of Varroa destructor and Nosema Spp. in Commercial Apiaries Located in the Northwest of Argentina.

Lactobacillus salivarius A3iob was administered to productive colonies belonging to commercial apiaries of small beekeepers (around 30-50 hives each one), from four departments of the province of Jujuy (Argentina): Yala, Tilquiza, El Carmen, and Los Alisos. The incidence of Varroa destructor and Nosema spp., before and after winter, was monitored during 2 years of study (2014-2015). Depending on the geographical location of each apiary and the application time, a monthly dose of the bacteria (105 CFU/mL) reduced the levels of varroasis between 50 and 80%. Interestingly, L. salivarius A3iob cells remitted the percentage of the mites to undetectable values in an apiary treated with flumethrin (at Yala, Yungas region).On the other hand, the spore levels of Nosema spp. in the lactobacilli-treated colonies also depended on the apiary and the year of application, but a significant decrease was mainly observed in the post-winter period. However, at Rivera (El Carmen's department), no significant changes were detected in both parameters.These results obtained after 2 years of work suggest that delivering L. salivarius A3iob cells to the bee colonies can become a new eco-friendly tool to cooperate with the control of these bees' pests.

Postpartum hemorrhage with pelvic arterial embolization, study of 33 cases.

OBJECTIVE: To describe our cases of postpartum hemorrhage (PPH) with pelvic arterial embolization (PAE). MATERIAL AND METHODS: All patients with PPH who underwent PAE in our center in the interval 2011-1016 were retrospectively studied, evaluating the technical procedure, clinical results, and subsequent fertility. RESULTS: There were 33 cases of PPH with PAE. The majority occurred in primiparous women (N = 22, 66.6%) who delivered vaginally (N = 20, 61%). In addition, most PPH with PAE cases had an early onset (N = 26, 79%) and were caused by uterine atony (N = 14, 42.4%). Success of PAE occurred in 27 (81.8%) cases and a satisfactory clinical follow-up was the rule, with 21 (64%) women recovering their normal menstruation, and six (18.2%) becoming pregnant in the following years. CONCLUSIONS: PAE is a safe and efficacious technique with minor complications. Moreover, it allows conservation of the uterus with preservation of fertility.

Use of bias correction techniques to improve seasonal forecasts for reservoirs - A case-study in northwestern Mediterranean.

In this paper, we have compared different bias correction methodologies to assess whether they could be advantageous for improving the performance of a seasonal prediction model for volume anomalies in the Boadella reservoir (northwestern Mediterranean). The bias correction adjustments have been applied on precipitation and temperature from the European Centre for Middle-range Weather Forecasting System 4 (S4). We have used three bias correction strategies: two linear (mean bias correction, BC, and linear regression, LR) and one non-linear (Model Output Statistics analogs, MOS-analog). The results have been compared with climatology and persistence. The volume-anomaly model is a previously computed Multiple Linear Regression that ingests precipitation, temperature and in-flow anomaly data to simulate monthly volume anomalies. The potential utility for end-users has been assessed using economic value curve areas. We have studied the S4 hindcast period 1981-2010 for each month of the year and up to seven months ahead considering an ensemble of 15 members. We have shown that the MOS-analog and LR bias corrections can improve the original S4. The application to volume anomalies points towards the possibility to introduce bias correction methods as a tool to improve water resource seasonal forecasts in an end-user context of climate services. Particularly, the MOS-analog approach gives generally better results than the other approaches in late autumn and early winter.

Urea-based recirculation validation of the symmetrical palindrome catheter.

BACKGROUND: High blood flow and low recirculation rates are central for adequate haemodialysis. A new symmetrical tip has been invented promising efficient haemodialysis even if the ports are reversed. OBJECTIVE: To evaluate access recirculation of the 'palindrome' catheter and to report initial experiences in a clinical setting. MATERIAL AND METHODS: After implantation of the new catheter in 20 patients (male: 14; female: 6; mean age 72 ± 12.2), access recirculation was evaluated using the urea-based recirculation test. After 30 minutes of haemodialysis, ultrafiltration was stopped and arterial and venous samples were taken. Afterwards, the blood flow rate was reduced to 120 ml/min. Another systemic arterial blood sample was taken 10 seconds after the blood pump was switched off. RESULTS: All 20 interventions were performed successfully without complications. The average recirculation rate was 8.1% with a median of 2.5% ranging from 0 to 85.8%. Recirculation rates under 5% were measured in 13 patients and more than 10% recirculation were found in two patients. The median of days between catheter implantation and recirculation assessment was the day following implantation. CONCLUSION: The new symmetrical catheter presented low recirculation rates in a clinical setting. Since there is just a single tip, fluoroscopic placement in the right atrium is facilitated.

Seasonal predictability of water resources in a Mediterranean freshwater reservoir and assessment of its utility for end-users.

In this study we explore the seasonal predictability of water resources in a Mediterranean environment (the Boadella reservoir, in north-eastern Spain). Its utility for end-users is assessed through the analysis of economic value curve areas (EVA). Firstly, we have built monthly multiple linear regression (MLR) models for the in-flow, out-flow and volume anomalies by identifying the underlying relationships between these predictands and their potential predictors, both meteorological and human influenced: rainfall, maximum and minimum temperatures, reservoir volume and discharge. Subsequently, we have forecast the monthly anomalies with these models for the period 1981-2010 (up to seven months ahead). We have tested the aforementioned models with four strategies in a leave-one-out cross-validation procedure (LOOCV): a) Climatology (Clim.), b) persistence (Pers.), c) antecedent observations+climatology (A+Clim.), d) antecedent observations+European Centre for Medium-range Weather Forecasts (ECMWF) System 4 anomalies (A+S4). Climatology is the operational strategy against which the other approximations are compared. The second and third approaches only use observations as input data. Finally, the last one combines both observations and ECMWF System 4 forecasts. The LOOCV revealed that reservoir volume is the variable best described by the MLR models, followed by in-flow and out-flow anomalies. In the case of volume anomalies, the predictability displayed provides added value with respect to climatology with a minimum of four months in advance. For in-flow and out-flow this is true at one month ahead, and regarding the latter variable we encounter enhanced predictability also at longer horizons for the summer months, when water demands peak (a valuable result for end-users). Hence, there is a window of opportunity to develop future operational frameworks that could outperform the use of climatology for these variables and forecast horizons.

Preliminary studies of new strains of Trametes sp. from Argentina for laccase production ability

Abstract Oxidative enzymes secreted by white rot fungi can be applied in several technological processes within the paper industry, biofuel production and bioremediation. The discovery of native strains from the biodiverse Misiones (Argentina) forest can provide useful enzymes for biotechnological purposes. In this work, we evaluated the laccase and manganese peroxidase secretion abilities of four newly discovered strains of Trametes sp. that are native to Misiones. In addition, the copper response and optimal pH and temperature for laccase activity in culture supernatants were determined.The selected strains produced variable amounts of laccase and MnP; when Cu2+ was added, both enzymes were significantly increased. Zymograms showed that two isoenzymes were increased in all strains in the presence of Cu2+. Strain B showed the greatest response to Cu2+ addition, whereas strain A was more stable at the optimal temperature and pH. Strain A showed interesting potential for future biotechnological approaches due to the superior thermo-stability of its secreted enzymes.

Preliminary studies of new strains of Trametes sp. from Argentina for laccase production ability.

Oxidative enzymes secreted by white rot fungi can be applied in several technological processes within the paper industry, biofuel production and bioremediation. The discovery of native strains from the biodiverse Misiones (Argentina) forest can provide useful enzymes for biotechnological purposes. In this work, we evaluated the laccase and manganese peroxidase secretion abilities of four newly discovered strains of Trametes sp. that are native to Misiones. In addition, the copper response and optimal pH and temperature for laccase activity in culture supernatants were determined. The selected strains produced variable amounts of laccase and MnP; when Cu(2+) was added, both enzymes were significantly increased. Zymograms showed that two isoenzymes were increased in all strains in the presence of Cu(2+). Strain B showed the greatest response to Cu(2+) addition, whereas strain A was more stable at the optimal temperature and pH. Strain A showed interesting potential for future biotechnological approaches due to the superior thermo-stability of its secreted enzymes.

Parto tras miomectomía con radiofrecuencia / Delivery after radiofrquency myolysis

INTRODUCCIÓN: Los miomas uterinos son la tumoración pélvica más frecuente en la mujer en edad reproductiva. Aunque existen múltiples tratamientos quirúrgicos, radiológicos y médicos, las técnicas que garanticen la fertilidad posterior de las pacientes son limitadas. CASO CLÍNICO: En nuestro centro, una mujer de 36 ańos sana nuligesta con útero miomatoso se sometió a miomectomía por radiofrecuencia. La paciente quedó gestante 10 meses tras la intervención y la gestación cursó con normalidad. Llegando a término, finalizó la gestación mediante parto vaginal sin incidencias. DISCUSIÓN: El caso presentado apoya a la miomectomía por radiofrecuencia como alternativa de tratamiento segura para pacientes útero miomatoso con deseo genésico posterior

INTRODUCTION: Uterine fibroids are the most common pelvic tumor in women of reproductive age. Although there is a wide variety of surgical, radiological and medical treatments, techniques that preserve efficiently the fertility are limited. CASE REPORT:A 31-year-old nuligravid woman with uterine fibroids underwent a radiofrequency myolysis in our Center. Ten months after the procedure, she became pregnant and had a vaginal delivery without complications during pregnancy or delivery. DISCUSSION: Radiofrequency myolysis could be an alternative treatment for patients with uterine fibroids who desire to preserve their fertility

Locoregional therapy and systemic cetuximab to treat colorectal liver metastases.

AIM: To investigate efficacy and safety of second-line treatment with irinotecan-loaded drug-eluting beads (DEBIRI) and cetuximab (DEBIRITUX) of unresectable colorectal liver metastases. METHODS: Patients with the following characteristics were included in the study: unresectable hepatic metastases from colorectal carcinoma (CRC-LM), progression after first line chemotherapy (any type of chemotherapeutic drug and combination was allowed), second line treatment (mandatory), which included for each patient (unregarding the KRas status) two cycles of DEBIRI (using 100-300 µm beads loaded with irinotecan at a total dose 200 mg) followed by 12 cycles of cetuximab that was administered weekly at a first dose of 400 mg/m(2) and then 250 mg/m(2); good performance status (0-2) and liver functionality (alanine aminotransferase and gamma-glutamyl transferase not exceeding three times the upper limit of normal, total bilirubin not exceeding 2.5 mg/mL). Data were collected retrospectively and included: tumor response (evaluated monthly for 6 mo then every 3 mo), overall response rate (ORR), KRas status, type and intensity of adverse events (G according to the Common Terminology Criteria for Adverse Events v3.0, CTCAE), overall survival (OS) and progression free survival (PFS). RESULTS: Forty consecutive cases of CRC hepatic metastases were included in the study. Median duration of DEBIRITUX was 4.4 mo (range, 4.0-6.5). Sixteen patients (40%) received the planned 2 cycles of DEBIRI and an average of 10 cetuximab cycles. ORR of the whole sample was 50%, in particular 4 patients were complete responders (10%) and 16 (40%) partial responders. The most observed side effects (G2) were: post-embolization syndrome (30%), diarrhea (25%), skin rushes (38%) and asthenia (35%). The retrospective evaluation of KRas status (24 wild type, 16 mutated) showed that the group of patients with wild type KRas had ORR significantly higher than mutant KRas. Median follow-up was 29 mo (8-48 range); median PFS was 9.8 mo and OS was 20.4 mo. Future randomized trials are required in this setting to establish a role for DEBIRITUX compared with systemic chemotherapy. CONCLUSION: DEBIRITUX seems to be efficacious after first line chemotherapy for the treatment of unresectable CRC-LM.

Treatment of O2-free toluene emissions by anoxic biotrickling filtration.

Toluene biotrickling filtration under anoxic denitrifying conditions was evaluated in two identical bioreactors (R1 and R2) operated at liquid recycling rates of 1.3, 2.7 and 5.3 m h−1 and liquid renewal rates of 0 and 0.17 d−1. R1 and R2 achieved a similar maximum elimination capacity (EC ∼30 g m−3 h−1) at the same toluene inlet load (∼50 g m−3 h−1), which was approximately 7 times higher compared with available literature on continuous toluene removal under anoxic conditions. Nevertheless, higher metabolite accumulation was observed in the bioreactor operated without periodical liquid phase renewal (R2), leading to intermittent drops in its toluene removal performance. This is the first work operating an anoxic biotrickling filter at empty bed residence time of 3 min, which is comparable with those employed in conventional aerobic systems. A characterization of the metabolites accumulated in the liquid phase revealed a dynamic metabolite production and degradation.

Primary extraosseous intradural spinal Ewing's sarcoma: report of two cases.

Two cases of primary extraosseous intradural spinal Ewing's sarcoma are reported with a review of the current literature. This rare neoplasm shares features with cerebral primitive neuroectodermal tumors, complicating a correct diagnosis. Gross total resection seems to be the main treatment, although adjuvant therapies could improve the prognosis. In case 1, a 56-year-old man presented with cauda equina syndrome. MRI showed an intradural tumor from L4 to S2. An emergency laminectomy was performed with gross total resection of a hemorrhagic tumor, followed by adjuvant treatment. In the second case, a 25-year-old female developed leg and lumbar pain. MRI study identified a homogeneously enhancing intradural mass at the L2-L3 level. A laminoplasty was performed, followed by tumor resection; no adjuvant treatment was administered afterwards. Immunohistochemical workup confirmed the diagnosis of Ewing's sarcoma in both cases.