Complete Genome Sequence and Methylome Analysis of Micrococcus luteus SA211, a Halophilic, Lithium-Tolerant Actinobacterium from Argentina.

Micrococcus luteus has been found in a wide range of habitats. We report the complete genome sequence and methylome analysis of strain SA211 isolated from a hypersaline, lithium-rich, high-altitude salt flat in Argentina with single-molecule real-time sequencing.

QRS duration and dispersion for predicting ventricular arrhythmias in early stage of acute myocardial infraction. / Duración y dispersión del QRS para predecir arritmias ventriculares en las fases iniciales del infarto agudo de miocardio.

OBJECTIVE: To determine the relationship between QRS duration and dispersion and the occurrence of ventricular arrhythmias in early stages of acute myocardial infarction (AMI). DESIGN: A retrospective, longitudinal descriptive study was carried out. SETTING: Hospital General Universitario "Camilo Cienfuegos", Sancti Spíritus, Cuba. Secondary health care. PATIENTS OR PARTICIPANTS: A total of 209 patients diagnosed with ST-segment elevation AMI from January 2012 to June 2014. MAIN VARIABLES OF INTEREST: The duration and dispersion of the QT interval, corrected QT interval, and QRS complex were measured in the first electrocardiogram performed at the hospital. The presence of ventricular tachycardia/fibrillation was assessed during follow-up (length of hospital stay). RESULTS: Arrhythmias were found in 46 patients (22%); in 25 of them (15.9%), arrhythmias originated in ventricles, and were more common in those subjects with extensive anterior wall AMI, which was responsible for 81.8% of the ventricular fibrillations and more than half (57.1%) of the ventricular tachycardias. The widest QRS complexes (77.3±13.3 vs. 71.5±6.4ms; P=.029) and their greatest dispersion (24.1±16.2 vs. 16.5±4.8ms; P=.019) were found on those leads that explore the regions affected by ischemia. The highest values of all measurements were found in extensive anterior wall AMI, with significant differences: QRS 92.3±18.8ms, QRS dispersion 37.9±23.9ms, corrected QT 518.5±72.2ms, and corrected QT interval dispersion 94.9±26.8ms. Patients with higher QRS dispersion values were more likely to have ventricular arrhythmias, with cutoff points at 23.5ms and 24.5ms for tachycardia and ventricular fibrillation, respectively. CONCLUSIONS: Increased QRS duration and dispersion implied a greater likelihood of ventricular arrhythmias in early stages of AMI than increased duration and dispersion of the corrected QT interval.

Malignant mixed mullerian tumors

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Malignant mixed mullerian tumours (MMMTs) arerare neoplasms, highly aggressive and with an extremelypoor prognosis, usually arising in elderlypostmenopausal women and presenting at an advancedstage. MMMTs derive from the mullerianmesodermus that differentiates in epithelial andstromal elements, both malignant elements.The clinic pathological features of 3 uterine MMMTsare reported here. The patients ranged in age from25 to 69 years. The initial manifestations weremainly bloody discharge, abdominal pain and increaseof the volume of the uterus. Treatment in 2patients was hysterectomy with double ooforectomy,and resection of the pelvic mass was the treatmentin the third case. Adjuvant radio chemotherapywas administrated in 2 of the 3 cases. Follow-uprevealed recurrent pelvic tumour in 1 patient at 59months, and breast metastases at 20 months in thesecond one.Because of the high incidence of recurrence andpoor prognosis of these tumours, they should bestudied and managed by a multidisciplinary teamcomposed by surgeons, oncologists, radiotherapistsand pathologists

Obesidad: aspectos patogénicos, alteraciones cardiovasculares asociadas y estrategias terapéuticas / Obesity: pathogenic issues, associated cardiovascular illness, and therapeutic approach

La obesidad es la alteración metabólica más frecuente delos seres humanos. Esta enfermedad aparece debido al excesode tejido adiposo que se produce por la acumulación progresivade grasa en sus reservorios debido a un desequilibrio dela homeostasis calórica donde la ingestión excede el gastoenergético. Afecta aproximadamente al 33% de los adultos ycada año se invierten en alimentos especiales y programas parareducir el peso corporal cerca de 30 millones de dólares; sinembargo, los tratamientos empleados han sido ineficaces y casiel 90% de las personas que bajan de peso, aumentan nuevamenteel peso perdido. En este artículo presentamos una revisiónsobre la obesidad, haciendo especial énfasis en ladefinición y su epidemiología, su patogenia, la relación conenfermedades cardiovasculares y el tratamiento actualizado

Obesity is the most frequent metabolic disturbance thataffects human beings. This disease appears due to the excessof fatty tissue which is produced because of progressive accumulationof fat on its reservoirs, as a response to misbalanceon caloric homeostasis where food intake exceedsenergetic needs. Obesity affects around 33% of adult population,and near 30 million dollars is inverted each year onspecial foods, and programs to reduce body weight; however,treatments applied have been unsuccessful, and almost90% of people who loose weight, gain the lost weight again.This article shows a review about obesity where we mainlyemphasis in concept and epidemiology, pathophysiology, itsrelation with cardiovascular diseases, and current treatment

[Giant atherosclerotic aneurysm. A case report]. / Aneurisma aterosclerótico gigante. Presentación de un caso.

INTRODUCTION: Intracraneal aneurysms are frequent in medical practice, most of them never produce symptoms, that is why occasionally, they are not diagnosed before death. Sacular is the most frequent aneurysm, and atherosclerotic aneurysm is rare. CASE REPORT: In this article we present the case of a 75 year old woman who has been suffering from high blood pressure and coronary artery disease since more than 20 years and in the last four months she had been complaining of dysphagia and dysartria. She was taken to the hospital because 24 hours ago mild headache started accompanied by vertigo, nausea and vomiting. On neurological exam we found sleepiness, dysartria, and right braguio crural hemiparesis, therefore we decided admitt her, but after 48 hours left braquio crural hemiparesis was added and later respiratory sepsis appeared. The patient died due to an acute respiratory failure. CONCLUSION: Necropsy revealed a huge atherosclerotic intracraneal aneurysm (31 mm) located on basilar artery. The case has been discussed and images were shown.

Complicated PEG-to-skin level gastrostomy conversions: analysis of risk factors for tract disruption.

BACKGROUND: PEG disruptions during conversions to skin-level gastrostomy devices have been described, but specific risk factors have not been reported. In this study, possible risk factors for tract disruption in a pediatric population were identified, and management of complications described. METHODS: The medical records of patients who underwent gastrostomy conversions during 1994 were reviewed. Statistical analysis was performed using two-tailed student's t test, and risk ratios with 95% confidence limits were calculated. RESULTS: Gastrostomy tract disruption occurred in 6 to 30 (20%) of tube conversions. Complicated and uncomplicated cases did not differ with regard to age, sex, primary or associated diagnoses, pregastrostomy or postgastrostomy nutritional status, tract maturity, or percutaneous gastrostomy tube type. The use of an 18F obturator-type skin-level gastrostomy tube increased the risk for gastric separation 4.8-fold. Tract disruptions were managed by fluoroscopic gastrostomy tube replacement, repeat PEG, or exploratory laparotomy with open gastrostomy. CONCLUSIONS: The use of obturator-type skin-level gastrostomy tubes was associated with an increased risk of tract disruption. Fluoroscopic verification of intragastric placement is warranted after initial conversions to skin-level gastrostomy tubes.

Rhabdomyosarcoma of the biliary tree: the case for aggressive surgery.

Embryonal rhabdomyosarcoma of the bile ducts is associated with a poor prognosis because complete resection rarely is considered possible. We reviewed the literature and report our experience with the management of 3 consecutive patients. The patients were 1, 4, and 9 yr old at presentation, and had jaundice, cachexia, and an abdominal mass. The tumor arose in the common hepatic duct in 2 patients, and in the left hepatic duct in the other. All had tumor extension into both lobes of the liver and residual disease was noted after resection. Two patients were given tumor bed irradiation and all received multiple-drug chemotherapy. Two patients are alive, jaundice free, and with no evidence of disease at 9 mo and 14 yr follow-up. The other patient was a long-term survivor, but developed local recurrent tumor after cessation of chemotherapy and expired 33 mo after diagnosis. The traditional anatomic criteria of hepatic tumor resectability may not apply to botryoid sarcoma of the bile ducts. Aggressive surgery combined with the new adjuvant therapies appears to provide the best chance for a longer survival.