Microbial ecology of the Southern Ocean.

The Southern Ocean (SO) distributes climate signals and nutrients worldwide, playing a pivotal role in global carbon sequestration. Microbial communities are essential mediators of primary productivity and carbon sequestration, yet we lack a comprehensive understanding of microbial diversity and functionality in the SO. Here, we examine contemporary studies in this unique polar system, focusing on prokaryotic communities and their relationships with other trophic levels (i.e. phytoplankton and viruses). Strong seasonal variations and the characteristic features of this ocean are directly linked to community composition and ecosystem functions. Specifically, we discuss characteristics of SO microbial communities and emphasise differences from the Arctic Ocean microbiome. We highlight the importance of abundant bacteria in recycling photosynthetically derived organic matter. These heterotrophs appear to control carbon flux to higher trophic levels when light and iron availability favour primary production in spring and summer. Conversely, during winter, evidence suggests that chemolithoautotrophs contribute to prokaryotic production in Antarctic waters. We conclude by reviewing the effects of climate change on marine microbiota in the SO.

Three Draft Single-Cell Genome Sequences of Novel SAR324 Strains Isolated from the Abyssopelagic Southern Ocean.

SAR324 is a ubiquitous and phylogenetically distinct clade of Deltaproteobacteria in marine environments. Here, we present three single-cell amplified genome sequences from the SAR324 lineage, obtained from the abyssopelagic zone of the Indian sector of the Southern Ocean.

The Healthy Human Blood Microbiome: Fact or Fiction?

The blood that flows perpetually through our veins and arteries performs numerous functions essential to our survival. Besides distributing oxygen, this vast circulatory system facilitates nutrient transport, deters infection and dispenses heat throughout our bodies. Since human blood has traditionally been considered to be an entirely sterile environment, comprising only blood-cells, platelets and plasma, the detection of microbes in blood was consistently interpreted as an indication of infection. However, although a contentious concept, evidence for the existence of a healthy human blood-microbiome is steadily accumulating. While the origins, identities and functions of these unanticipated micro-organisms remain to be elucidated, information on blood-borne microbial phylogeny is gradually increasing. Given recent advances in microbial-hematology, we review current literature concerning the composition and origin of the human blood-microbiome, focusing on bacteria and their role in the configuration of both the diseased and healthy human blood-microbiomes. Specifically, we explore the ways in which dysbiosis in the supposedly innocuous blood-borne bacterial microbiome may stimulate pathogenesis. In addition to exploring the relationship between blood-borne bacteria and the development of complex disorders, we also address the matter of contamination, citing the influence of contaminants on the interpretation of blood-derived microbial datasets and urging the routine analysis of laboratory controls to ascertain the taxonomic and metabolic characteristics of environmentally-derived contaminant-taxa.

Short- and mid-term outcomes of robotic-assisted total mesorectal excision for the treatment of rectal cancer. Our experience after 198 consecutive cases.

BACKGROUND: Robot-assisted total mesorectal excision is a safe alternative for rectal cancer treatment. Nevertheless, substantial data is still missing. Our aim was to assess the perioperative and oncological outcomes of the routine use of the robotic-assisted approach for rectal cancer treatment. PATIENTS AND METHODS: 198 Consecutive robotic rectal resections were performed between January 2011 and April 2015 in patients with stage I-IV disease. We prospectively evaluated peri and postoperative data, pathological findings and mid-term oncological outcomes. RESULTS: 36 Abdominoperineal Amputations, 28 High Anterior Resections, 131 Low Anterior Resections and 3 Hartmann operations were performed. Mean age, ASA, BMI and distance form anal verge were respectively 67.5 years, ASA II, 26.95 kg/m(2) and 5.9 cm. 71.2% Patients received neoadjuvant therapy. Mean OR time was 294 minutes. Conversion occurred in 4.5%. Mean postoperative stay was 8 days. 36 Patients required blood transfusion with a mean of 162 ml. Complications Clavien III-IV were 12.1%. 8 complete responses were observed, 50 UICC class I, 84 class II, 51 class III and 13 class IV. Mean lymph node harvested were 11.7. Mean distal margin was 3.3 cm. 11 Circumferential margins were affected in UICC class III-IV patients. Postoperative mortality was 0.5%. Local recurrence was observed in 5% patients. Median follow-up was 27.6 months. LIMITATIONS: Single institution descriptive study. CONCLUSIONS: The routine use of robotic assisted laparoscopic surgery may help to achieve lower conversion rates with lower ventral hernia rates and similar oncological outcomes using a minimally invasive approach in a non-selected group of patients with non-selected rectal tumours.

Preclinical cadaveric study of transanal robotic proctectomy with total mesorectal excision combined with laparoscopic assistance.

BACKGROUND: Anterior resection with total mesorectal excision (TME) is the standard method of rectal cancer resection. However, this procedure remains technically difficult. A robotic transanal approach could overcome some of these limitations. An initial laboratory experience with robotic transanal TME using a new designed port on human cadavers is reported. METHODS: The feasibility of robotic transanal TME and ideal set-up were evaluated in human cadavers. For the da Vinci Si HD system transanal access and total mesorectal excision, a specifically designed port was used. RESULTS: It was possible to complete a proctectomy with transanal total mesorectal excision. The port proved to be very reliable and facilitated docking of the robotic arms. CONCLUSION: Using the robotic technology and a specifically designed port for robotic transanal access, TME was shown to be feasible and one specific preferred set-up was determined. Further clinical trials will be necessary to assess the safety and efficacy of this technique.

[Polysplenia with partial abdominal visceral heterotaxia and small pancreas]. / Poliesplenia con heterotaxia visceral abdominal parcial y páncreas pequeño.

Several morphological congenital abnormalities are associated in the polysplenia syndrome: partial visceral abdominal heterotaxy, levoisomerism, abdominal vascular abnormalities, cardiac and extrahepatic biliary malformations and polysplenia. The syndrome is usually apparent during childhood because of its severe outcome; its detection during adult life is rare. We present a 42-years-old patient, asymptomatic, with right sided polysplenia and stomach, intestinal malrotation, centrally located liver with both lobes of similar size, preduodenal portal vein, interruption of the inferior caval vein with continuation via the azygos vein. There were no cardiac malformations nor lung levoisomerism. The pancreas was atrophic, an occasionally described finding. CT scan may be useful for the study of this patients in order to identify every anatomic abnormality, and plan for future surgical operations.

[Colorectal cancer in elderly patients: postoperative mortality and survival]. / Cancer colorrectal en pacientes de edad avanzada: mortalidad postoperatoria y supervivencia.

Twenty percent of colorectal cancers develop in elderly patients. Since the size of the geriatric population increases this percentage will get higher. The data collected from the Cantabria Colorectal Cancer Population Registry (1989-90) were divided into two groups: patients aged > or = 80 years at diagnosis and patients aged < 80. The postoperative mortality rates were 11% vs. 7%. Emergency surgery on patients over 80 years was associated with a significantly higher incidence of perioperative deaths (26%). Three-year survival rates for the two groups (20%) were not significantly different. These data suggest that elderly patients suffering from colorectal cancer can be treated by standard methods.