Addition of ß-glucans in diets for tropical gar (Atractosteus tropicus) larvae: effects on growth, digestive enzymes and gene expression of intestinal epithelial integrity and immune system.

The effect of ß-glucans 1,3/1,6 from Saccharomyces cerevisiae yeast at different inclusion percentages (0.0, 0.2, 0.4, 0.6, and 0.8%) in the diet for tropical gar (Atractosteus tropicus) larvae was evaluated on growth, digestive enzyme activity and, relative expression of the immune system genes. The bioassay started on the third day after hatching (DAH) and lasted 21 days, using a total of 1500 larvae of 0.055 ± 0.008 g and, a total length of 2.46 ± 0.26 cm. Larviculture was carried out in a recirculation system with 15 tanks of 70 L using a density of 100 organisms per experimental unit. No significant differences in larval growth were observed by the inclusion of ß-glucans (p > 0.05). Digestive enzymes showed changes in lipase and trypsin activities, presenting higher values in fish fed 0.6% and 0.8% ß-glucans diets compared to the other treatments (p < 0.05). Leucine-aminopeptidase, chymotrypsin, acid phosphatase, and alkaline phosphatase activity showed higher activities in larvae fed with a 0.4% ß-glucan diet compared to the control group. The relative expression of intestinal membrane integrity (mucin 2) muc-2, (occludins) occ, (nucleotide-binding oligomerization domain) nod-2, and immune system lys (lysosome) genes showed over-expression in larvae fed the 0.4% ß-glucan diet to the rest of the treatments (p < 0.05). The inclusion of ß-glucans at 0.4-0.6% in diets for A. tropicus larvae could improve larviculture, as effects on the increase in the activity of several digestive enzymes and the expression of genes of the immune system.

Protein and lipid requirements of three-spot cichlid Cichlasoma trimaculatum larvae.

Determination of the main nutritional requirements at different developmental stages is a prerequisite in the formulation of feeds for newly cultured fish species. In the present study, the lipid and protein requirements of larvae of a native Mexican fish, the three-spot cichlid Cichlasoma trimaculatum, were assessed using a two-factor experimental design that considered four protein (35, 40, 45, and 50%) and two lipid levels (16 and 22%) on growth, survival, and digestive enzyme activities. The best growth and feed efficiency results were obtained when larvae were fed diets including 45% protein and 22% lipids. Comprehensive evaluation of the profile of digestive enzymes using multivariate analysis also demonstrated significant differences in nutritional condition generated by varying inclusion of nutrients. Thus, an increase in protein led to an increase in alkaline protease activity and a reduction in leucine aminopeptidase activity, and the reduction of dietary lipid content led to a significant increase in lipase and trypsin enzymatic activities. Based on our results, C. trimaculatum larvae have a high capacity to hydrolyze both nutrients (protein and lipids) for the high digestive enzyme activities and increase their growth, particularly with a diet containing 45% protein and 22% lipids.

Anticipándonos al desastre: trombectomía mecánica en paciente con NIHSS bajo / Anticipating disaster: Mechanical thrombectomy in patients with low NIHSS scores

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Adaptación al español de las Good Urodynamic Practices de la International Continence Society / Adaptation to Spanish of the ICS Good Urodynamic Practices

El grupo de trabajo de estandarización de la Sociedad Internacional de Continencia ha actualizado las directrices de Buenas Prácticas en Urodinámica de dicha sociedad. Estas GUP2016 basadas en la evidencia han definido los términos y estándares para la práctica de la Urodinámica tanto en los gabinetes como para la práctica individual, en el control de calidad durante la cistomanometría o el estudio de presión-flujo. Además, el grupo de trabajo ha incluido recomendaciones previas a la prueba e información sobre la preparación del paciente, así como recomendaciones para realizar el informe urodinámico. Basándose en la estandarización previa de la Sociedad Internacional de Continencia y en la evidencia actual, se ha detallado la práctica de la uroflujometría, la cistomanometría y el estudio de presión-flujo, con el objetivo de que esta actualización de las Buenas Prácticas en Urodinámica ayude a mejorar la calidad de la clínica e investigación en Urodinámica

The standardisation working group of the International Continence Society has updated the Good Urodynamic Practice directives. This evidence-based ICS-GUP2016 has defined the terminology and standards of Urodynamic practice, for the laboratory and for individual practice, in quality control during cystometry and pressure-flow analysis. In addition, the working group included recommendations prior to the test and information about how to prepare the patient, as well as recommendations for the reporting of urodynamics. Based on earlier International Continence Society standardisations and current evidence, the practice of uroflowmetry, cystometry and pressure-flow study have been detailed with a view to ensuring that this Good Urodynamic Practice update contributes towards improving clinical and research quality in urodynamics

Adaptation to Spanish of the ICS Good Urodynamic Practices. / Adaptación al español de las Good Urodynamic Practices de la International Continence Society.

The standardisation working group of the International Continence Society has updated the Good Urodynamic Practice directives. This evidence-based ICS-GUP2016 has defined the terminology and standards of Urodynamic practice, for the laboratory and for individual practice, in quality control during cystometry and pressure-flow analysis. In addition, the working group included recommendations prior to the test and information about how to prepare the patient, as well as recommendations for the reporting of urodynamics. Based on earlier International Continence Society standardisations and current evidence, the practice of uroflowmetry, cystometry and pressure-flow study have been detailed with a view to ensuring that this Good Urodynamic Practice update contributes towards improving clinical and research quality in urodynamics.

Fístulas arteriovenosas durales medulares: las malformaciones vasculares más frecuentes de la médula espinal / Spinal dural arteriovenous fistulas: the most frequent vascular malformations of the spinal cord

Las fístulas arteriovenosas durales medulares se producen por una comunicación directa entre los sistemas arterial y venoso de la médula espinal, ocasionando hipertensión en el último con disfunción del drenaje medular. Se trata de una patología rara, con etiología desconocida y una clínica inespecífica que suele provocar retraso en el diagnóstico. A menudo los radiólogos son los primeros que orientan el cuadro hacia un diagnóstico adecuado. Mediante resonancia magnética (RM) o angiografía por RM se pueden ver hallazgos característicos, pudiendo incluso localizar el lugar de la fístula en un porcentaje elevado de los casos, aunque la patología debe confirmarse mediante angiografía medular. Existen dos modalidades de tratamiento: terapia endovascular y quirúrgica. El tratamiento endovascular ha mejorado en los últimos años y presenta las ventajas de un abordaje menos invasivo, por lo que suele elegirse como terapia primaria. En este artículo revisamos las principales características clínicas, el diagnóstico por la imagen y el tratamiento de esta patología

Spinal dural arteriovenous fistulas are produced by direct communication between the arterial and venous systems of the spinal cord, causing hypertension in the latter with spinal cord dysfunction. It is a rare pathology with unknown etiology and non-specific clinical symptoms that usually results in a delayed diagnosis. Often radiologists are the first to guide the disease towards an adequate diagnosis. Characteristic findings can be seen through MR or MR angiography, and may even locate the fistula in a high percentage of cases, although the pathology must be confirmed by spinal angiography. There are two treatment modalities: endovascular and surgical therapy. Endovascular treatment has improved in recent years with the advantages of a less invasive approach and is therefore usually chosen as primary therapy. In this article we review the main clinical manifestations, imaging findings and treatment of this pathology

Recanalización espontánea de una oclusión crónica de arteria carótida interna / Spontaneous recanalisation of a chronic internal carotid artery occlusion

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Spinal dural arteriovenous fistulas: the most frequent vascular malformations of the spinal cord. / Fístulas arteriovenosas durales medulares: las malformaciones vasculares más frecuentes de la médula espinal.

Spinal dural arteriovenous fistulas are produced by direct communication between the arterial and venous systems of the spinal cord, causing hypertension in the latter with spinal cord dysfunction. It is a rare pathology with unknown etiology and non-specific clinical symptoms that usually results in a delayed diagnosis. Often radiologists are the first to guide the disease towards an adequate diagnosis. Characteristic findings can be seen through MR or MR angiography, and may even locate the fistula in a high percentage of cases, although the pathology must be confirmed by spinal angiography. There are two treatment modalities: endovascular and surgical therapy. Endovascular treatment has improved in recent years with the advantages of a less invasive approach and is therefore usually chosen as primary therapy. In this article we review the main clinical manifestations, imaging findings and treatment of this pathology.

Adaptación cultural al español (España) del cuestionario Overactive Bladder Family Impact Measure (OAB-FIM) / Cultural adaptation to Spanish (Spain) of the questionnaire

Objetivo: El OAB-FIM se desarrolló como una medida del impacto de la vejiga hiperactiva en los familiares que conviven con el paciente. El objetivo fue realizar la adaptación cultural al español (España) del cuestionario OAB-FIM. Métodos: La adaptación incluyó una fase de validación conceptual y lingüística, y otra de medición de las propiedades psicométricas en 25 familiares (edad media 63,0 años [DE: 14,3], siendo el 44% mujeres) con convivencia habitual con pacientes con vejiga hiperactiva, de ambos géneros y ≥18 años. Se midieron equivalencia conceptual y lingüística, fiabilidad interna, validez de constructo y validez de contenido. Se valoró la aplicabilidad y carga de administración. Resultados: El OAB-FIM fue equivalente conceptual y lingüísticamente al original, manteniendo sus 6 dominios: social, viajes, preocupación, irritabilidad, sueño y sexual. El acuerdo interjueces ubicó correctamente a todos los ítems en su dominio, excepto el 10, que se ubicó más en preocupación que en irritabilidad, motivando su reformulación. Un 2,95% de ítems estuvieron ausentes. Los efectos suelo y techo de los ítems variaron, respectivamente, entre 20-28% y 0-16%. El tiempo medio para cumplimentar el cuestionario fue de 5,2 minutos (DE: 2,8) y un 24% necesitó algún tipo de ayuda. El coeficiente α-Cronbach varió entre 0,948-0,839. Las correlaciones con escalas similares en el familiar fueron moderadas-altas (0,407-0,753) o pequeñas-moderadas con las administradas al paciente (0,004-0,423). Conclusión: Se ha obtenido una versión española (España) del OAB-FIM conceptual y lingüísticamente equivalente al original. El cuestionario ha mostrado buena consistencia interna y validez de contenido y constructo, además de ser aplicable

Objective: The OAB-FIM was developed as a measure of the impact of an overactive bladder (OAB) on relatives who live with the patient. The objective of this study was conduct a cultural adaptation to Spanish (Spain) of the OAB-FIM questionnaire. Methods: The adaptation included a conceptual and linguistic validation phase, as well as a phase for measuring the psychometric properties in 25 relatives [mean age, 63.0 years (SD, 14.3); 44% women] who regularly live with patients with OAB, who are of either sex and 18 years of age or older. We measured conceptual and linguistic equivalence, internal reliability, construct validity and content validity. We assessed the applicability and administration load. Results: The OAB-FIM was conceptually and linguistically equivalent to the original, maintaining its 6 domains: social, travel, worry, irritability, sleep and sex. The interagreement correctly placed all items in their domain, except for number 10, which was placed more in worry than in irritability, motivates its reformulation. Some 2.95% of the items were missing. The floor and ceiling effects of the items varied, respectively, between 20-28%, and 0-16%. The mean time for completing the questionnaire was 5.2minutes (SD, 2.8), and 24% of the participants required some type of assistance. The α-Cronbach coefficient varied between 0.948-0.839. The correlations with similar scales in the family were moderate-high (0.407-0.753) or small-moderate with those administered to the patient (0.004-0.423). Conclusion: We obtained a Spanish (Spain) version of the OAB-FIM that was conceptually and linguistically equivalent to the original. The questionnaire showed good internal consistency, content and construct validity and applicability

Cultural adaptation to Spanish (Spain) of the "Overactive Bladder - Family Impact Measure (OAB-FIM)" questionnaire. / Adaptación cultural al español (España) del cuestionario Overactive Bladder Family Impact Measure (OAB-FIM).

OBJECTIVE: The OAB-FIM was developed as a measure of the impact of an overactive bladder (OAB) on relatives who live with the patient. The objective of this study was conduct a cultural adaptation to Spanish (Spain) of the OAB-FIM questionnaire. METHODS: The adaptation included a conceptual and linguistic validation phase, as well as a phase for measuring the psychometric properties in 25 relatives [mean age, 63.0 years (SD, 14.3); 44% women] who regularly live with patients with OAB, who are of either sex and 18 years of age or older. We measured conceptual and linguistic equivalence, internal reliability, construct validity and content validity. We assessed the applicability and administration load. RESULTS: The OAB-FIM was conceptually and linguistically equivalent to the original, maintaining its 6 domains: social, travel, worry, irritability, sleep and sex. The interagreement correctly placed all items in their domain, except for number 10, which was placed more in worry than in irritability, motivates its reformulation. Some 2.95% of the items were missing. The floor and ceiling effects of the items varied, respectively, between 20-28%, and 0-16%. The mean time for completing the questionnaire was 5.2minutes (SD, 2.8), and 24% of the participants required some type of assistance. The α-Cronbach coefficient varied between 0.948-0.839. The correlations with similar scales in the family were moderate-high (0.407-0.753) or small-moderate with those administered to the patient (0.004-0.423). CONCLUSION: We obtained a Spanish (Spain) version of the OAB-FIM that was conceptually and linguistically equivalent to the original. The questionnaire showed good internal consistency, content and construct validity and applicability.

Cushing's syndrome in pregnancy. Laparoscopic adrenalectomy during pregnancy: the mainstay treatment.

INTRODUCTION: Cushing's syndrome (CS) is a rare disease in pregnancy and its differential diagnosis is complicated. It is usually confused with complicated pregnancy cases, such us preeclampsia and gestational diabetes. This usually leads to a delayed diagnosis and is also associated with severe materno-foetal complications. PURPOSE: We present a case of a pregnant woman in her third trimester of pregnancy with CS secondary to an adrenal adenoma without response to medical treatment who underwent laparoscopic adrenalectomy without complications. DISCUSSION: Most authors consider adrenalectomy as the first-choice treatment, since it presents higher rate of successful pregnancies. However, previously published cases did not reflect this stance. These publications prefer to maintain medical treatment, allowing pregnancy to go to term and delaying adrenalectomy after childbirth. We consider that experience in laparoscopic surgery, obstetric knowledge and resources now available, all offer sufficient guarantees to carry out the laparoscopic procedure to treat CS in pregnancy even in the third trimester. Laparoscopic adrenalectomy for CS in pregnancy is a safe and efficacious procedure allowing stopping the disease and curbing the dreadful consequences it may have for both mother and foetus.

Facile synthesis of cobalt ferrite nanotubes using bacterial nanocellulose as template.

A facile method for the preparation of cobalt ferrite nanotubes by use of bacterial cellulose nanoribbons as a template is described. The proposed method relays on a simple coprecipitation operation, which is a technique extensively used for the synthesis of nanoparticles (either isolated or as aggregates) but not for the synthesis of nanotubes. The precursors employed in the synthesis are chlorides, and the procedure is carried out at low temperature (90 °C). By the method proposed a homogeneous distribution of cobalt ferrite nanotubes with an average diameter of 217 nm in the bacterial nanocellulose (BC) aerogel (3%) was obtained. The obtained nanotubes are formed by 26-102 nm cobalt ferrite clusters of cobalt ferrite nanoparticles with diameters in the 9-13 nm interval. The nanoparticles that form the nanotubes showed to have a certain crystalline disorder, which could be attributed in a greater extent to the small crystallite size, and, in a lesser extent, to microstrains existing in the crystalline lattice. The BC-templated-CoFe2O4 nanotubes exhibited magnetic behavior at room temperature. The magnetic properties showed to be influenced by a fraction of nanoparticles in superparamagnetic state.

Using cornstarch in microparticulate diets for larvicultured tropical gar (Atractosteus tropicus).

Aquaculture in Mexico has been developed by the cultivation of commercial species. In Tabasco, the cultivation of native species is mainly limited by the lack of nutrition studies to support its crop profitability. Among these species is the tropical gar (Atractosteus tropicus), which has great potential for cultivation. However, the nutritional value of carbohydrates in diets for this species which contribute to improved growth and survival, have not been evalulated,. Thus, in the present investigation, isoprotein and isolipid diets have been designed based on the substitution of cellulose by corn starch (D1: 0% starch-15% cellulose, D2: 7.5% starch-7.5% cellulose and D3: 15% starch-0% cellulose) and compared with a commercial trout diet (45% protein and 16% lipids). A total of 1800 larvae (0.008 ± 0.002 g and 10.5 ± LT 0.126 mm) were used, distributed in a recirculation system in order to evaluate growth and survival for 30 days. The results show higher growth and survival of 97% of larvae fed the D3 diet, while cannibalism in the species was mitigated. Major digestive enzyme activities occurred (acid protease, alkaline protease, trypsin, chymotrypsin, leucine aminopeptidase, carboxypeptidase A, lipase, α-glucosidase and amylase) for larvae fed D3. It is concluded that the contribution of corn starch (15%) replacing cellulose in the diet improves growth and survival of this species.

Development of digestive tract and enzyme activities during the early ontogeny of the tropical gar Atractosteus tropicus.

Changes in digestive enzyme activity and histology were studied in Atractosteus tropicus embryos, larvae and juvenile periods. Alkaline protease, chymotrypsin, carboxypeptidase A, lipase and α-amylase were detected in all periods and gradually increased until reaching the maximum peak in juveniles; meanwhile, acid protease was first detected at 5 days after hatching (dah) when first feeding started and trypsin and leucine aminopeptidase activities were detected from 19 dah, their values being increased gradually until reaching a maximum value at 31 dah. Acid and alkaline phosphatase activities increased from yolk-sac absorption (3 dah) until day 31 after hatching. Zymogram for acid protease showed two bands in active forms (0.4 and 0.5 Rfs) from day 5 after hatching and a third protease form (0.3 Rf) that appears at 31 dah. Two active forms (26.3 and 24.9 kDa) were detected using SDS-PAGE alkaline proteases zymogram at 5 dah, and an additional active form (44.1 kDa) was detected at 7 dah. Regarding the histological development of the digestive system, the exocrine pancreas containing zymogen granules was already visible at 3 dah, whereas at 5 dah first gastric glands were already detected in the stomach. Between 7 and 9 dah, the digestive tract of A. tropicus resembled that of a juvenile specimen with a well-developed and short oesophagus, stomach divided into a glandular and non-glandular (pyloric) stomach, folded intestine with pyloric caeca and a well-developed spiral valve (posterior intestine). Considering this, larvae of A. tropicus are capable of digesting several foods from yolk absorption (3 dah), maximizing its activities at 15 dah, age at which the organisms maximize its capability to absorb nutrients from diets provided.

Changes on digestive enzymes during initial ontogeny in the three-spot cichlid Cichlasoma trimaculatum.

A study was performed in order to understand the development of digestive enzymes during initial ontogeny of Cichlasoma trimaculatum, for which the activity of acidic and alkaline proteases, lipases, amylases and phosphatases was determined by means of biochemical and electrophoretic analysis. Our results showed that the activity of alkaline proteases, trypsin and chymotrypsin is present from day 6 after hatching (dah) during exogenous feeding with Artemia nauplii. The activities of carboxypeptidase A and leucine aminopeptidase are present from the first days, increasing at 6 dah and reaching their maximum activity at 9 dah while acid protease activity started at 9 dah. Furthermore, the lipase activity is detected on 6 dah and keeps increasing and decreasing on 17 dah. Amylase activity is detected on 3 dah, presenting fluctuations until 45 dah, where it reaches its maximum activity. Acid and alkaline phosphatases are detected from 3 dah and reach a maximum activity between 13 and 19 dah. The SDS-PAGE electrophoresis revealed six types of bands in the alkaline proteases, with molecular weight between 113.4 and 20.4 kDa. First three bands appear on 6 dah, but it is until 11 dah when all isoforms appear. Based on these results, it is considered that this species completes its digestive enzymatic machinery from day 9 after hatching, therefore is recommended to perform the transition from live feed to inert feed at 15 dah.

Partial characterization of digestive proteases in tropical gar Atractosteus tropicus juveniles.

Tropical gar (Atractosteus tropicus) is an economically and socially important freshwater species from Southeastern Mexico, with a high aquaculture potential. With this in mind, the purpose of this study was to characterize the digestive proteases of tropical gar juveniles through biochemical and electrophoretic analyses. Twenty specimens with an average weight of 73.6 ± 12.7 g were used to obtain stomach and intestinal tissue from which multienzymatic extracts were prepared. The general activities of the acid and alkaline proteases were evaluated, as well as the specific activities of trypsin, chymotrypsin, leucine aminopeptidase and carboxypeptidase A. The effect of the pH and temperature on the proteases was also analyzed, together with the composition of the multienzymatic extracts using protease inhibitors and electrophoretic tests. Results showed that A. tropicus have a functional stomach in which protein hydrolysis starts with pepsin and which contains endo- and exopeptidases (trypsin, chymotrypsin, leucine aminopeptidase and carboxypeptidase A) and proteases that are resistant to high temperatures (45 and 55 °C for alkaline and acid proteases, respectively) and pH values. Using zymogram technique, we found two acid protease isoforms (0.35 and 0.71 rf) and five alkaline protease isoforms (83.7, 43.7, 27.5, 24.0 and 19.4 kDa), which decrease or disappear with the different inhibitors. Thus, this species is considered to be a carnivore capable of adapting to its environment by consuming different types of proteins from preys and also could adapt rapidly to consume a compound diet with different animal protein sources.

Enuresis nocturna / Nocturnal enuresis

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Factores de riesgo en el fracaso de la reparación quirúrgica del prolapso de suelo pelviano / Risk Factors in the Failure of Surgical Repair of Pelvic Organ Prolapse

Introducción: La cirugía del prolapso de órganos pelvianos (POP) presenta resultados variables de recurrencia y complicaciones. El objetivo es analizar nuestros resultados para conocer los factores que se asocian al fracaso anatómico y funcional tras la corrección con malla del POP. Material y métodos: Estudio retrospectivo de 69 pacientes intervenidas de POP en nuestro centro. Se registró la edad, IMC, número de partos, cirugía pélvica previa, menopausia, calidad de vida, incontinencia urinaria, frecuencia-urgencia asociada y presencia de POP de alto grado, compartimentos reparados, mallas usadas, uretrosuspensión e histerectomía vaginal durante la cirugía y las complicaciones. Se evaluó a las pacientes al mes, a los 6 y 12 meses, considerando fracaso de la cirugía si se extruyó la malla, si la paciente no estaba satisfecha o si recidivó. Se describe la muestra, se analizan la relación de las variables analizadas mediante análisis univariante (Chi cuadrado y U Mann-Whitney) y se estudia qué variables pueden tener valor predictivo en el fracaso de la reparación (regresión logística múltiple). Resultados: En 17 casos la cirugía se consideró fracaso al año de seguimiento. El IMC (29,6±2,03 vs 27,1±3,32), número de partos (3,4±0,71 vs 2,8±1,88), la menopausia, la presencia de frecuencia-urgencia y el número de mallas se asociaron al fracaso del tratamiento. Las variables independientes predictivas de fracaso según la regresión logística fueron: IMC, número de partos y la presencia de urgencia-incontinencia. Conclusión: El sobrepeso-obesidad, el número de partos previos y la sintomatología de incontinencia-urgencia preexistente son factores asociados al fracaso anatómico y funcional tras la reparación del POP (AU)

Introduction: Pelvic organ prolapse (POP) surgery has variable results of recurrence and complications. We have aimed to analyze our outcomes in order to know the factors associated with anatomical and functional failure in POP surgery. Material and methods: A retrospective study of 69 patients who underwent POP surgery at our hospital was performed. Registered variables were: Age, BMI, number of deliveries, previous pelvic surgery, menopause, quality of life, urinary incontinence, associated frequency-urgency symptoms, high POP stage, vaginal compartments repaired, type of mesh, urethro-suspension and vaginal hysterectomy during POP surgery and its complications. Patients were evaluated at 1, 6 and 12 months post-surgery. The technique was considered as failed when relapse or mesh erosion occurred and when the patient is not satisfied or there was relapse. The sample is described, analyzing the relationship of the variables studied by univariate analysis (Chi square and Mann-Whitney U test) and a study was made of which variables may have predictive value in the failure of the repair (multiple logistic regression). Results: Surgery failed in 17 patients during the follow-up at one year. BMI (29.6±2.03 vs 27.1±3.32), delivery number (3.4±0.71 vs. 2.8±1.88), menopause, frequency- urgency symptoms and number of vaginal compartments repaired were associated with treatment failure although only BMI, delivery number and frequency-urgency symptoms were defined as independent predictive variables when the logistic regression was carried out. Conclusions: Overweightness-obesity, previous delivery number and frequency-urgency symptoms before surgery are factors associated to anatomical and functional failure after POP repair (AU)