Oceanic islands are not sinks of biodiversity in spore-producing plants

Islands have traditionally been considered as migratory and evolutionary dead ends for two main reasons: island colonizers are typically assumed to lose their dispersal power, and continental back colonization has been regarded as unlikely because of niche preemption. The hypothesis that islands might actually represent dynamic refugia and migratory stepping stones for species that are effective dispersers, and in particular, for spore-producing plants, is formally tested here, using the archipelagos of the Azores, Canary Islands, and Madeira, as a model. Population genetic analyses based on nuclear microsatellite variation indicate that dispersal ability of the moss Platyhypnidium riparioides does not decrease in the island setting. The analyses further show that, unlike island populations, mainland (southwestern Europe and North Africa) populations underwent a severe bottleneck during the last glacial maximum (LGM). Our results thus refute the traditional view of islands as the end of the colonization road and point to a different perception of North Atlantic archipelagos as major sources of biodiversity for the postglacial recolonization of Europe by spore-producing plants.

[Posterior C1-C2 arthrodesis. Experience in transarticular and interarticular fixation in 36 patients]

OBJECTIVE

The stabilization of C1-C2 segment has evolved with the appearance of several techniques from sublaminar, transarticular or interarticular fixation and over recent years with the introduction of neuronavegation systems. The aim of the study was to review patients treated in our center with transarticular and interarticualr fixation and compare the results obtained with both techniques.

METHODS

Thirty six patients with C1-C2 instability that required a surgical fixation between 1995-2008 were retrostpectively analized. The causes of instability were principaly traumatic (18 cases) or degeneritive (16) and two cases of neoplasic lesions. In the first period (1995-2001) 20 patients were treated with transarticular fixation (Magerl's technique), and later (2002-2008) with interarticular fixation (Goel-Harms technique) in another 16 patients. Data was obtainned regarding complications, radiological evolution and clinical results (EVA pain score) and functionals (PROLO score) at 3, 6, 12 and >12 months post-op, as well as post-op cervical mobility and signs of bone fusion. A good result was considered if clinical improvement exi ted with decrease in EVA pain score > 5 points and funcional if a PROLO score > 4, regular if EVA decreased but <5 and PROLO <3 , and bad if there was no clinical or functional improvement. The results were statistically compared between both techniques.

RESULTS

Of the 20 patients treated with transarticular fixation, good results were obtained in 17 cases (85%) , regular in 2 (10%), and bad in 1 (5%). Complications included 1 case of vertebral artery lesion and 3 screw misplacements, one case in contact with vertebral artery. Regarding those treated with interarticualr fixation, in 14 (89%), good results were obtained, regular in 2 (12.5%) with 1 case of screw misplacement and another of postsurgical infection. No statistical significant differences were recorded between both techniques, although in those treated with interarticular fixation there was a higher rate of bone fusion and no cases of vertebral arterial lesions were recorded.

CONCLUSIONS

Transarticular and interarticular C1- C2 fixation is safe and provides a high rate of good results with few complications. The introduction of neuronavigation systems can increase the efficacy and safety of these techniques.

[Percutaneous Endoscopic Gastrostomy (PEG): ten years of experience]

INTRODUCTION

The PEG is shown as a technique rather aggressive and with few complications. These characteristics have become the route of choice for enteral nutrition in patients who require nutritional support for prolonged periods.

OBJECTIVES

To know the evolution and quality of life of patients and caregivers with nutrition through PEG.

METHODS

Retrospective study of patients with PEG in a district hospital from July 1998 to July 2009. We reviewed hospital records and telephone contact with patients.

RESULTS

There were 299 patients with PEG during the study period. There was a gradual increase in its use for nutritional therapy. Males were 152 (50.8%). There were 152 (50,8%) males. The age was 73.62 ± 13,05 years, males being the youngest (t = 5.07, P < 0.001). The most frequent indication was "neurological disease" 222 (85.7%). The duration of nutrition therapy was 390 days (range 1-2,913) showing independent from the rest of the variables. The completion of treatment was on death 134 (93.1%) or recovering the mouth 10 (6.9%). The QL was significantly improved in both patients (Z = -6.59, p < 0.001) and caregivers (Z = -6.83, P < 0.001) after PEG.

CONCLUSIONS

There is a progressive increase in the use of PEG. with the mean time of treatment greater than one year, and being complete in most patients with the death. The quality of life experienced an improvement after PEG in both patients and caregivers in this series.

[Intraoperative complications of corticosubcortical mapping]

By looking through our cases and literature, an analysis of the surgical complications derived from direct cerebral stimulation under general anesthesia and local anesthesia and sedation was made. A retrospective descriptive study was performed including patients who were intervened in our centre from 2004 to 2008 and had the cortico-subcortical mapping technique. Common pre-operation variables were as follow: Age, sex, tumor localization and tumor's pathology; On patients intervened while awake, we collected the ASA, BMI and duration of the intervention. Afterwards, variable like epileptic attacks and cerebral edema were included in two groups. In addition, on those awake, respiratory and circulatory complications, local anesthesia toxicity, poor level of sedation, nausea and vomiting, pain and feeling uncomfortable with body posture were collected as well. A total of 20 patients had surgery. 10 of them were operated under local anesthesia and sedation with a mean age of 41 years, mean BMI of 26.8 and a pre-operatory ASA score of I or II ( except one patient with ASA III). The mean time duration of the surgical procedure was 5 hours and 20 minutes. On the other side, 10 patients were intervened with general anesthesia with a mean age of 55 years. There were no cases of cerebral edema in either group, although in 4 patients had epileptic attacks which resolved with cold saline irrigation. Five patients with local anesthesia and sedation did not have any complication, 2 patients showed desaturation episodes without further complications, three manifested hypertension episodes and two signs of feeling uncomfortable with body posture. None of the intra-operatory complications registered interfered wit the overall surgical procedure. This is a safe technique if performed following recommended indications and parameters. Regarding complications, respiratory complications are the most common and the most dangerous, as they can influence in the surgical procedure for difficult cases.

South American Heart Transplantation Registry of patients receiving everolimus in their immunosuppressive regimens

The increasing number of heart transplant recipients receiving immunosuppression with mammalian target of rapamycin inhibitors prompted the implementation of a South American Transplant Physicians Group to register these patients in a database. Everolimus (EVL) is a signal proliferation inhibition that reduces graft vascular disease when used de novo. Recently, its administration has expanded to subjects with resistant rejection or with side effects due to other immunosuppressive drugs (calcineurin inhibitors and/or steroids), allowing for better regulation of the immunosuppressive regimen. Herein we have shown the data collected from patients receiving EVL in ten South American Heart Transplant Centers. We have concluded that the administration of EVL is a useful adjunctive therapy that allows the reduction or suspension of other immunosuppressive drugs that caused unwanted side effects, without a loss of immunosuppressive efficacy, with manageable side effects, and constituting a valuable therapeutic option.

Synergism between COX-3 inhibitors in two animal models of pain

OBJECTIVE AND DESIGN

The antinociception induced by the intraperitoneal coadministration in mice of combinations of metamizol and paracetamol was evaluated in the tail flick test and orofacial formalin test.

METHODS

The antinociception of each drugs alone and the interaction of the combinations was evaluated by isobolographic analysis in the tail-flick and in the formalin orofacial assay of mice.

RESULTS

Mice pretreated with the drugs demonstrated that the antinociception of metamizol and paracetamol is dose-dependent. The potency range on the antinocifensive responses for metamizol or paracetamol was as follows: orofacial (Phase II) > orofacial (Phase I) > tail flick. In addition, the coadministration of metamizol with paracetamol induced a strong synergistic antinociception in the algesiometer assays. Both drugs showed effectiveness in inflammatory pain.

CONCLUSION

These actions can be related to the differential selectivity of the drugs for inhibition of COX isoforms and also to the several additional antinociception mechanisms and pathways initiated by the analgesic drugs on pain transmission. Since the efficacy of the combination of metamizol with paracetamol has been demonstrated in the present study, this association could have a potential beneficial effect on the pharmacological treatment of clinical pain.

Human Papillomavirus (HPV) infection in pregnant women and mother-to-child transmission of genital HPV genotypes: a prospective study in Spain

BACKGROUND

Studies on HPV infection in pregnant women and HPV transmission to the child have yielded inconsistent results.

METHODS

To estimate mother-to-child HPV transmission we carried out a prospective cohort study that included 66 HPV-positive and 77 HPV-negative pregnant women and their offspring attending a maternity hospital in Barcelona. To estimate HPV prevalence and genotype distribution in pregnancy we also carried out a related screening survey of cervical HPV-DNA detection among 828 pregnant women. Cervical cells from the mother were collected at pregnancy (mean of 31 weeks) and at the 6-week post-partum visit. Exfoliated cells from the mouth and external genitalia of the infants were collected around birth, at the 6-week post-partum visit, and around 3, 6, 12, and 24 months of age. All samples were tested for HPV using PCR. Associations between potential determinants of HPV infection in pregnant women and of HPV positivity in infants were also explored by logistic regression modelling.

RESULTS

Overall cervical HPV-DNA detection in pregnant women recruited in the HPV screening survey was 6.5% (54/828). Sexual behavior-related variables, previous histories of genital warts or sexually transmitted infections, and presence of cytological abnormalities were statistically significantly and positively associated with HPV DNA detection in pregnant women recruited in the cohort. At 418 infant visits and a mean follow-up time of 14 months, 19.7% of infants born to HPV-positive mothers and 16.9% of those born to HPV-negative mothers tested HPV positive at some point during infants' follow-up. The most frequently detected genotype both in infants and mothers was HPV-16, after excluding untyped HPV infections. We found a strong and statistically significant association between mother's and child's HPV status at the 6-week post-partum visit. Thus, children of mothers' who were HPV-positive at the post-partum visit were about 5 times more likely to test HPV-positive than children of corresponding HPV-negative mothers (p = 0.02).

CONCLUSION

This study confirms that the risk of vertical transmission of HPV genotypes is relatively low. HPV persistence in infants is a rare event. These data also indicate that vertical transmission may not be the sole source of HPV infections in infants and provides partial evidence for horizontal mother-to-child HPV transmission.