La demencia postdialítica es una comorbilidad relativamente frecuente en pacientes con enfermedad renal crónica y se desarrolla después de varios años de tratamiento. Las características clínicas más ...frecuentes incluyen alteraciones cognitivas, mioclonías y crisis epilépticas. Actualmente su diagnóstico es menos frecuente desde que se eliminó el aluminio de los líquidos para diálisis; sin embargo, se han descrito casos esporádicos donde persiste la correlación entre la terapia dialítica, la intoxicación con aluminio y las alteraciones neuropsiquiátricas, con fuentes de intoxicación como aguas poco tratadas. Presentamos el caso: paciente femenino de 57 años, cuyo familiar refirió enfermedad actual desde 1 mes previo a su ingreso al hospital, después de recibir terapia hemodialítica, inicia de forma progresiva e insidiosa, desorientación en tiempo y espacio, a la que se asoció cambios bruscos del humor con episodios de ira inmotivados, asociándose progresivamente alteración de la memoria, y se agregan movimientos involuntarios, continuos, reptantes, amplios, en 4 extremidades, por lo que es evaluada por servicio de neurología. Al examen de las funciones mentales superiores, se encontró desorientada en tiempo y espacio, bradipsíquica, hipertímica displacentera con tendencia a la depresión, lenguaje hablado fluente, articulado, incoherente, comprendía órdenes sencillas de forma ambígua, no denominaba, no repetía. Presentó movimientos de flexo-extensión, repetitivos, en miembros superiores e inferiores, bilaterales, amplios, sinuosos hacia la línea media, sugestivos de movimientos coreatetósicos. Entre los resultados de pruebas de laboratorio resaltan niveles de aluminio sérico en 136±7ugr/l, con valores normales de 1-5ug/l. La demencia postdialítica es inusual en la actualidad, gracias a la mejora en los líquidos de diálisis, que contienen cantidades mínimas de sales de aluminio. Sin embargo; se conoce que la sangre de los pacientes en hemodiálisis se expone de 60 a 90 litros de agua en cada tratamiento. En caso de enfermedad renal, la fijación del aluminio a las proteínas plasmáticas es elevada, por lo que la captación de aluminio será importante incluso en los casos en los que la concentración del metal en el líquido de diálisis sea pequeña. Aunque la incidencia de demencia postdialítica ha disminuido, se ha demostrado que los pacientes con enfermedad renal crónica, presentan predisposición a acumular aluminio en los tejidos corporales, por disminución en su excreción renal, siendo frecuente su acumulación en la corteza cerebral. El tratamiento se basa en la administración de quelantes como la desferrioxamina
Many understory birds and other groups form genetically differentiated subspecies or closely related species on opposite sides of major rivers of Amazonia, but are proposed to come into geographic ...contact in headwater regions where narrower river widths may present less of a dispersal barrier. Whether such forms hybridize in headwater regions is generally unknown, but has important implications to our understanding of the role of rivers as drivers of speciation. We used a dataset of several thousand single nucleotide polymorphisms to show that seven taxon pairs that differentiate across a major Amazonian river come into geographic contact and hybridize in headwater regions. All taxon pairs possessed hybrids with low numbers of loci in which alleles were inherited from both parental species, suggesting they are backcrossed with parentals, and indicating gene flow between parental populations. Ongoing gene flow challenges rivers as the sole cause of in situ speciation, but is compatible with the view that the wide river courses in the heart of Amazonia may have driven interfluvial divergence during episodes of wet forest retraction away from headwater regions. Taxa as old as 4 Ma in our Amazonian dataset continue to hybridize at contact zones, suggesting reproductive isolation evolves at a slow pace.
Hybrid speciation is rare in vertebrates, and reproductive isolation arising from hybridization is infrequently demonstrated. Here, we present evidence supporting a hybrid-speciation event involving ...the genetic admixture of the snow-capped (Lepidothrix nattereri) and opal-crowned (Lepidothrix iris) manakins of the Amazon basin, leading to the formation of the hybrid species, the golden-crowned manakin (Lepidothrix vilasboasi). We used a genome-wide SNP dataset together with analysis of admixture, population structure, and coalescent modeling to demonstrate that the golden-crowned manakin is genetically an admixture of these species and does not represent a hybrid zone but instead formed through ancient genetic admixture. We used spectrophotometry to quantify the coloration of the species-specific male crown patches. Crown patches are highly reflective white (snow-capped manakin) or iridescent whitish-blue to pink (opal-crowned manakin) in parental species but are a much less reflective yellow in the hybrid species. The brilliant coloration of the parental species results from nanostructural organization of the keratin matrix feather barbs of the crown. However, using electron microscopy, we demonstrate that the structural organization of this matrix is different in the two parental species and that the hybrid species is intermediate. The intermediate nature of the crown barbs, resulting from past admixture appears to have rendered a duller structural coloration. To compensate for reduced brightness, selection apparently resulted in extensive thickening of the carotenoid-laden barb cortex, producing the yellow crown coloration. The evolution of this unique crown-color signal likely culminated in premating isolation of the hybrid species from both parental species.
Introducción. El síndrome de Bouveret es una variante del íleo biliar, de rara presentación dentro de las causas de obstrucción intestinal, generada por la impactación de un lito biliar a nivel del ...duodeno, secundario a la formación de una fístula bilioentérica. Es más común en mujeres en la octava década de la vida, con múltiples comorbilidades. y presenta síntomas inespecíficos, documentándose la triada de Rigler hasta en el 80 % de las tomografías de abdomen. La cirugía sigue siendo el tratamiento de elección.
Caso clínico. Presentamos el caso de una paciente de 76 años, con múltiples antecedentes y cuadros previos de cólico biliar, que consultó por dolor abdominal y signos de hemorragia de vías digestivas altas y se documentó un síndrome de Bouveret. Fue tratada en la misma hospitalización mediante extracción quirúrgica del cálculo con posterior resolución de su sintomatología.
Conclusión. A pesar de que el síndrome de Bouveret es una entidad de infrecuente presentación, los cirujanos generales deben estar familiarizados con esta patología, en el contexto del paciente que consulta con un cuadro de obstrucción intestinal, conociendo el valor de la tomografía de abdomen y la endoscopia de vías digestivas altas, teniendo en cuenta la edad y las condiciones del paciente para definir el manejo quirúrgico más adecuado.
•Enrolled 65 mother-baby pairs in an endemic hydrofluorosis area in Mexico.•Pregnant women from endemic hydrofluorosis areas had high levels of fluoride in urine.•Maternal exposure to Fluoride was ...negatively associated with cognitive functions in infants.
The objective of this study was to evaluate the association between in utero exposure to fluoride (F) and Mental and Psychomotor Development (MDI and PDI) evaluated through the Bayley Scale of Infant Development II (BSDI-II) in infants. The sample included 65 mother-infant pairs. Environmental exposure to F was quantified in tap and bottled water samples and F in maternal urine was the biological exposure indicator; samples were collected during the 1st, 2nd and 3rd trimester of pregnancy. The mean values of F in tap water for the 1st, 2nd and 3rd trimester were 2.6±1.1mg/l, 3.1±1.1mg/l and 3.7±1.0mg/l respectively; above to 80% of the samples exceeded the reference value of 1.5mg/l (NOM-127-SSA1-1994). Regarding F in maternal urine, mean values were 1.9±1.0mg/l, 2.0±1.1mg/l and 2.7±1.1mg/l for the 1st, 2nd and 3rd trimester respectively. The infants with MDI and PDI scores less than 85 points were 38.5% and 20.9% respectively. After adjusting for potential confounding factors (gestational age, age of child, marginalization index and type of water for consumption), the MDI showed an inverse association with F levels in maternal urine for the first (β=−19.05, p=0.04) and second trimester (β=−19.34, p=0.01). Our data suggests that cognitive alterations in children born from exposed mothers to F could start in early prenatal stages of life.
Phylogeographical studies of the most species‐rich region of the planet—the Amazon basin—have repeatedly uncovered genetically distinctive, allopatric lineages within currently named species, but ...understanding whether such lineages are reproductively isolated species is challenging. Here we harness the power of genome‐wide data sets together with detailed phylogeographical sampling to both characterize the number of unique lineages and infer levels of reproductive isolation for three parapatric manakin species that make up the genus Pipra. The mitochondrial and nuclear genomes both support six distinctive lineages. The youngest lineages are now highly admixed with each other across major portions of their geographical ranges with one lineage now extinct in a genomically unadmixed state. In contrast, the oldest sets of lineages—dated to 1.4 million years—exhibit narrow hybrid zones. By fitting demographic models to parapatric lineage pairs we found that levels of gene flow and genomic homogenization decline with increasing evolutionary age. Only lineages descending from the basal node at 1.4 million years ago in the genus experience negligible gene flow, possess genomes resistant to homogenization and are separated by narrow hybrid zones. We conclude that a million years or more were required for Pipra manakins to become reproductively isolated. We suggest the six lineages be reclassified as two or three reproductively isolated species. Our unique approach to quantifying reproductive isolation in parapatric lineages could be applied broadly to other phylogeographical studies and would help determine species classification of the plethora of newly identified lineages in the Amazon basin and other regions.
More on MAD families and P-points Garcia-Ferreira, S.; Guzmán, O.
Topology and its applications,
01/2022, Volume:
305
Journal Article
Peer reviewed
We prove that, under the assumption of CH, for every MAD family A there is a P-point U such that the Franklin compact space associated to A is a Fréchet-Urysohn space (FU(U)-space). This solves a 25 ...years old question of V. I. Malykhin and the first author.
Objectives
To determine whether patients with Duchenne/Becker muscular dystrophy (DMD/BMD) have components of metabolic syndrome (MetSy) and to evaluate whether leptin is associated with components ...of MetSy.
Methods
This study included 78 patients (nine, <6 years of age; 54, 6 to <16 years of age; and 15 patients, ≥16 years of age). Obesity and body fat mass were determined by waist circumference and dual‐energy X–ray absorptiometry, respectively. A 12‐h fasting blood sample was collected in the morning. Patients were categorized into four groups according to the number of criteria for MetSy: group 0: none; group 1: one; group 2: two and group 3: three or more criteria.
Results
All age groups showed components of MetSy. The concentration of these components was significantly higher in patients ≥16 years old. The prevalence of hypertriglyceridemia was from ~37% to 46% in all age groups. The prevalence of MetSy was 7.1% for patients from 6 to <16 years of age and 24% for patients ≥16 years of age. Serum leptin levels increased significantly (P < 0.05) with age; the highest (13.43 ± 9.4 ng/ml) value was observed in patients >16 years of age. Total leptin was correlated with the number of patients with MetSy (r = 0.383; P = 0.001).
Conclusions
Components of MetSy are significant in patients with DMD/BMD. A high prevalence of hypertriglyceridemia was observed. Younger patients with DMD/BMD have risk factors for MetSy. Although leptin increased according to different degrees of MetSy, this relation disappeared when the body fat was corrected by leptin; therefore, the association could be caused by a common risk factor—fat.
The effect of
,
,
spp., and their interaction was evaluated in seedlings of
AAB ‘Dominico Hartón’. The study was conducted in a nursery in Palestina, Caldas department, Colombia. Forty-day-old ...plantain seedlings were infected separately with 750, 1,500, 2,250 and 3,000 of each species of nematodes/plant. Two experiments were conducted to evaluate the damage of
,
,
spp. and the mixture of 750
+ 750
+ 750
spp. compared with the mixture of different proportions (1,500, 2,250 and 3,000 of each species of nematodes). Noninfected plants were included as a control treatment, for a total of 17 treatments in a randomized complete block design with ten replications. Twelve weeks after inoculation, all nematodes, both alone and in combination, reduced (
< 0.05) plantain dry root and shoot weight. In two experiments,
,
, and
spp. alone, each with a population density of 3,000, reduced (
< 0.05) root dry weight by 32.5%, 9.5% and 49%, respectively, and decreased (
< 0.05) shoot dry weight by 21.5%, 23%, and 31.5%, respectively, compared to the control. The interaction of nematodes with the lowest population decreased root (33%) and shoot (21%) weight. We conclude that the growth of ‘Dominico Hartón’ seedlings was affected by plant-parasitic nematodes, but the greatest damage occurred with concomitant nematode infection.
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