Search

Resumen: Antecedentes: En España, aunque el Ministerio de Sanidad elabora el informe de posicionamiento terapéutico (IPT) y las condiciones de reembolso de los fármacos, las Comunidades Autónomas (CC. AA.) gestionan los servicios de salud y deciden sobre las condiciones de prescripción en su ámbito territorial. El objetivo del estudio EQUIDAD fue describir los condicionantes para la prescripción de los nuevos fármacos en Dermatología en las CC. AA. y sus posibles diferencias. Material y métodos: Estudio transversal realizado en abril-mayo del 2023. Dos dermatólogos con responsabilidades directivas de cada Comunidad Autónoma (C. A.) informaron sobre los condicionantes autonómicos y locales en la prescripción de los fármacos cuyo IPT para el tratamiento de enfermedades dermatológicas fue publicado en los años 2016-2022. Los datos fueron recogidos mediante un cuestionario online. Resultados: Un total de 33 investigadores de 17 CC. AA. participaron en el estudio. Se observaron inequidades entre CC. AA. para el acceso a los nuevos fármacos. Existieron condicionantes autonómicos adicionales al IPT en psoriasis en el 64,7% de las CC. AA., siendo este porcentaje menor en dermatitis atópica (35,3%) o melanoma (11,8%). El más frecuente fue el requisito de un orden de prescripción previo para el uso del fármaco. En algunas CC. AA. se detectaron además variaciones y condicionantes locales (diferencias entre centros de una misma C. A.). Conclusiones: Existe una multiplicidad de criterios tanto a nivel autonómico como local que añade restricciones adicionales a las establecidas por los IPT y que plantean una situación de inequidad entre los pacientes y los profesionales de las diferentes CC. AA. en el acceso a los nuevos fármacos. Abstract: Background: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. Material and methods: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. Results: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected atthe local level (i.e., differences between hospitals within the same autonomous community). Conclusions: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain.

Abundancia de la población reproductiva más septentrional de jaguar Panthera onca El jaguar es el depredador apical de los ecosistemas tropicales y subtropicales en las Américas, pero su conservación está comprometida debido a la pérdida de hábitat, la cacería furtiva y los conflictos por depredación. La Reserva Jaguar del Norte (RJN) fue creada por Naturalia A.C. con la finalidad de proteger la población más norteña de jaguar en una propiedad privada de 24,4 ha, que acoge a otras especies protegidas. Con el propósito de verificar el estado de su población y con ello evaluar el grado de efectividad de la RJN y contribuir al conocimiento de su ecología poblacional, se estimó la densidad mediante modelos tradicionales de marcaje y modelos de captura-recaptura espacialmente explícitos (SERC) y áreas de actividad, mediante un muestreo en 56 estaciones de cámaras-trampa durante 12 periodos bimestrales. En total, se obtuvo un esfuerzo de muestreo de 40.880 días-cámaras y 2,32 reg./1.000 días-cámara para todo el estudio. La densidad de jaguares, calculada con los modelos de captura-recaptura, varió entre 0,30 y 1,44 indiv./100 km2, mientras que en los modelos SERC se obtuvo una densidad de entre 0,21 y 3,04 indiv./100 km2. El área de actividad fue de 78,9 y 45,1 km2 para machos y hembras, respectivamente. El seguimiento de la población a largo plazo y la creación de nuevas Áreas Destinadas Voluntariamente a la Conservación (ADVC), una figura creada recientemente por el Gobierno mexicano, como la RJN, podrían ser una estrategia válida para fortalecer la conservación del jaguar y, con ello, mantener procesos ecológicos clave para otras especies y su hábitat en el noroeste de México.

Background: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. Material and methods: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. Results: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected at the local level (i.e., differences between hospitals within the same autonomous community). Conclusions: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain. Resumen: Antecedentes: En España, aunque el Ministerio de Sanidad elabora el informe de posicionamiento terapéutico (IPT) y las condiciones de reembolso de los fármacos, las Comunidades Autónomas (CC. AA.) gestionan los servicios de salud y deciden sobre las condiciones de prescripción en su ámbito territorial. El objetivo del estudio EQUIDAD fue describir los condicionantes para la prescripción de los nuevos fármacos en Dermatología en las CC. AA. y sus posibles diferencias. Material y métodos: Estudio transversal realizado en abril-mayo del 2023. Dos dermatólogos con responsabilidades directivas de cada Comunidad Autónoma (C. A.) informaron sobre los condicionantes autonómicos y locales en la prescripción de los fármacos cuyo IPT para el tratamiento de enfermedades dermatológicas fue publicado en los años 2016-2022. Los datos fueron recogidos mediante un cuestionario online. Resultados: Un total de 33 investigadores de 17 CC. AA. participaron en el estudio. Se observaron inequidades entre CC. AA. para el acceso a los nuevos fármacos. Existieron condicionantes autonómicos adicionales al IPT en psoriasis en el 64,7% de las CC. AA., siendo este porcentaje menor en dermatitis atópica (35,3%) o melanoma (11,8%). El más frecuente fue el requisito de un orden de prescripción previo para el uso del fármaco. En algunas CC. AA. se detectaron además variaciones y condicionantes locales (diferencias entre centros de una misma C. A.). Conclusiones: Existe una multiplicidad de criterios tanto a nivel autonómico como local que añade restricciones adicionales a las establecidas por los IPT y que plantean una situación de inequidad entre los pacientes y los profesionales de las diferentes CC. AA. en el acceso a los nuevos fármacos.

Resumen: El comienzo de la psoriasis en la edad pediátrica, aunque generalmente leve, puede requerir tratamiento sistémico en las formas moderadas o graves de la enfermedad. El objetivo de este trabajo es analizar la frecuencia relativa, las características de los pacientes, el tratamiento empleado y los eventos adversos (EA) observados a partir del registro BIOBADADERM en niños y jóvenes con psoriasis moderada-grave. Del total de 3.946 pacientes del registro, se incluyen 24 pacientes menores de 21 años, con una edad media al inicio del tratamiento en BIOBADADERM de 16,1 años y un PASI medio de 9,4. El 67% de los pacientes estaba en tratamiento sistémico clásico al inicio del registro. Catorce pacientes (58%) suspendieron el tratamiento por pérdida o falta de eficacia o por EA. En conclusión, los datos del registro BIOBADADERM muestran que los menores representan un grupo muy pequeño dentro de los pacientes con psoriasis que reciben tratamiento sistémico y son manejados más frecuentemente con tratamientos clásicos. Abstract: Childhood-onset psoriasis generally follows an indolent course but patients with moderate or severe disease may require systemic treatment. The aim of this study was to determine the relative proportion of children and young people aged up to 21 years with moderate to severe psoriasis in the BIOBADADERM registry and to analyze the characteristics of these patients, treatments used, and adverse events. Of the 3946 patients in the registry, 24 were aged 21 years or younger. They had mean age of 16.1 years on starting treatment. When the registry was started, they had a Psoriasis Area and Severity Index of 9.4 and 67% were being treated with a conventional systemic drug. Treatment was discontinued in 14 patients (58%) due to adverse events or a loss or lack of effectiveness. In conclusion, the BIOBADADERM registry shows that young people account for a small proportion of psoriasis patients receiving systemic treatment, and they are more likely to be treated using conventional systemic drugs.

Space and time analyses of channel changes, especially within large rivers subject to high levels of human impact, are critical to address multiple questions about rivers in the Anthropocene era. The reconstruction of long-term (> 150 year) evolutionary trajectories permits an understanding of how natural and anthropogenic factors impact hydromorphological and ecological processes in rivers, helps with the design of sustainable management and restoration options, and may also help in the assessment of future changes. However, the reconstruction of channel changes can be challenging: historical data are often scattered across many archives, and the quantity and accuracy of information generally decreases as one goes back in time. This data article provides a historical database of 350 cartographic and topo-bathymetric resources on the French Rhône River (530 km in length) compiled from the 17th to mid-20th century, with a temporal focus prior to extensive river training (1860s). The data were collected in 14 national, regional, and departmental archive services. A table describes the properties of each archived data item and its associated iconographic files. Some of the historical maps are available in a georeferenced format. A GIS layer enables one-click identification of all archive data available for a given reach of the French Rhône River. This database provides substantial new material for deeper analyses of channel changes over a longer time period and at a finer time step compared with previously available data. The database has several potential applications in geomorphology, retrospective hydraulic modelling, historical ecology, and river restoration, as well as permitting comparisons with other multi-impacted rivers worldwide. The dataset is available at https://doi.org/10.1594/PANGAEA.922437 (Arnaud et al., 2020a). Iconographic extracts of the 350 archived items are available at http://photo.driihm.fr/index.php/category/52 (last access: 2 May 2021).

Resumen: Sonidegib es un inhibidor del receptor transmembrana Smoothened (SMO), de la vía de señalización de Hedgehog, indicado para el tratamiento del carcinoma basocelular localmente avanzado (CBCla), no susceptible a cirugía curativa ni a radioterapia. Sonidegib ha demostrado su eficacia y seguridad en pacientes con CBCla en el ensayo de fase II (BOLT), donde el 61% (IC 95%: 48; 72) de los pacientes tratados con 200 mg de sonidegib tuvo una respuesta objetiva al tratamiento, con un tiempo medio hasta la respuesta de cuatro meses. La mediana de duración de respuesta fue de 26,1 meses y la mediana de supervivencia libre de progresión fue de 22,1 meses. Los eventos adversos más frecuentes fueron los espasmos musculares (54,4%), alopecia (49,4%) y disgeusia (44,3%), siendo principalmente de grado 1 y 2. Esta revisión proporciona un resumen sobre la eficacia, seguridad y tolerabilidad de sonidegib, así como consideraciones sobre su uso en el manejo de pacientes con CBCla. Abstract: Sonidegib is an antagonist of the transmembrane protein Smoothened in the Hedgehog signaling pathway. It is indicated for the treatment of locally advanced basal cell carcinoma (BCC) that is not amenable to curative surgery or radiotherapy. Sonidegib's efficacy and safety were demonstrated in the phase 2 BOLT trial, where 61% (95% CI, 48-72%) of patients with locally advanced BCC treated with sonidegib 200 mg achieved an objective response to treatment with a mean time to response of 4 months. The median duration of response was 26.1 months and the median progression-free survival was 22.1 months. The most common adverse events were muscle spasms (54.4%), hair loss (49.4%), and loss of taste (44.3%); most events were grade 1 or 2. In this review, we summarize the main findings on the efficacy, safety, and tolerability of sonidegib and discuss the management of locally advanced BCC with this drug.

Childhood-onset psoriasis generally follows an indolent course but patients with moderate or severe disease may require systemic treatment. The aim of this study was to determine the relative proportion of children and young people aged up to 21 years with moderate to severe psoriasis in the BIOBADADERM registry and to analyze the characteristics of these patients, treatments used, and adverse events. Of the 3946 patients in the registry, 24 were aged 21 years or younger. The mean age of this group when they started treatment upon registration on Biobadaderm was 16.1 years and the mean Psoriasis Area and Severity Index was 9.4. In 67% the first treatment recorded was with a conventional systemic drug. Treatment was discontinued in 14 patients (58%) due to adverse events or a loss or lack of effectiveness. In conclusion, the BIOBADADERM registry shows that young people account for a small proportion of psoriasis patients receiving systemic treatment, and they are more likely to be treated using conventional systemic drugs. Resumen: El comienzo de la psoriasis en la edad pediátrica, aunque generalmente leve, puede requerir tratamiento sistémico en las formas moderadas o graves de la enfermedad. El objetivo de este trabajo es analizar la frecuencia relativa, las características de los pacientes, el tratamiento empleado y los eventos adversos observados a partir del registro BIOBADADERM en niños y jóvenes con psoriasis moderada-grave. Del total de 3.946 pacientes del registro, se incluyen 24 pacientes menores de 21 años, con una edad media al inicio del tratamiento en BIOBADADERM de 16,1 años y un PASI medio de 9,4. El 67% de los pacientes estaban en tratamiento sistémico clásico al inicio del registro. Catorce pacientes (58%) suspendieron el tratamiento por pérdida o falta de eficacia o por eventos adversos. En conclusión, los datos del registro BIOBADADERM muestran que los menores representan un grupo muy pequeño dentro de los pacientes con psoriasis que reciben tratamiento sistémico y son manejados más frecuentemente con tratamientos clásicos.

In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls.The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20–24-year-olds.Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15–19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour.Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure.Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk.

El trabajo fue realizado en un pastizal bajo, en la región de las colinas de La Pampa (Dpto. Toay), para determinar disponibilidad total aérea y de los distintos compartimentos. Los cortes se realizaron mensualmente en un área previamente pastoreada, a lo largo de un año de muestreo. La disponibilidad de fitomasa aérea total fue de 173 gMS/m2 de promedio anual. Las especies valiosas más importantes fueron Poa ligularis, Piptochaetium napostaense, Bothriochloa springfieldii y Rhynchosia senna. La fitomasa del compartimento vivo fue máxima en los meses de verano con el mayor aporte en Enero (131 gMS/m2). El material muerto en pie aumentó en otoño hasta alcanzar el máximo valor en Junio (168 gMS/m2); mientras que la broza tuvo el mayor valor en setiembre (288 gMS/m2). El pastizal estudiado resultó ser bi-estacional con un período de crecimiento mayor a fines de primavera-verano y otro menor a mediados de otoño. El pasaje de material vivo al compartimento muerto en pie fue rápido. También lo fue la aparici6n de broza en primavera a causa de la intensidad de los vientos.

Introduction: Biomarkers such as α-defensin demonstrated to be a potentially useful option in periprosthetic joint infection (PJI) diagnosis. Recently, a new point-of-care test for α-defensin level detection in synovial fluid has been commercialized in Europe. The aim of this study is to compare the α-defensin test (SynovasureTM) diagnostic ability with the main available clinical tests for periprosthetic joint infection diagnosis in a practical clinical setting of a Bone Infection Unit.Methods: Between 2015 and 2017, 146 patients with suspected chronic PJI were screened with SynovasureTM. Seventy-three of these met the Musculoskeletal Infection Society (MSIS) criteria and were included in the analysis. According to MSIS criteria, 40 patients (54.7%) were classified as infected and 33 (45.3%) as not infected. The results obtained with SynovasureTM were recorded and compared with standard diagnostic methods for PJI diagnosis.Results: SynovasureTM showed a sensitivity of 85.0 % (95% CI 70.2 to 94.3) and a specificity of 96.9 % (95% CI 83.8 to 99.9) for PJI detection. The positive likelihood ratio of SynovasureTM was 27.2 (95% CI 3.9 to 188.1) and the negative likelihood ratio was 0.2 (95% CI 0.1 to 0.3). The diagnostic odds ratio was 181.3 (95% CI 20.7 to 1590.4). SynovasureTM demonstrated a statistical significant difference when compared to Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP) specificity (at least one positive test) and preoperative culture sensitivity (1 positive culture).Conclusion: Our findings show that SynovasureTM sensitivity is lower than quantitative α-D test, but when compared to the main available tests shows a good specificity and the highest DOR. On the SF it is the easier test to do, due to the fact that it needs a minimal amount of SF and it is not limited by blood contamination or antibiotic use. Whereas there is no single standalone test, SynovasureTM should be considered a reliable additional test for periprosthetic joint infection diagnosis in everyday clinical practice.

El pioderma gangrenoso es una rara enfermedad cutánea ulcerada no infecciosa, perteneciente a las dermatosis neutrofílicas. Su etiopatogenia no está bien definida hasta el momento, barajándose un mecanismo inmunológico. La localización mamaria de la afectación es inusual, apareciendo tras cirugía en la mayoría de casos en relación con el fenómeno de patergia, pero también puede ser de aparición espontánea. Presentamos un caso de paciente con carcinoma de mama izquierda sometida a mastectomía radical con reconstrucción que desarrolla un pioderma gangrenoso bilateral postquirúrgico. Se diagnosticó erróneamente como dehiscencia de herida quirúrgica, procediéndose a múltiples desbridamientos que exacerbaron el problema y retrasaron el diagnóstico más de un año. Tras múltiples tratamientos, se decide inicio de terapia con infliximab debido a la refractariedad del proceso, evolucionando satisfactoriamente. La presentación de este caso tiene como objetivo el reconocimiento y abordaje precoz de esta entidad para aprender a prevenir su morbilidad física y psicológica.

Background: The aim of this study was to evaluate the results of sentinel lymph node biopsy (SLNB) in cutaneous melanoma at our institution. Materials and Methods: 128 patients with primary cutaneous melanoma who underwent SLNB between April, 2004, and August, 2010 were studied. Univariate and multivariate analysis was performed to explore the effect of variables on mortality and sentinel node status. Survival analysis was performed using the Kaplan-Meier approach. Results: Positive SLNB were detected in 35 (27.3%) of 128 cases. Mean Breslow depths were 3.7 mm for SLNB positive patients and 1.99 mm for SLNB negative patients. False negative rate was 1%. The recurrence rate was 40% for positive patients and 6.5% for negative patients (odds ratio 9.7 [confidence interval 95 % 3.3-28.1]). 33 patients (29%) had an ulcerated melanoma, 12 (10.5%) in the positive group and 21 (18.5%) in the negative group. The disease recurred in a 48.5% of patients with ulcerated melanoma, but only in a 2.5% of patients with non-ulcerated melanoma. Upon multivariate analysis, only Breslow thickness (P = 0.005) demonstrate statistically significance for SLNB status. Multivariate analysis for clinicopathologic predictors of death demonstrate statistically significance for Breslow thickness (P = 0.020), ulceration (P = 0.030) and sentinel node status (P = 0.020). Conclusions: This study confirms that the status of the sentinel node is a strong independent prognostic factor with a higher risk of death and lower survival. Patients with ulcerated melanoma are more likely to develop recurrence, and also higher risk of death than patients with non-ulcerated melanoma.

Introducción: El propósito de la investigación es conocer la eficacia del Secnidazol en el tratamiento de escolares asintornáticos portadores de Giardia lamblia y lo Entamoeba histolytica, así como el evaluar su tolerancia. Material y métodos: Se escogieron 50 niños parasitados (totalizando 53 casos con Entamoeba histolytica y/o Giardia lamblia), con edades comprendidas entre 5 y 14 años, de uno u otro sexo, a quienes se les administró el medicamento y tres días después se realizaron exámenes coproparasitológicos controles. La tolerancia del medicamento se evaluó mediante encuesta. Resultados: De 53 casos parasitados, la relación de protozoarios fue: Giardia lamblia (66,03%) seguidos de Entamoeba histolytica (33,97%). La efectividad parasitológica del Secnidazol contra Giardia lamblia fue del 100% y de Entamoeba histolytica de 95,45%. Se obtuvo un solo caso portador que no respondió al tratamiento (4.55%). El medicamento fue bien tolerado en el 50% de los casos. Los síntomas más frecuentes fueron: hiporexía, cefalea, dolor abdominal, mareos, náuseas, vómitos, diarrea, fatiga, alteración del gusto y prurito. Conclusiones: La eficacia y la relativamente buena tolerancia del Secnidazol fue demostrada en el presente estudio. Se obtuvo cura parasitológica al tercer día de administrado el medicamento.

Introducción: El propósito de la investigación es conocer la prevalencia de las enteroparasitosis en una escuela urbana de la parroquia San Francisco. Material y métodos: Del total de la población escolar, se escogieron 114 niños, de edades comprendidas entre 5 y 15 años, de ambos sexos, donde se les realizó exámenes coproparasitológicos y recolección de información a través de encuestas epidemiológicas. Resultados: De los niños seleccionados. 74,56% reportaron positividad para uno o más enteroparásitos. 40,35% fueron masculinos y 34,21 % femeninos. Las edades más parasitadas fueron las comprendidas entre 9 y 12 años (34,24%) seguidas de 5 a 8 años 30,69%. Los helmintos más frecuentes fueron: Enterobius vermicularis (45,55%), Trichuris trichiura (27,80%), Ascaris lumbricoides (23,35%) e Hymenolepis nana (3,30%) y los protozoos fueron: Blastocystis hominis (37,28%), Giardia lamblia (17,79%), Endolimax nana (16,95%), Entamoeba coli (15.26%). El poliparasitismo predominó sobre el monoparasitismo. Las helmintiasis observadas presentaron en su mayoría una infestación leve. Se evidencia acentuados malos hábitos higiénicos en los niños así como en la escuela.

Sarcoidosis is a chronic disease characterised by the development and accumulation of granulomas in multiple organs. We report two observations of disseminated Mycobacterium genavense infection in patients with proven sarcoidosis. High fever and abdominal pain appeared at 8 and 18 months following the initiation of immunosuppressive therapy. Abdominal computed tomography scans of the patients showed diffuse mesenteric lymphadenitis and splenomegaly. The diagnosis was obtained on bone marrow specimens for both patients with numerous acid-fast bacteria at direct examination and positive specific mycobacterial identification by nucleic acid amplification test. Despite prompt antimycobacterial therapy, occurrence of complications (peritonitis post-splenectomy surgery and lung carcinoma) resulted in a fatal outcome for both patients. These cases highlight that opportunistic infections like M. genavense or other nontuberculous mycobacterial infections should be considered for long-standing immunocompromised patients with sarcoidosis.

Data on aquatic fauna and flora have been collected for almost two centuries. More or less well conserved, these old data are used in setting up projects for biodiversity conservation and evaluation. To what purpose can the data be put? What precautions must be taken to ensure judicious use?

Depuis près de deux siècles, on recueille des données sur la faune et la flore aquatique. Ces données anciennes plus ou moins bien conservées sont utilisées pour construire des projets d'évaluation et de conservation de la biodiversité. Que peut-on en attendre ? Quelles précautions prendre pour une utilisation judicieuse ?

Background: Despite recent progress in the field of genetics, sporadic late-onset (> 40 years) cerebellar ataxia (SLOCA) etiology remains frequently elusive, while the optimal diagnostic workup still needs to be determined. We aimed to comprehensively describe the causes of SLOCA and to discuss the relevance of the investigations., Methods: We included 205 consecutive patients with SLOCA seen in our referral center. Patients were prospectively investigated using exhaustive clinical assessment, biochemical, genetic, electrophysiological, and imaging explorations., Results: We established a diagnosis in 135 (66%) patients and reported 26 different causes for SLOCA, the most frequent being multiple system atrophy cerebellar type (MSA-C) (41%). Fifty-one patients (25%) had various causes of SLOCA including immune-mediated diseases such as multiple sclerosis or anti-GAD antibody-mediated ataxia; and other causes, such as alcoholic cerebellar degeneration, superficial siderosis, or Creutzfeldt-Jakob disease. We also identified 11 genetic causes in 20 patients, including SPG7 (n = 4), RFC1-associated CANVAS (n = 3), SLC20A2 (n = 3), very-late-onset Friedreich's ataxia (n = 2), FXTAS (n = 2), SCA3 (n = 1), SCA17 (n = 1), DRPLA (n = 1), MYORG (n = 1), MELAS (n = 1), and a mitochondriopathy (n = 1) that were less severe than MSA-C (p < 0.001). Remaining patients (34%) had idiopathic late-onset cerebellar ataxia which was less severe than MSA-C (p < 0.01)., Conclusion: Our prospective study provides an exhaustive picture of the etiology of SLOCA and clues regarding yield of investigations and diagnostic workup. Based on our observations, we established a diagnostic algorithm for SLOCA., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

In this study, we isolated 15 endophytic fungi from five Sudanese medicinal plants. Each fungal endophytic strain was identified by sequencing of internal transcribed spacer (ITS) regions of rDNA. Ethyl acetate extracts were prepared from each endophyte cultivated in vitro and tested for their respective antibacterial activities and antiproliferative activities against human cancer cells. Antibacterial screening was carried out against two bacterial strains: Gram-negative Escherichia coli and Gram-positive methicillin-resistant Staphylococcus aureus, by the broth dilution method. Cell viability was evaluated by the MTT procedure after exposure of MCF7 breast cancer cells and HT29 or HCT116 human colon adenocarcinoma cells to each endophytic extract. Of interest, Byssochlamys spectabilis isolated from Euphorbia prostata showed cytotoxicity (IC50 = 1.51 ± 0.2 μg mL(-1)) against MCF7 cells, but had a low effect against HT29 or HCT116 cells (IC50 > 20 μg mL(-1)). Cladosporium cladosporioides 2, isolated from Vernonia amygdalina leaves, showed antiproliferative activities against MCF7 cells (IC50 = 10.5 ± 1.5 μg mL(-1)) only. On the other hand, B. spectabilis and Alternaria sp. extract had antibacterial activities against the S. aureus strain. The findings of this work revealed that endophytic fungi associated with medicinal plants from Sudan could be considered as an attractive source of new therapeutic compounds., (© FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Ethnopharmacological Relevance: Dodoneine (Ddn) is one of the active compounds identified from Agelanthus dodoneifolius (DC.) Polhill and Wiens, a medicinal plant used in traditional medicine for the treatment of hypertension. This dihydropyranone exerts hypotensive and vasorelaxant effects on rats, and two molecular targets have been characterized: the carbonic anhydrase and the L-type calcium channel in cardiomyocytes with biochemical and electrophysiological techniques, respectively. To further evaluate the involvement of these two molecular targets in vasorelaxation, the effect of Ddn on rat vascular smooth muscle was investigated., Material and Methods: The effects of Ddn on L-type calcium current and on resting membrane potential were characterized in A7r5 cell line using the whole-cell patch-clamp configuration. The molecular identities of carbonic anhydrase isozymes in smooth muscle cells were examined with RT-PCR. Vascular response was measured on rat aortic rings in an organ bath apparatus and the effect of Ddn on intracellular pH was determined by flow cytometry using the pH-sensitive fluorescent probe BCECF-AM [2,7-Bis-(2-Carboxyethyl)-5-(and-6)-Carboxyfluorescein, Acetoxymethyl Ester]., Results: 100µM Ddn reduced calcium current density of about 30%. In addition, carbonic anhydrase II, III, XIII and XIV were shown to be expressed in rat aorta and inhibited in smooth muscle cells by Ddn. This inhibition resulted in a rise in pHi of about 0.31, leading to KCa channel activation, thereby inducing membrane hyperpolarization and vasorelaxation. The results of vascular reactivity experiments obtained with pharmacological tools acting on the L-type calcium current and carbonic anhydrase suggest that Ddn produces its vasorelaxant effect via the inhibition of these two molecular targets., Conclusion: This study demonstrates that Ddn induced vasorelaxation by targeting two proteins involved in the modulation of excitation-contraction coupling: L-type calcium channels and carbonic anhydrase., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Norepinephrine depletion of the central nervous system by peripheral N-(2-chloroethyl)-N-ethyl bromobenzylamine administration accelerates the development of seizures kindled by repeated stimulation of the amygdala. These data, in conjunction with previous 6-hydroxydopamine data, demonstrate the robustness of this phenomenon and emphasize the importance of noradrenergic innervation originating from the locus ceruleus in the suppression of seizure development.

Reference intervals for normal concentrations in blood of vitamins B1, B2, E, D, retinol, beta-carotene, and folic acid were determined from a selected sample of people attending a Health Examination Center or being examined in occupational health services in France. This reference sample consisted of 362 men and women, ages 18 to 44 years, selected according to the main variation factors known for the vitamins studied: consumption of tobacco and alcohol, ponderal index (relating height and weight), use of drugs and oral contraceptives, and past history of surgical or medical treatment. Reference intervals were determined for each sex. Vitamin B1 (erythrocyte transketolase activity), plasma retinol, and folic acid values in whole blood are significantly higher in men than in women (p less than 0.001), but vitamin B2 (activation of erythrocyte glutathione reductase) and plasma beta-carotene values are significantly higher in women (p less than 0.001 and less than 0.01 respectively). Dietary intake of vitamins produced no significant displacement of the reference values. For each vitamin we discuss the other major sources of variation factors and the usual values reported in the literature.