Effects of endocrine disorders on maxillary and mandibular growth in Colombian children and adolescents: a cross-sectional study

OBJECTIVE

To establish the influence of overweight/obesity, medicated hypothyroidism, and medicated non-syndromic hypogrowth on maxillary and mandibular growth.

MATERIALS AND METHODS

The relation between 10 craniofacial anthropometric measurements and hypothyroidism (n = 216), overweight/obesity (n = 108), and non-syndromic hypogrowth (n = 250) were evaluated in patients aged 1-19 years and a control group of healthy patients (n = 587). A subgroup analysis was performed at the peak growth in all groups.

RESULTS

Patients with overweight/obesity and hypothyroidism showed increased craniofacial growth, while hypogrowth patients showed differences in zygomatic width and nasal base growth. Females with hypothyroidism and non-syndromic hypogrowth showed decreased head circumference at peak growth. Several anthropometric measurements were increased in patients with overweight/obesity, including head circumference. When all age groups were analyzed, overweight/obese and hypothyroidism patients showed increased zygomatic width while decreased hypogrowth. Overall, most craniofacial anthropometric measurements in overweight/obese patients were increased. Finally, the peak growth in males with hypothyroidism and subjects with non-syndromic hypogrowth was delayed compared to the control group (p < 0.05).

CONCLUSIONS

Children and adolescents with overweight/obesity and endocrine disorders showed alterations in craniofacial growth. Clinicians must be aware that the growth peak in these patients may be delayed when planning maxillary and mandibular orthopedic treatment.

Ligand and metal-centred reactivity in 2,6-bis(imino)-1,4-dihydropyridinate Zn(II) alkyls: the dual behaviour of an intriguing type of complex

Dihydropyridines, either free or metal-coordinated, are organic hydride transfer reductants that perform on the same premises as the natural redox cofactor NAD(P)⁺/NAD(P)H. 1-Bn and 1-Me are alkylzinc complexes containing dihydropyridinate-based pincer ligands that have been synthesized through different routes involving the addition of ZnR₂ (R = Bn, Me) to the 2,6-bis(imino)-pyridine and 2,6-bis(imino)-4-Bn-dihydropyridine (^iPrBIP and 4-Bn^iPrBIPH₂) ligands, respectively. The alkyls complexes 1-R react with fluorinated alcohols R^FOH (R^F = C₆F₅ or t-C₄F₉) yielding isolable fluoroalkoxides 2-F5 and 2-F9, in which the reactive 1,4-dihydropyridinate ligand remains unchanged. The crystal structure of 2-F5 shows the shortest Zn⋯F-C interaction reported so far, involving one of the o-F atoms of the C₆F₅ group. However, the mechanism of the alcoholysis reactions is not straightforward, as NMR monitoring revealed that acidic R^FOH first protonates the dihydropyridine nitrogen, releasing the dihydropyridine base 4-BniPrBIPH2 and a highly reactive Zn(R)(OR^F) species that re-captures the dihydropyridine in a subsequent step, eliminating the corresponding alkane (R-H). Depending on the mixing conditions, the pincer dihydropyridinate ligand may undergo aromatization to produce the new Zn(II) dialkoxides 3-F5 and 3-F9 stabilised by a neutral ^iPrBIP ligand [(4R-^iPrBIP)Zn(OR^F)₂]. These protonation and hydride transfer reactions illustrate the dual reactivity of the pincer 1,4-dihydropyridinate zinc entity.

A higher incidence of moult–breeding overlap in great tits across time is linked to an increased frequency of second clutches: a possible effect of global warming?

The rise of temperatures due to global warming is related to a lengthening of the breeding season in many bird species. This allows more pairs to attempt two clutches within the breeding season, thus finishing their breeding activity later in the season and therefore potentially overlapping these with post–breeding moult. We tested whether this occurred in two Spanish great tit Parus major populations. The proportion of pairs laying second clutches increased from 1 % to 32 % over the study period in one of the populations (Sagunto, 1995–2019), while it did not change in the other (Quintos, 2006–2019; mean 5 %). We did not find any temporal trend for moult start date of late–breeding birds in any population. The proportion of individuals of both sexes that overlapped moult and breeding increased in Sagunto. For this latter population, sex and age, but not clutch type, contributed to the variability in the probability of overlapping in late–breeding individuals, this being higher for first–year males and lower for older females.

P–492 Knowledge about reproductive health among cohort of oocyte donors in Spain

Study question

What degree of reproductive health knowledge have oocyte donors?

Summary answer

The results of this study reveal that although oocyte donors are aware of the risks of possible fertility disorders, reproductive health knowledge is insufficient

What is known already

Sterility affects approximately 15% of the population of reproductive age, that is, young people. However, the information that young people have about fertility is scarce. Gamete donors are a group especially involved in reproductive issues since they help many people to solve their fertility problems and must undergo numerous tests before being accepted as such. However, there are no studies in Spain that deal with the knowledge that young people and, more specifically, donors, have about reproductive health and fertility

Study design, size, duration

A prospective, cross-sectional multicenter study including oocyte donors at ten fertility clinics performing gamete donation treatment in Spain. During a 2-month period (September-October 2020), 63 donors aged between 19 and 35 years old were recruited consecutively and a total of 63 oocyte donors were included as sample population. Most of them (78%) had not donated before

Participants/materials, setting, methods

54% oocyte donors had secondary education and 43% have achieved university studies. Participants anonymously completed a questionnaire containing 41 questions divided into three sections: sociodemographic characteristics (11 items), knowledge on fertility and reproduction (22 items) and with a Likert scale, response to determine general reproductive health information as well as known risks for fertility disorders (8 items).

Besides descriptive statistics, statistical analysis was performed with Chi square test. p &lt; 0.05 was considered significant

Main results and the role of chance

In the survey 96.8% of the participants reported that they had already known the tests for fertility disorders.

The increasing age of the women was correctly assessed by the participants of the study as a decisive risk factor for fertility, but it was found that exact knowledge was lacking: the decrease of a woman’s fertility by 39.7% was stated to occur on average at the age of 35–40 and by 30% at 40–45. Nevertheless, 66% of donors considered that fertility preservation should be carried out before the age of 35.

61.1% of the non-university donors reported that fertility can drop as a woman ages due to the decreasing number and quality of the remaining eggs. Among university donors, this percentage increases to 92,6% (p:0,034). Merely 47% of the participants informed what they understood that ovarian reserve is and 47.6% of donors believed that women create new eggs every month.

Regarding the known risk factors for fertility, lifestyle was mentioned most frequently by all participants (91,2%), followed by chemo/radiotherapy (83,8%) and smoking, alcohol, and drugs (82,4%). Concerning the influence of the body mass index on fertility, differences were found between non-university (61%) and university donors (88,9%) (p:0,012).

Limitations, reasons for caution

Financial compensation has been found to be a motivating factor for oocyte donors and therefore one could question the representativeness of the participating oocyte donors. It would be of great interest to explore the significance of the financial compensation further.

Wider implications of the findings: The present study reveals an existing requirement for information among oocyte donors, which is not only important for the success of prevention plans but also provides a foundation for possible strategies for the prevention of fertility disorder.

Trial registration number

Not applicable

P–781 Birthweight is not affected by freezing process. Results from a quasi-experimental study using the Oocyte Donation Model

Study question

Is the freezing process responsible to increase the birthweight or the incidence of Large for Gestational Age (LGA) in Frozen Embryo Transfers (FET)?

Summary answer

Neither the birthweight nor the LGA incidence were different in embryos that underwent the freezing-thawing process.

What is known already

Freezing-thawing constitutes one of the processes with a potential impact on the health of the newborn. Data coming from register-based studies and metaanalisis have found an increase in birthweight with a higher incidence of LGA in newborns coming from FET. This is a matter of concern since epigenetic alterations have been suggested to explain this finding casting doubts on future health during childhood and adulthood. Clarifying the safety of cryotechniques should be a priority taken into account that at present frozen embryo transfers outnumber fresh embryo transfers in IVF clinics.

Study design, size, duration

This retrospective cohort study evaluated 670 women oocyte recipients who underwent fresh (367 cycles) or frozen embryo transfer (303 cycles) at Instituto Bernabeu between July 2017 and March 2019. All recipients were prepared with substitutive cycle and received single blastocyst embryo transfers on day five. All of them at the same culture medium, resulting in a singleton live birth.

Participants/materials, setting, methods

1637 patients were assessed for eligibility but 967 were excluded. The sample size has been calculated accepting an alpha risk of 5% and a beta risk of 20%. A sample size of 266 patients (133 per group) is required to detect a minimum mean difference of 275 grams with a standard deviation of 800 grams. Pearsońs Chi-square test (univariate) and binary logistic regression (multivariate for confounding factors) were used to analyze association between variables.

Main results and the role of chance

Maternal age (42.21 ± 4.45; 42.79 ± 3.83 p = 0.519), BMI (23.34 ± 3.69; 24.99 ± 15.52; p = 0.060), maternal parity (Nulliparous 81.5%; 85.5%; Multiparous 18.5%; 14.5% p = 0.177), gestational diabetes (4.9%; 4.3% p = 0.854), preeclampsia (2.7%; 5.6% p = 0.074), hypertensive disorders (3.3%; 2.3% p = 0.494), maternal smoking (10.8%; 13.0% p = 0.475), gestational age (38.96 ± 1.97; 38.77 ± 2.15; p = 0.207) and liveborn gender (Female 44.5%; 48.8%; Male 55.5%; 51.2%p=0.276) do not present statistically significant differences between fresh or frozen groups, respectively.

However endometrial thickness was statistically signiticantly different in both groups (8.83mm ± 1.73 fresh; 8.57mm ± 1.59 frozen p = 0.035)

The mean birthweight did not present statistically significant differences (3239.21 ± 550.43 fresh; 3224.56 ± 570.83 frozen p = 0.211). There were also no differences regarding macrosomy (7.1% fresh; 6.3% frozen p = 0.317), LGA (6.0% fresh; 6.7% frozen p = 0.866), pre-term birth (10.9% fresh; 9.0% frozen p = 0.988), very pre-term birth (0.8% fresh; 1.3% frozen p = 0.999), and extremely pre-term birth (0% fresh; 1.0% frozen p = 0.998).

There were statistically significant differences regarding underweight (10.0% fresh; 7.0% frozen p = 0.020), but there were no differences in very low weight (0.6 fresh; 1.1% frozen p = 0.972) and SGA (1.9% fresh; 0.7% frozen p = 0.432).

Limitations, reasons for caution

Despite a quasi-experimental design, the synchronization in fresh embryo transfer drove to a longer preparation with a thicker endometrium. It’s not possible to rule-out the influence in the results of this parameter.

Wider implications of the findings: As a hypothesis, the increase in birthweight and/or an abnormal placentation in FET could be explained by the endometrial preparation more than the freezing process. Studies must be planned in the future to explore the possibility of changes in the birthweight between embryos transferred in natural vs artificial endometrial preparations.

Trial registration number

Not applicable

Characterization of inflammatory bowel disease in Colombia: Results of a national register

AIM

To determine the clinical, sociodemographic, and treatment characteristics of inflammatory bowel disease (IBD) in a Colombian population register.

METHODS

A descriptive, analytic, observational, cross-sectional, multicenter study on patients with IBD from 17 hospital centers in 9 Colombian cities was conducted.

RESULTS

A total of 2,291 patients with IBD were documented, 1,813 (79.1%) of whom presented with ulcerative colitis (UC), 456 (19.9%) with Crohn's disease (CD), and 22 with IBD unclassified (0.9%). The UC/CD ratio was 3.9:1. A total of 18.5% of the patients with UC and 47.3% with CD received biologic therapy. Patients with extensive UC had greater biologic therapy use (OR = 2.78, 95% CI: 2.10-3.65, p = 0.000), a higher surgery rate (OR = 5.4, 95% CI: 3.5-8.3, p = 0.000), and greater frequency of hospitalization (OR = 4.34, 95% CI: 3.47-5.44, p = 0.000). Patients with severe UC had greater biologic therapy use (OR = 5.04, 95% CI: 3.75-6.78, p = 0.000), a higher surgery rate (OR = 8.64, 95% CI: 5.4-13.78, p = 0.000), and greater frequency of hospitalization (OR = 28.45, 95% CI: 19.9-40.7, p = 0.000). CD patients with inflammatory disease behavior (B1) presented with a lower frequency of hospitalization (OR = 0.12, 95% CI: 0.07-0.19, p = 0.000), a lower surgery rate (OR = 0.08, 95% CI: 0.043-0.15, p = 0.000), and less biologic therapy use (OR = 0.26, 95% CI: 0.17-0.41, p = 0.000).

CONCLUSION

In Colombia, there is a predominance of UC over CD (3.9:1), as occurs in other Latin American countries. Patients with extensive UC, severe UC, or CD with noninflammatory disease behavior (B2, B3) have a worse prognosis.

Human papilloma virus genotypes in dysplasia and epithelial hyperplasia of oral cavity using the luminex xmap technology. A multicenter study

Background

Oral cancer associated with high risk (HPV-HR) human papilloma virus (HPV) has been increasing. HPV-HR has been associated with epithelial dysplasia, however, little information exists on its frequency in epithelial hyperplasia lesions. The aim of this study is to compare HPV genotypes in dysplastic and hyperplastic lesions of oral cavity.

Material and Methods

Two hundred and fifty oral lesions: 131 dysplasia and 119 hyperplasia from two regions of Colombia were evaluated. One hundred seventy-four coming from urban area and 104 from a high risk population to oral cancer from a rural area. HPV was identified by qPCR and Twenty-four HPVs genotypes were evaluated by Luminex® technology. Logistic regressions were performed to establish the associations between HPV infections with oral dysplasia.

Results

Twenty-eight percent (70/250) of the samples were positives for any HPV and HPV-HRs were more frequently than low risk HPVs. HPV-16 was the most detected genotype (16%) followed by HPV-31, 53, 18 and 45. HPV, HPV-HRs and HPV-16 were only associated with dysplasia in urban area; OR 3.28 (CI 95% 1.49-7.17), OR 7.94 (CI 95% 2.97-21.2) and OR 5.90 (CI 95% 2.05-17). Individuals in rural area showed more HPV and HPV-HRs infection in hyperplasic lesions than urban population. The majority of HPV+ lesions had multi-type of HPV (52/70) and the urban individuals showed more genotypes than rural population.

Conclusions

HPV-.HRs are frequently found in hyperplastic and dysplastic epithelial lesions. HPV-HRs and HPV-16 were associated with dysplasia in urban population. Rural high risk population and urban population differ in the frequency and variety of HPV genotypes.

Key words:Human papilloma virus, epithelial dysplasia, epithelial hyperplasia, HPV-genotypes.

NATURAL RADIUM ISOTOPES PRESENT IN SOME COSMETIC PRODUCTS: DETERMINATION OF ACTIVITY CONCENTRATION AND DOSE ESTIMATION

Since the early days, clays, plant extracts and raw materials have been used for therapeutic and beauty purposes. Nowadays, this use is widely spread, as a huge amount of companies have developed new cosmetics based on natural sources. This may lead to an accumulation of radionuclides that can be hazardous for people. Especially dangerous are radium isotopes (226,228Ra), which can be part of the raw materials that cosmetics are made from. In this paper, the concentration of radium isotopes of 18 natural cosmetics was determined. Concentrations resulted in the range 7.9 ± 5.0-37.6 ± 12.5 Bq kg-1 for 226Ra; and 2.5 ± 1.7-35.4 ± 2.6 Bq kg-1 for 228Ra. The effective dose in the skin has been estimated, obtaining a mean value of 13.1 ± 4.9 μSv y-1. This value is far from the reference level of 50 mSv y-1 for the public members. Therefore, no radiological risk derived from the use of these samples, has been found.

Hipnosis anestésica inducida por profesional de Enfermería. Reporte de un caso

Introducción: La hipnosis anestésica puede ser un recurso útil para procedimientos dolorosos. Desarrollo: Se reporta caso de una joven que requiere exodoncia de terceros molares, con uso de hipnosis como único anestésico. El proceso de enfermería inicia con la valoración según patrones funcionales, impresiona lo sana que se encuentra, sin antecedentes mórbidos relevantes ni contraindicación para anestesia química. Se selecciona diagnóstico NANDA de Disposición para mejorar el confort. Dentro del plan se incorporan el NIC 5920 Hipnosis y 5922 Facilitar la autohipnosis, con buena evolución según lo planificado. Resultados: La extracción con hipnosis anestésica se desarrolló de forma similar a la cirugía con anestesia química, la cual se realizó sin dolor. En posoperatorio, paciente practica autohipnosis, sin necesitar analgésicos y evolucionó favorablemente. Discusión: La hipnosis requiere mayor evidencia científica, pero su uso es prometedor. Se constataron los beneficios de la hipnosis en el abordaje del dolor. Conclusión: La hipnosis anestésica, fue útil como intervención de enfermería en cirugía dental. La autohipnosis contribuyó al buen resultado. El profesional de Enfermería entrenado en hipnosis está en condiciones de incorporarla en la gestión del cuidado. El caso resulta interesante, dado que la paciente opta por la hipnosis, sin contraindicación para anestesia química, ya que no se encontró otro reporte de hipnoanestesia inducida por profesional de Enfermería, como anestésico único. Anecdóticamente, durante la filmación del procedimiento, una periodista entra espontáneamente en trance, por lo que requiere intervención del profesional de Enfermería para salir de él.

Patient characteristics driving clinical utility in psychiatric pharmacogenetics: a reanalysis from the AB-GEN multicentric trial

Clinical utility of commercial multi-gene pharmacogenetic tests in depression is starting to be studied with some promising results on efficacy and tolerability. Among the next steps is the definition of the patient profile that is most likely to benefit from testing. Here we present a reanalysis of data from the AB-GEN randomized clinical trial showing that clinical utility of pharmacogenetic testing can be markedly influenced by patient characteristics such as age, baseline severity and duration of current depressive episode.Trial registration ClinicalTrials.gov NCT02529462.

Hydrogenation of an iridium-coordinated imidazol-2-ylidene ligand fragment

The unprecedented hydrogenation of a metal-coordinated imidazolylidene to imidazolidinylidene is observed under mild conditions in an iridium complex containing a metalated lutidine derived CNP ligand.

Laser technique for the fabrication of blood vessels-like models for preclinical studies of pathologies under flow conditions

In this work a method for fabricating functionalized preclinical devices is presented. The manufacturing process combines a laser indirect writing technique to fabricate a soda-lime glass master and soft-lithography methods to obtain the final structure in polydimethylsiloxane (PDMS). The roughness of the device is modified in a controlled manner by applying a post-thermal treatment to the master, and thus devices with different roughness values are created. The PDMS devices are fully covered with human umbilical vein cells in a two-step process. In order to determine the most suitable device to perform bioassays, the cell attachment to the channel is evaluated with regards to the walls roughness when flow experiments are carried out.

Phosphine-functionalized NHC Ni(ii) and Ni(0) complexes: synthesis, characterization and catalytic properties

Ni(ii) and Ni(0) complexes bearing chelating diphenylphosphine-functionalized NHC ligands have been prepared and characterized. Their catalytic behavior in various cross-coupling reactions has also been examined.

Multinuclear silver(I) XPhos complexes with cyclooctatetraene: photochemical C-C bond cleavage of acetonitrile and cyanide bridged Ag cluster formation

Cationic mono-, di-, tri- and tetra-nuclear silver complexes with Buchwald-type phosphane (XPhos) and cyclooctatetraene (COT) have been synthesized and characterized. Formation of [(XPhos-Ag)n(COT)][SbF6]n (n = 1 and 2) complexes was confirmed by single-crystal X-ray crystallography and multinuclear NMR spectroscopy. Variable-temperature NMR spectroscopy in CD2Cl2 solution shows the fluxionality of the COT ring in the mono-Ag(i) XPhos complex. Fluxionality of COT was also confirmed in the case of the di-Ag(i) XPhos complex by solid-state and solution (31)P NMR spectroscopy. The C-C bond cleavage of coordinated acetonitrile [XPhos-Ag(i)-NCCH3] resulting in cyanide bridged Ag cluster formation [(XPhos-Ag)2(μ-CN)n(μ-Ag)n-1] (n = 1, 2, 3 and 4) upon light excitation of [(XPhos-Ag)n(COT)] was confirmed by HRESI-MS, UV-Absorption and HR-TEM.

Change of concept about the regulation of angiotensin II-induced monocyte chemoattractant protein-1 production in human endothelial cells

AIMS

Some intriguing clinical observations about the anti-inflammatory effects of angiotensin type 1 (AT1) receptor blockers and angiotensin converting enzyme inhibitors in cardiovascular patients brought us to study the signalling pathways which lead to angiotensin II (ANG)-induced monocyte chemoattractant protein-1 (MCP-1) production in human endothelial cells.

METHODS

MCP-1 production in human umbilical vein endothelial cells (HUVECs) under treatments with ANG, AT1 and angiotensin type 2 (AT2) receptor blockers and pravastatin was measured by ELISA. The expression of AT1 and AT2 receptors and NADPH oxidase catalytic subunits (NOX 1-5) was analysed at mRNA and protein levels. Nuclear factor-kappa B (NF-κB) activation was studied by p65 subunit translocation to the cellular nucleus. Cell viability was tested by the MTT method. Nox4 subcellular distribution was analysed by subcellular protein fractionation and by immunoprecipitation followed by matrix-assisted laser desorption/ionization mass spectrometry analysis.

RESULTS

ANG-induced MCP-1 production was mediated by AT2 receptor, but not AT1 receptor in HUVECs in culture, which in turn activated NF-κB, promoting p65 subunit translocation to the nucleus. Reactive oxygen species produced by NADPH oxidase participated in this activation, mainly by the Nox4 subunit, ubiquitously expressed in all the compartments of HUVECs. Pravastatin inhibited ANG-induced MCP-1 production.

CONCLUSIONS

Our results support that ANG-induced MCP-1 production in HUVECs is mediated by AT2 instead AT1 receptor activation, which in turn activates NF-κB involving reactive oxygen species produced by the NADPH oxidase complex. Statins can also block ANG-induced MCP-1 production, probably by their inhibitory effects on NADPH oxidase activity.

Volumetric MRI study of the habenula in first episode, recurrent and chronic major depression

The habenula (Hb) can play an important role in major depressive disorder (MDD) as it is a key node between fronto-limbic areas and midbrain monoaminergic structures. In vivo neuroimaging studies have shown reductions in Hb volume in a post-mortem sample of patients with affective disorders but findings in unipolar MDD are not consistent. The current study aimed to investigate whether the Hb volume differed between patients with different stages of unipolar MDD and healthy subjects. We also explored differences in grey (GM) and white matter (WM) volumes and potential age and gender effects. High-resolution images were acquired using a 3T-scanner from 95 participants (21 with first-episode MDD; 20 with remitted-recurrent MDD; 20 with treatment-resistant/chronic MDD; and 34 healthy controls).Two researchers blinded to clinical data manually delineated habenular nuclei, with excellent inter-rater agreement. Multivariate analysis of covariance revealed a significant group-by-gender interaction (F9,258=2.22; p=0.02). Univariate effects emerged for Hb-WM volumes (F3,86=3.12; p=0.03) but not for total Hb volumes (F3,86=0.59; p=0.62) or Hb-GM volumes (F3,86=2.01; p=0.12). Women with a first-episode MDD had greater Hb-WM volumes than healthy controls and patients with treatment-resistant/chronic MDD (p<0.01). These findings remained unaltered when controlled for total intracranial volume or medication load. Our results do not support decreased total Hb volumes in unipolar MDD, in patients with first-episode or in patients with long-lasting recurrent or chronic depression. However, the increased Hb-WM volume we observed in women with a first-episode suggests involvement of Hb and its projections in early stages of the recovery process and in the course of MDD.

Identifying and Analyzing the Diversity of Resistance Gene Analogs in Colombian Rubus Genotypes

Five Andean blackberry Rubus genotypes, three resistant and two susceptible to anthracnose, were used to identify regions in the Rubus genome with homology to disease-resistance genes found in other plant species. Polymerase chain reaction amplification with 12 pairs of primers and fragment cloning yielded 520 clones, of which 151 showed inserts between 500 and 700 bp long. When sequenced, 47 clones showed homology with two types of resistance genes, non-Toll/interleukin-1 receptor (TIR) nucleotide binding site (NBS) leucine-rich repeat (LRR) and TIR-NBS-LRR, thereby confirming their designation as resistance gene analogs (RGAs). The number of RGAs detected per Rubus genotype ranged from 7 to 11, with the highest in a wild resistant and a cultivated susceptible genotype. Rubus RGAs were also homologous with several non-TIR- and TIR-type RGAs found in other members of the Rosaceae family (Rosa hybrid cultivar, Rosa roxburghii, Malus × domestica, M. prunifolia, M. baccata, M. floribunda, Pyrus communis, Prunus persica, P. kansuensis, P. avium, and Fragaria vesca). Three RGAs shared identity with two Rosaceae RGAs associated with the CRPM1 locus for powdery mildew resistance in R. roxburghii and the Rosa hybrid cultivar. This is the first report on RGAs present in the Andean blackberry in Colombia.

Prevalence of anti-rubella, anti-measles and anti-mumps IgG antibodies in neonates and pregnant women in Catalonia (Spain) in 2013: susceptibility to measles increased from 2003 to 2013

Non-immune neonates and non-immune pregnant women are at risk of developing rubella, measles and mumps infections, including congenital rubella syndrome. We describe the seroepidemiology of measles, mumps and rubella (MMR) in neonates and pregnant women in Catalonia (Spain). Anti-rubella, anti-measles and anti-mumps serum IgG titres were assessed using enzyme-linked immunosorbent assay (ELISA) tests in 353 cord blood samples from neonates of a representative sample of pregnant women obtained in 2013. The prevalence of protective antibody titres in neonates was 96 % for rubella IgG (≥8 IU/ml), 90 % for measles IgG (>300 IU/ml) and 84 % for mumps IgG (>460 EU/ml). Slightly lower prevalences of protective IgG titres, as estimated from the cord blood titres, were found in pregnant women: 95 % for rubella IgG, 89 % for measles IgG and 81 % for mumps IgG. The anti-measles and anti-mumps IgG titres and the prevalences of protective IgG titres against measles and mumps increased significantly (p < 0.001) with maternal age. The prevalence of protective anti-measles IgG titres decreased by 7 % [odds ratio (OR) = 0.15, p < 0.001), the prevalence of protective anti-rubella IgG titres increased by 3 % (OR = 1.80, p < 0.05) and the MMR vaccination coverage (during childhood) in pregnant women increased by 54 % (OR = 2.09, p < 0.001) from 2003 to 2013. We recommend to develop an MMR prevention programme in women of childbearing age based on mass MMR vaccination or MMR screening and vaccination of susceptible women to increase immunity levels against MMR.

First Report of a 16SrIII-L Phytoplasma Associated with Frogskin Disease in Cassava (Manihot esculenta Crantz) in Brazil

Cassava (Manihot esculenta Crantz) is a major staple crop in developing countries and a large source of raw material for industrial purposes as flour, starch, and ethanol. In July 2012, 24 cassava genotypes (corresponding to 1.85% of the accessions) with typical symptoms of frogskin disease (CFSD) were observed in one of the maintenance areas of the Brazilian Cassava Germplasm (located at Embrapa Cassava & Fruits, Cruz das Almas, Bahia State, Brazil). All diseased plants were asymptomatic on the aboveground parts (leaves and stem). However, for accessions BGM 880, BGM 1094, BGM 1100, BGM 1212, BGM 1218, and BGM 1526, all roots showed a woody appearance, thickened cork-like peel with opaque aspect, and coalescent lip-like slits in a honeycomb pattern. Based on literature description, two pathogens could be associated with CFSD: a dsRNA virus (belonging to family Reoviridae) and a 16SrIII-L phytoplasma (1). To investigate the presence of phytoplasma associated with the CFSD symptoms, total DNA was extracted from 0.5 g of root tissue collected from both symptomatic and asymptomatic roots by scratching the secondary vessel at the center of the cassava root with a CTAB method. The nested PCR was carried out using phytoplasma-specific primer set P1/Tint followed by R16F2n/R16R2, targeting the 16S rRNA gene sequence of 1.2 kb in length, for the final reaction (4). No phytoplasma was detected in asymptomatic cassava roots that were sampled from the same field. A posterior extraction of total RNA was made but no dsRNA was noticed on the agarose gel, and reaction of RT-PCR with specific primers (2) had no amplification. In order to characterize the strains, the 1.2-kb amplicon was digested with BamHI, MseI, MspI, KpnI, and TaqI endonucleases. The resulting patterns indicated that the symptomatic accessions were infected with a phytoplasma belonging to the 16SrIII group, sharing similarities with pseudo gel mapping from the reference strain of Peach X-Disease Phytoplasma (GenBank Accession No. L33733). Nested PCR products from accessions BGM 1526 and BGM 1212 were purified and sequenced by Macrogen, (Seoul, South Korea) in both directions, manually edited, and the consensus sequences were deposited in the NCBI database (GenBank Accession Nos. KF019184 and KF019185). Phylogenetic studies were conducted based on maximum parsimony, neighbor-joining, and maximum likelihood analysis for 16S rRNA. The phytoplasma 16S rRNA gene sequences from both strains had 99% identity (P < 0.0001) with the 16SrIII-L CFSD phytoplasma (EU346761 and AY737647), described by Alvarez et al. (1) infecting cassava in Colombia. To our knowledge, this is the first report of a phytoplasma associated with Cassava Frogskin Disease in Brazil, where only the dsRNA virus was recognized as causing this symptom (3). This is not likely to be an isolated case, and possibly more cassava plants are infected with this phytoplasma in Brazil. Due to the difficulties to observe the symptoms at the field level, this could be an emerging disease in that country. References: (1) E. Alvarez et al. Plant. Dis. 93:1139, 2009. (2) L. A. Calvert et al. J. Phytopathol. 156:647, 2008. (3) L. S. Poltroniere et al. Comun. Tec., Belem-PA. 006:2p, 1999. (4) C. D. Smart et al. Appl. Environ. Microb. 62:2988, 1996.

Estimators and confidence intervals for the proportion using binary auxiliary information with applications to pharmaceutical studies

Estimation of a proportion is commonly used in areas such as medicine, biopharmaceutical experiments, etc. Estimation of a proportion using auxiliary information has not been investigated in the literature. Ratio estimators of the population proportion and two-sided confidence intervals based upon auxiliary information are derived in this paper. Real data extracted from the Spanish National Health Survey are used to demonstrate the application of the proposed methods in the estimation of prevalences. Results derived from simulation studies show that proposed estimators are more efficient than the traditional estimator. Proposed confidence intervals outperform the alternative methods, especially in terms of interval width. A study on patients with hypertension is also considered to calculate various estimators and confidence intervals.

Mirtazapine in combination

Depression is undoubtedly a particularly important disease in terms of personal suffering and death as well as social, family, and economic costs. Pharmacological treatment is a reasonably effective therapeutic approach;however, a delayed therapeutic response and the persistence of depressive symptoms represent serious drawbacks to clinical recovery.Although the pharmacological action of anti depressants begins a few hours after the start of treatment, an antidepressant response usually takes between 2 and 6 weeks.The persistence of depressive symptoms after the first weeks of treatment is indicative of a poor prognosis in terms of chronicity and a return to normal social function.The combination of mirtazapine with other antidepressants may significantly lessen these drawbacks.Its antagonist effect on the presynaptic receptors reduces the latency of the antidepressant response. Moreover, its robust noradrenergic effect enhances the serotoninergic effects of the most common antidepressants. In addition, the side effects of mirtazapine can be partially neutralized by the pharmacodynamic activity of other antidepressants, while mirtazapine can ameliorate the serious adverse effects, such as sexual dysfunction, of other medications.

Phase II study of biweekly XELOX (capecitabine and oxaliplatin) as first line chemotherapy in elderly patients with metastatic colorectal cancer

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Background: Analysis of efficacy and toxicity of biweekly XELOX as first line monotherapy in elderly patients (pts) with metastatic colorectal cancer (MCRC), based in results of W. Scheithauer (J Clin Oncol 2003; 21: 1307). Methods: From March/06 to November/08, 28 chemonaïve elderly pts (>75 years old) with MCRC, PS: 0–2, and adequate renal, hepatic and bone marrow functions, were included in a phase II study of: oxaliplatin 85 mg/ m2/ day 1 plus capecitabine 2000/ m2/ in 2 divided doses/ days 1–7 every 2 weeks. Treatment was continued until 12 cycles, tumour progression or innaceptable toxicity. Response evaluation every 6 cycles and toxicity every cycle was performed. At present 28 pts for toxicity and 24 pts for response are evaluable. Results: Median age: 78.2 years (range: 73.5–79.5). Male/Female: 14/14. Rectal/Colon: 9/19. Metastatic sites 1/2/>2: 15/6/6. Liver 78.6%, Lung 32.1%, Local tumour 7.1%, Retroperitoneum 14.2%, Peritoneum 10.7%. and Bones 7.1 %. Previous adjuvant with 5-FU regimens to 4 pts. Comorbidity grade by Charlson index 0–1/2/>2: 60.8%/ 28.6% / 10.7%, respectively. Median number of cycles for oxaliplatin and capecitabine were 8 (5.25–12) and 8 (5.25–11.75). Response rate: 2 pts complete response (8.3%), 8 pts partial response (33.3%),10 pts stable disease (41.7 %) and 4 pts progression (16.7%). The main CTC toxicity was Asthenia G2+3 in 6 (21.5%), Nausea and emesis G2 in 7 (25%), Diarrhea G2+3 in 7 (25%) and Hand-foot syndrome G1+2 in 5 pts (17.8%). No G4 toxicity or toxic deaths were observed. Median time to progression was 8.6 months.Median overall survival will be given updated at the congress. Conclusions: Preliminary results suggest that bi-weekly XELOX is an effective first line treatment for MCRC in elderly pts with an acceptable toxicity profile (especial surveillance of diarrhea is necessary) and protocol cumpliment. Combination with bevacizumab should be considered.

No significant financial relationships to disclose.