Murine experimental models of amyotrophic lateral sclerosis: an update

INTRODUCTION

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease whose aetiology is unknown. It is characterised by upper and lower motor neuron degeneration. Approximately 90% of cases of ALS are sporadic, whereas the other 10% are familial. Regardless of whether the case is familial o sporadic, patients will develop progressive weakness, muscle atrophy with spasticity, and muscle contractures. Life expectancy of these patients is generally 2 to 5 years after diagnosis.

DEVELOPMENT

In vivo models have helped to clarify the aetiology and pathogenesis of ALS, as well as the mechanisms of the disease. However, as these mechanisms are not yet fully understood, experimental models are essential to the continued study of the pathogenesis of ALS, as well as in the search for possible therapeutic targets. Although 90% of cases are sporadic, most of the models used to study ALS pathogenesis are based on genetic mutations associated with the familial form of the disease; the pathogenesis of sporadic ALS remains unknown. Therefore, it would be critical to establish models based on the sporadic form.

CONCLUSIONS

This article reviews the main genetic and sporadic experimental models used in the study of this disease, focusing on those that have been developed using rodents.

Unified perspective on exponential tilt and bridge algorithms for rare trajectories of discrete Markov processes

This article analyzes and compares two general techniques of rare event simulation for generating paths of Markov processes over fixed time horizons: exponential tilting and stochastic bridge. These two methods allow us to accurately compute the probability that a Markov process ends within a rare region which is unlikely to be attained. Exponential tilting is a general technique for obtaining an alternative or tilted sampling probability measure, under which the Markov process becomes likely to hit the rare region at terminal time. The stochastic bridge technique involves conditioning paths towards two endpoints: the terminal point and the initial one. The terminal point is generated from some appropriately chosen probability distribution that covers well the rare region. We show that both methods belong to the class of importance sampling procedures by providing a common mathematical framework of these two conceptually different methods of sampling rare trajectories. We also conduct a numerical comparison of these two methods, revealing distinct areas of application for each Monte Carlo method, where they exhibit superior efficiency. Detailed simulation algorithms are provided.

Recommendations for the prevention of healthcare-associated infections in nursing homes

Nursing homes (NH) conceptually should look as much like a home as possible. However NH have unquestionable similarities with a nosocomium as they are places where many patients with underlying diseases and comorbidities accumulate. There is evidence of transmission of microorganisms between residents and between residents and caregivers. We have not found any recommendations specifically aimed at the prevention of nosocomial infections in NH by the major Public Health Agencies and, therefore, the Health Sciences Foundation (Fundación de Ciencias de la Salud) has convened a series of experts and 14 Spanish scientific societies to discuss recommendations that could guide NH personnel in establishing written programs for the control and reduction of these infections. The present document is the result of these deliberations and contains suggestions for establishing such control programs on a voluntary and flexible basis in NH. We also hope that the document can help the health authorities to encourage this control activity in the different territorial areas of Spain. In our opinion, it is necessary to draw up a written plan and establish the figure of a coordinator or person responsible for implementing these projects. The document includes measures to be implemented and ways of quantifying the reality of different problems and of monitoring the impact of the measures established.

Transcranial static magnetic stimulation reduces seizures in a mouse model of Dravet syndrome

Dravet syndrome is a rare form of severe genetic epilepsy characterized by recurrent and long-lasting seizures. It appears around the first year of life, with a quick evolution toward an increase in the frequency of the seizures, accompanied by a delay in motor and cognitive development, and does not respond well to antiepileptic medication. Most patients carry a mutation in the gene SCN1A encoding the α subunit of the voltage-gated sodium channel Nav1.1, resulting in hyperexcitability of neural circuits and seizure onset. In this work, we applied transcranial static magnetic stimulation (tSMS), a non-invasive, safe, easy-to-use and affordable neuromodulatory tool that reduces neural excitability in a mouse model of Dravet syndrome. We demonstrate that tSMS dramatically reduced the number of crises. Furthermore, crises recorded in the presence of the tSMS were shorter and less intense than in the sham condition. Since tSMS has demonstrated its efficacy at reducing cortical excitability in humans without showing unwanted side effects, in an attempt to anticipate a possible use of tSMS for Dravet Syndrome patients, we performed a numerical simulation in which the magnetic field generated by the magnet was modeled to estimate the magnetic field intensity reached in the cerebral cortex, which could help to design stimulation strategies in these patients. Our results provide a proof of concept for nonpharmacological treatment of Dravet syndrome, which opens the door to the design of new protocols for treatment.

The distribution of cadmium in soil and cacao beans in Peru

Peru is the eighth largest producer of cacao beans globally, but high cadmium contents are constraining access to international markets which have set upper thresholds for permitted concentrations in chocolate and derivatives. Preliminary data have suggested that high cadmium concentrations in cacao beans are restricted to specific regions in the country, but to date no reliable maps exist of expected cadmium concentrations in soils and cacao beans. Drawing on >2000 representative samples of cacao beans and soils we developed multiple national and regional random forest models to develop predictive maps of cadmium in soil and cacao beans across the area suitable for cacao cultivation. Our model projections show that elevated concentrations of cadmium in cacao soils and beans are largely restricted to the northern parts of the country in the departments of Tumbes, Piura, Amazonas and Loreto, as well as some very localized pockets in the central departments of Huánuco and San Martin. Unsurprisingly, soil cadmium was the by far most important predictor of bean cadmium. Aside from the south-eastern to north-western spatial trend of increasing cadmium values in soils and beans, the most important predictors of both variables in nation-wide models were geology, rainfall seasonality, soil pH and rainfall. At regional level, alluvial deposits and mining operations were also associated with higher cadmium levels in cacao beans. Based on our predictive map of cadmium in cacao beans we estimate that while at a national level <20 % of cacao farming households might be impacted by the cadmium regulations, in the most affected department of Piura this could be as high as 89 %.

Cuprous oxide nanoparticles incorporated into a polymeric matrix embedded in fabrics to prevent spread of SARS-CoV-2

This paper describes the development of a coating for cotton and polypropylene (PP) fabrics based on a polymeric matrix embedded with cuprous oxide nanoparticles (Cu₂O@SDS NPs) in order to inactivate SARS-CoV-2 and manufactured by a simple process using a dip-assisted layer-by-layer technology, at low curing temperature and without the need for expensive equipment, capable of achieving disinfection rates of up to 99%. The polymeric bilayer coating makes the surface of the fabrics hydrophilic, enabling the transportation of the virus-infected droplets to achieve the rapid inactivation of SARS-CoV-2 by contact with the Cu₂O@SDS NPs incorporated in the coated fabrics.

Receptor-binding domain-based SARS-CoV-2 vaccine adjuvanted with cyclic di-adenosine monophosphate enhances humoral and cellular immunity in mice

Novel adjuvants are highly desired to improve immune responses of SARS-CoV-2 vaccines. This work reports the potential of the stimulator of interferon genes (STING) agonist adjuvant, the cyclic di-adenosine monophosphate (c-di-AMP), in a SARS-CoV-2 vaccine based on the receptor binding domain (RBD). Here, mice immunized with two doses of monomeric RBD adjuvanted with c-di-AMP intramuscularly were found to exhibit stronger immune responses compared to mice vaccinated with RBD adjuvanted with aluminum hydroxide (Al(OH)₃ ) or without adjuvant. After two immunizations, consistent enhancements in the magnitude of RBD-specific immunoglobulin G (IgG) antibody response were observed by RBD + c-di-AMP (mean: 15360) compared to RBD + Al(OH)₃ (mean: 3280) and RBD alone (n.d.). Analysis of IgG subtypes indicated a predominantly Th1-biased immune response (IgG2c, mean: 14480; IgG2b, mean: 1040, IgG1, mean: 470) in mice vaccinated with RBD + c-di-AMP compared to a Th2-biased response in those vaccinated with RBD + Al(OH)₃ (IgG2c, mean: 60; IgG2b: n.d.; IgG1, mean: 16660). In addition, the RBD + c-di-AMP group showed better neutralizing antibody responses as determined by pseudovirus neutralization assay and by plaque reduction neutralization assay with SARS-CoV-2 wild type. Moreover, the RBD + c-di-AMP vaccine promoted interferon-γ secretion of spleen cell cultures after RBD stimulation. Furthermore, evaluation of IgG-antibody titers in aged mice showed that di-AMP was able to improve RBD-immunogenicity at old age after 3 doses (mean: 4000). These data suggest that c-di-AMP improves immune responses of a SARS-CoV-2 vaccine based on RBD, and would be considered a promising option for future COVID-19 vaccines.

Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.

Sampling rare trajectories using stochastic bridges

The numerical quantification of the statistics of rare events in stochastic processes is a challenging computational problem. We present a sampling method that constructs an ensemble of stochastic trajectories that are constrained to have fixed start and end points (so-called stochastic bridges). We then show that by carefully choosing a set of such bridges and assigning an appropriate statistical weight to each bridge, one can focus more processing power on the rare events of a target stochastic process while faithfully preserving the statistics of these rare trajectories. Further, we also compare the stochastic bridges we produce to the Wentzel-Kramers-Brillouin (WKB) optimal paths of the target process, derived in the limit of low noise. We see that the generated paths, encoding the full statistics of the process, collapse onto the WKB optimal path as the level of noise is reduced. We propose that the method can also be used to judge the accuracy of the WKB approximation at finite levels of noise.

Polymerization of aniline hydrochloride in reverse of microemulsion by batch and semicontinuous process using ionic and nonionic surfactants

The polymerization of aniline hydrochloride by inverse microemulsion in a batch process and the semicontinuous process was studied as a function of the surfactant ionic and nonionic. Polymerizations were carried out at 60°C for 4 h with a yield polymer of circa 67 and 27% wt. for ionic and nonionic surfactants. The conductivity of synthesized polyaniline by the semicontinuous process is higher up to three orders of magnitude than that of the batch process for both surfactants. The calculating degree of oxidation by UV-Vis showed the relative intensities of the quinoid to benzenoid unit around one. The morphology was determined by Scanning Electron Microscopy (SEM) and observed that the formation of the different morphologies is due to the self-assembly behavior of surfactant. The diameter z-average particle size (Dz) was studied by Transmission Electron Microscopy (TEM), which determined that the diameter particle in a semicontinuous state is larger than the one produced in a batch; this is due to the control of monomer addition in the system. These findings suggest that the polymerization process and the type of surfactant influence the properties of polyaniline.

Impact of urban structure on infectious disease spreading

The ongoing SARS-CoV-2 pandemic has been holding the world hostage for several years now. Mobility is key to viral spreading and its restriction is the main non-pharmaceutical interventions to fight the virus expansion. Previous works have shown a connection between the structural organization of cities and the movement patterns of their residents. This puts urban centers in the focus of epidemic surveillance and interventions. Here we show that the organization of urban flows has a tremendous impact on disease spreading and on the amenability of different mitigation strategies. By studying anonymous and aggregated intra-urban flows in a variety of cities in the United States and other countries, and a combination of empirical analysis and analytical methods, we demonstrate that the response of cities to epidemic spreading can be roughly classified in two major types according to the overall organization of those flows. Hierarchical cities, where flows are concentrated primarily between mobility hotspots, are particularly vulnerable to the rapid spread of epidemics. Nevertheless, mobility restrictions in such types of cities are very effective in mitigating the spread of a virus. Conversely, in sprawled cities which present many centers of activity, the spread of an epidemic is much slower, but the response to mobility restrictions is much weaker and less effective. Investing resources on early monitoring and prompt ad-hoc interventions in more vulnerable cities may prove helpful in containing and reducing the impact of future pandemics.

Is Guy's stone score useful for predicting outcomes in percutaneous nephrolithotomy?

INTRODUCTION

Percutaneous Nephrolithotomy (PCNL) is currently the treatment of choice in large kidney stones. Guy's stone score was developed to predict treatment outcomes. The aim of this study was to evaluate the relationship between Guy's score and outcomes in our institution.

MATERIALS AND METHODS

The medical records of patients diagnosed with urolithiasis and treated by PCNL were retrospectively evaluated between January 2017 and December 2018. Analyzed data included: age, sex, Guy's score based on preoperative findings, transfusion, stone-free rate and requirement of auxiliary procedures. Chi-square test was used for the comparison of proportions. Odds ratios (OR) with confidence intervals (CIs) of 95% were calculated by logistic regression.

RESULTS

A total of 386 patients, 53.89% female, mean age of 45.59 ± 15 years were analyzed. Guy's score was as follows: 112 patients (29.04%) were classified as Guy I, 92 patients (23.82%) as Guy II, 94 patients (24.34%) as Guy III, and 88 patients (22.80%) as Guy IV. There were no differences between groups in terms of blood transfusions. Stone-free rate was 96.43% (n = 108) for patients Guy I; 84.78% (n = 72) for Guy II; 76.59% (n = 72) for Guy III and 50% (n = 44) for Guy IV categories (p < 0.0001). Taking as a reference Guy I group, the OR to require new treatment for residual stones were: Guy II 4.85 (CI = 0.95 to 24.60, P = 0.05) to Guy III 8.25 (CI = 1.73 to 39.44, P = 0.008) and Guy IV 27 (CI = 5.84 to 124.70; p < 0.0001).

CONCLUSION

There was a statistically significant association between Guy's Score and stone-free rates following PCNL. Guy's score was useful to predict results of PCNL in our group.

Raw data of silver extraction from sodium-silver jarosite using three different lixiviants in alkaline medium

This article presents the raw data of silver concentration ([Ag]) obtained as a function of time (t) from silver leaching experiments, which were conducted using a synthetic sodium-silver jarosite and different complexing agents: thiosulfate, thiocyanate, and cyanide. Leaching experiments were performed under different conditions of temperature, pH and lixiviant concentration. The data refer to the article “Silver leaching from jarosite-type compounds using cyanide and non-cyanide lixiviants: a kinetic approach” (Islas et al., 2021), in which they were used to determine the leaching kinetics of jarosite-type compounds. The datasets were obtained experimentally from batch experiments. Concentration of silver, [Ag], was determined in each experiment as a function of time by atomic absorption spectroscopy. The information presented in this article can be useful for engineering students interested in mineral processing; particularly, for the calculation of kinetic parameters of silver leaching process. The data could also help in the formulation, implementation, or optimization of strategies for extraction of valuable metals from residues generated by the hydrometallurgical industry.

P–329 Müllerian anomalies and embryo implantation in oocyte donation

Study question

Do patients with Mullerian anomalies (MA) who receive donated oocytes have different embryo implantation rate than patients with normal uterus?

Summary answer

In oocyte donation, patients with MA had lower implantation rate than patients with normal uterus.

What is known already

MA are associated with infertility and miscarriage but the mechanisms to explain this relation are not known. Some studies describe both oocyte and/or uterine factor. All studies describing the outcome in patients with MA, so far, are with own oocytes but none in oocyte donation.

Study design, size, duration

A multicentre restrospective cohort study from January 2000 to December 2019. Patients receiving donated oocytes were divided between those with MA (n = 473) according ESHRE classification and other group with normal uterus (n = 57 869). The primary outcome was implantation rate at fresh embryo transfer. Secondary aims were biochemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate and live pregnancy rate.

Participants/materials, setting, methods

We considered the first oocyte donation cycle, without severe male factor, myomas, hydrosalpinx, Asherman syndrome, polyps or indication for preimplantational genetic diagnosis divided in two groups; patients with MA and no malformed uterus. MA group includes cycles of complete bicorporeal uterus (162), partial bicorporeal (30), bicorporeal septate (15), T shaped uterus (26), infantilis uterus (8), complete septate uterus (110), partial septate uterus (94) and hemi-uterus without rudimentary cavity (29).

Main results and the role of chance

We registered 58 342 patients from our oocyte donation program. Results are shown as mean and 95%CI and differences in pregnancy rates were expressed as relative risks (RR) with 95% CI being reference patients with normal uterus. In patients with MA, the implantation rate was different according the categories being significantly lower in patients with unicornuate uterus (0.29 95%CI: 0.14–0.43. p = 0.03). Biochemical pregnancy rate was significantly higher in patients with septate uterus (RR 1.51 (95%CI 1.02–2.22, p = 0.03) and significantly lower in unicornuate uterus (RR 0.49 (95%CI 0.27–0.90). No differences were found in clinical pregnancy rate among groups, but ongoing pregnancy rate and live birth rate were lower in unicornuate uterus ( RR 0.28 (95%CI 0.13–0.63, p = 0.002), (RR 0.32 (95%CI 0.14–0.73, p = 0.007) respectively. Miscarriage rate was significantly higher in patients with septate uterus (RR 1.78 (95%CI 1.18–2.68, p = 0.006)

Limitations, reasons for caution

As this was a retrospective cohort study, we were unable to study differences due to modifications in medical or laboratory protocols during this long period time. Different size of sample in some groups of MA makes impossible to translate conclusions to general population.

Wider implications of the findings: Our results indicate that there might be a defect in the embryo implantation rate in patients with MA depending on uterine factor. Different sample size among groups and some groups with scarce number of cases make less precise results. More studies controlling biases are needed to confirm our results.

Trial registration number

NCT04571671

Smell and Taste Dysfunction in COVID-19 Is Associated With Younger Age in Ambulatory Settings: A Multicenter Cross-Sectional Study

BACKGROUND AND OBJECTIVE

Since the initial anecdotal reports of coronavirus disease 2019 (COVID-19) from China, a growing number of studies have reported on smell and/or taste dysfunction (STD). Objective: The aim of our study was to investigate the frequency and severity of STD in COVID-19 patients and to evaluate the association with demographic characteristics, hospital admission, symptoms, comorbidities, and blood biomarkers.

METHODS

We performed a multicenter cross-sectional study on patients who were positive for SARS-CoV-2 (n=846) and controls (n=143) from 15 Spanish hospitals. Data on STD were collected prospectively using an in-person survey. The severity of STD was categorized using a visual analog scale. We analyzed time to onset, recovery rate, time to recovery, hospital admission, pneumonia, comorbidities, smoking, and symptoms.

RESULTS

STD was at least 2-fold more common in COVID-19-positive patients than in controls. COVID-19-positive hospitalized patients were older, with a lower frequency of STD, and recovered earlier than outpatients. Analysis stratified by severity of STD showed that more than half of COVID-19 patients presented severe loss of smell (53.7%) or taste (52.2%); both senses were impaired in >90%. In the multivariate analysis, older age (>60 years), being hospitalized, and increased C-reactive protein were associated with a better sense of smell and/or taste. COVID-19-positive patients reported improvement in smell (45.6%) and taste (46.1%) at the time of the survey; in 90.6% this was within 2 weeks of infection.

CONCLUSION

STD is a common symptom in COVID-19 and presents mainly in young and nonhospitalized patients. More studies are needed to evaluate follow-up of chemosensory impairment.

Collective clog control: Optimizing traffic flow in confined biological and robophysical excavation

Groups of interacting active particles, insects, or humans can form clusters that hinder the goals of the collective; therefore, development of robust strategies for control of such clogs is essential, particularly in confined environments. Our biological and robophysical excavation experiments, supported by computational and theoretical models, reveal that digging performance can be robustly optimized within the constraints of narrow tunnels by individual idleness and retreating. Tools from the study of dense particulate ensembles elucidate how idleness reduces the frequency of flow-stopping clogs and how selective retreating reduces cluster dissolution time for the rare clusters that still occur. Our results point to strategies by which dense active matter and swarms can become task capable without sophisticated sensing, planning, and global control of the collective.

Primary Esophageal Lymphoepithelioma

Lymphoepitheliomas are extremely rare outside the nasopharynx. Extranasopharyngeal lymphoepitheliomas may be located in the stomach or digestive tract, and only one single case of esophageal location has been found in our review. In many cases the tumor is related to Epstein-Barr virus infection. We report a case of undifferentiated carcinoma of the distal third of the esophagus in a 79-year-old man. Pathological examination of the esophagus revealed an undifferentiated carcinoma with lymphoid stroma (lymphoepithelioma). In situ hybridization of the neoplastic cells was negative for Epstein-Barr virus. To our knowledge, the present case is the first documented esophageal lymphoepithelioma in Western countries.

Alphaviruses: Serological Evidence of Human Infection in Paraguay (2012-2013)

INTRODUCTION

Alphaviruses can produce febrile illness and encephalitis in dead-end hosts such as horses and humans. Within this genus, the Venezuelan Equine Encephalitis virus (VEEV) complex includes pathogenic epizootic subtypes and enzootic subtypes that are not pathogenic in horses (except subtype IE, Mexican strains), although they can cause febrile symptoms in humans. The Rio Negro virus (RNV-VEEV subtype VI) circulates in Argentina, where it was associated with undifferentiated febrile illness. Mayaro (MAYV) and Una (UNAV) viruses belong to a different group, the Semliki Forest virus complex, with confirmed circulation.

OBJECTIVE

The present study aimed to determine RNV, MAYV, and UNAV seroprevalences by plaque reduction neutralization test in 652 samples of Paraguayan individuals mainly from the Central Department, between years 2012 and 2013.

METHODS

Samples with antibodies titer >1:20 against RNV were also tested for Mosso das Pedras-subtype IF, subtype IAB, and Pixuna (PIXV)-subtype IV viruses that belongs to VEEV antigenic complex.

RESULTS

The overall seroprevalence of RNV was 3.83%, and for UNAV it was 0.46%, and no neutralizing antibodies were detected against MAYV in the studied population. Two of the twenty-seven heterotypic samples were positive for PIXV. The 50.1% of neutralizing antibody titers against RNV were high (equal to or greater than 1/640), suggesting recent infections. The effect of age on the prevalence of RNV was negligible.

CONCLUSIONS

These results bring new information about neglected alphaviruses in South America, and these data will serve as the basis for future studies of seroprevalence of other VEEV, and studies to search potential hosts and vectors of these viruses in the region.

Comparative histomorphological study of endometrium in mares

Uterine acute post-breeding inflammation is a physiological tissue response to the entry of exogenous elements, with persistent endometritis being the main pathology responsible for subfertility in the mare (Equus ferus caballus; Linnaeus, 1758). Mares can be classified as susceptible or resistant to endometritis according to their ability to remove intrauterine fluid within 48 hr after experimental inoculation. Endometrial biopsy is a technique that is commonly used to establish the degree of lesions that can affect the fertility of the mare. Endometrial histomorphometry is an objective and highly precise diagnostic method. The aim of this study was to compare, during oestrus, the endometrial histomorphometry of mares previously classified as susceptible (SM) or resistant (RM) to endometritis. Endometrial biopsies from 24 mares at the oestrus phase of the cycle were obtained. For the histomorphometric analysis, samples were histologically processed and subjected to routine Haematoxylin-Eosin staining. For the evaluation, the variables were considered as follows: 1-Height of the lining and glandular epithelia (Lining SM = 15.9 μm vs. RM = 13.3 μm; Glandular SM = 15.0 μm vs. RM = 13.0 μm); 2-Perpendicular diameters of endometrial glands (SM = 51.3 μm vs. RM = 44.8 μm); 3-Number of endometrial glands per field (SM = 24.8 glands/field vs. RM = 20.5 glands/field). The results from this study suggest the existence of a relationship between the studied characteristics and the susceptibility/resistance to post-breeding endometritis in mares. Thus, increased epithelial height, greater glandular density and greater development of the glands during oestrus would be related to a higher susceptibility to endometritis.

Update on management of invasive candidiasis

Given the growing incidence of invasive candidiasis in critically ill and haemato-oncological patients and its poor outcomes, an early diagnosis and treatment are need for get a better prognosis. This document reviews the current ap-proaches that help in diagnosis of invasive candidiasis based on culture-independent microbiological tests. The combination of clinical prediction scores with fungal serological markers could facilitate the approach in antifungal therapy, optimiz-ing it. This article also reviews the epidemiology and primary risk factors for invasive candidiasis in these patients, updating the therapeutic approach algorithms in both clinical contexts based on the main evidence and international guidelines.

Melatonin and periodontal tissues: Molecular and clinical perspectives

Periodontal disease is a frequent chronic inflammatory pathology that implies the destruction of the tissues supporting the teeth, which represents a high sanitary cost. It usually appears associated with other systemic conditions such as diabetes, metabolic syndrome, depression and Alzheimer disease among others. The presence of melatonin and its receptors in the oral cavity supports the hypothesis that this hormone could play a role in homeostasis of periodontal tissues. In the present review we will discuss the potential role of melatonin, a circadian synchronizing hormone, with proved antiinflammatory and antioxidant profile, in the pathogenesis and treatment of periodontitis. Particular emphasis will be placed on the role of the indolamine in the treatment of periodontal disease when this oral condition is comorbid with other pathologies that would also benefit from the therapeutic potential of melatonin and its analogs through diverse mechanisms.

Unplanned flexible ureteroscopy during percutaneous nephrolithotomy in the prone position

BACKGROUND

Over time, the prone position has been shown to be effective and safe for performing percutaneous nephrolithotomy. One of its disadvantages, however, is the inability to simultaneously perform an ureteroscopy after positioning the patient, which is feasible in the supine position. Our objective is to demonstrate the feasibility of implementing flexible ureteroscopy with the patient in the prone position.

MATERIAL AND METHODS

We present a case of percutaneous nephrolithotomy of partial staghorn calculi in the prone position during which access to the middle calyx was not possible. It was therefore necessary to conduct flexible ureteroscopy. The 64-year-old female patient had consulted for lumbar pain of 6 months of evolution.

RESULTS

We performed percutaneous nephrolithotomy in the prone position. After extracting calculi from the inner calyx and renal pelvis, access to the fragments located in the middle calyx could not be achieved. Rather than performing a new puncture, we decided to enter in a retrograde manner with a flexible ureteroscope, succeeding in extracting the residual calculi, leaving the patient completely free of calculi.

CONCLUSION

In our case, the implementation of retrograde flexible ureteroscopy was feasible without changing the patient's original position.

Cortical reorganization after spinal cord injury: always for good?

Plasticity constitutes the basis of behavioral changes as a result of experience. It refers to neural network shaping and re-shaping at the global level and to synaptic contacts remodeling at the local level, either during learning or memory encoding, or as a result of acute or chronic pathological conditions. 'Plastic' brain reorganization after central nervous system lesions has a pivotal role in the recovery and rehabilitation of sensory and motor dysfunction, but can also be "maladaptive". Moreover, it is clear that brain reorganization is not a "static" phenomenon but rather a very dynamic process. Spinal cord injury immediately initiates a change in brain state and starts cortical reorganization. In the long term, the impact of injury - with or without accompanying therapy - on the brain is a complex balance between supraspinal reorganization and spinal recovery. The degree of cortical reorganization after spinal cord injury is highly variable, and can range from no reorganization (i.e. "silencing") to massive cortical remapping. This variability critically depends on the species, the age of the animal when the injury occurs, the time after the injury has occurred, and the behavioral activity and possible therapy regimes after the injury. We will briefly discuss these dependencies, trying to highlight their translational value. Overall, it is not only necessary to better understand how the brain can reorganize after injury with or without therapy, it is also necessary to clarify when and why brain reorganization can be either "good" or "bad" in terms of its clinical consequences. This information is critical in order to develop and optimize cost-effective therapies to maximize functional recovery while minimizing maladaptive states after spinal cord injury.

Venezuelan equine encephalitis viruses (VEEV) in Argentina: serological evidence of human infection

Venezuelan equine encephalitis viruses (VEEV) are responsible for human diseases in the Americas, producing severe or mild illness with symptoms indistinguishable from dengue and other arboviral diseases. For this reason, many cases remain without certain diagnosis. Seroprevalence studies for VEEV subtypes IAB, ID, IF (Mosso das Pedras virus; MDPV), IV (Pixuna virus; PIXV) and VI (Rio Negro virus; RNV) were conducted in persons from Northern provinces of Argentina: Salta, Chaco and Corrientes, using plaque reduction neutralization test (PRNT). RNV was detected in all studied provinces. Chaco presented the highest prevalence of this virus (14.1%). Antibodies against VEEV IAB and -for the first time- against MDPV and PIXV were also detected in Chaco province. In Corrientes, seroprevalence against RNV was 1.3% in the pediatric population, indicating recent infections. In Salta, this was the first investigation of VEEV members, and antibodies against RNV and PIXV were detected. These results provide evidence of circulation of many VEE viruses in Northern Argentina, showing that surveillance of these infectious agents should be intensified.

Venezuelan equine encephalitis viruses (VEEV) are responsible for human diseases in the Americas. They produce severe or mild illnesses with symptoms indistinguishable from dengue and other arboviral diseases; for this reason, many cases remain undiagnosed. We detected neutralizing antibodies (NTAbs) against VEEV IAB, VEEV ID, MDPV (VEEV subtype IF), PIXV (VEEV subtype IV) and RNV (VEEV subtype VI) in human serum samples of Northern provinces of Argentina. Chaco province showed presence of NTAbs against VEEV IAB, MDPV, PIXV and RNV. In Corrientes province, we detected NTAbs against RNV in a pediatric population. NTAbs against PIXV and RNV were also detected in Salta province. These findings demonstrated the circulation of many VEEV strains in Northern Argentina and underscore the need for surveillance of dengue like illness in this region.