Morpho-Physiological Evaluation of Solanum betaceum Cav. In Vitro Cloned Plants: A Comparison of Different Micropropagation Methods

Tamarillo (Solanum betaceum Cav.) is a subtropical solanaceous tree with increasing agronomic interest due to its nutritious edible fruits. Growing demand for tamarillo plants and fruits requires optimization of existing propagation methods and scaled-up systems for large-scale cloning of selected germplasm. Three in vitro protocols have been used to micropropagate tamarillo: (1) axillary shoot proliferation in a semisolid medium, (2) organogenesis, and (3) somatic embryogenesis procedures. Variables such as the age of the established shoot cultures and rooting treatments were also analyzed. The morphological and physiological quality of acclimatized plants derived from all the methodologies were compared, with seed-derived plants used as a control group. Overall, the results show that in vitro-derived plants have a similar development to seed-derived plants. Micropropagation by axillary shoot proliferation was highly efficient, with rooting rates above 80% in most treatments. Organogenesis induction was more effective from lamina explants using MS media with 2.0 mg·L^-1 6-benzylaminopurine. Both organogenesis and somatic embryogenesis-derived plants were also morphologically and physiologically equivalent to seed and axillary shoot-derived plants. The specificities of each micropropagation method are discussed.

Targeted Axillary Dissection after Chemotherapy: Feasibility Study with Clip and Carbon Dye Tattoo - Neotarget Trial

Background

Axillary staging in patients with complete response after neoadjuvant chemotherapy (NAC) is still controversial. Our objective was to test tattoo alone and subsequentially tattoo plus clip as markers in the targeted axillary dissection of ycN0 patients.

Methods

Prospective cohort of cT1-T3, cN1 (proven histologically), M0 patients scheduled to receive NAC. Exclusion criteria were lobular histology, prior axillary surgery, and clinical N2/3. In cohort 1 this positive node (Neotarget node) was tattooed at diagnosis. If ycN0, a targeted axillary dissection was performed. After an interim analysis with negative results we changed the protocol in order to do a double marking procedure (Cohort 2): the positive node was clipped at diagnosis and after NAC a tattoo was done before surgery.

Results

Thirteen patients in Cohort 1 and 18 patients in Cohort 2. Failure to identify the Neotarget node with multiple nodes retrieved in 9/13 (69%) of Cohort 1 patients. Also in 5/13 (38%) of Cohort 1 patients and 3/18 (17%) of Cohort 2 there was a failure to clearly identify tattooed nodes. In Cohort 2, clip identification by surgical specimen radiography allowed the identification of the tagged node in 17/18 (94,4%) of cases. The concordance between the clipped node and sentinel nodes was 16/18 (89%).

Conclusions

The introduction of double marking by clipping the metastatic node and verifying their removal by surgical specimen radiography, using carbon ink as a tracer, allowed the identification of the metastatic node in 94% of cases, with a simple, reproducible, and easy-to-implement targeted axillary dissection procedure.

Smart ultrasound device for real-time myocardial stiffness quantification of the human heart

Funding Acknowledgements

Type of funding sources: Public grant(s) – EU funding. Main funding source(s): ERC

Introduction

Myocardial stiffness (MS) is crucial to understand cardiac biomechanics and evaluate cardiac function. We recently demonstrated that shear wave imaging using acoustic radiation force can provide quantitative end-diastolic MS in human patients [1] . However, the dependence of shear wave velocity with myofiber orientation remained a limitation and required to perform Shear Wave Velocity (SWV) estimations from different probe orientations which is challenging in clinical practice. We propose a new approach to provide real-time quantitative assessment of MS without dependence of the probe orientation based on a dedicated smart ultrasound (US) device.

Methods

A new US probe was designed and manufactured to generate acoustic radiation force along the central axis and track the SWV simultaneously along three different orientations to obtain an elliptic profile of SWS. The probe was connected to dedicated electronics and software to provide real-time end-diastolic MS with ECG gating. Validation was performed on 4 in-vitro calibrated phantoms (0.92 – 1.49 – 2.58 – 3.49 m/s) and on ex vivo porcine hearts. MS along and across the fibers were compared to the values measured by conventional shear wave imaging with a linear probe mounted on a rotation motor (angular step of 10°) (Aixplorer, Supersonic imaging). Finally, the in vivo feasibility and reproducibility of measuring MS of the antero-septal wall and of the right ventricular (RV) wall was assessed transthoracically on four human volunteer .

Results

In vitro results on phantoms showed a good agreement with calibrated value (r2 = 0.98, std = 4.8%). Elliptic profiles on ex-vivo porcine heart showed good agreement with Aixplorer measurements acquired at different angles, with a relative difference along the long axis (LA) of: Δ=7.0%, Δ=7.1%, Δ=9% respectively for left ventricle (LV), right ventricle (RV) and septum. Finally, myocardial SWV assessment in human volunteers was obtained successfully on the RV and on the septum in late diastole. The mean MS was 1.79+/- 0.15 m/s along the fiber direction, the  fractional anisotropy (FA) was 0.25 +/- 0.06 on septal wall  in good agreement with previous results [1] and 1.06 +/- 0.11 m/s along fibers orientation and a FA of 0.27 +/- 0.08 on RV.  Finally the beat to beat reproducibility of MS measurement was estimated to be 8.22%.

Conclusion

The new smart US device allowed non-invasive quantification of anisotropic myocardial tissues in real time. Results showed the accuracy of the methods. This approach could offer a new clinical tool for the evaluation of the myocardium in cardiomyopathies and in heart failure patients.

Abstract Figure. SWV on myocardium human volonteer

Blood biomarkers associated with inflammation predict poor prognosis in cerebral venous thrombosis:: a multicenter prospective observational study

BACKGROUND AND PURPOSE

Experimental studies suggest inflammation can contribute to blood barrier disruption and brain injury in cerebral venous thrombosis (CVT). We aimed to determine whether blood biomarkers of inflammation were associated with the evolution of brain lesions, persistent venous occlusion or functional outcome in patients with CVT.

METHODS

Pathophysiology of Venous Infarction-Prediction of Infarction and Recanalization in CVT (PRIORITy-CVT) was a multicenter prospective cohort study of patients with newly diagnosed CVT. Evaluation of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) concentrations in peripheral blood samples was performed at admission in 62 patients. Additional quantification of interleukin (IL)-6 was performed at day 1, 3 and 8 in 35 patients and 22 healthy controls. Standardized magnetic resonance imaging was performed at day 1, 8 and 90. Primary outcomes were early evolution of brain lesion, early recanalization and functional outcome at 90 days.

RESULTS

Interleukin-6 levels were increased in patients with CVT with a peak at baseline. IL-6, NLR and CRP levels were not related with brain lesion outcomes or early recanalization but had a significant association with unfavourable functional outcome at 90 days (IL-6: OR = 1.28, 95% CI: 1.05-1.56, P = 0.046; NLR: OR = 1.39, 95% CI: 1.4-1.87, P = 0.014; CRP: OR = 1.756, 95% CI: 1.010-3.051, P = 0.029). Baseline IL-6 had the best discriminative capacity, with an area under the receiver operating characteristic curve to predict unfavourable functional outcome of 0.74 (P = 0.031).

CONCLUSIONS

Increased baseline levels of NLR, CRP and IL-6 may serve as new predictive markers of worse functional prognosis at 90 days in patients with CVT. No association was found between inflammatory markers and early evolution of brain lesion or venous recanalization.

Quantitative imaging of coronary flows using 3D ultrafast Doppler coronary angiography

Coronary flow rate remains complex to assess in clinical practice using non-invasive, non-ionizing imaging tools. In this study, we introduce 3D ultrafast Doppler coronary angiography (3D UDCA), an ultrasound-based method to assess coronary blood flows in three-dimensions at high volume-rate and in one single heartbeat. We demonstrate that 3D UDCA can visualize the coronary vasculature with high temporal and spatial resolution and quantify the absolute flow. The feasibility of the technique was demonstrated in an open-chest swine model. The flow rate of the left-anterior descending artery (LAD) assessed by 3D UDCA was reconstructed successfully at the early diastolic and late diastolic phases and was in good agreement with an invasive gold-standard flowmeter during baseline, reactive hyperemia and coronary stenosis (r² = 0.84). Finally, we demonstrate that a coronary stenosis on the LAD can be visualized as well as its associated flow acceleration.

Position Statement on Atopic Dermatitis in Sub-Saharan Africa: current status and roadmap

BACKGROUND

The first International Society of Atopic Dermatitis (ISAD) global meeting dedicated to atopic dermatitis (AD) in Sub-Saharan Africa (SSA) was held in Geneva, Switzerland in April 2019. A total of 30 participants were present at the meeting, including those from 17 SSA countries, representatives of the World Health Organization (WHO), the International Foundation for Dermatology (IFD) (a committee of the International League of Dermatological Societies, ILDS www.ilds.org), the Fondation pour la Dermatite Atopique, as well as specialists in telemedicine, artificial intelligence and therapeutic patient education (TPE).

RESULTS

AD is one of the most prevalent chronic inflammatory skin diseases in SSA. Besides neglected tropical diseases (NTDs) with a dermatological presentation, AD requires closer attention from the WHO and national Departments of Health.

CONCLUSIONS

A roadmap has been defined with top priorities such as access to essential medicines and devices for AD care, in particular emollients, better education of primary healthcare workers for adequate triage (e.g. better educational materials for skin diseases in pigmented skin generally and AD in particular, especially targeted to Africa), involvement of traditional healers and to a certain extent also patient education, bearing in mind the barriers to effective healthcare faced in SSA countries such as travel distances to health facilities, limited resources and the lack of dermatological expertise. In addition, several initiatives concerning AD research in SSA were discussed and should be implemented in close collaboration with the WHO and assessed at follow-up meetings, in particular, at the next ISAD meeting in Seoul, South Korea and African Society of Dermatology and Venereology (ASDV) meeting in Nairobi, Kenya, both in 2020.

Colorectal Cancer Screening Programme: Algarve Preliminary data

Problem

The burden of disease for oncological problems is significant in Portugal. Population-based screenings, such as colorectal cancer screening (CCS) with faecal occult blood tests (FIT) is a priority program to reduce the burden of disease and a cost-effectiveness measure.

Description problem

Algarve CCS started in 2017,to early detect colorectal cancer reducing morbidity and mortality. Screening strategy to detect and remove cancer precursors (adenomas) and early cancer detection with less invasive treatment using a non-invasive stool test was selected. A quantitative faecal immunochemical test for haemoglobin (FIT) with higher sensitivity for adenoma and cancer, specific for human globin with no dietary restriction, with a single sample screening is considered a test with higher participation. Target population all gender from 50 to 75 are invited to participate in the CCS by letter. Screening interval is 2 years and FIT cut-off- 117 (ng Hb/mL). Software was used to manage all CCS. Health units distribute the test and a flyer. All FIT-positive were invited to do a full colonoscopy at University Hospital.

Results

A preliminary descriptive analysis (2017/2019) was made. After exclusions 25017 of target population participate 34,4%(n = 8594),27.5%(n = 6883) submitted it for analysis, 3.9% (n = 266) had positive FIT and were invited for a full colonoscopy with 57.5% (n = 153)participation rate. Cancer detection was 0.9‰ and adenomas detection rate was 9.9%. FIT positive with colonoscopy 3.9% (n = 6) had carcinoma and 44.4% (n = 68) had adenoma.

Lessons

Some operational changes were made to improve participants and professionals adherence to CCS. Pathology observed in the positive cases, reinforce the need to implement strategies to increase literacy, raise public awareness, keep the screening test and improve accessibility of health facilities.

Key messages

The importance of a colorectal cancer early diagnosis prevent aggressive interventions in a precancerous phase. The importance of a colorectal cancer early diagnosis improves survival and population quality of life.

Algarve Cervical Cancer Screening Programme

Issue

Cervical Cancer (CC) is the 7th most frequent and the 2nd most common in women. The standardized mortality rate, in Portugal is 2.3/100000 inhabitants and Algarve is the region with highest rate, 4.9/100000.

Description

Programme started in 2010. Population-based screening programme can reduce incidence, mortality and morbidity with an early diagnosis, preventing aggressive interventions in precancerous phase, improving survival and life quality. Target population, woman age 25-64.are invited to primary test liquid-based cytology (ThinPrep) every 3 years. Health Centres are responsible for select, invite, collect samples and send to Hospital laboratory. For positives, a cervical pathology consultation is required. National Guidelines now indicates DNA testing for human papillomavirus (HPV) as primary screening test, each 5 years, to woman age 25 to 60 and screening program changes will be implemented in 2019 with improved response time and lower cost.

Results

Since 2010 the target population has increased 12% every 2 years and the adhesion rate increased ≈68% and≈108%. Nevertheless the 3rd cycle has showed 10,8% (17.975) adhesion rate. Most women 16.112 (89.6%) had a negative diagnosis, 503 (2,8%) is ASC-US + (HPV test), and 761(4,2%) had a cervical pathology consultation. From those, 117 (15.4%) had a LSIL, 69 (9,1%) HSIL and 2(0,3%) cancer. Cancer detection rate is 0,1 ‰.

Lessons

The small adhesion rate particularly by aged women, the users unfriendly Information System and direct screening health units management are some of the issues that requires improvement. Also population literacy, self-sampling vaginal fluid and clinical meetings are some of the options to improve screening program.

Key messages

Cervical Cancer early diagnosis prevent aggressive interventions in a precancerous phase, improves survival and life quality. Better access and health communication are major points in screening programs.

Breast Cancer Screening (BCS) by Mammography Tomosynthesis

Issue

Breast cancer is the 2nd cause of death for women in Portugal and 6000 new cases are detected annually. The prognosis is better for women whose cancers are detected earlier.

Description

Algarve BCS begin in 2005 using a digital mammography with 2 incidences/breast with double reading and consensus by a 3rd radiologist. Each 2 years women age 50 to 69, are invited to a Mobile Unit to do the mammography, a partnership with Algarve Oncologic Association. In 2017, direct digital mammography with Tomosynthesis(DDMT)was implemented. This technique increase cancer detection, reduction of false positives, false negatives and radiation dose. Diagnostic accuracy is better and also improves accessibility to the most vulnerable population groups to this technology.

Results

BCS covers 100% of the region and the mobile unit is user friendly for women with mobility impairment. Adhesion rate is > 62%. Is the 1st screening using Tomosynthesis in Portugal.Preliminary results show that the confirmation rate increased (10 %), the detection rate per 1.000 women also increased and the positive predictive value >95%.

Costs associated with the program decrease and less number of women called for false positives is observed. The number of positive mammograms increased, due to diagnostic acuity, with better visualization of the breast, namely in the patterns of greater mammary density; which leads to an improvement in further assessment rates.

Lessons

The technique increases the adhesion rate, with the same human resources. The decrease of the false positives improves the number of women send to further assessment and Senology Center. Earlier diagnoses, less aggressive treatments, and a higher survival rate are also expected.

Messages- Using this technology is expected that cancer diagnosis will be earlier, more reliable and wiht higher survival rate for this disease. The possibility of a population based screening with DDMT is an opportunity to reduce inequalities in the region.

Key messages

Mammography Tomosynthesis is expected that cancer diagnosis will be earlier, more reliable and wiht higher survival rate for this disease. The possibility of a population based screening with Mammography Tomosynthesis is an opportunity to reduce inequalities in the region.

Cumulative Helicobacter Pylori Eradication Rates by Adopting First- and Second- Line Regimens Proposed by the Maastricht IV Consensus in Obese Patients Undergoing Gastric Bypass Surgery

AIMS AND METHODS

Our aim was to assess, in obese patients undergoing Roux-en-Y gastric bypass (RYGB) surgery, the cumulative Helicobacter pylori (HP) eradication rates by adopting Maastricht IV guidelines in areas of high clarithromycin resistance rates (CLT)-14 days concomitant first-line therapy with proton-pump inhibitor (PPI) bid, CLT 500 mg bid, metronidazole (MTZ) 500 bid, and amoxicillin (AMX) 1000 mg bid and 14 days second-line therapy with PPI bid, AMX 1000 mg bid and levofloxacin (LVF) 500 mg od. Single-center prospective study was over 4 years. Endoscopy and HP assessment (by histology or C13 urea breath test) were performed at baseline and post-treatment HP status was assessed by C13 urea breath test 4-6 weeks after the end of therapy.

RESULTS

Seven hundred seventy-seven consecutive HP-positive patients completed concomitant first-line treatment: 636 (81.9%) female, age 41.1 (± 10.2) years. HP was eradicated in 556 patients-71.56% (95% CI: 68.28-74.62%). In the remaining 221 patients, second-line LVF-based regimens eradicated HP in 121 patients-54.75% (95% CI: 48.16-61.18%). These results give 87.13% (95% CI: 84.58-89.31%) ITT and 89.43% (95% CI: 87.03-91.44%) PP cumulative eradication rates. Eradication rates were not significantly different by gender, age, endoscopy findings, and smoking habits.

CONCLUSIONS

By adopting Maastricht IV consensus quadruple concomitant first-line treatment and second-line LVF-based therapy, high cumulative HP eradication rates are achieved but still leaves around 10.6% of obese patients undergoing RYGB in need of the culture and susceptibility testing prior to third-line treatment.

Drug-induced anaphylaxis: seven-year single-center survey

Summary

Background and Objective. Drug-induced anaphylaxis (DIA) is the most common cause of fatal anaphylaxis. We aimed to characterize patients with DIA and their allergological workup. Methods. Systematic review of patients with history of DIA referred to our center over 7 years. Results. Included 125 patients (10% pediatric age), being 36 years the median age of first episode (from 1 to 74 years). The main culprits were nonsteroidal anti-inflammatory drugs (NSAIDs) (43%), antibiotics (42%) and anesthetic agents (6%). In 24% the reactions occurred in hospital setting and 14% perioperative. The etiology was confirmed in 75% through allergological workup. Conclusions. NSAIDs and antibiotics were responsible for most of DIA. The heterogeneity of mechanisms, the severity of the reactions and the lack of standardized in vivo and/or in vitro tests for some drugs do not allow to confirm the diagnosis in all cases. Patients with DIA should be evaluated in specialized centers to perform accurate diagnosis, to prevent recurrence and to find safe alternatives.

Hidradenite Supurativa: Compreender para Tratar

A hidradenite supurativa é uma doença inflamatória cutânea, de caráter crónico e altamente debilitante, causada por oclusão folicular e consequente inflamação pilossebácea, manifestando-se através de nódulos, abcessos, fibrose e trajetos fistulosos. O profundo impacto que a hidradenite supurativa tem na qualidade de vida dos doentes levou a que, na última década, se tenha assistido a um crescente interesse da comunidade médica e científica. Este trabalho tem por objetivo a abordagem global da hidradenite supurativa tendo, para tal, sido conduzida uma pesquisa na base de dados bibliográfica PubMed/MEDLINE. Foram incluídos artigos originais, artigos de revisão e meta-análises, escritos apenas em língua inglesa. Da pesquisa efetuada, concluímos que existem questões fundamentais que carecem de esclarecimento, essencialmente no que diz respeito à definição dos mecanismos fisiopatológicos e fatores de risco associados, história natural e abordagem terapêutica da hidradenite supurativa.

Effects of naltrexone are influenced by childhood adversity during negative emotional processing in addiction recovery

Naltrexone is an opioid receptor antagonist used in the management of alcohol dependence. Although the endogenous opioid system has been implicated in emotion regulation, the effects of mu-opioid receptor blockade on brain systems underlying negative emotional processing are not clear in addiction. Individuals meeting criteria for alcohol dependence alone (n=18, alcohol) and in combination with cocaine and/or opioid dependence (n=21, alcohol/drugs) and healthy individuals without a history of alcohol or drug dependence (n=21) were recruited. Participants were alcohol and drug abstinent before entered into this double-blind, placebo-controlled, randomized, crossover study. Functional magnetic resonance imaging was used to investigate brain response while viewing aversive and neutral images relative to baseline on 50 mg of naltrexone and placebo. We found that naltrexone modulated task-related activation in the medial prefrontal cortex and functional connectivity between the anterior cingulate cortex and the hippocampus as a function of childhood adversity (for aversive versus neutral images) in all groups. Furthermore, there was a group-by-treatment-by-condition interaction in the right amygdala, which was mainly driven by a normalization of response for aversive relative to neutral images under naltrexone in the alcohol/drugs group. We conclude that early childhood adversity is one environmental factor that influences pharmacological response to naltrexone. Pharmacotherapy with naltrexone may also have some ameliorative effects on negative emotional processing in combined alcohol and drug dependence, possibly due to alterations in endogenous opioid transmission or the kappa-opioid receptor antagonist actions of naltrexone.

Laparoscopic cholecystectomy under continuous spinal anesthesia in a patient with Steinert's disease

Steinert's disease is an intrinsic disorder of the muscle with multisystem manifestations. Myotonia may affect any muscle group, is elicited by several factors and drugs used in general anesthesia like hypnotics, sedatives and opioids. Although some authors recommend the use of regional anesthesia or combined anesthesia with low doses of opioids, the safest anesthetic technique still has to be established. We performed a continuous spinal anesthesia in a patient with Steinert's disease undergoing laparoscopic cholecystectomy using 10mg of bupivacaine 0.5% and provided ventilatory support in the perioperative period. Continuous spinal anesthesia was safely used in Steinert's disease patients but is not described for laparoscopic cholecystectomy. We reported a continuous spinal anesthesia as an appropriate technique for laparoscopic cholecystectomy and particularly valuable in Steinert's disease patients.

Resting energy expenditure, macronutrient utilization, and body composition in term infants after corrective surgery of major congenital anomalies: A case-study

INTRODUCTION

Knowledge on the metabolic changes and nutritional needs during the postsurgical anabolic phase in infants is scarce. This analysis explores the associations of resting energy expenditure (REE) and macronutrient utilization with body composition of full-term infants, during catch-up growth after corrective surgery of major congenital anomalies.

METHODS

A cohort of full-term appropriate for-gestational-age neonates subjected to corrective surgery of major congenital anomalies were recruited after gaining weight for at least one week. REE and macronutrient utilization, measured by respiratory quotient (RQ), were assessed by indirect calorimetry using the Deltatrac II Metabolic Monitor ®. Body composition, expressed as fat-free mass (FFM), fat mass (FM) and adiposity defined as percentage of FM (% FM), was measured by air displacement plethysmography using the Pea Pod ®.

RESULTS

Four infants were included at 3 to 5 postnatal weeks. Recommended energy and macronutrient intakes for healthy term infants were provided. Through the study, the median (min-max) REE (Kcal/Kg FFM/d) was 70.8 (60.6-96.1) and RQ was 0.99 (0.72-1.20). Steady increases in both body weight and FFM were associated with initial decrease in FM and adiposity followed by their increase. Low RQ preceded decrease in adiposity.

CONCLUSION

The marked adiposity depletion, not expected during steady weight gain in the postsurgical period, prompts us to report this finding. The subsequent adiposity catch-up was associated with relatively high REE and RQ, suggesting preferential oxidation of carbohydrates and preservation of lipids for fat storage.

The non-genomic effects of endocrine-disrupting chemicals on mammalian sperm

Exposure to toxicants present in the environment, especially the so-called endocrine-disrupting chemicals (EDCs), has been associated with decreased sperm quality and increased anomalies in male reproductive organs over the past decades. Both human and animal populations are continuously exposed to ubiquitous synthetic and natural-occurring EDCs through diet, dermal contact and/or inhalation, therefore potentially compromising male reproductive health. Although the effects of EDC are likely induced via multiple genomic-based pathways, their non-genomic effects may also be relevant. Furthermore, spermatozoa are transcriptionally inactive cells that can come in direct contact with EDCs in reproductive fluids and secretions and are therefore a good model to address non-genomic effects. This review thus focuses on the non-genomic effects of several important EDCs relevant to mammalian exposure. Notably, EDCs were found to interfere with pre-existing pathways inducing a panoply of deleterious effects to sperm function that included altered intracellular Ca2+oscillations, induction of oxidative stress, mitochondrial dysfunction, increased DNA damage and decreased sperm motility and viability, among others, potentially jeopardizing male fertility. Although many studies have used non-environmentally relevant concentrations of only one compound for mechanistic studies, it is important to remember that mammals are not exposed to one, but rather to a multitude of environmental EDCs, and synergistic effects may occur. Furthermore, some effects have been detected with single compounds at environmentally relevant concentrations.

Seahorse (Hippocampinae) population fluctuations in the Ria Formosa Lagoon, south Portugal

Comparisons of three sets of surveys in the Ria Formosa Lagoon, Portugal, over a 13 year period (2001-2002, 2008-2009 and 2010-2013) revealed significant population fluctuations in at least one of the two seahorse (Hippocampinae) species living there, and that those fluctuations were potentially associated with habitat changes in the lagoon. After a significant decline between the first two survey periods (2001-2002 v. 2008-2009), long-snouted seahorse Hippocampus guttulatus populations increased significantly between 2008-2009 surveys and new 2010-2013 surveys. There were no significant differences in H. guttulatus populations between the 2001-2002 and 2010-2013 surveys. In contrast, there were no significant differences in short-snouted seahorse Hippocampus hippocampus densities among the 16 sites surveyed throughout the three sampling periods, although the ability to detect any change was hampered by the low densities of this species in all time periods. Fluctuations in H. guttulatus densities were positively correlated with the percentage of holdfast coverage, but with none of the other environmental variables tested. These results highlight the importance of holdfast availability in maintaining stable seahorse populations. While population fluctuations are certainly more promising than a consistent downward decline, such extreme fluctuations observed for seahorses in the Ria Formosa Lagoon could still leave these two species vulnerable to any additional stressors, particularly during low density periods.

Short-term outcome of patients with possible transient ischemic attacks: a prospective study

BACKGROUND

Patients with transient ischemic attack (TIA) have an increased risk of vascular events. There is scarce data regarding the prognosis of patients with transient neurological symptoms less typical of TIA, in whom a vascular origin cannot be excluded, also known as possible TIA. In this study we aimed to compare the short-term prognosis between TIA and Possible TIA patients.

METHODS

Patients with transient neurological events consecutively referred to a TIA Clinic during five years were classified as TIA, Possible TIA or mimic. Patients were prospectively followed. We compared the outcome at 30 and 90 days after TIA or Possible TIA. The primary outcome was stroke and the secondary outcome was a combination of vascular events (stroke, TIA, myocardial infarction or vascular death).

RESULTS

Two hundred and fifty eight TIA and 109 Possible TIA patients were included. Possible TIA patients had no stroke 30 and 90 days after the event. In contrast, 3.1 % and 4 % of TIA patients had stroke at the same time points. Combined vascular events occurred in 1.9 % of Possible TIA (myocardial infarction) and 9.8 % of TIA patients (stroke and TIA) after 30 days (OR = 0.18, 95 % CI 0.04 to 0.76, P = 0.02); and in 1.9 % of Possible TIA patients (myocardial infarction) and 11.3 % of TIA patients (stroke and TIA) after 90 days (OR = 0.16, 95 % CI 0.04 to 0.67, P = 0.012).

CONCLUSIONS

In this exploratory study, Possible TIA patients had less short-term vascular events than TIA patients.

A dietary-driven redox modulation of gut microbiome-host interactions: the rescue of epithelial barrier and mucus production during dysbiosis by dietary nitrate

Dietary nitrate, from green-leafy vegetables, is reduced to nitrite in the oral cavity and to nitric oxide ((•)NO) in the stomach. Gut microbiota is raising a great deal of interest since it has been recognized to be crucial to maintain gastrointestinal (GI) and systemic welfare. Dysbiosis (altered gut flora) is associated with increased epithelial permeability, deficient mucus production and with the activation of inflammatory pathways. Here we investigate whether dietary nitrate rescues GI physiology during dysbiosis. Four groups of Wistar rats were maintained in the animal facilities for 7 days during which, in addition to food, they had access to 1) water, 2) an antibiotic cocktail (neomycin, bacitracin, imipenem), 3) antibiotic cocktail sodium nitrate 10mM, 4) sodium nitrate. Animals were weighted daily. At the end of 7(th) day they were anesthetized (isoflurane) and euthanized. Ceca were collected and weighted. The stomach was isolated and occludin, claudin-5, ZO-1, iNOS and myeloperoxidase (MPO) were analyzed by western blot and immunofluorescence (n=4, triplicate). Values are mean±SEM. Antibiotic exposure prevented weight gain in all animals when compared to controls. Nitrate prevented body weight loss under dysbiosis. Ceca from animals with altered gut flora contained more fecal material than the ones from animals treated with nitrate under the same circumstances (18.47±0.99g vs 14.7±71.12g, p<0.05). Dysbiosis reduced occludin expression but supplementation with nitrate recovered this protein to control levels (p<0.05). No significant differences were observed for ZO-1 or claudin-5. Nitrate prevented MPO (115.70±5.36 vs 61.00±19.00, p<0.05; % of control) and iNOS (279.8±88.1 vs 57.3±18.4, p<0.05, % of control) overexpression under dysbiosis suggesting the prevention of an over stimulated inflammatory status in the gut. This data suggests that dietary nitrate may ensure gastric epithelial integrity and mucus production during dysbiosis. Supported by PTDC/AGR-ALI/115744/2009.

The use of a non-invasive tool for capture-recapture studies on a seahorse Hippocampus guttulatus population

In this study, the spot pattern in Hippocampus guttulatus was analysed using a computer programme algorithm that allowed individual comparison. This methodology was first tested in a controlled environment using 51 adult and 55 juvenile H. guttulatus. Positive matches were obtained in 86·3 and 83·6% of the adults and juveniles, respectively. In a second experiment, monthly surveys were carried out in five selected locations in the Ria Formosa Lagoon, south Portugal, over the course of a year and a total of 980 photographs were analysed. Photographed H. guttulatus were re-sighted one to nine times during the course of the survey period with an overall re-sight record of over 30%. Photo-identification was therefore shown to be a useful tool for non-invasive mark-recapture studies that can be successfully used to survey the population abundance of H. guttulatus aged 6 months or older in consecutive years. This could be of great value when considering the assessment of H. guttulatus populations and understanding changes over time.

Chronic stress disrupts neural coherence between cortico-limbic structures

Chronic stress impairs cognitive function, namely on tasks that rely on the integrity of cortico-limbic networks. To unravel the functional impact of progressive stress in cortico-limbic networks we measured neural activity and spectral coherences between the ventral hippocampus (vHIP) and the medial prefrontal cortex (mPFC) in rats subjected to short term stress (STS) and chronic unpredictable stress (CUS). CUS exposure consistently disrupted the spectral coherence between both areas for a wide range of frequencies, whereas STS exposure failed to trigger such effect. The chronic stress-induced coherence decrease correlated inversely with the vHIP power spectrum, but not with the mPFC power spectrum, which supports the view that hippocampal dysfunction is the primary event after stress exposure. Importantly, we additionally show that the variations in vHIP-to-mPFC coherence and power spectrum in the vHIP correlated with stress-induced behavioral deficits in a spatial reference memory task. Altogether, these findings result in an innovative readout to measure, and follow, the functional events that underlie the stress-induced reference memory impairments.