RESUMO
Interactions between bacterial microbiota and epibenthic species of the dinoflagellate Prorocentrum may define the onset and persistence of benthic harmful algal blooms (bHABs). Chemical ecological interactions within the dinoflagellate phycosphere potentially involve a complex variety of organic molecules, metabolites, and toxins, including undefined bioactive compounds. In this study, the bacterial diversity and core members of the dinoflagellate-associated microbiota were defined from 11 strains of three epibenthic Prorocentrum species, representing three geographically disjunct locations within Mexican coastal waters. Microbiota profiles in stable monoclonal Prorocentrum cultures were obtained by sequencing amplicons of the V3-V4 region of the 16S rRNA gene. Thirteen classes of bacteria were identified among dinoflagellate clones, where Alphaproteobacteria, Gammaproteobacteria, and Bacteroidia were consistently dominant. The bacterial community structure exhibited significantly different grouping by the location of origin of dinoflagellate clones. No significant diversity difference was found among free-living or unattached bacteria in the dinoflagellate culture medium (M) compared with those in closer association with the dinoflagellate host cells (H). Twelve taxa were defined as core members of the bacterial assemblage, representing the genera Algiphilus, Cohaesibacter, Labrenzia, Mameliella, Marinobacter, Marivita, Massilia, Muricauda, Roseitalea, and an unclassified member of the Rhodobacteraceae. The core members are inferred to significantly contribute to primary and secondary metabolic functions, but no direct correlation with dinoflagellate toxigenicity was apparent. Overall the bacterial profile and implied gene functionality indicated a suite of positive interactions, suggesting either mutualism or commensalism with the dinoflagellate. The further characterization and interpretation of specific gene functions and interactions between bacteria and dinoflagellates, such as epibenthic members of genus Prorocentrum, are key to understanding their role in toxigenesis and bHAB development.
Assuntos
Dinoflagellida , Microbiota , RNA Ribossômico 16S , Dinoflagellida/genética , Microbiota/genética , RNA Ribossômico 16S/genética , Bactérias/genética , Bactérias/classificação , Filogenia , Proliferação Nociva de Algas , BiodiversidadeRESUMO
Background: Every year, worldwide, the celebration for patient safety is carried out; since about 2.6 million people are documented who die each year from events that can potentially be avoided during their medical care, it is even estimated that around 15% of hospital costs can be attributed to treatment resulting in patient safety. As an important part of its dissemination in the medical-surgical community, we present the following article in relation to the critical vision of safety in the bile duct, promoted and published initially by Dr Steven Strasberg, which aims to reduce the number of complications during laparoscopic cholecystectomies. Materials and methods: A bibliographic search was carried out in PubMed, Medline, Clinical Key, and Index Medicus. From May 2020 to July 2021 in Spanish and English with the following. Conclusions: Strasberg's critical view is a proposed strategy to minimize the risk to zero during laparoscopic gallbladder surgery. It consists of obtaining a plane in which the surgeon can visualize the anatomical structures that make up the bile duct, as well as its irrigation and drainage. Being able to clearly observe these structures allows the surgeon to cut freely and safely to avoid bile duct injuries which are not so uncommon during this procedure. How to cite this article: Montalvo-Javé EE, Contreras-Flores EH, Ayala-Moreno EA, et al. Strasberg's Critical View: Strategy for a Safe Laparoscopic Cholecystectomy. Euroasian J Hepato-Gastroenterol 2022;12(1):40-44.
RESUMO
The vine mealybug, Planococcus ficus (Signoret, 1875), is the most important insect pest in growing areas of the grapevine Vitis vinifera L. in several countries, including Mexico. In Mexico, Baja California (B.C.) is the region with the highest production of V. vinifera L. grapes for industrial purposes. Recently, the diversity of viruses infecting insects only (insect-specific viruses) has been broadly explored to elucidate further ecological viral-host interactions in many insect species, which in some cases has resulted in the application of virus-based biological control agents for insect pests. However, a survey of the Pl. ficus virome has not been done yet. In the present study, we pooled Pl. ficus individuals collected through different vineyards of Ensenada, B.C., Mexico and analysed them by meta-transcriptomics. Novel nearly complete genomes of five RNA viruses were retrieved. These viruses were related to the Iflaviridae and Reoviridae families, and to the Picornavirales and Tolivirales orders. A new isolate belonging to the Dicistroviridae family was also found. Phylogenetic analyses showed that these putative viral genomes group with viruses having hemipteran (including a mealybug species) or other insect hosts, or with viruses associated with insects. Our results suggest that the identified novel RNA viruses could be insect-specific viruses of Pl. ficus. This work is the first insight into the Pl. ficus virome; it guarantees further studies aimed to characterize those viruses with potential for application in biological control of this economically important insect.
Assuntos
Ficus , Hemípteros , Vitis , Animais , Genoma Viral , Humanos , Insetos , México , Filogenia , RNA Viral/genéticaRESUMO
In the past three decades, several technologies designed for other purposes, have been applied in surgery to provide more precision to the surgical procedures and better outcomes. In surgery, innovation requires evidence before widespread implementation of novelties and a continuous quality improvement process to assess benefits and risks. Robotics in surgery has been widely implemented, but in some cases, there are many doubts regarding its clinical benefit and cost utility. The future of surgery lies in the fulfillment of four main conditions: safety, access, efficiency, and efficacy. Innovation and technology should help to accomplish these conditions, but it must not be the center of surgical practice. We present here our perspective on the main issues related to technology and robotics focusing on evidence-based surgery.
Assuntos
Cirurgia Geral/tendências , Robótica , Tecnologia , Humanos , Procedimentos Cirúrgicos RobóticosAssuntos
Ductos Biliares Extra-Hepáticos/lesões , Colecistectomia/efeitos adversos , Colecistite/cirurgia , Complicações Intraoperatórias/etiologia , Síndrome de Mirizzi/diagnóstico , Ductos Biliares Extra-Hepáticos/fisiopatologia , Colecistectomia/métodos , Colecistite/fisiopatologia , Diagnóstico Diferencial , Humanos , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/prevenção & controle , SíndromeRESUMO
BACKGROUND: An international group proposed a standardized terminology to report outcomes after bile duct repair. Data on this surgical complication vary depending on the center and country where patients are treated. The aim of this work is to show disparities in the care process of bile duct injury between patients from two different income-level countries, using a standard terminology of outcomes and clinical reporting. METHODS: A retrospective review comparing primary repair and re-repaired cases performed in an upper middle-income country (UMIC) versus primary repair cases treated in a high-income country (HIC) was performed. All pertinent data included in the tabular reporting system and outcomes classification were collected. Patients' characteristics were reported by calculating descriptive statistics. RESULTS: A total of 261 patients from UMIC (148 (56%) primary repair and 113 (44%) re-repair) were compared with 122 primary repair from HIC. Open cholecystectomy (55.4% vs 3.3%) and more E4 injuries (37.8% vs 19.7%) were found in the UMIC group. More Accordion 3 and higher complications were present in the UMIC primary and repair groups, as well as more episodes of postoperative acute cholangitis. Eleven patients were listed for liver transplant in the UMIC re-repair group. Primary patency by the end of the index treatment period was present in 217 (83%) of the full UMIC cohort. Median time to loss of primary patency was not reached in the primary repair, and was 3.8 years in the re-repair group. Patency was below HIC primary repaired cases. CONCLUSIONS: Standardized reporting outcomes after primary repair are applicable to re-repaired patients and are helpful to compare different populations, showing better outcomes in HIC. Measures of surgical access disparities exist among the process of bile duct injury care.
Assuntos
Ductos Biliares , Colecistectomia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Complicações Pós-Operatórias , Ductos Biliares/lesões , Ductos Biliares/cirurgia , Fatores Econômicos , HumanosRESUMO
BACKGROUND: Early hepatic artery thrombosis (HAT) is a potentially lethal complication after orthotopic liver transplantation (OLT) requiring immediate intervention. AIM: To report an infrequent cause of HAT after OLT and by itself a controversial clinical entity, the median arcuate ligament celiac artery compression. CASE REPORT: A 59-year-old female with hepatitis C virus-induced cirrhosis, Child B, MELD 15, underwent cadaveric-donor OLT with complete vena cava exclusion. Type 1 hepatic artery anatomy was found both in the donor and the recipient, the gastroduodenal artery was ligated. During the first eight postoperative days, clinical and analytical evolution was satisfactory and Doppler ultrasound showed no abnormalities. On the ninth postoperative day, the patient developed hypovolemic shock due to bleeding at the hepatic artery anastomosis, surgical reconstruction was performed. Postoperative color Doppler showed absent hepatic artery flow and an angiography suggested celiac artery compression. The patient was explored again the same day, liberating the celiac artery from the median arcuate ligament and performing thrombectomy and reconstruction of the hepatic artery anastomosis. The patient made a satisfactory recovery and color Doppler showed adequate flow in the hepatic artery. She is alive, free of biliary complications and enjoying a good quality of life 12 months after transplantation. CONCLUSION: Median arcuate ligament celiac artery compression is an infrequent anatomical variant that should be intentionally evaluated in the recipient at the time of arterial reconstruction in OLT and specifically be considered in early HAT to allow recognition and effective correction.
Assuntos
Arteriopatias Oclusivas/etiologia , Artéria Celíaca , Artéria Hepática , Ligamentos/anormalidades , Transplante de Fígado/efeitos adversos , Trombose/etiologia , Angiografia Digital , Arteriopatias Oclusivas/diagnóstico , Arteriopatias Oclusivas/cirurgia , Artéria Celíaca/diagnóstico por imagem , Artéria Celíaca/cirurgia , Feminino , Artéria Hepática/diagnóstico por imagem , Artéria Hepática/cirurgia , Humanos , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/etiologia , Reoperação , Trombectomia , Trombose/diagnóstico , Trombose/cirurgia , Fatores de Tempo , Ultrassonografia Doppler em CoresRESUMO
Se informa un caso de lipoma primario del hígado en una mujer de 57 años con historia de diabetes mellitus no insulinodependiente y tres días con dolor abdominal, distensión, náusea y vómito. A la exploración física se encontró hígado palpable 5 cm por debajo del margen costal derecho sin esplenomegalia ni ascitis. La tomografía computada reveló un tumor bien delimitado con atenuación de grasa y la RM demostró lesión bien circunscrita con intensidad de señal brillante. Se realizó lobectomía hepática derecha. El espécimen resecado midió 28.6 x 18.3 x 8.2 cm y pesó 2,200 g. El tumor de color amarillo y bien circunscrito midió 15 x 9.5 cm, estaba constituido por células adiposas maduras que empujaban al tejido hepático en la periferia. La paciente se encontraba asintomática seis meses después de la cirugía.