A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients

Background The objective of this systematic review and meta-analysis was to determine the effect of REBOA, compared to resuscitative thoracotomy, on mortality and among non-compressible torso hemorrhage trauma patients. Methods Relevant articles were identified by a literature search in MEDLINE and EMBASE. We included studies involving trauma patients suffering non-compressible torso hemorrhage. Studies were eligible if they evaluated REBOA and compared it to resuscitative thoracotomy. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for final analysis. We conducted meta-analysis using random effect models. Results We included three studies in our systematic review. These studies included a total of 1276 patients. An initial analysis found that although lower in REBOA-treated patients, the odds of mortality did not differ between the compared groups (OR 0.42; 95% CI 0.17–1.03). Sensitivity analysis showed that the risk of mortality was significantly lower among patients who underwent REBOA, compared to those who underwent resuscitative thoracotomy (RT) (RR 0.81; 95% CI 0.68–0.97). Conclusion Our meta-analysis, mainly from observational data, suggests a positive effect of REBOA on mortality among non-compressible torso hemorrhage patients. However, these results deserve further investigation

Environmental value calculus of the frontal urban gardens. : Mendoza (Argentina)

Los espacios verdes y, en general, la vegetación que cumple funciones estéticas y de protección ambiental son valorados, medidos y calculados por el área destinada al cultivo, en lugar de basar los cálculos en los elementos vegetales constitutivos. Esto significa una simplificación excesiva de la valoración de la vegetación (actual o proyectada) que no aporta criterios de cuantificación valorativa necesarios, actualmente, tanto para preservar vegetación existente como para políticas de desarrollo urbano y proyectos de ingeniería del mejoramiento ambiental. En el presente trabajo se propone aplicar a la valoración de los jardines frontales urbanos de la ciudad de Mendoza una metodología cuantitativa desarrollada por R. Codina et al., que se apoya en un concepto nuevo que es su influencia como mejoradores ambientales. La ecuación de cálculo se integra con índices de valoración como el Índice de Vegetación Ambientalmente Activa y el Índice Ambiental Urbanístico, que permiten cuantificar la importancia urbanística y ambiental de la vegetación. También se propone una base para implementar una política de incentivo de los jardines frontales mediante la disminución del avalúo valor terreno del impuesto inmobiliario, en una escala progresiva según el Índice Ambiental Urbanístico de cada propiedad, tendiente a la transformación de la ciudad en una ciudad-jardín, mejorando la calidad de vida y el atractivo turístico urbano.The green spaces and in general, the vegetation used for aesthetics and environmental protection are valuated, measured and calculated through the area destinated to the cultivation instead of calculus based in the component vegetal elements. This means an excessive simplification in the vegetal valoration (current or projected) that not contribute with cuantitative valoration criterion, which are needed today in preservation of existent vegetation, urban development policies and in engineering projects of environmental improvement. This work proposes the application to the frontal urbans gardens in Mendoza city, of a cuantitative metodology developed by R. Codina et al., which is based in a new concept, it influences as environmental improvement. The calculus equation is to be composed of valoration indexes as the Environmental Active Vegetation Index and the Urbanistic Environmental Index, that allow the cuantification of the urbanistic and environmental importance of vegetation. Also is proposed a base for the implementation of an incentive policy of the frontals urban gardens through the diminution of the real estate tax land appraisal, in a progressive scale according the Urbanistic Environmental Index of each property, tending to transformation the city in a garden-city, to improve the life´s quality and the urban touristic charm.Fil: Codina, Ramón A.. Universidad Nacional de Cuyo. Facultad de Ciencias Agrarias. Departamento de Producción AgropecuariaFil: Passera, Carlos B.. Universidad Autónoma de Nuevo León (México). Facultad de Ciencias BiológicasFil: Naranjo, Gabriela. Universidad Nacional de Cuyo. Facultad de Ciencias Agrarias. Departamento de Producción AgropecuariaFil: Carrieri, Sergio A.. Universidad Nacional de Cuyo. Facultad de Ciencias Agrarias. Departamento de Producción AgropecuariaFil: Fioretti, Sonia B.. Universidad Nacional de Cuyo. Facultad de Ciencias Agrarias. Departamento de Producción AgropecuariaFil: Manzano, Enrique R.. Universidad Nacional de Cuyo. Facultad de Ciencias Agrarias. Departamento de Producción Agropecuari

Obesity-associated variants within FTO form long-range functional connections with IRX3

PMCID: PMC4113484.-- et al.Genome-wide association studies (GWAS) have reproducibly associated variants within introns of FTO with increased risk for obesity and type 2 diabetes (T2D). Although the molecular mechanisms linking these noncoding variants with obesity are not immediately obvious, subsequent studies in mice demonstrated that FTO expression levels influence body mass and composition phenotypes. However, no direct connection between the obesity-associated variants and FTO expression or function has been made. Here we show that the obesity-associated noncoding sequences within FTO are functionally connected, at megabase distances, with the homeobox gene IRX3. The obesity-associated FTO region directly interacts with the promoters of IRX3 as well as FTO in the human, mouse and zebrafish genomes. Furthermore, long-range enhancers within this region recapitulate aspects of IRX3 expression, suggesting that the obesity-associated interval belongs to the regulatory landscape of IRX3. Consistent with this, obesity-associated single nucleotide polymorphisms are associated with expression of IRX3, but not FTO, in human brains. A direct link between IRX3 expression and regulation of body mass and composition is demonstrated by a reduction in body weight of 25 to 30% in Irx3-deficient mice, primarily through the loss of fat mass and increase in basal metabolic rate with browning of white adipose tissue. Finally, hypothalamic expression of a dominant-negative form of Irx3 reproduces the metabolic phenotypes of Irx3-deficient mice. Our data suggest that IRX3 is a functional long-range target of obesity-associated variants within FTO and represents a novel determinant of body mass and composition.This work was funded by grants from the National Institutes of Health (DK093972, HL119967, HL114010 and DK020595) to M.A.N. and (MH101820, MH090937 and DK20595) to N.J.C. J.L.G.-S. was funded by grants from the Spanish Ministerio de Economía y Competitividad (BFU2010-14839, CSD2007-00008) and the Andalusian Government (CVI-3488). C.-C.H. was supported by a grant from the Canadian Institute of Health Research. K.-H.K. is supported by a fellowship from the Heart and Stroke Foundation of Canada. S.S. is supported by an NIH postdoctoral training grant (T32HL007381)Peer Reviewe

NaRALap: augmented reality system for navigation in laparoscopic surgery

The final publication is available at Springer via http://dx.doi.org/10.1007/s11548-011-0579-z.The AR system has a good resolution and currently is used for the placement of the trocars. Possible improvements will be performed to make the system independent of the camera position or to use natural marks. The biomechanical model and the AR algorithms will be combined with a tracker, for tracking the surgical instruments, in order to implement a valid system for liver biopsies. It will take into account the deformation due to the pneumoperitoneum and due to the breath of the patient. To develop the navigator that will guide the laparoscopic interventions, both AR system and biomechanical model will be combined with the laparoscopic camera in order to make an easier environment with only one vision in a 2D monitor.This work has been supported by the project MITYC (ref. TSI020100-2009-189). We would like to express our deep gratitude to the Hospital Clínica Benidorm for its participation in this project.López-Mir, F.; Martínez Martínez, F.; Fuertes Cebrián, JJ.; Lago, MA.; Rupérez Moreno, MJ.; Naranjo Ornedo, V.; Monserrat Aranda, C. (2011). NaRALap: augmented reality system for navigation in laparoscopic surgery. International Journal of Computer Assisted Radiology and Surgery. 6:98-99. https://doi.org/10.0.3.239/s11548-011-0579-zS9899

Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) secondary to epidermoid cyst in the right cerebellopontine angle successfully treated with surgery

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome is a rare headache syndrome classified among the trigeminal autonomic cephalalgias. It is usually idiopathic, although infrequent secondary forms have been described. Recently, the term short-lasting unilateral headache with cranial autonomic symptoms (SUNA) has been defined by the International Headache Society (ICHD-2) as similar to SUNCT with less prominent absent conjunctival injection and lacrimation. We report a patient with paroxysmal orbito-temporal pains, phenotypically suggesting SUNA, secondary to epidermoid cyst in the cerebellopontine angle which disappeared after tumor resection. Neuroimaging should be considered in all patients with SUNA, notably in those with atypical presentation as our patient who presented on examination trigeminal hypoesthesia and tinnitus. Realization of a brain MRI would rule out injuries that causes this type of syndrome

Evolutionary comparison reveals that diverging CTCF sites are signatures of ancestral topological associating domains borders

Increasing evidence in the last years indicates that the vast amount of regulatory information contained in mammalian genomes is organized in precise 3D chromatin structures. However, the impact of this spatial chromatin organization on gene expression and its degree of evolutionary conservation is still poorly understood. The Six homeobox genes are essential developmental regulators organized in gene clusters conserved during evolution. Here, we reveal that the Six clusters share a deeply evolutionarily conserved 3D chromatin organization that predates the Cambrian explosion. This chromatin architecture generates two largely independent regulatory landscapes (RLs) contained in two adjacent topological associating domains (TADs). By disrupting the conserved TAD border in one of the zebrafish Six clusters, we demonstrate that this border is critical for preventing competition between promoters and enhancers located in separated RLs, thereby generating different expression patterns in genes located in close genomic proximity. Moreover, evolutionary comparison of Six-associated TAD borders reveals the presence of CCCTC-binding factor (CTCF) sites with diverging orientations in all studied deuterostomes. Genome-wide examination of mammalian HiC data reveals that this conserved CTCF configuration is a general signature of TAD borders, underscoring that common organizational principles underlie TAD compartmentalization in deuterostome evolution