Miasis Intracerebral, Generalidades y limitantes en el tratamiento, reporte de caso.

La Miasis es un parasitismo de los tejidos vivos o necróticos y órganos de los seres humanos causados por larvas de díptero, dentro de la clasificación según su localización se describe la miasis cavitaria, la miasis cerebral se describe como una entidad excepcionalmente rara, en esta se puede presentar la invasión del tejido meníngeo y encefálico, posterior a la perforación de los huesos del cráneo. Presentamos el caso de un paciente atendido en servicio de urgencias del Hospital Departamental Universitario del Quindío San Juan de Dios de Armenia - Colombia, quien consultó por múltiples cuadros de cefalea y malestar general, encontrando ulceración excavada, mal oliente, con infestación por larvas y huevos en el cuero cabelludo de región parietal y occipital con pérdida de tejido, recibió inicialmente manejo médico, los cuales no se lograban finalizar, dado que en la mayoría de ocasiones el paciente solicitaba retiros voluntarios. Luego de varios reingresos hospitalarios y tratamientos incompletos, el paciente ingresa al servicio de urgencias con gran deterioro neurológico, empeoramiento en su estado clínico y posteriormente fallece

Short- and Long-Term Prognosis of Patients With Takotsubo Syndrome Based on Different Triggers: Importance of the Physical Nature

Background Takotsubo syndrome (TTS) is an acute reversible heart condition initially believed to represent a benign pathology attributable to its self-limiting clinical course; however, little is known about its prognosis based on different triggers. This study compared short- and long-term outcomes between TTS based on different triggers, focusing on various physical triggering events. Methods and Results We analyzed patients with a definitive TTS diagnosis recruited for the Spanish National Registry on TTS (RETAKO [Registry on Takotsubo Syndrome]). Short- and long-term outcomes were compared between different groups according to triggering factors. A total of 939 patients were included. An emotional trigger was detected in 340 patients (36.2%), a physical trigger in 293 patients (31.2%), and none could be identified in 306 patients (32.6%). The main physical triggers observed were infections (30.7%), followed by surgical procedures (22.5%), physical activities (18.4%), episodes of severe hypoxia (18.4%), and neurological events (9.9%). TTS triggered by physical factors showed higher mortality in the short and long term, and within this group, patients whose physical trigger was hypoxia were those who had a worse prognosis, in addition to being triggered by physical factors, including age >70 years, diabetes mellitus, left ventricular eyection fraction <30% and shock on admission, and increased long-term mortality risk. Conclusions TTS triggered by physical factors could present a worse prognosis in terms of mortality. Under the TTS label, there could be as yet undiscovered very different clinical profiles, whose differentiation could lead to individual better management, and therefore the perception of TTS as having a benign prognosis should be generally ruled out

A case of behavioural diversification in male floral function – the evolution of thigmonastic pollen presentation

The authors gratefully acknowledge funding provided by an Else-Neumann-Stipendium (http://www.fu-berlin.de/sites/promovieren/drs/nachwuchs/nachwuchs/nafoeg.html), Deutscher Akademischer Austausch Dienst (DAAD) and botconsult GmbH at different stages of data acquisition. We thank Tobias Grass, Joana Bergmann and Franziska Weber (Freie Universität Berlin) for help with data collection in the field and in the greenhouse. Nicole Schmandt, Federico Luebert, Juliana Chacón and Dietmar Quant (Universität Bonn) provided help in the molecular laboratory and the edition of the molecular dataset. We furthermore thank Markus Ackermann (Koblenz) for providing photographs, Philipp Klein (Berlin) for editing the video and Katy Jones (Berlin) for helpful comments on an earlier version of the manuscript. Rafael Acuña has been supported by the ALECOSTA scholarship program. Coverage of the article processing charge by the German Research Foundation via the Open Access Publication Fund of the Freie Universität Berlin is gratefully acknowledged.Peer reviewedPublisher PD

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Altitudinal assisted migration of Mexican pines as an adaptation to climate change

Since shifts in altitudinal range are expected in response to climate change, we explored the effect on survivorship and growth of moving populations of three Mexican pine species (Pinus devoniana, P. leiophylla and P. pseudostrobus) to higher altitude, aiming to realign the populations to projected future climates in an experimental assisted migration. Twelve populations were collected across an altitudinal gradient (1650-2520 m above sea level [asl]) in a mountainous zone in the central-west region of the Mexican Trans-Volcanic Belt, and were planted in common garden tests at three forest sites of different altitudes (low: 2110, medium: 2422 and upper: 2746 m asl). Climate was estimated using a spline climatic model at the seed source and test sites and also measured using in situ data loggers. Survivorship and seedling height were evaluated in the field during the second and third growing seasons. Results were analyzed using mixed models to include the effect of climatic transfer distances (difference in climate between seed source and test site). Significant differences were found in seedling growth among Pinus devoniana, P. pseudostrobus and P. leiophylla, and among populations within the former two species. These were associated primarily with climatic transfer distances of extreme temperatures (minimum temperature in the coldest month and mean temperature in the warmest month). There was a significant decrease in growth in P. devoniana when the transfer exceeded 650 m of upward altitudinal shift or a reduction of 1.5 degrees C with transfer to colder sites. There was also a decrease of growth in P. pseudostrobus when transfer exceeded 400 m of upward altitudinal shift or 1.5 degrees C, with a significant decrease in survivorship. Pinus leiophylla, however, exhibited similar growth at all altitudes tested, probably due to phenotypic plasticity. Although further research is required with field tests using commercial spacing and trees of older ages, the results suggest that an assisted upwards migration of 300 m in altitude, in order to approach a realignment of the populations to the climate projected for the decade centered around the year 2030, appears to be a viable strategy with which to accommodate the effects of climate change

Mexican conifers differ in their capacity to face climate change

International audienceThe recent massive dieback of forest trees due to drought stress makes assessment of the variability of physiological traits that might be critical for predicting forest response and adaptation to climate change even more urgent. We investigated xylem vulnerability to cavitation and xylem specific hydraulic conductivity in seven species of three principal conifer genera (Juniperus monticola, Juniperus deppeana, Juniperus flaccida, Pinus pseudostrobus, Pinus leiophylla, Pinus devoniana, and the endangered Picea chihuahuana) of the Mexican mountains in order to identify the species most vulnerable to future warmer and drier climates. Hydraulic traits were examined using the in situ flow centrifuge technique (Cavitron) on branches collected from adult trees of natural populations and seedlings growing in a common garden. We found evidence of significant differences in xylem safety between genera (P 50 : pressure inducing 50% loss of hydraulic conductance): the three juniper species exhibited low P 50 values (ranging from-9.9 to-10.4 MPa), relative to the much more vulnerable pine and spruce species (P 50 ranging between-2.9 to-3.3 MPa). Our findings also revealed no variation in P 50 between adult trees assessed in the field and seedlings growing in a common garden. We therefore propose that if, as projected, climate change makes their natural habitats much warmer and drier, populations of Mexican pines and the studied spruce will be likely to decline severely as a result of drought-stress induced cavitation, while the juniper species will survive

Climate based seed zones for Mexico: spatial grids to guide reforestation under observed and projected climate change

This database entry provides climate-based seed zone system for Mexico to address climate change observed over the last 30 years and projected climate change for the 2050s. The database corresponds to a journal publication by Castellanos-Acuña et al. (2018), available at https://doi.org/10.1007/s11056-017-9620-6. This seed zone classification is based on bands of two climate variables that have often been shown to drive genetic adaptation of tree species: mean coldest month temperature (MCMT), and an aridity index (AHM). MCMT was divided into ten bands of 3°C intervals, with the limits of these bands being, temperatures below <2°C, 2-5°, 5-8°, 8-11°, 11-14°, 14-17°, 17-20°, 20-23°, 23-26°, >26°C. AHM was divided into seven bands with intervals that are approximately equal width under a log-transformation: <20, 20-30, 30-45, 45-65, 65-95, 95-140, and >140 °C/mm. The gridded files provided in this database entry, the classes are coded as integer numbers, with the last digit representing the AHM class (1-7) and the first or first and second digit representing the MCMT class (1-10)