Nanoprecipitated catestatin released from pharmacologically active microcarriers (PAMs) exerts pro-survival effects on MSC.

Catestatin (CST), a fragment of Chromogranin-A, exerts angiogenic, arteriogenic, vasculogenic and cardioprotective effects. CST is a very promising agent for revascularization purposes, in "NOOPTION" patients. However, peptides have a very short half-life after administration and must be conveniently protected. Fibronectin-coated pharmacologically active microcarriers (FN-PAM), are biodegradable and biocompatible polymeric microspheres that can convey mesenchymal stem cell (MSCs) and therapeutic proteins delivered in a prolonged manner. In this study, we first evaluated whether a small peptide such as CST could be nanoprecipitated and incorporated within FN-PAMs. Subsequently, whether CST may be released in a prolonged manner by functionalized FN-PAMs (FN-PAM-CST). Finally, we assessed the effect of CST released by FN-PAM-CST on the survival of MSCs under stress conditions of hypoxia-reoxygenation. An experimental design, modifying three key parameters (ionic strength, mixing and centrifugation time) of protein nanoprecipitation, was used to define the optimum condition for CST. An optimal nanoprecipitation yield of 76% was obtained allowing encapsulation of solid CST within FN-PAM-CST, which released CST in a prolonged manner. In vitro, MSCs adhered to FN-PAMs, and the controlled release of CST from FN-PAM-CST greatly limited hypoxic MSC-death and enhanced MSC-survival in post-hypoxic environment. These results suggest that FN-PAM-CST are promising tools for cell-therapy.

Susceptibility to acidification of groundwater-dependent wetlands affected by water level declines, and potential risk to an early-breeding amphibian species.

Eggs of the Western spadefoot toad (Pelobates cultripes) reached a 100% mortality in all 29 clutches deposited at a pH below 5.0 in a temporary pond of the Doñana National Park (SW Spain) throughout the wet season of 2006-2007. A similar trend was detected in a neighbouring pond. The proximity of these two ponds to a groundwater pumping area (<1.5km), prompted us to elucidate the possible links between the reduction in pond hydroperiod over past decades (1989-2008) and the decrease of groundwater pH-buffering capacity. The average hydroperiod had decreased by 4months since 1998-99 in the pond where the extensive egg mortality had occurred. The total alkalinity, and the Mg(2+)concentration had also significantly declined in the shallow water-table since 1998-99, from an average of 8.56 to 0.32meql(-1), and of 3.57 to 1.15meql(-1), respectively. This decline of the shallow groundwater buffering capacity could turn this pond more susceptible to the inorganic acidity associated with pyrite oxidation as the sediment S content was often above 0.03%. The initial ratio of S/Ca+Mg in the summer dry sediment was a good predictor of pore-water pH on re-wetting after desiccation (r(2)=0.802, p<0.01). Therefore, this ratio can give some anticipation to mitigate the impact of acidity on toad hatching before these temporary ponds are reflooded on the next wet season. Our results suggest that the long-term damage to pond water levels can trigger a potential risk of soil acidification in the presence of iron-sulphide minerals.

Topiramate as concomitant antiepileptic treatment; an isolated perioperative hypofibrinogenaemia.

A description of a case is presented of an isolated hypofibrinogenaemia acquired in relation to taking topiramate used as concomitant treatment of a drug resistant epilepsy. The hypofibrinogenaemia developed in the course of a month after the introduction of the drug, and was diagnosed in the perioperative period.

[The 2013 Seville Consensus Document on alternatives to allogenic blood transfusion. An update on the Seville Document]. / 2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Actualización del Documento Sevilla.

Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: « Does this particular AABT reduce the transfusion rate or not?¼ All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology.

[The 2013 Seville Consensus Document on alternatives to allogenic blood transfusion. An update on the Seville Document]. / 2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Actualización del Documento Sevilla.

Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: "Does this particular AABT reduce the transfusion rate or not?" All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology.

[Assessment strategies of the impact of healing touch in nursing care]. / Strategie d'evaluation de l'impact du toucher dans les soins infirmiers.

New care methods have emerged in the last few years. Healing Touch is relaxing and as such, helps prepare the patient for the medical act, the pain of which he may often feel anxious about As they foster confidence between the patient and the medical practitioner, such practices create better conditions for the medical care act to be performed. Even if there is no doubt about its impact on the patient, the effect of Healing Touch has never been scientifically assessed, and the only available references are rather scarce. This is the reason why we wished to assess the impact of this care in a number of clinical situations through a randomised clinical experiment. The object of this paper is to assert the efficacy of such care on the patient, especially on pain relief and the decrease of anxiety. To this end, authenticated assessment scales were used, such as the visual analog pain scale or Spielberg's test anxiety inventory. A prospective multicentre randomised study was carried out to create a control group to be compared to the group treated with Healing Touch. Only willing patients who were prescribed healing touch were included in the experiment. Patients with cognitive problems - be they temporary (linked to a temporary clinical conditions) or not - or those suffering from some disabilities preventing them from using assessment scales and questionnaires are excluded. The recruitment of a 784-patient panel was needed to set out the 8 situations in which a Healing Touch indication may be effective.

Helminth communities of the exotic introduced turtle, Trachemys scripta elegans in southwestern Spain: Transmission from native turtles.

We report the prevalence and diversity of helminth parasites found in native turtles Mauremys leprosa and Emys orbicularis from three localities in southwestern Spain and we describe the helminth communities of exotic turtles Trachemys scripta elegans coexisting in the wild with both native turtle species. Five nematodes species were identified, of which Serpinema microcephalus was the only species common between two localities, although infection parameters were different between them. This is the first report of cross transmission of S. microcephalus and Falcaustra donanaensis from native to exotic turtles and the first report of genus Physaloptera in turtles of the Palearctic Region. Continuous releasing of exotic pet turtles in wildlife ecosystems increases the risk of parasite introductions and, consequently, potential transmission to native species, and highlights the impending need for regulation of pet turtle trade in Europe.

Salmonella in free-living exotic and native turtles and in pet exotic turtles from SW Spain.

We screened 78 native and 94 exotic turtles from natural ponds and 39 exotic pet turtles for presence of Salmonella, resulting with infection rates of 6.61%, 6.4%, and 5.1%, respectively. Concurrent shedding of multiple serotypes of the bacteria was only detected in one pet turtle. Eleven isolates were obtained in free-living turtles, including serotypes commonly found in reptiles and also the serotype Typhimurium, which is commonly related to human infections. In pet turtles, the five serotypes isolated were different to those isolated in free-living turtles and had been reported to cause reptile-associated salmonellosis in humans. These results confirm the risk of transmission of Salmonella from free-living and pet turtles to humans, demanding the necessity of regulation of pet turtle trade in Europe.

PCB, DDT, arsenic, and heavy metal (Cd, Cu, Pb, and Zn) concentrations in chameleon (Chamaeleo chamaeleon) eggs from Southwest Spain.

This work presents the concentrations of twenty PCB congeners, p,p'-DDT, and its two main metabolites, p,p'-DDE, p,p'-TDE, As, Cd, Cu, Pb, and Zn found in common chameleon eggs from nine different nests located in Southwest Spain. Of the heavy metals and arsenic, Zn and Cu exhibited the highest concentrations in egg contents (ranging from 10100 to 12950 and from 567 to 706 ng g(-1) wet weight basis [w.w.], respectively) and eggshells (ranging from 5605 to 13290 ng g(-1)w.w. for Zn and from 1487 to 4361 ng g(-1)w.w. for Cu). Total PCB concentrations in egg contents ranged from 32 to 52 ng g(-1)w.w. and were higher than total dichlorodiphenylethanes concentrations (ranging from 0.67 to 1.9 ng g(-1)w.w., calculated as the sum of p,p'-DDT plus p,p'-DDE and p,p'-TDE). Comparison of the data from the present study with the data from a study conducted in 1997 revealed a large decrease in Pb concentration and a twofold increase in PCB concentrations. Taking into account all the pollutants investigated, the contamination level found in common chameleon eggs from Southwest Spain was generally lower than has been reported in the literature for eggs of different reptile species. However, it should be borne in mind that most of the data found in the literature refer to highly polluted areas.

Salmonella in free living terrestrial and aquatic turtles.

Detection of Salmonella in pet turtles has been the focus of extensive research, but its incidence in free living turtles is not well known. The aim of this study was to evaluate the incidence of Salmonella in terrestrial and aquatic species of chelonians inhabiting a National Park in southwestern Spain. Individuals of the terrestrial tortoise Testudo graeca (n = 16) and the aquatic turtles Emys orbicularis (n = 26) and Mauremys leprosa (n = 50) were investigated. Maximum incidence of Salmonella was recorded in the terrestrial species (100%). In contrast, the incidence of infected animals was low in the aquatic species, 12% in M. leprosa and 15.4% in E. orbicularis. Five serotypes of Salmonella belonging to subspecies enterica (I) and salamae (II) were identified. All serotypes were found in the terrestrial species, and three in the aquatic ones, suggesting that wild terrestrial chelonians are important reservoirs of Salmonella in our study area. Cloacal transmission during mating is the most probable mode of transmission among individuals.

Hematology and clinical chemistry in dystocic and healthy post-reproductive female chameleons.

Prevalence of egg-laying disorders and hematology and blood chemical parameters were analyzed in free-ranging common chameleons (Chamaeleo chamaeleon) from southern Spain. During four reproductive seasons oviposition failures occurred only during dry years. Egg binding appeared to be an important cause of mortality. Oviductal eggs of dystocic females were longer and wider than those of females with normal oviposition. Blood cell counts, white blood cell differentials, hematocrit, and concentration of hemoglobin, total plasma protein, glucose, uric acid, aspartate aminotransferase, and creatinine phosphokinase in blood were determined for eight apparently healthy post-reproductive females and considered as reference values. These chameleons differed from other reptiles in high concentrations of glucose in blood, averaging 362 mg/dl, and in high numbers of heterophils. Females with dystocia differed from reference values in an increase in monocytes and in the high concentrations of aspartate aminotransferase probably associated with tissue trauma.

The attraction of topographical technique.

The author argues that although the topographical model is useful for understanding certain psychological phenomena, its technical applications pose certain problems. The model's inherent tendency to bypass the analysand's ego capacities and mix his or her associations with the analyst's own make it less than adequate. There has never been a rapid evolution of psychoanalytic technique, and topographical and structural concepts have been applied in an unclear way. It is inaccurate to think that making the unconscious conscious is mostly characteristic of topographical technique, for the structural approach is a more comprehensive method for attaining this goal. The difficulties in transcending topographical technique seem to be related to certain historical inertias and irrational factors that make it especially attractive. Among these are the appeal of its simplicity, the gratification of epistemophilic and narcissistic tendencies, and the propitious ground for the analyst's projections that is provided by interpretations. The role of suggestion in topographical technique, its therapeutic effectiveness and its syntonicity are discussed and two brief clinical vignettes are presented. The author concludes that it is mainly because of its magnetic regressive features that this technique has not been superseded by the structural approach.

[Neurobiology and psychoanalysis]. / Neurobiología y psicoanálisis.

Psychiatry obtains benefits from integrating the findings of neurobiology with the knowledge of depth psychology. In this paper, relevant recent research in neuroscience is reviewed from the perspective of psychoanalytic theory. Psychoanalytic experience and hypotheses have stimulated numerous experiments and research projects in neurobiology. Neurobiological findings have brought forward the neurophysiological substrate of clinical phenomena described by psychoanalysts, assisting in the specification of some theoretical notions, and making us modify others that were considered as already established. From a neurobiological viewpoint, some studies considered pertinent are commented upon on associations, apperception and unconscious perception, memory, and hemispheric specialisation and its psychological corollary.

Mitochondrial DNA haplotyping of Testudo graeca on both continental sides of the Straits of Gibraltar.

Testudo graeca is an endangered species of tortoise that inhabits Mediterranean areas of Africa, Asia, and Europe. Western populations are found on both sides of the Straits of Gibraltar. The effects of geographical isolation on genetic divergence were assessed by the sequence analysis of two mitochondrial DNA regions of the 12S rRNA and cytochrome b genes. Four different haplotypes were identified. A single haplotype was shared by all Spanish and some east Moroccan specimens. Two haplotypes were unique to the west Moroccan T. graeca populations and allowed the clear discrimination between individual specimens found west of the Moulouya River. Phylogenetic analysis based on the estimation of nucleotide sequence distances of the haplotypes suggests an African origin for the Spanish populations and a subspecies status for the west Moroccan pool.

Acting in revisited.

Acting in' is a term that has not met with much success in the psychoanalytic literature. The literature has focused mainly on quite dramatic forms of acting during sessions rather than on subtler and more common forms of intraclinical acting. Zeligs (1957) gave the term 'acting in' a surprisingly restrictive denotation. A redefinition is suggested, characterising this concept with three features: it is a non-verbal action involving the somatic musculature; it has conscious or unconscious meaning conducive to the exploration of dynamics; and it takes place in the session. Inclusive and exclusive criteria are reviewed for the clarification of this important concept. 'Acting in' is not considered synonymous with 'acting out in the transference'. Unlike 'acting out', 'acting in' can be predominantly of an extratransferential or a genetic nature. Enactments usually include episodes of acting in. What is considered most typical of acting in is the fact of its direct observability and consequent demonstrability to the patient. It is contended that instances of acting in represent a nodal point where the clinical surface becomes especially workable. Clinical vignettes are provided. It is suggested that in order to include acting in in the mainstream of resistance analysis, interpretive assistance should be given to analysands to translate these episodes consistently into verbal understanding.