Unravelling the drivers of variability in body condition and reproduction of the European sardine along the Atlantic-Mediterranean transition.

Body condition and reproduction data are broadly used to assess the health status of fish because of its implications for recruitment and ecosystem structure. Sardina pilchardus is a small pelagic distributed throughout both Mediterranean and Eastern Atlantic. Seasonal trend analysis of energy storage and reproduction was carried out in sardines from two areas along the Atlantic-Mediterranean transition: Southern Portugal-Gulf of Cádiz (POR-GC) (Atlantic Ocean) and Alboran Sea (Alb) (Mediterranean Sea) from 2019 to 2021. Energetic condition was estimated using tissue and mesenteric fat content, hepatosomatic index (HSI), and the relative condition factor (Kn). Sex, reproductive developmental stage, and gonadosomatic index (GSI) were also obtained. In addition, the oceanographic and meteorological characteristics of the areas were analysed. Results showed that seasonal Kn, tissue and mesenteric fat content, and HSI values of POR-GC specimens exceeded Alb's with summer arrival, period in which sardine acquires reserves to allocate them to reproduction. These differences could be associated to greater productivity of the former area mainly due to rivers discharges and trade winds intensification during summer (from July to September). Furthermore, gonad maturation of POR-GC stock occurred before the Alb. However, no spawning capable individuals were identified until February in POR-GC. In contrast, in Alb it was observed a remarkable fraction of spawning capable and active spawner individuals in October. We hypothesized the migration of mature individuals from POR-GC to the spawning areas located in the Alb. Seasonal genetic population studies are required to untangle it and reliably evaluate the environmental effect on the stocks.

Haemoperitoneum caused by spontaneous haemorrhage of the greater omentum: a rare complication occurring in a patient with severe SARS-CoV-2 infection.

Haemorrhagic events in patients diagnosed with coronavirus disease 19 (COVID-19) are infrequent but reports have accumulated since the beginning of the pandemic. The pathophysiological mechanisms are unclear, but endothelial damage secondary to systemic vasculitis and the onset of anticoagulation therapy, both associated with severe forms of the infection, have been proposed to play a role in the development of this complication. We present the case of a 66-year-old man who presented to the emergency department with acute abdominal pain, hypotension and decrease of consciousness, a few hours after being discharged after a prolonged hospitalisation of 26 days due to severe SARS-CoV-2 pneumonia. Initial resuscitation was carried out and, when haemodynamic stabilisation was achieved, a computed tomography scan showed contrast extravasation at the topography of the greater omentum. Urgent angiography revealing contrast extravasation originating in a pseudoaneurysm dependent on the right gastroepiploic artery was done, and embolisation with cyanoacrylate was performed at the bleeding point. Owing to persistent haemodynamic instability despite angiographic treatment and aggressive resuscitation, emergency laparotomy was indicated. Partial resection of the greater omentum was carried out and histopathologic examination showed a 5cm×4cm×6cm haematoma, with no signs of abnormalities such as aneurysm or malignancy. No rebleeding occurred. Spontaneous haemorrhage of the greater omentum associated with haemoperitoneum is a serious condition, with reported mortality rates exceeding 30%. This case highlights a very infrequent but potentially life-threatening complication in a patient diagnosed with COVID-19 on anticoagulation therapy.

Ethics and empathy: The relationship between moral reasoning, ethical sensitivity and empathy in medical students. / Ética y empatía: relación entre razonamiento moral, sensibilidad ética y empatía en estudiantes de medicina.

High-quality clinical practice includes not only improving clinicians' expertise in scientific and technical aspects but also managing values, ethical sensitivity and skills for assessing and dealing with ethical conflicts. The reviewed literature suggests the presence of an "ethical erosion", according to which ethical competence and empathy decrease or do not progress during medical training. The aim of this study was to determine the relationship between ethics (moral reasoning and ethical sensitivity) and empathy in a group of medical students and to determine the relationship with other variables such as academic year and sex. MATERIAL AND METHOD: A cross-sectional observational study was conducted with 193 medical students from different academic years, who were administered a sociodemographic questionnaire, the Rest sociomoral dilemma test, clinical vignettes to measure ethical sensitivity (Problem Identification Test [PIT]) and a cognitive and emotional empathy test (test de empatía cognitiva y afectiva, TECA). RESULTS: We found a direct and significant relationship between moral development, ethical sensitivity and greater empathy. We detected an increase in moral reasoning and ethical sensitivity among first and third-year students, with no increase between the third year and later academic years. There were no significant differences between these variables and sex. CONCLUSIONS: This study found a correlation between moral reasoning, ethical sensitivity and empathy and a lack of progression of the first 2 variables in the last years of the medical degree.

MC1R polymorphism associated with plumage color variations in Coturnix chinensis.

The melanocortin 1 receptor (MC1R) gene was investigated as a candidate for plumage variations in Chinese painted quail, Coturnix chinensis. Four silent and two missense nucleotide polymorphisms were identified. The correspondent amino acid changes, p.Glu92Lys and p.Pro292Leu, were found in Blue Face and Red Breasted animals respectively. Blue Face is a melanic phenotype similar to the co-dominant Extended Brown of Japanese quail, and both share the p.Glu92Lys mutation. The association of p.Pro292Leu with the recessive Red Breasted was confirmed in 23 animals from an experimental F2 cross.

[Latest developments in ataxias]. / Novedades en ataxias.

This article reviews the advances made in the field of ataxias over the past four years. It concludes that there is no single spectacular finding like those that have taken place in the last 25 years and they can all be attributed to the remarkable evolution of genetics and neuroimaging. Nevertheless, algorithms have been perfected that allow a more rational use of the previous techniques to reach a correct diagnosis and possible treatment. With regard to the treatments proposed to alleviate the symptoms of ataxias, there is no unquestionable evidence leading us to think that the symptoms can be reverted with the means currently available, except for a few treatable ataxias, which were already known before that time.

TITLE: Novedades en ataxias.Se pasa revista a los avances acaecidos en el campo de las ataxias durante estos ultimos cuatro años, concluyendo que no hay un unico hallazgo espectacular como los acaecidos en los ultimos 25 años y se pueden atribuir todos ellos a la evolucion de la genetica y de la neuroimagen. Sin embargo, se han puesto a punto algoritmos que permiten usar de forma mas racional las tecnicas anteriores para alcanzar un correcto diagnostico y un eventual tratamiento. Respecto a los tratamientos propuestos para el alivio sintomatico de las ataxias, no hay evidencias incuestionables que hagan pensar que puedan revertirse los sintomas con los medios actuales a nuestra disposicion, a excepcion de algunas ataxias tratables, conocidas ya desde antes de esta fecha.

Deep brain stimulation for patients with Parkinson's disease: Effect on caregiver burden. / Influencia de la estimulación cerebral profunda en la carga de cuidadores de pacientes con enfermedad de Parkinson.

INTRODUCTION: Our aim is to assess the burden on caregivers of patients with Parkinson's disease treated with deep brain stimulation (DBS) compared to those caring for patients at advanced stages and undergoing other treatments. We have also assessed the variables associated with presence of caregiver overload. MATERIAL AND METHODS: We included consecutive patients with Parkinson's disease treated with DBS. Our control group included patients in advanced stages of Parkinson's disease undergoing other treatments. Patients were assessed with the following scales: UPDRS-II, UPDRS-III, UPDRS-IV, Hoehn and Yahr, Schwab & England, Barthel, PDQ-39, MoCA, Apathy Evaluation Scale, HADS, and the abbreviated QUIP. Caregiver burden was evaluated with the Zarit caregiver burden interview and their moods were assessed with the HADS scale. RESULTS: We included 11 patients treated with DBS and 11 with other treatments. For patients treated with DBS, we observed a better quality of life according to the PDQ-39 questionnaire (P=.028), and a lower score on the HADS anxiety subscale (P=.010). Caregiver overload was observed in 54.5% of the caregivers of patients in both groups (P=1.000); Zarit scores were similar (P=.835). Caregiver overload was associated with higher scores on the caregiver's Apathy Evaluation Scale (P=.048) and on the HADS anxiety subscale (P=.006). CONCLUSION: According to our results, treatment with DBS is not associated with lower caregiver burden. Apathy in patients and anxiety in caregivers are factors associated with the appearance of overload.

Anterior cervical arthrodesis using a vertebral body autograft.

OBJECTIVE: To assess fusion rates and functional outcomes in patients undergoing anterior cervical discectomy and fusion by using a vertebral body autograft for interbody filling and anterior cervical plate fixation. MATERIAL AND METHODS: The study included a total of 102 patients, 54 men and 48 women, who underwent surgery between 2006 and 2010 patients with degenerative disease, cervical disc herniation and radiculopathy, and who had failed standard conservative treatment (3 months). The study was limited to patients with fusion levels 1-3. The mean patient follow-up was 44 (24-96) months. Their mean age was 48.8 years. RESULTS: The clinical variables analyzed were: duration of symptoms (> 12 months), smoking (31% smokers), employment status (76% active), average days of hospitalization (2.2 days), operation time (62 min), etiology (100%, degenerative disease), notable comorbidities (28%), fusion levels (42% 1, 49% 2, 9% 3), symptoms (radiculalgia or axial pain). The functional variables analyzed (score pre-and post-operative scores) were: VAS (8.6-1.32), Neck Disability Index (37.7-5.8), and Odom criteria (76% reflected excellent results after surgery). Finally, radiological variables were also analyzed: anterior reactive osteophytosis (16%), significant collapse (0%), and fusion rate (98%). There were 4 cases of acute postoperative complications, and 4 chronic, none of them were related to the surgical technique. DISCUSSION: The use of autograft bone of the vertebral body itself reduces comorbidities associated with the use of the iliac crest of the patient. Our results using the technique described are comparable to those in the literature, with a fusion rate of 98% and a mean of 62 min duration of the procedure.

miRNA let-7e targeting MMP9 is involved in adipose-derived stem cell differentiation toward epithelia.

miRNA let-7e is involved in stem cell differentiation, and metalloproteinases are among its potential target genes. We hypothesized that the inhibitory action of let-7e on regulation of MMP9 expression could represent a crucial mechanism during differentiation of adipose-derived stem cells (ASCs). ASCs were differentiated with all-trans retinoic acid (ATRA) to promote differentiation, and the effect of let-7 silencing during differentiation was tested. Results indicate that ASCs cultured with ATRA differentiated into cells of the epithelial lineage. We found that ASCs cultured with ATRA or transfected with miRNA let-7e expressed epithelial markers such as cytokeratin-18 and early renal organogenesis markers such as Pax2, Wt1, Wnt4 and megalin. Conversely, the specific knockdown of miRNA let-7e in ASCs significantly decreased the expression of these genes, indicating its vital role during the differentiation process. Using luciferase reporter assays, we also showed that MMP9 is a direct target of miRNA let-7e. Thus, our results suggest that miRNA let-7e acts as a matrix metalloproteinase-9 (MMP9) inhibitor and differentiation inducer in ASCs.

Influence of pollen level on hospitalizations for asthma.

The effect of pollen level on asthma hospitalizations is still under debate. The aim of this study was to analyze hospital admissions due to asthma and its relation with environmental pollen and meteorological factors. During 13 years, we included every patient admitted with asthma as primary or secondary diagnosis. For this purpose, we used a case-crossover analysis to compare pollen concentrations at the time of admission with values of the same variables 2 to 6 days before admission. We included 6,687 hospital admissions. High maximum temperature and low humidity were associated with lower risk of asthma admissions. High mean pollen levels exerted a moderate effect and high maximum pollen levels led to a dramatic increase of hospital admissions due to asthma, especially among females. In conclusion, environmental pollen level increases the risk of asthma hospital admissions.

Telomere length is a prognostic factor for overall survival in colorectal cancer.

AIM: The aim of this study was to determine whether telomere length is an independent prognostic factor for the prevention and survival of colorectal cancer. METHOD: Terminal restriction fragment (TRF) length was determined by Southern blot in tumours and paired normal tissue samples from 147 patients with sporadic colorectal cancer who had undergone surgery. The TRF length ratio (TRFLR) was determined as the ratio between the length of the patient's tumour and normal tissue.The classification and regression tree technique was used to determine optimal cut-off values (≤ 1 or > 1). RESULTS: Mean TRF length was 6.79 Kbp (1.19-13.99) in tumour tissue and 7.81 Kbp (3.63-15.70) in normal mucosa (P < 0.001). Mean TRFLR was 0.88. Telomere length and telomere length ratio were not correlated with any clinicopathological factors. In univariate analysis, overall survival was related to N stage (lymph node +/-; P = 0.002), TNM classification (P = 0.019) and TRFLR (≤ 1 or > 1; P = 0.014). In multivariate analysis, overall survival was significantly associated with TRFLR and N stage. Colorectal cancer patients with TRFLR ≤ 1 and negative lymph node involvement had a higher overall survival rate. CONCLUSION: Telomere length ratio is an independent prognostic factor for survival in colorectal cancer patients, and the telomere lengths in the normal and tumour mucosa of the same patient present with parallel behaviour.

Variability of the melanocortin 1 receptor (MC1R) gene explains the segregation of the bronze locus in turkey (Meleagris gallopavo).

By sequencing the full coding region of the turkey melanocortin 1 receptor (MC1R) gene, we have found 4 mutations (c.96G > A, c.364A > T, c.450C > T, and c.887C > T) that are organized in 5 different haplotypes (MC1R*1 to MC1R*5). These haplotypes correlate perfectly with the 3 alleles of the bronze locus (i.e., B, b(+), and b(1)). We suggest that the dominant black phenotype, associated with the B allele, results from the constitutive activation of the receptor, an effect that might be mediated by the missense mutation c.364A > T (p.Ile122Phe). Moreover, we propose that the recessive black-winged bronze phenotype (linked to b(1)) might be produced by 2 deleterious mutations of MC1R (c.96G > A and c.887C > T). This is an unexpected finding because in mammals, MC1R deleterious polymorphisms are usually related with either red or lighter fur colors.

Trends in hospital admissions due to asthma in north-west Spain from 1995 to 2007.

PURPOSE: Asthma is the most common chronic disease in childhood. Hospital admissions in the child population appear to be reducing in different populations. METHODS: We have retrospectively analysed admissions into hospitals in our region due to asthma in a 0 to 14 years population, between the years 1995 and 2007. The age, sex, date of admission, and length of hospital stay of each patient was recorded and analysed. RESULTS: A total of 9106 admissions (64% males) have been included. A gradual trend towards a reduction in admissions is observed during the period analysed. There were more admissions in 1996, with 2.91 per thousand inhabitants, gradually reducing to 1.33 per thousand in 2007. There were more admissions in May and between September and December, being less frequent in July and August. The mean stay in this period was 4.18 days, which was stable during the whole period of the study. Older children tended to have a longer hospital stay. CONCLUSIONS: Our study shows that admissions due to childhood asthma tend to be decreasing, particularly due to younger males, with no change in the length of hospital stay. Asthma exacerbations seemed to be associated with infections and exposure to allergens.

[In favour of early detection and moderate interventionism: to what extent is early stimulation effective?]. / A favor de la detección precoz e intervencionismo moderado: hasta qué punto es efectiva la estimulación temprana?

AIM: To review the bases and outcomes of early stimulation in the light of the results reported in the literature. DEVELOPMENT: We survey the papers that report results obtained from early stimulation in children at risk and in others with known dysfunctions, who were treated using diverse techniques with heterogeneous theoretical bases, programmes of intervention and application times and which range from the early stages of life (neonatal intensive care units) to the later stages of development. The main data taken into account were the meta-analyses. No data were found indicating permanent positive effects on the neurodevelopment of children to whom stimulation techniques were applied and, when short-term effects were reported, they were not detected in the medium or long term. CONCLUSIONS: Early stimulation techniques are politically correct, but are not effective enough to make their application recommendable as a valid preventive procedure. We suggest applying the treatments to children with known impairments in order to prevent the appearance of the self-fulfilling prophecy effect.

An evaluation of data quality in a network for surveillance of Mycobacterium tuberculosis resistance to antituberculosis drugs in Ile-de-France region-2001-2002.

We evaluated the French Azay-Mycobacteria network for surveillance of Mycobacterium tuberculosis drug resistance by matching data with those collected through the mandatory notification (MNTB). Sensitivity of Azay was 96% by capture-recapture analysis. Cases reported to MNTB were more often smear-positive than non-reported cases. Concordance of data collected for common cases was excellent for a majority of variables (k > 0.79), excepted for tuberculosis site (k = 0.52). These results suggest a good quality of the network.

Postencephalitic chronic granulomatous disease.

This report details the evolution of a case of herpes simplex encephalitis to chronic granuloma in a 13-year old female who, at the age of 8, suffered herpes simplex virus type 1 encephalitis. Eight months later, she developed an intracranial hypertension syndrome with the onset of a new lesion in the necrosed zone of her right temporal lobe, with no viral presence in the cerebrospinal fluid. The histologic characteristics were those of chronic granuloma with multinucleated giant cells and calcifications. Initially treated for neurosarcoidosis, the patient remained steroid-dependent for 4 years and the steroids could only be withdrawn by treatment with Infliximab. This type of evolutive pattern has probably been completely overlooked until now; it can only be accurately diagnosed by biopsy. It was initially mistaken for neurosarcoidosis.

[Effectiveness and safety of levetiracetam in 133 children with medication resistant epileptic seizures]. / Eficacia y tolerabilidad del levetiracetam en 133 niños con crisis epilépticas farmacorresistentes.

INTRODUCTION: Levetiracetam (LEV) is the latest drug approved in the European Union for use in polytherapy in children over 4 years of age with partial epileptic seizures that are resistant to other antiepileptic drugs. AIM. To report our experience of associating LEV in children with medication resistant epileptic seizures. PATIENTS AND METHODS: We conducted an open, observational, respective study involving 133 children with refractory epilepsies: 106 with focal seizures and 27 with other types of seizures. LEV was associated over a period of more than 6 months and we evaluated its repercussion on the frequency of the seizures and the side effects related to the drug. RESULTS: With average doses of LEV of 1,192 +/- 749 mg/day the frequency of the seizures was reduced by over 50% in 58.6% of cases and seizures were quelled in 15.8% of patients. Side effects were produced in 27.8% of cases, and were usually transient or tolerable; these effects led to withdrawal of LEV in only eight cases (6.02%). In 37 children (27.8%), their relatives noted an improvement in their social behaviour and cognitive abilities. CONCLUSIONS: a) LEV is an effective drug that is well tolerated in children with refractory epilepsy; b) Its effectiveness in different types of seizures indicates a broad therapeutic spectrum; and c) LEV can even condition favourable secondary effects, a circumstance that has been reported only exceptionally in the case of other antiepileptic drugs.