Plant carnivory beyond bogs: reliance on prey feeding in Drosophyllum lusitanicum (Drosophyllaceae) in dry Mediterranean heathland habitats.

Background and Aims: In a cost-benefit framework, plant carnivory is hypothesized to be an adaptation to nutrient-poor soils in sunny, wetland habitats. However, apparent exceptions to this cost-benefit model exist, although they have been rarely studied. One of these exceptions is the carnivorous subshrub Drosophyllum lusitanicum , which thrives in Mediterranean heathlands on dry sandstone soils and has relatively well-developed, xeromorphic roots. Here, the roles of leaf (carnivory) and root (soil) nutrient uptake in growth promotion of this particular species were assessed. Methods: In a greenhouse experiment, plants were fed with laboratory-reared fruit flies ( Drosophila virilis ) and received two concentrations of soil nutrients in a factorial design. Above-ground plant growth and final above- and below-ground dry biomass after 13 weeks were recorded. Nutrient uptake via roots was also evaluated, using stable nitrogen isotope analysis. Key Results: Insect feeding resulted in significantly higher growth and above- and below-ground biomass compared with soil fertilization. No additional benefits of fertilization were discernable when plants were insect-fed, indicating that roots were not efficient in nutrient absorption. Conclusions: The first evidence of strong reliance on insect prey feeding in a dry-soil carnivorous plant with well-developed roots is provided, suggesting that carnivory per se does not preclude persistence in dry habitats. Instead, the combination of carnivory and xeromorphic root features allows Drosophyllum to thrive on non-waterlogged soils. New evidence is added to recent research emphasizing the role of root systems of carnivorous plants in explaining their distribution, partly challenging the cost-benefit hypothesis.

Factors triggering medical consultation for symptoms of colorectal cancer and perceptions surrounding diagnosis.

This study aims to find out how the presenting symptoms of colorectal cancer are interpreted by those who get them, to identify the main triggering factors that lead someone with colorectal cancer symptoms to consult a doctor, and to describe how those affected perceive the process of being diagnosed with colorectal cancer. It is a qualitative study performed within the theoretical framework of symbolic interactionism and from a gender perspective. Grounded theory has been used for the analysis. Semi-structured interviews were conducted. Twelve individuals with colorectal cancer - seven men and five women - were interviewed. At first, both the men and women attributed their symptoms to trivial causes. Changes in symptoms or the persistence of symptoms trigger medical consultation. Close relatives, especially the closest female family members, can trigger medical consultation, particularly among men. The women said nothing to their families until they had already gone to the doctor. Knowledge about colorectal cancer could be a factor triggering medical consultation. The time between consulting the family doctor and seeing a specialist feels drawn out. Gender-related differences have been observed in respect to help-seeking in colorectal cancer. Health education programmes focusing on knowledge about cancer are needed.

The Reference Site Collaborative Network of the European Innovation Partnership on Active and Healthy Ageing.

Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) have been recognised by the European Commission in 2016 for their commitment to excellence in investing and scaling up innovative solutions for active and healthy ageing. The Reference Site Collaborative Network (RSCN) brings together the EIP on AHA Reference Sites awarded by the European Commission, and Candidate Reference Sites into a single forum. The overarching goals are to promote cooperation, share and transfer good practice and solutions in the development and scaling up of health and care strategies, policies and service delivery models, while at the same time supporting the action groups in their work. The RSCN aspires to be recognized by the EU Commission as the principal forum and authority representing all EIP on AHA Reference Sites. The RSCN will contribute to achieve the goals of the EIP on AHA by improving health and care outcomes for citizens across Europe, and the development of sustainable economic growth and the creation of jobs.

[Dietary behavior disorders: opinions and expectancies on prevention and treatment strategies from the perspective of the several social actors]. / Trastornos de la conducta alimentaria: opiniones y expectativas sobre estrategias de prevención y tratamiento desde la perspectiva de diferentes actores sociales.

AIMS: The prevalence increase of Eating Disorders in the last decades emphasizes the necessity to develop strategies from the public healthcare system which include the perspective of the principal implicated social actors. The present study aims to know their opinions and expectations regarding the prevention and treatment of Eating Disorders. METHODS: Realization of 5 focus groups (with relatives, adolescents, professionals from the health and educational sector, representatives from institutions and support groups) and 14 semi-structured interviews (with Eating Disorder patients and relatives) about strengths and weaknesses of actual prevention and treatment programs, expectations of change and suggestions for improvement. Analysis of contents and triangulation of results. RESULTS: The absence of resources and knowledge about Eating Disorders, the scarcity of transversal programs and insufficient coordination were named as the main weaknesses whereas interdisciplinary pilot programs were positively valued. As principal demands, major endowment of human and material resources, increased coverage of specialized services, promotion of specific training and improvement of coordination was asked for. Regarding prevention, preference toward an unspecific approach to the subject in order to hinder imitation between young people was highlighted. The care in Day Hospitals was considered one of the most appropriate treatment modalities for the characteristics of this disease being valued the potentially therapeutic effect of contact between Eating Disorder patients. The support network, the education field and the family were named as other important pillars in a multidisciplinary approach to the disease. There was also a demand for the development of combined programs. CONCLUSIONS: The discussion of different psychotherapeutic approaches, the role of support groups in the caring network as well as the post-hospital follow-up were identified as issues open to future research.

Ki-ras mutation modifies the protective effect of dietary monounsaturated fat and calcium on sporadic colorectal cancer.

The geographic differences in the incidence of colorectal cancer have been mostly attributed to variations in diet. The diversity of the Mediterranean diet and the heterogeneity of acquired genetic alterations in colorectal cancer sets the stage for investigating the possible association between dietary factors and mutations in tumor genes known to play a role in the pathogenesis of these neoplasms. With this purpose, we have studied the Ki-ras gene in 108 colorectal cancers using archival tissue and epidemiological data from our previous case-control study. Mutations in exon 1 of the Ki-ras gene were detected by a PCR-single strand conformation polymorphism approach. A polychotomous logistic regression model was used to assess the significance of observed differences between wild-type and mutated tumors with respect to population controls in the different categories of nutrient consumption. Multivariate density models were used to adjust the correlation between nutrients and total energy. Our studies show that high consumption of monounsaturated fats, mostly derived from olive oil, is associated with a statistically significant decrease in the risk of cancer with wild-type Ki-ras genotype but not of Ki-ras mutated cancers. Conversely, we find that high calcium intake is associated with a decreased risk of Ki-ras mutated tumors but not of wild-type tumors. Tumor genotyping can reveal epidemiological associations that are weak or unapparent when cases-control studies are not stratified by tumor genotype.

Diet and cancer risk: an overview of Spanish studies.

Diet has been identified as a risk factor for various cancers. The geographic distribution of cancer frequency within the European Economic Community shows how the Mediterranean area has the lowest incidence rates for most tumours associated with diet. The first studies on diet and cancer realized in this area are fairly recent and their results have been especially informative. This article endeavours to review Spanish epidemiological studies on diet and cancer, highlighting the most important findings on colorectal, stomach, bladder and breast cancer and the repeated observations of the protective effect of high vegetable consumption of different tumours.

[Diverticular disease. Our experience]. / La enfermedad diverticular. Nuestra experiencia.

The authors herein present their personal experience on the surgical treatment of complicated diverticular disease. The series consists of 243 patients seen between January 1974 and May 1994. One hundred and fifty nine (65.4%) were admitted in an elective and 84 (34.6%) in an emergency setting. Medical therapy was efficacious in resolving the clinical symptoms in 133. One hundred and ten pts. were treated surgically: 91 (82.7%) underwent a left hemicolectomy (one-step surgery), 13 (11.8%) the Hartmann's procedure and 6 (5.4%) a sigmoid resection. Between 1974 and 1980, when anastomoses were performed manually and an excluding colostomy was the procedure of choice, the reported rate of anastomotic dehiscence was 21%. With the technological break-through of mechanical staplers, that enabled the performance of colostomies "on demand" such rate decreased to 8% and finally to 2%, as reported during 1987-94. The operative mortality, between 1974-84, of those patients who underwent emergency surgery was 14% and decreased to 3% between 1985-94. The operative mortality of patients who underwent elective surgery between 1974-84 was 1.3% and decreased to 0% between 1985-1994. The authors underline the importance of respecting the surgical indications and the proper evaluation of pre-operative parameters aiming at a one-step surgery, that reduces both post-operative complications and recovery time.

[Knowledge, beliefs and attitudes of the female population towards cancer in Mallorca]. / Conocimientos, creencias y actitudes de la población femenina de Mallorca respecto al cáncer.

BACKGROUND: To analyze the knowledge of the facts on the part of the female population of Mallorca with regard to the causes of cancer, the beliefs regarding diagnosis and treatment and their attitude toward prevention. METHODS: A descriptive cross-section study of a random population sample (n = 124) of women within the 40-69 age range. The questionnaire includes socio-demographic variables, risk factors, early warning symptoms and beliefs regarding diagnosis and treatment and attitudes toward prevention. RESULTS: Cigarette smoking (92.7%; CI:88.1-97.3) and drinking alcoholic (85.7%; CI:79.4-92.0) are the most well-identified causes. Also the presence of a lump in the breast (92.6%; CI:87.9-97.2) and changes in a mole or wart on the skin (89.7%; CI:84.2-95.2%). The underestimate the role of the diet (44.4%; CI:35.1-53.8) and overestimate the environmental factors. The knowledge and use of self-examination procedures on the breast are associated directly with the degree of education (p < 0.05). Most believe that early diagnosis improves the prognosis (IC:94.2-99.5) and that treatment is beneficial (85.2%; CI:78.5-91.9). They consider surgery to be the most highly effective method, and in the event of any doubt they would first see their primary care physician (41.9%; CI:33.2-50.6). It is mainly older women having a low level of completed schooling who get their information regarding cancer above all from the television (43.5%; CI:34.8-52.3). Worthy of special mention is the very small impact of health care personal as a source of information (6.5%; CI:2.1-10.8). CONCLUSIONS: A major knowledge of the facts exists regarding the causes and warning signs, although some misconceptions do exist. In view of future prevention campaigns, educational measures addressed mainly to older women having a low level of completed schooling should be carried out.

[Radiolabeling of a new agent for the study of colorectal tumors]. / Radiomarcaje de un nuevo agente para el estudio de tumores colorrectales.

A new Monoclonal Antibody (AcMo) ior-C5, highly specific for the most part of colorectal adenocarcinomas has been developed. The AcMo was labeled with 99mTc by the Schwarz's direct method using molar ratios MAb: reductant of 1:1,000 and 1:2,000. The first molar ratio was the most adequate for the preparation of the radiopharmaceutical. A labeling yield greater than 95% was obtained. Several <> assays were carried out in order to evaluate the stability of the preparation, whose results reflected the presence of the stable complex 99mTc-IgG. The biodistribution patterns for both preparations were similar. The excreting organs behaved like normal. Nevertheless, a greater renal excretion was observed for the preparation of the molar ratio of 1:2.000, which could be due to the presence of low affinity sites observed in this preparation. They are vulnerable to the trans-chelation of the 99mTc toward cysteine or glutathione present in plasma and tissues.

[Diaphragmatic hernia after transhiatal esophagectomy]. / Hernia diafragmática tras esofagectomía transhiatal.

Iatrogenic herniation of abdominal contents after transhiatal esophagectomy for the treatment of esophageal cancer is a rare complication. Its appearance in the early postoperative period is usually accompanied by acute respiratory insufficiency; herniation may develop without symptoms and the patient may have to be readmitted with signs of perforation or strangulation of the intestinal loops in the chest cavity. We report the case of a patient in this situation who developed a clinical picture of acute respiratory insufficiency and who required several exploratory procedures (fiberoptic bronchoscopy and echography) before a firm diagnosis could be made. Early diagnosis and emergency treatment reduces complications and increases survival. A lower incidence of iatrogenic herniation of abdominal contents depends on correct closure of the diaphragm. We review correct surgical treatment to decrease the frequency of this complication.

[Hormonal response and two special techniques of postoperative analgesia in pediatric surgery]. / Respuesta hormonal con dos técnicas distintas de analgesia postoperatoria en cirugía pediátrica.

AIMS: We studied neuroendocrine response in the postoperative pain relief in pediatric patients treated with two analgesic techniques (conventional intravenous analgesia and patient controlled analgesia). MATERIAL AND METHODS: A double blind study was made in 30 patients, 6-14 year-old children, under total intravenous anesthesia for programmed surgery. An intravenous analgesia dose of 0.5 mg/Kg was given 10 minutes before operation was finished. Postoperative analgesia was achieved by two techniques: A. Patient controlled analgesia (PCA), and B. Conventional intravenous analgesia every 6 hours. Hormones measurements were made (catecholamines, cortisol, ACTH and beta-endorphin), hemodynamic monitoring (blood pressure and heart rate), and pain measurement (Hannallah's score) in both pre and postoperative times (1, 6 and 24 hours after operation). RESULTS: Pain score was low and without significant differences in both groups (p > 0.05). beta-endorphin level decreased in both groups, and a cortisol and catecholamine level increase was noticed at 6 hours after operation; these changes were less significant in PCA group (p < 0.001). ACTH level did not change significantly in both groups. Hemodynamic monitoring measurements were not significantly different. CONCLUSIONS: Both analgesic techniques were appropriate to postoperative pain relief in pediatric patients. Low pain score shows better conditions to attend these patients. We suggest PCA technique is better to treat postoperative stress response following pediatric surgery.

[Secretory otitis media of unconventional course]. / Otitis serosa, una evolución inusual.

Case report of a secretory otitia of sluggish unfolding that put forward serious diagnostic difficulties resulting, at last, to be an otic tuberculousis. Review and discussion on bibliography on otic tuberculousis, its presentation forms, diagnosis difficulties, complications and management.

[Paraneoplastic syndrome as a manifestation of cancer of the hypopharynx]. / El síndrome paraneoplásico como manifestación de un cáncer de hipofaringe.

A 45-year-old male patient had a squamous-cell carcinoma of the laryngopharynx (T1pN2bM0). The first clinical manifestation was polyarthritis of large and small joints and a skin rash. The symptoms were identified as paraneoplastic syndrome associated with squamous-cell carcinoma of the laryngopharynx. After treatment (surgery + radiotherapy), the articular symptoms, initially treated with conventional therapy for rheumatoid arthritis, disappeared. Paraneoplastic syndrome can be defined as a set of physiological signs and symptoms of malignant origin that occur remote from the tumor. Squamous-cell carcinoma is the most frequent malignant tumor of the head and neck that produces paraneoplastic syndrome. We reviewed the most common features associated with malignant tumors and the pathogenic mechanisms involved. We conclude that paraneoplastic disorders can be markers of treatment response and predictors of recurrence.

[Leiomyosarcoma of the larynx]. / Leiomiosarcoma de localización laríngea.

A patient with leiomyosarcoma of the larynx met diagnostic criteria for radiation-induced malignancy. In a review of the literature, only 27 leiomyosarcomas of the larynx were found, none radiation-induced. The histological features and diagnosis and treatment are analyzed.

[Otorhinolaryngological manifestations of varicella-zoster virus]. / Manifestaciones otorrinolaringológicas del virus varicela-zoster.

Otological complications of varicella-zoster syndrome (Ramsay Hunt syndrome) include facial paralysis, tinnitus, hearing loss, vertigo, dysgeusia, and skin rash. The lower cranial nerves sometimes are affected by this neuritis. A case is reported of a woman without immune-system impairment who had cranial multineuritis with unilateral involvement of the VII, VIII, IX and X cranial nerves after infection with varicella-zoster virus without herpetic lesions.