Population collapse of habitat-forming species in the Mediterranean: a long-term study of gorgonian populations affected by recurrent marine heatwaves.

Understanding the resilience of temperate reefs to climate change requires exploring the recovery capacity of their habitat-forming species from recurrent marine heatwaves (MHWs). Here, we show that, in a Mediterranean highly enforced marine protected area established more than 40 years ago, habitat-forming octocoral populations that were first affected by a severe MHW in 2003 have not recovered after 15 years. Contrarily, they have followed collapse trajectories that have brought them to the brink of local ecological extinction. Since 2003, impacted populations of the red gorgonian Paramuricea clavata (Risso, 1826) and the red coral Corallium rubrum (Linnaeus, 1758) have followed different trends in terms of size structure, but a similar progressive reduction in density and biomass. Concurrently, recurrent MHWs were observed in the area during the 2003-2018 study period, which may have hindered populations recovery. The studied octocorals play a unique habitat-forming role in the coralligenous assemblages (i.e. reefs endemic to the Mediterranean Sea home to approximately 10% of its species). Therefore, our results underpin the great risk that recurrent MHWs pose for the long-term integrity and functioning of these emblematic temperate reefs.

Persistent natural acidification drives major distribution shifts in marine benthic ecosystems.

Ocean acidification is receiving increasing attention because of its potential to affect marine ecosystems. Rare CO2 vents offer a unique opportunity to investigate the response of benthic ecosystems to acidification. However, the benthic habitats investigated so far are mainly found at very shallow water (less than or equal to 5 m depth) and therefore are not representative of the broad range of continental shelf habitats. Here, we show that a decrease from pH 8.1 to 7.9 observed in a CO2 vent system at 40 m depth leads to a dramatic shift in highly diverse and structurally complex habitats. Forests of the kelp Laminaria rodriguezii usually found at larger depths (greater than 65 m) replace the otherwise dominant habitats (i.e. coralligenous outcrops and rhodolith beds), which are mainly characterized by calcifying organisms. Only the aragonite-calcifying algae are able to survive in acidified waters, while high-magnesium-calcite organisms are almost completely absent. Although a long-term survey of the venting area would be necessary to fully understand the effects of the variability of pH and other carbonate parameters over the structure and functioning of the investigated mesophotic habitats, our results suggest that in addition of significant changes at species level, moderate ocean acidification may entail major shifts in the distribution and dominance of key benthic ecosystems at regional scale, which could have broad ecological and socio-economic implications.

Implications of taxonomic misidentification for future invasion predictions: Evidence from one of the most harmful invasive marine algae.

Invasive species have been a focus of concern in recent decades, becoming more problematic due to the cumulative impacts of climate change. Understanding the interactions among stress factors is essential to anticipate ecosystems' responses. Hereby, robust modeling frameworks must be able to identify the environmental drivers of invasion and forecast the current and future of their potential distribution. These studies are essential for the management of invasions and to be prepared for the future we are facing. Here we demonstrate that taxonomic misidentifications may lead to absolutely erroneous predictions, by using as an example one of the worst invasive species in the Mediterranean Sea (Lophocladia lallemandii), which has been misidentified for three decades and now is correctly identified. Consequently, and bearing in mind overall trends in species misidentification due to the loss of taxonomic expertise and the presence of cryptic species, among others, attempts to understand and predict species involved in invasion processes must always first consider taxonomic studies.

Warming may increase the vulnerability of calcareous algae to bioinvasions.

Understanding the interactions between various stressors, and the resulting cumulative impacts they exert, is essential in order to predict the potential resilience of marine habitats to climate change. Crustose coralline algae (CCA) are a major calcifying component of marine habitats, from tropical to polar oceans, and play a central role as ecosystem engineers in many rocky reefs. These species are increasingly threatened by the stress of climate change. However, the effects of other stressors linked to global change, such as invasive species, have scarcely been addressed. We have studied the interactive effects of invasive algae and global warming on CCA, combining observational and experimental approaches. CCA sensitivity to invasive algae is heightened when they are concurrently exposed to elevated seawater temperature, and the interaction between these two stressors triggers drastic synergistic effects on CCA. The reduction and eventual disappearance of these "ecosystem foundation species" may undermine ecological functioning, leading to the disappearance and/or fragmentation of the communities associated with them.

[Evaluation of the management of inhalers by the nursing personnel in a reference hospital]. / Valoración del manejo de los inhaladores por el personal de enfermería en un hospital de referencia.

OBJECTIVES: To evaluate the knowledge and skills of nurses on the management of inhaled therapy in different hospitalization wards. MATERIAL AND METHODS: We carried out a cross-sectional study, in which nurses were asked to perform a practical demonstration of the management of a pressurized canister with an inhalation chamber, without previous theoretical instruction about the technique. The inhalation technique was evaluated step by step following the recommendations of the Spanish Society of Pneumologists and Chest Surgeons (SEPAR). RESULTS: We could obtain the participation of 144 of the 177 nurses working in different wards (29 males, 115 females, mean age 42.5 + 7 years). Previous knowledge of the management of inhalers was declared by 85.4%. We found that 70.8% of the nurses did not correctly perform all the steps: 24.5% made only one mistake, while the rest had mistakes in two or more steps. The most common mistakes were: not to perform a slow and deep exhalation before using the inhaler (27.3%), not to hold the breath after the inhalation (24.4%), and not to wait 30 seconds between inhalation manoeuvres (21.5%). When evaluating different wards, we found that 44.4% of the nurses in the Short Stay Unit performed the technique correctly in contrast to 31.3% of the nurses in the Pneumology Ward. CONCLUSIONS: The percentage of mistakes in the inhalation technique by the nursing personnel was high. The health personnel must have an adequate level of training in order to correctly instruct the patient, because the efficacy of inhaled treatment greatly depends on the adequacy of the technique.

Contrasting effects of heavy metals and hydrocarbons on larval settlement and juvenile survival in sponges.

Metals and polycyclic aromatic hydrocarbons (PAHs) contaminate sediments and waters of coastal areas threatening early stages of invertebrate development. Effects on these stages may largely determine the decline and even disappearance of invertebrate populations in polluted environments. Our study aimed to determine the possible influence of metals (Cu and Cd) and PAHs on larval settlement and consecutive survival of two widespread sponges of the Mediterranean: Crambe crambe and Scopalina lophyropoda. Larvae of both species were exposed to Cu and Cd for a short period during 1 week, and settlement and following (6 months) survival of juvenile were monitored. Short exposures to copper and cadmium at the concentrations used did not affect C. crambe settlement compared with SW control, and no effect on consecutive survival of juveniles was observed. In contrast, short pulses of copper and cadmium at the concentrations used enhanced Scopalina lophyropoda settlement and did not affect the consecutive survival of juveniles with respect to SW controls. Furthermore, experiments designed to assess the effects of short exposures to PAHs and the combined effect of contamination by Cu(2+) and PAHs on larval settlement, were conduced during 10 days on C. crambe larvae. Hydrocarbons, differently than copper and cadmium, inhibited the settlement of sponge larvae to a certain extent. The synergetic negative effect of copper and hydrocarbons on C. crambe settlers may cause a decline of populations in areas with both sources of contamination. The present study provides the only available data on toxicity of copper, cadmium and hydrocarbon toxicants on sponge larval settlement.

Re-shifting the ecological baseline for the overexploited Mediterranean red coral.

Overexploitation leads to the ecological extinction of many oceanic species. The depletion of historical abundances of large animals, such as whales and sea turtles, is well known. However, the magnitude of the historical overfishing of exploited invertebrates is unclear. The lack of rigorous baseline data limits the implementation of efficient management and conservation plans in the marine realm. The precious Mediterranean red coral Corallium rubrum has been intensively exploited since antiquity for its use in jewellery. It shows dramatic signs of overexploitation, with no untouched populations known in shallow waters. Here, we report the discovery of an exceptional red coral population from a previously unexplored shallow underwater cave in Corsica (France) harbouring the largest biomass (by more than 100-fold) reported to date in the Mediterranean. Our findings challenge current assumptions on the pristine state of this emblematic species. Our results suggest that, before intense exploitation, red coral lived in relatively high-density populations with a large proportion of centuries-old colonies, even at very shallow depths. We call for the re-evaluation of the baseline for red coral and question the sustainability of the exploitation of a species that is still common but ecologically (functionally) extinct and in a trajectory of further decline.

Regional and local environmental conditions do not shape the response to warming of a marine habitat-forming species.

The differential response of marine populations to climate change remains poorly understood. Here, we combine common garden thermotolerance experiments in aquaria and population genetics to disentangle the factors driving the population response to thermal stress in a temperate habitat-forming species: the octocoral Paramuricea clavata. Using eight populations separated from tens of meters to hundreds of kilometers, which were differentially impacted by recent mortality events, we identify 25 °C as a critical thermal threshold. After one week of exposure at this temperature, seven of the eight populations were affected by tissue necrosis and after 30 days of exposure at this temperature, the mean % of affected colonies increased gradually from 3 to 97%. We then demonstrate the weak relation between the observed differential phenotypic responses and the local temperature regimes experienced by each population. A significant correlation was observed between these responses and the extent of genetic drift impacting each population. Local adaptation may thus be hindered by genetic drift, which seems to be the main driver of the differential response. Accordingly, conservation measures should promote connectivity and control density erosion in order to limit the impact of genetic drift on marine populations facing climate change.

Response of the Mediterranean sponge Chondrosia reniformis Nardo to copper pollution.

We examined the effects of exposure to copper pollution on the Atlanto-Mediterranean sponge Chondrosia reniformis. We transplanted sponges from an unpolluted control area to a harbour with a moderately high concentration of copper and measured several biological sponge variables. No effect of this habitat was detected on sponge growth, shape, heat-shock protein expression or metal accumulation. However, a decrease in the clearance rate, an increase in the collagen/cell rate (due to a decrease in the cellular components) and a lower survival rate after 4 months of the sponges transplanted to the harbour was observed. We suggest that copper may alter the sponge physiology, by reducing pumping capacity, which may ultimately lead to sponge death. Consequently, copper pollution exerts strong negative effects on this organism.

Does stress protein induction by copper modify natural toxicity in sponges?

Crambe crambe is a toxic Mediterranean sponge that inhabits the sublittoral rocky bottoms, including some contaminated habitats. We investigated whether contamination by copper induced stress proteins in C. crambe and whether such stress might alter the production of chemical defenses. The monoclonal antibody used cross-reacted with two heat shock proteins (HSP) of 54 and 72 kDa. Both proteins were induced to a greater or lesser extent by copper contamination. The HSP54 accumulated more than HSP72, which, in contrast, appeared to respond faster and be less persistent. In a field experiment, we found a higher accumulation of HSP54 in individuals naturally inhabiting a copper-contaminated site than in those transplanted to this site four months earlier. In contrast, HSP72 was significantly induced only in the individuals transplanted to the contaminated site. In the laboratory, both proteins were induced by copper at 30 microg/L but inhibited at 100 microg/L. The highest mean values of HSP54 and HSP72 corresponded to the sponges, which showed the lowest mean values of toxicity. Thus, toxicity and production of HSP displayed opposite trends, which seems to indicate a preferential investment in cell repair at the expense of toxic molecules under stress conditions.

Sublethal effects of contamination on the Mediterranean sponge Crambe crambe: metal accumulation and biological responses.

The effect of low levels of pollution on the growth, reproduction output, morphology and survival of adult sponges and settlers of the sponge Crambe crambe were examined. We transplanted sponges from a control area to a contaminated site and measured the main environmental variables (chemical and physical) of both sites during the study period. Except some punctual differences in particulate organic matter, silicates, nitrates, and water motion, most environmental variables in the water were similar at both sites during the study months. Mainly copper, lead and OM concentrations in the sediment, and water motion were significantly higher at the polluted site and may be implicated in the biological effects observed: decrease in the percentage of specimens with embryos, increase in shape irregularity and decrease in growth rate. Individuals naturally occurring at the polluted site and those transplanted there for four months accumulated ten times more copper than either untouched or transplant controls. Although lead concentration in sediment did not differ between sites, native specimens from the contaminated site accumulated this metal more than untouched controls. Vanadium concentration also tended to increase in the sponges living at or transplanted to the contaminated site but this difference was not significant. C. crambe is a reliable indicator of metal contamination since it accumulates copper, lead and vanadium in high amounts. At the contaminated site, sponge growth, fecundity and survival were inhibited, whereas sponge irregularity ending in sponge fission was promoted. All these effects may compromise the structure and dynamics of the sponge populations in sheltered, metal-contaminated habitats.

[Cytomorphological study of the cerebrospinal fluid. II. Leukemias and lymphomas (author's transl)]. / Citomorfología del líquido cefalorraquídeo. II. Leucemias y linfomas.

A cytological study of the cerebrospinal fluid from 25 patients with acute leukemias and five patients with malignant lymphomas (Hodgkin's disease and non-Hodgkin's lymphoma) has been performed. All patients had clinical manifestations of central nervous system involvement at the time of lumbar puncture. Cytological abnormalities were observed in 13 out of the 30 samples examined (positivity: 44 percent). The group of 17 patients with lymphoblastic leukemia accounted for the highest cytological positivity (12 our of 17 cases --70.5 percent--). Cerebrospinal fluid from eight patients with acute myeloblastic leukemia and from four patients with Hodgkin's disease was normal. Numerous cell atypias were found in a case of lymphocytic lymphoma. The importance of systematic cytological study of the cerebrospinal fluid in patients with leukemia in order to prevent recurrences and to control intrathecal administration of cytostatics and/or radiotherapy is stressed.

[Expandable stents in obstructive unresectable carcinoma of the gastric antrum]. / Prótesis autoexpandible en el cáncer obstructivo de antro gástrico inoperable.

We present a patient with obstructive unresectable carcinoma of the gastric antrum. An expandable stent was placed endoscopically along the tumor to paliate obstruction. Such a procedure allowed unrestricted oral feeding of the patient up to death six months later.

Treatment of left colon neoplasic obstruction by placement of self-expandable stents.

INTRODUCTION AND OBJECTIVE: Neoplasic stenoses of the left colon are most frequently caused by primary colon carcinoma, infiltration from an external tumour and great adenomatous polyps. These patients often develop obstruction as their first symptom, leading to emergency surgical procedures in adverse circumstances and without an appropriate intestinal preparation that might prevent primary anastomosis. Therapeutic options for this event, such as Hartmann's resection, subtotal colectomy or anterograde colon lavage are not always possible. In these patients a colostomy is performed that requires future reoperation for reconstruction of the intestinal transit. Transtumoral self-expandable stenting followed by elective surgery might be the best option in these cases, as well as an alternative to surgery in non-operable patients. PATIENTS AND METHODS: Twenty four patients treated with this procedure in the past four years were divided in two groups. In group 1 (14 patients), the stent was placed as a permanent and palliative measure for the management of the disease. In group 2 (10 patients), the stent was placed temporarily for the management of the intestinal obstruction and latter the patients underwent elective surgery with fully preoperative and extension study and an appropriate preparation of the colon in order to allow reliable primary anastomosis. RESULTS: There were no hospital mortality nor stent migrations. There was only one complication (perforation caused by the stent) that required emergency surgery, but with any further complications. Failure to place the stent occurred in one patient. CONCLUSIONS: Self-expandable stents relieve neoplasic colon obstructions and allow to complete the study protocol, followed by elective surgery associated to less morbi-mortality. In patients with advanced or irresectable cancer, they provide a palliative and safe alternative to surgery, with satisfactory results.

[Morbidity in hospital admission for stroke]. / Morbilidad por hospitalización en el ictus.

INTRODUCTION: In spite of advances in the prevention and treatment of ischemic vascular disease, this continues to be one of the main causes of disablement and prolonged hospitalization in developed countries. Also, hospitalization itself leads to complications which have a negative effect on the morbi-mortality of these patients during the time spent in hospital. OBJECTIVE: We decided to study the effect of systemic complications during the period of hospital stay, on the functional recovery of patients which ictusl. MATERIAL AND METHODS: A prospective study was made of 47 patients admitted to our unit for neurological deficit of more than 24 hours evolution and of cerebrovascular aetiology. Functional recovery was evaluated by means of the index of Barthel on discharge and after a period of 3 months with respect to the degree of neurological involvement (Canadian scale on admission), glycemia on admission, time spent in hospital and the occurrence of systemic complications in hospital. RESULTS: These were no differences between the groups of patients with and without systemic complications regarding age, glycemia and Canadian scale on admission. Nor wes there any difference between the groups regarding the number of patients with significant deterioration of their neurological condition (decrease > 20% in the EC). Functional recovery on hospital discharge was worse in the group with systemic complications (IB: 43.05 +/- 34.1: as compared with IB: 72.8 +/- 22.7 in the group without complications). This difference persisted after 3 months. CONCLUSIONS: Systemic complications related to hospitalization have a negative effect on the functional recovery of patient with ictus and also prolong the time spent in hospital.

[Cognitive and neuropsychiatric disorders in Parkinson's disease]. / Trastornos cognitivos y neuropsiquiátricos en la enfermedad de Parkinson.

INTRODUCTION: In Parkinson's disease there are patients with isolated and multiple cognitive impairment, and their cognitive performance ranges from normal to an advanced degree of dementia. Most patients present an executive deficit, either in isolation or combined with other cognitive disorders, which is considered to be the most characteristic aspect of the disease, and 30-40% of those affected will end up with a clinically-defined dementia. DEVELOPMENT: The presence of a mild cognitive disorder in patients with Parkinson means that the risk of dementia appearing at some time during the development of the disease is high. The dementia associated with Parkinson's disease is specifically related with neuropsychiatric signs and symptoms, which may have three possible explanations: disorders affecting the mesolimbic pathways, diffuse limbic and cortical compromise, or associated Alzheimer-type phenomenology. Psychotic episodes tend to present more often in patients with dopaminergic treatment and the clinical spectrum of Parkinson-related psychosis covers visual illusions, visual-audio-olfactory hallucinations, delirium and severe paranoid hallucinatory psychosis. All the antiparkinsonian drugs can give rise to hallucinations and psychosis, but the dopamine agonists are the ones with the greatest capacity to do so. CONCLUSIONS: In managing these problems, it is crucial for prevention as well as diagnosis and treatment to be carried out as soon as they are detected. Doses of antiparkinsonian drugs must be reduced, although this is not usually enough, and so it will be necessary to associate atypical antipsychotics, which act mainly on 5-HT receptors and, in most cases, do not produce D2 blockage.

[Quality of professional life (QoPL) among primary care workers in area 7 of the Madrid Autonomous Region]. / Estudio de la Calidad de Vida Profesional en trabajadores de Atención Primaria del Área 7 de la Comunidad de Madrid.

OBJECTIVE: To describe the QoPL as perceived by Primary Care workers in the Primary Care Area 7 and to describe the progress since 2004. MATERIAL AND METHODS: Cross - sectional study carried out in the Primary Care Area 7 in June 2008. Participants were all primary care workers (n=1003). Main measurements were: the CVP-35 questionnaire (anonymous and self-administered) and socio-demographic and professional variables that could be associated with QoPL. Results were compared to those obtained in previous years (2004-2006). RESULTS: Positive answers: 47%. By dimension, average scores were: perception of demands: 6.09, managerial support: 5.10 and intrinsic motivation: 7.56. Nurses, physiotherapists, and nursing assistants had significantly higher scores in intrinsic motivation, managerial support and quality of life. The individuals who carried out management activities had higher scores in managerial support and intrinsic motivation items. Slight improvements were seen in perception of demands, managerial support and quality of life. CONCLUSIONS: Item analysis allows us to develop improvement plans and subsequently evaluate their results. In this sense, we observed slight improvements, according to planned strategies, based on perceived demands in previous years. Some of these strategies have been recently introduced, so future evaluations using the CVP-35 questionnaire are needed in order to analyse their effectiveness.