The complex multi-sectoral impacts of drought: Evidence from a mountainous basin in the Central Spanish Pyrenees.

We analyzed the impacts of drought severity on a variety of sectors in a topographically complex basin (the upper Aragón basin 2181 km2) in the Central Spanish Pyrenees. Using diverse data sources including meteorological and hydrological observations, remote sensing and tree rings, we analyze the possible hydrological implications of drought occurrence and severity on water availability in various sectors, including downstream impacts on irrigation water supply for crop production. Results suggest varying responses in forest activity, secondary growth, plant phenology, and crop yield to drought impacts. Specifically, meteorological droughts have distinct impacts downstream, mainly due to water partitioning between streamflow and irrigation channels that transport water to crop producing areas. This implies that drought severity can extend beyond the physical boundaries of the basin, with impacts on crop productivity. This complex response to drought impacts makes it difficult to develop objective basin-scale operational definitions for monitoring drought severity. Moreover, given the high spatial variability in responses to drought across sectors, it is difficult to establish reliable drought thresholds from indices that are relevant across all socio-economic sectors. The anthropogenic impacts (e.g. water regulation projects, ecosystem services, land cover and land use changes) pose further challenges to assessing the response of different systems to drought severity. This study stresses the need to consider the seasonality of drought impacts and appropriate drought time scales to adequately assess and understand their complexity.

Clinical outcomes after tricuspid surgery : The role of previous cardiac surgery.

BACKGROUND: The aim of our study was to assess the outcomes of surgical treatment for severe tricuspid regurgitation according to whether cardiac surgery had been performed before the tricuspid valve intervention. METHODS: Between 1996 and 2013, 201 consecutive patients with severe tricuspid regurgitation underwent tricuspid surgery at our center. Patients were classified according to whether or not they had undergone previous cardiac surgery, which 33% of the sample had. Perioperative as well as long-term morbidity and mortality were analyzed. RESULTS: Mean patient age was 62.3 years. 32.8% underwent suture annuloplasty, 41.3% underwent ring annuloplasty, 15.4% received a bioprosthesis, and 10.4% received a mechanical prosthesis. There were no significant differences in perioperative mortality between the group that had not undergone previous cardiac surgery and the group that had (12.7% vs. 17.9%, respectively; p = 0.32). The long-term mortality rate (median follow-up time: 53 months) was 43.3%. Long-term survival curves showed no significant differences between the two groups (p = 0.884), and previous cardiac surgery was not a predictive factor for long-term mortality (hazard ratio = 1.211; p = 0.521). CONCLUSION: In a series of patients who underwent tricuspid valve surgery, no significant differences were observed in perioperative mortality or in long-term survival according to whether or not subjects had undergone previous cardiac surgery.

Late-onset Becker-type muscular dystrophy in a Border terrier dog.

A 9-year-old Border terrier was presented to a referral hospital after a 1-year history of progressive stiffness and exercise intolerance. Neurological examination was consistent with a neuromuscular disorder. Serum creatine kinase activity was mildly elevated. A myopathy was suspected based on MRI findings and electrophysiological examination. Muscle histopathology was consistent with a severe non-inflammatory myopathy of a dystrophic type. Immunofluorescence and western blotting confirmed a dystrophinopathy with an 80-kDa truncated dystrophin fragment similar to Becker muscular dystrophy in people. To our knowledge, this is the first description of a late-onset Becker-type muscular dystrophy in a dog, and the first description of a dystrophinopathy in a Border terrier. Muscular dystrophy in dogs should not be ruled out based on late onset clinical signs and only mildly elevated creatine kinase.

Winter drought impairs xylem phenology, anatomy and growth in Mediterranean Scots pine forests.

Continental Mediterranean forests face drought but also cold spells and both climate extremes can impair the resilience capacity of these forests. Climate warming could amplify the negative effects of cold spells by inducing premature dehardening. Here we capitalize on a winter drought-induced dieback triggered by a cold spell which occurred in December 2001 affecting Scots pine forests in eastern Spain. We assessed post-dieback recovery by quantifying and comparing radial growth and xylem anatomy of non-declining (ND, crown cover >50%) and declining (D, crown cover ≤50%) trees in two sites (VP, Villarroya de los Pinares; TO, Torrijas). We also characterized xylogenesis in both sites and aboveground productivity in site VP. Dieback caused legacy effects since needle loss, a 60% reduction in litter fall and radial-growth decline characterized D-trees 3 years after dieback symptoms started appearing in spring 2002. D-trees formed collapsed tracheids in the 2002-ring, particularly in the most affected VP site where xylogenesis differences between ND and D trees were most noticeable. The lower growth rates of D-trees were caused by a shorter duration of their major xylogenesis phases. In site VP the radial-enlargement and wall-thickening of tracheids were significantly reduced in D-trees as compared to ND-trees because these xylogenesis phases tended to start earlier and end later in ND-trees. Gompertz models fitted to tracheid production predicted that maximum growth rates occurred 11-12 days earlier in ND than in D-trees. The formation of radially-enlarging tracheids was enhanced by longer days in both study sites and also by wetter conditions in the driest TO site, but xylogenesis sensitivity to climate was reduced in D-trees. Winter-drought dieback impairs xylem anatomy and phenology, aboveground productivity, xylogenesis and growth in Mediterranean Scots pine populations. Affected stands show a costly post-dieback recovery challenging their resilience ability.

Metastatic anal sac carcinoma with hypercalcaemia and associated hypertrophic osteopathy in a dog.

A seven-year-old male neutered Irish setter was treated for a metastatic anal sac adenocarcinoma (ASAC) and hypercalcaemia by complete surgical excision of the primary tumour and partial excision of the sublumbar lymph nodes. Further enlargement of the sublumbar lymph nodes was linked to recurrent hypercalcaemia 3 months after surgical treatment. Medical treatment with Toceranib and Clodronate showed modest results in the treatment of the tumour and the hypercalcaemia. Radiotherapy of the sublumbar lymph nodes and later concurrent carboplatin chemotherapy resulted in partial tumour remission with marked reduction in size of the lymph nodes and normalization of the calcaemia. Unfortunately, concurrently with subsequent relapse of the hypercalaemia, the dog developed hypertrophic osteopathy (HO) and lumbar spinal metastasis and the dog was euthanized. To the authors' knowledge, this is the second case of metastatic apocrine gland carcinoma of the anal sac associated with HO and the first case that describe the development of HO late in the stage of the disease.

CT dimensions, volumes and densities of normal canine eyes.

Although ultrasound and MRI are the imaging modalities of choice for the investigation of ocular diseases, the eyes are included in routine CT examinations of the head and should be examined as part of the complete evaluation. This report describes the dimensions, volumes and densities of the normal canine globe in CT. Forty-four eyes were studied. The mean axial length of the globe was 2.09 cm and its mean volume was 4.65 cm(3). The mean anteroposterior distance of the anterior chamber was 0.4 cm and of the vitreous chamber was 0.96 cm. There was a statistically significant difference between the mean aqueous humour density, 14.76 Hounsfield units (HU), and the mean vitreous humour density, 11.20 HU (P=0.0009). Statistically significant differences were also seen in both humours in precontrast and postcontrast studies. The mean anteroposterior dimension of the lens was 0.74 cm; its mean equatorial distance was 1.15 cm. The mean volume was 0.43 cm(3) and its mean density was 131.9 HU. There was contrast enhancement of the ciliary body, iris and retina/sclera/choroid complex. This study provides reference values to help in the interpretation of ocular structures on CT scans of the head, where incidental findings can change the medical management of specific cases.

Selección de ovocitos competentes, utilizando el factor de crecimiento nervioso (NFG) y el factor de crecimiento vascular endotelial (VEGF), con el fin de aumentar las posibilidades de embarazo en pacientes que se encuentran en tratamientos de fecundación in vitro: [revisión] / Competent oocytes selection, using nerve growth factor (NGF) and vascular endothelial growth factors (VEGF), with the purpose of to increase the possibilities of pregnancy in patients who are in treatments of fertilization in vitro: [review]

The attention from embryologist toward the assessment of oocyte quality in human in vitro fertilization (IVF) is increasing every day. Oocyte selection and the identification of the best oocytes, in fact, would help to limit embryo overproduction and to improve the results of oocyte cryostorage programs. Multiple methods have been proposed; but a good correlation between specific biochemical characteristics and measurable oocyte quality-linked, embryo-related variables has not been established to date. In IVF programs that include oocyte selection, levels of vascular endothelial growth factor (VEGF) and neural growth factor (NGF) could be used as an index to exclude oocytes that developed in a hypoxic follicle. The presence of both ovarian angiogenic factors provides an ideal environment to maintain the cyclical changes in vascular density that occurs during follicular development. NGF would act within a short time-frame to replenish the supply of VEGF required for the vascularization of growing preovulatory follicles and perhaps newly formed corpora lutea. Levels of these angiogenic factors can predict the necessary vascular changes within the follicles and the competence of the oocytes. A hypoxic status at this level could be responsible for the high intrafollicular and plasma concentrations of VEGF and for the low quality of the oocytes.

Amount of co-transplanted donor-derived leukocytes determines in-vivo microchimerism and mixed lymphocyte culture changes post-liver transplantation.

OBJECTIVE: To evaluate the impact of passenger leukocytes in liver grafts on the rate of microchimerism induction after liver transplantation and to evaluate immunological changes thereafter based on serial donor-specific MLC's in these patients. METHODS: 26 orthotopic liver transplant recipients were prospectively evaluated for immunological changes based on the co-transplantation of donor-derived leukocytes. Intraoperatively harvested liver biopsies and peripheral blood-lymphocytes of liver transplant recipients were sampled at various time points. Donor spleen cells were obtained during organ procurement. RESULTS: HLA-PCR analysis demonstrated a stable pattern of microchimerism in 15 out of 26 patients. Microchimerism was detectable by PCR up to a mean of 7 weeks after transplantation, when chimerism in the peripheral blood became negative. Passenger donor leukocytes were present in all biopsies obtained during backtable preparation of the liver graft. For the 15 patients presenting microchimerism the rate of passenger leukocytes in the liver graft biopsies showed a mean of 155.8 leukocytes per mm 2 liver tissue (SD +/- 23.2 cells/mm2, range 121 to 217 cells per mm2 tissue). Otherwise patients without chimerism showed a mean of 90.4 passenger leukocytes per mm2 tissue (SD +/- 14.5 cells/mm2, range: 52 to 99 cells/mm2). Lymphocyte proliferation, determined by donor-specific "multiple" single-way- mixed-lymphocyte-cultures (dsmMLC) was reduced to a mean of 62.2 % of preoperative values (SD +/- 14.5 %, range 33 % to 88 %) in the 15 patients with stable microchimerism. Otherwise in the 11 patients without microchimerism dsmMLC results stayed at continuously higher levels with a mean of 106 % (SD +/- 13.4, range 92 % to 134 %). CONCLUSIONS: The results from these studies of microchimerism and lymphocyte reactivity after liver transplantation suggest that the co-transplantation of donor leukocytes plays an important and active role in the modulation of the host-immune system.

[Transient complete atrioventricular block following a nonpenetrating chest trauma]. / Bloqueo auriculoventricular completo transitorio tras traumatismo torácico cerrado.

Cardiac contusion may cause disorders of impulse formation and propagation in the specific conduction system. Transient complete atrioventricular block following a nonpenetrating chest trauma is a rare complication.We describe the case of a patient who presented a transient complete atrioventricular block, and later a transient right bundle branch block and a left anterior hemiblock, following a nonpenetrating chest trauma due to a car accident. The difficulty for diagnosing myocardial contusion is pointed out, and the usefulness of the electrophysiological study for detecting baseline conduction system disorders is discussed.

Caregivers of persons with Alzheimer's Disease: cultural differences in perceived caregiver burden in Guatemala and Rhode Island.

The intent of this study is to illustrate cultural differences in the amount of perceived burden for primary caregivers of persons with Alzheimer's Disease. Caregivers in Guatemala and Rhode Island were given a questionnaire exploring: caregiver well-being, available supports, traditional ideology, and perceived burden. The data indicate that Guatemalans have less institutional and more informal supports available, as compared with USA caregivers. Guatemalan caregivers brought patients to a doctor sooner after the appearance of their first symptoms (0.9+/-1.0 years versus 1.6+/-1.8 years) and had poorer perceived health than USA subjects, suggesting a higher level of caregiver burden. Cultural response bias however may account for the difference in perceived health.