Warming overrides eutrophication effects on leaf litter decomposition in stream microcosms.

Several human activities often result in increased nitrogen (N) and phosphorus (P) inputs to running waters through runoff. Although headwater streams are less frequently affected by these inputs than downstream reaches, the joint effects of moderate eutrophication and global warming can affect the functioning of these ecosystems, which represent two thirds of total river length and thus are of major global relevance. In a microcosm study representing streams from a temperate area (northern Spain), we assessed the combined effects of increased water temperature (10.0, 12.5, and 15.0 °C) and nutrient enrichment (control, high N, high P, and high N + P concentrations) on the key process of leaf litter decomposition (mediated by microorganisms and detritivores) and associated changes in different biological compartments (leaf litter, aquatic hyphomycetes and detritivores). While warming consistently enhanced decomposition rates and associated variables (leaf litter microbial conditioning, aquatic hyphomycete sporulation rate and taxon richness, and detritivore growth and nutrient contents), effects of eutrophication were weaker and more variable: P addition inhibited decomposition, addition of N + P promoted leaf litter conditioning, and detritivore stoichiometry was affected by the addition of both nutrients separately or together. In only a few cases (variables related to detritivore performance, but not microbial performance or leaf litter decomposition) we found interactions between warming and eutrophication, which contrasts with other experiments reporting synergistic effects. Our results suggest that both stressors can importantly alter the functioning of stream ecosystems even when occurring in isolation, although non-additive effects should not be neglected and might require exploring an array of ecosystem processes (not just leaf litter decomposition) in order to be detected.

Synthesis, Post-Functionalization and Properties of Diphosphapentaarenes.

Linearly-fused polyarenes are an important class of compounds with high relevance in materials science. While modifying the shape and size represents a common means to fine-tune their properties, the precise placement of heteroatoms is a strategy that is receiving an increasing deal of attention to overcome the intrinsic limitations of all-carbon structures. Thus, linearly-fused diphosphaarenes recently emerged as a novel family of molecules with striking optoelectronic properties and outstanding stability. However, the properties of diphosphaarenes are far from being benchmarked. Herein, we report the synthesis, phosphorus post-functionalization and properties of new diphosphapentaarene derivatives. We describe their synthetic limitations and unveil their potential for optoelectronic applications.

Boron- and phosphorus-containing molecular/nano platforms: exploiting pathological redox imbalance to fight cancer.

Cancer is currently the second leading cause of death globally. Despite multidisciplinary efforts, therapies to fight various types of cancer still remain inefficient. Reducing high recurrence rates and mortality is thus a major challenge to tackle. In this context, redox imbalance is an undervalued characteristic of cancer. However, it may be targeted by boron- and phosphorus-containing materials to selectively or systemically fight cancer. In particular, boron and phosphorus derivatives are attractive building blocks for rational drug discovery due to their unique and wide regioselective chemistry, high degree of tuneability and chemical stability. Thus, they can be meticulously employed to access tunable molecular platforms to selectively exploit the redox imbalance of cancer cells towards necrosis/apoptosis. This field of research holds a remarkable potential; nevertheless, it is still in its infancy. In this mini-review, we underline recent advances in the development of boron- or phosphorus-derivatives as molecular/nano platforms for rational anticancer drug design. Our goal is to provide comprehensive information on different methodologies that bear an outstanding potential to further develop this very promising field of research.

Gold(i) complexes based on six-membered phosphorus heterocycles as bio-active molecules against brain cancer.

π-Systems based on six-membered phosphorus heterocycles possess structural and electronic characteristics that clearly distinguish them from the rest of the organophosphorus molecules. However, their use in cancer therapy has been uninvestigated. In particular, glioblastoma is one of the most lethal brain tumors. The development of novel and more efficient drugs for the treatment of glioblastoma is thus crucial to battle this aggressive disease. Herein, we report a new family of gold(i) complexes based on six-membered phosphorus heterocycles as a promising tool to investigate brain cancer. We discovered that the latter complexes inhibit the proliferation, sensitize to apoptosis and hamper the migration of not only conventional but also stem-like glioblastoma cells. Our results unveil thus new research opportunities for the treatment of glioblastoma.

Alternativas terapéuticas para la tocólisis en el manejo de la amenaza de parto pretérmino / Therapeutic alternatives for the tocolysis in the management of the threatened preterm labour

La amenaza de parto pretérmino (APP) es una urgencia obstétrica que, en ausencia de intervención, desemboca en un parto prematuro. Detener la APP y prolongar la gestación todo lo posible permite trasladar a la gestante a un centro apropiado, administrar los cuidados necesarios y conceder un mayor periodo de maduración al feto, esencial para reducir la morbimortalidad asociada al parto prematuro. El empleo de tocolíticos al inicio de este proceso es esencial. En este artículo se revisa el escenario clínico y la información sobre los tocolíticos actualmente autorizados en España, dos de ellos por vía intravenosa (ritodrina y atosibán) y otro por vía oral (nifedipino solución oral) (AU)

Threatened preterm labour is an urgent obstetric condition leading to a preterm birth in the absence of medical intervention. Intervention must focus on stopping birth progression in order for the patient and the fetus be administered an adequate medical care, providing a temporal window for fetus´ maturation. This medical management is aimed to reduce the morbimortality associated to preterm birth. This manuscript consists of a review of the toclytics of more extended use in our context. Currently, three drugs are authorised as tocolytics in Spain: ritodrine and atosiban (intravenous) and nifedipine (oral solution) (AU)

[Neurolaryngology]. / Neurolaringología.

The neuroanatomy of voice and speech is complex. An intricate neural network is responsible for ensuring the main functions of the larynx: airway protection, cough and Valsalva production, and providing voice. Coordination of these roles is very susceptible to disruption by neurological disorders. Neurological disorders that affect laryngeal function include Parkinson's disease, stroke, amyotrophic lateral sclerosis, multiple sclerosis, dystonia and essential tremor. A thorough neurological evaluation should be routine for any patient presenting with voice complaints suggestive of neurogenic cause. Endoscopic visualisation of the larynx using a dynamic voice assessment with a flexible laryngoscope is a crucial part of the evaluation and ancillary tests are sometimes performed. Otolaryngologic evaluation is important in the diagnosis and treatment of neurological disorders that affect laryngeal function.

[Demand and supply of otolaryngology specialists based on evidence: What is the required number of specialists who should be trained?]. / Demanda y oferta de otorrinolaringólogos basada en la evidencia: ¿cuál es el número necesario de especialistas que se deben formar?

Several concurrent circumstances have created an impression through the media of a presumed lack of specialists in Spain, which has one of the highest densities of doctors per population in the world: simultaneous creation of jobs in many newly built hospitals; accepting garbage contracts (for months, half/thirds of days, shifts) in relevant hospitals rather than moving to unattractive positions; full dedication to the field of public or private healthcare rather than matching them; bad public healthcare working conditions (low wages, excessive healthcare pressure, lack of respect from the public and from healthcare managers, shifts, scarce professional promotion, difficult family reunification); decreased mobility due to insulation of the markets as a result of decentralization of healthcare by regions. There is no shortage of specialists in otolaryngology, but instead there are sporadic inequalities in their geographical distribution. The current number of positions as training doctors offered annually is higher at the moment than the demand of the Spanish society, for specialists who have adapted smoothly to the requirements of the new medical practice: clinical management, care quality, technology-based efficiency, evidence-based medicine. The modification of working conditions through higher flexibility in the working models and an increase of salaries based on activity and quality will show that the otolaryngology workforce which is generated with the current offer can assume the present and future demand. A high quality of specialized otolaryngology training is the substrate to be improved, so that future otolaryngology specialists will be able to face health challenges without unduly increasing their number.

Paragangliomas de cabeza y cuello: revisión de 89 casos en 73 pacientes / Head and neck paragangliomas: revision of 89 cases in 73 patients

Introducción: Los paragangliomas son tumores poco frecuentes de origen neuroectodérmico. Se los considera tumores benignos, pero en algunas ocasiones tienen un comportamiento biológico similar a los tumores malignos (< 10 %). Las mutaciones germinales en los genes SDHB, SDHC y SDHD, que codifican las subunidades del mismo nombre en el complejo enzimático mitocondrial de la succinato deshidrogenasa, tienen un papel importante en la patogenia. Material y método: Se trata de un estudio retrospectivo en el que se revisa a 73 pacientes intervenidos en nuestro servicio con un total de 89 paragangliomas, ya que 8 pacientes presentaban paragangliomas múltiples. Los paragangliomas se distribuyeron de la siguiente forma: 33 yugulares, 17 timpánicos, 26 carotídeos y 13 vagales. Todos estos pacientes tuvieron un seguimiento mínimo de 1 año. Se evaluaron las vías de abordaje en función de la localización tumoral, las secuelas acaecidas y su ulterior evolución, así como las recurrencias y su relación con la localización del tumor primario. Resultados: El tratamiento fue quirúrgico, utilizando la radiocirugía como tratamiento complementario en un paciente. En los paragangliomas yugulares se realizó un abordaje infratemporal tipo A, en los carotídeos y vagales el abordaje fue cervical y en los timpánicos, transmeatal o transmastoideo. De los 73 pacientes con paragangliomas intervenidos que componen nuestra población en estudio, hubo 11 recurrencias, que aparecieron en los paragangliomas yugulares, que en 2 casos fueron paragangliomas múltiples. Las secuelas postoperatorias fueron sobre todo la parálisis de nervios craneales (VII, IX, X, XI y XII), junto con las fístulas de líquido cefalorraquídeo en el 14 % de los paragangliomas yugulares. Conclusiones: Con este artículo pretendemos reflejar nuestra experiencia en el tratamiento de este tipo de tumores. El tratamiento quirúrgico consigue un excelente control de la enfermedad con una morbilidad aceptable en pacientes de mediana edad o jóvenes. Para disminuir las probabilidades de parálisis facial en los paragangliomas yugulares, debe evitarse la transposición del facial en el abordaje infratemporal de la fosa yugular

Introduction: Paragangliomas (PGL) are uncommon neuroectodermal tumours. PGL are usually clinically benign tumours, although metastasis has been reported and invasive growth can occur in adjacent tissues (<10 %). Mutations in SDHB, SDHC, and SDHD, which encode sub-units of mitochondrial complex II (succinate dehydrogenase), play an important role in the pathogenesis of these tumours. Material and method: Retrospective review of 73 patients with 89 paragangliomas who had undergone resection of the PGL in our hospital. There were 8 patients who displayed multiple PGL. PGL were distributed as follows: 33 were jugular, 17 tympanic, 26 carotid body tumours, and 13 vagal paragangliomas. All these patients had a follow-up time of at least a year. The surgical approach was evaluated in terms of tumour origin, sequelae, and subsequent evolution, as well as the relapses and their relation with location of the primary tumour. Results: The treatment was surgical, using complementary radiosurgery in just 1 patient. The type A infratemporal fossa approach was used in jugular paragangliomas, the approach was cervical in the carotid and vagal ones and, in the tympanics, a transmeatal or transmastoid approach was performed. In the 73 patients making up our study group, there were 11 recurrences which appeared in jugular paragangliomas (two of them in multiple PGL cases). The post-operative sequelae were mainly cranial nerve paralysis (VII, IX, X, XI, and XII), along with cerebrospinal fluid fistulas in 14 of the jugular PGLs. Conclusions: With this article we try to reflect our experience in the treatment of this type of tumour. Surgical treatment achieves excellent control of the disease with an acceptable morbidity in young or middle-aged patients. In order to diminish the probabilities of facial nerve paralysis in jugular PGL we must avoid the facial nerve transposition in the infratemporal approach