The branched mitochondrial respiratory chain from the jellyfish Stomolophus sp2 as a probable adaptive response to environmental changes.

During their long evolutionary history, jellyfish have faced changes in multiple environmental factors, to which they may selectively fix adaptations, allowing some species to survive and inhabit diverse environments. Previous findings have confirmed the jellyfish's ability to synthesize large ATP amounts, mainly produced by mitochondria, in response to environmental challenges. This study characterized the respiratory chain from the mitochondria of the jellyfish Stomolophus sp2 (previously misidentified as Stomolophus meleagris). The in-gel activity from isolated jellyfish mitochondria confirmed that the mitochondrial respiratory chain contains the four canonical complexes I to IV and F0F1-ATP synthase. Specific additional activity bands, immunodetection, and mass spectrometry identification confirmed the occurrence of four alternative enzymes integrated into a branched mitochondrial respiratory chain of Stomolophus sp2: an alternative oxidase and three dehydrogenases (two NADH type II enzymes and a mitochondrial glycerol-3-phosphate dehydrogenase). The analysis of each transcript sequence, their phylogenetic relationships, and each protein's predicted models confirmed the mitochondrial alternative enzymes' identity and specific characteristics. Although no statistical differences were found among the mean values of transcript abundance of each enzyme in the transcriptomes of jellyfish exposed to three different temperatures, it was confirmed that each gene was expressed at all tested conditions. These first-time reported enzymes in cnidarians suggest the adaptative ability of jellyfish's mitochondria to display rapid metabolic responses, as previously described, to maintain energetic homeostasis and face temperature variations due to climate change.

The problem of misidentification between edible and poisonous wild plants: Reports from the Mediterranean area.

Today, in many European countries, people are looking for wild edible plants to experience new tastes and flavors, by following the new trend of being green and environmentally friendly. Young borage and spinach leaves can be easily confused by inexpert pickers with those of other plants, including poisonous ones, such as Mandragora autumnalis Bertol. (mandrake) or Digitalis purpurea L. (foxglove), common in southern and northern Italy respectively. In the last twenty years, several cases of intoxication by accidental ingestion of mandrake and foxglove have been reported. The purpose of this work was to perform a pharmacognostic characterization of young leaves from borage, mandrake, foxglove and spinach, by micro-morphological, molecular and phytochemical techniques. The results showed that each of the three techniques investigated could be sufficient alone to provide useful information for the identification of poisonous species helping the medical staff to manage quickly the poisoned patients. However, the multi-disciplinary approach proposed could be very useful to asses the presence of poisonous plants in complex matrices, to build a database containing morphological, molecular and phytochemical data for the identification of poisonous species or in forensic toxicology, given their increasingly frequent use due to their low cost and relatively common availability.

Integrated Care Program for Older Adults: Analysis and Improvement.

OBJECTIVE: We aimed to in-depth analyse the Integrated Care Programme for older in- and out-patients implemented for more than 25 years at the Hospital Universitario de Getafe, in Madrid, Spain. We identify the strengths and barriers hindering the full operation, and we proposed a technological solution that overcame these constraints and facilitated integration. DESIGN: First, we carried out a comprehensive analysis of the integrated care program at the HUG following Case Study Research; the primary unit of analysis was the Geriatrics service and its clinical units. Secondary sources of analyses were professionals' insights (obtained thought direct observation and interviews) and statistics on the service. After the identification of the barriers preventing complete success; we designed a Health Information System and developed a mock-up that was validated with the professionals. Finally, we passed the specifications to the Information System Unit at the Hospital to develop and integrate the system into the hospital one. SETTING: The Geriatrics Service of the University Hospital of Getafe, pertaining to the public Healthcare System of the Region of Madrid (Spain). PARTICIPANTS: No patient participated in the study. All staff from the Geriatrics Service and the ICT manager of the hospital contributed to the design of the Health Information System; and 3 geriatricians from the Service and 1 primary care physician validated it. MEASUREMENTS: First, we qualitative analysed the Integrated Care Program taking as dimensions eight facilitators towards integrated care. In response, we proposed an integrated information system solution. Later, we interviewed the staff geriatricians to analyse the Integrated Care Programme. Finally, we validated our proposed system in terms of usability and user experience using the System Usability Score-SUS and the User Experience Questionnaire-UEQ, respectively. RESULTS: The Integrated Care Program has demonstrated a high impact since its launch; however, the lack of integration in terms of information system was hindering the full deployment. We have designed an integrated information system which has been validated by physicians and nurses from the Geriatrics Service in terms of usability. We obtained a SUS score of 81 (68 is considered to be the cut-off point for usable systems). Besides, the perception of these professionals on our system was 'Excellent' in 5 out of the 6 items covered by UEQ (Attractiveness, Perspicuity, Dependability, Stimulation and Novelty) and 'Good' in terms of the 1 remaining (Efficiency), where there is still room for improvement. CONCLUSIONS: Our dedicated Health Information System is a robust solution to bridge information gaps and facilitate the complete integration of our Integrated Care Programme for older in- and outpatients.

Epicondilitis humeral: tratamiento ortopédico, combinado con férula antebraquiopalmar en flexión dorsal / Humeral epicondylitis: orthopaedic treatment, combined with antebrachiopalmar splint in dorsal flexion

La epicondilitis humeral es la lesión más frecuente del codo y la dolencia de inserción más conocida. Metodología: Se han estudiado 50 pacientes (28 mujeres) diagnosticados de epicondilitis unilateral de entre 32 y 67 años, que llevaron durante al menos una semana una férula antebraquiopalmar con la muñeca en flexión dorsal, además de otro tipo de tratamiento físico y/o médico adicional. El 72% de los pacientes completó el tiempo establecido para el tratamiento de 1 mes. Resultados: Se obtuvo una curación final del 96% de los pacientes. El 68% curó al mes, el 32% al repetir el tratamiento a los 3 meses y el 4% precisó tratamiento quirúrgico. Consideramos que el tratamiento descrito es aconsejable puesto que es bien aceptado por un 80% de los pacientes, logra desaparición casi total y prolongada de la sintomatología en el 68%, y en otro 28% mejoría notable, permitiendo la realización de las actividades de la vida diaria sin limitaciones

Humeral epicondylitys is the most frequent lesion of the elbow and the best-known complaint of the joint. The aim of this study is to present our experience, criteria and results obtained regarding this pathology, including as a novelty the use of an antebrachiopalmar splint in dorsal flexion in order to relax the extensor group. Methodology: Fifty patients (28 women) with humeral epicondylitis diagnosis aged 32 to 67 were included in the study. They wore an antebrachiopalmar splint with the wrist in dorsal flexion at least during one week; 72% completed the treatment (1 month). They also received additional physical and/or medical treatment. Results: Ninety-six percent of the patients were cured, 68% after one month, 32% after 3 months and repeat of the treatment and 4% needed chirurgical treatment. We conclude that the described treatment can be advised as it was well accepted by 80% of the patients, induced long and almost total improvement of symptoms in 68% of the cases, and remarkable recovery in 28% of the cases, allowing patients to perform daily activities without restriction

Intravenous ascorbic acid: protocol for its application and use

High dose intravenous(i.v.) ascorbic acid (AA) has been used as therapy for infectious disease from bacterial and viral origin and adjuvant therapy for cancer. In this publication we describe a clinical protocol that has been developed over the past twenty years utilizing high dose i.v. AA as therapy for cancer. This includes principles of treatment, rationale, baseline workup, infusion protocol, precautions and side effects.

Integrative medicine: a paradigm shift in medical education and practice.

The use of alternative/complementary medicine has been increasing considerably. Conventional medicine must begin to address issues related to the use, safety, regulation, research and education of alternative/complementary medicine. Integrative medicine combines conventional medicine and alternative complementary practices. Integrative medicine is an innovative approach to medicine and medical education. It involves the understanding of the interaction of the mind, body and spirit and how to interpret this relationship in the dynamics of health and disease. Integrative medicine shifts the orientation of the medical practice from disease based approach to a healing based approach. It does not reject conventional medicine nor uncritically accepts unconventional practices. Integrative medicine is an effective, more fulfilling human approach to medicine based on the benefit of the patient by following good medicine practices in a scientific manner.