Facilitation of macrofaunal assemblages in marinas by the habitat-forming invader Amathia verticillata (Bryozoa: Gymnolaemata) across a spatiotemporal scale.

Widespread habitat-forming invaders inhabiting marinas, such as the spaghetti bryozoan Amathia verticillata, allow exploring facilitation processes across spatiotemporal contexts. Here we investigate the role of this bryozoan as habitat for native and exotic macrofaunal assemblages across different ecoregions of Western Mediterranean and East Atlantic coasts, and a monthly variation over a year. While only 7 (all peracarid crustaceans) of the 54 associated species were NIS, they dominated macrofaunal assemblages in terms of abundance, raising the potential for invasional meltdown. NIS richness and community structure differed among marinas but not among ecoregions, highlighting the importance of marina singularities in modulating facilitation at spatial scale. Despite facilitation did not depend on bryozoan abundance fluctuations, it was affected by its deciduous pattern, peaking in summer and disappearing in late winter. Monitoring A. verticillata in marinas, especially in summer periods, may improve the detection and management of multiple associated NIS.

Therapeutic intervention with virtual reality in patients with Parkinson's disease for upper limb motor training: A systematic review / Intervención terapéutica con realidad virtual en pacientes con enfermedad de Parkinson para entrenamiento motor del miembro superior: revisión sistemática

To analyze the scientific evidence regarding changes in upper extremities in patients with Parkinson's disease who use virtual reality as part of their neurological rehabilitation treatment. The search was carried out in the following databases: MEDLINE, Cochrane Library, PEDROs and SCOPUS. The following inclusion criteria were applied to a total of 106 articles: Randomized clinical trials with an age of 5 years, the sample had to be of patients with PD (regardless of their state of involvement) and who had performed RV in the treatment of limbs superiors. A total of n=7 articles were used, in which the variables corresponding to upper limb motor control were measured, such as: fine motor dexterity, gross motor dexterity, strength, tremor, functionality and speed. Virtual Reality as tool in neurorehabilitation in patients with Parkinson's disease shows positive effects in all measurements related to upper limb motor control.(AU)

Analizar la evidencia científica relativa a los cambios en las extremidades superiores en pacientes con enfermedad de Parkinson que utilizan realidad virtual como parte de su tratamiento de rehabilitación neurológica. La búsqueda se realizó en las bases de datos siguientes: MEDLINE, Cochrane Library, PEDROs y SCOPUS. Se aplicaron los siguientes criterios de inclusión a un total de 106 artículos: ensayos clínicos aleatorizados con edad de 5 años, muestra que incluyera pacientes con EP (independientemente de su estado de compromiso), y que hubieran realizado RV para el tratamiento de los miembros superiores. Se utilizó un total de n=7 artículos, en los que se midieron las variables correspondientes al control motor de los miembros superiores, tales como: destreza motora fina, destreza motora bruta, fuerza, temblor, funcionalidad y velocidad. La realidad virtual como herramienta de neurorehabilitación en los pacientes con enfermedad de Parkinson muestra efectos positivos en todas las medidas relacionadas con el control motor de las extremidades superiores.(AU)

Therapeutic intervention with virtual reality in patients with Parkinson's disease for upper limb motor training: A systematic review.

To analyze the scientific evidence regarding changes in upper extremities in patients with Parkinson's disease who use virtual reality as part of their neurological rehabilitation treatment. The search was carried out in the following databases: MEDLINE, Cochrane Library, PEDROs and SCOPUS. The following inclusion criteria were applied to a total of 106 articles: Randomized clinical trials with an age of 5 years, the sample had to be of patients with PD (regardless of their state of involvement) and who had performed RV in the treatment of limbs superiors. A total of n=7 articles were used, in which the variables corresponding to upper limb motor control were measured, such as: fine motor dexterity, gross motor dexterity, strength, tremor, functionality and speed. Virtual Reality as tool in neurorehabilitation in patients with Parkinson's disease shows positive effects in all measurements related to upper limb motor control.

Coastal armouring affects intertidal biodiversity across the Alboran Sea (Western Mediterranean Sea).

Intertidal ecosystems are key habitats that are being replaced by artificial hard substrates due to the increment of human activities in coastal areas. These new substrates host generally less biodiversity mainly due to differences in complexity and composition. This is a global phenomenon and has led to the development of strategies in the framework of eco-engineering. However, mitigating measures, such as new eco-designs, must cope with the high spatial variability of the region where they are applied. Therefore, in order to assess if differences in biodiversity detected at local scales in previous studies could be scaled up to predict patterns at a wider scale, we studied taxa richness and taxonomic structure of intertidal communities across the Alboran Sea (western Mediterranean Sea). We compared four different types of artificial substrates (cubes, rip-raps, seawalls and tetrapods) to assess which produces less impact. Overall, artificial substrates host low benthic biodiversity, specially on seawalls, whereas boulder-like artificial structures such as rip-raps were more similar to natural ones. Nevertheless, the effect of a particular type of artificial structure at a regional scale seems unpredictable, highlighting the challenge that eco-engineering measures face in order to establish global protocols for biodiversity enhancement and the importance of local scale in management programmes.

[Validity of the Wisconsin Gait Scale to predict the risk of falls in stroke patients]. / Validez de la Wisconsin Gait Scale para predecir el riesgo de caídas en pacientes con ictus.

INTRODUCTION: Approximately, half of the stroke patients suffered a fall during the first year after the injury, affecting its functionality. Gait evaluation scales could evaluate to predict the risk of falls. OBJECTIVE: To study the ability of the Wisconsin Gait Scale (WGS) to predict the risk of falls in stroke subjects. PATIENTS AND METHODS: Retrospective observational study that included stroke patients between May 2010 and October 2016. Data from the WGS and the Berg Balance Scale (BBS) were collected after hospitalization (acute phase), at 3 months (subacute phase) and at 6 and 12 months (chronic phases). BBS was used as the outcome variable to determine the ability of the WGS to predict the risk of falls. The calculation of the predictive validity was carried out using the ROC (Receiver Operating Characteristics) curves and the analysis of the area under the curve (AUC, area under the curve). RESULTS: Data were collected from 61 patients who met the inclusion criteria (after admission: 61; 3 months: 61; 6 months: 58; 12 months: 42). In all measurements, the AUC was greater than 0.9, so the WGS distinguishes stroke patients with moderate risk of falling from those with low risk. CONCLUSIONS: The WGS scale is a valid instrument to predict the risk of falls in patients with a criterion in relation to the cut-off points established in the BBS.

TITLE: Validez de la Wisconsin Gait Scale para predecir el riesgo de caídas en pacientes con ictus.Introducción. Aproximadamente, la mitad de las personas que han sufrido un ictus sufre una caída durante el primer año tras la lesión, lo que afecta a su funcionalidad. Las escalas de evaluación de la marcha podrían utilizarse para predecir el riesgo de caídas. Objetivo. Estudiar la capacidad de la Wisconsin Gait Scale (WGS) para predecir el riesgo de caídas en pacientes con ictus. Pacientes y métodos. Estudio observacional retrospectivo que incluyó a pacientes con ictus entre mayo de 2010 y octubre de 2016. Se recopilaron datos de la WGS y de la Berg Balance Scale (BBS) tras la hospitalización (fase aguda), a los tres meses (fase subaguda) y a los seis y 12 meses (fases crónicas). Se empleó la BBS como variable de resultado para determinar la capacidad de la WGS para predecir el riesgo de caídas. El cálculo de la validez predictiva se llevó a cabo mediante las curvas receiver operating characteristics y el análisis del área bajo la curva (AUC). Resultados. Se recopilaron datos de 61 pacientes que cumplieron los criterios de inclusión (tras la admisión: 61; a los tres meses: 61; a los seis meses: 58; a los 12 meses: 42). En todas las mediciones, el AUC fue mayor de 0,9, por lo que la WGS distingue a los pacientes con ictus con riesgo moderado de sufrir caídas de los de riesgo bajo. Conclusiones. La WGS es un instrumento válido para predecir el riesgo de caídas en pacientes con un ictus en relación con los puntos de corte establecidos en la BBS.

Validez de la Wisconsin Gait Scale para predecir el riesgo de caídas en pacientes con ictus / Validity of the Wisconsin Gait Scale to predict the risk of falls in stroke patients

Introducción: Aproximadamente, la mitad de las personas que han sufrido un ictus sufre una caída durante el primer año tras la lesión, lo que afecta a su funcionalidad. Las escalas de evaluación de la marcha podrían utilizarse para predecir el riesgo de caídas. Objetivo: Estudiar la capacidad de la Wisconsin Gait Scale (WGS) para predecir el riesgo de caídas en pacientes con ictus. Pacientes y métodos: Estudio observacional retrospectivo que incluyó a pacientes con ictus entre mayo de 2010 y octubre de 2016. Se recopilaron datos de la WGS y de la Berg Balance Scale (BBS) tras la hospitalización (fase aguda), a los tres meses (fase subaguda) y a los seis y 12 meses (fases crónicas). Se empleó la BBS como variable de resultado para determinar la capacidad de la WGS para predecir el riesgo de caídas. El cálculo de la validez predictiva se llevó a cabo mediante las curvas receiver operating characteristics y el análisis del área bajo la curva (AUC). Resultados: Se recopilaron datos de 61 pacientes que cumplieron los criterios de inclusión (tras la admisión: 61; a los tres meses: 61; a los seis meses: 58; a los 12 meses: 42). En todas las mediciones, el AUC fue mayor de 0,9, por lo que la WGS distingue a los pacientes con ictus con riesgo moderado de sufrir caídas de los de riesgo bajo. Conclusiones: La WGS es un instrumento válido para predecir el riesgo de caídas en pacientes con un ictus en relación con los puntos de corte establecidos en la BBS.(AU)

Introduction: Approximately, half of the stroke patients suffered a fall during the first year after the injury, affecting its functionality. Gait evaluation scales could evaluate to predict the risk of falls. Objective: To study the ability of the Wisconsin Gait Scale (WGS) to predict the risk of falls in stroke subjects. Patients and methods. Retrospective observational study that included stroke patients between May 2010 and October 2016. Data from the WGS and the Berg Balance Scale (BBS) were collected after hospitalization (acute phase), at 3 months (subacute phase) and at 6 and 12 months (chronic phases). BBS was used as the outcome variable to determine the ability of the WGS to predict the risk of falls. The calculation of the predictive validity was carried out using the ROC (Receiver Operating Characteristics) curves and the analysis of the area under the curve (AUC, area under the curve). Results: Data were collected from 61 patients who met the inclusion criteria (after admission: 61; 3 months: 61; 6 months: 58; 12 months: 42). In all measurements, the AUC was greater than 0.9, so the WGS distinguishes stroke patients with moderate risk of falling from those with low risk. Conclusions: The WGS scale is a valid instrument to predict the risk of falls in patients with a criterion in relation to the cut-off points established in the BBS.(AU)

Understanding the effects of coastal defence structures on marine biota: The role of substrate composition and roughness in structuring sessile, macro- and meiofaunal communities.

The increasing deployment of artificial structures into the marine environment is creating new hard substrates that differ from natural ones in physical and biological aspects. However, studies of macrofaunal and meiofaunal communities associated with artificial structures are very limited. Seawalls, cubes, acropods and rip-raps in Algeciras Bay (southern Spain) were each compared with the nearest natural hard substrate and their community structure was related to substrate roughness, composition, carbonates content, crystallinity and age, using db-RDA. The results showed clear differences between substrates for the three community levels (sessile, macro- and meiofauna). Overall, rip-raps were the most similar to natural substrates. Under similar environmental conditions, substrate roughness, composition (only for sessile) and age of the structures seemed to play important roles in structuring those communities. They especially affected the sessile community, initiating strong cascading effects that were detectable at high taxonomic level in the associated fauna.

Do artificial structures cause shifts in epifaunal communities and trophic guilds across different spatial scales?

In the current frame of proliferation of artificial structures in the sea, the ecological effects of artificial substrates on marine environments and their associate biota become a topic of great scientific and conservationist interest. This study was focused on the amphipod communities from western Mediterranean Sea and tested, using the same secondary substrate, Ellisolandia elongata, if the community and trophic structure differ between artificial (two concrete-based: cubes and tetrapods, and one natural rock-based: rip-raps) and natural substrates. Results usually showed lower taxa number and diversity in artificial substrates, as well as differences in composition and trophic structure of the amphipod community. However, patterns were not consistent for all localities, evidencing the importance of local scale. Other potential factors, besides the substrate type, should be considered to understand particularities of each locality in management and conservation strategies.

Construct validity of the Wisconsin Gait Scale in acute, subacute and chronic stroke.

OBJECTIVE: To assess the construct validity of the Wisconsin Gait Scale (WGS) in subjects after stroke. METHODS: A retrospective observational study was conducted at inpatient rehabilitation hospital. Data from 61 stroke patients was compiled. The Functional Ambulatory Categories (FAC), the Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke Patients (PASS), the Barthel Index (BI) and the Functional Independence Measure (FIM) were selected to analyze the WGS construct validity at four specific time points after stroke (acute, subacute and chronic stages). Spearman correlation coefficients investigated the relationship between WGS and clinical measures. RESULTS: The construct validity of the WGS in patients with stroke at acute stage was moderate with the FAC (r=-.773), the BBS (r=-.676), the PASS (r=-.646) and the FIM (r=-.592). At subacute stage, the construct validity of the WGS was excellent with the FAC (r=-878), the BBS (r=-.882), the PASS (r=-.847) and the BI (r=-.813). The correlation was moderate with the FIM (r=-.693). At six and twelve months, the construct validity of WGS with the FAC, the BBS, the PASS, the BI and the FIM was excellent (r ≥ .8). CONCLUSION: The WGS has moderate construct validity with walking, balance and functionality scales in patients with acute stroke. The correlation with the FAC, the BBS, the PASS and the BI at subacute and chronic stages was excellent.

Habitat selection of intertidal caprellid amphipods in a changing scenario.

Habitat selection is a complex process, dependent on numerous fluctuating conditions and key to species coexistence. In a changing global scenario, it will greatly determine the fate of marine organisms and hence is an important subject to be explored. The present study evaluates host specificity of two caprellid amphipod species, Caprella grandimana and Caprella takeuchii, dwelling on a rocky intertidal where the calcifying macroalgae Jania rubens and Ellisolandia elongata show opposite seasonal fluctuation patterns throughout the year. To avoid confounding preference with other factors, the substrate selection experimental design included both multiple choice and non-choice treatments. Macroalgal structure analyses using fractals and interstitial space index were included in the study, as substrate complexity is a main factor driving preference for epifauna. Caprella grandimana actively selected J. rubens, whereas C. takeuchii did not show any preference; both behaviours remaining consistent regardless of the original substrate. Preference for J. rubens is probably owed to its interstitial space and thalli characteristics, as the complexity analysis suggested, since these allow for better refuge against predators and a more suitable surface for grasping. Meanwhile, the plasticity of C. takeuchii seems to favor an ongoing taking over of its congener at the time of the year when J. rubens drops. We highlight the need for rigor when performing substrate selection experiments; the importance of including habitat selection lessons in conservation strategies and modelling studies dealing with global change; and the risk in generalizing results within the family or genus level, which is occasionally inadequate for understanding the functioning of the ecosystem as a whole.

Evaluation of MYC status in oral lichen planus in patients with progression to oral squamous cell carcinoma.

BACKGROUND: Malignant transformation of oral lichen planus (OLP) to oral squamous cell carcinoma (OSCC) is controversial. C-MYC is a proto-oncogene involved in various solid tumours, including OSCC. OBJECTIVES: To determine MYC status using fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) in OLP lesions from 10 patients with progression to OSCC (group I) and to compare this with OLP lesions from patients without progression to OSCC (group II). METHODS: We constructed two tissue microarrays with 11 OSCC samples (group IA), 17 OLP samples from the same patients (group IB) and 13 OLP specimens from 12 control patients (group II). FISH evaluation of the MYC gains was determined in 100 nonoverlapping nuclei per sample. IHC evaluation was determined by calculating the percentage C-MYC expression in the epithelial cells. RESULTS: OSCC samples showed MYC copy number gains and C-MYC overexpression in 91% and 73% of cases, respectively. MYC gains were detected in 47% of samples from group IB and were absent from all samples from group II. C-MYC was overexpressed in 87% of cases from group IB and in only 44% of control specimens (group II). The differences in MYC status between groups IB and II were statistically significant. CONCLUSIONS: OLP lesions in patients with progression to OSCC show MYC gains and C-MYC overexpression. In patients with severe OLP, determining MYC status may predict a subgroup of subjects with a higher risk of progression to OSCC.

Role of Leishmania spp. infestation in nondiagnostic cutaneous granulomatous lesions: report of a series of patients from a Western Mediterranean area.

BACKGROUND: Leishmaniasis is a parasitic disease prevalent in countries of the Mediterranean area. OBJECTIVES: The potential role of Leishmania as the aetiological factor for cutaneous granulomatous lesions in a series of patients from a Western Mediterranean area was evaluated. The practical usefulness of Leishmania-specific polymerase chain reaction (PCR) amplification and immunohistochemical techniques in skin biopsy specimens was assessed. METHODS: Twenty-five skin biopsies diagnosed as nonspecific granulomatous dermatoses were included in the study. A panel of histopathological features was blindly evaluated by two independent observers. Only those cases showing nondiagnostic clinicopathological features and lacking demonstrable microorganisms after bacteriological, mycological or mycobacteriological cultures and specific stains (Ziehl-Neelsen, Giemsa, Gram, periodic acid-Schiff stains) were finally selected. Quantitative real-time PCR was performed in all selected samples. In available samples, immunohistochemical detection of specific Leishmania spp. antigens was also performed. RESULTS: From the selected 25 biopsies, Leishmania spp. DNA was detected by real-time PCR in 13 cases. In seven of eight PCR-positive cases the presence of a varying density of amastigotes could also be demonstrated immunohistochemically. CONCLUSIONS: Leishmania infection seems to be an important aetiological factor in cutaneous granulomatous lesions showing nondiagnostic features in endemic areas. In such areas, Leishmania-specific PCR amplification and/or immunohistochemical studies may be useful diagnostic tools. These techniques may be specifically indicated in the evaluation of patients showing nonspecific granulomatous inflammatory infiltrates of unknown aetiology lacking the histopathological evidence of parasites.

Cutaneous lymphomas showing prominent granulomatous component: clinicopathological features in a series of 16 cases.

BACKGROUND: The presence of a prominent granulomatous tissue reaction in skin biopsies from primary cutaneous or systemic malignant lymphomas with secondary cutaneous involvement is a rare but well-known phenomenon. OBJECTIVE: This paper aims to characterize and study a series of cutaneous lymphomas showing a prominent granulomatous component. PATIENTS AND METHODS: The clinical, histopathological and evolutive features of granulomatous variants of mycosis fungoides (5 patients, 2 of them associating 'granulomatous slack skin' features), Sézary syndrome (1 patient), CD30(+) cutaneous T-cell lymphoma (2 patients), CD4(+) small/medium pleomorphic cutaneous T-cell lymphoma (1 patient), primary cutaneous B-cell lymphoma (3 patients) and peripheral T-cell lymphoma with secondary epithelioid granulomatous cutaneous involvement (4 patients) were reviewed. RESULTS: The observed features were clinically non-distinctive. Only those cases presenting with granulomatous slack skin features were clinically suspected (2 patients). Non-necrotizing granulomata (11 patients) and granuloma annulare-like (4 patients) were the most frequently observed histopathological patterns. In five cases, no diagnostic lymphomatous involvement was initially observed. From our series, no definite conclusions regarding prognosis could be established. CONCLUSION: The diagnosis of cutaneous lymphoma may be difficult when a prominent cutaneous granulomatous inflammatory infiltrate obscures the true neoplastic nature of the condition. However, the presence of concomitant lymphoid atypia may help to suspect the diagnosis. In doubtful cases, the clinical evolution and the demonstration of a monoclonal lymphoid B- or T-cell population may lead to a definite diagnosis.

[Analysis of cytogenetic abnormalities in squamous cell carcinoma by array comparative genomic hybridization]. / Estudio de las lesiones citogenéticas en el carcinoma escamoso cutáneo mediante la técnica de arrays de hibridación genómica comparada.

INTRODUCTION: Few conventional cytogenetic studies of squamous cell carcinoma (SCC) have been performed to date. The introduction of cytogenetic techniques such as comparative genomic hybridization (CGH) has resolved some of the problems associated with conventional cytogenetics. The aim of this study was to analyze the presence of genetic abnormalities in a series of patients with SCC using the technique of array CGH. MATERIAL AND METHODS: The study included 8 patients (7 men and 1 woman; mean age, 75 years) diagnosed with primary SCC. DNA was extracted from frozen tissue and analyzed by array CGH. RESULTS: All cases had genetic alterations, with gains more frequent than losses. The chromosomal regions with gains, in descending order of frequency, were as follows: 5p15.2, 9q31.3-q33.2, 13q, 18q22, 1p21-p22, 1q24-q25, 3p13, 4q33-q34 (HMGB2, SAP30), 20p12.2 (JAG1), 21q21.1, and Xq21.33. The region 9p13.1-p13.3 was the only one to display recurrent loss. No correlation was observed between the presence of gains or losses and the clinical and pathological characteristics of the tumors. CONCLUSIONS: This is the first study to use the technique of array CGH to analyze genetic alterations in SCC. The finding of certain previously described aberrations (gain of 5p) suggests the existence of recurrent abnormalities. Likewise, the observation of alterations in small regions of chromosome 1 highlights the sensitivity of the technique to detect small changes. Application of the technique to a larger series of cases will provide greater insight into the genetic abnormalities implicated in the process of tumorigenesis in SCC.

Linear unilateral hamartomatous basal cell naevus with glandular and follicular differentiation.

Mosaicisms are characterized by genetic or functional differences between > or = 2 cell lines in one person, derived from a single zygote. Of the various clinical patterns of cutaneous mosaicism, linear lesions following Blaschko's lines are probably the most commonly encountered, Several cases of multiple basal cell carcinomas or basaloid hamartomatous lesions distributed in a segmentary distribution and following Blaschko's lines have been described. The various terms of 'linear unilateral basal cell naevus with comedones', 'linear unilateral basaloid follicular hamartoma', 'linear unilateral basal cell naevus', and 'basal-cell and linear unilateral adnexal hamartoma' have been used to define this apparently heterogeneous group of disorders. We report a 66-year-old woman with a linear unilateral lesion that appeared during puberty and that histologically showed an adnexal hamartomatous lesion with multiple superficial and nodular basal cell carcinomas. Focal areas of glandular and follicular differentiation were also noted. Molecular studies from these lesions ruled out loss of heterozygosity or mutations in patched gene.

Quantification and characterization of carotid calcium with multi-detector CT-angiography.

OBJECTIVE: The aim of this study was to assess the accuracy of CT-angiography for identification and measurement of calcification of carotid atherosclerotic plaques and to characterise the content and distribution pattern of mineral calcium (hydroxyapatite, Ca) in carotid bifurcations and investigate its relationship with neurological symptoms. METHODS: Twenty-six patients with ICA stenosis > 60% (13 symptomatic, 13 asymptomatic) were selected for study. Ca was estimated from the weight of the ashed remnants of carotid endarterectomy (CEA) specimens in 11 patients. Calcium content (calcification volume (mm3),CV), and average calcium density (Hounsfield units (HU),CD), were determined by CT-angiography. The distribution pattern of calcium within the lesion (base (posterior), shoulder or luminal surface) was assessed in all cases. RESULTS: CT-derived estimation of CV and Ca mass (modified Agatston Score, (mAS) = CV x CD) showed a good correlation with its direct measurement in CEA specimens (r = 0.911 and 0.993 respectively, p < 0,005). Asymptomatic patients with ICA stenosis > 60% showed statistically significant higher content of Ca than those who were symptomatic (mAS: 122.6 +/- 138.0 HU mm3 vs 42.8 +/- 59.1 HU mm3, p = 0.04). Calcification on the surface of the plaque was observed more commonly in asymptomatic patients (9/12 vs 3/15, p = 0.006). Non-calcified or plaques with posterior calcification were 12 times more likely to be symptomatic (OR: 12, 95%CI 1.5-91.1, p = 0.021). CONCLUSIONS: CT-angiography permits the reliable quantification of calcification of carotid plaques. A lower content of calcium in carotid plaques, as well as its distribution in the base of the lesion, was associated with a greater prevalence of neurological symptoms. These parameters may be useful to identify those patients at higher risk of stroke.