[Sacroiliac pain: diagnosis and treatment]. / Dolor sacroilíaco: diagnóstico y tratamiento.

The purpose of this review is to provide an overview of current literature on the diagnosis and treatment of sacroiliac pain. Designation as a source of lower back pain has been controversial; However, as knowledge about the joint increases, its role as a generator of chronic pain has become better elucidated. The literature states that sacroiliac joint is the cause of pain in up to 30% of patients. Clinically, diagnosing sacroiliac pain can be difficult to assess; However, pain semiology, patient posture/movement and manual testing are useful for making the presumptive diagnosis of sacroiliac dysfunction. The most effective diagnostic test is image-guided injection of anesthetic solutions into the joint, which is considered positive if there is at least 75% acute symptom relief. Treatment begins with physiotherapy and/or intra-articular infiltration of steroids. If these fails, a possible option is radiofrequency (rizotomy) denervation of the joint. If this does not provide adequate relief, surgery may be considered, in the form of fusion; various work supports favorable outcomes in selected patients.

El propósito de esta revisión es proporcionar una visión general de la literatura actual sobre el diagnóstico y tratamiento del dolor sacroilíaco. La designación como fuente de dolor lumbar ha sido controvertida; sin embargo, a medida que aumenta el conocimiento sobre la articulación, su papel como generador de dolor crónico se ha dilucidado mejor. La literatura afirma que la articulación sacroilíaca es la causa de dolor en hasta 30% de los pacientes. Clínicamente, el diagnóstico de dolor sacroilíaco puede ser difícil de evaluar; sin embargo, la semiología del dolor, la postura/movimiento del paciente y las pruebas manuales son útiles para hacer el diagnóstico presuntivo de disfunción sacroilíaca. La prueba diagnóstica más efectiva es la inyección guiada por imagen de soluciones anestésicas en la articulación, que se considera positiva si hay al menos 75% de alivio de los síntomas de forma aguda. El tratamiento comienza con fisioterapia y/o infiltración intraarticular de esteroides. Si éstos fallan, una posible opción es la denervación por radiofrecuencia (rizotomía) de la articulación. Si esto no proporciona un alivio adecuado, se puede considerar la intervención quirúrgica en forma de fusión; diversos trabajos respaldan los resultados favorables en pacientes seleccionados.

Salbutamol tolerability and efficacy in patients with spinal muscular atrophy type II.

Spinal muscular atrophy (SMA) is an autosomal recessive disease caused by homozygous deletions or loss-of-function mutations in SMN1, which result in a degeneration of motor neurons in the spinal cord and brain stem. Even without a randomized placebo-controlled trial, salbutamol has been offered to patients with SMA in the neuromuscular clinics of most of hospitals for many years. We describe the response to salbutamol in 48 patients with SMA type II who were not taking any other medication. We investigate the changes over an eighteen-month period in motor functional scales and we analyze side effects and subjective response to treatment. Our results suggest that oral administration of salbutamol might be helpful in the maintenance of motor function in patients with SMA type II. An apparent beneficial effect was observed in functional scales of children under the age of 6, especially during the first 6 months of therapy. The majority of patients of all ages referred some kind of subjective positive effect associated with therapy intake. Salbutamol seemed safe and was well tolerated without serious side effects.

Metastable Nonextremal Antibranes.

We find new and compelling evidence for the metastability of supersymmetry-breaking states in holographic backgrounds whose consistency has been the source of ongoing disagreements in the literature. As a concrete example, we analyze anti-D3 branes at the tip of the Klebanov-Strassler throat. Using the blackfold formalism we examine how temperature affects the conjectured metastable state and determine whether and how the existing extremal results generalize when going beyond extremality. In the extremal limit we exactly recover the results of Kachru, Pearson, and Verlinde, in a regime of parameter space that was previously inaccessible. Away from extremality we uncover a metastable black Neveu-Schwarz five-brane (NS5) state that disappears near a geometric transition where black anti-D3 branes and black NS5 branes become indistinguishable. This is remarkably consistent with complementary earlier results based on the analysis of regularity conditions of backreacted solutions. We therefore provide highly nontrivial evidence for the metastability of antibranes in noncompact throat geometries since we find a consistent picture over different regimes in parameter space.

Manejo de las rinosinusitis en Atención Primaria / Management of Rhinosinusitis in Primary Care

La rinosinusitis aguda representa un importante problema de salud, y, aunque su frecuencia no está bien establecida en nuestro país, es motivo de una no desdeñable carga económica, alterando notablemente la calidad de vida de los pacientes que la padecen. Su diagnóstico es eminentemente clínico, debiendo reservar las exploraciones complementarias para el diagnóstico diferencial de las complicaciones y de procesos tumorales. Las causas más frecuentes son las infecciones, siendo los virus los agentes más comunmnte implicados. De entre las bacterias Streptococcus pneumoniae y Haemophilus influenzae son las más habitualmenta aisladas. Hoy las complicaciones no son frecuentes, pero sí pueden llegar a ser graves, de las cuales las más comunes son las orbitarias, seguidas de las endocráneales y las óseas. El tratamiento se basa en médidas sintomáticas, como los lavados con soluciones salinas y antibióticos para los casos de etiología bacteriana. Management of Rhinosinusitis in Primary Care

Acute rhinosinusitis is an important health problem. Even though its frequency is not well documented in our country?, the economic burden it bears is not insignificant as it notably alters the quality of life of affected patients. Its diagnosis is generally clinical in nature, with further studies reserved only for the differential diagnoses of complications or tumour-like processes. The most frequent causes are viral infections, although Streptococcus pneumoniae and Haemophilus influenzae are the most commonly isolated bacterial agents. Although complications are uncommon nowadays, they can be serious when they occur, and commonly include orbital infections, closely followed in frequency by intracranial and bone infections. Treatment should consist of symptomatic measures, like saline rinses and antibiotics in cases of bacterial origin

Riesgo de eventos fatales/no fatales en pacientes con enfermedad coronaria/infarto agudo de miocardio previo y tratamiento con antiinflamatorios no esteroideos / Risk of fatal/non-fatal events in patients with previous coronary heart disease/acute myocardial infarction and treatment with non-steroidal anti-inflammatory drugs

Antecedentes: La Atención Primaria es el eje fundamental de nuestro sistema sanitario y nos obliga a ser consecuentes con nuestras prescripciones. Los antiinflamatorios no esteroideos (AINE) se han asociado con un incremento en el riesgo cardiovascular y de muerte por todas las causas y por infarto agudo de miocardio (IAM) en pacientes con infarto de miocardio previo. El manejo del dolor y de los pacientes cardiópatas son 2 pilares básicos en nuestra actividad diaria, y debemos conocer las limitaciones de los AINE en pacientes con riesgo cardiovascular establecido. Objetivos: Presentamos una revisión de la literatura científica con especial interés en la relación entre los AINE y el riesgo cardiovascular. El objetivo es analizar la relación entre el consumo de diferentes AINE y los eventos fatales y no fatales en pacientes con enfermedad coronaria conocida. Método: Revisión de la literatura científica con un interés inicial en el papel de los AINE y el riesgo cardiovascular. La revisión de la literatura se realizó en los motores de búsqueda PubMed y Tripdatabase, con determinadas palabras clave. Contamos con 15 documentos originales, de los cuales 9 no correspondían completamente al enfoque central, por lo que el desarrollo se decidió a partir de 6 artículos originales de los últimos 5 años que sí abordan, como enfoque principal, el aumento del riesgo cardiovascular encontrado (eventos fatales y no fatales) en pacientes con enfermedad cardiovascular o IAM previo a los que se les prescribió algún AINE por cualquier razón. El riesgo de eventos fatales/no fatales en cada uno de los estudios se expresa por la odds ratio (OR)/hazard ratio (HR), definido como la probabilidad de que ocurra un evento. Resultados: Se observó un riesgo moderado para el ibuprofeno. Aumenta el riesgo de síndrome coronario agudo tras 5 años del evento cardiovascular, sobre todo en el segundo año (OR 1,63; IC 95% 1,42-1,87), y eleva el riesgo de ACVA (HR 1,23; IC 95% 1,10-1,38). Los inhibidores de la ciclooxigenasa-2 fueron el tercer grupo de riesgo, por detrás de nabumetona y diclofenaco: celecoxib aumenta el riesgo a partir del día 14 de tratamiento (HR 2,3; IC 95% 1,79-3,02), presentando una OR de 1,47 (IC 95% 1,05-2,07) para un nuevo IAM; rofecoxib presenta riesgo de eventos fatales cardiovasculares incluso a dosis bajas y tras 7 días de tratamiento (HR 2,5; IC 95% 1,91-3,46), con una OR de 2,30 (IC 95% 1,76-2,99) para un nuevo IAM; naproxeno presentó un menor riesgo de muerte cardiovascular y de nuevos eventos cardiovasculares, pero sin resultados significativos excepto para el tratamiento durante más de 90 días (HR 1,55; IC 95% 1,10-2,17). Aumento del sangrado gastrointestinal y comorbilidad asociada durante el primer año de tratamiento (HR 1,44; IC 95% 1,07-1,94). Se observa que el ketorolaco es el fármaco de mayor riesgo de nuevo IAM: vía oral OR 3,91 (IC 95% 2,02-7,58). Destaca, como dato de interés, el factor cardioprotector que ejercen ciertos fármacos, tales como los antiagregantes plaquetarios y las estatinas, en pacientes con consumo de AINE. Por ejemplo, en pacientes con mayor comorbilidad se observaron diferencias en la OR. La toma de antiagregantes ofreció una OR de 1,37 (IC 95% 0,68-2,74) en comparación a la no toma de estos, OR 1,79 (IC 95% 1,16-2,78). Conclusiones: Se estratificó por años el consumo de varios AINE y su relación con un mayor riesgo de síndrome coronario agudo fatal y no fatal. Aumenta el riesgo independientemente del tiempo transcurrido en relación con los que no lo toman, manteniéndose prácticamente estables durante 5 años. Se observó que el diclofenaco y los inhibidores de la ciclooxigenasa-2 (especialmente rofecoxib) mostraron un mayor riesgo, a diferencia del naproxeno, que presenta un menor aumento del riesgo. Sin embargo, el naproxeno, debido a su mayor capacidad para generar sangrado gastrointestinal, aumentó por esta razón los eventos fatales y la comorbilidad en estos pacientes. A pesar de esto, sigue siendo el que presenta mejor perfil de seguridad cardiovascular

Background: Primary Care is the fundamental axis of our health system and obliges us to be consistent with our prescriptions. The non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk and increased risk of all causes of death, as well as acute myocardial infarction (AMI) in patients with a previous myocardial infarction. Pain and cardiac patient management are 2 basic pillars in our daily activity, and we must know the limitations of NSAIDs in patients with established cardiovascular risk. Objectives: We present a review of the scientific literature with primary interest in the role of NSAIDs and cardiovascular risk. The objective is to determine the relationship between the consumption of different NSAIDs and the fatal and non-fatal events among patients with known coronary disease. Method: This is a review of the scientific literature with primary interest in the role of NSAIDs and cardiovascular risk. The literature review was conducted in PubMed search engines like Tripdatabase and with certain keywords. Of the 15 original papers found, 9 did not correspond completely to the central focus, so the approach was decided from 6 original articles from the past 5 years, which address the central focus of increased cardiovascular risk found (fatal and non-fatal events) in patients with prior cardiovascular disease or AMI being prescribed NSAIDs for any reason. The risk of fatal/non-fatal events in each of the studies is expressed by the odds ratio (OR)/hazard ratio (HR), defined as the probability of an event occurring. Results: A moderate risk was observed for ibuprofen. It increases the risk of acute coronary syndrome after 5 years of cardiovascular event, especially in the 2nd year (OR 1.63; 95% CI 1.42-1.87). It also increases the risk of stroke (HR 1.23; 95% IC 1.10-1.38). Cyclo-oxygenase-2 inhibitors were the third risk group, after nabumetone and diclofenac. Celecoxib increases risk from the 14th day of treatment (HR 2.3; 95% CI 1.79-3.02), having an OR of 1.47 (95% CI 1.05-2.07) for new AMI. Rofecoxib shows a risk of fatal cardiovascular events, even at low doses, and after 7 days of treatment (HR 2.5; 95% CI 1.91-3.46), with an OR of 2.30 (95% CI 1.76-2.99) for new AMI. Naproxen had a lower risk of cardiovascular death and new cardiovascular events, but no significant results except for treatment longer than 90 days (HR 1.55; 95% CI 1.10-2.17), with increased gastrointestinal bleeding and associated comorbidity during the first year of treatment (HR 1.44; 95% CI 1.07-1.94). Ketorolac is seen as the drug of greatest risk for new AMI: Oral treatment (OR 3.91; 95% CI 2.02-7.58). The review highlights the cardio-protective factor of certain drugs, such as antiplatelet agents and statins in patients, with NSAIDs use. For example, in patients with greater comorbidity, differences were observed in the OR, with antiplatelet agents consumption giving an OR of 1.37 (95% CI 0.68-2.74), compared to the non-consumption, OR 1.79 (95% CI 1.16-2.78). Conclusions: The consumption of various NSAIDs and their relationship to increased risk of fatal and non-fatal acute coronary syndrome is classified by years. Consumption increases the risk regardless of the time elapsed in relation to those that did not take them, with the figures remaining virtually stable for five years. Diclofenac and cyclooxygenase-2 inhibitors (especially Rofecoxib) showed an increased risk, unlike naproxen, which had a lower risk. However, naproxen, and because of its greater capacity to generate gastrointestinal bleeding, increased for this reason, fatal events and comorbidity in these patients. Despite this, it still has the best cardiovascular safety profile

[Management of Rhinosinusitis in Primary Care]. / Manejo de las rinosinusitis en Atención Primaria.

Acute rhinosinusitis is an important health problem. Even though its frequency is not well documented in our country?, the economic burden it bears is not insignificant as it notably alters the quality of life of affected patients. Its diagnosis is generally clinical in nature, with further studies reserved only for the differential diagnoses of complications or tumour-like processes. The most frequent causes are viral infections, although Streptococcus pneumoniae and Haemophilus influenzae are the most commonly isolated bacterial agents. Although complications are uncommon nowadays, they can be serious when they occur, and commonly include orbital infections, closely followed in frequency by intracranial and bone infections. Treatment should consist of symptomatic measures, like saline rinses and antibiotics in cases of bacterial origin.

Hyphoderma paramacaronesicum sp. nov. (Meruliaceae, Polyporales, Basidiomycota), a cryptic lineage to H. macaronesicum.

This article re-evaluates the taxonomy of Hyphoderma macaronesicum based on various strategies, including the cohesion species recognition method through haplotype networks, multilocus genetic analyses using the genealogical concordance phylogenetic concept, as well as species tree reconstruction. The following loci were examined: the internal transcribed spacers of nuclear ribosomal DNA (ITS nrDNA), the intergenic spacers of nuclear ribosomal DNA (IGS nrDNA), two fragments of the protein-coding RNA polymerase II subunit 2 (RPB2), and two fragments of the translation elongation factor 1-α (EF1-α). Our results indicate that the name H. macaronesicum includes at least two separate species, one of which is newly described as Hyphoderma paramacaronesicum. The two species are readily distinguished based on the various loci analysed, namely ITS, IGS, RPB2 and EF1-α.

[Risk of fatal/non-fatal events in patients with previous coronary heart disease/acute myocardial infarction and treatment with non-steroidal anti-inflammatory drugs]. / Riesgo de eventos fatales/no fatales en pacientes con enfermedad coronaria/infarto agudo de miocardio previo y tratamiento con antiinflamatorios no esteroideos.

BACKGROUND: Primary Care is the fundamental axis of our health system and obliges us to be consistent with our prescriptions. The non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk and increased risk of all causes of death, as well as acute myocardial infarction (AMI) in patients with a previous myocardial infarction. Pain and cardiac patient management are 2 basic pillars in our daily activity, and we must know the limitations of NSAIDs in patients with established cardiovascular risk. OBJECTIVES: We present a review of the scientific literature with primary interest in the role of NSAIDs and cardiovascular risk. The objective is to determine the relationship between the consumption of different NSAIDs and the fatal and non-fatal events among patients with known coronary disease. METHOD: This is a review of the scientific literature with primary interest in the role of NSAIDs and cardiovascular risk. The literature review was conducted in PubMed search engines like Tripdatabase and with certain keywords. Of the 15 original papers found, 9 did not correspond completely to the central focus, so the approach was decided from 6 original articles from the past 5 years, which address the central focus of increased cardiovascular risk found (fatal and non-fatal events) in patients with prior cardiovascular disease or AMI being prescribed NSAIDs for any reason. The risk of fatal/non-fatal events in each of the studies is expressed by the odds ratio (OR)/hazard ratio (HR), defined as the probability of an event occurring. RESULTS: A moderate risk was observed for ibuprofen. It increases the risk of acute coronary syndrome after 5 years of cardiovascular event, especially in the 2nd year (OR 1.63; 95% CI 1.42-1.87). It also increases the risk of stroke (HR 1.23; 95% IC 1.10-1.38). Cyclo-oxygenase-2 inhibitors were the third risk group, after nabumetone and diclofenac. Celecoxib increases risk from the 14th day of treatment (HR 2.3; 95% CI 1.79-3.02), having an OR of 1.47 (95% CI 1.05-2.07) for new AMI. Rofecoxib shows a risk of fatal cardiovascular events, even at low doses, and after 7 days of treatment (HR 2.5; 95% CI 1.91-3.46), with an OR of 2.30 (95% CI 1.76-2.99) for new AMI. Naproxen had a lower risk of cardiovascular death and new cardiovascular events, but no significant results except for treatment longer than 90 days (HR 1.55; 95% CI 1.10-2.17), with increased gastrointestinal bleeding and associated comorbidity during the first year of treatment (HR 1.44; 95% CI 1.07-1.94). Ketorolac is seen as the drug of greatest risk for new AMI: Oral treatment (OR 3.91; 95% CI 2.02-7.58). The review highlights the cardio-protective factor of certain drugs, such as antiplatelet agents and statins in patients, with NSAIDs use. For example, in patients with greater comorbidity, differences were observed in the OR, with antiplatelet agents consumption giving an OR of 1.37 (95% CI 0.68-2.74), compared to the non-consumption, OR 1.79 (95% CI 1.16-2.78). CONCLUSIONS: The consumption of various NSAIDs and their relationship to increased risk of fatal and non-fatal acute coronary syndrome is classified by years. Consumption increases the risk regardless of the time elapsed in relation to those that did not take them, with the figures remaining virtually stable for five years. Diclofenac and cyclooxygenase-2 inhibitors (especially Rofecoxib) showed an increased risk, unlike naproxen, which had a lower risk. However, naproxen, and because of its greater capacity to generate gastrointestinal bleeding, increased for this reason, fatal events and comorbidity in these patients. Despite this, it still has the best cardiovascular safety profile.

Human leucocyte antigens class II allele and haplotype association with Type 1 Diabetes in Madeira Island (Portugal).

This study confirms for Madeira Island (Portugal) population the Type 1 Diabetes (T1D) susceptible and protective Human leucocyte antigens (HLA) markers previously reported in other populations and adds some local specificities. Among the strongest T1D HLA associations, stands out, as susceptible, the alleles DRB1*04:05 (OR = 7.3), DQB1*03:02 (OR = 6.1) and DQA1*03:03 (OR = 4.5), as well as the haplotypes DRB1*04:05-DQA1*03:03-DQB1*03:02 (OR = 100.9) and DRB1*04:04-DQA1*03:01-DQB1*03:02 (OR = 22.1), and DQB1*06:02 (OR = 0.07) and DRB1*15:01-DQA1*01:02-DQB1*06:02 (OR = 0.04) as protective. HLA-DQA1 positive for Arginine at position 52 (Arg52) (OR = 15.2) and HLA-DQB1 negative for Aspartic acid at the position 57 (Asp57) (OR = 9.0) alleles appear to be important genetic markers for T1D susceptibility, with higher odds ratio values than any single allele and than most of the haplotypes. Genotypes generated by the association of markers Arg52 DQA1 positive and Asp57 DQB1 negative increase T1D susceptibility much more than one would expected by a simple additive effect of those markers separately (OR = 26.9). This study also confirms an increased risk for DRB1*04/DRB1*03 heterozygote genotypes (OR = 16.8) and also a DRB1*04-DQA1*03:01-DQB1*03:02 haplotype susceptibility dependent on the DRB1*04 allele (DRB1*04:01, OR = 7.9; DRB1*04:02, OR = 3.2; DRB1*04:04, OR = 22.1).

HLA-DQA1 and HLA-DQB1 allele diversity and its extended haplotypes in Madeira Island (Portugal).

This study shows, for the first time, high-resolution allele frequencies of HLA-DQA1 loci in Madeira Island (Portugal) and allows us to better understand and refine present knowledge on DQB1 variation, with the identification of several alleles not previously reported in this population. Estimates on haplotype profile, involving HLA-A, HLA-B, HLA-DRB1, HLA-DQA1 and HLA-DQB1, are also reported.

Diagnostic reference levels and complexity indices in interventional radiology: a national programme.

OBJECTIVES: To propose national diagnostic reference levels (DRLs) for interventional radiology and to evaluate the impact of the procedural complexity on patient doses. METHODS: Eight interventional radiology units from Spanish hospitals were involved in this project. The participants agreed to undergo common quality control procedures for X-ray systems. Kerma area product (KAP) was collected from a sample of 1,649 procedures. A consensus document established the criteria to evaluate the complexity of seven types of procedures. DRLs were set as the 3rd quartile of KAP values. RESULTS: The KAP (3rd quartile) in Gy cm2 for the procedures included in the survey were: lower extremity arteriography (n = 784) 78; renal arteriography (n = 37) 107; transjugular hepatic biopsies (THB) (n = 30) 45; biliary drainage (BD) (n = 314) 30; uterine fibroid embolization (UFE) (n = 56) 214; colon endoprostheses (CE) (n = 31) 169; hepatic chemoembolization (HC) (n = 269) 303; femoropopliteal revascularization (FR) (n = 62) 119; and iliac stent (n = 66) 170. The complexity involved the increases in the following KAP factors from simple to complex procedures: THB x4; BD x13; UFE x3; CE x3; HC x5; FR x5 and IS x4. CONCLUSIONS: The evaluation of the procedure complexity in patient doses will allow the proper use of DRLs for the optimization of interventional radiology. KEY POINTS: • National DRLs for interventional procedures have been proposed given level of complexity • For clinical audits, the level of complexity should be taken into account. • An evaluation of the complexity levels of the procedure should be made.

Influence of source batch S dispersion on dosimetry for prostate cancer treatment with permanent implants.

PURPOSE: In clinical practice, specific air kerma strength (SK) value is used in treatment planning system (TPS) permanent brachytherapy implant calculations with (125)I and (103)Pd sources; in fact, commercial TPS provide only one SK input value for all implanted sources and the certified shipment average is typically used. However, the value for SK is dispersed: this dispersion is not only due to the manufacturing process and variation between different source batches but also due to the classification of sources into different classes according to their SK values. The purpose of this work is to examine the impact of SK dispersion on typical implant parameters that are used to evaluate the dose volume histogram (DVH) for both planning target volume (PTV) and organs at risk (OARs). METHODS: The authors have developed a new algorithm to compute dose distributions with different SK values for each source. Three different prostate volumes (20, 30, and 40 cm(3)) were considered and two typical commercial sources of different radionuclides were used. Using a conventional TPS, clinically accepted calculations were made for (125)I sources; for the palladium, typical implants were simulated. To assess the many different possible SK values for each source belonging to a class, the authors assigned an SK value to each source in a randomized process 1000 times for each source and volume. All the dose distributions generated for each set of simulations were assessed through the DVH distributions comparing with dose distributions obtained using a uniform SK value for all the implanted sources. The authors analyzed several dose coverage (V100 and D90) and overdosage parameters for prostate and PTV and also the limiting and overdosage parameters for OARs, urethra and rectum. RESULTS: The parameters analyzed followed a Gaussian distribution for the entire set of computed dosimetries. PTV and prostate V100 and D90 variations ranged between 0.2% and 1.78% for both sources. Variations for the overdosage parameters V150 and V200 compared to dose coverage parameters were observed and, in general, variations were larger for parameters related to (125)I sources than (103)Pd sources. For OAR dosimetry, variations with respect to the reference D0.1cm(3) were observed for rectum values, ranging from 2% to 3%, compared with urethra values, which ranged from 1% to 2%. CONCLUSIONS: Dose coverage for prostate and PTV was practically unaffected by SK dispersion, as was the maximum dose deposited in the urethra due to the implant technique geometry. However, the authors observed larger variations for the PTV V150, rectum V100, and rectum D0.1cm(3) values. The variations in rectum parameters were caused by the specific location of sources with SK value that differed from the average in the vicinity. Finally, on comparing the two sources, variations were larger for (125)I than for (103)Pd. This is because for (103)Pd, a greater number of sources were used to obtain a valid dose distribution than for (125)I, resulting in a lower variation for each SK value for each source (because the variations become averaged out statistically speaking).

Melatonin prevents dopaminergic cell loss induced by lentiviral vectors expressing A30P mutant alpha-synuclein.

Two hallmarks of Parkinson's disease (PD) are dopaminergic cell loss and the presence of cytoplasmic inclusions (Lewy bodies). Different point mutations in alpha-synuclein, the main constituent of Lewy bodies, have been identified in familial PD. Alpha-synuclein also constitutes one of the main components of Lewy bodies in sporadic cases of PD. Moreover, oxidant stress and generation of free radicals from both mitochondrial impairment and dopamine metabolism are considered to play critical roles in PD etiopathogenesis. Melatonin, a known potent antioxidant secreted by the pineal gland, may protect against the effect of several Parkinsonogenic compounds that are associated with progressive impairment of mitochondrial function and increased oxidative damage. However, the neuroprotective effect of melatonin has never been tested in the newly available genetic models of PD based on the viral expression of mutated alpha-synuclein. Lentiviral vectors encoding A30P mutant human alpha-synuclein (lenti-A30P) were stereotactically injected into the right substantia nigra of adult male Sprague-Dawley rats and neuroprotection was examined by administration of melatonin or vehicle from two days before nigral administration of lenti-A30P until eight weeks after injection. It was found that lenti-A30P induced a significant TH⁺ cell-loss both in the medial and lateral substantia nigra versus the contrallateral side injected with lenti-eGFP. However, melatonin administration showed a total neuroprotective effect in both regions of the substantia nigra. In conclusion, the data here show that melatonin is neuroprotective against mutant alpha-synuclein-induced injury in the substantia nigra.

Arrival of radionuclides released by the Fukushima accident to Tenerife (Canary Islands).

Two weeks after the accident at the Fukushima-Daichi nuclear power plant, 131I, 137Cs and 134Cs activities were measured in two different stations located in Tenerife (Canary Islands), situated at 300 (FIMERALL) and 2400 (IZAÑA) m.a.s.l, respectively. Peak measured activity concentrations were: 1.851 mBq/m3 (131I); 0.408 mBq/m3 (137Cs) and 0.382 mBq/m3 (134Cs). The activities measured at the FIMERALL station were always higher than at IZAÑA station, suggesting that the radioactive plume arrived to the island associated with low altitude air masses. Simulations of potential dispersion of the radioactive cloud (137Cs) after the nuclear accident in reactor Fukushima I show that radioactive pollution reached remote regions such as the Canary Islands in the Eastern subtropical North Atlantic. The corresponding effective dose to the local population was 1.17 nSv, a value less than one millionth of the annual limit for the general public. Therefore, there was no risk to public health.

A new species of Hyphoderma (Meruliaceae, Polyporales) and its discrimination from closely related taxa.

Thirty-five corticioid collections from the Canary Islands and Azores Archipelago were examined morphologically and subjected to molecular phylogenetic analysis. These specimens, almost all collected on endemic and/or xerophilic vegetation, were similar in morphological and ecological characteristics to Hypochnicium prosopidis from the Sonoran Desert (Arizona, USA) and Hyphoderma amoenum. Thirty-seven new ITS nrDNA sequences from these specimens, including the nomenclatural type of the above-mentioned species, were obtained and aligned with homologous sequences from GenBank. These collections were distributed in two strongly supported monophyletic clades. However, similar patterns of morphological variability shared by specimens included in both clades and their differences with related species suggest that they should be described as a single new species. Therefore Hyphoderma macaronesicum is proposed. Studies will be required to test, in a more robust multilocus genealogical framework, whether these populations constitute two cryptic species or whether they are the same taxon. The position of Hypochnicium prosopidis in the resolved tree and its morphological characters suggest that it should be included in Hyphoderma and the new combination Hyphoderma prosopidis is proposed.

A national programme for patient and staff dose monitoring in interventional cardiology.

A national programme on patient and staff dose evaluation in interventional cardiology made in cooperation with the haemodynamic section of the Spanish Society of Cardiology has recently been launched. Its aim is to propose a set of national diagnostic reference levels (DRLs) for patients as recommended by the International Commission on Radiological Protection and to initiate several optimisation actions to improve radiological protection of both patients and staff. Six hospitals have joined the programme and accepted to submit their data to a central database. First to be acquired were the quality control data of the X-ray systems and radiation doses of patients and professionals. The results from 9 X-ray systems, 1467 procedures and staff doses from 43 professionals were gathered. Provisional DRLs resulted in 44 Gy cm(2) for coronary angiography and 78 Gy cm(2) for interventions. The X-ray systems varied up to a factor of 5 for dose rates in reference conditions. Staff doses showed that 50 % of interventional cardiologists do not use their personal dosemeters correctly.

[Non invasive gene therapy in neurological diseases]. / Terapia genica no invasiva en enfermedades neurologicas.

INTRODUCTION: Brain gene therapy consists of introducing nucleic acids into nerve tissue whose expression may prove to be therapeutically useful. This genetic material is indirectly introduced by means of non invasive gene therapy into the blood thereby avoiding its direct injection into the brain and the damage to the blood brain barrier. AIM: The different non invasive vectors and means of gene transfer to the central nervous system will be discussed. DEVELOPMENT: There has been a remarkable breakthrough in recent years in non invasive gene transfer strategies into the central nervous system. The development of new serotypes of adenoassociated vectors, such as AAV9, and of functionalized nanoparticles, such as pegylated immunoliposomes, polymeric nanoparticles, pegylated nanoparticles, dendrimers, fullerens, as well as specific transporters specific to the low density lipoprotein receptor family, means that it is now possible to introduce and express gene material in nerve tissue following peripherical administration of the above mentioned vectors. CONCLUSIONS: Non invasive gene therapy entails exciting new perspectives for the treatment of the numerous neurological diseases for which there are no effective pharmacological treatments. Studies already performed on animals have proved to be highly promising and it is likely that, in the next few years, they will give rise to non invasive gene therapy procedures which will be useful and safe for treating patients.

Radiometric analysis of farmed fish (sea bass, gilthead bream, and rainbow trout) from Tenerife Island, Spain.

This study analyzed the content of gamma-emitting radionuclides in fish farmed on the island of Tenerife (Canary Islands, Spain). The fish species included in this study were sea bass, gilthead bream, and rainbow trout. The first two species are produced in offshore enclosures, while the third is produced in a freshwater fish farm. All measurements were performed using two high-purity germanium gamma-ray detectors. The content of gamma-emitting radionuclides in the fodder used to feed the different species of farmed fish studied was also determined. The following nuclides were often detected in the analyzed samples: 137Cs, 40K, 235U, 228Ac, 214Bi, 208Tl, 212Pb, and 214Pb. As a complement to this analysis, 210Po concentrations in two fish samples were determined by alpha spectrometry. The nuclide presenting the highest concentration was, as expected, the naturally occurring 40K, with an average concentration of 0.13 +/- 0.01 Bq/g (wet weight) (Bq/gww) in gilthead bream and sea bass and 0.12 +/- 0.01 Bq/gww in rainbow trout. The 235U concentrations determined in the same fish species were 0.6 +/- 0.5, 0.8 +/- 0.7, and 1.6 +/- 1.0 mBq/gww, respectively. This nuclide is seldom reported in fish samples. The concentrations of 137Cs (the only artificial nuclide determined in this study) in gilthead bream and sea bass were 0.026 +/- 0.006 and 0.044 +/- 0.01 mBq/gww, respectively. In addition to the radiometric analysis, the contribution of the analyzed nuclides to the effective dose from the mean daily intake of the fish was calculated. The calculated contribution, in terms of dose per person, produced by intake of the analyzed fish was 0.8 microSv/year. This value does not represent a significant risk to the local population.

HLA-A polymorphisms in four ethnic groups from Guinea-Bissau (West Africa) inferred from sequence-based typing.

Human leukocyte antigen (HLA)-A locus polymorphisms were examined at high-resolution level, using sequence-based typing, in the four most representative Guinea-Bissau (Northwest Africa) ethnic groups: Balanta, Bijagós, Fula and Papel. Despite the Fula group having significant differences when compared with the other three ethnic groups, all four groups most likely received a genetic input from non sub-Saharans. The Bijagós and Papel groups showed similarities to neighboring populations from Mali and Senegal. The Balanta, despite their oral tradition of an East Africa origin, show affinities to Cameroon populations, highly influenced by Bantu migrations. These results are congruent with historical sources and other genetic studies that support the finding that the Guinea-Bissau genetic pool was influenced by several migrations from North Africa, Sahara and East Africa.

Gloeodontia xerophila (Aphyllophorales, Basidiomycota), a new species with corticioid basidioma from the Canary Islands.

Gloeodontia xerophila sp. nov. is described and illustrated from material collected on dead xerophyte debris in the Canary Islands. This species is characterized by the odontioid hymenophore with short aculei, up to 2 mm long, dimitic hyphal system and amyloid, subglobose and verrucose spores, 4-5 x 3-4 microm. The new taxon is compared with other species in the genus and a key to the species of Gloeodontia is provided.