Phylogenetics and phylogeography of Euphorbia canariensis reveal an extreme Canarian-Asian disjunction but limited inter-island colonization.

Euphorbia canariensis is an iconic endemic species representative of the lowland xerophytic communities of the Canary Islands. It is widely distributed in the archipelago despite having diasporas unspecialized for long-distance dispersal. Here, we reconstructed the evolutionary history of E. canariensis at two levels: a time-calibrated phylogenetic analysis aimed at clarifying interspecific relationships and large-scale biogeographic patterns; and a phylogeographic study focused on the history of colonization across the Canary Islands. For the phylogenetic study, we sequenced the ITS region for E. canariensis and related species of Euphorbia sect. Euphorbia. For the phylogeographic study, we sequenced two cpDNA regions for 28 populations representing the distribution range of E. canariensis. The number of inter-island colonization events was explored using PAICE, a recently developed method that includes a sample size correction. Additionally, we used species distribution modelling (SDM) to evaluate environmental suitability for E. canariensis through time. Phylogenetic results supported a close relationship between E. canariensis and certain Southeast Asian species (E. epiphylloides, E. lacei, E. sessiliflora). In the Canaries, E. canariensis displayed a west-to-east colonization pattern, not conforming to the "progression rule", i.e. the concordance between phylogeographic patterns and island emergence times. We estimated between 20 and 50 inter-island colonization events, all of them in the Quaternary, and SDM suggested a late Quaternary increase in environmental suitability for E. canariensis. The extreme biogeographic disjunction between Macaronesia and Southeast Asia (ca. 11,000 km) parallels that found in a few other genera (Pinus, Dracaena). We hypothesize that these disjunctions are better explained by extinction across north Africa and southwest Asia rather than long-distance dispersal. The relatively low number of inter-island colonization events across the Canaries is congruent with the low dispersal capabilities of E. canariensis.

Estudio multicéntrico sobre los comités multidisciplinarios en cáncer de próstata avanzado / Multicenter study on multidisciplinary committees in advanced prostate cancer

Introducción y objetivoAunque los comités multidisciplinares (CMD) están recomendados en el manejo del cáncer de próstata avanzado (CPA), su funcionamiento en práctica real se ha evaluado escasamente. Desarrollamos un estudio multicéntrico con el objetivo de evaluar el funcionamiento de los CMD urooncológicos en seis hospitales.Materiales y métodosRealizamos un estudio transversal descriptivo. El nivel de cumplimiento de los requisitos de calidad fundamentales (CRCF) de los CMD, se evaluó aplicando un cuestionario a los coordinadores de los CMD de cada hospital. La perspectiva de los miembros de los CMD se evaluó aplicando una encuesta anónima telemática.ResultadosEvidenciamos un alto nivel de CRCF en los CMD (75%), mostrando deficiencias en la actualización de protocolos, agendas, auditorías y producción científica. La encuesta fue respondida por un 62,32% de los 69 médicos encuestados (urólogos, oncólogos, radioterapéutas, radiólogos y anatomopatólogos). El 88,4% considera adecuado el tiempo de las reuniones. Existen opiniones dispares sobre la protección del tiempo de las reuniones y la actualización de protocolos. El 62,8% de los pacientes presentados requieren la intervención de dos especialidades. La mitad de los encuestados cree que se discuten todos los casos de CPRC y que existe una agenda previa. Las decisiones del CMD quedan reflejadas en la historia clínica en un 65,1% y son vinculantes en un 60,5%. La mitad de los encuestados niegan capacitación en CMD. La mayoría de los participantes (90,7%) avalan los beneficios de los CMD.ConclusionesLas evaluaciones de los CMD identifican deficiencias subsanables modificando la inercia hospitalaria y la planificación asistencial (AU)

Introduction and objectiveAlthough Multidisciplinary Teams (MDTs) are recommended in the management of Advanced Prostate Cancer (APC), their functioning in real practice has been poorly evaluated. We carried out a multicenter study with the objective of evaluating the functioning of uro-oncology MDTs in 6 hospitals.Materials and methodsA descriptive cross-sectional study was performed. The level of Compliance with the Fundamental Quality Requirements (CFQR) of the MDTs was evaluated by means of a questionnaire filled out by the coordinators of the MDTs in each hospital. The information on the perspective of the members of the MDTs was evaluated through an anonymous survey.ResultsA high level of CFQR in MDTs was evidenced (75%), showing deficiencies in terms of protocol update, agendas, audits, and scientific production. The survey was answered by 62.32% of the 69 physicians surveyed (urologists, oncologists, radiation therapists, radiologists, and pathologists). The 88.4% consider the duration of the meetings appropriate. There are disparate opinions concerning the protection of the MDT meeting time as well as protocol update. Of the patients with APC presented at the MDTs meeting, 62,8% require intervention from two specialties. Only 50% of respondents believe that all CRPC cases are discussed and that there is a prior agenda. The decisions made by the MDTs are reflected in the clinical history in 65.1% and are binding only in 60.5% of the cases. Half of the respondents have not been trained in MDTs. Most participants (90.7%) agree on the fact that MDTs. convey benefits.ConclusionsThe evaluations of the MDTs identify rectifiable deficiencies by modifying hospital inertia and care planning (AU)

Multicenter study on multidisciplinary committees in advanced prostate cancer.

INTRODUCTION AND OBJECTIVE: Although Multidisciplinary Teams (MDTs) are recommended in the management of Advanced Prostate Cancer (APC), their functioning in real practice has been poorly evaluated. We carried out a multicenter study with the objective of evaluating the functioning of uro-oncology MDTs in 6 hospitals. MATERIALS AND METHODS: A descriptive cross-sectional study was performed. The level of Compliance with the Fundamental Quality Requirements (CFQR) of the MDTs was evaluated by means of a questionnaire filled out by the coordinators of the MDTs in each hospital. The information on the perspective of the members of the MDTs was evaluated through an anonymous survey. RESULTS: A high level of CFQR in MDTs was evidenced (75%), showing deficiencies in terms of protocol update, agendas, audits, and scientific production. The survey was answered by 62.32% of the 69 physicians surveyed (urologists, oncologists, radiation therapists, radiologists, and pathologists). The 88.4% consider the duration of the meetings appropriate. There are disparate opinions concerning the protection of the MDT meeting time as well as protocol update. Of the patients with APC presented at the MDTs meeting, 62,8% require intervention from two specialties. Only 50% of respondents believe that all CRPC cases are discussed and that there is a prior agenda. The decisions made by the MDTs are reflected in the clinical history in 65.1% and are binding only in 60.5% of the cases. Half of the respondents have not been trained in MDTs. Most participants (90.7%) agree on the fact that MDTs. convey benefits. CONCLUSIONS: The evaluations of the MDTs identify rectifiable deficiencies by modifying hospital inertia and care planning.

Assessment of three commercial ELISAs for the detection of antibodies against Porcine epidemic diarrhea virus at different stages of the immune response.

Three commercial ELISAs -two based on spike (E1 and E3) and one on nucleocapsid protein (E2)-were used to analyze the development and persistence of antibodies against Porcine epidemic diarrhea virus (PEDV). Seventy-five four-week-old PEDV-negative piglets were inoculated orally with a European G1b PEDV (INOC) and fourteen were kept as controls (CTRL). After the inoculation, E3 detected positive animals as soon as 7 days post inoculation (dpi), while the earliest detection with E1 and E2 was at 14 dpi. All samples were positive at 21 and 28 dpi using E1 and E3, respectively, while E2 failed to detect 23.3 % of the inoculated pigs at any time point. The percentages of positive samples were different through the study: E1 and E3 > E2 from 14 to 56 dpi; and E3 > E1 > E2 from 56 to 154 dpi (P < 0.05). Five months after the inoculation, E3 still detected 92.0 % (IC95 % = 85.1-98.8 %) of pigs as positive, while E1 and E2 detected only 27.0 % (IC95 % = 16.0-37.9 %) and 0%, respectively. The sensitivity for E2 never exceeded 0.62. Specificity was 1 for all ELISAs. These different outcomes could be related to the ELISA strategies (indirect versus competition), the antigens used, the cut-off, or to other intrinsic factors of each test. The observed differences could be of importance when assessing whether older animals, such as fatteners or gilts, had previously been in contact with PEDV.

Short communication: Red deer (Cervus elaphus) colostrum during its transition to milk.

We studied changes in chemical composition, somatic cell count, and immunoglobulin G (IgG) and M (IgM) content in red deer (Cervus elaphus) colostrum during the transition to milk at different times after parturition (<5 h, 24 h, 48 h, 2 wk, and 4 wk). The production level was higher at 2 and 4 wk of lactation than during the first day after parturition, with intermediate values at 48 h postpartum. Fat content did not vary during the study period. However, total protein and casein contents were particularly high in the initial 5 h after parturition, decreasing to approximately 50% after 24 h postpartum. Conversely, lactose concentration was low in the beginning (<5 h), increasing gradually throughout the study. Similarly, dry matter dropped during the first 24 h and then remained constant throughout the study. Urea content decreased during the study, showing a slight recovery at 4 wk. Somatic cell count was higher during the first hours after parturition and gradually decreased throughout the study period. The IgG content was higher before 5 h postpartum than at 24 h postpartum. After 5 h, the level of IgG decreased progressively until it reached 0.18 mg/mL at 4 wk of lactation. We observed a similar pattern for IgM content, but it decreased more quickly than IgG and was not detected after 2 wk. In the case of deer, milk should be considered transitional from 24 to 48 h after parturition, and samples collected after 2 wk can be considered mature milk.

Aß42 Peptide Promotes Proliferation and Gliogenesis in Human Neural Stem Cells.

Amyloid-ß 42 [Aß1-42 (Aß42)] is one of the main Aß peptide isoforms found in amyloid plaques of brains with Alzheimer's disease (AD). Although Aß42 is associated with neurotoxicity, it might mediate several normal physiological processes during embryonic brain development and in the adult brain. However, due to the controversy that exists in the field, relatively little is known about its physiological function. In the present work, we have analyzed the effects of different concentrations of monomeric Aß42 on cell death, proliferation, and cell fate specification of human neural stem cells (hNSCs), specifically the hNS1 cell line, undergoing differentiation. Our results demonstrate that at higher concentrations (1 µM), Aß42 increases apoptotic cell death and DNA damage, indicating that prolonged exposure of hNS1 cells to higher concentrations of Aß42 is neurotoxic. However, at lower concentrations, Aß42 significantly promotes cell proliferation and glial cell specification of hNS1 cells by increasing the pool of proliferating glial precursors, without affecting neuronal differentiation, in a concentration-dependent manner. At the molecular level, these effects could be mediated, at least in part, by GSK3ß, whose expression is increased by treatment with Aß42 and whose inhibition prevents the glial specification induced by Aß42. Since the cellular and molecular effects are known to appear decades before the first clinical symptoms, these types of studies are important in discovering the underlying pathophysiological processes involved in the development of AD. This knowledge could then be used in diagnosing the disease at early stages and be applied to the development of new treatment options.

[Tumor hip prosthesis in fibrous dysplasia of proximal femur. Case report]. / Prótesis tumoral de cadera en displasia fibrosa de fémur proximal. Informe de un caso.

BACKGROUND: fibrous dysplasia is characterized by the formation of fibrous tissue that generates immature malformed trabeculae. Their involvement may be monostotic or poliostotic. CASE REPORT: Thirty years old female with fibrous dysplasia of the left hip. At age 15 suffered hip fracture without apparent trauma, she was managed conservatively and significant shortening of the same limb was observed. At 30 years old, is pregnant, it had left hip pain, deformity and shortening is exacerbated. Simple radiography showed «shepherds crook deformity¼, she was treated with bisphosphonates. Computed axial tomography corroborates previous findings. She subsequently underwent subtrochanteric fracture fall with left hip dysplasia site, ground glass image of cystic appearance involving the femoral neck, trochanteric and subtrochanteric area. Tumor prosthesis of the left hip was implanted, four months evolution was favorable. CONCLUSION: Modular hip prosthesis system, reduces deformity, improves length and reduces pain in patients with resection of fibrous dysplasia of the hip.

ANTECEDENTES: La displasia fibrosa se caracteriza por la formación de tejido fibroso inmaduro que genera trabéculas mal formadas. Su afectación puede ser monostótica o poliostótica. CASO CLÍNICO: Femenino de 30 años con displasia fibrosa de cadera izquierda. A los 15 años sufre fractura de la misma cadera sin trauma aparente, manejada conservadoramente y con acortamiento importante de la misma extremidad. A los 30 años de edad se embaraza, presenta dolor en cadera izquierda y se exacerba la deformidad y el acortamiento. La radiografía simple muestra deformidad en «cayado de pastor¼, se manejó con bifosfonatos y la tomografía corrobora los hallazgos anteriores. Posteriormente sufrió caída con fractura subtrocantérica de cadera izquierda en sitio de displasia, imagen de vidrio despulido de apariencia quística que involucra el cuello femoral, zona trocantérica y subtrocantérica. Se colocó prótesis tumoral de cadera izquierda, a los cuatro meses mostró evolución favorable. CONCLUSIÓN: La prótesis tumoral femoral reduce la deformidad, mejora la longitud y disminuye el dolor en pacientes con resección de displasia fibrosa de cadera.

Prótesis tumoral de cadera en displasia fibrosa de fémur proximal. Informe de un caso / Tumor hip prosthesis in fibrous dysplasia of proximal femur. Case report

Resumen: Antecedentes: La displasia fibrosa se caracteriza por la formación de tejido fibroso inmaduro que genera trabéculas mal formadas. Su afectación puede ser monostótica o poliostótica. Caso clínico: Femenino de 30 años con displasia fibrosa de cadera izquierda. A los 15 años sufre fractura de la misma cadera sin trauma aparente, manejada conservadoramente y con acortamiento importante de la misma extremidad. A los 30 años de edad se embaraza, presenta dolor en cadera izquierda y se exacerba la deformidad y el acortamiento. La radiografía simple muestra deformidad en «cayado de pastor¼, se manejó con bifosfonatos y la tomografía corrobora los hallazgos anteriores. Posteriormente sufrió caída con fractura subtrocantérica de cadera izquierda en sitio de displasia, imagen de vidrio despulido de apariencia quística que involucra el cuello femoral, zona trocantérica y subtrocantérica. Se colocó prótesis tumoral de cadera izquierda, a los cuatro meses mostró evolución favorable. Conclusión: La prótesis tumoral femoral reduce la deformidad, mejora la longitud y disminuye el dolor en pacientes con resección de displasia fibrosa de cadera.

Abstract: Background: Fibrous dysplasia is characterized by the formation of fibrous tissue that generates immature malformed trabeculae. Their involvement may be monostotic or poliostotic. Case report: Thirty years old female with fibrous dysplasia of the left hip. At age 15 suffered hip fracture without apparent trauma, she was managed conservatively and significant shortening of the same limb was observed. At 30 years old, is pregnant, it had left hip pain, deformity and shortening is exacerbated. Simple radiography showed «shepherd's crook deformity¼, she was treated with bisphosphonates. Computed axial tomography corroborates previous findings. She subsequently underwent subtrochanteric fracture fall with left hip dysplasia site, ground glass image of cystic appearance involving the femoral neck, trochanteric and subtrochanteric area. Tumor prosthesis of the left hip was implanted, four months evolution was favorable. Conclusion: Modular hip prosthesis system, reduces deformity, improves length and reduces pain in patients with resection of fibrous dysplasia of the hip.

Enfermero transfusor como especialidad complementaria en las Fuerzas Armadas / Transfusion nurse as a complementary specialisation in the Armed Forces

La sangre es un recurso crítico de disponibilidad limitada, necesidad imprevisible y con gran dependencia del transporte para su suministro a zona de operaciones. La sanidad militar de los ejércitos aliados plantea diversas soluciones: donación de emergencia, de sangre total y plaquetoaféresis, transfusión de sangre completa, congelación de hemocomponentes, instauración del «point of care». El objetivo de este trabajo es dar a conocer la situación actual de la enfermería como profesión y desarrollar una propuesta formativa de especialidad complementaria dentro del Cuerpo Militar de Sanidad, el enfermero transfusor, que permita adaptar las soluciones propuestas a las necesidades de las Fuerzas Armadas Españolas. La implementación de este perfil educativo podría mejorar la seguridad transfusional y disminuir los requisitos logísticos para conseguir la misión, que no es otra que disponer de componentes sanguíneos cumpliendo los estándares de calidad (AU)

Blood is a critical resource with limited availability, unpredictable need and high transportation dependency for its supply to operations zone. Military healthcare of allied armed forces suggests various solutions: walking blood bank, of fresh whole blood and platelet aphaeresis, fresh whole blood transfusion, frozen blood components, point of care establishment. The aim of this work is to introduce current situation of nursery as profession and develop a training proposal of complementary specialisation within the Spanish Military Healthcare Body, the transfusion nurse, which allows to adapt the proposed solutions to the Spanish Armed Forces' needs. The implementation of this educational profile could improve transfusion safety and reduce logistic requirements to accomplish the mission, which is not other than making blood components available, meeting the required quality standards (AU)

[Correlation between prenatal ultrasound and postnatal diagnosis of birth defects]. / Correlación entre la ecografía prenatal y el diagnóstico postnatal de las malformaciones congénitas.

OBJECTIVES: To assess the accuracy of prenatal ultrasound diagnosis and to analyze the protocol applied for congenital defects (CD) in our environment. METHODS: Descriptive study of prenatally diagnosed CD in our area between 2004-2013. Includes: total births, fetal medicine referrals (number of consultations, ultrasound, invasive techniques) anatomical and chromosomal abnormalities, confirmed diagnoses, necropsies performed, false diagnoses, absence of prenatal diagnoses, and number and reasons for abortions (VIEs). RESULTS: Mean annual births were 3,646 ± 1,299, with a mean prenatal ultrasound of 2,144 ± 307 and 512 ± 74 invasive techniques per year. The annual average of prenatal chromosomopathies diagnosed were 26 ± 8 and 140 ± 14 anatomical abnormalities, which represents a 36.44% from all of the prenatal ultrasound performed. These include: neurological, cardiac and nephron-urological anatomic anomalies. Pre and post-natal correlation was observed in 95.6% of the DCs detected. Most common causes of abortion were chromosomal abnormalities, heart and neurological diseases. CONCLUSIONS: Due to the variety of CD that cause VIEs, a highly specialized multidisciplinary approach is recommended to ensure optimal information for parents.

OBJETIVOS: Valorar la precisión del diagnóstico ecográfico prenatal y analizar el protocolo de actuación frente a un determinado defecto congénito (DC) en nuestro medio. MATERIAL Y METODOS: Estudio descriptivo de los DC diagnosticados prenatalmente en nuestra área sanitaria entre los años 2004-2013. Como variables del estudio se incluyeron el número de nacimientos totales, derivaciones a medicina fetal (número de consultas, ecografías, técnicas invasivas) anomalías anatómicas por sistemas, cromosomopatías, diagnósticos confirmados, necropsias realizadas, falsos diagnósticos, ausencia de diagnóstico prenatal, número y motivo de interrupciones voluntarias del embarazo (IVEs). RESULTADOS: Durante el período estudiado, la media de nacimientos anuales fue de 3.646 ± 1.299, con una media de 2.144 ± 307 ecografías prenatales y 512 ± 74 técnicas invasivas anuales. La media anual de diagnóstico prenatal fue de 26 ± 8 cromosomopatías y 140 ± 14 anomalías anatómicas que suponen un 36,44% del total de las ecografías prenatales realizadas. Entre estas últimas se observaron malformaciones del sistema urinario, cardíacas y neurológicas, entre otras. Se observó correlación pre y postnatal en el 95,6% de los DC detectados. Las causas de interrupción del embarazo más frecuentes fueron las cromosomopatías, seguidas de las malformaciones congénitas (MC) cardíacas y neurológicas. CONCLUSIONES: Debido a la variedad de DC que originan IVE, es recomendable un abordaje multidisciplinar altamente especializado que garantice una información óptima a los padres.

Correlación entre la ecografía prenatal y el diagnóstico postnatal de las malformaciones congénitas / Correlation between prenatal ultrasound and postnatal diagnosis of birth defects

Objetivos. Valorar la precisión del diagnóstico ecográfico prenatal y analizar el protocolo de actuación frente a un determinado defecto congénito (DC) en nuestro medio. Material y métodos. Estudio descriptivo de los DC diagnosticados prenatalmente en nuestra área sanitaria entre los años 2004-2013. Como variables del estudio se incluyeron el número de nacimientos totales, derivaciones a medicina fetal (número de consultas, ecografías, técnicas invasivas) anomalías anatómicas por sistemas, cromosomopatías, diagnósticos confirmados, necropsias realizadas, falsos diagnósticos, ausencia de diagnóstico prenatal, número y motivo de interrupciones voluntarias del embarazo (IVEs). Resultados. Durante el período estudiado, la media de nacimientos anuales fue de 3.646 ± 1.299, con una media de 2.144 ± 307 ecografías prenatales y 512 ± 74 técnicas invasivas anuales. La media anual de diagnóstico prenatal fue de 26 ± 8 cromosomopatías y 140 ± 14 anomalías anatómicas que suponen un 36,44% del total de las ecografías prenatales realizadas. Entre estas últimas se observaron malformaciones del sistema urinario, cardíacas y neurológicas, entre otras. Se observó correlación pre y postnatal en el 95,6% de los DC detectados. Las causas de interrupción del embarazo más frecuentes fueron las cromosomopatías, seguidas de las malformaciones congénitas (MC) cardíacas y neurológicas. Conclusiones. Debido a la variedad de DC que originan IVE, es recomendable un abordaje multidisciplinar altamente especializado que garantice una información óptima a los padres (AU)

Objectives. To assess the accuracy of prenatal ultrasound diagnosis and to analyze the protocol applied for congenital defects (CD) in our environment. Methods. Descriptive study of prenatally diagnosed CD in our area between 2004-2013. Includes: total births, fetal medicine referrals (number of consultations, ultrasound, invasive techniques) anatomical and chromosomal abnormalities, confirmed diagnoses, necropsies performed, false diagnoses, absence of prenatal diagnoses, and number and reasons for abortions (VIEs). Results. Mean annual births were 3,646 ± 1,299, with a mean prenatal ultrasound of 2,144 ± 307 and 512 ± 74 invasive techniques per year. The annual average of prenatal chromosomopathies diagnosed were 26 ± 8 and 140 ± 14 anatomical abnormalities, which represents a 36.44% from all of the prenatal ultrasound performed. These include: neurological, cardiac and nephron-urological anatomic anomalies. Pre and post-natal correlation was observed in 95.6% of the DCs detected. Most common causes of abortion were chromosomal abnormalities, heart and neurological diseases. Conclusions. Due to the variety of CD that cause VIEs, a highly specialized multidisciplinary approach is recommended to ensure optimal information for parents (AU)

PEGylated Nanoemulsions for Oral Delivery: Role of the Inner Core on the Final Fate of the Formulation.

Since the past decade, there has been growing interest to grant nanoparticles with diffusion properties across mucosae. In this sense, the nonionic block copolymer Pluronic F127 (PF127) has emerged as a promising coating agent to formulate mucus-penetrating particles. In the journey to find efficient coating agents, researchers have focused more on the effect of the coating agent architecture rather than on the role of the physicochemical properties of the nanoparticle used as the substrate. The current knowledge about mucodiffusive particles is in general based on model-like nanoparticles, such as polystyrene or poly(lactic-co-glycolic) acid nanoparticles, but there is a lack of information about the potential of PF127 on other colloidal systems. This work aims to shed some light on this issue by selecting three oils, palm (solid), coconut (semisolid), and wheat germ (liquid), with different physicochemical properties to formulate PF127-coated nanoemulsions. The obtained nanoemulsions were characterized, and their colloidal stability was tested. Their diffusion capacity was determined by particle tracking after challenging the nanoemulsions across an intestinal porcine mucus layer. In accordance with the evidence of model-like nanoparticles, our results state that PF127 allows mucodiffusion, but its effectiveness as a coating agent clearly depends on the physicochemical properties of the nanostructure core over which PF127 is placed. Among other physicochemical properties, the results certainly showed that the hydrophobic character of the nanostructure core emerges as a critical factor in the formulation of successful PF127 coatings.

Uso del antígeno prostático específico en atención primaria (PSA) / Use of prostatic specific antigen in primary care (PSA)

Introducción. En la literatura publicada queda demostrado que el uso del PSA es incorrecto en ocasiones, solicitando este marcador en varones muy jóvenes o muy ancianos, y repitiendo determinaciones en cortos periodos de tiempo. El objetivo principal de este trabajo ha sido describir la utilización del PSA en la práctica diaria por parte de los médicos de atención primaria de nuestra área, tratando aspectos como la importancia de la edad de los pacientes, el valor en el cribado del cáncer de próstata, o las creencias subjetivas sobre su utilidad. Como objetivo secundario se ha comparado el uso y las creencias entre los médicos que dicen conocer bien el PSA y los que no. Pacientes y métodos. Estudio descriptivo y comparativo llevado a cabo mediante cuestionarios que fueron administrados en mano a los médicos de atención primaria de todos los centros de salud de nuestra área. Se realizó un análisis descriptivo y se compararon los porcentajes de respuestas entre los médicos que creían tener suficiente información sobre el PSA y los que no mediante un test Chi-cuadrado. Resultados. Se recibieron cuestionarios de 103 profesionales. Un 83,5% afirmaba tener suficiente conocimiento sobre el PSA. Los profesionales de este último grupo solicitan PSA a edades más tempranas (p=0,029), con una mayor frecuencia (p=0,011) y dudan más sobre su utilidad (p=0,009) que aquellos con menor conocimiento. Un 49,5% decía solicitar al año menos de 50 determinaciones, y un 33% entre 50 y 100. Un 53,4% de los médicos no pediría el primer PSA hasta la década de los 50, y hasta un 49% lo solicita hasta los 80 años. Un 64,1% se ha planteado muchas veces la verdadera utilidad del PSA, y un 29,1% cree que es poco útil para diagnosticar cáncer. Conclusiones. En nuestro estudio, el 64% de los médicos de atención primaria se ha planteado bastantes veces la verdadera utilidad del PSA, y un 29% cree que es poco útil para el diagnóstico del cáncer de próstata. Además, algunos datos apuntan a un uso limitado del mismo, como el hecho de que el 50% realizan menos de 50 peticiones de PSA anuales, o que un 28% de los profesionales no lo solicitarían nunca en un varón sin sintomatología urinaria. En el presente trabajo se ha observado que aquellos profesionales que afirman no tener suficiente información sobre el PSA realizan más peticiones en pacientes con edades tardías y se plantean menos la utilidad o el rendimiento del marcador (AU)

Introduction. In the literature it is shown that the use of PSA is occasionally wrong, by requesting this marker in very young or very old men, and repeated measurements in short periods of time. The main objective of this study was to describe the use of PSA in daily practice by primary care physicians in our area, dealing with aspects such as the importance of patient age, the value in the screening for prostate cancer, or the subjective beliefs about its usefulness. A secondary objective was the comparison of use, and beliefs among doctors who claim to know PSA well, and those who do not. Patients and methods. A descriptive and comparative study was conducted using questionnaires that were handed to primary care doctors in all health centres in our area. A descriptive analysis was performed and response rates among doctors who thought they had enough information about PSA, and those who did not, were compared using the Chi-squared test. Results. A total of 103 questionnaires were received from the physicians, with 83.5% claiming to have sufficient knowledge about the PSA. The professionals in this latter group request PSA at an earlier age (P=.029), with a higher frequency (P=.011) and have more doubts about its usefulness (P=.009) than those with less knowledge. Almost half (49.5%) said they request less than 50 determinations per year, and 33% between 50 and 100. More than half (53.4%) of doctors would not request the first PSA on a patient until their 50s, and up to 49% request it up to 80 years. The true value of PSA has been established many times by 64.1% of requesters, and 29.1% believe it is unhelpful in the diagnosis of cancer. Conclusions. In our study, 64% of primary care physicians have considered the true value of the PSA several times, and 29% believe it to be of little use in the diagnosis of prostate cancer. In addition, some data suggest it has limited use due to the fact that 50% made less than 50 PSA requests per years, and 28% of the professionals would never request it on a male without urinary symptoms. In this study, it has been observed that those professionals who claim not to have enough information about the PSA make more requests in patients of an older age, and consider that it is of limited use as a marker (AU)

Revisiting the fission track method for the analysis of particles in safeguards environmental samples.

This paper details an improved approach to environmental particle analysis for safeguards by means of a combination of an upgraded version of the so-called fission track method with state-of-the-art microscope and microprobe techniques. Improvements to the fission track method comprise a novel sample assembly, the automation of several of its steps and the extensive use of correlative microscopy. This is followed by an automated isolation of particles-of-interest by means of laser micro-dissection (LMD) and their collection onto a harvester for transfer to other micro-analytical instruments for further analysis. The samples examined in this contribution were analysed for their nuclear material signatures, in particular the presence of uranium isotopes. The length of a single analysis cycle herewith was reduced to 12 days.

[Use of prostatic specific antigen in primary care (PSA)]. / Uso del antígeno prostático específico en atención primaria (PSA).

INTRODUCTION: In the literature it is shown that the use of PSA is occasionally wrong, by requesting this marker in very young or very old men, and repeated measurements in short periods of time. The main objective of this study was to describe the use of PSA in daily practice by primary care physicians in our area, dealing with aspects such as the importance of patient age, the value in the screening for prostate cancer, or the subjective beliefs about its usefulness. A secondary objective was the comparison of use, and beliefs among doctors who claim to know PSA well, and those who do not. PATIENTS AND METHODS: A descriptive and comparative study was conducted using questionnaires that were handed to primary care doctors in all health centres in our area. A descriptive analysis was performed and response rates among doctors who thought they had enough information about PSA, and those who did not, were compared using the Chi-squared test. RESULTS: A total of 103 questionnaires were received from the physicians, with 83.5% claiming to have sufficient knowledge about the PSA. The professionals in this latter group request PSA at an earlier age (P=.029), with a higher frequency (P=.011) and have more doubts about its usefulness (P=.009) than those with less knowledge. Almost half (49.5%) said they request less than 50 determinations per year, and 33% between 50 and 100. More than half (53.4%) of doctors would not request the first PSA on a patient until their 50s, and up to 49% request it up to 80 years. The true value of PSA has been established many times by 64.1% of requesters, and 29.1% believe it is unhelpful in the diagnosis of cancer. CONCLUSIONS: In our study, 64% of primary care physicians have considered the true value of the PSA several times, and 29% believe it to be of little use in the diagnosis of prostate cancer. In addition, some data suggest it has limited use due to the fact that 50% made less than 50 PSA requests per years, and 28% of the professionals would never request it on a male without urinary symptoms. In this study, it has been observed that those professionals who claim not to have enough information about the PSA make more requests in patients of an older age, and consider that it is of limited use as a marker.

Endothelial fibrinolytic response onto an evolving matrix of fibrin.

BACKGROUND: Fibrin provides a temporary matrix at the site of vascular injury. The aims of the present work were (1) to follow fibrin formation and lysis onto the surface of human dermal microvascular endothelial cells (HMEC-1), and (2) to quantify the secretion of fibrinolytic components in the presence of fibrin. METHODS: Fibrin clots at different fibrinogen concentrations were formed on top of (model 1) or beneath (model 2) the endothelial cells. Fibrin formation or lysis onto the surface of HMEC-1 cells, was followed by turbidity. Clot structure was visualized by laser scanning confocal microscopy (LSCM). The secretion of uPA and PAI-1 by HMEC-1 cells was quantified by ELISA. RESULTS: The rate of fibrin formation increased approximately 1.5-fold at low fibrinogen content (0.5 and 1 mg/mL; p < 0.05) compared to the condition without cells; however, it was decreased at 2 mg/mL fibrinogen (p < 0.05) and no differences were found at higher fibrinogen concentrations (3 and 5 mg/mL). HMEC-1 retarded dissolution of clots formed onto their surface at 0.5 to 3 mg/mL fibrinogen (p < 0.05). Secretion of uPA was 13 × 10(-6) ng/mL per cell in the absence of RGD and 8 × 10(-6) ng/mL per cell in the presence of RGD, when clots were formed on the top of HMEC-1. However, the opposite was found when cells were grown over fibrin: 6 × 10(-6) ng/mL per cell without RGD vs. 17 × 10(-6) ng/mL per cell with RGD. The secretion of PAI-1 by HMEC-1 cells was unrelated to the presence of fibrin or RGD, 7 × 10(-6) µg/mL per cell and 5 × 10(-6) µg/mL per cell, for the apical (model 1) and basal clots (model 2), respectively. CONCLUSIONS: HMEC-1 cells influence fibrin formation and dissolution as a function of the fibrin content of clots. Clot degradation was accentuated at high fibrin concentrations. The secretion of fibrinolytic components by HMEC-1 cells seemed to be modulated by integrins that bind RGD ligands.

Promising pharmacological profile of a Kunitz-type inhibitor in murine renal cell carcinoma model

Renal cell carcinoma (RCC), also called kidney cancer or renal adenocarcinoma, is highly resistant to current treatments. It has been previously reported that a Kunitz-type inhibitor domain-containing protein, isolated from the salivary glands of the Amblyomma cajennense tick, triggers apoptosis in murine renal adenocarcinoma cells (Renca) by inhibiting the proteasome and endoplasmic reticulum stress. Of note, Amblyomin-X is the corresponding recombinant protein identified in the cDNA library from A. cajennense salivary glands. Herein, using orthotopic kidney tumors in mice, we demonstrate that Amblyomin-X is able to drastically reduce the incidence of lung metastases by inducing cell cycle arrest and apoptosis. The in vitro assays show that Amblyomin-X is capable of reducing the proliferation rate of Renca cells, promoting cell cycle arrest, and down-regulating the expression of crucial proteins (cyclin D1, Ki67 and Pgp) involved in the aggressiveness and resistance of RCC. Regarding non-tumor cells (NIH3T3), Amblyomin-X produced minor effects in the cyclin D1 levels. Interestingly, observing the image assays, the fluorescence-labelled Amblyomin-X was indeed detected in the tumor stroma whereas in healthy animals it was rapidly metabolized and excreted. Taken the findings together, Amblyomin-X can be considered as a potential anti-RCC drug candidate

Asymmetric brain edema after cardiac transplantation: cerebroautoregulatory failure and relative hyperperfusion.

Asymmetric brain edema is a rare neurologic complication after cardiovascular surgery. We describe the clinical and imaging features of an asymmetric brain edema syndrome in a 52-year-old man following cardiac transplantation who presented with facial myoclonus and left hemiparesis in the postoperative period. To our knowledge, this is the first case report of asymmetric brain edema syndrome after cardiac transplant and the second following cardiac surgery. Arterial bypass cannula malposition in the ascending aorta or brachiocephalic artery with subsequent cerebral hypoperfusion and subsequent hyperperfusion appears to be the most likely physiologic cause.

Evidence for structural and functional abnormality in the subgenual anterior cingulate cortex in major depressive disorder.

BACKGROUND: The subgenual anterior cingulate cortex (sgACC) is considered to be an important site of abnormality in major depressive disorder. However, structural alterations in this region have not been a consistent finding and functional imaging studies have also implicated additional areas. METHOD: A total of 32 patients with major depressive disorder, currently depressed, and 64 controls underwent structural imaging with MRI. Also, 26 patients and 52 controls were examined using functional magnetic resonance imaging (fMRI) during performance of the n-back working memory task. Structural and functional changes were evaluated using whole-brain, voxel-based methods. RESULTS: The depressed patients showed volume reductions in the sgACC and orbitofrontal cortex bilaterally, plus in both temporal poles and the hippocampus/parahippocampal gyrus on the left. Functional imaging revealed task-related hypo-activation in the left lateral prefrontal cortex and other regions, as well as failure of deactivation in a subcallosal medial frontal cortical area which included the sgACC. CONCLUSIONS: Whole-brain, voxel-based analysis finds evidence of both structural and functional abnormality in the sgACC in major depressive disorder. The fact that the functional changes in this area took the form of failure of deactivation adds to previous findings of default mode network dysfunction in the disorder.