Mushroom productivity trends in relation to tree growth and climate across different European forest biomes.

Although it is logical to think that mycorrhizal mushroom production should be somehow related to the growth of the trees from which the fungi obtain carbohydrates, little is known about how mushroom yield patterns are related to tree performance. In this study, we delved into the understanding of the relationships between aboveground fungal productivity, tree radial growth patterns and climatic conditions across three latitudinally different bioclimatic regions encompassing Mediterranean, temperate and boreal forest ecosystems in Europe. For this purpose, we used a large assemblage of long-term data of weekly or biweekly mushroom yield monitoring in Spain, Switzerland and Finland. We analysed the relationships between annual mushroom yield (considering both biomass and number of sporocarps per unit area), tree ring features (tree ring, earlywood and latewood widths), and meteorological conditions (i.e. precipitation and temperature of summer and autumn) from different study sites and forest ecosystems, using both standard and partial correlations. Moreover, we fitted predictive models to estimate mushroom yield from mycorrhizal and saprotrophic fungal guilds based on climatic and dendrochronological variables. Significant synchronies between mushroom yield and climatic and dendrochronological variables were mostly found in drier Mediterranean sites, while few or no significant correlations were found in the boreal and temperate regions. We observed positive correlations between latewood growth and mycorrhizal mushroom biomass only in some Mediterranean sites, this relationship being mainly mediated by summer and autumn precipitation. Under more water-limited conditions, both the seasonal wood production and the mushroom yield are more sensitive to precipitation events, resulting in higher synchrony between both variables. This comparative study across diverse European forest biomes and types provides new insights into the relationship between mushroom productivity, tree growth and weather conditions.

Author Correction: Climatic controls of decomposition drive the global biogeography of forest-tree symbioses.

In this Letter, a middle initial and additional affiliation have been added for author G. J. Nabuurs; two statements have been added to the Supplementary Acknowledgements; and a citation to the French National Institute has been added to the Methods; see accompanying Author Correction for further details.

Climatic controls of decomposition drive the global biogeography of forest-tree symbioses.

The identity of the dominant root-associated microbial symbionts in a forest determines the ability of trees to access limiting nutrients from atmospheric or soil pools1,2, sequester carbon3,4 and withstand the effects of climate change5,6. Characterizing the global distribution of these symbioses and identifying the factors that control this distribution are thus integral to understanding the present and future functioning of forest ecosystems. Here we generate a spatially explicit global map of the symbiotic status of forests, using a database of over 1.1 million forest inventory plots that collectively contain over 28,000 tree species. Our analyses indicate that climate variables-in particular, climatically controlled variation in the rate of decomposition-are the primary drivers of the global distribution of major symbioses. We estimate that ectomycorrhizal trees, which represent only 2% of all plant species7, constitute approximately 60% of tree stems on Earth. Ectomycorrhizal symbiosis dominates forests in which seasonally cold and dry climates inhibit decomposition, and is the predominant form of symbiosis at high latitudes and elevation. By contrast, arbuscular mycorrhizal trees dominate in aseasonal, warm tropical forests, and occur with ectomycorrhizal trees in temperate biomes in which seasonally warm-and-wet climates enhance decomposition. Continental transitions between forests dominated by ectomycorrhizal or arbuscular mycorrhizal trees occur relatively abruptly along climate-driven decomposition gradients; these transitions are probably caused by positive feedback effects between plants and microorganisms. Symbiotic nitrogen fixers-which are insensitive to climatic controls on decomposition (compared with mycorrhizal fungi)-are most abundant in arid biomes with alkaline soils and high maximum temperatures. The climatically driven global symbiosis gradient that we document provides a spatially explicit quantitative understanding of microbial symbioses at the global scale, and demonstrates the critical role of microbial mutualisms in shaping the distribution of plant species.

Perfluorocarbono líquido subfoveal. Extracción después de 3 meses / Subfoveal perfluorocarbon liquid. Removal after three months

CASO CLÍNICO: Presentamos un caso de extracción quirúrgica de una burbuja de perfluorocarbono líquido (PFCL) subfoveal, mediante la producción de un desprendimiento retiniano macular terapéutico y aspirado de la burbuja de PFCL. DISCUSIÓN: El tiempo transcurrido hasta la extracción del PFCL subfoveal parece tener influencia sobre el resultado visual. Existen otros factores que pueden influir de manera importante en la agudeza visual final, a pesar de los cuales es posible conseguir una visión útil, siempre y cuando no se dañe la fóvea, y se eviten lesiones iatrogénicas durante la extracción de la burbuja de PFCL

CLINICAL CASE: A case of surgical removal of a subfoveal perfluorocarbon liquid (PFCL) bubble that remained trapped inside the subretinal space. PFCL bubble extraction was performed by performing a therapeutic and vacuum PFCL bubble macular retinal detachment. DISCUSSION: The elapsed time before subfoveal PFCL extraction seems to influence the visual result. There are other factors which could influence the final visual acuity significantly, nevertheless it is possible to achieve useful vision, as long as the fovea is not damaged and iatrogenic injuries are avoided during PFCL bubble extraction

Subfoveal perfluorocarbon liquid. Removal after three months. / Perfluorocarbono líquido subfoveal. Extracción después de 3 meses.

CLINICAL CASE: A case of surgical removal of a subfoveal perfluorocarbon liquid (PFCL) bubble that remained trapped inside the subretinal space. PFCL bubble extraction was performed by performing a therapeutic and vacuum PFCL bubble macular retinal detachment. DISCUSSION: The elapsed time before subfoveal PFCL extraction seems to influence the visual result. There are other factors which could influence the final visual acuity significantly, nevertheless it is possible to achieve useful vision, as long as the fovea is not damaged and iatrogenic injuries are avoided during PFCL bubble extraction.

Síndrome de abstinencia en Cuidados Intensivos Pediátricos. Incidencia y factores de riesgo / Withdrawal syndrome in the pediatric intensive care unit. incidence and risk factors

Objetivo Conocer la incidencia de síndrome de abstinencia tras perfusión prolongada de fentanilo y midazolam en niños, y los factores de riesgo asociados. Diseño Estudio de cohorte histórica o retrospectiva. Ámbito UCI pediátrica de seis camas de un hospital universitario. Pacientes Se incluyen 48 pacientes pediátricos que recibieron sedoanalgesia en perfusión continua con midazolam y fentanilo exclusivamente, durante al menos 48 horas. Intervenciones Ninguna. Variables de interés principales Se recogen datos clínicos y demográficos, dosis y duración de sedoanalgesia recibida, aparición de síndrome de abstinencia, gravedad y tratamiento del mismo. Resultados El 50% desarrolló síndrome de abstinencia. Hubo diferencias significativas entre los que lo desarrollaron y los que no en cuanto a duración del tratamiento previo y dosis acumulada de ambos fármacos. Una dosis acumulada de fentanilo de 0,48mg/kg o de midazolam de 40mg/kg, y una duración de la perfusión de ambos de 5,75 días fueron factores de riesgo para el desarrollo de abstinencia. La mayoría presentó un cuadro leve o moderado, que comenzó a las 12-36 horas de suspender la perfusión. El fármaco más utilizado en el tratamiento fue la metadona. Conclusiones La incidencia de síndrome de abstinencia en niños tras perfusión prolongada de midazolam y fentanilo es elevada. El desarrollo del síndrome se relaciona con tiempos de perfusión prolongados y con dosis acumuladas elevadas de ambos fármacos (AU)

Objective To determine the incidence of withdrawal syndrome after prolonged infusion of fentanyl and midazolam in children, and the associated risk factors. Design Historic or retrospective cohort study. Setting Pediatric Intensive Care Unit in an academic center. Patients Forty-eight pediatric patients who received sedation and analgesia only with fentanyl and midazolam through continuous infusion for at least 48hours.InterventionsNone.Main variables of interest Collected data included demographic and clinical parameters, dose and duration of sedation received, and incidence, severity and treatment of withdrawal syndrome. Results Fifty percent of the patients developed withdrawal syndrome. There were significant differences between the patients who developed withdrawal syndrome and those who did not, in terms of the duration of infusion and the cumulative doses of both drugs. A cumulative fentanyl dose of 0.48mg/kg, a cumulative midazolam dose of 40mg/kg, and a duration of infusion of both drugs of 5.75 days were risk factors for the development of withdrawal syndrome. Most children developed mild or moderate disease, beginning about 12-36hours after weaning from infusion. Methadone was used in most cases for treating with drawal. Conclusions There is a high incidence of withdrawal syndrome in children following the continuous infusion of midazolam and fentanyl. The duration of infusion of both drugs and higher cumulative doses are associated with the development of withdrawal syndrome (AU)

Withdrawal syndrome in the pediatric intensive care unit. Incidence and risk factors.

OBJECTIVE: To determine the incidence of withdrawal syndrome after prolonged infusion of fentanyl and midazolam in children, and the associated risk factors. DESIGN: Historic or retrospective cohort study. SETTING: Pediatric Intensive Care Unit in an academic center. PATIENTS: Forty-eight pediatric patients who received sedation and analgesia only with fentanyl and midazolam through continuous infusion for at least 48 hours. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: Collected data included demographic and clinical parameters, dose and duration of sedation received, and incidence, severity and treatment of withdrawal syndrome. RESULTS: Fifty percent of the patients developed withdrawal syndrome. There were significant differences between the patients who developed withdrawal syndrome and those who did not, in terms of the duration of infusion and the cumulative doses of both drugs. A cumulative fentanyl dose of 0.48 mg/kg, a cumulative midazolam dose of 40 mg/kg, and a duration of infusion of both drugs of 5.75 days were risk factors for the development of withdrawal syndrome. Most children developed mild or moderate disease, beginning about 12-36 hours after weaning from infusion. Methadone was used in most cases for treating withdrawal. CONCLUSIONS: There is a high incidence of withdrawal syndrome in children following the continuous infusion of midazolam and fentanyl. The duration of infusion of both drugs and higher cumulative doses are associated with the development of withdrawal syndrome.

Mitomicina C tópica endotraqueal como terapia complementaria al tratamiento endoscópico de la estenosis laringotraqueal fibrótico-cicatricial recurrente / Topical endotracheal mitomycin C as a complementary treatment for endoscopic treatment of recurrent laryngotracheal stenosis

Objetivo Describir la preparación de mitomicina C tópica endotraqueal y los resultados clínicos de 4 pacientes tratados de forma coadyuvante con mitomicina C tópica para estenosis laringotraqueales (ELT) graves y recurrentes. Método Revisión bibliográfica para determinar la concentración y forma de elaboración de mitomicina C para uso tópico endotraqueal. Revisión de las historias clínicas. Resultados Se determina una concentración de 0,4mg/ml mitomicina C tópica en el tratamiento de las estenosis laringotraqueales. En los casos tratados se aplicó la solución de 0,4mg/ml en la zona estenosada tras fotorresección con láser y dilatación con broncoscopio. Tres pacientes se encuentran asintomáticos desde el punto de vista respiratorio y en uno, ha fracasado el tratamiento. Conclusiones El tratamiento ELT es complejo debido al continuo desarrollo de tejido de granulación y fibrosis como consecuencia de lesiones de la vía aérea. La mitomicina C tópica, por sus potentes efectos antifibróticos, parece ser el agente coadyuvante idóneo (AU)

Objective To describe the preparation of topical endotracheal mitomycin C and the clinical outcomes of four patients with recurrent and severe laryngotracheal stenosis (LTS) treated with adjuvant topical mitomycin C. Method Literature review to determine the concentration and method of preparation of topical mitomycin C for endotracheal use. Review of clinical histories. Results We established a concentration of 0.4mg/ml topical mitomycin C for the treatment of laryngotracheal stenosis. In the treated cases, we applied a 0.4mg/ml solution to the wound site following laser surgery and dilatation with bronchoscope. Three patients remain asymptomatic from a respiratory perspective, and treatment failed in one case. Conclusions LTS treatment is complex due to the continuous development of granulation tissue and fibrosis following injury to the airways. Topical mitomycin C seems to be the ideal adjuvant agent thanks to its powerful antifibrotic effects (AU)

Topical endotracheal mitomycin C as a complementary treatment for endoscopic treatment of recurrent laryngotracheal stenosis.

OBJECTIVE: To describe the preparation of topical endotracheal mitomycin C and the clinical outcomes of four patients with recurrent and severe laryngotracheal stenosis (LTS) treated with adjuvant topical mitomycin C. METHOD: Literature review to determine the concentration and method of preparation of topical mitomycin C for endotracheal use. Review of clinical histories. RESULTS: We established a concentration of 0.4 mg/ml topical mitomycin C for the treatment of laryngotracheal stenosis. In the treated cases, we applied a 0.4 mg/ml solution to the wound site following laser surgery and dilatation with bronchoscope. Three patients remain asymptomatic from a respiratory perspective, and treatment failed in one case. CONCLUSIONS: LTS treatment is complex due to the continuous development of granulation tissue and fibrosis following injury to the airways. Topical mitomycin C seems to be the ideal adjuvant agent thanks to its powerful antifibrotic effects.

Validación de la medición transcutánea de la presión parcial de dióxido de carbono en el paciente crítico pediátrico / Validation of the transcutaneous carbon dioxide tension measurements in critical paediatric patients

Objetivo: Valorar la fiabilidad de la medición de la presión transcutánea de dióxido de carbono (PtCO2) respecto a la medición de la presión arterial de dióxido de carbono (PaCO2). Material y métodos: Estudio analítico, observacional, longitudinal y prospectivo. Cohorte de pacientes ingresados en unidad de cuidados intensivos pediátricos. La PtCO2 se midió con el monitor digital SenTec, aplicando el sensor con un anillo específico (sensor V-sign, versión MDB 04.04.02). Se recogieron al mismo tiempo la PtCO2 y PaCO2. La significación estadística de la asociación se calculó mediante el test F de Snedecor, el coeficiente de correlación r2 de Pearson y el coeficiente de correlación intraclase. El grado de acuerdo se estimó con el método de Bland y Altman. La consistencia de los resultados se estudió con el ANOVA. Resultados: Se compararon 106 mediciones pareadas de PtCO2 y PaCO2, de 12 pacientes. Las PaCO2 y PtCO2 medias fueron 51,0±13mmHg y 50,1±14mmHg; r2=0,87 (p<0,001), CCI=0,96 (IC: 0,94–0,97). El análisis de Bland-Altman mostró una media de las diferencias de−0,9mmHg (IC:−2,0 a 0,2mmHg). La correlación fue mejor en ausencia de patología respiratoria, con asistencia respiratoria baja, con PaCO2>50mmHg y con aplicación frontal del sensor. Hubo consistencia de los resultados. No se observaron efectos secundarios derivados de la utilización del anillo. Conclusiones: La correlación obtenida entre la PtCO2 y PaCO2 fue muy buena. El monitor digital SenTec y el sensor de anillo específico constituyen una herramienta fiable, segura y fácil de utiliza (AU)

Objective: To estimate the accuracy of the transcutaneous carbon dioxide tension measurement (PtCO2) compared to the measurement of the arterial carbon dioxide tension (PaCO2). Material and methods: An analytical, longitudinal, prospective and observational study, of a dynamic cohort taken from the in-patients of a Paediatric Intensive Care Unit (PICU). The PtCO2 was measured with the SenTec AG analyzer, and the sensor was applied with the specific Multi-Site Attachment Ring. PtCO2 and PaCO2 were recorded at the same time. The statistical significance of the association between paired measurements was evaluated with the Snedecor's F test, the Pearson's r2 correlation coefficient and the Interclass Correlation Coefficient (ICC). The degree of agreement was evaluated with the Bland & Altman method. The consistency of the results was evaluated with the ANalysis Of the VAriance (ANOVA). Results: One hundred and six paired measurements, PtCO2 and PaCO2, from twelve patients, were compared. The means of the PaCO2 and PtCO2 were 51.0±13mmHg and 50.1±14mmHg, respectively; r2=0.87 (p<0.001), ICC=0.96, (95% CI: 0.94–0.97). The Bland-Altman analysis showed a mean difference of−0.9mmHg (95% CI:−2.0 to 0.2mmHg). The correlation was better in cases with no respiratory disease, with low respiratory assistance, with PaCO2>50mmHg and with the sensor applied on the forehead. The results were consistent. No side effects derived from the use of the ring were observed. Conclusion: The correlation between PtCO2 and PaCO2 is excellent and stable. The ring sensor was safe and easy to us (AU)

[Validation of the transcutaneous carbon dioxide tension measurements in critical paediatric patients]. / Validación de la medición transcutánea de la presión parcial de dióxido de carbono en el paciente crítico pediátrico.

OBJECTIVE: To estimate the accuracy of the transcutaneous carbon dioxide tension measurement (PtCO(2)) compared to the measurement of the arterial carbon dioxide tension (PaCO(2)). MATERIAL AND METHODS: An analytical, longitudinal, prospective and observational study, of a dynamic cohort taken from the in-patients of a Paediatric Intensive Care Unit (PICU). The PtCO(2) was measured with the SenTec AG analyzer, and the sensor was applied with the specific Multi-Site Attachment Ring. PtCO(2) and PaCO(2) were recorded at the same time. The statistical significance of the association between paired measurements was evaluated with the Snedecor's F test, the Pearson's r(2) correlation coefficient and the Interclass Correlation Coefficient (ICC). The degree of agreement was evaluated with the Bland & Altman method. The consistency of the results was evaluated with the ANalysis Of the VAriance (ANOVA). RESULTS: One hundred and six paired measurements, PtCO(2) and PaCO(2), from twelve patients, were compared. The means of the PaCO(2) and PtCO(2) were 51.0+/-13mmHg and 50.1+/-14mmHg, respectively; r(2)=0.87 (p<0.001), ICC=0.96, (95% CI: 0.94-0.97). The Bland-Altman analysis showed a mean difference of-0.9mmHg (95% CI:-2.0 to 0.2mmHg). The correlation was better in cases with no respiratory disease, with low respiratory assistance, with PaCO(2)>50mmHg and with the sensor applied on the forehead. The results were consistent. No side effects derived from the use of the ring were observed. CONCLUSION: The correlation between PtCO(2) and PaCO(2) is excellent and stable. The ring sensor was safe and easy to use.

Protocolo de actuación ante el maltrato infantil y situaciones de riesgo en el ámbito sanitario en la provincia de Salamanca / Action protocol when there is child battering and situations of risk in the health care setting in the province of Salamanca (Spain)

El maltrato infantil en sus diversas formas de manifestaciónes un problema que afecta a la infancia en el mundo entero y los pediatras, como responsables de la salud integral del niño, debemos estar concienciados de la importancia de intervenir en nuestro entorno para identificar situaciones de riesgo y aprovechar todos los recursos sociosanitarios para la implementación de medidas preventivas adecuadas. Se ha elaborado un protocolo con el fin de facilitarla atención adecuada de estos niños en la provincia de Salamanca (AU)

Child battering in its different manifestation forms is a problem that affects young children worldwide. The pediatricians, who are responsible for the integral health of the child, should be aware of the importance of intervening within their setting in order to identify risk situations and to take advantage of the social-health care resources for the establishment of adequate preventive measures. A protocol has been elaborated in order to facilitate adequate care for these children in the providence of Salamanca (AU)

Potential relationship between herpes viruses and rheumatoid arthritis: analysis with quantitative real time polymerase chain reaction.

OBJECTIVE: To determine whether the human herpes viruses, cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesvirus 6 (HHV-6), are detectable in serum and peripheral blood mononuclear cells (PBMCs) of patients with rheumatoid arthritis (RA). METHODS: 133 PBMC samples (61 RA, 72 healthy donors) and 136 serum samples (59 RA, 77 healthy donors) were analysed by quantitative real time polymerase chain reaction for DNA prevalence and viral load of HHV-6, EBV, and CMV. RESULTS: For PBMC samples significant differences were found for EBV in DNA prevalence (56% in RA v 33% in controls, p = 0.009) and viral load (copies/microg DNA 0-592.3 for RA v 0-40.4 for controls, p = 0.001). For serum samples a significant difference was found for HHV-6 DNA prevalence (10% in RA v 0% in controls, p = 0.006) and viral load (copies/microg DNA 0-529.1 for RA v 0 for controls, p = 0.007). CONCLUSIONS: Herpes viruses may have a role in RA, although alternative explanations are possible: (a) defects in cellular immunity in patients with RA may result in a relatively high viral load; (b) patients with RA may be more prone to infection/reactivation. The usefulness of monitoring the DNA viral load in patients with RA is questioned by these data.

[Chronic multifocal osteomyelitis]. / Osteomielitis crónica múltiple.

The cases of three female Guinean children are described. Bloods tests were nonspecific, showing a moderately high globular sedimentation rate. The patients received combined therapy with systemic antibiotic therapy (including local gentamicin administration in two of the three patients) and surgery. One patient returned to Guinea and was lost to follow-up. The second patient showed severe sequelae and the third patient had a favorable outcome. In recent years, the prevalence of chronic osteomyelitis in Africa has increased. Most patients have multiple bone involvement and multiple etiology. Blood cultures are negative in 40 % of patients and severe radiologic abnormalities, most commonly fractures, are frequent. A successful therapeutic regimen must be based on antibiotic and surgical treatment.