Mesozooplankton assemblage in the gulf of cádiz estuaries: Taxonomic and trait-based approaches.

In this study, two different approaches based on taxonomic assemblages and on copepod functional groups were used to investigate the mesozooplankton assemblage structure and its relationship with environmental variables in the main estuaries of the Gulf of Cádiz (Guadalquivir, Guadiana and Tinto-Odiel) during the dry-warm season. In general, the mesozooplankton assemblages were dominated by copepods, especially the calanoid Acartia tonsa, which reached its highest abundance in the inner zones while the adjacent coastal zones were characterized by a mixture of copepods and cladocerans, especially Penilia avirostris. Regarding the trait-based approach, three copepod functional groups were identified, principally sorted by their feeding strategy. Group 1 (composed of omnivorous copepods displaying a mixed feeding strategy and broadcast-spawners) was found mainly in the inner areas, while Groups 2 (omnivorous cyclopoids, sac-spawners that feed via active ambush) and 3 (herbivores-omnivores employing a filter feeding strategy and mostly broadcast-spawners) were predominant in the adjacent coastal zones. The relative abundance of copepod functional groups suggested that Group 1 could be considered the most important contributor to secondary production in the estuarine systems of the Gulf of Cádiz. In relation to environmental factors, salinity was the most influential variable on mesozooplankton assemblages in both approaches. Our results suggest that the studied estuaries, although taxonomically different, have mesozooplankton assemblages that perform similar ecological functions. Both methods provide valuable and complementary information about mesozooplankton assemblage dynamics in the main estuaries of the Gulf of Cádiz.

Sport fishing and vessel pressure on the endangered cetacean Delphinus delphis. Towards an international agreement of micro-sanctuary for its conservation.

Delphinus delphis Linnaeus 1758 is considered an endangered species in the Mediterranean. The species is resident in the Bay of Algeciras - Gibraltar (southern Spain; waters partially shared with Gibraltar, UK). This area is subject to strong anthropogenic pressure, but with an input of renewed waters in its central area. During three consecutive years (March 2017-March 2020), sightings were observed concentrated along the submarine canyon that runs north to south across the bay, forming a "specular S″ with a maximum depth of 460 m. The pods of Dd showed a continuous or semi-continuous spatial distribution along the vertical axis of the submarine canyon, where they feed, mate, breed and rear calves in a well-defined area that constitutes a critical habitat. This area has been cartographically delimited, choosing the area of maximum dolphin frequency as highly vulnerable due to the possibility of collisions with small vessels (<15 m) and interactions with sport fishing activities (popping, ballooning, trolling) which constitute the main threat counting the derived impacts from noise pollution. Spatio-temporal mapping has been developed to visualize the overlapping between the dolphin groups and small vessels. Mapping analysis has shown that an international Spanish-British micro-sanctuary urgently needs to be established in order to create a protected area specifically for the common dolphins, and for other species which inhabit/use the waters between Spain and Gibraltar. Coordinates and a delimited surface area have been proposed in this paper.

Effects of maintenance dredging on the macrofauna of the water column in a turbid estuary.

Many human activities in or near aquatic habitats generate alterations in their environmental conditions, which could affect the organisms that inhabit them. Maintenance dredging of navigation channels in order to allow large ships access to inland ports is one such source of disturbance. In this study, by taking multiple approaches (immediate-, short- and medium term), we analysed the effects of a maintenance dredging operation on physiochemical variables and the early life stages of fish and other macrofauna groups present in two zones of the Guadalquivir estuary with different salinity ranges (poly- and mesohaline). Most physiochemical variables were homogenized in the water column immediately after the water mass passed by the dredger, including sediment resuspension. However, this process seemed to be transient as no significant increments in the depth-averaged levels of turbidity were observed in the short- and medium-terms. Instead, metal concentrations of Cr, Fe and Zn increased in the polyhaline station. Even so, these perturbations did not appear to be severe enough to influence the macrofauna. Still, organisms can suffer direct mechanical impacts of the trailer suction. Hyperbenthic species, like Pomatoshcistus spp. or decapods, tended to decrease slightly, while pelagic species such as Engraulis encrasicolus or mysids did not, indicating that benthic organisms are usually more susceptible to high entrainment. Nonetheless, the possible effects of this disturbance were of the same order or less than those of natural ones; therefore, organisms of the macrofauna could be well adapted to cope with them.

Consensus of the Spanish society of laboratory medicine and the Spanish society of medical oncology on the methodology and criteria for evaluation of circulating tumour markers in breast cancer

The measurement of circulating tumour markers (TMs) for the diagnosis or monitoring of breast cancer has sometimes been considered of limited utility. In addition to the overinterpretation of irrelevant changes in marker levels, the characteristics of the patient, the disease or other pathologies that can modify them are often not considered in their evaluation. On the other hand, there are recent data on the relationship of TMs with molecular subtypes and on their prognostic value, the knowledge of which may improve their clinical utility. This consensus article arises from a collaboration between the Spanish Society of Laboratory Medicine (SEQCML) and the Spanish Society of Medical Oncology (SEOM). It aims to improve the use and interpretation of circulating TMs in breast cancer. The text summarizes the current knowledge and available evidence on the subject and proposes a series of recommendations mainly focussed on the indication, the frequency of testing and the factors that should be considered for correctly interpreting changes in the levels of TMs (AU)

SEOM clinical guideline for management of adult medulloblastoma (2020)

Recent advances in molecular profiling, have reclassified medulloblastoma, an undifferentiated tumor of the posterior fossa, in at least four diseases, each one with differences in prognosis, epidemiology and sensibility to different treatments. The recommended management of a lesion with radiological characteristics suggestive of MB includes maximum safe resection followed by a post-surgical MR < 48 h, LCR cytology and MR of the neuroaxis. Prognostic factors, such as presence of a residual tumor volume > 1.5 cm2, presence of micro- or macroscopic dissemination, and age > 3 years as well as pathological (presence of anaplastic or large cell features) and molecular findings (group, 4, 3 or p53 SHH mutated subgroup) determine the risk of relapse and should guide adjuvant management. Although there is evidence that both high-risk patients and to a lesser degree, standard-risk patients benefit from adjuvant craneoespinal radiation followed by consolidation chemotherapy, tolerability is a concern in adult patients, leading invariably to dose reductions. Treatment after relapse is to be considered palliative and inclusion on clinical trials, focusing on the molecular alterations that define each subgroup, should be encouraged. Selected patients can benefit from surgical rescue or targeted radiation or high-dose chemotherapy followed by autologous self-transplant. Even in patients that are cured by chemorradiation presence of significant sequelae is common and patients must undergo lifelong follow-up (AU)

SEOM clinical guideline for management of adult medulloblastoma (2020).

Recent advances in molecular profiling, have reclassified medulloblastoma, an undifferentiated tumor of the posterior fossa, in at least four diseases, each one with differences in prognosis, epidemiology and sensibility to different treatments. The recommended management of a lesion with radiological characteristics suggestive of MB includes maximum safe resection followed by a post-surgical MR < 48 h, LCR cytology and MR of the neuroaxis. Prognostic factors, such as presence of a residual tumor volume > 1.5 cm2, presence of micro- or macroscopic dissemination, and age > 3 years as well as pathological (presence of anaplastic or large cell features) and molecular findings (group, 4, 3 or p53 SHH mutated subgroup) determine the risk of relapse and should guide adjuvant management. Although there is evidence that both high-risk patients and to a lesser degree, standard-risk patients benefit from adjuvant craneoespinal radiation followed by consolidation chemotherapy, tolerability is a concern in adult patients, leading invariably to dose reductions. Treatment after relapse is to be considered palliative and inclusion on clinical trials, focusing on the molecular alterations that define each subgroup, should be encouraged. Selected patients can benefit from surgical rescue or targeted radiation or high-dose chemotherapy followed by autologous self-transplant. Even in patients that are cured by chemorradiation presence of significant sequelae is common and patients must undergo lifelong follow-up.

Consensus of the Spanish society of laboratory medicine and the Spanish society of medical oncology on the methodology and criteria for evaluation of circulating tumour markers in breast cancer.

The measurement of circulating tumour markers (TMs) for the diagnosis or monitoring of breast cancer has sometimes been considered of limited utility. In addition to the overinterpretation of irrelevant changes in marker levels, the characteristics of the patient, the disease or other pathologies that can modify them are often not considered in their evaluation. On the other hand, there are recent data on the relationship of TMs with molecular subtypes and on their prognostic value, the knowledge of which may improve their clinical utility. This consensus article arises from a collaboration between the Spanish Society of Laboratory Medicine (SEQCML) and the Spanish Society of Medical Oncology (SEOM). It aims to improve the use and interpretation of circulating TMs in breast cancer. The text summarizes the current knowledge and available evidence on the subject and proposes a series of recommendations mainly focussed on the indication, the frequency of testing and the factors that should be considered for correctly interpreting changes in the levels of TMs.

Environmental consequences of dredged-material disposal in a recurrent marine dumping area near to Guadalquivir estuary, Spain.

In this study we assessed the effects of the recurrent disposal of dredged material from the Guadalquivir estuary (south-western Spain) in a marine disposal area. We analysed shifts in sediment characteristics as well as bioaccumulation and biomagnification of heavy metals through the benthic food web. Results showed that the significant increase in concentration of some heavy metals observed in the marine disposal area after the latest disposal event could be attributed to the deposition of river-dredged sediments. This increase could also explain the decreased amphipod survival in the ecotoxicology analysis. Heavy metal concentrations in organisms indicated some bioaccumulation in deposit feeders and predators but with no clear patterns nor biomagnification through the food web. Hence, combining studies that monitor shifts in sediment characteristics and their possible consequences for the food web seems to be an interesting approach that should be assessed further in this type of studies.

Environmental factors affecting the nursery function for fish in the main estuaries of the Gulf of Cadiz (south-west Iberian Peninsula).

Hydrological, geomorphological, physicochemical and biological factors influence the nursery function of estuaries. Our study compared the environmental conditions and the assemblages of early life stages of fish in the main four estuaries of the Gulf of Cadiz (Cadiz Bay, Guadalquivir, Odiel-Tinto and Guadiana). Samples were taken within each estuary and on their adjacent coast, during the dry-warm seasons of 2016, 2017 and 2018. Results showed that rivers with smaller basins had a very low freshwater input and their estuaries, Odiel-Tinto and Cadiz Bay, were essentially sea extensions into the land, containing similar physicochemical conditions to nearshore zones, as well as similar assemblages and densities of early life stages of fish. Open water masses of these estuaries do not have important nursery functions. In contrast, inner zones of estuaries with bigger basins and higher freshwater discharges, Guadalquivir and Guadiana, have different environmental characteristics and a long transition zone with a well-defined salinity gradient. Their assemblages and densities of early life stages of fish were different between them and with other estuaries. The Guadalquivir estuary held the highest abundance of larval and early juvenile fish, as well as macrozooplankton biomass. The most abundant fish species in all zones of every estuary was the anchovy Engraulis encrasicolus; the Guadalquivir inner zone had the highest density. High concentration of suspended organic matter, provided by freshwater input and correlated with total suspended solid, suspended inorganic matter and turbidity, was the physicochemical characteristic more typical of the Guadalquivir. This characteristic, in addition to the salinity gradient, could explain the highest densities of macrozooplankton found in this estuary, and consequently, of early fish stages. Recurrent jellyfish blooms were observed in Cadiz Bay and the inner zone of Guadiana, affecting their nursery functions. Odiel-Tinto showed altered physicochemical and biological characteristics, which may need further specific research.

Efficacy and safety of trifluridine/tipiracil in third-line and beyond for the treatment of patients with metastatic colorectal cancer in routine clinical practice: patterns of use and prognostic nomogram.

INTRODUCTION: Trifluridine/tipiracil combination has shown a benefit over placebo in the treatment of patients with chemorefractory metastatic colorectal cancer (mCRC). We evaluated the efficacy and safety of this combination in the real-life setting at eight Galician centers in Spain. PATIENTS AND METHODS: This is a retrospective study of a cohort of patients with mCRC in treatment with trifluridine/tipiracil within usual clinical practice who have been previously treated or are not considered candidates for treatment with available therapies. RESULTS: A total of 160 mCRC patients were included. Our data showed that 11.9% of patients achieved disease control. Median progression-free survival was 2.75 months; at 5.66 months follow-up, median overall survival was 7.94 months. Asthenia and neutropenia (48.1% both) were the most frequent adverse events. Overall survival was lower in patients with ECOG 2, multiple metastatic sites, platelets count 350,000/µl, alkaline phosphatase > 500 IU/l, and carcinoembryonic antigen > 10 ng/ml. CONCLUSION: The results of this study confirm the efficacy and safety of trifluridine/tipiracil in chemorefractory mCRC patients. However, patients in clinical practice differ from patients in clinical trials. Due to this, prognostic factors have special importance to offer the best therapeutic approach.

Human pressures on two estuaries of the Iberian Peninsula are reflected in food web structure.

As a result of the increased urban and agricultural development in coastal environments, estuaries are among the most modified and threatened aquatic ecosystems. This study used stable isotopes to examine the effects of human impacts by contrasting the food web structures of two Iberian estuaries exposed to different degrees of human pressure. More complex feeding pathways were found in the more altered estuary (Guadalquivir). Greater spread among species along the carbon axis suggests that the primary consumers exploit organic matter with various origins, whereas different nitrogen signals of the secondary consumers suggest that they feed on different suites of prey. In contrast, the similar isotopic signals of secondary consumers in the relatively little influenced estuary (Guadiana) suggests similarity in diet composition and feeding on the same organic matter sources. Understanding trophic interactions in estuaries is vital for defining proper management and conservation, and the preliminary data provided here are one step in this direction.

Adenocarcinoma papilar de nasofaringe de bajo grado "thyroid-like". Caso clínico y revisión de la literatura / Low-grade papillary adenocarcinoma of nasopharynx. Case report and review of the literatura

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Maintenance dredging impacts on a highly stressed estuary (Guadalquivir estuary): A BACI approach through oligohaline and polyhaline habitats.

Understanding the effects of dredging in estuaries is a hard task due to the difficulty of implementing an adequate environmental diagnosis, as a consequence of the salinity gradient and anthropogenic disturbances. To assess the effects of maintenance dredging work on the Guadalquivir estuary (southwestern Spain), we used a Before-After-Control-Impact (BACI) approach to determine both direct and indirect effects in two salinity ranges. No effects were found on water and sediment physicochemical characteristics. The small impacts on dredged areas were followed by a rapid recovery of opportunistic species. The poor status of the benthos does not permit the detection of significant effects on macrofaunal community structure. The use of stable isotopes analysis to determine impacts on food web structure showed that changes over time seem to be explained by natural temporal variation rather than the dredging works. This paper emphasises the need to define proper management and conservation plans to improve the status of the benthic communities of the Guadalquivir estuary.

Impact of dredged-material disposal on soft-bottom communities in a recurrent marine dumping area near to Guadalquivir estuary, Spain.

This study assesses the effects of dredged material disposal in a recurrent marine dump near the Guadalquivir Estuary (south-western Spain). We compared the changes observed with two reference areas combining a classical ecological approach with new stable isotope techniques to analyse trophic structure. We detected permanent changes in the macrofaunal community structure as well as in the diversity and biotic indices applied, which showed higher values in the disposal area. The community in the marine dump had lost the natural temporal variations observed in the reference areas. These effects could be due to the last disposal event carried out in the summer of 2015 or to the recurrent disposals since 2010. Despite the structural changes shown by the benthic community, these impacts were not reflected in the food web structure of the marine dump. Our results confirm the high variability of disposal disturbances. Hence, we recommend performing studies in every disposal event, merging different functional and structural approaches.

BENFES, a new biotic index for assessing ecological status of soft-bottom communities. Towards a lower taxonomic complexity, greater reliability and less effort.

The new biotic index BENFES (Benthic Families Ecological Status Index) for assessing the ecological status of soft-bottom communities based on presence/absence at the taxonomic family level, is described. BENFES was primarily developed for the communities from the Guadalquivir estuary (South-western Spain), but the aim of the present work was to evaluate the reliability and validity of this index for its application in the Water Framework Directive (WFD), especially as a preliminary and rapid assessment method for monitoring the ecological status of transitional and coastal waters. BENFES was compared with five widely used indices (BOPA, BO2A, BENTIX; AMBI and M-AMBI) in several studies from Southwestern Spain. In addition, we have also established comparisons between these indices and the most commonly used Shannon-Wiener diversity. M-AMBI and BENFES showed the best agreement in ecological status assignation and were the most useful and discriminant between the studied areas. BENTIX was a good discriminant in coastal areas but was severe with the environmental condition from estuaries; BOPA/BO2A did not show clear trends in most of the zones; and AMBI tended to provide overestimations of the ecological status. In conclusion, BENFES shows several advantages such as lower taxonomic resolution, greater reliability and only requiring presence/absence. All this implies a huge possibility to perform a simplified monitoring routine for the control of the ecological quality of water bodies.

Ki-67 is a prognostic marker for hormone receptor positive tumors

Purpose: To evaluate the utility of Ki67 as a prognostic marker in Luminal B node-negative breast cancer patients. Methods: We identified 888 patients with invasive breast carcinomas who underwent surgery between 1997 and 2004. Several classical factors were collected: age, tumor size, node involvement, tumor grade, estrogen and progesterone receptors, HER2 and Ki-67 expression. We analyzed if these parameters could be considered as a prognostic factor. In early Luminal B group, we investigated which of the following biological features provide information about bad prognosis: lack of progesterone receptor expression, HER2 overexpression/amplification or high Ki-67 value. Results: The majority of patients were alive and without relapse of tumor at the moment of the analysis (70 %). The prognostic factors founded in multivariate analysis were: tumor size, node involvement, grade 3 and Ki-67 expression. When we stratified the sample by immunohistochemistry (IHC) in tumor subtypes, we assessed 680 patients and we observed 191 Luminal B tumors. The biological parameter related to the worst survival in absence of nodal involvement was Ki-67 value. Conclusions: Ki-67 represents an additional predictor of survival in Luminal B node negative breast cancer. Conversely, neither Progesterone-receptor nor HER2 status proved prognostic significance in this group in our study (AU)

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Ki-67 is a prognostic marker for hormone receptor positive tumors.

PURPOSE: To evaluate the utility of Ki67 as a prognostic marker in Luminal B node-negative breast cancer patients. METHODS: We identified 888 patients with invasive breast carcinomas who underwent surgery between 1997 and 2004. Several classical factors were collected: age, tumor size, node involvement, tumor grade, estrogen and progesterone receptors, HER2 and Ki-67 expression. We analyzed if these parameters could be considered as a prognostic factor. In early Luminal B group, we investigated which of the following biological features provide information about bad prognosis: lack of progesterone receptor expression, HER2 overexpression/amplification or high Ki-67 value. RESULTS: The majority of patients were alive and without relapse of tumor at the moment of the analysis (70 %). The prognostic factors founded in multivariate analysis were: tumor size, node involvement, grade 3 and Ki-67 expression. When we stratified the sample by immunohistochemistry (IHC) in tumor subtypes, we assessed 680 patients and we observed 191 Luminal B tumors. The biological parameter related to the worst survival in absence of nodal involvement was Ki-67 value. CONCLUSIONS: Ki-67 represents an additional predictor of survival in Luminal B node negative breast cancer. Conversely, neither Progesterone-receptor nor HER2 status proved prognostic significance in this group in our study.

SEOM guide too antiemetic prophylaxis in cancer patients treated with chemotherapy 2013

Chemotherapy-induced emesis (CIE) both in the form of nausea and vomiting is one of the adverse effects most feared by patients who receive treatment, and one of the factors that most affect their quality of life and limit their functional capacity for everyday activities. Chemotherapy-induced emesis can result from many factors, depending on the treatment and the patients themselves. The best treatment for CIE is prevention, based on the use of drugs aimed at inhibiting the signal of certain neurotransmitters involved in the process. Antiemetic prophylaxis for chemotherapy of high-emetogenous potential lasting 1 day includes a combination of anti-5-HT3, neurokinin-1 inhibitors and dexamethasone. Antiemetic prophylaxis for chemotherapy of moderate-emetogenous potential lasting 1 day includes a combination of palonosetron and dexamethasone. Prophylaxis is not recommended for chemotherapy with minimal emetogenous potential. In the case of unforeseen or refractory emesis the use of olanzapine, metoclopramide or phenothiazine should be considered (AU)