Migraine treatment consensus document of the Spanish Society of Neurology (SEN), Spanish Society of Family and Community Medicine (SEMFYC), Society of Primary Care Medicine (SEMERGEN) and Spanish Association of Migraine and Headache (AEMICE) on migraine treatment. / Documento de consenso de la Sociedad Española de Neurología (SEN), Sociedad Española de Medicina de Familia y Comunitaria (SEMFYC), Sociedad de Medicina de Atención Primaria (SEMERGEN) y Asociación Española de Migraña y Cefalea (AEMICE) sobre el tratamiento de la migraña.

Migraine is a disease with a high prevalence and incidence, in addition to being highly disabling, causing a great impact on the patient's quality of life at a personal, family and work level, but also social, given its high expense due to its direct (care) and indirect (presenteeism and work absenteeism) costs. The multiple and recent developments in its pathophysiological knowledge and in its therapy require updating and, therefore, in this article the Spanish scientific societies most involved in its study and treatment (SEN, SEMFYC and SEMERGEN), together with the Association Spanish Association for Patients with Migraine and other Headaches (AEMICE), we have developed these updated care recommendations. We reviewed the treatment of migraine attacks, which consisted mainly of the use of NSAIDs and triptans, to which ditans and gepants have been added. We also discuss preventive treatment consisting of oral preventive drugs, botulinum toxin, and treatments that block the action of calcitonin-related peptide (CGRP). Finally, we emphasize that pharmacological treatments must be complementary to carrying out general measures consisting of identifying and managing/deletion the precipitating factors of the attacks and the chronicizing factors, controlling the comorbidities of migraine and eliminating analgesic overuse.

Diseases of Iberian ibex (Capra pyrenaica).

Iberian ibex (Capra pyrenaica) is an ecologically and economically relevant medium-sized emblematic mountain ungulate. Diseases participate in the population dynamics of the species as a regulating agent, but can also threaten the conservation and viability of vulnerable population units. Moreover, Iberian ibex can also be a carrier or even a reservoir of pathogens shared with domestic animals and/or humans, being therefore a concern for livestock and public health. The objective of this review is to compile the currently available knowledge on (1) diseases of Iberian ibex, presented according to their relevance on the health and demography of free-ranging populations; (2) diseases subjected to heath surveillance plans; (3) other diseases reported in the species; and (4) diseases with particular relevance in captive Iberian ibex populations. The systematic review of all the information on diseases affecting the species unveils unpublished reports, scientific communications in meetings, and scientific articles, allowing the first comprehensive compilation of Iberian ibex diseases. This review identifies the gaps in knowledge regarding pathogenesis, immune response, diagnostic methods, treatment, and management of diseases in Iberian ibex, providing a base for future research. Moreover, this challenges wildlife and livestock disease and wildlife population managers to assess the priorities and policies currently implemented in Iberian ibex health surveillance and monitoring and disease management.

Molecular Characterization of Peronospora variabilis Isolates Infecting Chenopodium quinoa and Chenopodium album in Spain.

Quinoa is an expanding crop in southern Spain. Downy mildew, caused by Peronospora variabilis, is the most important quinoa disease in Spain and worldwide. In Spain, this disease has also been observed on the weed Chenopodium album. The objectives of this study were to unravel the origin of the P. variabilis isolates currently infecting quinoa in southern Spain and to study their genetic diversity. We hypothesized that P. variabilis isolates infecting quinoa in Spain could have been introduced through the seeds of the quinoa varieties currently grown in the country or, alternatively, that these isolates are endemic isolates, originally infecting C. album, that jumped to quinoa. In order to test these hypotheses, we sequenced the internal transcribed spacer (ITS), cytochrome c oxidase subunit 1 (cox1), and cox2 regions of 33 P. variabilis isolates infecting C. quinoa and C. album in southern Spain and analyzed their phylogenetic relationship with isolates present in other countries infecting Chenopodium spp. cox1 gene sequences from all of the Spanish P. variabilis isolates were identical and exhibited nine single-nucleotide polymorphisms (SNPs) compared with a single P. variabilis cox1 sequence found at GenBank. Phylogenetic analyses based on the ITS ribosomal DNA region were not suitable to differentiate isolates according to their geographical origin or host. The cox2 sequences from P. variabilis Spanish isolates collected from C. quinoa and C. album were all identical and had a distinctive SNP in the last of four polymorphic sites that distinguished Spanish isolates from isolates from other countries. These results suggest that P. variabilis infecting quinoa in southern Spain could be native isolates that originally infected C. album.[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

Genetic structure and historical and contemporary gene flow of Astyanaxmexicanus in the Gulf of Mexico slope: a microsatellite-based analysis.

BACKGROUND: Astyanax mexicanus from the river basins of the Gulf of Mexico slope are small freshwater fish that usually live in large groups in different freshwater environments. The group is considered successful due to its high capacity for dispersal and adaptation to different habitats, and the species present high morphological variability throughout their distribution in Mexico. This has produced the most extreme morphotype of the group; the hypogeous or troglobite, which has no eyes or coloration, and is probably the cause of taxonomic uncertainty in the recognition of species across the entire range. Most studies of A. mexicanus have mainly focused on cave individuals, as well as their adjacent surface locations, providing an incomplete evolutionary history, particularly in terms of factors related to dispersal and the potential corridors used, barriers to gene flow, and distribution of genetic variability. The aim of the present study is to determine the population structure and the degree and direction of genetic flow in this complex taxonomic group, incorporating geographic locations not previously included in analyses using microsatellite loci. Our aim is to contribute to the knowledge of the intricate evolutionary history of A. mexicanus throughout most of its range. METHODS: The present study included a set of several cave and surface locations of A. mexicanus, which have been widely sampled along the Gulf of Mexico slope, in a genetic population analysis using 10 microsatellite loci. RESULTS: Ten genetic populations or lineages were identified. In these populations, gene flow was recorded at two time periods. Historical gene flow, both inter and intra-basin, was observed among surface populations, from surface to cave populations, and among cave populations, whereas recording of contemporary gene flow was limited to intra-basin exchanges and observed among surface populations, surface to cave populations, and cave populations.

Dignidad humana, libertad y bioética / Human dignity, freedom and bioethics

Este artículo es una introducción general a la bioética y a los distintos modelos éticos que pueden articularla. El autor analiza las principales teorías éticas y su fundamentación: la ética ontologista, la ética utilitarista, el deontologismo y la ética personalista. Asimismo, sienta las bases de una bioética personalista y reflexiona sobre los principios fundamentales que debe respetar: la dignidad, la libertad y los derechos humanos

This article is a general introduction to bioethics and the different ethical patterns that comprise it. The author analyzes the main ethical theories and their foundation: the ontological ethic, the utilitarian ethic, deodontologism and the personal ethic. Besides, it sets out the bases for personal bioethics and reflects on the main principles that it must respect: dignity, freedom and human right

Este artigo é uma introdução geral à bioética e aos diferentes modelos éticos que podem articulá-la. O autor analisa as principais teorias éticas e sua fundamentação: a ética ontológica, a ética utilitarista, a deontologia e a ética personalista. Além disso, finca as bases de uma bioética personalista e reflete sobre os princípios fundamentais que deve respeitar: a dignidade, a liberdade e os direitos humanos

La evaluación de impacto en protección de datos en los proyectos de investigación / Impact assessment on data protection in research projects

Los recientes cambios en la normativa europea de protección de datos de carácter personal siguen permitiendo el uso de los datos sanitarios con fines de investigación, pero establecen la evaluación de impacto en protección de datos como instrumento de reflexión y análisis de riesgos en el proceso de tratamiento de datos. La publicación de una guía facilita la realización de esta evaluación de impacto, aunque no es de aplicación directa para los proyectos de investigación. Se detalla la experiencia en un proyecto concreto, y se muestra cómo el contexto del tratamiento toma relevancia respecto a las características de los datos. La realización de una evaluación de impacto es una oportunidad para asegurar el cumplimiento de los principios de la protección de datos en un entorno cada vez más complejo y con mayores desafíos éticos

Recent changes in European regulations for personal data protection still allow the use of health data for research purposes, but they have set the Impact Assessment on Data Protection as an instrument for reflection and risk analysis in the process of data processing. The publication of a guide for facilitates this impact assessment, although it is not directly applicable to research projects. Experience in a specific project is detailed, showing how the context of the treatment becomes relevant with respect to the data characteristics. Carrying out an impact assessment is an opportunity to ensure compliance with the principles of data protection in an increasingly complex environment with greater ethical challenges

Consumo de tabaco en estudiantes universitarios: motivación a la cesación y dependencia / Tobacco consumption in university students: motivation to the cessation and dependence / Uso do tabaco em estudantes universitários: motivação para cessação e dependência

Resumen Introducción. En 2018, el cáncer de pulmón se ubicó en primer lugar a nivel mundial, tanto en incidencia y mortalidad con 2,0 y 1,8 millones de casos respectivamente. Además, en los últimos cuatro años, ocupó el cuarto lugar en prevalencia, con 2,1 millones de casos anuales. Objetivo. Determinar la dependencia y motivación a la cesación del consumo de tabaco en una muestra de estudiantes universitarios mediante pruebas estandarizadas y entrevista semi-estructurada. Materiales y métodos. Se trata de un estudio mixto, transversal. Para evaluar la dependencia a la nicotina y la cesación del consumo se emplearon las pruebas de Fagerstrõm y Richmond. Resultados. Se observa ausencia de relación entre el grado de motivación para la cesación del consumo de tabaco y el nivel de dependencia. Los sujetos presentan un nivel dudoso de dejación del consumo de tabaco a pesar de encontrarse en una dependencia muy baja. El factor familiar y social se convierte en promotor de la dependencia e iniciación. Conclusión. Se identifica una baja motivación para la dejación del consumo, por lo tanto, es necesario promover intervenciones dirigidas a la atención del tabaquismo.

Abstract Introduction. In 2018, lung cancer ranked first worldwide in both incidence and mortality with 2.0 and 1.8 million cases respectively. In addition, in the last four years, it ranked fourth in prevalence, with 2.1 million cases per year. Objective. To determine tobacco dependence and motivation to quit in a sample of university students through standardized tests and semi-structured interviews. Materials and methods. This is a mixed, cross-sectional study. Fagerstrõm and Richmond tests were used to evaluate nicotine dependence and cessation. Results. There is no relationship between the degree of motivation for smoking cessation and the level of dependence. The subjects presented a doubtful level of tobacco cessation despite being in a very low dependency. The family and social factor becomes a promoter of dependence and initiation. Conclusion. A low motivation for quitting consumption is identified, therefore, it is necessary to promote interventions aimed at tobacco care.

Resumo Introdução. Em 2018, o cancro do pulmão ocupava o primeiro lugar mundial em incidência e mortalidade, com 2,0 e 1,8 milhões de casos, respectivamente. Além disso, nos últimos quatro anos, classificou-se em quarto lugar em prevalência, com 2,1 milhões de casos por ano. Alvo. Determinar a dependência do tabaco e a motivação para deixar de fumar numa amostra de estudantes universitários através de testes padronizados e entrevistas semi-estruturadas. Materiais e métodos. Este é um estudo misto, de corte transversal. Os testes Fagerstrõm e Richmond foram utilizados para avaliar a dependência e cessação da nicotina. Resultados. Não existe qualquer relação entre o grau de motivação para deixar de fumar e o nível de dependência. Os sujeitos apresentaram um nível duvidoso de cessação do tabaco apesar de se encontrarem numa dependência muito baixa. O factor familiar e social torna-se um promotor de dependência e de iniciação. Conclusão. Identifica-se uma baixa motivação para deixar de consumir, pelo que é necessário promover intervenções que visem os cuidados com o tabaco.

Conexión de registros sanitarios: base poblacional de salud de Andalucía / Health record linkage: Andalusian health population database

OBJETIVO: Describir el desarrollo de un sistema de información que conecta datos procedentes de múltiples registros, sanitarios y otros, para su uso con fines asistenciales, de administración, gestión, evaluación, inspección, investigación y salud pública. MÉTODO: Conexión determinística de datos pseudonimizados de una población de 8,5 millones de habitantes, procedentes de Base de datos de usuarios, Historia clínica electrónica DIRAYA, Conjunto mínimo básico de datos (hospitalización, cirugía mayor ambulatoria, urgencias hospitalarias y hospital de día médico) y sistemas de información de salud mental, pruebas de imagen, pruebas analíticas, vacunas, pacientes renales y farmacia. Se utilizó un codificador automático para los diagnósticos clínicos y se definieron 80 enfermedades crónicas para su seguimiento. La arquitectura del sistema de información constó de tres capas: datos (base de datos Oracle 11g), aplicaciones (MicroStrategy BI) y presentación (MicroStrategy Web, librerías JavaScript, HTML 5 y hojas de estilo CSS). Se implantaron medidas para la gobernanza del sistema. RESULTADOS: Se incluyeron datos de 12,5 millones de personas que fueron usuarias entre los años 2001 y 2017, con 435,5 millones de diagnósticos. El 88,7% de estos diagnósticos fueron generados por el codificador automático. Los datos se presentan mediante informes predefinidos o consultas dinámicas, ambos exportables a ficheros CSV para su tratamiento fuera del sistema. Analistas expertos pueden acceder directamente a las bases de datos y realizar extracciones mediante SQL o tratar directamente los datos con herramientas externas. CONCLUSIÓN: El trabajo ha mostrado cómo la conexión de registros sanitarios abre nuevas posibilidades en el análisis de datos

OBJECTIVE: To describe the development of an information system that connects data from multiple health records to improve assistance to patients, health services administration, management, evaluation, and inspection, as well as public health and research. METHOD: Deterministic connection of pseudonymized data from a population of 8.5 million inhabitants provided by: a users database, DIRAYA electronic medical records, minimum basic data sets (inpatients, outpatient mayor surgery, hospital emergencies and medical day hospital), mental health information systems, analytical and image tests, vaccines, renal patients, and pharmacy. An automatic coder was used to code clinical diagnoses and 80 chronic pathologies were identified to follow-up. The architecture of the information system consisted of three layers: data (Oracle Database 11g), applications (MicroStrategy BI) and presentation (MicroStrategy Web, JavaScript libraries, HTML 5 and CSS style sheets). Measures for the governance of the system were implemented. RESULTS: Data from 12.5 million health system users between 2001 and 2017 were gathered, including 435.5 million diagnoses, 88.7% of which were generated by the automatic coder. Data can be accessed through predefined reports or dynamic queries, both exportable to CSV files for processing outside the system. Expert analysts can directly access the databases and perform queries using SQL or directly treat the data with external tools. CONCLUSION: The work has shown that the connection of health records opens new possibilities for data analysis

Attitudes Toward Organ Donation: Differences Between Medical and Nursing Andalusian Students.

INTRODUCTION: A favorable attitude toward organ donation and transplantation (ODT) is fundamental among health professionals at the time of transplant promotion. In this sense, the training and awareness of professionals are fundamental. OBJECTIVE: To analyze the differences in the attitude toward ODT and the factors that condition it among Andalusian medical and nursing students. METHODS AND DESIGN: The study is a sociologic, multicenter, observational study. The population includes medical and nursing students in Andalusian universities. Database of the Collaborative International Donor Project is used and data are stratified by geographic area and academic course. The instrument of measurement was a validated questionnaire (PCID-DTO-RIOS) that was handed out to every student in a compulsory session. Completion of the questionnaire was anonymous and self-administered. The sample included Andalusian medical and nursing students (99% confidence and precision of ±1%) stratified by geographic area and year of study. RESULTS: There was a completion rate of 91%; 79% (n = 2879) of Andalusian students were in favor of donation and 21% were not in favor. The attitude toward ODT is more favorable in medical compared with nursing students (80% vs 77%; P = .021). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): knowing a transplant patient, having received information about the subject, attitude toward family donation, and having discussed transplantation with family and friends. CONCLUSION: Andalusian medical students favored organ donation more than Andalusian nursing students, and the favorable attitude is associated with having an awareness of the subject.

[Impact assessment on data protection in research projects]. / La evaluación de impacto en protección de datos en los proyectos de investigación.

Recent changes in European regulations for personal data protection still allow the use of health data for research purposes, but they have set the Impact Assessment on Data Protection as an instrument for reflection and risk analysis in the process of data processing. The publication of a guide for facilitates this impact assessment, although it is not directly applicable to research projects. Experience in a specific project is detailed, showing how the context of the treatment becomes relevant with respect to the data characteristics. Carrying out an impact assessment is an opportunity to ensure compliance with the principles of data protection in an increasingly complex environment with greater ethical challenges.

[Health record linkage: Andalusian health population database]. / Conexión de registros sanitarios: base poblacional de salud de Andalucía.

OBJECTIVE: To describe the development of an information system that connects data from multiple health records to improve assistance to patients, health services administration, management, evaluation, and inspection, as well as public health and research. METHOD: Deterministic connection of pseudonymized data from a population of 8.5 million inhabitants provided by: a users database, DIRAYA electronic medical records, minimum basic data sets (inpatients, outpatient mayor surgery, hospital emergencies and medical day hospital), mental health information systems, analytical and image tests, vaccines, renal patients, and pharmacy. An automatic coder was used to code clinical diagnoses and 80 chronic pathologies were identified to follow-up. The architecture of the information system consisted of three layers: data (Oracle Database 11g), applications (MicroStrategy BI) and presentation (MicroStrategy Web, JavaScript libraries, HTML 5 and CSS style sheets). Measures for the governance of the system were implemented. RESULTS: Data from 12.5 million health system users between 2001 and 2017 were gathered, including 435.5 million diagnoses, 88.7% of which were generated by the automatic coder. Data can be accessed through predefined reports or dynamic queries, both exportable to CSV files for processing outside the system. Expert analysts can directly access the databases and perform queries using SQL or directly treat the data with external tools. CONCLUSION: The work has shown that the connection of health records opens new possibilities for data analysis.

Student nurses at Spanish universities and their attitude toward xenotransplantation.

INTRODUCTION: Recent immunological and transgenic advances are a promising alternative using limited materials of human origin for transplantation. However, it is essential to achieve social acceptance of this therapy. OBJECTIVE: To analyze the attitude of nursing students from Spanish universities toward organ xenotransplantation (XTx) and to determine the factors affecting their attitude. MATERIALS AND METHODS: Type of study: A sociological, multicentre, and observational study. STUDY POPULATION: Nursing students enrolled in Spain (n = 28,000). SAMPLE SIZE: A sample of 10 566 students estimating a proportion of 76% (99% confidence and precision of ±1%), stratified by geographical area and year of study. Instrument of measurement: A validated questionnaire (PCID-XenoTx-RIOS) was handed out to every student in a compulsory session. This survey was self-administered and self-completed voluntarily and anonymously by each student in a period of 5-10 min. STATISTICAL ANALYSIS: descriptive analysis, Student's t test, the chi-square test, and a logistic regression analysis. RESULTS: A completion rate: 84% (n = 8913) was obtained. If the results of XTx were as good as in human donation, 74% (n = 6564) would be in favor and 22% (n = 1946) would have doubts. The following variables affected this attitude: age (P < 0.001); sex (P < 0.001); geographical location (P < 0.001); academic year of study (P < 0.001); attitude toward organ donation (P < 0.001); belief in the possibility of needing a transplant (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); and the opinion of one's partner (P < 0.001). The following variables persisted in the multivariate analysis: being a male (OR = 1.436; P < 0.001); geographical location (OR = 1.937; P < 0.001); an attitude in favor of donation (OR = 1.519; P < 0.001); belief in the possibility of needing a transplant (OR = 1.497; P = 0.036); and having spoken about the issue with family (OR = 1.351; P < 0.001) or friends (OR = 1.240; P = 0.001). CONCLUSIONS: The attitude of nursing students toward organ XTx is favorable and is associated with factors of general knowledge about organ donation and transplantation and social interaction.

Polimorfismo rs4998 del gen ADRB3 y su relación con el índicede masa corpora / Polymorphism rs4998 of the ADRB3 gene and its relationship with the bodymass index

Introducción: Para el 2007 en Colombia se estimó que el 56% de la población adulta era obesa, condición que se considera un problema de salud pública con implicaciones en el desarrollo de enfermedad coronaria. Objetivo: Determinar la distribución de las frecuencias alélicas y genotípicas y la relación del polimorfismo rs4998 del gen ADRB3 con el índice de masa corporal en una población de docentes y administrativos. Materiales y Métodos: La extracción de ADN se llevó a cabo mediante un método comercial, para la amplificación de ADN se emplearon cebadores específicos no marcado con fluorocromos, los fragmentos obtenidos fueron purificados mediante las enzimas SAP y EXOSAP, finalmente se realizó minisecuenciación en el ABI PRISM 310 y posterior lectura de electroferogramas. El análisis de las variables sociode mográficas se realizó mediante métodos univariados y métodos bivariados empleando pruebas de significancia como: test Chi2 de Pearson y test exacto de Fisher. Modelos logísticos fueron empleados para evaluar asociación. Resultados: Las frecuencias genotípicas encontradas fueron 0.96 GG, 0.014 CG y 0,020 CC. Las frecuencias alélicas fueron 0,027 C y 0,973 G. La muestra se encontró en equilibrio de Hardy-Weinberg con Chi2 = 81.153(1) (p = 0.000) y se calculó la estructura poblacional mediante la prueba Fst = 0,743. Discusión: Encontrar la población en equilibrio de Hardy-Weinberg indica que los individuos se están mezclando al azar. El coeficiente de endogamia o estadístico Fst, indica que la población presenta una alta estructura o diferenciación genética y existe fijación del alelo mutado G; esto podría obtener falsas asociaciones con la patología de interés. Conclusión: Las frecuencias obtenidas en este estudio no se ajustan a los modelos génicos propuestos para estudios de asociación; por lo tanto, se recomienda aumentar el tamaño de la muestra para futuras investigaciones o plantear estudios de casos y controles

Introduction: At 2007 in Colombia it was estimated that a portion 56 % from the adult population was obese, a condition that is considered a public health problem with implications in the development of coronary heart disease.Objective: Determine the distribution of allelic and genotypic frequencies and the relation of the polymorphism rs4998 of the ADRB3 gene with the Body Mass Index in a population of teachers and administrators of an university institution in Colombia. Methods: DNA extraction was carried out by a commercial method, for specific DNA amplification, specific primers not labeled with fluorochromes were used, fragments obtained were purified by SAP and EXOSAP enzymes, and finally minisequencing was performed in the ABI PRISM 310 and later electropherogram reading. The analysis of the sociodemographic variables was performed using univariate methods and bivariate methods using significance tests such as: Pearson's Chi2 test and Fisher's exact test. Logistic models were used to evaluate association. Results: The genotype frequencies found were 0.96 GG, 0.014 CG and 0.020 CC. The allele frequencies were 0.027 C and 0.973 G. The sample was found in Hardy-Weinberg equilibrium with Chi2 = 81.153 (1) (p = 0.000) and the population structure was calculated by means of the Fst test = 0.743. Discussion: Finding the population in Hardy-Weinberg equilibrium, indicates that individuals were mixed randomly. The coefficient of inbreeding or statistical Fst, is very close to one, which indicates that the population has a high structure or genetic differentiation and there is fixation of the mutated allele G. This could obtain false associations with the pathology of interest. Conclusion: The frequencies obtained in this study do not fit the proposed gene models for association studies, therefore, it is recommended to increase the sample size for future researches or to propose case-control studies

Microsatellite loci obtained by next generation sequencing on the sablefish (Anoplopoma fimbria).

Eleven microsatellite loci were developed and characterized for the sablefish, Anoplopoma fimbria. The markers were identified from sequences obtained by next generation sequencing. Thirty samples from Aleutians Islands were genotyped. The amplifications were performed with three different annealing temperature and amplification products were visualized in ABI 3500 Genetic Analyzer. No evidence for scoring errors was detected by stuttering or due large allele dropout and neither of the loci presented a high null allele frequency (> 0.2). The number means of alleles per locus was of 12.21 and mean of observed and expected heterozygosity were of 0.60 and 0.75 respectively. The sablefish represents a resource of high commercial value on the coasts of Japan, Russia, Canada and west coast of the United States and these new primers could be useful to future diversity and structure population studies.

Role of oceanography in shaping the genetic structure in the North Pacific hake Merluccius productus.

Determining the relative influence of biotic and abiotic factors on genetic connectivity among populations remains a major challenge in evolutionary biology and in the management and conservation of species. North Pacific hake (Merluccius productus) inhabits upwelling regions in the California Current ecosystem from the Gulf of California to the Gulf of Alaska. In this study, we examined mitochondrial DNA (mtDNA) and microsatellite variation to estimate levels of genetic differentiation of M. productus in relation to the role of oceanographic features as potential barriers to gene flow. Samples were obtained from nine sites spanning a large part of the geographic range of the species, from Puget Sound, Washington to Costa Rica. The microsatellite results revealed three genetically discrete populations: one spanning the eastern Pacific coast, and two apparently resident populations circumscribed to the Puget Sound and the northern Gulf of California (FST = 0.032, p = 0.036). Cytochrome b sequence data indicated that isolation between the Puget Sound and northern Gulf of California populations from the coastal Pacific were recent phenomena (18.5 kyr for Puget Sound and 40 kyr for the northern Gulf of California). Oceanographic data obtained from the Gulf of California support the hypothesis that permanent fronts within the region, and strong gradients at the entrance to the Gulf of California act as barriers to gene flow. A seascape genetics approach found significant genetic-environment associations, where the daytime sea surface temperature and chlorophyll concentrations were the best predictive variables for the observed genetic differentiation. Considering the potential causes of genetic isolation among the three populations, e.g. spawning areas in different latitudes associated with upwelling processes, oceanographic barriers, asymmetric migration and specialized diet, oceanographic barriers appear to be a likely mechanism restricting gene flow.

Guía clínica para la resección mucosa endoscópica de lesiones colorrectales no pediculadas / Clinical guidelines for endoscopic mucosal resection of non-pedunculated colorectal lesions

Este documento resume el contenido de la Guía de resección mucosa endoscópica elaborada por el grupo de trabajo de la Sociedad Española de Endoscopia Digestiva (GSEED de Resección Endoscópica) y expone las recomendaciones sobre el manejo endoscópico de las lesiones neoplásicas colorrectales superficiales (AU)

This document summarizes the contents of the Clinical Guidelines for the Endoscopic Mucosal Resection of Non-Pedunculated Colorectal Lesions that was developed by the working group of the Spanish Society of Digestive Endoscopy (GSEED of Endoscopic Resection). This document presents recommendations for the endoscopic management of superficial colorectal neoplastic lesions (AU)

Guía clínica para la resección mucosa endoscópica de lesiones colorrectales no pediculadas / Clinical guidelines for endoscopic mucosal resection of non-pedunculated colorectal lesions

Este documento resume el contenido de la Guía de resección mucosa endoscópica elaborada por el grupo de trabajo de la Sociedad Española de Endoscopia Digestiva (GSEED de Resección Endoscópica) y expone las recomendaciones sobre el manejo endoscópico de las lesiones neoplásicas colorrectales superficiales (AU)

This document summarizes the contents of the Clinical Guidelines for the Endoscopic Mucosal Resection of Non-Pedunculated Colorectal Lesions that was developed by the working group of the Spanish Society of Digestive Endoscopy (GSEED of Endoscopic Resection). This document presents recommendations for the endoscopic management of superficial colorectal neoplastic lesions (AU)

Clinical guidelines for endoscopic mucosal resection of non-pedunculated colorectal lesions.

This document summarizes the contents of the Clinical Guidelines for the Endoscopic Mucosal Resection of Non-Pedunculated Colorectal Lesions that was developed by the working group of the Spanish Society of Digestive Endoscopy (GSEED of Endoscopic Resection). This document presents recommendations for the endoscopic management of superficial colorectal neoplastic lesions.

Clinical guidelines for endoscopic mucosal resection of non-pedunculated colorectal lesions. / Guía clínica para la resección mucosa endoscópica de lesiones colorrectales no pediculadas.

This document summarizes the contents of the Clinical Guidelines for the Endoscopic Mucosal Resection of Non-Pedunculated Colorectal Lesions that was developed by the working group of the Spanish Society of Digestive Endoscopy (GSEED of Endoscopic Resection). This document presents recommendations for the endoscopic management of superficial colorectal neoplastic lesions.

Tratamiento del cáncer de laringe avanzado y calidad de vida. Revisión sistemática / Treatment of advanced laryngeal cancer and quality of life. Systematic review

Introducción y objetivos: El objetivo fue comparar la calidad de vida de los pacientes con cáncer de laringe en estadio avanzado tratados con preservación de órgano respecto a aquellos tratados quirúrgicamente. Métodos: Se realizó una revisión sistemática consultando MedLine, EMBASE, y PubMed (1991-2014) y Web of Science (2012-2014). Los términos de búsqueda fueron: cáncer de laringe, preservación de órgano, quimioterapia, laringectomía, resultados de tratamiento y calidad de vida. Se incluyeron revisiones sistemáticas, metaanálisis, informes de evaluación de tecnologías sanitarias y estudios comparativos con grupo control, publicados en idioma español, francés o inglés. La selección y evaluación de la calidad fue realizada por dos investigadores. Se usaron los criterios de la Colaboración Cochrane para evaluar el riesgo de sesgo y los del Scottish Intercollegiate Guidelines Network (SIGN) para el nivel de evidencia. Resultados: De los 208 estudios identificados en la búsqueda se incluyeron tres: un ensayo clínico y dos estudios observacionales, con un total de 211 pacientes. Su calidad y nivel de evidencia fueron bajos. Los resultados fueron contradictorios, en algunas ocasiones favorables a la cirugía y en otras, a la combinación de radioterapia y quimioterapia, pero en general, sin diferencias significativas entre los tratamientos. Se trataba de estudios heterogéneos, con metodología diferente, tamaño insuficiente, limitaciones en su calidad, con importante riesgo de sesgo y utilización de escalas de medida distintas. Conclusiones: Carecemos de estudios de calidad suficiente para establecer si la calidad de vida en los pacientes con cáncer de laringe en estadio avanzado es diferente en función del tratamiento recibido (AU)

Introduction and objectives: The objective was the comparison of the quality of life in patients with advanced laryngeal cancer treated with organ preservation versus surgical treatment. Methods: We performed a systematic review in the databases MedLine, EMBASE, and PubMed (2014 1991) and Web of Science (2012 - 2014). The search terms were: Laryngeal cancer, organ preservation, chemotherapy, laryngectomy, treatment outcomes and quality of life. Systematic reviews, meta-analysis, reports of health technology assessment and comparative studies with control group, published in Spanish, French or English were included. The selection and quality assessment was made by two researchers. The criteria of the Cochrane Collaboration were used to assess the risk of bias and Scottish Intercollegiate Guidelines Network (SIGN) for the level of evidence. Results: Of the 208 studies identified in the search, three were included a clinical trial and two observational studies, with a total of 211 patients. Quality and level of evidence was low. The results were contradictory, on occasion they favoured surgery, and on other occasions chemotherapy, but in general there were no statistical differences between the treatments. The studies were heterogeneous, with different methodology, undersized, limitations in quality with high risk of bias and use of different measurement scales. Conclusions: There are not enough studies of quality to establish differences in the quality of life in patients with advanced laryngeal cancer according to the treatment received (AU)