Study of pelvic organ prolapse as a predictor of osteoporotic fracture risk.

Purpose: The present study aimed to examine the association between the stage of pelvic organ prolapse (POP) and the risk of fracture in postmenopausal women.Methods: A cross-sectional design was used, which included 133 women with POP over 50 years of age. The participants were classified according to their POP stage, underwent blood tests (hemogram, biochemistry, bone remodeling markers, and hormone tests), and completed a sociodemographic and lifestyle questionnaire along with densitometry, FRAX, and FRIDEX tests.Results: Of the 133 women studied, 66 presented stages I-II POP (49.6%) and 67 III-IV POP (50.4%). The mean age of the participants was 64.47 years. Women with a high POP stage showed higher FRAX scores for major osteoporotic and hip fracture (p .001 and p < .001p). Bivariate analysis revealed that higher scores on the FRIDEX scale were associated with a higher POP stage (p = .032). In addition, there was a marginally significant negative association between bone mineral density (BMD) and POP stage (p = .054).Conclusions: High-stage POP can be considered an independent predictor of osteoporotic fracture risk, as measured using the FRAX and FRIDEX scales.

Successful lichen translocation on disturbed gypsum areas: A test with adhesives to promote the recovery of biological soil crusts.

The loss of biological soil crusts represents a challenge for the restoration of disturbed environments, specifically in particular substrates hosting unique lichen communities. However, the recovery of lichen species affected by mining is rarely addressed in restoration projects. Here, we evaluate the translocation of Diploschistes diacapsis, a representative species of gypsum lichen communities affected by quarrying. We tested how a selection of adhesives could improve thallus attachment to the substrate and affect lichen vitality (as CO2 exchange and fluorescence) in rainfall-simulation and field experiments. Treatments included: white glue, water, hydroseeding stabiliser, gum arabic, synthetic resin, and a control with no adhesive. Attachment differed only in the field, where white glue and water performed best. Adhesives altered CO2 exchange and fluorescence yield. Notably, wet spoils allowed thalli to bind to the substrate after drying, revealing as the most suitable option for translocation. The satisfactory results applying water on gypsum spoils are encouraging to test this methodology with other lichen species. Implementing these measures in restoration projects would be relatively easy and cost-effective. It would help not only to recover lichen species in the disturbed areas but also to take advantage of an extremely valuable biological material that otherwise would be lost.

Enhancing seedling production of native species to restore gypsum habitats.

Gypsum habitats are widespread globally and are important for biological conservation. Nevertheless, they are often affected by human disturbances and thus require restoration. Sowing and planting have shown positive results, but these actions are usually limited by the lack of native plant material in commercial nurseries, and very little information is available on the propagation of these species. We address this issue from the hypothesis that gypsum added to a standard nursery growing medium (peat) can improve seedling performance of gypsum species and, therefore, optimise the seedling production for outplanting purposes. We test the effect of gypsum on emergence, survival, and growth of nine native plant species, including gypsophiles (exclusive to gypsum) and gypsovags (non-exclusive to gypsum). We used four treatments according to the proportions, in weight, of gypsum:standard peat (G:S), i.e. high-g (50G:50S), medium-g (25G:75S), low-g (10G:90S), and standard-p (0G:100S). Our results showed that the gypsum treatments especially benefited the emergence stage, gypsophiles as group, and Ononis tridentata as a taxon. In particular, the gypsum treatments enhanced emergence of seven species, survival of three species, and growth of two gypsophiles, while the use of the standard peat favoured only the emergence or growth of three gypsovags. Improving emergence and survival at the nursery can provide a reduction of costs associated with seed harvesting, watering, and space, while enlarging seedlings can favour the establishment of individuals after outplanting. Thus, we suggest adding gypsum to standard peat for propagating seedlings in species from gypsum habitats, thereby potentially cutting the costs of restoring such habitats. Our assessment enables us to provide particular advice by species. In general, we recommend using between 25 and 50% of gypsum to propagate gypsophiles, and between 0 and 10% for gypsovags. The results can benefit not only the production of widely distributed species commonly affected by gypsum quarrying, but also of narrow and threatened endemic species that require particularly efficient use of their seeds. In addition, our study highlights the importance of using appropriate growing media to propagate plants characteristic of special substrates for restoration purposes.

Evolution of pollination niches and floral divergence in the generalist plant Erysimum mediohispanicum.

BACKGROUND AND AIMS: How generalist plants diverge in response to pollinator selection without becoming specialized is still unknown. This study explores this question, focusing on the evolution of the pollination system in the pollination generalist Erysimum mediohispanicum (Brassicaceae). METHODS: Pollinator assemblages were surveyed from 2001 to 2010 in 48 geo-referenced populations covering the entire geographic distribution of E. mediohispanicum. Bipartite modularity, a complex network tool, was used to find the pollination niche of each population. Evolution of the pollination niches and the correlated evolution of floral traits and pollination niches were explored using within-species comparative analyses. KEY RESULTS: Despite being generalists, the E. mediohispanicum populations studied can be classified into five pollination niches. The boundaries between niches were not sharp, the niches differing among them in the relative frequencies of the floral visitor functional groups. The absence of spatial autocorrelation and phylogenetic signal indicates that the niches were distributed in a phylogeographic mosaic. The ancestral E. mediohispanicum populations presumably belonged to the niche defined by a high number of beetle and ant visits. A correlated evolution was found between pollination niches and some floral traits, suggesting the existence of generalist pollination ecotypes. CONCLUSIONS: It is conjectured that the geographic variation in pollination niches has contributed to the observed floral divergence in E. mediohispanicum. The process mediating this floral divergence presumably has been adaptive wandering, but the adaptation to the local pollinator faunas has been not universal. The outcome is a landscape where a few populations locally adapted to their pollination environment (generalist pollination ecotypes) coexist with many populations where this local adaptation has failed and where the plant phenotype is not primarily shaped by pollinators.

Clinical guidelines for late-onset Pompe disease.

Before 2006, Pompe disease or glycogenosis storage disease type II was an incurable disease whose treatment was merely palliative. The development of a recombinant human alpha-glucosidase enzymatic replacement therapy has become the first specific treatment for this illness. The aim of this guide is to serve as reference for the management of the late-onset Pompe disease, the type of Pompe disease that develops after one year of age. In the guide a group of Spanish experts make specific recommendations about diagnosis, follow-up and treatment of this illness. With regard to diagnosis, the dried blood spots method is essential as the first step for the diagnosis of Pompe disease. The confirmation of the diagnosis of Pompe disease must be made by means of an study of enzymatic activity in isolated lymphocytes or a mutation analysis of the alpha-glucosidase gene. With regard to treatment with enzymatic replacement therapy, the experts say that is effective improving or stabilizating the motor function and the respiratory function and it must be introduced when the first symptoms attributable to Pompe disease appear.

Diagnóstico prenatal de teratomainmaduro intracraneal / Prenatal diagnosis of intracranial immature

Los tumores intracraneales fetales tienen una baja incidencia.La variedad anatomopatológica más frecuente la constituyeel teratoma. En la mayoría de los casos el pronósticoes malo ya que supera la línea media, suele presentar un rápidocrecimiento y la mayoría de los fetos mueren intraúteroo poco después de su nacimiento.Presentamos una gestante de 27 semanas que consultapor brusco aumento de la altura uterina y distensión abdominal.En la valoración ecográfica se aprecia una circunferenciacefálica muy aumentada a expensas de una masa heterogéneaque ocupa todo el cráneo, no visualizándose estructurascerebrales indemnes y que produce exoftalmos derecho. Dadoel mal pronóstico fetal, se induce el parto por interés maternoy finalmente éste se produce mediante cesárea de un fetomujer fallecido intraparto. El estudio anatomopatológico informade teratoma inmaduro intracraneal (AU)

Intracranial fetal tumors have a low incidence. Mostof the cases are teratomas in the histology. The prognosisis poor because they normally override the middle line ofthe brain, present a rapid growth and almost all the fetusesdie intrauterus or short after birth.We present a 27 weeks pregnant woman that cameto the emergency casualty because of a sudden increasedof the abdominal height. In the ultrasound we could seea very large cephalic circumference at expense of a heterogeneous mass that occupied all the fetal head and producedextrusion of the facial structures. There were notany recognizable anatomical parts of the normal fetalbrain remaining. In view of the fatal prognosis, the labourwas induced and terminated by a cesarean sectioneven after trying to reduce the head volume by intrapartumaspiration of the tumoral mass. The histology wasreported as immature teratoma (AU)

Spanish family with myalgia and cramps syndrome.

A Spanish family is reported with dystrophinopathy of myalgia and cramps syndrome type. There were five affected males and three females, and also six asymptomatic carriers. Muscle biopsy showed a dystrophic pattern, but immunohistochemistry carried out with three anti-dystrophin antibodies was normal. Dystrophin analysis by western blot revealed a dystrophin of reduced quantity and molecular weight. DNA analysis showed a deletion of the dystrophin gene involving exons 45-52. The natural history of this disorder and the large intrafamilial clinical variability are discussed.

Análisis de 18 pacientes diagnosticados de distrofia muscular de tipo Becker / Analysis of 18 cases of Becker muscular dystrophy

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Empeoramiento por el uso de estatinas de una miopatía por déficit de carnitina palmitoil transferasa / Worsening for using statin in carnitine palmityol transferase deficiency myopathy

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Atrofia espinal distal juvenil de miembros superiores. Revisión de la literatura a propósito de un caso / Juvenile distal spinal atrophy of the arms: a case report and review of the literature

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[Accuracy and validity of the lactic threshold compared to other noninvasive methods of measuring the anaerobic threshold in patients with metabolic myopathies]. / Exactitud y validez del umbral láctico frente a otros métodos no invasivos de medición del umbral anaerobio en pacientes con miopatías metabólicas.

UNLABELLED: Poor correlation among the various methods for measuring anaerobic threshold (AT) has been reported, and some authors have even reported interobserver variability within a single method. It is unknown whether such variability exists in patients with metabolic myopathies (MM). OBJECTIVE: To determine intra- and interobserver variability in the measurement of AT in patients with MM and analyze the differences for each method used. We enrolled 16 patients with differing forms of MM for exercise testing. AT was determined by 4 methods: lactic threshold (LT), semi-log LT, respiratory equivalent and V-slope. AT was assessed by 2 observers, who analyzed plots in random order on 2 different occasions, locating the AT in each plot. The respiratory equivalent method gave the best intraobserver correlation (r' = 0.95; p < 0.05) and was superior to the LT method (r' = 0.68; p < 0.05). Interobserver correlation was equally acceptable for all except the V-slope method (r' = 0.36; p > 0.05). The most important finding after comparison of the methods was the significant difference in VO2 (ml/min) in AT between the LT method and the non invasive methods (LT = 1,006; respiratory equivalent 1,312; p < 0.05; LT = 1,095; V-slope = 1,251; p < 0.05). CONCLUSION: Intra- and interobserver variability is slight in patients with MM; the best method in this respect is that of the V-slope. AT appears later with non invasive methods and for that reason, invasive measurement (LT) is preferable.