The impacts of seasonal variation and climate on food utilization in a population of critically endangered cotton-top tamarins (Saguinus oedipus) in Colombia: A 22-year longitudinal study.

To examine how precipitation patterns and climate change impact feeding choices made by a population of critically endangered cotton-top tamarins (Saguinus oedipus), we examined 22 years of feeding data (1999-2020) from 21 groups collected at Parque Natural Regional Bosque Seco El Ceibal Mono Tití in Santa Catalina, Colombia. We describe the diet and examine the role of seasonal rainfall and annual variation in rainfall on diet. Rainfall is highly seasonal (mean annual rainfall 1562 mm [range 940-2680 mm]) with a dry, early rainy, and late rainy season in each year. Over 80 species of plants formed part of the fruit, nectar, and exudate components of the diet. Fruits, although available year-round, were more commonly available and consumed during the late rainy seasons (August-November). Exudates were consumed more frequently in the dry season (December-March) and invertebrate consumption was stable across the year. Nectar feeding from a single species (Combretum fruticosum) peaked in November. Rainfall varied over the years, with 13 years exceeding the 99% confidence intervals for mean rainfall. Ten of these extreme years (both drought and extremely wet) occurred in the last 11 years. Fruit consumption did not vary between extreme and average years, but cotton-top tamarins consumed more invertebrates and exudates in wet years. Presently, cotton-top tamarins appear to be able to cope with these extreme variations in rainfall due to their highly varied diet. However, the forests that these primates depend upon for survival are threatened by human exploitation making it critically important to maintain a generalist feeding strategy for survival as many fruiting trees that compose a large proportion of the diet are removed. As conservation efforts continue, plant species consumed by cotton-top tamarins provide useful data when selecting species for habitat restoration programs.

Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy.

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving "Aortic teams" made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols. The latest consensus document of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society for Vascular Surgery (ESVS) define the concept of "AORTIC TEAM"(1). The aortic team should be closely involved from diagnosis to treatment and finally follow-up, and should be formed of cardiac and vascular surgeons working together with anaesthesiologists, cardiologists, radiologists and geneticists. Treatment of aortic pathologies should be centralised in large centres, because this is the only way to effectively understand the natural course of the disease, provide the entire range of treatment options under one umbrella and treat potential complications. A streamlined emergent care pathway (24/7 availability), adequate transportation and transfer capabilities, as well as rapid activation of the multidisciplinary team must be available. In light of the complexity and constant evolution of therapeutic options, we present this first version of the Anaesthesiology and surgical guidelines for surgery of the ascending aorta and aortic arch. Some questions will no doubt remain unanswered, and future versions will include new techniques that, though implemented in some centres, are still not widely recommended.

Current Situation and Prognostic Evolution of Combined Heart-lung Transplantation in a European Union Country.

Background: This study aims to evaluate the entire experience in heart-lung transplantation (HLTx) in a country of the European Union with 47 million inhabitants according to the etiologies that motivated the procedure. Methods: A retrospective study on 1,751 consecutive transplants (HLTx: 78) was performed from 1990 to 2020 in two centers. Overall survival, adjusted for clinical profile and etiological subgroups, was compared. 7 subgroups were considered: 1) Cardiomyopathy with pulmonary hypertension (CM + PH). 2) Eisenmenger syndrome. 3) Congenital heart disease (CHD). 4) Idiopathic pulmonary arterial hypertension (IPAH). 5) Cystic fibrosis. 6) Chronic obstructive pulmonary disease (COPD)/Emphysema. 7) Diffuse interstitial lung disease (ILD). Results: Early mortality was 44% and that of the rest of the follow-up was 31%. There were differences between HTLx and HTx in survival, also comparing groups with a similar clinical profile with propensity score (p= 0.04). Median survival was low in CM + PH (18 days), ILD (29 days) and CHD (114 days), intermediate in Eisenmenger syndrome (600 days), and longer in IPAH, COPD/Emphysema and cystic fibrosis. Conclusion: HLTx has a high mortality. The etiological analysis is of the utmost interest to make the most of the organs and improve survival.

Volumetric assessment of the sella turcica: a re-evaluation.

BACKGROUND: The sella turcica volume is widely measured by the Di Chiro-Nelson method. The purpose is to compare the fidelity of a proposed volumetry method vs. the Di Chiro-Nelson method, using computed tomography (CT) images. MATERIALS AND METHODS: Morphometric examination of 173 CT scans were included, of which 52.6% were female. The mean age was 53.2 ± 17.6 years. Considering the Di Chiro-Nelson method, two measurements were added for each axis in the CT evaluation: length (central, left, and right), width (central, anterior, and posterior), and height (central, left, and right). RESULTS: The mean measurements were length: central 10.11 ± 1.44, left 7.45 ± 1.67, right 7.53 ± 1.59; width: central 12.27 ± 2.11, anterior 10.99 ± 1.92, posterior 10.10 ± 1.74; height: central 7.68 ± 1.38, left 7.16 ± 1.35, right 7.40 ± 1.41. A statistically significant difference between sexes was found only in the anterior width (p = 0.01). Using the proposed method, the volume was 342.2 ± 88.5 and 378. 6 ± 113.9 mm³, respectively for females and males (p = 0.02) vs. 476.1 ± 132.4 and 523.8 ± 186.0 mm3 (p = 0.05) using the Di Chiro-Nelson's method. CONCLUSIONS: Women had significantly smaller sella turcica volume than men. This proposed method considers the sella turcica as a not strictly symmetrical structure and indicates reduced variation between the maximum and minimum values, compared to the Di Chiro-Nelson's. Our findings may be useful for reassessment the volume of the sella turcica as the measurements indicate a higher precision.

SEDAR/SECCE ECMO management consensus document.

ECMO is an extracorporeal cardiorespiratory support system whose use has been increased in the last decade. Respiratory failure, postcardiotomy shock, and lung or heart primary graft failure may require the use of cardiorespiratory mechanical assistance. In this scenario perioperative medical and surgical management is crucial. Despite the evolution of technology in the area of extracorporeal support, morbidity and mortality of these patients continues to be high, and therefore the indication as well as the ECMO removal should be established within a multidisciplinary team with expertise in the area. This consensus document aims to unify medical knowledge and provides recommendations based on both the recent bibliography and the main national ECMO implantation centres experience with the goal of improving comprehensive patient care.

Anaesthetic-surgical guide in the treatment of ascending aorta and surgery of the ascending aorta and aortic arch. Consensus document of the Spanish Society of Cardiovascular and Endovascular Surgery and the Sociedad of Anaesthesiology, Resuscitation and Pain Therapy. / Guía anestésico-quirúrgica en el tratamiento de la cirugía de aorta ascendente y del arco aórtico. Documento de consenso de la Sociedad Española de Cirugía Cardiovascular y Endovascular y la Sociedad Española de Anestesiología, Reanimación y Terapeútica del Dolor.

Aortic pathology is always a challenge for the clinician, and must be diagnosed and treated by a multidisciplinary team due to the technical and technological complexity of the resources used. Ongoing efforts to implement a systematic, protocolized approach involving "Aortic teams" made up of cardiologists, cardiac surgeons, vascular surgeons, anaesthesiologists and radiologists, among others are now leading to improved outcomes. The aim of this consensus document drawn up by the Aortic working groups of the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy (SEDAR) and the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) is to disseminate a set of working protocols. The latest consensus document of the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society for Vascular Surgery (ESVS) define the concept of "AORTIC TEAM"(1). The aortic team should be closely involved from diagnosis to treatment and finally follow-up, and should be formed of cardiac and vascular surgeons working together with anaesthesiologists, cardiologists, radiologists and geneticists. Treatment of aortic pathologies should be centralised in large centres, because this is the only way to effectively understand the natural course of the disease, provide the entire range of treatment options under one umbrella and treat potential complications. A streamlined emergent care pathway (24/7 availability), adequate transportation and transfer capabilities, as well as rapid activation of the multidisciplinary team must be available. In light of the complexity and constant evolution of therapeutic options, we present this first version of the Anaesthesiology and surgical guidelines for surgery of the ascending aorta and aortic arch. Some questions will no doubt remain unanswered, and future versions will include new techniques that, though implemented in some centres, are still not widely recommended.

RETRACTED: Anesthesic and surgical guideline for the treatment of the thoraco-abdominal aorta. Consensus Document of the Spanish Societies of Anesthesia and Cardiovascular Surgery. / Guía anestésico-quirúrgica en el tratamiento de la patología de aorta toracoabdominal. Documento de Consenso de la Sociedad Española de Cirugía Cardiovascular Endovascular y la Sociedad Española de Anestesiología, Reanimación y Terapeútica del Dolor.

Este artículo ha sido retirado por indicación del Editor Jefe de la revista, después de constatar que parte de su contenido había sido plagiado, sin mencionar la fuente original: European Heart Journal (2014) 35, 2873 926.: https://academic.oup.com/eurheartj/article/35/41/2873/407693#89325738 El autor de correspondencia ha sido informado de la decisión y está de acuerdo con la retirada del artículo. El Comité Editorial lamenta las molestias que esta decisión pueda ocasionar. Puede consultar la política de Elsevier sobre la retirada de artículos en https://www.elsevier.com/about/our-business/policies/article-withdrawal

The influence of high-density lipoprotein (HDL) and HDL subfractions on insulin secretion and cholesterol efflux in pancreatic derived ß-cells.

BACKGROUND: High-density lipoprotein (HDL) is considered a complex plasma-circulating particle with subfractions that vary in function, size, and chemical composition. We sought to test the effects of HDL, and HDL subfractions on insulin secretion and cholesterol efflux in the ß-cell line MIN-6. METHODS: We used total HDL and HDL subfractions 2a, 2b, 3a, 3b, and 3c, isolated from human plasma, to test insulin secretion under different glucose concentrations as well as insulin content and cholesterol efflux in the insulinoma MIN-6 cell line. RESULTS: Incubation of MIN-6 cells with low glucose and total HDL increased insulin release two-fold. Meanwhile, when high glucose and HDL were used, insulin release increased more than five times. HDL subfractions 2a, 2b, 3a, 3b, and 3c elicited higher insulin secretion and cholesterol efflux than their respective controls, at both low and high glucose concentrations. The insulin content of the MIN-6 cells incubated with low glucose and any of the five HDL subclasses had a modest reduction compared with their controls. However, there were no statistically significant differences between each HDL subfraction on their capacity of eliciting insulin secretion, insulin content, or cholesterol efflux. CONCLUSIONS: HDL can trigger insulin secretion under low, normal, and high glucose conditions. We found that all HDL subfractions exhibit very similar capacity to increase insulin secretion and cholesterol efflux. This is the first report demonstrating that HDL subfractions act both as insulin secretagogues (under low glucose) and insulin secretion enhancers (under high glucose) in the MIN-6 cell line.

The -514C>T polymorphism in the LIPC gene modifies type 2 diabetes risk through modulation of HDL-cholesterol levels in Mexicans.

PURPOSE: Both type 2 diabetes (T2D) and low levels of high-density lipoprotein cholesterol (HDL-C) are very prevalent conditions among Mexicans. Genetic variants in the LIPC gene have been associated with both conditions. This study aimed to evaluate the association of the -514C < T (rs1800588) LIPC gene polymorphism with different metabolic traits, particularly the effects of this polymorphism on HDL-C plasma levels and T2D risk. METHODS: Mediation analysis was used to assess the direct and indirect effects of the -514C>T LIPC gene variant on HDL-C levels, T2D risk, and body mass index (BMI), in 2105 Mexican mestizo participants. We also assessed the functional effect of the -514C>T LIPC variant on the promoter activity of a reporter gene in the HepG2 cell line. RESULTS: Direct effects show that the -514C>T LIPC polymorphism is significantly associated with increased HDL-C plasma levels (ß = 0.03; p < 0.001). The -514C>T variant resulted in an indirect protective effect on T2D risk through increasing HDL-C levels (ß = - 0.03; p < 0.001). Marginal direct association between -514C>T and T2D was found (ß = 0.08; p = 0.06). Variables directly influencing T2D status were European ethnicity (ß = - 7.20; p < 0.001), age (ß = 0.04; p < 0.001), gender (ß = - 0.15; p = 0.017) and HDL-C (ß = - 1.07; p < 0.001). In addition, we found that the -514C>T variant decreases the activity of LIPC promoter by 90% (p < 0.001). CONCLUSIONS: The -514C>T polymorphism was not directly associated with T2D risk. HDL-C acts as a mediator between -514C>T LIPC gene variant and T2D risk in the Mexican population.

Incidence of diabetes mellitus in Spain as results of the nation-wide cohort di@bet.es study.

Our aim was to determine the incidence of type 2 diabetes mellitus in a nation-wide population based cohort from Spain (di@bet.es study). The target was the Spanish population. In total 5072 people older than 18 years,were randomly selected from all over Spain). Socio-demographic and clinical data, survey on habits (physical activity and food consumption) and weight, height, waist, hip and blood pressure were recorder. A fasting blood draw and an oral glucose tolerance test were performed. Determinations of serum glucose were made. In the follow-up the same variables were collected and HbA1c was determined. A total of 2408 subjects participated in the follow-up. In total, 154 people developed diabetes (6.4% cumulative incidence in 7.5 years of follow-up). The incidence of diabetes adjusted for the structure of age and sex of the Spanish population was 11.6 cases/1000 person-years (IC95% = 11.1-12.1). The incidence of known diabetes was 3.7 cases/1000 person-years (IC95% = 2.8-4.6). The main risk factors for developing diabetes were the presence of prediabetes in cross-sectional study, age, male sex, obesity, central obesity, increase in weight, and family history of diabetes. This work provides data about population-based incidence rates of diabetes and associated risk factors in a nation-wide cohort of Spanish population.

Infección fúngica tras cirugía cardiaca. Nuestra experiencia / Experience of a fungal infection after cardiac surgery

Introducción y objetivos: Los pacientes operados de cirugía cardiaca presentan numerosas complicaciones postoperatorias, entre ellas, infecciosas. El objetivo de este estudio es investigar la incidencia, gravedad y factores de riesgo de candidiasis invasiva en estos pacientes, partiendo de la hipótesis de que factores como la politransfusión y los tiempos prolongados de circulación extracorpórea están relacionados con ella. Material y métodos: Se analizó prospectivamente a 669 pacientes operados de cirugía cardiaca programada desde abril de 2016 hasta diciembre de 2017. Se procedió a la extracción de cultivos de vigilancia al ingreso en la Unidad de Cuidados Intensivos de Anestesia, así como cultivos posteriores. Resultados: La incidencia de candidiasis invasiva fue del 2,69%, confirmada en el 1,79% de los casos. La especie de Candida más frecuentemente aislada fue Candida auris. La mortalidad en el postoperatorio inmediato fue del 11% en la candidiasis invasiva, que aumentó al 22% al mes de ingreso. Tras el estudio univariable se encontró una relación estadísticamente significativa entre la candidiasis invasiva y la politransfusión (OR 15,86; IC %: 5,15-69,14; p <0,001). Asimismo, también se encontró una relación estadísticamente significativa con otros factores de riesgo conocidos en pacientes hospitalizados. Conclusiones: La politransfusión se asocia a un mayor riesgo de candidiasis invasiva. Es necesario implementar medidas de vigilancia para la infección fúngica en pacientes con factores de riesgo que vayan a ser operados mediante cirugía cardiaca en hospitales con elevada incidencia de candidiasis

Introduction and objectives: Patients undergoing cardiac surgery can have post-operative complications, including infections. The aim of this article was to study the incidence, severity and risk factors of invasive candidiasis in these patients, based on the hypothesis that several factors (multiple transfusions and time on extracorporeal circulation) are related to invasive candidiasis. Material and methods: The study included a prospective analysis of 669 patients undergoing scheduled cardiac surgery from April 2016 to December 2017. Control cultures were collected on admittance to the Surgical Intensive Care Unit. Results: The incidence of invasive candidiasis was 2.69%, being confirmed in 1.79% of cases. The most frequently isolated Candida species was Candida auris. Mortality rate in the invasive candidiasis group was 11% in the immediate post-operative period and 22% at 30 days. After the univariate study, a statistically significant relationship was found between invasive candidiasis and multiple transfusions (OR 15.86; 95% CI: 5.15-69.4; p<.001). A statistically significant relationship was also found with other known risk factors in hospitalised patients. Conclusions: Multiple transfusions are associated with an increased risk of invasive candidiasis. Surveillance measures for fungal infection in patients with risk factors undergoing cardiac surgery should be implemented in hospitals with a high incidence of candidiasis

Neurotoxicity induced by microcystins and cylindrospermopsin: A review.

Microcystins (MCs) and cylindrospermopsin (CYN) are among the most frequent toxins produced by cyanobacteria. These toxic secondary metabolites are classified as hepatotoxins and cytotoxin, respectively. Furthermore, both may present the ability to induce damage to the nervous system. In this sense, there are many studies manifesting the potential of MCs to cause neurotoxicity both in vitro and in vivo, due to their probable capacity to cross the blood-brain-barrier through organic anion transporting polypeptides. Moreover, the presence of MCs has been detected in brain of several experimental models. Among the neurological effects, histopathological brain changes, deregulation of biochemical parameters in brain (production of oxidative stress and inhibition of protein phosphatases) and behavioral alterations have been described. It is noteworthy that minority variants such as MC-LF and -LW have demonstrated to exert higher neurotoxic effects compared to the most studied congener, MC-LR. By contrast, the available studies concerning CYN-neurotoxic effects are very scarce, mostly showing inflammation and apoptosis in neural murine cell lines, oxidative stress, and alteration of the acetylcholinesterase activity in vivo. However, more studies are required in order to clarify the neurotoxic potential of both toxins, as well as their possible contribution to neurodegenerative diseases.

Experience of a fungal infection after cardiac surgery. / Infección fúngica tras cirugía cardiaca. Nuestra experiencia.

INTRODUCTION AND OBJECTIVES: Patients undergoing cardiac surgery can have post-operative complications, including infections. The aim of this article was to study the incidence, severity and risk factors of invasive candidiasis in these patients, based on the hypothesis that several factors (multiple transfusions and time on extracorporeal circulation) are related to invasive candidiasis. MATERIAL AND METHODS: The study included a prospective analysis of 669 patients undergoing scheduled cardiac surgery from April 2016 to December 2017. Control cultures were collected on admittance to the Surgical Intensive Care Unit. RESULTS: The incidence of invasive candidiasis was 2.69%, being confirmed in 1.79% of cases. The most frequently isolated Candida species was Candida auris. Mortality rate in the invasive candidiasis group was 11% in the immediate post-operative period and 22% at 30 days. After the univariate study, a statistically significant relationship was found between invasive candidiasis and multiple transfusions (OR 15.86; 95% CI: 5.15-69.4; p<.001). A statistically significant relationship was also found with other known risk factors in hospitalised patients. CONCLUSIONS: Multiple transfusions are associated with an increased risk of invasive candidiasis. Surveillance measures for fungal infection in patients with risk factors undergoing cardiac surgery should be implemented in hospitals with a high incidence of candidiasis.

Microfiltración apical entre tres cementos utilizados en obturación retrógrada / Apical microfiltration between three cements used in retrograde obturation

Objetivo: Determinar la microfiltración apical de tres cementos utilizados en obturación retrógrada. Métodos: 45 piezas unirradiculares estandarizadas a 16 mm de longitud se instrumentaron con sistema ProTaper ® manual e irrigaron con NaClO al 5,25%. Las muestras fueron obturadas con cono principal ProTaper ® F3 y accesorios Denstply ® #A y #B; se realizó la recesión apical de 3 mm, posteriormente se desobturó 3 mm con ultrasonido (Satelec Acteon) con punta s12/70D; se dividió la muestra en tres grupos para realizar obturación retrógrada con diferentes cementos de obturación cada uno. Las muestras se incubaron a 37 °C por 3 días; se cubrieron con barniz de uñas excepto 2 mm apicales para ser sumergidas en azul de metileno al 1% por 48 horas, se lavaron y reali- zaron un corte longitudinal con disco de diamante #2 para su análisis en el estereomi- croscopio (EduBlue ED 1402S), con la ayuda de un micrómetro (Stainless Hardened) se obtuvieron diferentes valores de cada grupo, mismos que fueron analizados por medio de la comparación de medias y pruebas paramétricas. Resultados: La valoración media de la microfiltración que produce la obturación retrógrada indica que: el MTA ® presentó un valor de 87,33 ± 9,61 µm (14,57%), seguido del Biodentine ® con 136 ± 12,42 µm (22,69%), con respecto al IRM ® con mayor cantidad de microfiltración con un valor de 376 ± 12,98 µm (62,74%). Conclusiones: Al comparar las medias y porcentajes de la microfiltración apical que presentan los cementos IRM ® , Biodentine ® y MTA ® , se evidenció que el MTA ® presentó el menor valor de microfiltración

Objective: To determine the apical microfiltration of three cements used in retrograde obturation. Methods: 45 monoradicular pieces standardized to 16 mm in length were instrumented with manual ProTaper ® system and irrigated with 5.25% NaClO. The samples were sealed with ProTaper ® F3 main cone and Denstply ® accessories #A and #B; an apical recession of 3 mm was performed, subsequently a 3 mm of obturation was removed with ultrasound (Satelec Acteon) using tip s12/70D; the samples were divided into three groups to perform retrograde filling, each with different sealing cements. The samples were incubated at 37°C for 3 days; then covered with nail varnish except 2 mm apical to be immersed in 1% methylene blue for 48 hours, washed and longitudinally cut with #2 diamond disc for analysis in the stereo microscope (EduBlue ED 1402S), with the help of a micrometer (Stainless Hardened); different values of each group were obtained, then analyzed through comparison of means and parametric tests. Results: The average evaluation of the microfiltration produced by the retrograde filling indicates that: the MTA ® presented a value of 87.33 ± 9.61 µm (14.57%), followed by the Bio- dentine ® with 136 ± 12.42 µm ( 22.69%), compared to the IRM ® with the highest amount of microfiltration with a value of 376 ± 12.98 µm (62.74%). Conclusions: When comparing the means and percentages of the apical microfiltration of the IRM ® , Biodentine ® and MTA ® cements; it was evident that the MTA ® showed the lowest microfiltration value.

Disección espontánea de arteria renal / Spontaneous renal artery dissection

No disponible

Predictive factors and clinical biomarkers for treatment in patients with chronic pain caused by osteoarthritis with a central sensitisation component.

AIMS: The aim of this non-systematic review was to provide a practical guide for clinicians on the evidence for central sensitisation in chronic osteoarthritis (OA) pain and how this pain mechanism can be addressed in terms of clinical diagnosis, investigation and treatment. METHODS: The authors undertook a non-systematic review of the literature including a MEDLINE search (search terms included central sensitisation, osteoarthritis, osteoarthrosis) for relevant and current clinical studies, systematic reviews and narrative reviews. Case reports, letters to the editor and similar literature sources were excluded. Information was organised to allow a pragmatic approach to the discussion of the evidence and generation of practical recommendations. RESULTS: There is good evidence for a role of central sensitisation in chronic OA pain in a subgroup of patients. Clinically, a central sensitisation component in chronic OA pain can be suspected based on characteristic pain features and non-pain features seen in other conditions involving central sensitisation. However, there are currently no diagnostic inventories for central sensitisation specific to OA. Biomarkers may be helpful for confirming the presence of central sensitisation, especially when there is diagnostic uncertainty. Several non-pharmacological and pharmacological treatments may be effective in OA patients with central sensitisation features. Multimodal therapy may be required to achieve control of symptoms. DISCUSSION: Clinicians should be aware of central sensitisation in patients with chronic OA pain, especially in patients presenting with severe pain with unusual features.

On the origin of Robertsonian fusions in nature: evidence of telomere shortening in wild house mice.

The role of telomere shortening to explain the occurrence of Robertsonian (Rb) fusions, as well as the importance of the average telomere length vs. the proportion of short telomeres, especially in nature populations, is largely unexplored. In this study, we have analysed telomere shortening in nine wild house mice from the Barcelona Rb system with diploid numbers ranging from 29 to 40 chromosomes. We also included two standard (2n=40) laboratory mice for comparison. Our data showed that the average telomere length (considering all chromosomal arms) is influenced by both the diploid number and the origin of the mice (wild vs. laboratory). In detail, we detected that wild mice from the Rb Barcelona system (fused and standard) present shorter telomeres than standard laboratory mice. However, only wild mice with Rb fusions showed a high proportion of short telomeres (only in p-arms), thus revealing the importance of telomere shortening in the origin of the Rb fusions in the Barcelona system. Overall, our study confirms that the number of critically short telomeres, and not a simple reduction in the average telomere length, is more likely to lead to the origin of Rb fusions in the Barcelona system and ultimately in nature.

Complicaciones tras el empleo del dispositivo de cierre arterial StarClose® en punciones femorales / Complications after the use of a StarClose® vascular closure device for femoral punctures

El dispositivo de cierre arterial StarClose® (Abbot Vascular Devices, Abbot Laboratories,Redwood city, CA, EE.UU.) sella de forma rápida una punción arterial femoral mediante la colocación de un clip de nitinol en la adventicia de la arteria. Es un dispositivo seguro y efectivo, con ventajas respecto a la compresión manual, pero que no está exento de complicaciones. Presentamos dos casos con complicaciones tras utilización de StarClose® (AU)

The StarClose® arterial device (Abbot Vascular Devices, Abbot Laboratories, Redwood City, CA, USA) rapidly seals a femoral artery puncture by means of a nitinol clip in the adventitia of the artery. It is a safe and effective device, with advantages as regards manual compression, but is not free of complications. We present two cases with complications after using a StarClose® vascular device (AU)

Condiciones de trabajo de los pediatras de Atención Primaria / Working conditions of primary care pediatricians

Introducción: en el sistema público de salud, la población debería ser el centro del sistema y el profesional sanitario su principal activo; garantizar que el encuentro asistencial se realice bajo unas condiciones de calidad es fundamental en la organización y diseño de los sistemas sanitarios. Conocer la realidad de los Equipos de Atención Primaria (EAP) y las condiciones de trabajo de los pediatras de Atención Primaria (PAP) resulta imprescindible para poder ofrecer una mejor asistencia a nuestros pacientes. El objetivo es conocer las condiciones del lugar de trabajo y los medios y recursos disponibles, las cargas de trabajo, la autonomía de gestión y la conciliación de la vida familiar y laboral. Material y métodos: estudio observacional descriptivo mediante encuesta realizada on-line a PAP en España a través de la lista de distribución PEDIAP y de la lista de correo de la Asociación Española de Pediatría de Atención Primaria (AEPap) en diciembre de 2012. Resultados: recogidas 809 respuestas de todas las comunidades autónomas (CC. AA.) de un total de 6258 plazas de PAP. Un 40,6% opina que las condiciones de la consulta no permiten una correcta realización de su trabajo. El 50% no tiene acceso a las pruebas complementarias que considera necesarias. Ocho de cada diez dedican más del 75% de su jornada a labores exclusivamente asistenciales. Hasta un tercio de los pediatras tiene que asumir la consulta completa del compañero durante periodos prolongados por falta de cobertura con suplentes. Casi el 80% considera que existen condiciones que facilitan la conciliación de la vida familiar y laboral. Solo el 28% de los equipos tiene capacidad para autogestionar el presupuesto asignado a suplencias. Existen diferencias importantes para todos los ítems estudiados entre las distintas CC. AA. Conclusiones: las condiciones laborales de los PAP distan de cumplir unos requisitos que aseguren una correcta atención clínica. La escasa capacidad de participación en la gestión sitúa las posibilidades de mejora fuera de los PAP e incluso de los propios EAP (AU)

Introduction: in the Public Health System, the population should be the focus and its main asset; ensuring that the patient-doctor encounter takes place under quality conditions is fundamental in the organization and design of health systems. To know the reality of primary care teams (AP) and the working conditions of Primary Care Pediatricians (PAP) is essential in order to provide better care to our patients. The objectives are: to know the conditions of the workplace and the means, resources, workloads, management autonomy and work-life balance. Methods: descriptive observational study by online survey to PAP in Spain through a distribution list (PEDIAP) and the mailing list of the Spanish Association of Primary Care Pediatrics (AEPap) in December 2012. Results: 809 responses from all the regions of a total of 6258 PAP posts. Some 40.6% believe that the conditions of the office does not allow the proper development of their work, 50% have no access to any additional tests deemed necessary, eight in ten spend more than 75% of their time working exclusively in care tasks. Up to a third of the pediatricians have to take care of the full work of a colleague for extended periods due to lack of a substitute doctor. Nearly 80% believe that there are conditions that facilitate work-life balance. Only 28% of health care teams have the ability to self-manage the budget for substitutions. There are significant differences for all items studied among the various autonomous regions. Conclusions:PAP working conditions are far from fulfilling the requirements that ensure proper clinical care. The limited ability to participate in managing the potential for improvement lies outside the PAP and even the AP's team (AU)

Effects of depuration on oxidative biomarkers in tilapia (Oreochromis niloticus) after subchronic exposure to cyanobacterium producing cylindrospermopsin.

Cylindrospermopsin (CYN) is a cytotoxic polyketide-derived alkaloid produced by several freshwater cyanobacterial species. It is now considered the second most studied cyanotoxin worldwide. Among the toxic mechanisms suggested for CYN pathogenicity are inhibition of protein and glutathione synthesis, genotoxicity by DNA fragmentation, and oxidative stress. The study of depuration of cyanobacterial toxins by aquatic organisms, particularly by fish, is important for fish economy and public health, but in the case of CYN is practically nonexistent. In this work, we investigated the efficiency of two distinct depuration periods, 3 or 7d, in a clean environment, as a mean of restoring the levels of several oxidative stress biomarkers in tilapia (Oreochromis niloticus) subchronically exposed to CYN by immersion in an Aphanizomenon ovalisporum culture (by adding 10 µg CYN/L every two days during 14 d). Lipid peroxidation (LPO) and DNA oxidation returned to normal values after 7d of depuration, whereas the time needed for restoring of the oxidatively damaged proteins was longer. Superoxide dismutase (SOD) and gamma-glutamyl-cysteine-synthetase (γ-GCS) activities recovered after just 3d of depuration, while catalase (CAT) activity needed up to 7d to return to control values. Ratio of reduced glutathione to oxidized glutathione (GSH/GSSG) returned to control levels after 7d of depuration in both organs. These results validate the depuration process as a very effective practice for detoxification in fish contaminated with these toxins.