Síndrome doloroso regional complejo tipo i. Análisis de una casuística infantil / Complex regional pain syndrome type i. An analysis of 7 cases in children

Introducción: El síndrome doloroso regional complejo (SDRC) se caracteriza por la presencia de dolor acompañado de síntomas sensoriales, autonómicos y motores. Es precedido habitualmente por una lesión o inmovilización. Su curso clínico es desproporcionado con respecto a la lesión inicial tanto en su intensidad como en su duración. Su distribución es regional, predominando en las extremidades. Se clasifica en tipo I y tipo II según ausencia o presencia de lesión nerviosa. Casos clínicos: Se presentan 7 casos clínicos, 6 niñas y un varón con SDRC tipo I, con edades comprendidas entre 7-15 años. Tres tenían antecedente de traumatismo previo. En 5 casos los síntomas se localizaron en miembros inferiores. La demora diagnóstica fue entre 4-90 días. Tres pacientes presentaron elementos de ansiedad y depresión. En todos se realizaron pruebas complementarias de imagen e inmunológicas para descartar diagnósticos diferenciales. Se realizó tratamiento interdisciplinario no farmacológico (fisioterapia y psicoterapia) y farmacológico con analgésicos mayores, gabapentina o pregabalina. Todos presentaron buena evolución, sin recidivas en el seguimiento que fue entre 4 meses y 2,5 años. Conclusiones: El poco reconocimiento de este síndrome en niños, la ansiedad familiar que genera y los costos en paraclínica innecesaria, resaltan la importancia de su difusión entre pediatras y neuropediatras para favorecer su reconocimiento, evitar estudios innecesarios y múltiples consultas a especialistas que retrasan el diagnóstico y el inicio de un tratamiento efectivo

Introduction: Complex regional pain syndrome (CRPS) is characterised by the presence of pain accompanied by sensory, autonomic and motor symptoms, usually preceded by a lesion or immobilisation. The clinical course is disproportionate to the initial injury in intensity and in duration. Its distribution is regional, predominantly in limbs. It is classified as type I and type II according to the absence or presence of nerve injury. Cases: We present the cases of seven children, 6 girls and 1 boy, aged 7 to 15 years. Three had a history of previous trauma. In 5 cases, the symptoms were located in the lower limbs. Time to diagnosis was between 4 and 90 days. Three patients had clinical features of anxiety and depression. Imaging and immunological studies were performed to rule out differential diagnoses in all the children. Interdisciplinary treatment was performed with physiotherapy, psychotherapy, and gabapentin or pregabalin. All patients had a good clinical outcome, with no relapses in the follow-up period (between 4 and 30 months). Conclusions: CRPS is frequently unrecognised in children, leading to family anxiety and unnecessary para-clinical costs. Paediatricians and paediatric neurologists should be aware of this syndrome in order to avoid delay in diagnosis, unnecessary studies, and multiple visits to specialists, with a view to providing effective treatment

Establishment of a coastal fish in the Azores: recent colonisation or sudden expansion of an ancient relict population?

The processes and timescales associated with ocean-wide changes in the distribution of marine species have intrigued biologists since Darwin's earliest insights into biogeography. The Azores, a mid-Atlantic volcanic archipelago located >1000 km off the European continental shelf, offers ideal opportunities to investigate phylogeographic colonisation scenarios. The benthopelagic sparid fish known as the common two-banded seabream (Diplodus vulgaris) is now relatively common along the coastline of the Azores archipelago, but was virtually absent before the 1990 s. We employed a multiple genetic marker approach to test whether the successful establishment of the Azorean population derives from a recent colonisation from western continental/island populations or from the demographic explosion of an ancient relict population. Results from nuclear and mtDNA sequences show that all Atlantic and Mediterranean populations belong to the same phylogroup, though microsatellite data indicate significant genetic divergence between the Azorean sample and all other locations, as well as among Macaronesian, western Iberian and Mediterranean regions. The results from Approximate Bayesian Computation indicate that D. vulgaris has likely inhabited the Azores for ∼ 40 (95% confidence interval (CI): 5.5-83.6) to 52 (95% CI: 6.32-89.0) generations, corresponding to roughly 80-150 years, suggesting near-contemporary colonisation, followed by a more recent demographic expansion that could have been facilitated by changing climate conditions. Moreover, the lack of previous records of this species over the past century, together with the absence of lineage separation and the presence of relatively few private alleles, do not exclude the possibility of an even more recent colonisation event.

Complex regional pain syndrome type i. An analysis of 7 cases in children.

INTRODUCTION: Complex regional pain syndrome (CRPS) is characterised by the presence of pain accompanied by sensory, autonomic and motor symptoms, usually preceded by a lesion or immobilisation. The clinical course is disproportionate to the initial injury in intensity and in duration. Its distribution is regional, predominantly in limbs. It is classified as type I and type II according to the absence or presence of nerve injury. CASES: We present the cases of seven children, 6 girls and 1 boy, aged 7 to 15 years. Three had a history of previous trauma. In 5 cases, the symptoms were located in the lower limbs. Time to diagnosis was between 4 and 90 days. Three patients had clinical features of anxiety and depression. Imaging and immunological studies were performed to rule out differential diagnoses in all the children. Interdisciplinary treatment was performed with physiotherapy, psychotherapy, and gabapentin or pregabalin. All patients had a good clinical outcome, with no relapses in the follow-up period (between 4 and 30 months). CONCLUSIONS: CRPS is frequently unrecognised in children, leading to family anxiety and unnecessary para-clinical costs. Paediatricians and paediatric neurologists should be aware of this syndrome in order to avoid delay in diagnosis, unnecessary studies, and multiple visits to specialists, with a view to providing effective treatment.

Different stocks of brook lamprey in Spain and their origin from Lampetra fluviatilis at two distinct times and places.

Using the mitochondrial non-coding region I, it was shown that the two Spanish Lampetra planeri populations (Cares-Deva and Olabidea-Ugarana) correspond to different genetic units. The Cares-Deva population is probably a recent offshoot of Lampetra fluviatilis, being the Olabidea-Ugarana population less diverse and of older origin.

Gaidropsarus (Gadidae, Teleostei) of the North Atlantic Ocean: a brief phylogenetic review.

The phylogenetic relationships among the North Atlantic Gaidropsarus and between the three Gaidropsarinae genera Gaidropsarus, Ciliata and Enchelyopus are reviewed with the hitherto most comprehensive taxonomic sampling of this group. Phylogenetic results (maximum parsimony, maximum likelihood and Bayesian inference) based on nuclear (rhodopsin) and concatenated mitochondrial (12s, 16s and cytb) markers clearly support this subfamily. For the north-eastern Atlantic species of Gaidropsarus, two previously unreported clades were strongly supported, clarifying the relationships within the genus, and revealing fewer distinct taxa in the north Atlantic Gaidropsarus than previously stipulated. The data challenge the specific status of Gaidropsarus mediterraneus and Gaidropsarus guttatus and raise doubts concerning the distinctiveness of other species. A taxonomic revision of the genus is suggested.

Spatial heterogeneity in the Mediterranean Biodiversity Hotspot affects barcoding accuracy of its freshwater fishes.

Incomplete knowledge of biodiversity remains a stumbling block for conservation planning and even occurs within globally important Biodiversity Hotspots (BH). Although technical advances have boosted the power of molecular biodiversity assessments, the link between DNA sequences and species and the analytics to discriminate entities remain crucial. Here, we present an analysis of the first DNA barcode library for the freshwater fish fauna of the Mediterranean BH (526 spp.), with virtually complete species coverage (498 spp., 98% extant species). In order to build an identification system supporting conservation, we compared species determination by taxonomists to multiple clustering analyses of DNA barcodes for 3165 specimens. The congruence of barcode clusters with morphological determination was strongly dependent on the method of cluster delineation, but was highest with the general mixed Yule-coalescent (GMYC) model-based approach (83% of all species recovered as GMYC entity). Overall, genetic morphological discontinuities suggest the existence of up to 64 previously unrecognized candidate species. We found reduced identification accuracy when using the entire DNA-barcode database, compared with analyses on databases for individual river catchments. This scale effect has important implications for barcoding assessments and suggests that fairly simple identification pipelines provide sufficient resolution in local applications. We calculated Evolutionarily Distinct and Globally Endangered scores in order to identify candidate species for conservation priority and argue that the evolutionary content of barcode data can be used to detect priority species for future IUCN assessments. We show that large-scale barcoding inventories of complex biotas are feasible and contribute directly to the evaluation of conservation priorities.

Phylogeny of Parablennius Miranda Ribeiro, 1915 reveals a paraphyletic genus and recent Indo-Pacific diversification from an Atlantic ancestor.

A molecular phylogeny of 15 (out of 26 recognized) species of Parablennius Miranda Ribeiro, 1915 was constructed based on two mitochondrial and two nuclear gene fragments, and using maximum parsimony, maximum likelihood and Bayesian approaches. The closely related genera Hypleurochilus, Salaria and Scartella were also studied to ascertain their relationship with Parablennius. Phylogenetic analyses were compared with morphology-based taxonomical studies. Hypleurochilus, Salaria and Scartella appear well supported within a clade including all Parablennius, indicating that this genus is paraphyletic. The species pairs P. parvicornis-P. sanguinolentus and P. gattorugine-P. ruber are well-supported and relatively distant from remaining Parablennius. Remaining Parablennius form two distinct well-supported groups: (1) a clade of Atlantic-Mediterranean Parablennius (P. pilicornis, P. marmoreus, P. rouxi, P. salensis and P. tentacularis); (2) a clade including Hypleurochilus, the Indo-Western Pacific Parablennius (P. cornutus, P. intermedius, P. tasmanianus and P. yatabei) and the Atlantic-Mediterranean P. incognitus and P. zvonimiri. Use of a relaxed molecular clock suggests that Indo-Pacific Parablennius originated recently from an Atlantic Parablennius that may have dispersed via southern Africa, rather than via the Tethys seaway.

Homing in rocky intertidal fish. Are Lipophrys pholis L. able to perform true navigation?

Although navigation is common in many animals, only a few perform true navigation, meaning that they have the ability to return to a given place by relying on indirect cues obtained at the release site (i.e., by relying on information from a "map and compass" mechanism). The common intertidal fish, Lipophrys pholis, is thought to have homing abilities through a mechanism that primarily makes use of familiar landmarks (i.e., piloting). Anecdotal reports that individuals return to their home pools after release at unfamiliar sites suggest that L. pholis might use cues collected at the release site to find their way back (i.e., they might use map and compass information). Using a completely artificial setup, we tested the homing abilities of L. pholis as a function of age, sex, and familiarity with the release site. The findings showed that motivation for homing is present only in the adult phase and is independent of sex and/or familiarity with the release site. Moreover, adults released at a completely unfamiliar place oriented themselves in a direction roughly similar to that of their home pools. The fact that L. pholis were tested in a complete artificial environment means that hydrodynamic cues can be excluded as playing a role in this process and restricts the candidate options (e.g., magnetic cues). The ability to perform navigation based on a "map and compass" mechanism raises many interesting questions about the learning process, once these individuals have restricted home ranges during their lives. In vertebrate navigation, the cues used during the navigation process are a question of debate, and L. pholis offers an outstanding model to test hypotheses and ultimately provide answers.

Multilocus phylogenetic analysis of the genus Atherina (Pisces: Atherinidae).

Sand-smelts are small fishes inhabiting inshore, brackish and freshwater environments and with a distribution in the eastern Atlantic and Mediterranean Sea, extending south into the Indian Ocean. Here, we present a broad phylogenetic analysis of the genus Atherina using three mitochondrial (control region, 12S and 16S) and two nuclear markers (rhodopsin and 2nd intron of S7). Phylogenetic analyses fully support the monophyly of the genus. Two anti-tropical clades were identified, separating the South African Atherina breviceps from the north-eastern Atlantic and Mediterranean Atherina' species. In European waters, two groups were found. The first clade formed by a well supported species-pair: Atherina presbyter (eastern Atlantic) and Atherina hepsetus (Mediterranean), both living in marine waters; a second clade included Atherina boyeri (brackish and freshwater environments) and two independent lineages of marine punctated and non-punctated fishes, recently proposed as separate species. Sequence divergence values strongly suggest multiple species within the A. boyeri complex.

The Lusitania Province as a center of diversification: the phylogeny of the genus Microlipophrys (Pisces: Blenniidae).

The Lusitania Province has been considered a transition zone between the Atlantic northern cold waters and Tropical warm waters. Tropical species have expanded their ranges during warm periods and either retreated during cold periods or survived in local refuges. Successive waves of dispersion into this Province could have favored diversification through geographic isolation. Taxa that remained in this large Province may also have diversified in loco. We analyzed molecular markers of the genus Microlipophrys (family Blenniidae) that confirm the validity of this genus and of the seven recognized species. Microlipophrys and its sister clade apparently originated within Lusitania and dispersed into the tropics at a later stage.

Comparisons of the genetic structure of Squalius populations (Teleostei, Cyprinidae) from rivers with contrasting histories, drainage areas and climatic conditions based on two molecular markers.

The genetic structure of Squalius populations from Portuguese Atlantic- and Mediterranean-type streams (assigned to six distinct morphoclimatic regions) was compared using sequences of the cytb and beta-actin genes. The drainage area was significantly correlated to all the genetic diversity indices, pointing to the need to control for this effect in comparing populations with different histories and paleoecologies. A significant correlation was also found between genetic diversity and the morphoclimatic regions to which the rivers were assigned, with the highest diversity in warmer, lower latitude, Mediterranean-type streams. This relationship was not due to idiosyncratic characteristics of the clades compared. When the drainage area and phylogenetic effects were removed, the southern Mediterranean streams harboured significantly more genetic diversity even when compared with much larger northern streams. It is argued that these results are likely caused both by the metapopulation structure of the Mediterranean streams and by the severe reduction or local extinction of populations in the northern rivers during glaciations.

Phylogeographical analysis reveals multiple conservation units in brook lampreys Lampetra planeri of Portuguese streams.

The populations of brook lamprey Lampetra planeri of Portuguese Rivers were analysed phylogeographically using a fragment of 644 bp of the mitochondrial control region of 158 individuals from six populations. Samples representing L. planeri and migratory lampreys Lampetra fluviatilis of rivers draining to the North Sea and the Baltic Sea were also included to assess the relationships of Portuguese samples. The data support a clear differentiation of all the populations studied. Several populations, which are isolated among themselves and also from the migratory lampreys, proved to be entirely composed of private haplotypes, a finding that supports some time of independent evolutionary history for these populations. This, combined with the geographic confinement to small water bodies, justifies the recognition of at least four conservation units in the Portuguese rivers Sado, São Pedro, Nabão and Inha.

Phylogenetic analysis of peri-Mediterranean blennies of the genus Salaria: molecular insights on the colonization of freshwaters.

In this paper, the phylogenetic relationships of the marine blenny Salaria pavo and the freshwater S. fluviatilis and S. economidisi were analyzed using four molecular markers: the mitochondrial 12S rRNA, 16S rRNA, and the control region and the nuclear first intron of the S7 ribosomal protein. The monophyly of Salaria is supported, as well as that of S. pavo and that of all the freshwater members of Salaria. Thus, the present results support a single origin for all freshwater Mediterranean blenniids. Our results reject the placement of the species of Salaria in the genus Lipophrys as proposed in previous studies. Using a molecular clock calibrated with trans-Isthmian geminate blenniid species, the split between the ancestor of the freshwater lineage and the ancestor of S. pavo is tentatively placed in the Middle Miocene (well before the Messinian). The marine S. pavo displays a very low level of intraspecific sequence divergence consistent with a Pleistocene bottleneck. S. fluviatilis is a paraphyletic entity with S. economidisi nested within it. A Moroccan population of S. fluviatilis is more divergent than S. economidisi, both in nuclear and mitochondrial genes. Fish from Israel together with some Turkish samples represent the second oldest split. It is argued that these populations may represent cryptic species. Thus, further studies on the taxonomy of these freshwater blennies are urgently needed.

Can the limited marsupium space be a limiting factor for Syngnathus abaster females? Insights from a population with size-assortative mating.

1. Some syngnathid species show varying degrees of sex role reversal aside from male pregnancy, with females competing for access to mates and sometimes presenting conspicuous secondary sexual characters. Among other variables, brooding space constraints are usually considered a key element in female reproductive success, contributing strongly to the observed morphological and behavioural sexual differences. Nevertheless, a close relationship between sex role reversal and male brooding space limitation has not yet been accurately demonstrated in field studies. 2. The present work, conducted over two consecutive breeding seasons in a wild population of the sex role-reversed pipefish Syngnathus abaster, simultaneously analysed egg number and occupied space, as well as the free area in the male's marsupium. The number of eggs that would fit in the observed unoccupied space was estimated. 3. Contrary to what would be expected, given the marked sexual dimorphism observed in the population studied, where females were larger and more colourful, male brooding space did not appear to limit female reproduction as neither large nor small individuals presented a fully occupied pouch. Interestingly, the largest unoccupied areas of marsupium were found in the larger individuals, although they received more and larger eggs. Laboratory data also showed that larger females lay larger eggs. 4. Together, these results suggest the existence of assortative mating, which may result from: (i) the reluctance of larger males (which tend not to receive small eggs usually laid by small females) to mate with lower quality females, even at the expense of a smaller number of offspring; or (ii) female-female competition, which might strongly reduce the hypothesis of a small female mating with a large male. The potential impact of temperature on reproduction and population dynamics is also discussed in the light of ongoing climatic changes.

Insights on speciation patterns in the genus Iberochondrostoma (Cyprinidae): evidence from mitochondrial and nuclear data.

In this paper, the patterns of cladogenesis in the cyprinid fish genus Iberochondrostoma were analysed using a mitochondrial (cytochrome b) and a nuclear (beta-actin) gene fragment. The two genes yielded discordant results. While the cytochrome b gene yielded a fully dichotomous tree, where all species of the genus are monophyletic, the much slower beta-actin gene yielded star-like relationships. However, when information from both genes was considered together, the data suggested the persistence of a very large central unit from which at least two peripheral clades arose at different times. This pattern which is akin to peripatric speciation was shown to be compatible with the paleogeographical information available. It is suggested that combining the techniques of phylogeny and phylogeography and the use of multiple markers varying in their rate of evolution may enrich our understanding of speciation and evolution of clades beyond species level.

Reading the history of a hybrid fish complex from its molecular record.

Squalius alburnoides is a widely distributed intergeneric hybrid complex with fish of both sexes, varying ploidy levels and proportions of the parental genomes. Its dispersal routes were here delineated and framed by the reconstruction of the phylogeny and phylogeography of other Squalius with which it hybridizes, based on the available data on the paleohydrographical history of the Iberian Peninsula. Results based on sequences of cytochrome b and beta-actin genes showed that: proto-Squalius pyrenaicus originated at least five species as it dispersed throughout the Iberian Peninsula in the Mio-Pliocene; the S. alburnoides complex likely had a single origin in the bulk of Iberia, in the Upper Tagus/Guadiana area, when hydrographical rearrangements allowed the contact between its ancestors (around 700,000 years ago); interspecific crosses allowed the introgression of mitochondrial and nuclear genes of S. alburnoides in allopatric species/populations of other Squalius and vice-versa; and reconstituted S. alburnoides non-hybrid males may contribute to the replacement of the typical mtDNA of the complex (in the populations where they occur, crosses with females of other Squalius seem to have been especially frequent). A number of dispersal events and colonization routes are proposed.