Influence of Skin Phototype on the Level of Pain Perceived by Patients Receiving Enoxaparin: A Cross-Sectional Study.

Low Molecular Weight Heparin (LMWH) is commonly used as an antithrombotic in patients with reduced mobility. Its administration is performed by invasive technique (injections) that can cause pain: (1) Background: Pain and bruising are the most common side effects in patients treated with LMWH, but the skin phototype (PT) has never been included; (2) Methods: A cross-sectional descriptive study, developed in the Hospital Unit of Orthopedic and Trauma Surgery over one year. To classify all participants in the sample considering their skin PT and the different pain levels "during" and "after" the administration of enoxaparin. The STROBE checklist was used to evaluate the study. Data analyses were carried out: descriptive statistical analysis and analysis of Variance ANOVA of a non-parametric factor; (3) Results: The sample was 202 participants. The most frequent skin PTs were PT II 43.6% and PT III 33.2%. Mean pain after injection (1.96) was greater than pain during injection (1.4). Better natural protection against sunlight (high PT) would indicate greater post-injection pain; (4) Conclusions: Participants with a medium-high phototype (≥III) perceive a greater pain sensation than participants with a low phototype (≤II) after the administration of enoxaparin.

The demographic history of Castanea sativa Mill. in southwest Europe: A natural population structure modified by translocations.

In domesticated species, translocation of materials can alter natural demographic patterns; this may have occurred in Castanea sativa (European chestnut), a species conserved in several refuges, with a long domestication history for nut production. Bayesian analysis of population genetic structure in marginal areas and in the centre of C. sativa range, considering spatial information and making corrections for unbalanced size, allowed visualization of a genetic structure that was subsequently analysed by approximate Bayesian computation to assess its natural demographic history and test the origin of some hypothetical translocated germplasm. We obtained evidence of C. sativa population contraction during the earliest Pleistocene, resulting in a split into eastern (Greek) and western (Italian and Iberian) populations. The northern Iberian population, in the Eurosiberian area, is one of the vestiges that remained after the contraction that split the global Tertiary population. A secondary encounter, occurred from Middle to Upper Pleistocene, which explains the hybrid origin of the Western Mediterranean population present in Italy and in the centre and south of the Iberian Peninsula. It has been demonstrated that a germplasm translocation from Italy to the Central Iberian Range may have occurred. Recent translocations have hybridized with the local northern Iberian population, producing naturalized populations with high diversity. The populations of C. sativa in southwestern Europe have a genetic structure compatible with a natural origin, in which signs of population contractions and expansions caused by climatic oscillations since the Late Miocene have been imprinted.

The endophytic capacity of the entomopathogenic fungus Beauveria bassiana caused inherent physiological response in two barley (Hordeum vulgare) varieties.

In this study, the endophytic capacity of B. bassiana was determined for two barley (Hordeum vulgare) varieties, Josefa and Esmeralda, inoculated with a seedling immersion at three different concentrations (1 × 106, 1 × 107 and 1 × 108 conidia/mL). Seedling length and chlorophyll content were found to be not affected when inoculated with the entomopathogenic fungus, in both barley varieties. However, the colonisation percentage was found to be significantly lower with the inoculum concentration 1 × 106 conidia/mL for both barley varieties (P < 0.05) when compared to the other concentrations. Furthermore, a principal component analysis indicated that 96.23% of the variability in the data could be explained with two components. This analysis showed that the seedling length and chlorophyll content were positively correlated in both barley varieties for the 1 × 107 conidia/mL concentration. Likewise, a positive correlation was observed for colonisation percentage and treatment with 1 × 108 conidia/mL in the Josefa variety only. This is the first study in which the endophytic capacity of B. bassiana was evaluated in two different barley varieties, with the Josefa variety found to be the most susceptible.

Oxidative stress in elite athletes training at moderate altitude and at sea level.

Using a controlled parallel group longitudinal trial design, we investigated the effects of different training interventions on the prooxidant/antioxidant status of elite athletes: living and training at moderate altitude for 3 (Hi-Hi3) and 4 weeks (Hi-Hi), and for 4 weeks too, living high and training high and low (Hi-HiLo) and living and training at sea level (Lo-Lo). From 61 swimmers, 54 completed the study. Nitrites, carbonyls, and lipid peroxidation (LPO) levels were assessed in plasma. Enzymatic antioxidants glutathione peroxidase (GPx) and glutathione reductase (GRd), and non-enzymatic antioxidants total glutathione (GST), reduced glutathione (GSH) and oxidized glutathione (GSSG) were analysed in the erythrocyte fraction. At the end of the intervention, nitrites levels were similar in all altitude groups but higher than in the Lo-Lo controls (P = .02). Hi-HiLo had greater GPx activity than Hi-Hi and Hi-Hi3 during most of the intervention (P ≤ .001). GRd activity was higher in Lo-Lo than in Hi-Hi at the end of the training camp (P ≤ .001). All groups showed increased levels of LPO, except Lo-Lo, and carbonyls at the end of the study (P ≤ .001). Training at altitude for 3 or 4 weeks drives oxidative stress leading to cellular damage mainly by worsening the antioxidant capacities. The GSSG/GSH ratio appears to be related to perceived exertion and fatigue. The stronger antioxidant defence showed by the Hi-HiLo group suggests an inverse relationship between redox alterations and performance. Further studies are required to investigate the role of oxidative stress in acclimatization, performance, and health.

Factors which influence concordance among measurements obtained by different pulse oximeters currently used in some clinical situations.

AIMS AND OBJECTIVES: To evaluate both concordance among those measurements obtained by three different pulse oximeters currently used by nursing professionals in hospital units and the factors which can influence this concordance. BACKGROUND: Many models of wireless pulse oximeters in the present market do not offer possibility of calibration and, therefore, they do not ensure patients' safety in daily clinical practice. DESIGN: This is a descriptive and cross-sectional study. The sample of patients (140) was selected from such hospital units, and all of them had to fulfil inclusion and exclusion criteria for participation. METHODS: The instruments used to carry out this research were a monitor (calibrated), two models of portable wireless pulse oximeters (used for 3 years by the nursing staff, without being calibrated), a tympanic thermometer and a weather meter. The concordance correlation coefficient (CCC) was used to establish the concordance, whereas the Landis-Koch criteria were used to interpret the results. RESULTS: The concordance among the three devices was considered as "good" (CCC: 0.925 and 0.974 (95%)). The CCC (0.925) for saturation measures was regarded as "very good"/"almost perfect," and the pulse measure was considered as "very good" CCC 0.974, providing in both cases a high level of concordance (CCC > 0.91). CONCLUSIONS: The overall concordance as regards pulse and oxygen saturation among the three pulse oximeters analysed is considered as "very good" according to the Landis-Koch criteria. RELEVANCE TO CLINICAL PRACTICE: There exists a "very good" concordance among two wireless oximeters which have been used by the health staff for 3 years and which did not offer any possibility of calibration and one monitor which belongs to the healthcare institution. This aspect is of crucial importance in daily clinical practice, and it is also relevant to ensure patient's safety.

Atypical Kaposi's sarcoma in young inmunocompetent patient.

Kaposi´s sarcoma is a rare tumor associated with human herpes virus 8 (HHV-8) infection. Four main clinical subtypes have been described. This study reports on a form of KS in an HIV negative and immunocompetent middle-aged man. The only remarkable factor is that he has sex with other men. This form of Kaposi´s sarcoma is rare. It occurs more in younger patients than in the classic form, is limited to the skin, and is associated with a good prognosis. The means of transmission of the virus is through saliva in oroanal or orogenital sexual practices. Mechanisms of tumor development are still not well known. Given the possible increased number of this variant, it would be interesting to extend this study.

Dermatoscopic signs in cutaneous leishmaniasis

Abstract: Dermoscopy is a non-invasive technique widely used to aid in the characterization and diagnosis of pigmented skin lesions. Recently, it has also been employed for the evaluation of non-pigmented skin tumours, and inflammatory and infectious cutaneous diseases. Although the diagnosis of cutaneous leishmaniasis is confirmed by the demonstration of amastigotes in infected skin or by the growth of promastigotes in culture medium, dermoscopy could be useful as a further diagnostic test. We report a patient with a nodular lesion located on the right cheek for almost two years. The lesion was clinically suggestive of cutaneous leishmaniasis. Dermoscopy showed yellow tears, erythema and vascular structures. The diagnosis was confirmed by the demonstration of amastigotes in a skin scraping sample.

Peripatric speciation in an endemic Macaronesian plant after recent divergence from a widespread relative.

The Macaronesian Scrophularia lowei is hypothesized to have arisen from the widespread S. arguta on the basis of several phylogenetic studies of the genus, but sampling has been limited. Although these two annual species are morphologically distinct, the origin of S. lowei is unclear because genetic studies focused on this Macaronesian species are lacking. We studied 5 S. lowei and 25 S. arguta populations to determine the relationship of both species and to infer the geographical origin of S. lowei. The timing of S. lowei divergence and differentiation was inferred by dating analysis of the ITS region. A phylogenetic analysis of two nuclear (ITS and ETS) and two chloroplast (psbJ-petA and psbA-trnH) DNA regions was performed to study the relationship between the two species, and genetic differentiation was analysed by AMOVA. Haplotype network construction and Bayesian phylogeographic analysis were conducted using chloroplast DNA regions and a spatial clustering analysis was carried out on a combined dataset of all studied regions. Our results indicate that both species constitute a well-supported clade that diverged in the Miocene and differentiated in the Late Miocene-Pleistocene. Although S. lowei constitutes a well-supported clade according to nDNA, cpDNA revealed a close relationship between S. lowei and western Canarian S. arguta, a finding supported by the spatial clustering analysis. Both species have strong population structure, with most genetic variability explained by inter-population differences. Our study therefore supports a recent peripatric speciation of S. lowei-a taxon that differs morphologically and genetically at the nDNA level from its closest relative, S. arguta, but not according to cpDNA, from the closest Macaronesian populations of that species. In addition, a recent dispersal of S. arguta to Madeira from Canary Islands or Selvagens Islands and a rapid morphological differentiation after the colonization to generate S. lowei is the most likely hypothesis to explain the origin of the last taxon.

Dermatoscopic signs in cutaneous leishmaniasis.

Dermoscopy is a non-invasive technique widely used to aid in the characterization and diagnosis of pigmented skin lesions. Recently, it has also been employed for the evaluation of non-pigmented skin tumours, and inflammatory and infectious cutaneous diseases. Although the diagnosis of cutaneous leishmaniasis is confirmed by the demonstration of amastigotes in infected skin or by the growth of promastigotes in culture medium, dermoscopy could be useful as a further diagnostic test. We report a patient with a nodular lesion located on the right cheek for almost two years. The lesion was clinically suggestive of cutaneous leishmaniasis. Dermoscopy showed yellow tears, erythema and vascular structures. The diagnosis was confirmed by the demonstration of amastigotes in a skin scraping sample.

Atypical Kaposi's sarcoma in young inmunocompetent patient

Abstract: Kaposi´s sarcoma is a rare tumor associated with human herpes virus 8 (HHV-8) infection. Four main clinical subtypes have been described. This study reports on a form of KS in an HIV negative and immunocompetent middle-aged man. The only remarkable factor is that he has sex with other men. This form of Kaposi´s sarcoma is rare. It occurs more in younger patients than in the classic form, is limited to the skin, and is associated with a good prognosis. The means of transmission of the virus is through saliva in oroanal or orogenital sexual practices. Mechanisms of tumor development are still not well known. Given the possible increased number of this variant, it would be interesting to extend this study.

Scrophularia arguta, a widespread annual plant in the Canary Islands: a single recent colonization event or a more complex phylogeographic pattern?

Many studies have addressed evolution and phylogeography of plant taxa in oceanic islands, but have primarily focused on endemics because of the assumption that in widespread taxa the absence of morphological differentiation between island and mainland populations is due to recent colonization. In this paper, we studied the phylogeography of Scrophularia arguta, a widespread annual species, in an attempt to determine the number and spatiotemporal origins of dispersal events to Canary Islands. Four different regions, ITS and ETS from nDNA and psbA-trnH and psbJ-petA from cpDNA, were used to date divergence events within S. arguta lineages and determine the phylogenetic relationships among populations. A haplotype network was obtained to elucidate the phylogenetic relationships among haplotypes. Our results support an ancient origin of S. arguta (Miocene) with expansion and genetic differentiation in the Pliocene coinciding with the aridification of northern Africa and the formation of the Mediterranean climate. Indeed, results indicate for Canary Islands three different events of colonization, including two ancient events that probably happened in the Pliocene and have originated the genetically most divergent populations into this species and, interestingly, a recent third event of colonization of Gran Canaria from mainland instead from the closest islands (Tenerife or Fuerteventura). In spite of the great genetic divergence among populations, it has not implied any morphological variation. Our work highlights the importance of nonendemic species to the genetic richness and conservation of island flora and the significance of the island populations of widespread taxa in the global biodiversity.

Usefulness of Integrase resistance testing in proviral HIV-1 DNA in patients with Raltegravir prior failure.

BACKGROUND: In our study, we have hypothesized that proviral DNA may show the history of mutations that emerged at previous failures to a Raltegravir containing regimen, in patients who are currently undetectable and candidates to simplification to a Dolutegravir containing regimen, in order to decide on once a day or twice a day dosing. METHODS: We have performed a pilot, observational, retrospective, non interventional study, including 7 patients infected by HIV-1, all with a history of previous failure to a RAL containing regimen, that were successfully salvaged and had reached viral suppression. A genotypic viral Integrase region study was available for each patient at the moment of RAL failure. After an average (IQR) time of 48 months (29-53) Integrase resistance mutations in proviral DNA were studied. RESULTS: All the patients were infected by HIV-1 B subtypes, with a mean age of 55 (range 43 to 56), originating from Spain, and 4 were women. Median viral load (log) and CD4 count at the moment of the study on proviral DNA was of 1.3 log cp/ml (range 0-1.47) and 765.5 cells/µL (range; 436.75-1023.75). The median time (IQR) between previous failure to RAL and the study on proviral DNA was 48 (29-53) months. At Raltegravir failure, N155H was detected in four patients, and other secondary mutations were detected in five patients (71.4 %). In proviral DNA, N155H was detected by population sequencing in three patients (42.8 %), and UDS demonstrated a 9.77 % relative abundance of N155H in the remaining patient. Sanger sequencing correctly identified all the secondary mutations. CONCLUSION: This is a pilot study that demonstrates the possibility of properly identifying N155H and some secondary mutations 29-53 months after failure.

Evolution of the staminode in a representative sample of Scrophularia and its role as nectar safeguard in three widespread species.

Approximately 30% of the genera of Scrophulariaceae s.str. have a staminode, which is the remnant of a sterile stamen. However, there are no studies of the functionality or evolutionary pattern of staminodes in that family. This paper investigates three Scrophularia species with different staminode sizes to determine if the staminode safeguards nectar from dilution by rainwater and if it influences pollinator behavior. We also study staminode evolution and ancestral state reconstruction onto a phylogeny containing 71 species and subspecies with four different staminode developmental stages: tiny, large, enormous, and absent. The results showed that large staminodes did not hinder nectar collection or modify pollinator-visiting time but acted as a barrier to reduce rainwater entry. The latter reduced the dilution of nectar, which did not occur with tiny staminodes. The phylogenetic study revealed that the ancestral state in the genus corresponds with the presence of a large staminode vs. the tiny and enormous staminodes that are considered as derived. The complete disappearance of the staminode has occurred independently at least twice. Events occurred that increased or reduced the staminode size in one of the clades (Clade II), which includes species of sect. Caninae; most of these events occurred during the Pleistocene (0.6-2.7 Ma).

Concordance among Measurements Obtained by Three Pulse Oximeters Currently Used by Health Professionals.

INTRODUCTION: Oxygen saturation is considered as the 5(th) vital sign. Presently, there exist fixed and wireless pulse oximeters, being the latter most widely used in the last years. Some of them have no possibility of calibration. This situation leads the health staff to adopt therapeutic attitudes which can be wrong. Therefore, it is extremely important to know if these wireless oximeters show a right concordance as regards measurements, since it is of great interest in daily clinical practice. OBJECTIVE: To evaluate concordance among measurements obtained by three different pulse oximeters currently used by health professionals. MATERIALS AND METHODS: This is an observational, descriptive and cross-sectional study related to the concordance of the results obtained in measurements collected by three different pulse oximeters (one monitor and two wireless oximeters) which are available and in use in this hospital unit. The sample size calculation was performed for a concordance above 0.81 and an estimation error which did not exceed 0.20. The intraclass correlation index (ICI) was used to establish the concordance whereas the Landis-Koch criteria were used to interpret the results. Systematic errors were analyzed using the Bland-Altman plot. RESULTS: The overall concordance among the three pulse oximeters analyzed resulted in 0.88, a value considered as "good" according to the Landis-Koch criteria. CONCLUSION: The results obtained show that in daily clinical practice both wireless pulse oximeters analyzed can be used with a certain reliability, taking into account the limitations of this research.

[A case of lichenoid sarcoidosis with characteristic clinical and histopathological findings]. / Descripción de un caso de sarcoidosis liquenoide con hallazgos clínicos e histopatológicos característicos.

Sarcoidosis is a multisystem inflammatory disease characterized by the formation of noncaseating granulomas in various organs and tissues. The majority of patients with systemic sarcoidosis will present with lung and lymph node involvement. In addition, 20% have skin involvement that may be the only manifestation of the disease or may be an important prognostic marker for involvement of other organs. There are multiple forms of presentation of cutaneous sarcoidosis, which may be a true challenge.We report a patient with a one month history of an eruption of skin colored papules. Some were grouped in a symmetrical distribution on the trunk, inner arms, and lumbar region. Pathologic examination revealed an infiltrate in the papillary dermis showing a band of noncaseating granulomas along with disruption of the basal lamina and lichenoid changes. The clinicopathological correlation confirmed the diagnosis of lichenoid sarcoidosis. We consider our case interesting owing to the clinical presentation and the lichenoid distribution of granulomas.

Participación activa del alumno en prácticas de microscopía / Student’s active participation in microscopy laboratory

La implantación del Espacio Europeo de Educación Superior promueve un cambio en la metodología docente centrando su interés en el proceso de aprendizaje del estudiante y en la adquisición de una serie de competencias específicas y transversales. Con objeto de adecuar el proceso de enseñanza-aprendizaje hacia las actuales directrices introducimos una nueva actividad en nuestra práctica docente. Se pretende fomentar la participación activa de los alumnos y proporcionar un escenario adecuado para el desarrollo de distintas competencias transversales que nos permitan ponerlas de manifiesto y, por tanto, evaluarlas. La actividad consiste en la exposición oral, por parte de los alumnos de la asignatura ‘Biología celular y tisular humana’ de primer curso del grado de Fisioterapia, de una revisión/resumen del tema a trataren las clases prácticas, así como de la explicación de las características microscópicas de las muestras a observar endicha práctica. Tras la exposición se realiza una evaluación por parte del resto de compañeros y al finalizar el curso los alumnos ofrecen su valoración de la experiencia. Con esta actividad se logra una mayor participación de los alumnos y se mejora la adquisición y desarrollo de competencias específicas y transversales. El profesor tiene la oportunidad de asumir el papel de guía y gestor del aprendizaje del alumno. Los alumnos valoran positivamente la experiencia (AU)

The implantation of the European Higher Education Area promotes a change in teaching methodology focusing its interest in the process of student learning and the acquisition of a series of specific and generic competences. In order to adapt the teaching-learning process to the current guidelines we introduce a new activity in our teaching practice. It aims to encourage active student participation and provide a stage for the development of various generic competences that allow us to highlight and thus evaluate them. The activity is the oral presentation of a review of the issue of practicing class as well as the explanation of the microscopic characteristics of the samples to be observed in the practice, by students of the subject ‘Human Cell and Tissue Biology’ in the first-year degree in Physiotherapy. After exposure evaluation are performed by peers and in the end of the course we test students about the experience. With this activity there is a greater student participation and improves the acquisition and development of specific and transversal competences. The teacher has the opportunity to assume the role of guide and facilitates student learning. Students value the experience positively (AU)

Herbarium of vascular plants collection of the university of extremadura (Spain).

The herbarium of University of Extremadura (UNEX Herbarium) is formed by 36451 specimens of vascular plants whose main origin is the autonomous region of Extremadura (Spain) and Portugal, although it also contains a smaller number of specimens from different places, including the rest of peninsular Spain, the Baleares Islands, the Macaronesian region (Canary Islands, Madeira and Azores), northwest of Africa (Morocco) and Brazil. 98% of the total records are georeferenced. It is an active collection in continuous growth. Its data can be accessed through the GBIF data portal at http://data.gbif.org/datasets/resource/255 and http://www.eweb.unex.es/eweb/botanica/herbario/. This paper describes the specimen associated data set of the UNEX Herbarium, with an objective to disseminate the data contained in a data set with potential users, and promote the multiple uses of the data.