You'd better walk alone: Changes in forest composition affect pollination efficiency and pre-dispersal cone damage in Iberian Juniperus thurifera forests.

Changes in land-use patterns are a major driver of global environmental change. Cessation of traditional land-use practices has led to forest expansion and shifts in forest composition. Consequently, former monospecific forests maintained by traditional management are progressing towards mixed forests. However, knowledge is scarce on how the presence of other tree species will affect reproduction of formerly dominant species. We explored this question in the wind-pollinated tree Juniperus thurifera. We hypothesised that the presence of heterospecific trees would have a negative effect on cone production and on the proportion of cones attacked by specialised predators. We assessed the relative importance of forest composition on cone production, seed development and pre-dispersal cone damage on nine paired pure and mixed J. thurifera forests in three regions across the Iberian Peninsula. The effects of forest composition on crop size, cone and seed characteristics, as well as damage by pre-dispersal arthropods were tested using mixed models. Cone production was lower and seed abortion higher in mixed forests, suggesting higher pollination failure. In contrast, cone damage by arthropods was higher in pure forests, supporting the hypothesis that presence of non-host plants reduces damage rates. However, the response of each arthropod to forest composition was species-specific and the relative rates of cone damage varied depending on individual tree crops. Larger crop sizes in pure forests compensated for the higher cone damage rates, leading to a higher net production of sound seeds compared to mixed forests. This study indicates that ongoing changes in forest composition after land abandonment may impact tree reproduction.

¿Cómo evaluar y mejorar la adherencia en la consulta diaria? / How to assess and to improve adherence in clinical practice?

El incumplimiento del tratamiento farmacológico en la hipertensión arterial se sitúa entre el 35 y el 50%. En todos los hipertensos mal controlados, siempre hay que pensar en un posible incumplimiento farmacológico como su causa. Para detectar el incumplimiento hay que utilizar un método válido de medición, destacando el test de Haynes por su alta especificidad, el recuento de comprimidos y el uso de la receta electrónica. Para mejorar el cumplimiento, lo mejor es una combinación de estrategias eficaces y, de forma individual, la más favorable es la simplificación del tratamiento. Medidas eficaces son el programa de automedida domiciliaria de la presión arterial, la combinación de fármacos en doble o triple terapia fija, la educación sanitaria escrita y en grupos, los calendarios recordatorios y las tarjetas de control del cumplimiento o la mejora de la relación médico-paciente

Prevalence of non-adherence of pharmacological therapy in hypertension is between 35 and 50%. In every uncontrolled hypertensive one should assess drug adherence as the cause. Several validated methods to detect noncompliance exist, being most frequently used Haynes test, pill count, and use of electronic prescription. Strategies to improve compliance should include a combination of adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. Programs for home self-measurement of blood pressure, use of double or triple drug fixed combinations, group health education, reminders, calendars, and cards enforcement, and improving doctor-patient relationship are also useful tools for compliance optimization

[How to assess and to improve adherence in clinical practice?] / ¿Cómo evaluar y mejorar la adherencia en la consulta diaria?

Prevalence of non-adherence of pharmacological therapy in hypertension is between 35 and 50%. In every uncontrolled hypertensive one should assess drug adherence as the cause. Several validated methods to detect noncompliance exist, being most frequently used Haynes test, pill count, and use of electronic prescription. Strategies to improve compliance should include a combination of adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. Programs for home self-measurement of blood pressure, use of double or triple drug fixed combinations, group health education, reminders, calendars, and cards enforcement, and improving doctor-patient relationship are also useful tools for compliance optimization.

Resonancia magnética en la valoración de las conexiones venosas pulmonares anómalas / Magnetic resonance imaging in the assessment of anomalous pulmonary venous connections

Objetivo. El objetivo de este artículo es ilustrar los hallazgos morfológicos y funcionales en resonancia magnética (RM) de las conexiones venosas pulmonares anómalas congénitas, incluyendo las totales y parciales, y de las complicaciones posquirúrgicas más frecuentes. Conclusión. Los hallazgos en RM son fundamentales para definir el tipo de conexión venosa pulmonar anómala congénita, decidir el tratamiento, planificar la cirugía y detectar las complicaciones posquirúrgicas (AU)

Objective. To illustrate the morphological and functional magnetic resonance findings for total and partial anomalous pulmonary venous connections as well as of the most common complications after surgery. Conclusion. The magnetic resonance findings are fundamental in defining the type of anomalous connection, deciding on the treatment, planning the surgery, and detecting postsurgical complications (AU)

Hallazgos de imagen de las masas cardíacas (parte II): tumores malignos y lesiones pseudotumorales / Imaging findings in cardiac masses (part II): malignant tumors and pseudotumors

Los tumores cardíacos malignos son menos frecuentes que los tumores benignos; pueden ser primarios y secundarios. Los secundarios o metastásicos son entre 20 y 40 veces más frecuentes que los primarios, con una incidencia estimada del 0,05%. Las lesiones pseudotumorales no neoplásicas pueden presentarse como masas cardíacas con características de imagen que pueden plantear el diagnóstico con neoplasias. El objetivo de este trabajo es presentar los tumores cardíacos malignos y las lesiones pseudotumorales haciendo hincapié en los hallazgos en TC y RM y en las características que permiten diferenciarlos de los tumores cardíacos benignos (AU)

Malignant heart tumors are less common than benign ones. They can be primary or secondary. Secondary or metastatic heart tumors are 20 to 40 times more common than primary malignant heart tumors, which have an estimated incidence of 0.05%. Non-neoplastic pseudotumors can present as cardiac masses, with imaging characteristics than can suggest the diagnosis of a tumor. The aim of this article is to describe and illustrate malignant heart tumors and pseudotumors, stressing the CT and MRI findings that make it possible to differentiate them from benign cardiac tumors (AU)

Efficiency of pollination and satiation of predators determine reproductive output in Iberian Juniperus thurifera woodlands.

Fruit production in animal-dispersed plants has a strong influence on fitness because large crops increase the number of seeds dispersed by frugivores. Large crops are costly, and environmental control of plant resources is likely play a role in shaping temporal and spatial variations in seed production, particularly in fluctuating environments such as the Mediterranean. The number of fruits that start to develop and the proportion of viable seeds produced are also linked to the number of flowers formed and the efficiency of pollination in wind-pollinated plants. Finally, large fruit displays also attract seed predators, having a negative effect on seed output. We assessed the relative impact of environmental conditions on fruit production, and their combined effect on seed production, abortion and seed loss through three predispersal predators in Juniperus thurifera L., sampling 14 populations across the Iberian Peninsula. Wetter than average conditions during flowering and early fruit development led to larger crop sizes; this effect was amplified at tree level, with the most productive trees during more favourable years yielding fruits with more viable seeds and less empty and aborted seeds. In addition, large crops satiated the less mobile seed predator. The other two predispersal predators responded to plant traits, the presence of other seed predators and environmental conditions, but did not show a satiation response to the current-year crop. Our large-scale study on a dioecious, wind-pollinated Mediterranean juniper indicates that pollination efficiency and satiation of seed predators, mediated by environmental conditions, are important determinants of reproductive output in this juniper species.

[Imaging findings in cardiac masses. Part II: malignant tumors and pseudotumors]. / Hallazgos de imagen de las masas cardíacas. parte II: tumores malignos y lesiones pseudotumorales.

Malignant heart tumors are less common than benign ones. They can be primary or secondary. Secondary or metastatic heart tumors are 20 to 40 times more common than primary malignant heart tumors, which have an estimated incidence of 0.05%. Non-neoplastic pseudotumors can present as cardiac masses, with imaging characteristics than can suggest the diagnosis of a tumor. The aim of this article is to describe and illustrate malignant heart tumors and pseudotumors, stressing the CT and MRI findings that make it possible to differentiate them from benign cardiac tumors.

Magnetic resonance imaging in the assessment of anomalous pulmonary venous connections.

OBJECTIVE: To illustrate the morphological and functional magnetic resonance findings for total and partial anomalous pulmonary venous connections as well as of the most common complications after surgery. CONCLUSION: The magnetic resonance findings are fundamental in defining the type of anomalous connection, deciding on the treatment, planning the surgery, and detecting postsurgical complications.

Hallazgos de imagen de las masas cardíacas (parte I): protocolo de estudio y tumores benignos / Imaging findings in cardiac masses (Part I ): study protocol and benign tumors

Las masas cardíacas son un reto diagnóstico porque las decisiones terapéuticas se basan en los hallazgos de las técnicas de imagen. La ecocardiografía, la resonancia magnética (RM) y la tomografía computarizada (TC) son fundamentales para la detección, caracterización, estadificación y planificación del tratamiento. La mayoría de los tumores primarios son benignos; los más frecuentes son el mixoma, el fibroelastoma papilar y el lipoma. La localización del tumor y sus características en la TC y la RM orientan el diagnóstico etiológico en la mayor parte de los casos. Se describen los protocolos de estudio de TC y RM de las masas cardíacas, así como los hallazgos morfológicos, las localizaciones preferentes y las características más útiles para caracterizar las masas cardíacas benignas y establecer el diagnóstico diferencial con los tumores cardíacos malignos y las lesiones pseudotumorales no neoplásicas (AU)

Cardiac masses represent a diagnostic challenge because decisions about treatment are based on imaging techniques. Echocardiography, magnetic resonance (MR) and computed tomography (CT) are fundamental for the detection, characterization, and staging of cardiac masses as well as for planning their treatment. Most primary cardiac tumors are benign; myxomas, papillary fibroelastomas, and lipomas are the most common. The location of the tumors and its characteristics on CT and MR orient the etiologic diagnosis in most cases. This article describes the protocols for CT and MR studies of cardiac masses as well as the morphologic findings, predominant locations, and most useful characteristics for characterizing benign cardiac masses and establishing the differential diagnosis with malignant cardiac tumors and non-neoplastic pseudotumors (AU)

Imaging findings in cardiac masses (Part I): study protocol and benign tumors.

Cardiac masses represent a diagnostic challenge because decisions about treatment are based on imaging techniques. Echocardiography, magnetic resonance (MR) and computed tomography (CT) are fundamental for the detection, characterization, and staging of cardiac masses as well as for planning their treatment. Most primary cardiac tumors are benign; myxomas, papillary fibroelastomas, and lipomas are the most common. The location of the tumors and its characteristics on CT and MR orient the etiologic diagnosis in most cases. This article describes the protocols for CT and MR studies of cardiac masses as well as the morphologic findings, predominant locations, and most useful characteristics for characterizing benign cardiac masses and establishing the differential diagnosis with malignant cardiac tumors and non-neoplastic pseudotumors.

Formación continuada. Cómo redactar preguntas con opciones de respuesta múltiple / Continuing medical education: How to write multiple choice questions

La evaluación de la competencia profesional en medicina es una tarea difícil pero indispensable porque permite, en diferentes momentos y desde distintas perspectivas, valorar en qué medida se han adquirido los conocimientos, habilidades, actitudes y valores necesarios para el ejercicio profesional. Las pruebas basadas en preguntas de opciones múltiples han sido y son, una de las herramientas más útiles y utilizadas para evaluar de forma objetiva el aprendizaje en medicina. Cuando están bien diseñadas y se aplican de forma correcta, además de estimular el aprendizaje, pueden incluso medir habilidades cognitivas superiores. Redactar un cuestionario de preguntas con opciones de respuesta múltiple es una tarea difícil que requiere conocimientos sobre la materia que se ha de valorar, aprendizaje de una metodología y tiempo para su elaboración. El objetivo de este trabajo es revisar lo que las preguntas de opciones múltiples pueden evaluar, las reglas y normas que deben tenerse en cuenta para su redacción, los distintos formatos que pueden utilizarse, los errores más frecuentes que suelen cometerse en su elaboración y como analizar los resultados de los exámenes para poder verificar su calidad (AU)

Evaluating professional competence in medicine is a difficult but indispensable task because it makes it possible to evaluate, at different times and from different perspectives, the extent to which the knowledge, skills, and values required for exercising the profession have been acquired. Tests based on multiple choice questions have been and continue to be among the most useful tools for objectively evaluating learning in medicine. When these tests are well designed and correctly used, they can stimulate learning and even measure higher cognitive skills. Designing a multiple choice test is a difficult task that requires knowledge of the material to be tested and of the methodology of test preparation as well as time to prepare the test. The aim of this article is to review what can be evaluated through multiple choice tests, the rules and guidelines that should be taken into account when writing multiple choice questions, the different formats that can be used, the most common errors in elaborating multiple choice tests, and how to analyze the results of the test to verify its quality (AU)

[Continuing medical education: how to write multiple choice questions]. / Formación continuada. Cómo redactar preguntas con opciones de respuesta múltiple.

Evaluating professional competence in medicine is a difficult but indispensable task because it makes it possible to evaluate, at different times and from different perspectives, the extent to which the knowledge, skills, and values required for exercising the profession have been acquired. Tests based on multiple choice questions have been and continue to be among the most useful tools for objectively evaluating learning in medicine. When these tests are well designed and correctly used, they can stimulate learning and even measure higher cognitive skills. Designing a multiple choice test is a difficult task that requires knowledge of the material to be tested and of the methodology of test preparation as well as time to prepare the test. The aim of this article is to review what can be evaluated through multiple choice tests, the rules and guidelines that should be taken into account when writing multiple choice questions, the different formats that can be used, the most common errors in elaborating multiple choice tests, and how to analyze the results of the test to verify its quality.

[Connective tissue growth factor (CTGF): a key factor in the onset and progression of kidney damage]. / El factor de crecimiento de tejido conectivo (CTGF): factor clave en el inicio y la progresión del daño renal.

Connective tissue growth factor (CTGF) is increased in several pathologies associated with fibrosis, including multiple renal diseases. CTGF is involved in biological processes such as cell cycle regulation, migration, adhesion and angiogenesis. Its expression is regulated by various factors involved in renal damage, such as transforming growth factor- , Angiotensin II, high concentrations of glucose and cellular stress. CTGF is involved in the initiation and progression of renal damage to be able to induce an inflammatory response and promote fibrosis, identified as a potential therapeutic target in the treatment of kidney diseases. In this paper we review the main actions of CTGF in renal disease, the intracellular action mechanisms and therapeutic strategies for its blocking.

El factor de crecimiento de tejido conectivo (CTGF): factor clave en el inicio y la progresión del daño renal / No disponible

El factor de crecimiento de tejido conectivo (CTGF) aparece aumentado en diferentes patologías asociadas a fibrosis, incluidas múltiples enfermedades renales. CTGF participa en procesos biológicos, como la regulación del ciclo celular, migración, adhesión y angiogénesis. Su expresión está regulada por diversos factores implicados en el daño renal, entre los que destacan el factor la angiotensina II, el factor de crecimiento transformante-beta, altas concentraciones de glucosa y situaciones de estres celular. CTGF participa en el inicio y progresión del daño renal al ser capaz de inducir una respuesta inflamatoria y promover la fibrosis, señalándole como una posible diana terapéutica en el tratamiento de patologías renales. En este trabajo revisamos las principales acciones de CTGF en la patología renal, los mecanismos intracelulares de actuación y las estrategias terapéuticas para su bloqueo (AU)

Connective tissue growth factor (CTGF) is increased in several pathologies associated with fibrosis, including multiple renal diseases. CTGF is involved in biological processes such as cell cycle regulation, migration, adhesion and angiogenesis. Its expression is regulated by various factors involved in renal damage, such as Angiotensin II, transforming growth factor-beta, high concentrations of glucose and cellular stress. CTGF is involved in the initiation and progression of renal damage to be able to induce an inflammatory response and promote fibrosis, identified as a potential therapeutic target in the treatment of kidney diseases. In this paper we review the main actions of CTGF in renal disease, the intracellular action mechanisms and therapeutic strategies for its blocking (AU)

Bloqueo auriculoventricular inducido por risperidona a altas dosis / No disponible

No disponible

Síndrome climatérico y su escala: Estrategia para su manejo / Climateric síndrome and its range: Strategie for its management

Se realiza un estudio en la consulta de referencia provincial del Policlínico Universitario Mártires del 4 de agosto con la finalidad de caracterizar el síndrome climatérico según escala. El universo (80 mujeres) está conformado por aquellas pacientes con edades comprendidas entre los 40-59 años, que asistieron a la consulta desde diciembre–marzo de 2007. Las variables propuestas son: edad, ocupación, escolaridad, estado civil, funcionamiento familiar, tipo de menopausia y síntomas: circulatorios, psicológicos, genitourinarios, generales. Se evalúa su intensidad en leve moderado e intenso y se le da según su importancia. Los resultados se reflejan en tablas, se utiliza el porcentaje como unidad de medida. Se obtiene predominio en las edades entre 55-59 años, desocupadas, el nivel secundario, acompañadas, familias disfuncionales y menopausia natural. Entre los síntomas, los circulatorios de gran intensidad. En los psicológicos la intensidad es moderada, destacándose el nerviosismo. En los genitourinarios la disminución del placer sexual y en los generales los dolores musculares (AU)

Impact of fatigue in multiple sclerosis: the Fatigue Impact Scale for Daily Use (D-FIS).

OBJECTIVE: The Fatigue Impact Scale for Daily Use (D-FIS) is an eight-item instrument designed to measure subjective daily experience of fatigue. This study sought to determine the metric properties of the D-FIS in multiple sclerosis (MS) patients. METHODS: Sixty-eight patients with operationally-defined MS and fatigue (54.8% of the sample) underwent the D-FIS. Usual clinical measures for MS, the Montgomery-Asberg Depression Rating Scale (MADRS) and the Functional Assessment of Multiple Sclerosis (FAMS) were also applied. In addition, patients with fatigue completed the Fatigue Descriptive Scale, the Multidimensional Fatigue Inventory (MFI), a Visual Analogue Scale for Fatigue (VAS-F), and a Global Perception of Fatigue Scale (GPF). RESULTS: Full computable data, 95.6%; both floor and ceiling effect=1.54%; item-total correlation=0.62 (item 1) to 0.84 (item 6); Cronbach's alpha=0.91; item homogeneity =0.55; standard error of measurement=3.18; convergent validity with other fatigue measures=-0.57 (VAS-F); 0.52 (GPF); and 0.46 (MFI-general fatigue). Test-retest reliability (ICC)=0.81. There was a strong association between health-related quality of life (HRQoL) (FAMS) and D-FIS (rS=0.70). CONCLUSIONS: In this study, D-FIS proved to be a feasible and valid instrument for measuring MSrelated fatigue, a frequent symptom associated with deterioration of patients' HRQoL.