Bilateral macular edema in sistemic sclerosis.

Systemic sclerosis is a chronic, autoimmune, multisystem disease characterized by vascular dysfunction, chronic inflammation and widespread fibrosis. Although vascular involvement commonly manifests in the skin, it can also affect other organs, including the eyes. The characteristic vascular alteration is an obliterative fibroproliferative vasculopathy leading to hypoxia and tissue ischemia. We present a case of bilateral macular edema in a patient diagnosed with systemic sclerosis, as a consequence of retinal and choroidal vascular changes.

Broodstock nutritional programming differentially affects the hepatic transcriptome and genome-wide DNA methylome of farmed gilthead sea bream (Sparus aurata) depending on genetic background.

BACKGROUND: Broodstock nutritional programming improves the offspring utilization of plant-based diets in gilthead sea bream through changes in hepatic metabolism. Attention was initially focused on fatty acid desaturases, but it can involve a wide range of processes that remain largely unexplored. How all this can be driven by a different genetic background is hardly underlined, and the present study aimed to assess how broodstock nutrition affects differentially the transcriptome and genome-wide DNA methylome of reference and genetically selected fish within the PROGENSA® selection program. RESULTS: After the stimulus phase with a low fish oil diet, two offspring subsets of each genetic background received a control or a FUTURE-based diet. This highlighted a different hepatic transcriptome (RNA-seq) and genome-wide DNA methylation (MBD-seq) pattern depending on the genetic background. The number of differentially expressed transcripts following the challenge phase varied from 323 in reference fish to 2,009 in genetically selected fish. The number of discriminant transcripts, and associated enriched functions, were also markedly higher in selected fish. Moreover, correlation analysis depicted a hyper-methylated and down-regulated gene expression state in selected fish with the FUTURE diet, whereas the opposite pattern appeared in reference fish. After filtering for highly represented functions in selected fish, 115 epigenetic markers were retrieved in this group. Among them, lipid metabolism genes (23) were the most reactive following ordering by fold-change in expression, rendering a final list of 10 top markers with a key role on hepatic lipogenesis and fatty acid metabolism (cd36, pitpna, cidea, fasn, g6pd, lipt1, scd1a, acsbg2, acsl14, acsbg2). CONCLUSIONS: Gene expression profiles and methylation signatures were dependent on genetic background in our experimental model. Such assumption affected the magnitude, but also the type and direction of change. Thus, the resulting epigenetic clock of reference fish might depict an older phenotype with a lower methylation for the epigenetically responsive genes with a negative methylation-expression pattern. Therefore, epigenetic markers will be specific of each genetic lineage, serving the broodstock programming in our selected fish to prevent and mitigate later in life the risk of hepatic steatosis through changes in hepatic lipogenesis and fatty acid metabolism.

Anti-dsDNA Antibodies Increase the Cardiovascular Risk in Systemic Lupus Erythematosus Promoting a Distinctive Immune and Vascular Activation.

Objective: Systemic lupus erythematosus (SLE) is associated to boosted atherosclerosis development and a higher cardiovascular disease risk. This study aimed to delineate the role of anti-double stranded DNA (anti-dsDNA) antibodies on the molecular profile and the activity of immune and vascular cells, as well as on their enhanced cardiovascular risk. Approach and Results: Eighty SLE patients were included. Extensive clinical/analytical evaluation was performed, including cardiovascular disease parameters (endothelial function, proatherogenic dyslipidemia, and carotid intima-media thickness). Gene and protein expression profiles were evaluated in monocytes from patients diagnosed positive or negative for anti-dsDNA antibodies by using NanoString and cytokine arrays, respectively. NETosis and circulating inflammatory profile was assessed in both neutrophils and plasma. Positivity and persistence of anti-dsDNA antibodies in SLE patients were associated to endothelial dysfunction, proatherogenic dyslipidemia, and accelerated atherosclerosis. In parallel, anti-dsDNA antibodies were linked to the aberrant activation of innate immune cells, so that anti-dsDNA(+) SLE monocytes showed distinctive gene and protein expression/activity profiles, and neutrophils were more prone to suffer NETosis in comparison with anti-dsDNA(−) patients. Anti-dsDNA(+) patients further displayed altered levels of numerous circulating mediators related to inflammation, NETosis, and cardiovascular risk. In vitro, Ig-dsDNA promoted NETosis on neutrophils, apoptosis on monocytes, modulated the expression of inflammation and thrombosis-related molecules, and induced endothelial activation, at least partially, by FcR (Fc receptor)-binding mechanisms. Conclusions: Anti-dsDNA antibodies increase the cardiovascular risk of SLE patients by altering key molecular processes that drive a distinctive and coordinated immune and vascular activation, representing a potential tool in the management of this comorbidity.

Characterization of Antiphospholipid Syndrome Atherothrombotic Risk by Unsupervised Integrated Transcriptomic Analyses.

OBJECTIVE: Our aim was to characterize distinctive clinical antiphospholipid syndrome phenotypes and identify novel microRNA (miRNA)-mRNA-intracellular signaling regulatory networks in monocytes linked to cardiovascular disease. Approach and Results: Microarray analysis in antiphospholipid syndrome monocytes revealed 547 differentially expressed genes, mainly involved in inflammatory, cardiovascular, and reproductive disorders. Besides, this approach identified several genes related to inflammatory, renal, and dermatologic diseases. Functional analyses further demonstrated phosphorylation of intracellular kinases related to thrombosis and immune-mediated chronic inflammation. miRNA profiling showed altered expression of 22 miRNAs, enriched in pathways related to immune functions, cardiovascular disease, and autoimmune-associated pathologies. Unbiased integrated mRNA-miRNA analysis identified a signature of 9 miRNAs as potential modulators of 17 interconnected genes related to cardiovascular disease. The altered expression of that miRNA-mRNA signature was proven to be stable along time and distinctive of nonautoimmune thrombotic patients. Transfection studies and luciferase assays established the relationship between specific miRNAs and their identified target genes and proteins, along with their involvement in the regulation of monocytes procoagulant activity and cell adhesion. Correlation analyses showed relationship among altered miRNAs and their interconnected genes with aPL (antiphospholipid antibodies)-titers, along with microvascular endothelial dysfunction. In vitro studies demonstrated modulation in healthy monocytes by IgG-aPLs of several genes/miRNAs, which further intermediated downstream effects on endothelial function. The identified transcriptomic signature allowed the unsupervised division of three clusters of patients with antiphospholipid syndrome showing distinctive clinical profiles, mainly associated with their prothrombotic risk (thrombosis, autoantibody profile, cardiovascular risk factors, and atherosclerosis). CONCLUSIONS: Extensive molecular profiling of monocytes in patients with primary antiphospholipid syndrome might help to identify distinctive clinical phenotypes, thus enabling new patients' tailored treatments.

Usefulness of basic renal function tests in the management of hydronephrosis. / Utilidad de las pruebas básicas de función renal en el manejo de la hidronefrosis.

OBJECTIVE: Nowadays, the algorithms for the study of hydronephrosis in children include voiding cystourethrogram (VCUG) and diuretic renogram (DR) in all patients. Both are invasive, distressing, and associated with radiation risk. However, basic renal function tests (bRFTs) are not included. This study was designed to determine whether bRFTs may help avoid VCUG and/or DR in some children. METHODS: Retrospective review of hydronephrosis (≥20 mm renal pelvis) patient records over one year (n = 38) (pyeloureteral stenosis (PUS) n = 12; high-grade vesicoureteral reflux (VUR) n = 8; non-obstructive hydronephrosis (NOH) n = 18. Data from the three protocolized bRFTs (maximum urine osmolality after DDAVP (UOsm), albumin/creatinine ratio (Alb/Cr), and NAG/creatinine ratio (NAG/Cr), together with VCUG and DR, were analyzed. RESULTS: 38 hydronephrosis patients (pyeloureteral stenosis (PUS) n = 12; high grade vesicoureteral reflux (VUR) n = 8; non-obstructive hydronephrosis (NOH) n = 18. UOsm was decreased in 100% of VUR patients, 75% of PUS patients, and 16.7% of NOH patients. Alb/Cr ratio was increased in 62.5% of VUR patients, 8.3% of PUS patients, and 11.1% of NOH patients. NAG/Cr ratio was increased in 42.8% of VUR patients, 25% of PUS patients, and 6.7% of NOH patients. UOsm was decreased in most patients who required surgery (100% of VUR patients and 74% of PUS patients), but only in 11.1% of patients who did not (NOH group). CONCLUSIONS: These results suggest that bRFTs may be useful in delaying or avoiding VCUG in some hydronephrosis cases. UOsm is the most sensitive test. No child with (high grade) VUR had a normal UOsm. VCUG could have been avoided in 43% of our patients -with a normal UOsm- without missing any high grade VUR.

OBJETIVO: Actualmente, los algoritmos para estudiar hidronefrosis en niños, incluyen realizar cistografía miccional (CUMS) y renograma diurético (RD) a todos. Ambos son invasivos, molestos, y con riesgo de radiación. Contrariamente, las pruebas básicas de función renal (PFRb), no están incluidas. Este estudio se realizó para saber si las PFRb, pueden ayudarnos a evitar alguna CUMS y/o RD. METODOS: Análisis retrospectivo de todas las historias de niños con hidronefrosis (pelvis renal ≥20 mm) atendidos durante un año (n=38), [estenosis pieloureteral (EPU) n = 12; reflujo vesicoureteral (RVU) de alto grado n = 8; hidronefrosis no obstructiva (HNO) n = 18]. Analizamos las tres PFRb protocolizadas [osmolalidad urinaria máxima tras DDAVP (UOsm), albúmina/creatinina (Alb/Cr) y NAG/creatinina (NAG/Cr)], junto con CUMS y RD. RESULTADOS: UOsm estaba disminuida en 100% RVU, 75% EPU, 16,7% HNO. Alb/Cr estaba aumentado en 62,5% RVU, 8,3% EPU, 11,1% HNO. NAG/Cr estaba aumentado en 42,8% RVU, 25% EPU, 6,7% HNO. En relación a la necesidad de cirugía, UOsm estaba disminuida en la mayoría de pacientes intervenidos (100% con RVU y 74% con EPU), mientras solo en el 11% de pacientes sin cirugía (HNO). CONCLUSION: Estos resultados sugieren que las PFRb pueden ser útiles para retrasar o evitar CUMS en algunos niños con hidronefrosis. La UOsm es la PFRb más sensible. Ningún niño con RVU (de alto grado) mostró una UOsm normal. Se podrían haber evitado CUMS en el 43% de nuestros pacientes, con UOsm normal, sin haber perdido ningún diagnóstico de VUR (de alto grado).

Utilidad de las pruebas básicas de función renal en el manejo de la hidronefrosis / Usefulness of basic renal function tests in the management of hydronephrosis

OBJETIVO: Actualmente, los algoritmos para estudiar hidronefrosis en niños incluyen realizar cistografía miccional (CUMS) y renograma diurético (RD) a todos. Ambos son invasivos, molestos y con riesgo de radiación. Contrariamente, las pruebas básicas de función renal (PFRb) no están incluidas. Este estudio se realizó para saber si las PFRb pueden ayudarnos a evitar alguna CUMS y/o RD. MÉTODOS: Análisis retrospectivo de todas las historias de niños con hidronefrosis (pelvis renal ≥ 20 mm) atendidos durante un año (n = 38), [estenosis pieloureteral (EPU) n = 12; reflujo vesicoureteral (RVU) de alto grado n = 8; hidronefrosis no obstructiva (HNO) n = 18]. Analizamos las tres PFRb protocolizadas [osmolalidad urinaria máxima tras DDAVP (UOsm), albúmina/creatinina (Alb/Cr) y NAG/creatinina (NAG/Cr)], junto con CUMS y RD. RESULTADOS: UOsm estaba disminuida en 100% RVU, 75% EPU, 16,7% HNO. Alb/Cr estaba aumentado en 62,5% RVU, 8,3% EPU, 11,1% HNO. NAG/Cr estaba aumentado en 42,8% RVU, 25% EPU, 6,7% HNO. En relación a la necesidad de cirugía, UOsm estaba disminuida en la mayoría de pacientes intervenidos (100% con RVU y 74% con EPU), mientras solo en el 11% de pacientes sin cirugía (HNO). CONCLUSIÓN: Estos resultados sugieren que las PFRb pueden ser útiles para retrasar o evitar CUMS en algunos niños con hidronefrosis. La UOsm es la PFRb más sensible. Ningún niño con RVU (de alto grado) mostró una UOsm normal. Se podrían haber evitado CUMS en el 43% de nuestros pacientes, con UOsm normal, sin haber perdido ningún diagnóstico de VUR (de alto grado)

OBJECTIVE: Nowadays, the algorithms for the study of hydronephrosis in children include voiding cystourethrogram (VCUG) and diuretic renogram (DR) in all patients. Both are invasive, distressing, and associated with radiation risk. However, basic renal function tests (bRFTs) are not included. This study was designed to determine whether bRFTs may help avoid VCUG and/or DR in some children. METHODS: Retrospective review of hydronephrosis (≥ 20 mm renal pelvis) patient records over one year (n = 38) (pyeloureteral stenosis (PUS) n = 12; high-grade vesicoureteral reflux (VUR) n = 8; non-obstructive hydronephrosis (NOH) n = 18. Data from the three protocolized bRFTs (maximum urine osmolality after DDAVP (UOsm), albumin/creatinine ratio (Alb/Cr), and NAG/creatinine ratio (NAG/Cr), together with VCUG and DR, were analyzed. RESULTS: 38 hydronephrosis patients (pyeloureteral stenosis (PUS) n = 12; high grade vesicoureteral reflux (VUR) n = 8; non-obstructive hydronephrosis (NOH) n = 18. UOsm was decreased in 100% of VUR patients, 75% of PUS patients, and 16.7% of NOH patients. Alb/Cr ratio was increased in 62.5% of VUR patients, 8.3% of PUS patients, and 11.1% of NOH patients. NAG/Cr ratio was increased in 42.8% of VUR patients, 25% of PUS patients, and 6.7% of NOH patients. UOsm was decreased in most patients who required surgery (100% of VUR patients and 74% of PUS patients), but only in 11.1% of patients who did not (NOH group). CONCLUSIONS: These results suggest that bRFTs may be useful in delaying or avoiding VCUG in some hydronephrosis cases. UOsm is the most sensitive test. No child with (high grade) VUR had a normal UOsm. VCUG could have been avoided in 43% of our patients –with a normal UOsm-without missing any high grade VUR

Neural Mechanisms in Eating Behaviors: A Pilot fMRI Study of Emotional Processing.

OBJECTIVE: Emotional processing dysfunction evident in eating disorders (ED) such as anorexia nervosa (AN) and bulimia nervosa (BN), is considered relevant to the development and maintenance of these disorders. The purpose of the current functional magnetic resonance imaging (fMRI) study was to pilot a comparison of the activity of the fronto-limbic and fronto-striatal brain areas during an emotion processing task in persons with ED. METHODS: 24 women patients with ED were scanned, while showing emotionally stimulating (pleasant, unpleasant) and neutral images from the International Affective Picture System (IAPS). RESULTS: During the pleasant condition, significant differences in Dorsolateral Prefrontal Cortex (DLPFC) activations were found with AN participants presenting greater activation compared to BN and ED comorbid groups (EDc) and healthy controls also showing greater activation of this brain area compared to BN and EDc. Left putamen was less activated in EDc compared to both controls (C) and AN. During the unpleasant condition, AN participants showed hyperactivation of the Orbito-frontal Cortex (OFC) when compared to EDc. CONCLUSION: This study highlights the potential functional relevance of brain areas that have been associated with self-control. These findings should help advance understanding the neural substrate of ED, though they should be considered as preliminary and be cautiously interpreted.

Quantum Anomaly and 2D-3D Crossover in Strongly Interacting Fermi Gases.

We present an experimental investigation of collective oscillations in harmonically trapped Fermi gases through the crossover from two to three dimensions. Specifically, we measure the frequency of the radial monopole oscillation or breathing mode in highly oblate gases with tunable interactions. The breathing mode frequency is set by the adiabatic compressibility and probes the thermodynamic equation of state. In 2D, a dynamical scaling symmetry for atoms interacting via a δ potential predicts the breathing mode to occur at exactly twice the harmonic confinement frequency. However, a renormalized quantum treatment introduces a new length scale which breaks this classical scale invariance resulting in a so-called quantum anomaly. Our measurements deep in the 2D regime lie above the scale-invariant prediction for a range of interaction strengths providing evidence for the quantum anomaly and signifying the breakdown of an elementary δ-potential model of atomic interactions. By varying the atom number we can tune the chemical potential and see the breathing mode frequency evolve smoothly between the 2D to 3D thermodynamic limits.

Hydrological benefits of filtering swales for metal removal.

This paper studies the hydraulic performance of two swales composed of filters for stormwater management (filtering swales) in a large-scale experimental study and compares them to the performance of a swale composed of traditional bioretention soil (bioswale). Using experimental data, dimensionless formulations are derived to reflect the influence of swale design parameters on hydraulic performance. The developed formulas can be used to design swales accounting for practical factors for decision makers such as local rainfall patterns, volume capture requirements, and drainage area. The experimental data show that while the bioswale is characterized by large overland flows, the tested filtering swales manage, in the majority of cases, the complete inflow volume without overland flow. The longitudinal slope of the swales does not affect the infiltration capacity of the filtering swales for the tested experimental boundary conditions, only the inflow rate and media water content are found to be statistically significant. As an example, filtering swales tested in this study captured 90% of the runoff generated by a 12.2 mm/h storm (approximately a 5-year return period 1-h duration storm event in the city of Trondheim) on a road 40 times larger than the swale. This highlights the capacity of such swales for handling infrequent events.

Mecanismos de aterosclerosis y enfermedad cardiovascular en el síndrome antifosfolípido y el lupus eritematoso sistémico. Alternativas terapéuticas / Mechanisms of atherosclerosis and cardiovascular disease in antiphospholipid syndrome and systemic lupus erythematosus. New therapeutic approaches

La aterotrombosis en el síndrome antifosfolípido primario (SAF) y el lupus eritematoso sistémico (LES) constituye una enfermedad de carácter sistémico, en cuyo desarrollo interviene una compleja red de mediadores inmunológicos, procoagulantes, componentes inflamatorios y el estrés oxidativo, todos ellos conducentes a la activación del complemento, el daño endotelial y la activación leucocitaria. Estudios genómicos y epigenéticos han contribuido asimismo a identificar nuevos biomarcadores que, junto a factores de riesgo tradicionales, han permitido delinear nuevos mecanismos patogénicos implicados en el desarrollo de trombosis y enfermedad cardiovascular (CV) en estos pacientes. Actualmente se están estudiando nuevas herramientas terapéuticas para la prevención de la enfermedad CV, tales como las estatinas, los inhibidores del interferón α o la coenzima Q10, entre otros. Los nuevos anticoagulantes orales pueden suponer también avances importantes en el tratamiento de estos pacientes. El presente estudio examina aspectos moleculares y terapéuticos asociados al diagnóstico y el seguimiento de la enfermedad CV en SAF y LES (AU)

Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are 2 highly related autoimmune-rheumatic diseases associated with an increased risk of developing cardiovascular (CV) diseases. Despite the great progresses made in understanding the pathological mechanisms leading to CV diseases in those pathologies, there is still the unmet need to improve long term prognosis. CV diseases in SLE and APS is thought to happen as the result of a complex interaction between traditional CV risk factors, immune deregulation and disease activity, including the synergic effect of cytokines, chemokines, adipokines, proteases, autoantibodies, adhesion receptors, oxidative stress and a plethora of intracellular signalling molecules. Genomic and epigenomic analyses have further allowed the identification of specific signatures explaining the proathero-thrombotic profiles of APS and SLE patients. This review examines the complex role of these heterogeneous factors, and analyses new therapeutic approaches under study to reduce the CV risk in these autoimmune disorders (AU)

Disease resistance and response against Vibrio anguillarum intestinal infection in European seabass (Dicentrarchus labrax) fed low fish meal and fish oil diets.

The aim of this study was to assess the effects of low levels of dietary fish meal (FM) and fish oil (FO) on disease resistance and gut associated lymphoid tissue (GALT) response after an experimental intestinal infection with V. anguillarum in European sea bass (Dicentrarchus labrax) For that purpose, sea bass juveniles were fed one of four diets containing combined levels of FO and FM as follows: 20%FM/6%FO, 20%FM/3%FO, 5%FM/6%FO and 5%FM/3%FO during 153 days. At the end of the feeding trial, fish were subjected to either an in vivo exposure to a sub-lethal dose of V. anguillarum via anal inoculation or to an ex vivo exposure to V. anguillarum. Additionally, inducible nitric oxide synthase (iNOS) and tumor necrosis factor α (TNFα) gut patterns of immunopositivity were studied. Growth performance was affected by dietary FM level, however ex vivo gut bacterial translocation rates and survival after the in vivo challenge test were affected by dietary FO level. After 5 months of feeding, low dietary FM levels led to a posterior gut up-regulation of interleukin-1ß (IL-1ß) and TNFα, major histocompatibility complex-II (MHCII) and cyclooxygenase-2 (COX2), which in turn reduced the gut associated lymphoid tissue (GALT) capacity of response after 24 h post infection and conditioned European sea bass capacity to recover gut homeostasis 7 days post infection. Immunoreactivity to anti-iNOS and anti-TNFα presented a gradient of increased immunopositivity towards the anus, regardless of the dietary FM/FO fed. Strong positive anti-TNFα isolated enterocytes were observed in the anterior gut in relation to low levels of dietary FM/FO. Submucosa and lamina propria immunoreactivity grade was related to the amount of leucocyte populations infiltrated and goblet cells presented immunopositivity to anti-iNOS but not to anti-TNFα. Thus, reducing FO content from 6% to a 3% by VO in European sea bass diets increases ex vivo and in vivo gut bacterial translocation rates, whereas reducing FM content from 20% down to 5% up-regulates the expression of several posterior gut inflammation-related genes conditioning fish growth and GALT capacity of response after bacterial infection.

Mechanisms of atherosclerosis and cardiovascular disease in antiphospholipid syndrome and systemic lupus erythematosus. New therapeutic approaches. / Mecanismos de aterosclerosis y enfermedad cardiovascular en el síndrome antifosfolípido y el lupus eritematoso sistémico. Alternativas terapéuticas.

Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are 2 highly related autoimmune-rheumatic diseases associated with an increased risk of developing cardiovascular (CV) diseases. Despite the great progresses made in understanding the pathological mechanisms leading to CV diseases in those pathologies, there is still the unmet need to improve long term prognosis. CV diseases in SLE and APS is thought to happen as the result of a complex interaction between traditional CV risk factors, immune deregulation and disease activity, including the synergic effect of cytokines, chemokines, adipokines, proteases, autoantibodies, adhesion receptors, oxidative stress and a plethora of intracellular signalling molecules. Genomic and epigenomic analyses have further allowed the identification of specific signatures explaining the proathero-thrombotic profiles of APS and SLE patients. This review examines the complex role of these heterogeneous factors, and analyses new therapeutic approaches under study to reduce the CV risk in these autoimmune disorders.

Economic and environmental review of Waste-to-Energy systems for municipal solid waste management in medium and small municipalities.

The application of Directive 2008/98/CE on Municipal Solid Waste (MSW) implies the need to introduce technologies to generate energy from waste. Incineration, the most widely used method, is difficult to implement in low populated areas because it requires a large amount of waste to be viable (100,000 tons per year). This paper analyses the economic and environmental costs of different MSW-to-Energy technologies (WtE) in an area comprising of 13 municipalities in southern Spain. We analyse anaerobic digestion (Biomethanization), the production of solid recovered fuel (SRF) and gasification, and compare these approaches to the present Biological Mechanical Treatment (BMT) with elimination of the reject in landfill, and incineration with energy recovery. From an economic standpoint the implementation of WtE systems reduces the cost of running present BMT systems and incineration; gasification presents the lowest value. From the environmental standpoint, Life Cycle Assessment shows that any WtE alternatives, including incineration, present important advantages for the environment when compared to BMT. Finally, in order to select the best alternative, a multi-criteria method is applied, showing that anaerobic digestion is the optimal solution for the area studied.

Quantitative trait loci for a neurocranium deformity, lack of operculum, in gilthead seabream (Sparus aurata L.).

Lack of operculum, a neurocranial deformity, is the most common external abnormality to be found among industrially produced gilthead seabream (Sparus aurata L.), and this entails significant financial losses. This study conducts, for the first time in this species, a quantitative trait loci (QTL) analysis of the lack of operculum. A total of 142 individuals from a paternal half-sibling family (six full-sibling families) were selected for QTL mapping. They had previously shown a highly significant association with the prevalence of lack of operculum in a segregation analysis. All the fish were genotyped for 106 microsatellite markers using a set of multiplex PCRs (ReMsa1-ReMsa13). A linear regression methodology was used for the QTL analysis. Four QTL were detected for this deformity, two of which (QTLOP1 and QTLOP2) were significant. They were located at LG (linkage group) nine and LG10 respectively. Both QTL showed a large effect (about 27%), and furthermore, the association between lack of operculum and sire allelic segregation observed was statistically significant in the QTLOP1 analysis. These results represent a significant step towards including marker-assisted selection for this deformity in genetic breeding programmes to reduce the incidence of the deformity in the species.

Análisis de los factores asociados a la calidad de vida del paciente hipertenso / Analysis of factors associated with the quality of life i nhigh blood pressure patients

Introducción: En la Hipertensión Arterial (HTA) existen una serie de factores asociados a la misma que inciden en la Calidad de Vida Relacionada con la Salud (CVRS) de la población en general, como es el caso de la Diabetes Mellitus, el hábito tabáquico, alimentación, etc. Objetivo: Analizar la CVRS y los factores asociados a ésta, en pacientes con HTA controlados en la Unidad de Hipertensión de la Unidad de Gestión Clínica (UGC) Nefrología del Hospital Universitario Reina Sofía (HURS) de Córdoba. Pacientes y Métodos: Se ha realizado un estudio observacional, descriptivo y transversal, en 33 pacientes hipertensos con una edad media de 73,24±5,55 años; 20 hombres (60,6%) y 13 mujeres (39,4%) controlados en la Unida de Hipertensión de la UGC Nefrología del HURS de Córdoba. Se analizó la CVRS mediante el cuestionario de salud SF-36. Para el análisis de la dependencia se utilizó el Índice de Barthel. Resultados: Los valores de la CVRS fueron: Salud General 43.36±24.84, Función Física 58.18±32.71, Rol Físico 78.98±34.51, Rol Emocional 82.07±28.50, Función Social 81.81±33.67, Dolor Corporal 66.06±39.42, Vitalidad 63.83±33,80, Salud Mental 70.45±29.27. La Función Física, Salud General y Dolor Corporal fueron las dimensiones en las que puntuaron más bajo que la población de referencia. Respecto al grado de dependencia, el 45.45% eran independientes el 51.51% presentaban dependencia leve, y el 3.03% presentaban una dependencia grave. Se encontró una correlación estadísticamente significativa entre edad y la dimensión Función Física y Vitalidad; entre peso y Rol Físico y el Índice de Masa Corporal (IMC); entre ejercicio y Función Social; entre el IMC y Rol Físico y Componente Salud Física. Los pacientes con algún grado de dependencia tenían disminuida la CVRS en comparación con los independientes. Conclusiones: A la vista de nuestros resultados podemos afirmar que, al menos en la muestra estudiada, la disminución de la CVRS está relacionada con tener algún grado de dependencia y no con padecer HTA, siendo la Salud General, la Función Física y el Dolor Corporal las dimensiones que peor puntúan respecto a la población general. El aumento de la edad y/o el IMC se relacionan con peor CVRS (AU)

Introduction: High Blood Pressure (HBP) is associated with several factors that affect the health-related quality of life (HRQOL) of the general population, such as diabetes mellitus, smoking, feeding, etc. Objective: To analyze the HRQOL and associated factors in patients with controlled high blood pressure in the Hypertension Unit of Clinical Management Unit (CMU) of Nephrology, University Hospital Reina Sofía (UHRS) of Cordoba. Patients and Methods: An observational, descriptive study was conducted in 33 hypertensive patients with a mean age of 73.24 ± 5.55 years; 20 men (60.6%) and 13 women (39.4%) monitored in the Hypertension Unit of CMU of Nephrology in UHRS of Cordoba. HRQL was analyzed by the health SF-36 questionnaire. For the analysis of dependence, Barthel Index was used. Results: HRQL values were: General Health 43.36 ± 24.84; Physical Function 58.18 ± 32.71; Physical Role 78.98 ± 34.51; Emotional Role 82.07 ± 28.50; Social Function 81.81 ± 33.67; Body Pain 66.06 ± 39.42; Vitality 63.83 ± 33.80; Mental health 70.45 ± 29.27. Physical function, General Health and Body Pain were the dimensions in which they scored lower than the reference population. Regarding the degree of dependence, 45.45% were independent; 51.51% mild dependence and 3.03% severe dependence. A statistically significant correlation between age and Physical Function and Vitality dimensions was found; between weight and Physical Role and Body Mass Index (BMI); between exercise and Social Function; between BMI and Physical Role and Physical Health. Patients with some degree of dependency had diminished HRQOL compared to independents. Conclusions: According to the results, it can be stated that, at least in the studied sample, lower HRQOL is associated with some degree of dependency and not with suffering from high blood pressure; being the General Health, Physical Function and Body Pain the dimensions with worse scores compared to the general population. Increased age and/or BMI are related to lower HRQOL (AU)

Genetic parameters and genotype-environment interactions for skeleton deformities and growth traits at different ages on gilthead seabream (Sparus aurata L.) in four Spanish regions.

One of the most important problems of fish aquaculture is the high incidence of fish deformities, which are mainly skeletal. In this study, genetic parameters on gilthead seabream (Sparus aurata L.) for skeleton deformities at different ages (179, 269, 389, 539 and 689 days) and their correlations with growth traits were estimated, as were as their genotype × environment interactions (G × E) at harvesting age. A total of 4093 offspring from the mass spawning of three industrial broodstocks belonging to the PROGENSA(®) breeding programme were mixed and on-grown by different production systems in four Spanish regions: Canary Islands (tanks and cage), Andalusia (estuary), Catalonia (cage) and Murcia (cage). Parental assignment was inferred using the standardized SMsa1 microsatellite multiplex PCR. From three broodstocks, 139 breeders contributed to the spawn and a total of 297 full-sibling families (52 paternal and 53 maternal half-sibling families) were represented. Heritabilities at different ages were medium for growth traits (0.16-0.48) and vertebral deformities (0.16-0.41), and low for any type of deformity (0.07-0.26), head deformities (0.00-0.05) and lack of operculum (0.06-0.11). The genetic correlations between growth and deformity traits were medium and positive, suggesting that to avoid increasing deformities they should be taken into account in breeding programmes when growth is selected. The G × E interactions among the different facilities were weak for length and deformity and strong for growth rate during this period. These results highlight the potential for the gilthead seabream industry to reduce the prevalence of deformities by genetic improvement tools.

Inheritance of skeletal deformities in gilthead seabream (Sparus aurata) - lack of operculum, lordosis, vertebral fusion and LSK complex.

Morphological abnormalities in farmed gilthead seabream (Sparus aurata) are a major problem as it entails significant economic losses. In this study, 3 large scale experiments under different conditions of spawning, offspring handling and breeders phenotype were performed to analyze the inheritance of 4 types of deformities in this species: lack of operculum, lordosis, vertebral fusion, which are 3 of the most important skeletal deformities, and LSK, which is a consecutive repetition of lordosis/scoliosis/kyphosis. In Exp. [1] (mass spawning and fingerling sorting), 900 fish were analyzed at 509 d post-hatching: 846 fish that had been on-grown in a farm and 54 LSK-deformed fish that had been reared separately after being selected during the fingerling sorting process. A total of 89 families were represented. A statistically significant association between 5 of these families (from 6 breeders) and LSK-deformed fish was found. In Exp. [2] (mass spawning and no fingerling sorting), 810 fish were analyzed at 2 ages: 179 and 689 d post-hatching. Significant relationships between 2 of the breeders and 2 of the families with the lack of operculum prevalence of their descendants were found at 689 d but not at 179 d. Heritabilities: 0.09 ± 0.09 at 179 d and 0.17 ± 0.08 at 689 d. Column deformities prevalence was low and no association with family was observed. Family relationships were determined by microsatellites multiplex PCR in both experiments. In Exp. [3] (designed mating), sires suffering from lordosis or lack of operculum or vertebral fusion deformities were mated with non-deformed dams and a mass-spawning mating was considered as a control. After analyzing 11,503 offspring at 159 d post-hatching, a significant relationship between each deformity prevalence and the mating of breeders suffering from the same deformity was observed. In addition, a significant prevalence of lack of operculum in offspring from lordotic matings was observed. Heritabilities ranged from 0.34 to 0.46 for the 3 deformities. The results of the present study suggest that these deformities have a genetic origin. They also suggest that the sorting process is not recommended and that producers should consider these deformities in genetic breeding programs to significantly improve their fish morphological quality and to minimize farmed fish deformities incidence.

Una aproximación al benchmarking de indicadores de cuidados. Aprendiendo para mejorar la seguridad del paciente / An approach to care indicators benchmarking. Learning to improve patient safety

La mejora de la seguridad clínica puede alcanzarse mediante la promoción de una cultura de seguridad, formación y aprendizaje a través del benchmarking. El objetivo fue identificar áreas de mejora tras analizar indicadores relacionados con la seguridad de 2 hospitales públicos del área noroeste de la Comunidad de Madrid. Material y métodos. Estudio descriptivo realizado en 2011 en el Hospital Universitario Puerta de Hierro Majadahonda (HUPHM) y en el Hospital de Guadarrama (HG). Las variables fueron 40 indicadores sobre cuidados de enfermería relacionados con la seguridad; 19 habían sido definidos en el Proyecto SENECA como estándares de calidad de cuidados para mejorar la seguridad en los hospitales. Para la recogida de datos se utilizó la historia clínica, los informes de evaluación del Servicio Madrileño de Salud, los procedimientos de cuidados y la observación directa. Resultados. De 40 indicadores 22 eran de estructura (procedimientos), el HUPHM disponía del 86% y el HG del 95%. Hubo 14 indicadores de proceso (formación y cumplimiento de protocolos) con resultados similares en los 2 hospitales, excepto en los informes de continuidad de cuidados y formación en higiene de manos. Los 4 indicadores de resultado (incidencia, y prevalencia de úlceras por presión, caídas y dolor) mostraron resultados dispares. Conclusiones. Analizar indicadores permitió identificar acciones de mejora en cada hospital, elaborar conjuntamente un decálogo de seguridad en los cuidados y un protocolo de prevención y tratamiento de heridas crónicas, instaurar la evaluación sistemática del dolor y la realización de informes de continuidad de cuidados a los pacientes derivados del HUPHM al HG (AU)

Improvements in clinical safety can be achieved by promoting a safety culture, professional training, and learning through benchmarking. The aim of this study was to identify areas for improvement after analysing the safety indicators in two public Hospitals in North-West Madrid Region. Material and methods. Descriptive study performed during 2011 in Hospital Universitario Puerta de Hierro Majadahonda (HUPHM) and Hospital de Guadarrama (HG). The variables under study were 40 indicators on nursing care related to patient safety. Nineteen of them were defined in the SENECA project as care quality standards in order to improve patient safety in the hospitals. The data collected were clinical history, Madrid Health Service assessment reports, care procedures, and direct observation. Results. Within the 40 indicators: 22 of them were structured (procedures), HUPHM had 86%, and HG 95% 14 process indicators (training and protocols compliance) with similar results in both hospitals, apart from the care continuity reports and training in hand hygiene. The 4 results indicators (pressure ulcer, falls and pain) showed different results. Conclusions. The analysis of the indicators allowed the following actions to be taken: to identify improvements to be made in each hospital, to develop joint safety recommendations in nursing care protocols in prevention and treatment of chronic wound, to establish systematic pain assessments, and to prepare continuity care reports on all patients transferred from HUPHM to HG (AU)