Adaptation of sea turtles to climate warming: Will phenological responses be sufficient to counteract changes in reproductive output?

Sea turtles are vulnerable to climate change since their reproductive output is influenced by incubating temperatures, with warmer temperatures causing lower hatching success and increased feminization of embryos. Their ability to cope with projected increases in ambient temperatures will depend on their capacity to adapt to shifts in climatic regimes. Here, we assessed the extent to which phenological shifts could mitigate impacts from increases in ambient temperatures (from 1.5 to 3°C in air temperatures and from 1.4 to 2.3°C in sea surface temperatures by 2100 at our sites) on four species of sea turtles, under a "middle of the road" scenario (SSP2-4.5). Sand temperatures at sea turtle nesting sites are projected to increase from 0.58 to 4.17°C by 2100 and expected shifts in nesting of 26-43 days earlier will not be sufficient to maintain current incubation temperatures at 7 (29%) of our sites, hatching success rates at 10 (42%) of our sites, with current trends in hatchling sex ratio being able to be maintained at half of the sites. We also calculated the phenological shifts that would be required (both backward for an earlier shift in nesting and forward for a later shift) to keep up with present-day incubation temperatures, hatching success rates, and sex ratios. The required shifts backward in nesting for incubation temperatures ranged from -20 to -191 days, whereas the required shifts forward ranged from +54 to +180 days. However, for half of the sites, no matter the shift the median incubation temperature will always be warmer than the 75th percentile of current ranges. Given that phenological shifts will not be able to ameliorate predicted changes in temperature, hatching success and sex ratio at most sites, turtles may need to use other adaptive responses and/or there is the need to enhance sea turtle resilience to climate warming.

Growth Performance and Transcriptomic Response of Warm-Acclimated Hybrid Abalone Haliotis rufescens (♀) × H. corrugata (♂).

Along the Pacific coast of the Baja California Peninsula (Mexico), abalone represents one of the most lucrative fisheries. As wild populations are currently depleted, abalone farm production aims to balance the decreasing populations with the increasing demand. The Mexican abalone aquaculture is almost entirely based on red abalone (Haliotis rufescens). However, the increasing frequency of extreme temperature events is hampering this activity. The use interspecific hybrids can potentially improve abalone culture, as species have differences in their thermal tolerance. Therefore, the hybrid progeny between H. rufescens (♀) and pink abalone H. corrugata (♂), a temperate and a warmer water abalone species, respectively, will naturally support higher temperature. To test this hypothesis, growth rate, mortality and metabolic rate of both pure (RR) and hybrid abalone (RP) were assessed under the H. rufescens' optimum (18 °C) and thermally stressed (22 °C) conditions. To unveil the molecular pathways involved in the heat response, transcriptional profiling of both crosses was also investigated. At high temperature, we observed constrained growth and survival in RR while RP showed a significant increase in both rates, supporting the improved performance of the hybrid compared. These results match with the transcriptional profiling of hybrids showing higher expression of genes involved in growth and calcification, whereas in the pure red progeny, the transcriptional profile was mainly associated with the regulation of necroptosis process. Our results may contribute to propose new management plans to increase farm abalone production in Baja California.

Brentuximab vedotin and ESHAP is highly effective as second-line therapy for Hodgkin lymphoma patients (long-term results of a trial by the Spanish GELTAMO Group).

BACKGROUND: In this work, we assessed the efficacy and safety of brentuximab vedotin (BV) plus ESHAP (BRESHAP) as second-line therapy for Relapsed/Refractory Hodgkin lymphoma (RRHL) to improve the results before autologous stem-cell transplantation (ASCT). PATIENTS AND METHODS: This was a multicenter, open-label, phase I-II trial of patients with RRHL after first-line chemotherapy. Treatment had three 21-day cycles of etoposide, solumedrol, high-dose AraC, and cisplatin. BV was administered at three dose levels (0.9, 1.2, and 1.8 mg/kg) intravenous on day ‒1 to 3 + 3 cohorts of patients. Final BV dose was 1.8 mg/kg. Responding patients proceeded to ASCT, followed by three BV courses (1.8 mg/kg, every 21 days). Main end points for evaluation were maximum tolerable dose and overall and complete response (CR) before ASCT. RESULTS: A total of 66 patients were recruited (median age 36 years; range 18-66): 40 were primary refractory, 16 early relapse and 10 late relapse. There were 39 severe adverse events were reported in 22 patients, most frequently fever (n = 25, 35% neutropenic), including 3 deaths. Grade 3-4 hematological toxicity presented in 28 cases: neutropenia (n = 21), thrombocytopenia (n = 14), and anemia (n = 7). Grade ≥3-4 extrahematological adverse events (≥5%) were non-neutropenic fever (n = 13) and hypomagnesaemia (n = 3). Sixty-four patients underwent stem-cell mobilization; all collected >2×10e6/kg CD34+ cells (median 5.75; range 2.12-33.4). Overall response before transplant was 91% (CI 84% to 98%), including 70% (CRs 95% CI 59% to 81%). 60 patients were transplanted with no failure engraftments. Post-transplant response was CR in 49 patients (82% CI 73% to 91%) and partial responses in six (10% CI 5% to 15%). After a mean follow-up of 27 months, the 30-month time to treatment to failure was 74% (95% CI 68% to 80%), progression-free survival 71% (95% CI 65% to 77%), and overall survival 91% (CI 84% to 98%). CONCLUSION: BRESHAP looks a safe and effective pre-transplant induction regimen, does not jeopardize transplant and allows long-term remissions and survival.

Comorbidities, not age, are predictive of survival after autologous hematopoietic cell transplantation for relapsed/refractory Hodgkin's lymphoma in patients older than 50 years.

Autologous hematopoietic cell transplantation (AHCT) is the standard of care for young patients with relapsed/refractory (R/R) Hodgkin's lymphoma (HL). However, there is limited experience of its efficacy and feasibility in older patients. The characteristics and outcomes of 121 patients aged ≥50 years (42 of them are ≥60 years old) with R/R HL who underwent AHCT were reviewed. After a median follow-up of 3.1 years, overall survival (OS) and progression-free survival (PFS) at 5 years were 64 and 55 %, respectively, with no differences between 50-59-year-old and ≥60-year-old patients. Hematological and extra-hematological toxicities after AHCT were comparable between the two groups of age. In univariate analysis, poorer OS and PFS were associated with disease status other than complete remission, hematopoietic cell transplantation comorbidity index (HCT-CI) scores >1, and Charlson Comorbidity Index (CCI) scores >1. HCT-CI scores >1 were also associated with a higher risk of grade 3-4 extrahematologic toxicity. In multivariate analysis, HCT-CI and CCI remained significantly associated with OS and PFS after adjustment for disease status. Our data show that AHCT can be performed in selected patients with R/R HL ≥50 years with acceptable outcome and toxicity. Comorbidities appear to impact AHCT outcome more than age.

A fatal case of systemic fat embolism resulting from gluteal injections of vitamin e for cosmetic enhancement.

Recently in Mexico the number of cosmetic surgeries has increased. These procedures are often carried out by unqualified people using obsolete and contraindicated products such as injectable oil, which cause uncorrectable disfigurement or more serious complications, even death, after reaching the systemic circulation. We report the case of a fat embolism syndrome (FES) caused by injections of vitamin E (tocopherol) in order to increase the volume of the buttocks. This case of a FES caused by injections of vitamin E was confirmed by gas chromatography coupled to mass spectrometry.

Identification and expression of antioxidant and immune defense genes in the surf clam Mesodesma donacium challenged with Vibrio anguillarum.

The immune system in marine invertebrates is mediated through cellular and humoral components, which act together to address the action of potential pathogenic microorganisms. In bivalve mollusks biomolecules implicated in oxidative stress and recognition of pathogens have been involved in the innate immune response. To better understand the molecular basis of the immune response of surf clam Mesodesma donacium, qPCR approaches were used to identify genes related to its immune response against Vibrio anguillarum infection. Genes related to oxidative stress response and recognition of pathogens like superoxide dismutase (MdSOD), catalase (MdCAT), ferritin (MdFER) and filamin (MdFLMN) were identified from 454-pyrosequencing cDNA library of M. donacium and were evaluated in mantle, adductor muscle and gills. The results for transcripts expression indicated that MdSOD, MdFLMN and MdFER were primarily expressed in the muscle, while MdCAT was more expressed in gills. Challenge experiments with the pathogen V. anguillarum had showed that levels of transcript expression for MdSOD, MdCAT, MdFER, and MdFLMN were positively regulated by pathogen, following a time-dependent expression pattern with significant statistical differences between control and challenge group responses (p<0.05). These results suggest that superoxide dismutase, catalase, ferritin and filamin, could be contributing to the innate immune response of M. donacium against the pathogen V. anguillarum.

Psoriasis en el embarazo: qué sabemos hoy de las terapias delpasado y del futuro? / Psoriasis in pregnancy: what do we know today about the therapies of the past and the future?

La psoriasis es una enfermedad sistémica que puede ocurrir de múltiples formas durante el embarazo, con severidad variable, incluso con formas que amenazan la vida. Las variantes severas se han asociado a mayores riesgos maternos y fetales, y la mayor parte de los tratamientos tópicos y sistémicos disponibles están contraindicados durante el embarazo por el riesgo de toxicidad fetal. Los tratamientos de primera línea son los emolientes y los corticoides tópicos de baja-moderada potencia y en casos severos la fototerapia nbUVB es el tratamiento de elección. En pacientes con formas muy severas y refractarias otras alternativas de tratamiento son la ciclosporina, los corticoides sistémicos y los agentes biológicos, especialmente los anti-TNF-α, sin embargo, la información disponible sobre el uso de estas moléculas en embarazadas es muy limitada, y sólo deberían considerarse en casos muy seleccionados. El impétigo herpetiforme es una forma propia de psoriasis pustular severa durante el embarazo y las principales alternativas terapéuticas son la inducción del parto o el uso de corticoides sistémicos.

Psoriasis is a systemic disease that can be present during pregnancy in different clinical forms and variable severity; some forms can be life threatening. Severe clinical forms are associated with greater maternal and fetal risks, and topical and systemic treatments available are mainly contraindicated during pregnancy because of fetal toxicity risks. First line treatments are emollients and low-medium potency topical steroids; in severe cases nUVB phototherapy is the preferred treatment. In patients with more severe and recalcitrant clinical forms cyclosporine, systemic steroids and biologics agents specially anti-TNF-α are the options. Nevertheless the available information of the use of these treatments in pregnant women is limited and these drugs should be considered only in very special cases. Herpetiformis impetigo is a proper form of severe pustular psoriasis in pregnancy and the treatments for this entity should be delivery induction or systemic steroids.

Role of IncHI2 plasmids harbouring blaVIM-1, blaCTX-M-9, aac(6')-Ib and qnrA genes in the spread of multiresistant Enterobacter cloacae and Klebsiella pneumoniae strains in different units at Hospital Vall d'Hebron, Barcelona, Spain.

Seven Enterobacter cloacae isolates and seven Klebsiella pneumoniae isolates harbouring a phenotype compatible with the production of a metallo-ß-lactamase were recovered between 2009 and 2011 in three Intensive Care Units of Hospital Vall d'Hebron (Barcelona, Spain). The presence of bla(VIM), bla(IMP), bla(NDM), bla(CTX-M), aac(6')-Ib, qnrA, qnrB and qnrS genes was screened by polymerase chain reaction (PCR) and sequencing. Clonal relatedness of the isolates was assessed by pulsed-field gel electrophoresis (PFGE) and, in the case of K. pneumoniae isolates, by multilocus sequence typing (MLST). PCR-based replicon typing, Southern hybridisation, plasmid double-locus sequence typing and MOB relaxase classification methods were used to identify and characterise the plasmids carrying the resistance genes. Transferability of the identified plasmids was tested by conjugation assays. All 14 isolates were found to carry bla(VIM-1), bla(CTX-M-9) (except one isolate), aac(6')-Ib and qnrA genes. Clonality assessment demonstrated that E. cloacae isolates were distributed in three clonal clusters, whereas all of the K. pneumoniae isolates belonged to one unique clone, identified as sequence type ST252. All studied isolates harboured a large conjugative IncHI2 MOB(H11) plasmid carrying all of the detected resistance genes. Plasmid DNA analysis showed that all of them belonged to the ST1 IncHI2 plasmid cluster and shared the same relaxase partial sequence. In conclusion, the present study describes the dissemination within a hospital of multiresistant E. cloacae and K. pneumoniae isolates producing VIM-1. A complex clonal epidemiology of the E. cloacae isolates was observed and plasmid DNA analysis strongly supports horizontal exchanges of the same IncHI2 plasmid between different strains and species.

Penfigoide gestacional "Herpes gestationis": revisión a partir de un caso clínico / Gestational pemphigoid "Herpes gestationis": review from a clinical case

La embarazada es susceptible a cambios en la piel y fanéreos que pueden ser fisiológicos como patológicos. El reconocimiento de estas entidades es fundamental para un correcto manejo. La clasificación y nomenclatura de las dermatosis del embarazo ha sido controversial y confusa, principalmente dado el pobre conocimiento que se tiene sobre el origen de estas entidades. El objetivo de esta revisión es informar sobre el conocimiento actual del penfigoide gestacional a partir de un caso clínico, centrándose en su diagnóstico y tratamiento como patología multidiscilpinaria.

The pregnant woman is susceptible to both physiologic and pathologic changes of the skin and appendages. Recognition of these entities is important for appropriate management. The classification and nomenclature have been controversial and confusing, mainly because of the poor knowledge that we have regarding the origin of this entities. The purpose of this review is to contribute to the current knowledge of pemphigoid gestationis, based on a case-report its diagnosis and treatment as a multidisciplinary pathology.

Comorbilidades metabólicas y cardiovasculares en psoriasis / Cardiovascular and metabolic comorbidity in psoriasis

La psoriasis es una enfermedad crónica y aumenta el riesgo de mortalidad general, mortalidad cardiovascular y diversas enfermedades metabólicas y cardiovasculares. La inflamación crónica observada en psoriasis y aterosclorosis parece ser la razón de esta asociación. Diabetes, hipertensión, dislipidemia, obesidad, síndrome metabólico y otros factores de riesgo cardiovascular clásicos son más frecuentes en psoriasis; sin embargo, la psoriasis ha demostrado ser un factor de riesgo independiente de mortalidad y de enfermedades cardiovasculares. Infarto al miocardio, enfermedades cerebrovasculares, hígado graso y enfermedad pulmonar obstructiva crónica son alguna de las enfermedades específicas relacionadas con la psoriasis. Todas estas observaciones apoyan la idea de psoriasis como una enfermedad sistémica, más que sólo una condición cutánea.

Psoriasis is a chronic disease and increases the risk of general mortality, cardiovascular mortality and several metabolic and cardiovascular diseases. The chronic inflammation observed in psoriasis and atherosclerosis seems to be the reason for this association. Diabetes, hypertension, dyslipidemia, obesity, metabolic syndrome and other classical cardiovascular risk factors are more common in psoriasis; however, psoriasis has been shown as an independent risk factor for mortality and cardiovascular diseases. Myocardial infarction, cerebrovascular disorders, non-alcoholic fatty liver disease and chronic obstructive pulmonary disease are some specific disease related to psoriasis. All these observations support the idea that psoriasis behaves like a systemic disease, more than just as a cutaneous condition.

Phase-coherence effects in vortex transport entropy.

Nernst and electrical resistivity measurements in superconducting YBa2Cu3O7-delta and Bi2Sr2CaCu2O8+delta with and without columnar defects show a distinctive thermodynamics of the respective liquid vortex matter. At a field-dependent high temperature region in the H-T phase diagram, the Nernst signal is independent of structural defects in both materials. At lower temperatures, in YBa2Cu3O7-delta, defects contribute only to the vortex mobility, and the transport entropy is that of a system of vortex lines. The transition to lower temperatures in Bi2Sr2CaCu2O8+delta has a different origin; the maximum in the Nernst signal when decreasing temperature is not associated with transport properties but with the entropy behavior of pancake vortices in the presence of structural defects.

[Acute transverse myelitis in seven patients with systemic lupus erythematosus]. / Mielitis transversa aguda en siete pacientes con lupus eritematoso sistémico.

INTRODUCTION: Although the association between transverse myelitis and systemic lupus erythematosus is rather infrequent, it is important to take this form of clinical presentation into account because it is a serious complication, which can potentially be treated but even when dealt with in the early stages does not always have a good prognosis. PATIENTS AND METHODS: We conducted a retrospective review over the past 13 years of the cases that have been admitted to our specific centre for the treatment of spinal cord injuries that were diagnosed as suffering from myelitis associated with disseminated lupus erythematosus. Demographic and clinical data, together with data about acute phase and maintenance treatments, as well as the patients' progress and sequelae are described. RESULTS: The case reports of seven patients, all of whom were young females, are studied. In two cases, myelitis was the initial presentation of lupus. The main disorder was at the dorsal, followed by the cervical, levels. Only two patients had a favourable long-term progression from the neurological point of view (both managed to walk) despite acute treatment with high doses of intravenous corticoids, and regardless of the fact that cyclophosphamide was later used. CONCLUSIONS: Myelitis associated to lupus is a rare manifestation but, owing to its important functional repercussions, it must be taken into account when faced with an acute clinical picture involving the spinal cord; this is particularly the case when it occurs in young females, with or without a previous diagnosis of autoimmune disease.

Mielitis transversa aguda en siete pacientes con lupus eritematoso sistémico / Acute transverse myelitis is seven patients with systemic lupus erythematosus

Introducción. Aunque la asociación entre mielitis transversa y lupus eritematoso sistémico es bastante infrecuente, es importante tener en cuenta esta forma de presentación clínica, porque se trata de una complicación grave, con tratamiento potencial, que incluso con intervención temprana no siempre se asocia a un buen pronóstico. Pacientes y métodos. Revisamos de forma retrospectiva durante los últimos 13 años los casos que han ingresado en nuestro centro específico para el tratamientode lesión medular, con diagnóstico de un cuadro de mielitis asociada a lupus eritematoso diseminado. Se describen los datos demográficos, clínicos, el tratamiento realizado en la fase aguda y de mantenimiento, así como su evolución y secuelas.Resultados. Se estudian los casos clínicos de siete pacientes, todas ellas mujeres jóvenes. En dos de ellas la mielitis fue la forma de inicio del lupus. La afectación predominante fue a nivel dorsal y después cervical. Sólo dos pacientes tuvieron una evolución favorable a largo plazo desde el punto de vista neurológico, consiguiendo la deambulación, a pesar del tratamiento agudo con corticoides intravenosos en dosis altas, con independencia de que posteriormente se utilizase ciclofosfamida.Conclusión. La mielitis asociada al lupus es una manifestación infrecuente, pero debe tenerse en cuenta ante un cuadro medular agudo, sobre todo si éste ocurre en mujeres jóvenes, con o sin el diagnóstico previo de la enfermedad autoinmune, debido a su importante repercusión funcional

Introduction. Although the association between transverse myelitis and systemic lupus erythematosus is rather infrequent, it is important to take this form of clinical presentation into account because it is a serious complication, which can potentially be treated but even when dealt with in the early stages does not always have a good prognosis. Patients and methods. We conducted a retrospective review over the past 13 years of the cases that have been admitted to our specific centre for the treatment of spinal cord injuries that were diagnosed as suffering from myelitis associated with disseminated lupuserythematosus. Demographic and clinical data, together with data about acute phase and maintenance treatments, as well as the patients’progress and sequelae are described. Results. The case reports of seven patients, all of whom were young females, are studied. In two cases, myelitis was the initial presentation of lupus. The main disorder was at the dorsal, followed by the cervical, levels. Only two patients had a favourable long-term progression from the neurological point of view (both managedto walk) despite acute treatment with high doses of intravenous corticoids, and regardless of the fact that cyclophosphamide was later used. Conclusions. Myelitis associated to lupus is a rare manifestation but, owing to its important functional repercussions, it must be taken into account when faced with an acute clinical picture involving the spinal cord; this is particularly the case when it occurs in young females, with or without a previous diagnosis of autoimmune disease

[Sport dermatoses]. / Dermatosis en los deportistas.

Sports practice has become a part of modern life. As a result, the association of dermatoses with sports increases continuously. Proper diagnosis and treatment of these skin lesions requires familiarity with their characteristics clinical presentations. This article reviews the cutaneous manifestations of traumatic and environmental injuries, infections, and exacerbation of preexisting dermatoses.

Lesión persistente de un músculo ocular motor secundaria a la inyección de toxina botulínica / Persistent injury to an ocular motor muscle secondary to injection of botulinum toxin

No disponible

Dermatosis en los deportistas: [revisión] / Sport dermatoses: [review]

Sports practice has become a part of modern life. As a result, the association of dermatoses with sports increases continuously. Proper diagnosis and treatment of these skin lesions requires familiarity with their characteristics clinical presentations. This article reviews the cutaneous manifestations of traumatic and environmental injuries, infections, and exacerbation of preexisting dermatoses.

Effects of baclofen on temperature perception in humans.

The aim of this study was to evaluate the effect of chronic consumption of the GABAB agonist baclofen on temperature perception in humans. We investigated temperature perception thresholds to detect warm and cold stimuli in a group of 21 patients with spinal cord injury, who were chronically consuming oral baclofen at different daily doses to treat spasticity. Temperature perception thresholds were assessed above the level of the lesion, using a psychophysical approach based on the ability of the subjects to perceive precisely quantified sensory stimuli (quantitative sensory testing, QST). The data were compared with a control group of healthy subjects, not receiving baclofen. We found that chronic baclofen consumption increased temperature perception thresholds for both cold and warm stimuli in a dose-dependent manner. Temperature perception thresholds did not depend on the level of the lesion nor on the duration of baclofen treatment, suggesting that our finding represent normal GABAB-mediated modulation in spared nervous structures. We conclude that GABAB therefore plays a role in temperature perception in humans.