Highly dense linkage maps from 31 full-sibling families of turbot (Scophthalmus maximus) provide insights into recombination patterns and chromosome rearrangements throughout a newly refined genome assembly.

Highly dense linkage maps enable positioning thousands of landmarks useful for anchoring the whole genome and for analysing genome properties. Turbot is the most important cultured flatfish worldwide and breeding programs in the fifth generation of selection are targeted to improve growth rate, obtain disease resistant broodstock and understand sex determination to control sex ratio. Using a Restriction-site Associated DNA approach, we genotyped 18,214 single nucleotide polymorphism in 1,268 turbot individuals from 31 full-sibling families. Individual linkage maps were combined to obtain a male, female and species consensus maps. The turbot consensus map contained 11,845 markers distributed across 22 linkage groups representing a total normalised length of 3,753.9 cM. The turbot genome was anchored to this map, and scaffolds representing 96% of the assembly were ordered and oriented to obtain the expected 22 megascaffolds according to its karyotype. Recombination rate was lower in males, especially around centromeres, and pairwise comparison of 44 individual maps suggested chromosome polymorphism at specific genomic regions. Genome comparison across flatfish provided new evidence on karyotype reorganisations occurring across the evolution of this fish group.

Use of explicit ICD9-CM codes to identify adult severe sepsis: impacts on epidemiological estimates.

BACKGROUND: Severe sepsis is a challenge for healthcare systems, and epidemiological studies are essential to assess its burden and trends. However, there is no consensus on which coding strategy should be used to reliably identify severe sepsis. This study assesses the use of explicit codes to define severe sepsis and the impacts of this on the incidence and in-hospital mortality rates. METHODS: We examined episodes of severe sepsis in adults aged ≥18 years registered in the 2006-2011 national hospital discharge database, identified in an exclusive manner by two ICD-9-CM coding strategies: (1) those assigned explicit ICD-9-CM codes (995.92, 785.52); and (2) those assigned combined ICD-9-CM infection and organ dysfunction codes according to modified Martin criteria. The coding strategies were compared in terms of the populations they defined and their relative implementation. Trends were assessed using Joinpoint regression models and expressed as annual percentage change (APC). RESULTS: Of 222 846 episodes of severe sepsis identified, 138 517 (62.2 %) were assigned explicit codes and 84 329 (37.8 %) combination codes; incidence rates were 60.6 and 36.9 cases per 100 000 inhabitants, respectively. Despite similar demographic characteristics, cases identified by explicit codes involved fewer comorbidities, fewer registered pathogens, greater extent of organ dysfunction (two or more organs affected in 60 % versus 26 % of cases) and higher in-hospital mortality (54.5 % versus 29 %; risk ratio 1.86, 95 % CI 1.83, 1.88). Between 2006 and 2011, explicit codes were increasingly implemented. Standardised incidence rates in this cohort increased over time with an APC of 12.3 % (95 % CI 4.4, 20.8); in the combination code cohort, rates increased by 3.8 % (95 % CI 1.3, 6.3). A decreasing trend in mortality was observed in both cohorts though the APC was -8.1 % (95 % CI -10.4, -5.7) in the combination code cohort and -3.5 % (95 % CI -3.9, -3.2) in the explicit code cohort. CONCLUSIONS: Our findings suggest greater and increasing use of explicit codes for adult severe sepsis in Spain. This trend will have substantial impacts on epidemiological estimates, because these codes capture cases featuring greater organ dysfunction and in-hospital mortality.

Characteristics, incidence and temporal trends of sepsis in elderly patients undergoing surgery.

BACKGROUND: Despite increasing rates of surgery in the elderly, there is limited population-based information on sepsis in this age group. This study aimed to characterize the epidemiology and national trends of sepsis among elderly patients undergoing surgery in Spain. METHODS: This population-based longitudinal study of patients aged 65 years or older, undergoing surgery between 2006 and 2011, used data from the national hospital discharge database. Patients were identified by ICD coding. Primary endpoints were incidence and case-fatality rates of sepsis. Predefined age groups were examined. In-hospital mortality-related factors were assessed by means of exploratory logistic regression. Trends were assessed for annual percentage change in rates using Joinpoint regression analysis. RESULTS: A total of 44 342 episodes of sepsis were identified, representing 1·5 per cent of all 2 871 199 surgical hospital admissions of patients aged 65 years or older. The rates varied with age and sex. The in-hospital case-fatality rate was 43·9 per cent (19 482 patients), and associated with age, co-morbidity and organ dysfunction. Standardized rates of sepsis increased over time, with an annual change of 4·7 (95 per cent c.i. 1·4 to 8·5) per cent, whereas the case-fatality rate declined, with an overall annual change of -3·6 (-4·3 to -2·8) per cent. The decrease in mortality was more limited in patients with organ dysfunction and in the oldest age group. CONCLUSION: Rates of sepsis are increasing among elderly patients undergoing surgery, whereas in-hospital case fatality, although common, is showing a decreasing trend.

First records of Hippocampus algiricus in the Canary Islands (north-east Atlantic Ocean) with an observation of hybridization with Hippocampus hippocampus.

Morphometric and genetic analyses confirmed the first records of the West African seahorse Hippocampus algiricus at Gran Canaria Island (north-east Atlantic Ocean), and also the first evidence of interspecific hybridization in seahorses. These results provide additional data on the distribution of H. algiricus that may help to establish future conservation strategies, and uncover a new potential sympatric scenario between H. algiricus and Hippocampus hippocampus.

Effectiveness and safety of glimepiride and iDPP4, associated with metformin in second line pharmacotherapy of type 2 diabetes mellitus: systematic review and meta-analysis.

OBJECTIVE: Our review analyses the studies that have specifically compared the association iDPP4/metformin with glimepiride/metformin, both in second line pharmacotherapy of type 2 diabetes mellitus (DM2). METHODS: Systematic literature review with a meta-analysis of clinical trials comparing glimepiride with any iDPP4, both used together with metformin as a second line treatment of DM2. The effectiveness variables used were as follows: %HbA1c variation, fasting plasma glucose variation, patients achieving the therapeutic objective of HbA1c <7%, treatment dropouts due to lack of effectiveness and rescue treatments needed. The safety variables included were as follows: weight variation at the end of treatment; presentation of any type of adverse event; presentation of serious adverse events; patients who experienced any type of hypoglycaemia; patients who experienced severe hypoglycaemia; treatments suspended due to adverse effects; and deaths for any reason. RESULTS: Four studies met the inclusion criteria. The group treated with glimepiride showed better results in all effectiveness variables. Regarding safety variables, the main differences observed were in the greater number of cases with hypoglycaemia in the group treated with glimepiride, and the serious adverse events or treatment discontinuations due to these which occurred in slightly over 2% more cases in this group compared to the iDPP4 group. The remaining adverse events, including mortality, did not show any differences between both groups. The variation in the weight difference between groups (2.1 kg) is not considered clinically relevant. CONCLUSIONS: A greater effectiveness is seen in the glimepiride/metformin association, which should not be diminished by slight differences in adverse effects, with absence of severe hypoglycaemia in over 98% of patients under treatment. The association of glimepiride/metformin, both due to cost as well as effectiveness and safety, may be the preferential treatment for most DM2 patients, and it offers a potential advantage in refractory hyperglycemic populations, tolerant to treatment.

Uncovering QTL for resistance and survival time to Philasterides dicentrarchi in turbot (Scophthalmus maximus).

Disease resistance-related traits have received increasing importance in aquaculture breeding programs worldwide. Currently, genomic information offers new possibilities in breeding to address the improvement of this kind of traits. The turbot is one of the most promising European aquaculture species, and Philasterides dicentrarchi is a scuticociliate parasite causing fatal disease in farmed turbot. An appealing approach to fight against disease is to achieve a more robust broodstock, which could prevent or diminish the devastating effects of scuticociliatosis on farmed individuals. In the present study, a genome scan for quantitative trait loci (QTL) affecting resistance and survival time to P. dicentrarchi in four turbot families was carried out. The objectives were to identify QTL using different statistical approaches [linear regression (LR) and maximum likelihood (ML)] and to locate significantly associated markers for their application in genetic breeding strategies. Several genomic regions controlling resistance and survival time to P. dicentrarchi were detected. When analyzing each family separately, significant QTL for resistance were identified by the LR method in two linkage groups (LG1 and LG9) and for survival time in LG1, while the ML methodology identified QTL for resistance in LG9 and LG23 and for survival time in LG6 and LG23. The analysis of the total data set identified an additional significant QTL for resistance and survival time in LG3 with the LR method. Significant association between disease resistance-related traits and genotypes was detected for several markers, a single one explaining up to 22% of the phenotypic variance. Obtained results will be essential to identify candidate genes for resistance and to apply them in marker-assisted selection programs to improve turbot production.

Exploitation of a turbot (Scophthalmus maximus L.) immune-related expressed sequence tag (EST) database for microsatellite screening and validation.

In this study, we identified and characterized 160 microsatellite loci from an expressed sequence tag (EST) database generated from immune-related organs of turbot (Scophthalmus maximus). A final set of 83 new polymorphic microsatellites were validated after the analysis of 40 individuals of Atlantic origin including both wild and farmed individuals. The allele number and the expected heterozygosity ranged from 2 to 18 and from 0.021 to 0.951, respectively. Evidences of null alleles at moderate-high frequencies were detected at six loci using population data. None of the analysed loci showed deviations from Mendelian segregation after the analysis of five full-sib families including approximately 92 individuals/family. The markers are used to consolidate the turbot genetic map, and because they are mostly EST-derived, they will be very useful for comparative genomic studies within flatfishes and with model fish species. Using an in silico approach, we detected significant homologies of microsatellite sequences with the EST databases of the flatfish species with highest genomic resources (Senegalese sole, Atlantic halibut, bastard halibut) in 31% of these turbot markers. The conservation of these microsatellites within Pleuronectiformes will pave the way for anchoring genetic maps of different species and identifying genomic regions related to productive traits.

Trends on schizophrenia admissions during the deinstitutionalisation process in Spain (1980-2004).

BACKGROUND: The deinstitutionalisation reform in Spain started after 1980 with the aim of reducing the need for hospitalisation, length of stay and the number of psychiatric hospital beds, as well as fostering psychiatric patient's involvement in the community. The aim of this study was to review how this reform process has affected the management of schizophrenic patients from 1980 to 2004. METHODS: Longitudinal (1980-2004) study describing variables related to hospital morbidity in schizophrenia patients. RESULTS: Hospital admission rate has gradually increased from 1980 to 2004 from 3.71 admissions per 10,000 inhabitants to 5.89, respectively. Considering the type of admission, emergency or elective, whilst the latter has slightly decreased from 2.24 in 1980 to 1.72 in 2004, the first has almost tripled from 1.47 to 4.17. The point-prevalence of schizophrenic patients receiving inpatient treatment each year has decreased 78% in this period. Length of stay, in days per admission episode, has also decreased from 148 days in 1980 to 35 days in 2004. CONCLUSION: One of the main impacts of the psychiatric health care reform in Spain has been the considerable reduction in hospital capacity devoted to schizophrenic patients, based on the significant decrease in point-prevalence. Thus, it seems relevant to design new studies to quantify the resource reallocation to other areas of care, such as pharmacological treatment and community services.

High Ag-NOR-site variation associated to a secondary contact in brown trout from the Iberian Peninsula.

The analysis of nucleolar organizer regions (NORs) using silver (Ag-) staining and in situ hybridization (ISH) in brown trout (Salmo trutta) from various river basins in the Iberian Peninsula revealed high variation in the number and location of NORs. A total of 17 different Ag-NOR sites were revealed in 10 different chromosome pairs. Three different Ag-NOR patterns clustered by river basins and strongly associated to the internal transcribed spacer 1 (ITS1) variation were detected. The main variability in NOR-sites was found in a secondary contact between two divergent lineages of brown trouts at Duero basin. Our results confirmed the abrupt break in the spatial distribution of genetic variation of brown trout populations previously reported at Duero basin. We hypothesize that NOR-site variation might be a consequence of hybridization between divergent lineages of brown trouts and that NORs could play a major role in the maintenance of a hybrid zone in Duero basin via post-zygotic isolation mechanisms.

Characterization of EST-derived microsatellites for gene mapping and evolutionary genomics in turbot.

The detection of microsatellite sequences within expressed sequence tags (ESTs) connects potential markers with specific genes, generating type I markers. We have developed and mapped by linkage analysis a set of EST-derived microsatellites in the turbot, Scophthalmus maximus. One hundred and ninety-one microsatellites were identified from 9256 turbot ESTs. Primer design was possible with 98 microsatellites. After genotyping 25 wild turbot and the parents of two reference families for linkage analysis, 43 EST-derived microsatellites were selected because they met technical and polymorphism criteria. A final set of 31 EST-derived microsatellites could be mapped to 17 linkage groups of the turbot consensus map based on 242 anonymous microsatellites. Twenty-four microsatellite-containing ESTs were functionally annotated, confirming them as type I markers. Nineteen were mapped in the turbot consensus map. These EST-derived microsatellites constitute useful tools for genome scanning of turbot populations, marker-assisted selection programmes and comparative mapping.

Development and characterization of 248 novel microsatellite markers in turbot (Scophthalmus maximus).

The turbot is a flatfish species of great relevance to marine aquaculture in Europe. Only a limited number of microsatellites have been isolated to date in this species. To increase the number of potentially useful mapping markers, we screened simple sequence repeat (SSR)--enriched genomic libraries obtained from several di-, tri-, and tetranucleotide tandem repeat motifs. A total of 248 new polymorphic microsatellites were successfully optimized. The efficiency of the protocol applied (6.4%) was higher than that in other studies of fish that used the same method. Dinucleotide and perfect microsatellites were predominant in this species; the (AC)n motif was the most frequent class of repeat. Polymorphism and structural properties at these loci, together with 30 variable loci previously reported in turbot, were evaluated in 6 wild individuals. The number of alleles per locus ranged from 2 to 10, with an average of 4.046. The microsatellite markers characterized in this study will contribute to the development of the turbot genetic map, which can be used for quantitative trait locus (QTL) identification, marker-assisted selection programs, and other applications to improve its culture.

Hospitalised osteoporotic vertebral fractures in Spain: analysis of the national hospital discharge registry.

UNLABELLED: This population-based study reveals clinical and epidemiologic characteristics of hospitalised osteoporosis-related vertebral fractures and indicates an association with a substantial hospital burden in Spain. These data provide a basis for assessing the impact of these fractures on the Spanish health-care system and to estimate future care requirements. INTRODUCTION: Vertebral fractures (VF) are recognised as the most frequent complication of osteoporosis. Our objective was to determine the clinico-epidemiological characteristics and health-care burden of hospitalised VF in Spain. METHOD: From the 2002 National Hospital Discharge Register, records for all osteoporosis-related VF in the Spanish population aged >or=30 years and over were retrieved. Diagnostic categories included the ICD-9-CM codes 805 and 733.xx. Population data were drawn from the National Statistics Institute. RESULTS: In total, 7,100 records were eligible for analysis. According to Deyo-adapted Charlson index, 62% of cases had no associated comorbidity. VF were the cause of hospitalisation in 52% of cases. Overall in-hospital mortality was 3.5%. Men had higher adjusted mortality than women. Mean hospital stay was 11.4+/-0.2 days. Identified cases amounted to a hospitalisation rate of 2.76 cases per 10,000 population aged >or=30 years. Direct inpatient hospital costs exceeded 41 million euros and accounted for 0.078% of Spanish expenditure on hospitalisations and specialised care in 2002. CONCLUSIONS: The national discharge database reveals epidemiological features of hospitalised osteoporosis-attributable VF and indicates an association with a substantial hospital burden in Spain. Our data provide a basis for assessing the impact of these fractures on the Spanish health-care system and to estimate future care requirements.

Síndrome pospolio: revisión de sus características clínicas y tratamiento / Post-polio syndrome: a review of its clinical characteristics and treatment

Introducción. El síndrome pospolio (SPP) se reconocecomo un síndrome clínico causante del deterioro funcional tardío yprogresivo que sufren los supervivientes de un episodio de poliomielitisaguda. La importancia del SPP se reconoce por sectores cadavez más amplios de la población y las esferas sanitarias; sin embargo,tanto su epidemiología como sus características clínicas y sutratamiento están escasamente documentados. Objetivo. Revisar laevidencia científica actualmente disponible sobre las manifestacionesclínicas, factores de riesgo, prevalencia, diagnóstico y recomendacionesde tratamiento del SPP. Desarrollo. Revisión de la literaturamédica en la base de datos MEDLINE. La búsqueda se ha restringidoa estudios en humanos publicados de forma completa en inglésy/o castellano hasta diciembre de 2004. Conclusiones. El SPP se reconocecomo un síndrome neurológico específico que aparece variasdécadas después del episodio agudo de polio, agrava las secuelasmotoras ya presentes en dichos pacientes y reduce su capacidadfuncional hasta afectar las actividades de la vida diaria. Su etiologíaaún no ha sido claramente identificada y constituye un procesode difícil diagnóstico y manejo para el cual aún no existe un tratamientoespecífico. Sin embargo, el impacto psicológico y funcionalque supone en los afectados y la posibilidad de una notable mejoríasintomática exigen un esfuerzo de identificación por parte de losprofesionales de manera que se reconozcan las necesidades clínicasque dicho síndrome impone y se reduzcan las barreras asistencialesexistentes en la actualidad

Introduction. Post-polio syndrome (PPS) is recognised as a clinical syndrome that causes the late, progressivefunctional impairment suffered by survivors of an acute episode of poliomyelitis. The importance of PPS is acknowledged byincreasingly wider sectors of the population and health care sectors; nevertheless, few reports have been published about itsepidemiology or its clinical characteristics and treatment. Aim. To review the current scientific evidence available on theclinical manifestations, risk factors, prevalence, diagnosis and recommendations for treatment of PPS. Development. Weconducted a review of the medical literature in the MEDLINE database. The search was restricted to studies conducted inhumans that had been published as complete works in English and/or Spanish up to December 2004. Conclusions. PPS isrecognised as being a specific neurological syndrome that appears several decades after the acute episode of polio; itexacerbates the motor sequelae already present in these patients and reduces their functional capacity to a point where it affectstheir activities of daily living. Its causation has still not been clearly identified and it constitutes a process that is difficult todiagnose and manage. In addition, no specific treatment has been developed for this condition to date. Nevertheless, thepsychological and functional impact it has on its victims and the possibility of bringing about a significant improvement in thesymptoms call for a greater effort by professionals to identify the clinical needs imposed by the syndrome and to break downsome of the health care barriers that currently exist

[Post-polio syndrome: a review of its clinical characteristics and treatment]. / Sindrome pospolio: revision de sus caracteristicas clinicas y tratamiento.

INTRODUCTION: Post-polio syndrome (PPS) is recognised as a clinical syndrome that causes the late, progressive functional impairment suffered by survivors of an acute episode of poliomyelitis. The importance of PPS is acknowledged by increasingly wider sectors of the population and health care sectors; nevertheless, few reports have been published about its epidemiology or its clinical characteristics and treatment. AIM: To review the current scientific evidence available on the clinical manifestations, risk factors, prevalence, diagnosis and recommendations for treatment of PPS. DEVELOPMENT: We conducted a review of the medical literature in the MEDLINE database. The search was restricted to studies conducted in humans that had been published as complete works in English and/or Spanish up to December 2004. CONCLUSIONS: PPS is recognised as being a specific neurological syndrome that appears several decades after the acute episode of polio; it exacerbates the motor sequelae already present in these patients and reduces their functional capacity to a point where it affects their activities of daily living. Its causation has still not been clearly identified and it constitutes a process that is difficult to diagnose and manage. In addition, no specific treatment has been developed for this condition to date. Nevertheless, the psychological and functional impact it has on its victims and the possibility of bringing about a significant improvement in the symptoms call for a greater effort by professionals to identify the clinical needs imposed by the syndrome and to break down some of the health care barriers that currently exist.

[Epidemiology and costs of severe sepsis in Madrid. A hospital discharge study]. / Epidemiología y costes de la sepsis grave en Madrid. Estudio de altas hospitalarias.

BACKGROUND AND OBJECTIVE: Severe sepsis is a complex syndrome to define, diagnose and treat. This population-based study describes the epidemiology of sepsis in the Region of Madrid, estimates its incidence and mortality, and assesses its impact on hospital stays and costs. PATIENTS AND METHODS: The source of information was the Minimum Basic Hospital Data Set from the Region of Madrid in 2001. Severe sepsis cases were defined as discharges with a combination of organic failure and presence or suspicion of infection through a combination of codes previously proposed and utilized. A descriptive study was performed, incidence rates were calculated, lengths of stay and costs were estimated, and mortality was analyzed. RESULTS: 6,968 episodes were identified. Mean age was 62.5 year. 59.7% were male. Annual incidence was 14.1/10,000 inhabitants, being highest for those 84 and older (230.8/10,000). 1.7 infections per episode were detected. More frequently identified microorganisms were Streptococcus sp., Staphylococcus sp., Escherichia coli and Candida sp. The most frequent organic dysfunctions were renal (39.7%) and respiratory (35.7%). Mortality was 33%. Mortality was higher in cases with more than one organic failure, hepatic dysfunction or cancer. Mean length of stay was 28.9 day. Annual overall costs were 70 million euros. CONCLUSIONS: Severe sepsis is a frequent process, with a high mortality and a significant impact on health care resource utilization.

Epidemiología y costes de la sepsis grave en Madrid. Estudio de altas hospitalarias / Epidemiology and costs of severe sepsis in Madrid. A hospital discharge study

Fundamento y objetivo. La sepsis grave es un síndrome complejo de definir, diagnosticar y tratar. Este trabajo de base poblacional describe la epidemiología de la sepsis grave en la Comunidad de Madrid, estima su incidencia y mortalidad y evalúa su impacto en estancias y costes. Pacientes y método. La fuente de información fue el conjunto mínimo básico de datos de la Comunidad de Madrid del año 2001. Se definieron como casos de sepsis grave aquellos en los que existía la presencia de fracaso orgánico y presencia o sospecha de infección a partir de la combinación de códigos de enfermedad y códigos de procedimientos utilizando criterios propuestos y utilizados previamente. Se efectuó un estudio descriptivo, se calcularon tasas poblacionales de incidencia de sepsis, se obtuvieron las estancias medias, se estimó el coste y se analizó la mortalidad por sepsis. Resultados. Se identificaron 6.968 episodios. La edad media fue de 62,5 años. El 59,7% eran hombres. La incidencia anual fue de 14,1/10.000 habitantes, siendo máxima en los mayores de 84 años (230,8/10.000). Se detectaron 1,7 infecciones por episodio. Los microorganismos más frecuentes fueron Streptococcus sp., Staphylococcus sp., Escherichia coli y Candida sp. Las disfunciones orgánicas más frecuentes fueron renal (39,7%) y respiratoria (35,7%). La mortalidad global fue de un 33% y era superior para los episodios con más de una disfunción orgánica, disfunción hepática, o neoplasia. La estancia media fue de 28,9 días. El coste anual de la atención a la sepsis grave en la Comunidad de Madrid es de 70 millones de euros. Conclusiones. La sepsis grave es un proceso frecuente, presenta una elevada mortalidad y tiene un importante impacto en consumo de recursos asistenciales

Background and objective. Severe sepsis is a complex syndrome to define, diagnose and treat. This population-based study describes the epidemiology of sepsis in the Region of Madrid, estimates its incidence and mortality, and assesses its impact on hospital stays and costs. Patients and methods. The source of information was the Minimum Basic Hospital Data Set from the Region of Madrid in 2001. Severe sepsis cases were defined as discharges with a combination of organic failure and presence or suspicion of infection through a combination of codes previously proposed and utilized. A descriptive study was performed, incidence rates were calculated, lengths of stay and costs were estimated, and mortality was analyzed. Results. 6,968 episodes were identified. Mean age was 62.5 year. 59.7% were male. Annual incidence was 14.1/10,000 inhabitants, being highest for those 84 and older (230.8/10,000). 1.7 infections per episode were detected. More frequently identified microorganisms were Streptococcus sp., Staphylococcus sp., Escherichia coli and Candida sp. The most frequent organic dysfunctions were renal (39.7%) and respiratory (35.7%). Mortality was 33%. Mortality was higher in cases with more than one organic failure, hepatic dysfunction or cancer. Mean length of stay was 28.9 day. Annual overall costs were 70 million euros. Conclusions. Severe sepsis is a frequent process, with a high mortality and a significant impact on health care resource utilization

Efficacy of advanced dressings in the treatment of pressure ulcers: a systematic review.

A meta-analysis of published research enabled dressing efficacy to be estimated. Comparisons showed greater efficacy of hydrocolloid dressings but failed to confirm advantages of other advanced dressings compared with conventional ones.

Gynogenesis assessment using microsatellite genetic markers in turbot ( Scophthalmus maximus).

Gynogenesis was assessed by different methods in 2 families of gynogenetic offspring in turbot ( Scophthalmus maximus). Karyotype analysis in embryos and larvae demonstrated high accuracy in estimation of ploidy level, but performance was uneven given the low quality and number of plates obtained. The use of silver staining to estimate the number of nucleoli per nucleus resulted in a straightforward and easy method to evaluate the ploidy of the samples studied. However, the existence of a nucleolus organizer region polymorphism in turbot determined a small error in ploidy estimation, important when checking ploidy in specific individuals. The use of a set of 11 highly variable microsatellite loci proved to be a powerful method to confirm the exclusive maternal inheritance to gynogenetic offspring in turbot, with probabilities of detection of putative paternal genetic contribution above 99.99%.

[Views of primary care users concerning generic medicines and the cost of medication]. / Opinión de los usuarios de atención primaria sobre los medicamentos genéricos y el coste de la medicación.

OBJECTIVES: To assess primary care users' views on generic drugs, approach to them and degree of understanding of them; and to find the importance they attach to the economic cost of medication. DESIGN: Transversal, descriptive study. SETTING: Primary care. PARTICIPANTS: A sample of 231 patients was selected from all the people over 18 who attended the health centre for medical consultation during 2001. RESULTS: 60% (95% CI, 55.22%-67.42%) of those surveyed said they had heard of generic medicines. The communications media were the main source of information, accounting for 78.4% of cases (95% CI, 69.19%-83.96%). 48.04% (95% CI, 38.04%-58.16%) of those who had heard of generic medicines had taken them on some occasion; and 32.4% (95% CI, 23.42%-42.34%) normally took them. 76.47% (95% CI, 67.04%-84.30%) did not mind or, where appropriate, would not mind if their doctor changed a medicine they normally took for a generic one. The mean age of those who did not mind was significantly lower than that of those who did. 50% (95% CI, 42.25%-52.75%) of those questioned were very interested in the cost of drugs prescribed by their doctors: people still working were more interested than those on a pension. 67.6% (95% CI, 60.06%-74.61%) believed that doctors should try to prescribe the cheapest drugs, as long as they were equally efficacious. 78.8% of those questioned (95% CI, 71.91%-84.70%) would choose the cheaper of two drugs which were the same bar the cost. CONCLUSIONS: Most patients in our study were aware of generic drugs and were not against the replacement of a medicine they were already taking by a generic one. They did not relate drugs' cost to their quality.

Opinión de los usuarios de atención primaria sobre los medicamentos genéricos y el coste de la medicación / Views of primary care users concerning generic medicines and the cost of medication

Objetivos. Valorar la opinión, actitud y grado de conocimiento de los usuarios de atención primaria respecto a los medicamentos genéricos y conocer la importancia que conceden al coste económico de la medicación. Diseño. Estudio descriptivo, transversal. Emplazamiento. Atención primaria. Participantes. Se seleccionó una muestra de 231 pacientes entre todas las personas mayores de 18 años que acudieron a consulta médica del centro de salud durante el año 2001.Resultados. El 60 por ciento (IC del 95 por ciento, 55,2267,42 por ciento) de los incluidos refiere haber oído hablar de los medicamentos genéricos, y la principal fuente de información son los medios de comunicación en un 78,4 por ciento (IC del 95 por ciento, 69,19-83,96 por ciento) de los casos. El 48,04 por ciento (IC del 95 por ciento, 38,04-58,16 por ciento) de los que han oído hablar de los medicamentos genéricos los ha tomado en alguna ocasión y un 32,4 por ciento (IC del 95 por ciento, 23,42-42,34 por ciento) lo hace habitualmente. Al 76,47 por ciento (IC del 95 por ciento, 67,04-84,30 por ciento) no le importó, o en su caso no le importaría, que su médico le cambiase un medicamento que toma habitualmente por un genérico; la edad media de los que no les importó es significativamente menor que la de aquellos a los que sí lo hizo. Al 50 por ciento (IC del 95 por ciento, 42,25-52,75 por ciento) de los encuestados le interesa mucho el precio de los medicamentos que les receta su médico, y este interés es mayor en los activos que en los pensionistas. El 67,6 por ciento (IC del 95 por ciento, 60,0674,61 por ciento) cree que los médicos deben intentar recetar los medicamentos más baratos siempre que sean igual de eficaces. Entre 2 medicamentos iguales pero de distinto precio, un 78,8 por ciento de los encuestados (IC del 95 por ciento, 71,91-84,70 por ciento) elegiría el más barato. Conclusiones. La mayoría de los pacientes de nuestro estudio conocen los medicamentos genéricos y no se oponen a la sustitución de un medicamento previo por un genérico. Tampoco relacionan el precio con la calidad de los medicamentos (AU)