Estudio sobre la prevalencia de expresión del pd-l1 en las Células Neoplásicas en nuestros pacientes sometidos a EBUS-TBNA / Study on the prevalence of pd-l1 expression in neoplastic cells in our patients undergoing EBUS-TBNA

El Cáncer de pulmón es la primera causa mundial de muertepor Cáncer. La inmunoterapia con anticuerpos monoclonales antiPD-L1 ha supuesto un avance en su tratamiento. En nuestro estudiose ha revisado la prevalencia de este receptor en las muestrasobtenidas mediante aspiración con aguja transbronquial guiada porecobroncoscopia (EBUS-TBNA). (AU)

Lung cancer is the world's leading cause of death from cancer.Immunotherapy with anti-PD-L1 monoclonal antibodies hasrepresented an advance in its treatment. In our study, we reviewedthe prevalence of this receptor in samples obtained by ultrasoundguided transbronchial needle aspiration (EBUS-TBNA). (AU)

Seudotumor inflamatorio y tumor miofibroblástico inflamatorio. Criterios diagnósticos y diferencias pronósticas / Inflammatory pseudotumor and myofibroblastic inflammatory tumor. Diagnostic criteria and prognostic differences

Introducción El seudotumor inflamatorio (PTI) y el tumor miofibroblástico inflamatorio (TMI) son 2 entidades muy poco frecuentes que se incluían antiguamente en la misma categoría; sin embargo, en la actualidad se consideran 2 enfermedades diferentes debido al origen neoplásico del TMI. Nuestro objetivo es compartir nuestra experiencia en el manejo de estos 2 tipos de lesiones que debemos tener en cuenta en el diagnóstico diferencial de masas o nódulos pulmonares. Métodos Fueron estudiados retrospectivamente 13 pacientes con diagnóstico anatomopatológico de PTI o TMI, intervenidos entre los años 2008 y 2019. Registramos la información pre y postoperatoria de cada uno, así como el análisis de supervivencia. Resultados De los 13 pacientes, 8 eran varones y 5 mujeres. La media de edad de presentación fue de 53,5 años. En 6 pacientes se practicó una segmentectomía atípica, en 6 fue necesario realizar una lobectomía y en un caso una neumonectomía. En todos los casos se consiguió una resección completa. El diagnóstico fue posible gracias a la histología, técnicas de inmunohistoquímica (IHQ) y de hibridación fluorescente in situ (FISH) determinando la expresión de IgG4 y el reordenamiento de ALK, respectivamente. Tras una mediana de seguimiento de 49 meses no se observaron datos de recidiva locorregional ni a distancia en los pacientes estudiados. Conclusión El PTI y el TMI son tumores poco frecuentes con muy buen pronóstico. El diagnóstico de ambas entidades se basa principalmente en técnicas anatomopatológicas específicas. La cirugía tiene, en la mayor parte de las ocasiones, un papel tanto diagnóstico como terapéutico (AU)

Introduction Inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) are two very rare entities that were formerly included in the same category; however, today they are considered two different diseases due to the neoplastic origin of the IMT. Our objective is to share our experience in the management of these two types of tumors that we must take into account in the differential diagnosis of pulmonary masses or nodules. Methods Thirteen patients with a pathological diagnosis of IPT and IMT who underwent surgery between 2008 and 2019 were retrospectively studied. We recorded the pre and postoperative information of each one, as well as the survival analysis. Results Of the 13 patients, 8 were men and 5 women. The mean age of presentation was 53,5 years. An atypical segmentectomy was performed in 6 patients; a lobectomy was necessary in 6 and a pneumonectomy in 1 case. In all cases a complete resection was achieved. Diagnosis was possible thanks to histology, immunohistochemical (IHQ) and fluorescent in situ hybridization (FISH) techniques determining the expression of IgG4 and the rearrangement of ALK, respectively. After a median follow up of 49 months, we didńt find any loco-regional or distant recurrence in the patients studied. Conclusion IPT and IMT are rare tumors with a very good prognostic. The diagnosis of both entities is based mainly on specific anatomopathological techniques. Surgery has, in most cases, both a diagnostic and therapeutic role (AU)

Carcinoma microcítico pulmonar con afectación intramedular como primera manifestación clínica / Microcitic pulmonary carcinoma with intramedular affection as the first clinical manifestation

Las metástasis intramedulares son generalmente raras y se asocian a enfermedad neoplásica avanzada. Dentro de ellas, las más frecuentes son el carcinoma no microcítico de pulmón, el cáncer de mama y el melanoma. Además es poco habitual que se trate de la primera manifestación de la enfermedad. Debido a la sintomatología tan aguda que presentan estas lesiones, es importante realizar el diagnóstico diferencial con la compresión medular. Ambas entidades producen una sintomatología muy similar, siendo la debilidad la manifestación más frecuente. A continuación, presentamos un caso clínico de metástasis intramedular como primera manifestación de una neoplasia pulmonar (AU)

Intramedullary metastases are generally rare and are associated with advanced neoplastic disease. Among them, the most frequent are non-small cell lung carcinoma, breast cancer and melanoma. It is also unusual that it is the first manifestation of the disease. Due to the acute symptoms that these lesions present, it is important to perform a differential diagnosis with spinal cord compression. Both entities produce very similar symptoms, with weakness being the most frequent manifestation. Next, we present a clinical case of intramedullary metastasis as the first manifestation of a lung neoplasm (AU)

Geographic patterns of stress in insular lizards reveal anthropogenic and climatic signatures.

Anthropization of insular ecosystems may have negative impacts on native populations of lizards, which provide core ecosystem services on islands. We aimed to identify environmental factors to explain the interlocal variation in faecal glucocorticoids, parasite intensity, and body condition in populations of insular lizards. A cross-sectional design during the summer of 2017 and 2018 was used to sample 611 adult lizards, Gallotia galloti. Interlocal variation of three stress indicators was analysed in response to environmental variables across a wide environmental gradient in Tenerife (Canary Islands): (i) concentration of faecal glucocorticoids, (ii) intensities of infection by hematic parasites, and (iii) body condition. The data, with low spatial autocorrelation, were analysed using multimodel inference and model cross-validation. Bioclimatic variables associated with the extreme hot and dry climate of summer were the most informative predictors. Interlocal variation in faecal corticosterone in males was best fitted to a model that included the maximum temperature of the warmest month, although the best predictor was habitat anthropization. The thermal annual range, associated with extreme thermal events, was positively related to faecal corticosterone in females. Extreme hot temperatures were positively related to the median parasite intensities in both sexes, while the highest mean intensities of infection were found in females from the most xeric coastal localities. None of the predictors tested, including faecal glucocorticoids, explained individual or interlocal variation in body condition. Effects of human pressure and climate change on insular populations of lizards can be additive. However, the uncoupled relationship found between body condition and the faecal glucocorticoid content suggests that current negative effects may be aggravated during drought periods in summer. Given the impact of climate change on islands, our results may be of application to other archipelagos, where lizards also play key ecological roles.

The importance of integrative approaches in nematode taxonomy: the validity of Parapharyngodon and Thelandros as distinct genera.

Despite the advances of molecular tools, new nematode species are still described mainly based on morphological characters. Parapharyngodon and Thelandros are two genera of oxyurids with unclear related taxonomic histories. Here we use morphological characters (linear measurements and categorical variables) and genetic information (18S rRNA, 28S rRNA and COI partial gene sequences) to confirm the relationships between representatives of these two genera and to determine whether they can be discriminated morphologically. Genetic results confirm the existence of two main clades, mostly congruent with Parapharyngodon and Thelandros genera but with several discordances. Thelandros is polyphyletic, with two of the species analysed (T. filiformis and T. tinerfensis) being part of the Thelandros clade, but with a third one (T. galloti) falling within the Parapharyngodon clade. Regarding the Parapharyngodon clade, P. cubensis, P. scleratus and Parapharyngodon sp. from Mexico form congruent lineages, while most P. echinatus samples cluster in another group, with one exception. Interestingly, P. micipsae samples are scattered across the Parapharyngodon clade, suggesting that they were misidentified or rather represent alternative morphotypes of other species. Morphological analysis identified the length of the tail, number of caudal papillae, position of the nerve ring, presence of caudal alae and length of the lateral alae as reliable characters to distinguish between Parapharyngodon and Thelandros genetic clades. Our study highlights the current taxonomic inconsistency in these groups, mainly derived from the exclusive use of morphological data. As such, we advocate for the routine implementation of molecular data in nematode taxonomic studies.

The intestinal helminth community of the spiny-tailed lizard Darevskia rudis (Squamata, Lacertidae) from northern Turkey.

Populations of the lizard Darevskia rudis (Bedriaga, 1886) from northern Anatolia were examined for intestinal parasites in adult specimens. One cestode, Nematotaenia tarentolae López-Neyra, 1944 and four nematode species, Spauligodon saxicolae Sharpilo, 1962, Skrjabinelazia hoffmanni Li, 1934, Oswaldocruzia filiformis (Goeze, 1782) and Strongyloides darevskyi Sharpilo, 1976, were found. Three of these nematodes, S. saxicolae, S. hoffmanni and S. darevskyi are suggested to be part of a module in the network of Darevskia spp. and their parasites. Only one, S. darevskyi, was identified as a Darevskia spp. specialist. The very low infection and diversity parameters are indicative of the depauperate helminth communities found in this lacertid lizard, falling among the lowest within the Palaearctic saurians. Nevertheless these values are higher than those found in parthenogenetic Darevskia spp. Interpopulation variation in the intensity of S. saxicolae and N. tarentolae is attributable to local changes in ecological conditions. On the other hand, parasite abundance and richness increased in the warmer localities, while the effect of lizard sex and size on infection was negligible. The structure of these helminth communities in D. rudis are compared with those observed in other European lacertid lizards.

Ecophysiology Tracks Phylogeny and Meets Ecological Models in an Iberian Gecko.

Because fitness of ectotherms, including reptiles, is highly dependent on temperature and water availability, the study of ecophysiological traits, such as preferred temperature (T p) and water loss rates (WLRs), may provide mechanistic evidence on the restricting factors to the species ranges. The Moorish gecko, Tarentola mauritanica, is a species complex with a circum-Mediterranean distribution. In the Iberian Peninsula, two sister parapatric forms of the complex, known as the Iberian and the European clades, are found. Ecological models previously performed using presence records and bioclimatic variables suggest niche divergence between both lineages correlated with precipitation rather than with temperature. In this study, we test this correlative hypothesis using ecophysiological evidence. In the laboratory, we analyzed the T p and WLRs for 84 adult males from seven distinct populations ascribed to one of the two lineages present in Iberia. Specifically, we evaluated the existence of trait conservatism versus adaptation among populations, lineages, or both. In addition, we tested for a trade-off between water and thermal traits and assessed whether climate regime of sampling localities had any influence on the ecophysiological patterns found. We found that T p is quite conserved at both the population and lineage levels and independent from body size. In contrast, water loss experiments revealed some variation among populations, but the regression analysis failed to detect correlation between T p and WLR at any level. Overall, the European lineage displayed a trend for higher water loss and was more diverse among populations when compared with the Iberian lineage. The lack of correspondence between ecophysiological traits and local climatic conditions favors phylogenetic signal versus adaptation. This suggests divergent evolutionary responses to the environment, mainly acting on water ecology, in both lineages, which may account for the differences in their range expansion.

Geographic variation of life-history traits in the sand lizard, Lacerta agilis: testing Darwin's fecundity-advantage hypothesis.

The fecundity-advantage hypothesis (FAH) explains larger female size relative to male size as a correlated response to fecundity selection. We explored FAH by investigating geographic variation in female reproductive output and its relation to sexual size dimorphism (SSD) in Lacerta agilis, an oviparous lizard occupying a major part of temperate Eurasia. We analysed how sex-specific body size and SSD are associated with two putative indicators of fecundity selection intensity (clutch size and the slope of the clutch size-female size relationship) and with two climatic variables throughout the species range and across two widespread evolutionary lineages. Variation within the lineages provides no support for FAH. In contrast, the divergence between the lineages is in line with FAH: the lineage with consistently female-biased SSD (L. a. agilis) exhibits higher clutch size and steeper fecundity slope than the lineage with an inconsistent and variable SSD (L. a. exigua). L. a. agilis shows lower offspring size (egg mass, hatchling mass) and higher clutch mass relative to female mass than L. a. exigua, that is both possible ways to enhance offspring number are exerted. As the SSD difference is due to male size (smaller males in L. a. agilis), fecundity selection favouring larger females, together with viability selection for smaller size in both sexes, would explain the female-biased SSD and reproductive characteristics of L. a. agilis. The pattern of intraspecific life-history divergence in L. agilis is strikingly similar to that between oviparous and viviparous populations of a related species Zootoca vivipara. Evolutionary implications of this parallelism are discussed.

Ecomorphological variation in male and female wall lizards and the macroevolution of sexual dimorphism in relation to habitat use.

Understanding how phenotypic diversity evolves is a major interest of evolutionary biology. Habitat use is an important factor in the evolution of phenotypic diversity of many animal species. Interestingly, male and female phenotypes have been frequently shown to respond differently to environmental variation. At the macroevolutionary level, this difference between the sexes is frequently analysed using phylogenetic comparative tools to assess variation in sexual dimorphism (SD) across taxa in relation to habitat. A shortcoming of such analyses is that they evaluate the degree of dimorphism itself and therefore they do not provide access to the evolutionary trajectories of each sex. As such, the relative contribution of male and female phenotypes on macroevolutionary patterns of sexual dimorphism cannot be directly assessed. Here, we investigate how habitat use shapes phenotypic diversity in wall lizards using phylogenetic comparative tools to simultaneously assess the tempo and mode of evolution in males, females and the degree of sexual dimorphism. We find that both sexes have globally diversified under similar, but not identical, processes, where habitat use seems to drive macroevolutionary variation in head shape, but not in body size or relative limb length. However, we also observe small differences in the evolutionary dynamics of male and female phenotypes that have a marked impact on macroevolutionary patterns of SD, with important implications for our interpretation of what drives phenotypic diversification within and between the sexes.

Evolution of alternative male morphotypes in oxyurid nematodes: a case of convergence?

Male dimorphism has been reported across different taxa and is usually expressed as the coexistence of a larger morph with exaggerated male traits and a smaller one with reduced traits. The evolution and maintenance of male dimorphism are still poorly understood for several of the species in which it has been observed. Here, we analyse male dimorphism in several species of reptile parasitic nematodes of the genus Spauligodon, in which a major male morph (exaggerated morph), which presents the traditional male morphological traits reported for this taxon, coexists with a minor morph with reduced morphological traits (i.e. reduced genital papillae) resembling more closely the males of the sister genus Skrjabinodon than Spauligodon major males. Because of the level of uncertainty in the results of ancestral state reconstruction, it is unclear if the existence of male dimorphism in this group represents independent instances of convergent evolution or an ancestral trait lost multiple times. Also, although the number of major males per host was positively correlated with the number of females, the same did not hold true for minor males, whose presence was not associated with any other ecological factor. Nevertheless, the existence of male dimorphism in Spauligodon nematodes is tentatively interpreted as resulting from alternative reproductive tactics, with differences in presence and number of individuals as indicators of differences in fitness, with the lower numbers of minor males per host likely maintained by negative frequency-dependent selection.

[Assessment of nutritional status of patients candidates for lung resection by 2 methods]. / Valoración del estado nutricional de pacientes candidatos a resección pulmonar por 2 métodos.

INTRODUCTION: It is important to determine the nutritional status of an individual that may be submitted to a surgical intervention since it has been shown a relationship between nutritional status impairments and the incidence of complications. We present the data from a study comparing two nutritional assessment methods. OBJECTIVE: To study the rate of hyponutrition in patients candidates to lung resection in southern Galicia, and to determine if there were significant differences in the use of 2 different nutritional assessment methods. PATIENTS AND METHODS: 200 patients participated in this study: 144 males (aged 29-83 years) and 56 females (aged 20-80 years). All of them were assessed for their nutritional status according to Chang's method and we also performed a patient-generated global subjective assessment (PG-GSA) according to the SENBA working group protocol. RESULTS: There is agreement between the 2 methods in assessing 122 patients as having "good nutritional status". There are two cases with agreement between both methods in the diagnosis of "moderate hyponutrition or risk for hyponutrition". No case of "severe hyponutrition" is diagnosed by the Chang's method. CONCLUSIONS: We found statistically significant differences between the observations obtained with the two methods. The Chang's method performed more accurately than the PG-GSA, so that we believe it should be the first choice method for the preoperative nutritional assessment of patients candidate to a lung resection.

The helminth community of the skink Chalcides sexlineatus from Gran Canaria (Canary Islands).

A survey of the gastrointestinal helminth communities of a population of Chalcides sexlineatus Steindachner, a small skink endemic to Gran Canaria island (Canary Archipelago, Spain), was conducted to determine the prevalence, abundance and species diversity of intestinal parasites in these reptiles. Only three parasite species were found, one cestode, Oochoristica agamae Baylis, 1919 and two nematodes, Parapharyngodon micipsae (Seurat, 1917) and Pharyngodonidae gen. sp. Helminth infracommunities of C. sexlineatus showed low values of abundance and species richness and diversity, being more similar to the helminth community of Tarentola boettgeri boettgeri (Steindachner) rather than those of Gallotia stehlini (Schenkel), both syntopic with the sampled host.

Conflicting patterns of nucleotide diversity between mtDNA and nDNA in the Moorish gecko, Tarentola mauritanica.

The gecko Tarentola mauritanica is a Mediterranean species that is widely distributed across southern Europe and North Africa. Initial phylogeographic studies based on mtDNA concluded that the European populations originated from recent colonizations from North Africa, possibly involving man-mediated introductions. A distinct lineage, found to be a sister taxon to the widespread European lineage, was subsequently reported from parts of the Iberian Peninsula. Like many gecko species, T. mauritanica contains several deep intraspecific genetic lineages within North Africa. However, in contrast to this diversity, a single mtDNA haplotype is widespread across a large part of its European range. In this work, we analysed a total of 834 base pairs from two mtDNA genes (12SrRNA and 16SrRNA) for 154 specimens, and a total of 1876bp from three nuclear genes (ACM4, MC1R and Rag2) for 51 specimens to test the phylogenetic and phylogeographic patterns proposed for T. mauritanica based on mtDNA sequences. The mtDNA results reveal a Moroccan lineage basal to the common "European" haplotype, thus suggesting that the latter probably originated in Morocco. The remaining lineages obtained are the same as those observed in previous studies. In contrast, the nDNA data do not support the majority of the mtDNA phylogenetic relationships, possibly due to incomplete lineage sorting of these markers. Moreover, the mtDNA data suggest that the Iberian clade seems to have undergone a population expansion. Surprisingly, the European clade presents a higher nucleotide diversity for the nuclear genes when compared to the combined mtDNA dataset. These analyses suggest that the low mtDNA variability that characterises the European populations of T. mauritanica is the result of a selective sweep process and not solely due to a recent colonization event.

Intraspecific ecomorphological variation: linear and geometric morphometrics reveal habitat-related patterns within Podarcis bocagei wall lizards.

Morphological variation in relation to habitat is known to occur in several lizard groups. Comparative studies have linked morphology and habitat use, showing that locomotion is the principal mediator of this evolutionary relationship. Here, we investigate intraspecific ecomorphological variation in Podarcis bocagei by examining three habitat types, representing a variety between saxicolous and ground-dwelling habits. Our results indicate variation in absolute and relative limb length, but patterns are only partially concordant to biomechanical predictions. Whereas the femur and hind foot are longer in ground-dwelling lizards, confirming previous observations, the tibia and hind limb are relatively shorter, contradicting expectations. Additionally, head shape varies substantially between habitats, in line with a hypothesis of mechanical restrictions related to microhabitat and refuge use. Finally, we detect male-specific variation between habitats in total body size and head size, providing evidence for interactions between natural and sexual selection. Although performance and behaviour studies are necessary to definitely confirm the functional and evolutionary significance of the observed patterns, our study indicates that ecomorphological adaptations can arise in a very short evolutionary time in this group of lizards.

[Pericardial effusion as the only first clinical manifestation of systemic lupus erythematosus]. / Derrame pericárdico como manifestación clínica única de lupus eritematoso sistémico.

Pericarditis is the most frequent cardiac manifestation of systemic lupus erythematosus (SLE), but pericardial effusion rarely occurs as the only first clinical manifestation of SLE. We report the case of a male patient whose initial manifestation of lupus was a pericardial effusion. We comment on its clinical course and we reviewed in the medical literature different presenting features in SLE.

Derrame pericárdico como manifestación clínica única de lupus eritematoso sistémico / Pericardial effusion as the only first clinical manifestation of systemic lupus erythematosus

La afectación del pericardio es la manifestación cardíaca más frecuente del lupus eritematoso sistémico (LES). Sin embargo, es infrecuente que el derrame pericárdico sea la forma de presentación del LES. Describimos el caso de un paciente varón con LES que debutó clínicamente con derrame pericárdico, comentamos su curso clínico y revisamos en la bibliografía médica distintas formas de presentación del LES

Pericarditis is the most frequent cardiac manifestation of systemic lupus erythematosus (SLE), but pericardial effusion rarely occurs as the only first clinical manifestation of SLE. We report the case of a male patient whose initial manifestation of lupus was a pericardial effusion. We comment on its clinical course and we reviewed in the medical literature different presenting features in SLE

Relationship between diet and helminths in Gallotia caesaris (Sauria: Lacertidae).

Diet and helminth fauna were analysed in Gallotia caesaris, a small lacertid lizard endemic to El Hierro (Canary Islands, Spain) in order to study the evolutionary and functional relationships between the two traits. This species is omnivorous but consumed a high proportion (82.13%) of plant matter including not only seeds but also leaves and other vegetative parts. Helminth fauna included many helminth species typical of herbivorous reptiles. Both herbivory and helminth presence were higher than expected for a lizard of its size. Comparison with other lacertids suggests that both traits result from an adaptation to insular conditions but that some "evolutionary time" to develop them is needed. Canarian Gallotia lizards, a separate lineage evolving for a long time in insularity, constitutes the most advanced lacertid group in this way. Nevertheless, results for G. caesaris indicate that helminth fauna also changes seasonally tracking variation in diet (and herbivory) throughout the year, which suggests a dynamic interaction between diet and helminth parasites.

Absceso frío de pared torácica 58 años después de una toracoplastia / Cold abscess of the chest wall 58 years after thoracoplasty

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