Agenesia uterina y ovárica. una combinación inusual causante de hipogonadismo hipergonadotropo (HH)

Introduction: Hypergonadotropic Hypogonadism (HH) is the cause of delayed puberty, characterized by an intrinsic gonadal condition that interrupts the action of the hypothalamic-pituitary-gonadal axis. With a varied etiology, including genetic or acquired alterations. The association of uterine and ovarian agenesis in the same patient as the cause of HH is unusual. There are cases described in the HH literature with agenesis, dysgenesis, ovarian hypoplasia, but without uterine alteration. Case description: 12-year-old patient who consults for short stature with absence of pubertal development. Hormonal studies suffering from HH. Pelvic ultrasound and pelvic magnetic resonance imaging are requested, confirming gonadal and uterine agenesis. Management is performed with calcium supplements, estrogens as hormonal replacement to induce secondary sexual characteristics and support in your bone health. Achieve a normal final size according to your average parental size and improvement in your quality of life. Discussion: Short stature and absence of secondary sexual characteristics is a form of clinical presentation of HH. Ovarian agenesis as a cause of HH, associated with uterine agenesis in the same patient, is an unusual association, motivating the publication of the case. Conclusion: It is important to recognize HH early, in order to provide timely treatment, and thus improve quality of life.Introducción: El Hipogonadismo Hipergonadotropo (HH) es causal de pubertad retrasada, caracterizada por afección intrínseca gonadal que interrumpe la acción del eje hipotálamo – hipófisis- gonadal. Con etiología variada, incluyendo alteraciones genéticas o adquiridas. La asociación de agenesia uterina y ovárica en una misma paciente como causa de HH es insusual. Existen casos descritos en la literatura de HH con agenesia, disgenesia, e hipoplasia ovárica, pero sin alteración uterina. Descripción del caso: Paciente de 12 años que consulta por talla baja con ausencia de desarrollo puberal. Estudios hormonales que demuestran HH. Se solicita ecografía pélvica y resonancia magnética de pelvis confirmando agenesia gonadal y uterina. Se realiza manejo con suplementos de calcio, estrógenos como sustitución hormonal para inducir caracteres sexuales secundarios y apoyo en su salud ósea.  Logra una talla final normal acorde a su talla medio parental y mejoría de su calidad de vida. Discusión: La talla baja y ausencia de caracteres sexuales secundarios, es una forma de presentación clínica de HH.  La agenesia ovárica como causa de HH, asociada a agenesia uterina en una misma paciente, es una asociación inusual, motivando la publicación del caso.  Conclusión: Es importante reconocer al HH de manera temprana, con el fin de brindar un tratamiento oportuno, y así mejorar la calidad de vida

Problemática jurídica de las Comunidades de Regantes en el sigo XXI

Voy a realizar un estudio sobre las Comunidades de Regantes. El trabajo se compone de siete capítulos. En los primero realizo una breve introducción de las Comunidades, su naturaleza y régimen jurídico. A continuación, trato acerca de los diferentes tipos de comunidades que hay y como se componen todas ellas. Finalmente realizo una explicación de todos los problemas a los que se enfrentan y analizo y expongo casos reales en Aragón

Approach to the architecture and urban planning of Huelva in the VIII-VI centuries b. C.

El presente artículo tiene como propósito realizar una aproximación a la realidad arquitectónica y al fenómeno urbano desarrollado en la ciudad de Huelva entre los siglos VIII y VI a.C. Esta investigación parte de la consulta de los resultados de las diferentes intervenciones arqueológicas realizadas en lo que conocemos como la Zona Arqueológica de Huelva, destacando aquellas que han sido trascendentales para el desarrollo de esta línea de investigación. Asimismo, para enriquecer y proporcionar nuevas perspectivas al estado de la investigación, hemos propuesto el SIG como herramienta de apoyo por su capacidad para interconectar, gestionar y analizar toda la información relativa a nuestro caso de estudio. Así como un nuevo medio por el cual difundir virtualmente el patrimonio protohistórico y punto de partida para avanzar en la investigación en el futuro.The following article aims to make an approach to the reality of architectonic and to urban phenomenon developed in the city of Huelva between the 9th-6th centuries BC. This research starts from the study of every archaeological intervention done in the Archaeological Zone of Huelva (ZAP), distinguishing among the most important interventions for our line of research. Finally, to enrich and bring new perspectives to the state of the question, we have proposed the application ArcGIS, a geographic information system program, as a support tool due to its capacity to, interconnect, manage and analyze all the information related to our case study. As well as a new way to virtually disseminate historical heritage and a new point to advance in this line of research

Validación en línea de aspectos formales y corrección asistida de ejercicios en asignaturas con evaluación continua

Depto. de Sistemas Informáticos y ComputaciónFac. de InformáticaFALSEsubmitte

Wind effects on the migration routes of trans-Saharan soaring raptors: geographical, seasonal and interspecific variation.

Wind is among the most important environmental factors shaping birds' migration patterns. Birds must deal with the displacement caused by crosswinds and their behavior can vary according to different factors such as flight mode, migratory season, experience, and distance to goal areas. Here we analyze the relationship between wind and migratory movements of three raptor species which migrate by soaring-gliding flight: Egyptian vulture Neophron percnopterus , booted eagle Aquila pennata , and short-toed snake eagle Circaetus gallicus . We analyzed daily migratory segments (i.e., the path joining consecutive roosting locations) using data recorded by GPS satellite telemetry. Daily movements of Egyptian vultures and booted eagles were significantly affected by tailwinds during both autumn and spring migrations. In contrast, daily movements of short-toed eagles were only significantly affected by tailwinds during autumn migration. The effect of crosswinds was significant in all cases. Interestingly, Egyptian vultures and booted eagles showed latitudinal differences in their behavior: both species compensated more frequently at the onset of autumn migration and, at the end of the season when reaching their wintering areas, the proportion of drift segments was higher. In contrast, there was a higher drift at the onset of spring migration and a higher compensation at the end. Our results highlight the effect of wind patterns on the migratory routes of soaring raptors, with different outcomes in relation to species, season, and latitude, ultimately shaping the loop migration patterns that current tracking techniques are showing to be widespread in many long distance migrants

A Nephrologist Perspective on Obesity: From Kidney Injury to Clinical Management

Malaltia renal crònica; Obesitat; Trasplantament de ronyóEnfermedad renal crónica; Obesidad; Trasplante de riñónChronic kidney disease; Obesity; Kidney transplantationObesity is one of the epidemics of our era. Its prevalence is higher than 30% in the U.S. and it is estimated to increase by 50% in 2030. Obesity is associated with a higher risk of all-cause mortality and it is known to be a cause of chronic kidney disease (CKD). Typically, obesity-related glomerulopathy (ORG) is ascribed to renal hemodynamic changes that lead to hyperfiltration, albuminuria and, finally, impairment in glomerular filtration rate due to glomerulosclerosis. Though not only hemodynamics are responsible for ORG: adipokines could cause local effects on mesangial and tubular cells and podocytes promoting maladaptive responses to hyperfiltration. Furthermore, hypertension and type 2 diabetes mellitus, two conditions generally associated with obesity, are both amplifiers of obesity injury in the renal parenchyma, as well as complications of overweight. As in the native kidney, obesity is also related to worse outcomes in kidney transplantation. Despite its impact in CKD and cardiovascular morbility and mortality, therapeutic strategies to fight against obesity-related CKD were limited for decades to renin-angiotensin blockade and bariatric surgery for patients who accomplished very restrictive criteria. Last years, different drugs have been approved or are under study for the treatment of obesity. Glucagon-like peptide-1 receptor agonists are promising in obesity-related CKD since they have shown benefits in terms of losing weight in obese patients, as well as preventing the onset of macroalbuminuria and slowing the decline of eGFR in type 2 diabetes. These new families of glucose-lowering drugs are a new frontier to be crossed by nephrologists to stop obesity-related CKD progression

Genomic profiling of fungal cell wall-interfering compounds: identification of a common gene signature

[Background]: The fungal cell wall forms a compact network whose integrity is essential for cell morphology and viability. Thus, fungal cells have evolved mechanisms to elicit adequate adaptive responses when cell wall integrity (CWI) is compromised. Functional genomic approaches provide a unique opportunity to globally characterize these adaptive mechanisms. To provide a global perspective on these CWI regulatory mechanisms, we developed chemical-genomic profiling of haploid mutant budding yeast cells to systematically identify in parallel those genes required to cope with stresses interfering the cell wall by different modes of action: β-1,3 glucanase and chitinase activities (zymolyase), inhibition of β-1,3 glucan synthase (caspofungin) and binding to chitin (Congo red). [Results]: Measurement of the relative fitness of the whole collection of 4786 haploid budding yeast knock-out mutants identified 222 mutants hypersensitive to caspofungin, 154 mutants hypersensitive to zymolyase, and 446 mutants hypersensitive to Congo red. Functional profiling uncovered both common and specific requirements to cope with different cell wall damages. We identified a cluster of 43 genes highly important for the integrity of the cell wall as the common >signature of cell wall maintenance (CWM)>. This cluster was enriched in genes related to vesicular trafficking and transport, cell wall remodeling and morphogenesis, transcription and chromatin remodeling, signal transduction and RNA metabolism. Although the CWI pathway is the main MAPK pathway regulating cell wall integrity, the collaboration with other signal transduction pathways like the HOG pathway and the invasive growth pathway is also required to cope with the cell wall damage depending on the nature of the stress. Finally, 25 mutant strains showed enhanced caspofungin resistance, including 13 that had not been previously identified. Only three of them, wsc1δ, elo2δ and elo3δ, showed a significant decrease in β-1,3-glucan synthase activity. [Conclusions]: This work provides a global perspective about the mechanisms involved in cell wall stress adaptive responses and the cellular functions required for cell wall integrity. The results may be useful to uncover new potential antifungal targets and develop efficient antifungal strategies by combination of two drugs, one targeting the cell wall and the other interfering with the adaptive mechanisms.This work was supported by grants BIO2010-22146, BIO2013-48136-P (MINECO, Spain) and S2010/BMD-2414 (Comunidad de Madrid) to J.A, and grant BIO2012-35372 (MINECO, Spain) to JCR.Peer Reviewe

Search Foraging Strategies of Migratory Raptors Under Different Environmental Conditions

Several studies have shown in different organisms how their movements can be fitted to different patterns to optimize search of food resources. According to abundance and availability of resources, different strategies will be optimal, such as Lévy and Brownian random search. We analyze the movement patterns of four species of migratory raptors with different degrees of ecological specialization in diet during the breeding and wintering periods to evaluate the differences according to species and season: the Egyptian Vulture, the Short-toed Snake Eagle, the Booted Eagle, and the Red Kite. From GPS locations, we obtained a set of segments and lengths that were analyzed to verify their fitting to the functions of Lévy and Brownian strategies. Egyptian Vulture’s trajectories fitted to both patterns during the breeding period, whereas during the wintering period most trajectories fitted a Brownian pattern. In the case of the Short-toed Eagle, fit was greater to a Lévy strategy throughout the year, while Booted Eagles and Red Kites exhibited a combination of search patterns. These differences could be accounted for different feeding strategies and environmental context over the annual cycle. In species with a specialized diet (i.e., Short-toed Eagle) the Lévy pattern would maximize the encounters with scarce and unpredictable resources, whereas for species with a broad trophic niche (i.e., Booted Eagle and Red Kite), movements could be adapted to exploit different resources according to their abundance. Scavengers like the Egyptian Vulture shift also between search strategies according to the distribution of carrion. Therefore, the analysis of food search patterns can be used as an indirect indicator to track changes in food availability across a broad range of environmental conditions. This is particularly important under the current context of global change which is largely expected to affect migratory species that spend their vital cycle in distant areas.Tracking of Booted Eagles and Red Kites has been made within the “Migra” program (www.migraciondeaves.org/en/) developed by SEO/BirdLife and financed by Fundación Iberdrola España. The Basque Government and the Biodiversity Foundation financed the tagging of several Red Kites in Spain. Tracking of Italian individuals was funded by Gallipoli Cognato Piccole Dolomiti Lucane Regional Park (Italy). Servicio de Vida Silvestre (Generalitat Valenciana) and different local governments funded part of the tagging. JV-M was supported by a FPU grant of Spanish Ministry of Education (reference FPU014/04671)

Metamorfoseando: trabajando el currículum de forma transversal en educación primaria a través de las mariposas

El uso de insectos vivos en las aulas es un recurso que, a pesar de presentar grandes beneficios educativos en el proceso de enseñanza-aprendizaje, resulta relativamente inexplorado en las aulas de centros educativos españoles. El presente trabajo presenta una secuencia didáctica, enmarcada en el currículo del cuarto curso de Educación Primaria, la cual gira alrededor de la temática delas mariposas. Además de las actividades principales, que se centran en el uso de mariposas vivas, también se ofrecen actividades complementarias, tales como un cuento interactivo, un timeline del ciclo de la mariposa y la instalación de un jardín de mariposas. Todas estas actividades muestran cómo, gracias al uso de un recurso educativo que está al alcance de todos, se puede dotar ala práctica docente de un enfoque más transversal

Acute kidney injury in patients treated with immune checkpoint inhibitors

Antígeno CTLA-4; InmunoterapiaAntigen CTLA-4; ImmunoteràpiaCTLA-4 antigen; ImmunotherapyBackground Immune checkpoint inhibitor-associated acute kidney injury (ICPi-AKI) has emerged as an important toxicity among patients with cancer. Methods We collected data on 429 patients with ICPi-AKI and 429 control patients who received ICPis contemporaneously but who did not develop ICPi-AKI from 30 sites in 10 countries. Multivariable logistic regression was used to identify predictors of ICPi-AKI and its recovery. A multivariable Cox model was used to estimate the effect of ICPi rechallenge versus no rechallenge on survival following ICPi-AKI. Results ICPi-AKI occurred at a median of 16 weeks (IQR 8–32) following ICPi initiation. Lower baseline estimated glomerular filtration rate, proton pump inhibitor (PPI) use, and extrarenal immune-related adverse events (irAEs) were each associated with a higher risk of ICPi-AKI. Acute tubulointerstitial nephritis was the most common lesion on kidney biopsy (125/151 biopsied patients [82.7%]). Renal recovery occurred in 276 patients (64.3%) at a median of 7 weeks (IQR 3–10) following ICPi-AKI. Treatment with corticosteroids within 14 days following ICPi-AKI diagnosis was associated with higher odds of renal recovery (adjusted OR 2.64; 95% CI 1.58 to 4.41). Among patients treated with corticosteroids, early initiation of corticosteroids (within 3 days of ICPi-AKI) was associated with a higher odds of renal recovery compared with later initiation (more than 3 days following ICPi-AKI) (adjusted OR 2.09; 95% CI 1.16 to 3.79). Of 121 patients rechallenged, 20 (16.5%) developed recurrent ICPi-AKI. There was no difference in survival among patients rechallenged versus those not rechallenged following ICPi-AKI. Conclusions Patients who developed ICPi-AKI were more likely to have impaired renal function at baseline, use a PPI, and have extrarenal irAEs. Two-thirds of patients had renal recovery following ICPi-AKI. Treatment with corticosteroids was associated with improved renal recovery.The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors