Divertículo de Kommerell: Revisión bibliográfica y presentación de un caso

El divertículo de Kommerell, resultado de una alteración en el desarrollo embriológico del arco aórtico, es una anomalía de la aorta descendente proximal presente tanto en arcos aórticos izquierdos como en derechos, de los cuales surge una arteria subclavia aberrante del lado contralateral.Generalmente asintomático, las manifestaciones más frecuentes son resultado de la compresión de estructuras vecinas, presentando un alto riesgo de disección o rotura por la presencia de necrosis en la capa media de la pared del divertículo.Para su diagnóstico, la tomografía computarizada o la resonancia magnética con contraste son las pruebas de elección. En la actualidad, no existe un consenso en el manejo del divertículo, aunque se tiende a un tratamiento agresivo y precoz para evitar complicaciones y se recomienda tratar quirúrgicamente a todo paciente sintomático o que presente un divertículo de gran tamaño. Las opciones quirúrgicas incluyen cirugía abierta, tratamiento endovascular o la combinación de las dos (tratamiento híbrido), dependiendo de la anatomía y comorbilidades del paciente y de la experiencia de los profesionales.Se presenta uno de los pocos casos con seguimiento en Zaragoza, de un paciente pluripatológico diagnosticado de forma casual en una prueba de imagen de divertículo de Kommerell. Se decidió tratamiento quirúrgico híbrido en dos tiempos, la evolución no fue la esperada y se produjo el fallecimiento en el postoperatorio de la segunda intervención.<br /

Sea level and climate changes during OIS 5e in the Western Mediterranean

Palaeontological, geomorphological and sedimentological data supported by isotopic dating on Oxygen Isotopic Stage (OIS) 5e deposits from the Spanish Mediterranean coast, are interpreted with the aim of reconstructing climatic instability in the Northern Hemisphere. Data point to marked climatic instability during the Last Interglacial (OIS 5e), with a change in meteorological conditions and, consequently, in the sedimentary environment. The oolitic facies generated during the first part of OIS 5e (ca. 135 kyr) shift into reddish conglomeratic facies during the second part (ca. 117 kyr). Sea surface Temperature (SST) and salinity are interpreted mainly on the basis of warm Senegalese fauna, which show chronological and spatial differential distribution throughout the Western Mediterranean. Present hydrological and meteorological conditions are used also as modern analogues to reconstruct climatic variability throughout the Last Interglacial, and this variability is interpreted within the wider framework of the North Atlantic record. All the available data indicate an increase in storminess induced by an increase in the influence of northwesterlies, a slight drop of SST in the northern Western Mediterranean, and an important change in meteorological conditions at the end of OIS 5e (117 kyr). These changes correlate well with the decrease in summer insolation and with the climatic instability recorded in North Atlantic high latitudes

Nuclear and Chloroplast Microsatellites Show Multiple Introductions in the Worldwide Invasion History of Common Ragweed, Ambrosia artemisiifolia

BACKGROUND: Ambrosia artemisiifolia is a North American native that has become one of the most problematic invasive plants in Europe and Asia. We studied its worldwide population genetic structure, using both nuclear and chloroplast microsatellite markers and an unprecedented large population sampling. Our goals were (i) to identify the sources of the invasive populations; (ii) to assess whether all invasive populations were founded by multiple introductions, as previously found in France; (iii) to examine how the introductions have affected the amount and structure of genetic variation in Europe; (iv) to document how the colonization of Europe proceeded; (v) to check whether populations exhibit significant heterozygote deficiencies, as previously observed. PRINCIPAL FINDINGS: We found evidence for multiple introductions of A. artemisiifolia, within regions but also within populations in most parts of its invasive range, leading to high levels of diversity. In Europe, introductions probably stem from two different regions of the native area: populations established in Central Europe appear to have originated from eastern North America, and Eastern European populations from more western North America. This may result from differential commercial exchanges between these geographic regions. Our results indicate that the expansion in Europe mostly occurred through long-distance dispersal, explaining the absence of isolation by distance and the weak influence of geography on the genetic structure in this area in contrast to the native range. Last, we detected significant heterozygote deficiencies in most populations. This may be explained by partial selfing, biparental inbreeding and/or a Wahlund effect and further investigation is warranted. CONCLUSIONS: This insight into the sources and pathways of common ragweed expansion may help to better understand its invasion success and provides baseline data for future studies on the evolutionary processes involved during range expansion in novel environments

Arbuscular mycorrhizal colonisation of roots of grass species differing in invasiveness

Recent research indicates that the soil microbial community, particularly arbuscular mycorrhizal fungi (AMF), can influence plant invasion in several ways. We tested if 1) invasive species are colonised by AMF to a lower degree than resident native species, and 2) AMF colonisation of native plants is lower in a community inhabited by an invasive species than in an uninvaded resident community. The two tests were run in semiarid temperate grasslands on grass (Poaceae) species, and the frequency and intensity of mycorrhizal colonisation, and the proportion of arbuscules and vesicles in plant roots have been measured. In the first test, grasses representing three classes of invasiveness were included: invasive species, resident species becoming abundant upon disturbance, and non-invasive native species. Each class contained one C3 and one C4 species. The AMF colonisation of the invasive Calamagrostis epigejos and Cynodon dactylon was consistently lower than that of the non-invasive native Chrysopogon gryllus and Bromus inermis, and contained fewer arbuscules than the post-disturbance dominant resident grasses Bothriochloa ischaemum and Brachypodium pinnatum. The C3 and C4 grasses behaved alike despite their displaced phenologies in these habitats. The second test compared AMF colonisation for sand grassland dominant grasses Festuca vaginata and Stipa borysthenica in stands invaded by either C. epigejos or C. dactylon, and in the uninvaded natural community. Resident grasses showed lower degree of AMF colonisation in the invaded stand compared to the uninvaded natural community with F. vaginata responding so to both invaders, while S. borysthenica responding to C. dactylon only. These results indicate that invasive grasses supposedly less reliant on AMF symbionts have the capacity of altering the soil mycorrhizal community in such a way that resident native species can establish a considerably reduced extent of the beneficial AMF associations, hence their growth, reproduction and ultimately abundance may decline. Accumulating evidence suggests that such indirect influences of invasive alien plants on resident native species mediated by AMF or other members of the soil biota is probably more the rule than the exception

Ligand substitution and conformational effects on the ultrafast luminescent decay of [Re(CO) 3 (phen)(L)] + (L = imidazole, pyridine): non-adiabatic quantum dynamics

International audienc

Epilepsia y gestación. Factores asociados con la presencia de crisis en la gestación

Resumen: Introducción: El manejo de la epilepsia durante la gestación requiere un control óptimo de las crisis, evitando los potenciales efectos teratogénicos del tratamiento antiepiléptico. Objetivos: Describir las características clínicas y los resultados perinatales de las pacientes con epilepsia gestantes. Analizar los factores que se asocian a la presencia de crisis durante la gestación. Describir los fármacos antiepilépticos más utilizados y analizar los cambios en el régimen terapéutico en dos periodos: de 2000-2010 y 2011-2018. Métodos: Se realizó un estudio prospectivo observacional de pacientes con epilepsia que notificaron su gestación en el periodo de 2000-2018. Se evaluó a las pacientes en el primer y segundo trimestre de gestación, tras el parto y al año. Se recogieron variables demográficas, relacionadas con la epilepsia, perinatales y obstétricas. Resultados: Se incluyeron 101 gestaciones. La edad media fue de 32,6 años, el 55,4% tenía una epilepsia focal, el 38,6% una epilepsia generalizada y el 5,9% indeterminada. Se registraron 90 nacidos vivos, nueve abortos espontáneos y cinco malformaciones congénitas, cuatro de ellas en monoterapia con valproato. En 40 gestaciones (39,6%) se registraron crisis, siendo tónico-clónicas generalizadas en 16 (40%). Las variables asociadas con la presencia de crisis durante el embarazo fueron el mal control el año previo a la gestación (66,7% vs. 15,1%, p < 0,001), el tratamiento con dos o más fármacos antiepilépticos (30% vs. 14,8% p < 0,001) y no recibir tratamiento (25% vs. 0% p < 0,001). Los fármacos antiepilépticos más utilizados en monoterapia fueron lamotrigina (n = 19, 27,1%), valproato (n = 17, 24,2%) y levetiracetam (n = 12, 17,1%). En el periodo más reciente (2011-2018) se encontró una mayor proporción de monoterapias (81,5% vs. 55,3%), además de un descenso en el uso de carbamazepina (23,1% vs. 2,3%) y valproato (30,8% vs. 20,5%); y un aumento marcado de levetiracetam (0% vs. 27,3%). Conclusiones: Los factores asociados con la presencia de crisis durante la gestación fueron el mal control previo, el tratamiento con dos o más fármacos antiepilépticos y la ausencia de tratamiento. Los fármacos más utilizados fueron lamotrigina, valproato y levetiracetam, con un incremento de este último y un descenso de valproato en el periodo más reciente (2011-2018). Abstract: Introduction: The management of epilepsy during pregnancy requires optimal seizure control, avoiding the potential teratogenic effects of antiepileptic drugs. Objectives: This study aims to describe the clinical characteristics and perinatal outcomes of pregnant patients with epilepsy; to analyse the factors associated with seizures during pregnancy; to describe the most commonly used antiepileptic drugs in these patients; and to analyse changes in treatment regimens in 2 periods, 2000-2010 and 2011-2018. Methods: We conducted a prospective observational study of patients with epilepsy who reported their pregnancy between 2000 and 2018. Patients were evaluated in the first and second trimesters of pregnancy, after delivery, and at one year. Data were collected on demographic variables, epilepsy, and perinatal and obstetric variables. Results: A total of 101 pregnancies were included. Patients’ mean age was 32.6 years; 55.4% had focal epilepsy, 38.6% had generalised epilepsy, and 5.9% had undetermined epilepsy. We recorded 90 live births, 9 miscarriages, and 5 cases of congenital malformations, 4 of which were born to women who received valproate monotherapy. Forty patients (39.6%) presented seizures, with 16 (40%) presenting generalised tonic-clonic seizures. The variables associated with seizures during pregnancy were poor seizure control in the year prior to pregnancy (66.7% vs. 15.1%; P < .001), treatment with 2 or more antiepileptic drugs (30% vs. 14.8%; P < .001), and untreated epilepsy (25% vs. 0%; P < .001). The antiepileptic drugs most widely used in monotherapy were lamotrigine (n = 19; 27.1%), valproate (n = 17; 24.2%), and levetiracetam (n = 12; 17.1%). In the most recent period (2011-2018), we observed a greater proportion patients receiving monotherapy (81.5%, vs. 55.3%), as well as a decrease in the use of carbamazepine (2.3%, vs. 23.1%) and valproate (20.5%, vs. 30.8%); and a marked increase in the use of levetiracetam (27.3%, vs. 0%). Conclusions: The factors associated with the presence of seizures during pregnancy were previous poor seizure control, treatment with 2 or more antiepileptic drugs, and lack of treatment during pregnancy. The most commonly used drugs were lamotrigine, valproate, and levetiracetam, with an increase in levetiracetam use and a decrease in valproate use being observed in the later period (2011-2018)