Intervención nutricional en el paciente oncohematológico

Background: Oncohematological diseases such as lymphoma or leukaemia affect an increasing number of newly diagnosed patients in Spain and other countries. Both disease and treatment may have a negatively impact in the nutritional status of the patient. Malnutrition is not uncommon among oncohematological patients. This situation can compromised the course of the disease, the clinical response of the treatment and the patient’s quality of life. Method: The implementation of a multidisciplinary approach and a systematic and protocolled nutritional assessment would be useful when dealing with haematological malignancies. Results: We present a proposal of protocol for nutritional intervention in oncohematological patients. This proposal is been developed from the analysis of the published literature as well as clinical practice of a multidisciplinary team specialized in the management of patients with haematological malignanciesObjetivos: Las enfermedades oncohematológicas como el Linfoma o la Leucemia afectan a un número importante y creciente de personas en España. Tanto la enfermedad como las distintas modalidades de tratamiento que puede llegar a precisar el paciente a lo largo del curso de la misma impactan negativamente en el estado nutricional del paciente, no siendo infrecuente el desarrollo de desnutrición, situación que compromete la evolución, la respuesta al tratamiento y la calidad de vida del paciente. Método: La implementación de una estrategia multidisciplinar, sistematizada y protocolizada de valoración nutricional puede resultar de utilidad a la hora de abordar a los pacientes con enfermedades oncohematológicas. Resultados: Se presenta una propuesta de protocolo de evaluación y soporte nutricional en el paciente oncohematológico elaborada a partir del análisis de la literatura publicada al respecto, así como de la práctica clínica habitual de un equipo sanitario multidisciplinar especialmente implicado en el manejo de los pacientes con enfermedades oncohematológica

GeoloGuías-BioloGuías: an University Complutense of Madrid website for learning and dissemination of Natural Science through self-guided tours

El sitio GeoloGuías-BioloGuías (www.geologuias-biologuias.org) nace de un proyecto de innovación de la Universidad Complutense de Madrid y se estrena este verano. Es un espacio web dedicado a la divulgación y la formación en Ciencias Naturales a partir de actividades sobre el terreno y autoguiadas mediante dispositivos GPS; nos proponemos incluir actividades en campo, ciudad, yacimientos, espacios protegidos, etc. En la página GeoloGuías-BioloGuías usted puede encontrar o publicar guías de tres categorías: 1. Turismo Natural, para disfrutar de la Geología y la Biología para el aficionado a estas ciencias o para enriquecer los viajes. 2. Educación en Ciencias Naturales, para profesores de Ciencias Naturales de Educación Primaria y Secundaria. 3. Saber sobre la Naturaleza para profundizar: textos para profundizar en los avances recientes, guías para realizar experimentos, etc. Todas las publicaciones de las dos primeras categorías contienen un textoguía y uno o varios archivos de orientación y navegación (al menos uno en el. formato universal de intercambio *.gpx). Las publicaciones de la categoría 3 están abiertas a las ideas de los autores.The site GeoloGuías-BioloGuías (www.geologuias-biologuias.org) premieres this summer and derives from an innovation project of the Universidad Complutense de Madrid. It is a website dedicated to dissemination and training in Natural Sciences based on field activities self-guided by GPS devices – country, city, sites, protected areas, etc. In GeoloGuías-BioloGuías you can find three categories of guides, or publish your own guides: 1. Natural tourism –to enjoy geology and biology for the science enthusiast or to enrich these trips. 2. Natural Science Education –Natural Science for Teachers of Primary and Secondary Education. 3. Knowledge About Nature –texts to deepen into recent advances, guides to preform experiments, etc. All publications of categories 1 and 2 have the same structure: A text guide and on or several navigation files. Guides in category 3 can adopt other structures

Terapia de neuromodulación periférica PENS (Peripheral electrical nerve stimulation) como tratamiento del dolor crónico refractario de origen neuropático en adultos: evaluación de la seguridad, la eficacia, la efectividad clínica y el coste-efectividad

Teràpia de neuromodulació perifèrica; Dolor crònic; NeuropatiaTerapia de neuromodulación periférica; Dolor crónico; NeuropatíaPeripheral neuromodulation therapy; Chronic pain; NeuropathyL’objectiu d’aquest informe és avaluar la seguretat, l’eficàcia, l’efectivitat clínica i el cost-efectivitat de la PENS com a teràpia coadjuvant per a tractar el DN perifèric crònic refractari en adults, en comparació amb el tractament habitual farmacològic o altres tècniques de neuroestimulació. També s’estableix com a objectiu definir els criteris de selecció de pacients que podrien beneficiar-se de la tècnica i indicacions de tractament.El objetivo del presente informe es el de evaluar la seguridad, la eficacia, la efectividad clínica y el coste-efectividad de la PENS como terapia coadyuvante para tratar el DN periférico crónico refractario en adultos, en comparación con el tratamiento habitual farmacológico u otras técnicas de neuroestimulación. También se establece como objetivo definir los criterios de selección de pacientes que podrían beneficiarse de la técnica e indicaciones de tratamiento.The aim of this report is to evaluate the safety, efficacy, clinical effectiveness and cost-effectiveness of PENS as an adjunctive therapy for the treatment of chronic refractory peripheral NP in adults, compared with standard pharmacological treatment or other neurostimulation techniques. It also aims to define the selection criteria for patients who may benefit from the technique and the indications for treatment

High Cysteinyl Leukotriene Receptor 1 Expression Correlates with Poor Survival of Uveal Melanoma Patients and Cognate Antagonist Drugs Modulate the Growth, Cancer Secretome, and Metabolism of Uveal Melanoma Cells

Simple Summary This research investigates the disease relevance and therapeutic potential of cysteinyl leukotriene receptors in uveal melanoma (UM), a rare eye cancer that often spreads to the liver. Unfortunately, there are no therapies available to stop the spread of UM and patients are often faced with an extremely poor prognosis. We assess whether the cysteinyl leukotriene receptors (CysLT(1) and CysLT(2)) are relevant to the progression of UM. Using UM patient samples, we identified that increased levels of CysLT(1) in tumours is associated with reduced patient survival. Using UM cell lines and zebrafish models, we found that drugs targeting CysLT(1), but not CysLT(2), can alter hallmarks of cancer including cell growth, proliferation, and metabolism. This study is the first to examine the relationship of the CysLT receptors with clinical features of UM. Our data strengthen the importance of CysLT signalling in UM and suggest that antagonism of CysLT(1) may be of therapeutic interest in the disease. Metastatic uveal melanoma (UM) is a rare, but often lethal, form of ocular cancer arising from melanocytes within the uveal tract. UM has a high propensity to spread hematogenously to the liver, with up to 50% of patients developing liver metastases. Unfortunately, once liver metastasis occurs, patient prognosis is extremely poor with as few as 8% of patients surviving beyond two years. There are no standard-of-care therapies available for the treatment of metastatic UM, hence it is a clinical area of urgent unmet need. Here, the clinical relevance and therapeutic potential of cysteinyl leukotriene receptors (CysLT(1) and CysLT(2)) in UM was evaluated. High expression of CYSLTR1 or CYSLTR2 transcripts is significantly associated with poor disease-free survival and poor overall survival in UM patients. Digital pathology analysis identified that high expression of CysLT(1) in primary UM is associated with reduced disease-specific survival (p = 0.012; HR 2.76; 95% CI 1.21-6.3) and overall survival (p = 0.011; HR 1.46; 95% CI 0.67-3.17). High CysLT(1) expression shows a statistically significant (p = 0.041) correlation with ciliary body involvement, a poor prognostic indicator in UM. Small molecule drugs targeting CysLT(1) were vastly superior at exerting anti-cancer phenotypes in UM cell lines and zebrafish xenografts than drugs targeting CysLT(2). Quininib, a selective CysLT(1) antagonist(,) significantly inhibits survival (p < 0.0001), long-term proliferation (p < 0.0001), and oxidative phosphorylation (p < 0.001), but not glycolysis, in primary and metastatic UM cell lines. Quininib exerts opposing effects on the secretion of inflammatory markers in primary versus metastatic UM cell lines. Quininib significantly downregulated IL-2 and IL-6 in Mel285 cells (p < 0.05) but significantly upregulated IL-10, IL-1 beta, IL-2 (p < 0.0001), IL-13, IL-8 (p < 0.001), IL-12p70 and IL-6 (p < 0.05) in OMM2.5 cells. Finally, quininib significantly inhibits tumour growth in orthotopic zebrafish xenograft models of UM. These preclinical data suggest that antagonism of CysLT(1), but not CysLT(2), may be of therapeutic interest in the treatment of UM

A facility to Search for Hidden Particles (SHiP) at the CERN SPS

A new general purpose fixed target facility is proposed at the CERN SPS accelerator which is aimed at exploring the domain of hidden particles and make measurements with tau neutrinos. Hidden particles are predicted by a large number of models beyond the Standard Model. The high intensity of the SPS 400~GeV beam allows probing a wide variety of models containing light long-lived exotic particles with masses below ${\cal O}$(10)~GeV/c$^2$, including very weakly interacting low-energy SUSY states. The experimental programme of the proposed facility is capable of being extended in the future, e.g. to include direct searches for Dark Matter and Lepton Flavour Violation.Comment: Technical Proposa

Concurrent sampling of transitional and coastal waters by Diffusive Gradient in Thin-films (DGT) and spot sampling for trace metals analysis

This protocol was developed based on the knowledge acquired in the framework of the Interreg MONITOOL project (EAPA_565/2016) where extensive sampling campaigns were performed in transitional and coastal waters covering eight European countries. It provides detailed procedures and guidelines for the sampling of these waterbodies by concurrent collection of discrete water samples and the deployment of Diffusive Gradient in Thin-films (DGT) passive samplers for the measurement of trace metal concentrations. In order to facilitate the application of this protocol by end-users, it presents steps to follow in the laboratory prior to sampling campaigns, explains the procedures for field campaigns (including in situ measurement of supporting parameters) and subsequent sample processing in the laboratory in preparation for trace metal analyze by inductively coupled plasma-mass spectrometry (ICP-MS) and voltammetry. The protocol provides a systematic, coherent field sampling and sample preparation strategy that was developed in order to ensure comparability and reproducibility of the data obtained from each project Partner in different regions. • Standardization of the concurrent sampling of transitional and coastal waters by DGT passive samplers and spot sampling. • Robust procedures and tips based on existing international standards and comprehensive practical experience. • Links to demonstration videos produced within the MONITOOL project

Assessing variability in the ratio of metal concentrations measured by DGT-type passive samplers and spot sampling in European seawaters

The current study evaluates the effect of seawater physico-chemical characteristics on the relationship between the concentration of metals measured by Diffusive Gradients in Thin films (DGT) passive samplers (i.e., DGT-labile concentration) and the concentrations measured in discrete water samples. Accordingly, Inductively Coupled Plasma Mass Spectrometry (ICP-MS) was used to measure the total dissolved metal concentrations in the discrete water samples and the labile metal concentrations obtained by DGT samplers; additionally, lead and cadmium conditional labile fractions were determined by Anodic Stripping Voltammetry (ASV) and total dissolved nickel was measured by Cathodic Stripping Voltammetry (CSV). It can be concluded that, in general, the median ratios of DGT/ICP and DGT/ASV(CSV) were lower than 1, except for Ni (median ratio close to 1) and Zn (higher than 1). This indicates the importance of speciation and time-integrated concentrations measured using passive sampling techniques, which is in line with the WFD suggestions for improving the chemical assessment of waterbodies. It is the variability in metal content in waters rather than environmental conditions to which the variability of the ratios can be attributed. The ratios were not significantly affected by the temperature, salinity, pH, oxygen, DOC or SPM, giving a great confidence for all the techniques used. Within a regulatory context such as the EU Water Framework Directive this is a great advantage, since the simplicity of not needing to use corrections to minimize the effects of environmental variables could help in implementing DGTs within monitoring networks

Environmental effects of a marine fish farm of gilthead seabream (Sparus aurata) in the NW Mediterranean Sea on water column and sediment

This study examined the effects of organic enrichment on water column, sediments and macrofauna caused by a fish farm in the Mediterranean Sea. Samples were collected on four sampling campaigns over a one-year cycle. Significant differences were found in the water column in dissolved oxygen, dissolved inorganic nitrogen, phosphate and total phosphorus concentrations between the fish farm and the control. The increase in the dissolved inorganic nitrogen and phosphate concentrations at the fish farm modified the stoichiometric ratios between nutrients, with silicate acting as limiting nutrient at the fish farm 11% more than at the control. Nevertheless, chlorophyll a concentration in the water column was higher at the control station, probably due to the fouling of the underwater fish farm structures. Significant differences were found in sediment concentrations of organic matter, total phosphorus and redox potential between the fish farm and the control. The Canonical Correlation Analysis indicated that organic matter, total phosphorus, redox potential and% of gravels accounted for 68.9% of the total variance in the species data. Changes were observed in macrofauna, with a decrease in number of species and up to a nine-fold increase in abundance with respect to the control. © 2013 Blackwell Publishing Ltd.We would like to thank the Caja del Mediterraneo (CAM) for a pre-doctoral fellowship fund for this research and Antonio Asuncion Acuigroup Maremar Manager, for the facilities and support in conducting the study. The translation of this paper was funded by the Universidad Politecnica de Valencia, Spain.Morata Higón, T.; Falco Giaccaglia, SL.; Gadea, I.; Sospedra Ciscar, J.; Rodilla Alamá, M. (2013). Environmental effects of a marine fish farm of gilthead seabream (Sparus aurata) in the NW Mediterranean Sea on water column and sediment. Aquaculture Research. 1-16. https://doi.org/10.1111/are.12159S116Aguado F. 2001 Impacto ambiental de los sistemas piscícolas marinos: la acuicultura en jaulas flotantes. Series de química oceanográfica 35 83Aguado-Giménez, F., & García-García, B. (2004). Assessment of some chemical parameters in marine sediments exposed to offshore cage fish farming influence: a pilot study. Aquaculture, 242(1-4), 283-295. doi:10.1016/j.aquaculture.2004.08.035Aksu M. Kocatas A. 2007 Environmental effects of the three fish farms in Izmir Bay (Aegean Sea-Turkey) on water column and sediment 414Asociación Empresarial de Productores de Cultivos Marinos (APROMAR) 2011 La Acuicultura Marina de Peces en España 77Banta, G., Holmer, M., Jensen, M., & Kristensen, E. (1999). Effects of two polychaete worms, Nereis diversicolor and Arenicola marina, on aerobic and anaerobic decomposition in a sandy marine sediment. Aquatic Microbial Ecology, 19, 189-204. doi:10.3354/ame019189Borja, Á., Rodríguez, J. G., Black, K., Bodoy, A., Emblow, C., Fernandes, T. F., … Angel, D. (2009). Assessing the suitability of a range of benthic indices in the evaluation of environmental impact of fin and shellfish aquaculture located in sites across Europe. Aquaculture, 293(3-4), 231-240. doi:10.1016/j.aquaculture.2009.04.037Braeckman, U., Provoost, P., Gribsholt, B., Van Gansbeke, D., Middelburg, J., Soetaert, K., … Vanaverbeke, J. (2010). Role of macrofauna functional traits and density in biogeochemical fluxes and bioturbation. Marine Ecology Progress Series, 399, 173-186. doi:10.3354/meps08336Chou, C. L., Haya, K., Paon, L. A., Burridge, L., & Moffatt, J. D. (2002). Aquaculture-related trace metals in sediments and lobsters and relevance to environmental monitoring program ratings for near-field effects. Marine Pollution Bulletin, 44(11), 1259-1268. doi:10.1016/s0025-326x(02)00219-9Christensen, P., Rysgaard, S., Sloth, N., Dalsgaard, T., & Schwærter, S. (2000). Sediment mineralization, nutrient fluxes, denitrification and dissimilatory nitrate reduction to ammonium in an estuarine fjord with sea cage trout farms. Aquatic Microbial Ecology, 21, 73-84. doi:10.3354/ame021073Chung, I.-K., Kang, Y.-H., Yarish, C., George, P. K., & Lee, J.-A. (2002). Application of Seaweed Cultivation to the Bioremediation of Nutrient-Rich Effluent. ALGAE, 17(3), 187-194. doi:10.4490/algae.2002.17.3.187Cromey, C. J., Nickell, T. D., & Black, K. D. (2002). DEPOMOD—modelling the deposition and biological effects of waste solids from marine cage farms. Aquaculture, 214(1-4), 211-239. doi:10.1016/s0044-8486(02)00368-xCugier, P., Struski, C., Blanchard, M., Mazurié, J., Pouvreau, S., Olivier, F., … Thiébaut, E. (2010). Assessing the role of benthic filter feeders on phytoplankton production in a shellfish farming site: Mont Saint Michel Bay, France. Journal of Marine Systems, 82(1-2), 21-34. doi:10.1016/j.jmarsys.2010.02.013Davies, I. M., McHenery, J. G., & Rae, G. H. (1997). Environmental risk from dissolved ivermectin to marine organisms. Aquaculture, 158(3-4), 263-275. doi:10.1016/s0044-8486(97)00209-3Dean, R. J., Shimmield, T. M., & Black, K. D. (2007). Copper, zinc and cadmium in marine cage fish farm sediments: An extensive survey. Environmental Pollution, 145(1), 84-95. doi:10.1016/j.envpol.2006.03.050Delgado, O., Ruiz, J., Pérez, M., Romero, J., & Ballesteros, E. (1999). Effects of fish farming on seagrass (Posidonia oceanica) in a Mediterranean bay: seagrass decline after organic loading cessation. Oceanologica Acta, 22(1), 109-117. doi:10.1016/s0399-1784(99)80037-1Dell’Anno, A., Mei, M. ., Pusceddu, A., & Danovaro, R. (2002). Assessing the trophic state and eutrophication of coastal marine systems: a new approach based on the biochemical composition of sediment organic matter. Marine Pollution Bulletin, 44(7), 611-622. doi:10.1016/s0025-326x(01)00302-2Ferrón, S., Ortega, T., & Forja, J. M. (2009). Benthic fluxes in a tidal salt marsh creek affected by fish farm activities: Río San Pedro (Bay of Cádiz, SW Spain). Marine Chemistry, 113(1-2), 50-62. doi:10.1016/j.marchem.2008.12.002Garren, M., Smriga, S., & Azam, F. (2008). Gradients of coastal fish farm effluents and their effect on coral reef microbes. Environmental Microbiology, 10(9), 2299-2312. doi:10.1111/j.1462-2920.2008.01654.xHolmer, M., & Kristensen, E. (1992). Impact of marine fish cage farming on metabolism and sulfate reduction of underlying sediments. Marine Ecology Progress Series, 80, 191-201. doi:10.3354/meps080191Holmer, M., Wildish, D., & Hargrave, B. (s. f.). Organic Enrichment from Marine Finfish Aquaculture and Effects on Sediment Biogeochemical Processes. Environmental Effects of Marine Finfish Aquaculture, 181-206. doi:10.1007/b136010Huang, Y., Hsieh, H., Huang, S., Meng, P., Chen, Y., Keshavmurthy, S., … Chen, C. (2011). Nutrient enrichment caused by marine cage culture and its influence on subtropical coral communities in turbid waters. Marine Ecology Progress Series, 423, 83-93. doi:10.3354/meps08944Johansson, O., & Wedborg, M. (1980). The ammonia-ammonium equilibrium in seawater at temperatures between 5 and 25�C. Journal of Solution Chemistry, 9(1), 37-44. doi:10.1007/bf00650135Johansson, D., Juell, J.-E., Oppedal, F., Stiansen, J.-E., & Ruohonen, K. (2007). The influence of the pycnocline and cage resistance on current flow, oxygen flux and swimming behaviour of Atlantic salmon (Salmo salar L.) in production cages. Aquaculture, 265(1-4), 271-287. doi:10.1016/j.aquaculture.2006.12.047Juell, J.-E., & Fosseidengen, J. E. (2004). Use of artificial light to control swimming depth and fish density of Atlantic salmon (Salmo salar) in production cages. Aquaculture, 233(1-4), 269-282. doi:10.1016/j.aquaculture.2003.10.026Justić, D., Rabalais, N. N., Turner, R. E., & Dortch, Q. (1995). Changes in nutrient structure of river-dominated coastal waters: stoichiometric nutrient balance and its consequences. Estuarine, Coastal and Shelf Science, 40(3), 339-356. doi:10.1016/s0272-7714(05)80014-9Karakassis, I., Tsapakis, M., & Hatziyanni, E. (1998). Seasonal variability in sediment profiles beneath fish farm cages in the Mediterranean. Marine Ecology Progress Series, 162, 243-252. doi:10.3354/meps162243Karakassis, I. (2000). Impact of cage farming of fish on the seabed in three Mediterranean coastal areas. ICES Journal of Marine Science, 57(5), 1462-1471. doi:10.1006/jmsc.2000.0925Basaran, A. K., Aksu, M., & Egemen, O. (2009). Impacts of the fish farms on the water column nutrient concentrations and accumulation of heavy metals in the sediments in the eastern Aegean Sea (Turkey). Environmental Monitoring and Assessment, 162(1-4), 439-451. doi:10.1007/s10661-009-0808-xLa Rosa, T., Mirto, S., Favaloro, E., Savona, B., Sarà, G., Danovaro, R., & Mazzola, A. (2002). Impact on the water column biogeochemistry of a Mediterranean mussel and fish farm. Water Research, 36(3), 713-721. doi:10.1016/s0043-1354(01)00274-3Maldonado, M., Carmona, M. C., Echeverría, Y., & Riesgo, A. (2005). The environmental impact of Mediterranean cage fish farms at semi-exposed locations: does it need a re-assessment? Helgoland Marine Research, 59(2), 121-135. doi:10.1007/s10152-004-0211-5Mantzavrakos, E., Kornaros, M., Lyberatos, G., & Kaspiris, P. (2007). Impacts of a marine fish farm in Argolikos Gulf (Greece) on the water column and the sediment. Desalination, 210(1-3), 110-124. doi:10.1016/j.desal.2006.05.037Martins, C. I. M., Galhardo, L., Noble, C., Damsgård, B., Spedicato, M. T., Zupa, W., … Kristiansen, T. (2011). Behavioural indicators of welfare in farmed fish. Fish Physiology and Biochemistry, 38(1), 17-41. doi:10.1007/s10695-011-9518-8Morata, T., Sospedra, J., Falco, S., & Rodilla, M. (2012). Exchange of nutrients and oxygen across the sediment–water interface below a Sparus aurata marine fish farm in the north-western Mediterranean Sea. Journal of Soils and Sediments, 12(10), 1623-1632. doi:10.1007/s11368-012-0581-2Murray L. Bulling M. Mayor D. Sanz-Lázaro C. Paton G. Killham K. Sosal M. 2008 Interactive effects of biodiversity, copper and a chemotherapeutant on marine benthic function Proceedings of the World Conference on Marine Biodiversity (MARBEF) Valencia, SpainNizzoli, D., Bartoli, M., & Viaroli, P. (2007). Oxygen and ammonium dynamics during a farming cycle of the bivalve Tapes philippinarum. Hydrobiologia, 587(1), 25-36. doi:10.1007/s10750-007-0683-9Olivos-Ortiz, A. (2002). Continental runoff of nutrients and their possible influence over stoichiometrical relations (DIN:P:Si) in the Northwest Mediterranean waters. Ciencias Marinas, 28(4), 393-406. doi:10.7773/cm.v28i4.235Olsen L.M. Holmer M. Olsen Y. 2008 Perspectives of nutrient emission from fish aquaculture in coastal waters. Literature review with evaluated state of knowledge 87Oppedal, F., Juell, J.-E., & Johansson, D. (2007). Thermo- and photoregulatory swimming behaviour of caged Atlantic salmon: Implications for photoperiod management and fish welfare. Aquaculture, 265(1-4), 70-81. doi:10.1016/j.aquaculture.2007.01.050Pinedo, S., García, M., Satta, M. P., Torres, M. de, & Ballesteros, E. (2007). Rocky-shore communities as indicators of water quality: A case study in the Northwestern Mediterranean. Marine Pollution Bulletin, 55(1-6), 126-135. doi:10.1016/j.marpolbul.2006.08.044Porrello, S., Tomassetti, P., Manzueto, L., Finoia, M. G., Persia, E., Mercatali, I., & Stipa, P. (2005). The influence of marine cages on the sediment chemistry in the Western Mediterranean Sea. Aquaculture, 249(1-4), 145-158. doi:10.1016/j.aquaculture.2005.02.042Rosenberg, R. (2001). Marine benthic faunal successional stages and related sedimentary activity. Scientia Marina, 65(S2), 107-119. doi:10.3989/scimar.2001.65s2107Sakamaki, T., Nishimura, O., & Sudo, R. (2006). Tidal time-scale variation in nutrient flux across the sediment–water interface of an estuarine tidal flat. Estuarine, Coastal and Shelf Science, 67(4), 653-663. doi:10.1016/j.ecss.2006.01.005Sanz-Lázaro, C., & Marín, A. (2011). Diversity Patterns of Benthic Macrofauna Caused by Marine Fish Farming. Diversity, 3(2), 176-199. doi:10.3390/d3020176Siokou-Frangou, I., Christaki, U., Mazzocchi, M. G., Montresor, M., Ribera d&amp;apos;Alcalá, M., Vaqué, D., & Zingone, A. (2010). Plankton in the open Mediterranean Sea: a review. Biogeosciences, 7(5), 1543-1586. doi:10.5194/bg-7-1543-2010Teasdale, P. R., Minett, A. I., Dixon, K., Lewis, T. W., & Batley, G. E. (1998). Practical improvements for redox potential (EH) measurements and the application of a multiple-electrode redox probe (MERP) for characterising sediment in situ. Analytica Chimica Acta, 367(1-3), 201-213. doi:10.1016/s0003-2670(98)00171-8Vila, M., Garcés, E., Masó, M., & Camp, J. (2001). Is the distribution of the toxic dinoflagellate Alexandrium catenella expanding along the NW Mediterranean coast? Marine Ecology Progress Series, 222, 73-83. doi:10.3354/meps222073Vita, R., & Marin, A. (2007). Environmental impact of capture-based bluefin tuna aquaculture on benthic communities in the western Mediterranean. Aquaculture Research, 38(4), 331-339. doi:10.1111/j.1365-2109.2007.01649.xWajsbrot, N., Gasith, A., Krom, M. D., & Popper, D. M. (1991). Acute toxicity of ammonia to juvenile gilthead seabream Sparus aurata under reduced oxygen levels. Aquaculture, 92, 277-288. doi:10.1016/0044-8486(91)90029-7Wu, R. S. . (2002). Hypoxia: from molecular responses to ecosystem responses. Marine Pollution Bulletin, 45(1-12), 35-45. doi:10.1016/s0025-326x(02)00061-9Yucel-Gier, G., Kucuksezgin, F., & Kocak, F. (2007). Effects of fish farming on nutrients and benthic community structure in the Eastern Aegean (Turkey). Aquaculture Research, 38(3), 256-267. doi:10.1111/j.1365-2109.2007.01661.

De-Intensification of Antidiabetic Treatment Using Canagliflozin in Patients with Heart Failure and Type 2 Diabetes: Cana-Switch-HF Study

Canagliflozin is a sodium-glucose co-transporter 2 inhibitor that reduces glycemia as well as the risk of cardiovascular events. Our main objective was to analyze antidiabetic treatment de-intensification and the glycemic efficacy of replacing antidiabetic agents (excluding metformin) with canagliflozin in patients with heart failure and type 2 diabetes with poor glycemic control. In this observational, retrospective, real-world study, we selected patients treated with metformin in combination with ≥2 non-insulin antidiabetic agents or metformin in combination with basal insulin plus ≥1 non-insulin antidiabetic agent. Non-insulin antidiabetic agents were replaced with canagliflozin. Patients were followed-up on at three, six, and 12 months after the switch and a wide range of clinical variables were recorded. A total of 121 patients were included. From baseline to 12 months, the number of antidiabetic agents (3.1 ± 1.0 vs. 2.1 ± 0.8, p < 0.05), basal insulin dose (20.1 ± 9.8 vs. 10.1 ± 6.5 units, p < 0.01), and percentage of patients who used basal insulin (47.9% vs. 31.3%, p < 0.01) decreased. The proportion of patients who used diuretics also declined significantly. In addition, we observed improvement in glycemic control, with an increase in the proportion of patients with glycated hemoglobin <7% from 16.8% at three months to 63.5% at 12 (p < 0.001). Canagliflozin use was also beneficial in terms of body weight, blood pressure, heart failure status, functional class, and cardiovascular-renal risk. There were also reductions in the number of emergency department visits and hospitalizations for heart failure. Moreover, canagliflozin was well-tolerated, with a low rate of drug-related discontinuation. Mounting evidence from randomized controlled trials and real-world studies point to the beneficial profile of sodium-glucose co-transporter type 2 inhibitors such as canagliflozin in patients with heart failure.This work was supported by PI15/00256 from the Institute of Health “Carlos III” (ISCIII), co-funded by the Fondo Europeo de Desarrollo Regional-FEDER. Maria Isabel Queipo-Ortuño was supported by the “Miguel Servet Type II” program (CPI18/00003, ISCIII, Spain, co-funded by the Fondo Europeo de Desarrollo Regional-FEDER) and by the “Nicolas Monardes” research program of the Consejería de Salud (C-0030-2018, Junta de Andalucía, Spain. Bruno Ramos Molina was supported by the “Miguel Servet Type I” program (CP19/00098, ISCIII, Spain, co-funded by the Fondo Europeo de Desarrollo Regional-FEDER). Lidia Sanchez-Alcoholado was the recipient of a predoctoral grant (PE-0106-2019) from the Consejería de Salud y Familia (co-funded by the Fondo Europeo de Desarrollo Regional-FEDER, Andalucia, Spain). Aurora Laborda-Illanes was the recipient of a predoctoral grant, PFIS-ISCIII (FI19-00112), co-funded by the Fondo Europeo de Desarrollo Regional-FEDER, Madrid, Spain.Ye