Thoracic outlet syndrome. Clinical case

Introducción: el caso que se presenta a continuación es el de una mujer de 26 años que acude a consulta refiriendo algias en la región cervicotorácica que se irradia hacia el 4º y 5º dedo de la mano derecha junto con parestesias, desde hace aproximadamente un mes. La paciente tomaba AINES y relajantes musculares. Objetivos: Comprobar si los diferentes test de provocación que se utilizan en el SST, junto a una buena exploración pueden guiarnos para saber donde se ve comprometido el paquete vasculonervioso y comprobar la efectividad en un caso clínico de las diferentes técnicas de terapia manual para el SST. Material y métodos: para el caso clínico se realizó una búsqueda documental en diferentes bases de datos. Posteriormente se realizó una anamnesis y una exploración global y luego analítica acorde a la sospecha de un SST. Tras esta se realizó un protocolo de tratamiento acordes a los objetivos marcados resultantes de la exploración. Resultados: la paciente asistió a cuatro sesiones con recuperación total y habiéndose encontrado mejoría en la segunda sesión y casi desaparición del problema con la tercera. Discusión: el diagnóstico diferencial no es sencillo y en muchas ocasiones hay que descartar patologías que nos pueden inducir en un error de diagnóstico de un posible SST. Además esta patología constituye una de las más frecuentemente producidas en el ámbito laboral, prevaleciendo mucho más en mujeres que en hombres, siendo el porcentaje de tres a uno. Conclusión: una buena anamnesis del paciente junto con una buena exploración mediante test generales y específicos de la patología que se sospecha nos puede guiar a un diagnostico fisioterápico suficiente para poder abarcar una posible solución al problema. Una vez localizados el o los focos donde se ve comprometido el paquete vasculonerviosos, podemos diseñar un plan terapéutico a través de la terapia manual cuya efectividad puede llevarnos a la solución del problema.Terapia y Rehabilitació

Estudio del estado ecológico de los ríos de la cuenca hidrográfica del Júcar (España) mediante el índice BMWP'

El diseño de la Red Biológica, basado en el uso de indicadores hidromorfológicos, físico-químicos y biológicos, permitió realizar un diagnóstico de calidad en 221 puntos de muestreo en 104 ríos de la red hidrográfica del Júcar (Júcar, Turia, Mijares, Vinalopó, Palancia, Serpis y cuencas menores) durante el año 2000 y establecer su estado ecológico. En este trabajo se presentan los resultados obtenidos con el índice BMWP'. Los ríos con un estado ecológico muy bueno se hallan situados en los tramos altos, tanto de los ríos principales como de los afluentes de primer y segundo orden. La mayoría de los puntos de referencia (12.7%) se encuentran en altitudes superiores a los 800 m. Los ríos situados en altitudes medias (800-200 m) se hallan muy regulados y presentan, en general, un estado entre bueno y aceptable, existiendo pocos puntos de referencia (6.8%). Por último, los ríos situados en tierras bajas (< 200 m) se encuentran, la gran mayoría, en un estado deficiente o malo, siendo muy difícil hallar ríos en buen estado y casi imposible establecer puntos de referencia con un muy buen estado ecológico (0.5%). Las medidas correctoras propuestas para los ríos de la red hidrográfica del Júcar se centran en la mejora de las características hidromorfológicas y físico-químicas, y por tanto de las comunidades biológicas, con el propósito final de conseguir el mejor estado ecológico y químico posible para las aguas superficiales tal y como exige la DMA (Directiva Marco del Agua).The design of the Biological Network, based on the use of hydromorphological, physical, chemical, and biological indicators, allowed a diagnosis of the quality in 221 sampling points in 104 rivers of Júcar's Basin (Jucar, Turia, Mijares, Vinalopo, Palancia, Serpis and small basins) to be carried out during the year 2000 and to establish its ecological status. In this work the results obtained with the BMWP' index are presented. The rivers with a high ecological status are located in the high altitudes, so much of the main rivers as of the tributaries of first and second order. Most of the reference points (12.7%) are located at altitudes higher than 800 m. The rivers located at middle-altitudes (800-200 m) are very regulated and they present, in general, an ecological status between good and acceptable, with few reference points (6.8%). Last, the rivers located in lowlands (< 200 m) are, mostly, in a poor or bad ecological state, making it very difficult to find rivers in good ecological status and almost impossible to establish reference points with a high ecological status (0.5%). The correcting measures proposed for the rivers of the Júcar's Basin are centered in the improvement of the hydromorphological, physical, and chemical characteristics, and therefore of the biological communities, with the final purpose of achieving the highest ecological and chemical status possible for surface waters like the WFD (Water Framework Directive) demands

Synthesis, pharmacological and structural characterization of novel conopressins from Conus miliaris

Cone snails produce a fast-acting and often paralyzing venom, largely dominated by disulfide-rich conotoxins targeting ion channels. Although disulfide-poor conopeptides are usually minor components of cone snail venoms, their ability to target key membrane receptors such as GPCRs make them highly valuable as drug lead compounds. From the venom gland transcriptome of Conus miliaris, we report here on the discovery and characterization of two conopressins, which are nonapeptide ligands of the vasopressin/oxytocin receptor family. These novel sequence variants show unusual features, including a charge inversion at the critical position 8, with an aspartate instead of a highly conserved lysine or arginine residue. Both the amidated and acid C-terminal analogues were synthesized, followed by pharmacological characterization on human and zebrafish receptors and structural investigation by NMR. Whereas conopressin-M1 showed weak and only partial agonist activity at hV1bR (amidated form only) and ZFV1a1R (both amidated and acid form), both conopressin-M2 analogues acted as full agonists at the ZFV2 receptor with low micromolar a�nity. Together with the NMR structures of amidated conopressins-M1, -M2 and -G, this study provides novel structure-activity relationship information that may help in the design of more selective ligands

Acute stress response in gilthead sea bream (Sparus aurata L.) is time-of-day dependent: Physiological and oxidative stress indicators

Since fish show daily rhythms in most physiological functions, it should not be surprising that stressors may have different effects depending on the timing of exposure. In this study, we investigated the influence of time of day on the stress responses, at both physiological and cellular levels, in gilthead sea bream (Sparus aurataL.) submitted to air exposure for 30 s and then returned to their tank. One hour after air exposure, blood, hypothalamus and liver samples were taken. Six fish per experimental group (control and stressed) were sampled every 4 h during a 24-h cycle. Fish were fed in the middle of the light cycle (ML) and locomotor activity rhythms were recorded using infrared photocells to determine their daily activity pattern of behaviour, which showed a peak around feeding time in all fish. In the control group, cortisol levels did not show daily rhythmicity, whereas in the stressed fish, a daily rhythm of plasma cortisol was observed, being the average values higher than in the control group, with increased differences during the dark phase. Blood glucose showed daily rhythmicity in the control group but not in the stressed one which also showed higher values at all sampling points. In the hypothalamus of control fish, a daily rhythm ofcorticotropin-releasing hormone(crh) gene expression was observed, with the acrophase at the beginning of the light phase. However, in the stressed fish, this rhythm was abolished. The expression ofcrh-binding protein(crhbp) showed a peak at the end of the dark phase in the control group, whereas in the stressed sea bream, this peak was found at ML. Regarding hepatic gene expression of oxidative stress biomarkers: (i)cytochrome c oxidase 4showed daily rhythmicity in both control and stressed fish, with the acrophases located around ML, (ii)peroxiredoxin(prdx) 3 and5(prdx5) only presented daily rhythmicity of expression in the stressed fish, with the acrophase located at the beginning of the light cycle and (iii)uncoupling protein 1showed significant differences between sampling points only in the control group, with significantly higher expression at the beginning of the dark phase. Taken together, these results indicate that stress response in gilthead sea bream is time-dependent as cortisol level rose higher at night, and that different rhythmic mechanisms interplay in the control of neuroendocrine and cellular stress responses

Associative Conditioning Is a Robust Systemic Behavior in Unicellular Organisms: An Interspecies Comparison

The capacity to learn new efficient systemic behavior is a fundamental issue of contemporary biology. We have recently observed, in a preliminary analysis, the emergence of conditioned behavior in some individual amoebae cells. In these experiments, cells were able to acquire new migratory patterns and remember them for long periods of their cellular cycle, forgetting them later on. Here, following a similar conceptual framework of Pavlov’s experiments, we have exhaustively studied the migration trajectories of more than 2000 individual cells belonging to three different species: Amoeba proteus, Metamoeba leningradensis, and Amoeba borokensis. Fundamentally, we have analyzed several relevant properties of conditioned cells, such as the intensity of the responses, the directionality persistence, the total distance traveled, the directionality ratio, the average speed, and the persistence times. We have observed that cells belonging to these three species can modify the systemic response to a specific stimulus by associative conditioning. Our main analysis shows that such new behavior is very robust and presents a similar structure of migration patterns in the three species, which was characterized by the presence of conditioning for long periods, remarkable straightness in their trajectories and strong directional persistence. Our experimental and quantitative results, compared with other studies on complex cellular responses in bacteria, protozoa, fungus-like organisms and metazoans that we discus here, allow us to conclude that cellular associative conditioning might be a widespread characteristic of unicellular organisms. This new systemic behavior could be essential to understand some key principles involved in increasing the cellular adaptive fitness to microenvironments.This work was supported by a grant of the University of Basque Country (UPV/EHU), GIU17/066, the Basque Government grant IT974-16, the UPV/EHU and Basque Center of Applied Mathematics, grant US18/21, and the Israel Science Foundation (536/19)Peer reviewe

ICAM-1 nanoclusters regulate hepatic epithelial cell polarity by leukocyte adhesion-independent control of apical actomyosin

Epithelial intercellular adhesion molecule (ICAM)-1 is apically polarized, interacts with, and guides leukocytes across epithelial barriers. Polarized hepatic epithelia organize their apical membrane domain into bile canaliculi and ducts, which are not accessible to circulating immune cells but that nevertheless confine most of ICAM-1. Here, by analyzing ICAM-1_KO human hepatic cells, liver organoids from ICAM-1_KO mice and rescue-of-function experiments, we show that ICAM-1 regulates epithelial apicobasal polarity in a leukocyte adhesion-independent manner. ICAM-1 signals to an actomyosin network at the base of canalicular microvilli, thereby controlling the dynamics and size of bile canalicular-like structures. We identified the scaffolding protein EBP50/NHERF1/ SLC9A3R1, which connects membrane proteins with the underlying actin cytoskeleton, in the proximity interactome of ICAM-1. EBP50 and ICAM-1 form nano-scale domains that overlap in microvilli, from which ICAM-1 regulates EBP50 nano-organization. Indeed, EBP50 expression is required for ICAM-1-mediated control of BC morphogenesis and actomyosin. Our findings indicate that ICAM-1 regulates the dynamics of epithelial apical membrane domains beyond its role as a heterotypic cell– cell adhesion molecule and reveal potential therapeutic strategies for preserving epithelial architecture during inflammatory stress

Genomic transformation and social organization during the Copper Age-Bronze Age transition in southern Iberia

The emerging Bronze Age (BA) of southeastern Iberia saw marked social changes. Late Copper Age (CA) settlements were abandoned in favor of hilltop sites, and collective graves were largely replaced by single or double burials with often distinctive grave goods indirectly reflecting a hierarchical social organization, as exemplified by the BA El Argar group. We explored this transition from a genomic viewpoint by tripling the amount of data available for this period. Concomitant with the rise of El Argar starting ~2200 cal BCE, we observe a complete turnover of Y-chromosome lineages along with the arrival of steppe-related ancestry. This pattern is consistent with a founder effect in male lineages, supported by our finding that males shared more relatives at sites than females. However, simple two-source models do not find support in some El Argar groups, suggesting additional genetic contributions from the Mediterranean that could predate the BA

Obstructive sleep apnea severity is associated with left ventricular mass independent of other cardiovascular risk factors in morbid obesity

OBJECTIVE: To evaluate the relation between obstructive sleep apnea (OSA) and left ventricular mass (LVM) in morbid obesity and the influence of gender, menopausal status, anthropometry, body composition, hypertension, and other cardiovascular risk factors in this relationship. DESIGN: Cross-sectional descriptive study. METHODS: Polysomnographic and echocardiographic studies were performed in a cohort of 242 patients (86 men, 100 premenopausal (PreM) and 56 postmenopausal (PostM) women), with grade II obesity and above (BMI: 43.7 ± 0.4 kg/m(2)) to investigate OSA and LVM respectively. Anthropometry, body composition, glucose tolerance, and blood pressure were also recorded. RESULTS: OSA to different degrees was diagnosed in 76.2% of the patients (n: 166), its prevalence being 90.9% (n: 70) for men, and 76% (n: 38) and 63.8% (n: 58) for PostM and PreM women, respectively (p < 0.01). LVM excess was greatest for PostM women (90.2%), followed by men (81.9%) and PreM females (69.6%) (p < 0.01). LVM values increased in accordance to OSA severity (absence, 193.7 ± 6.9 g; mild, 192.6 ± 7.8 g; moderate, 240.5 ± 12.5 g; severe, 273.6 ± 14.6 g; p < 0.01). LVM magnitude correlated with the menopausal state, age, central adiposity, hypertension (HT), type 2 diabetes (DM), desaturation index (DI), and apnea-hypopnea index (AHI) (r = 0.41; p < 0.01). The relationship between LVM and AHI persisted in the multivariate analysis (β = 0.25; p < 0.05) after adjusting for age, gender, menopausal state, BMI, waist circumference, neck circumference, DI, fasting plasma glucose, DM, and HT. But if tobacco habits are included, the statistical difference disappears (β = 0.22; p = 0.06). CONCLUSIONS: Morbid obesity is frequently associated with abnormal LVM, particularly in patients with OSA; this association is independent of HT, BMI, body composition, and other clinical factors, supporting a direct role of OSA on LVM in morbid obesity. This suggests that OSA and LVM might be taken as predictors of the cardiovascular risk in these patients. KEYWORDS: Sleep apnea; apnea-hypopnea index; left ventricular mass; morbid obesit

ICAM-1 nanoclusters regulate hepatic epithelial cell polarity by leukocyte adhesion-independent control of apical actomyosin

Epithelial intercellular adhesion molecule (ICAM)-1 is apically polarized, interacts with, and guides leukocytes across epithelial barriers. Polarized hepatic epithelia organize their apical membrane domain into bile canaliculi and ducts, which are not accessible to circulating immune cells but that nevertheless confine most of ICAM-1. Here, by analyzing ICAM-1_KO human hepatic cells, liver organoids from ICAM-1_KO mice and rescue-of-function experiments, we show that ICAM-1 regulates epithelial apicobasal polarity in a leukocyte adhesion-independent manner. ICAM-1 signals to an actomyosin network at the base of canalicular microvilli, thereby controlling the dynamics and size of bile canalicular-like structures. We identified the scaffolding protein EBP50/NHERF1/SLC9A3R1, which connects membrane proteins with the underlying actin cytoskeleton, in the proximity interactome of ICAM-1. EBP50 and ICAM-1 form nano-scale domains that overlap in microvilli, from which ICAM-1 regulates EBP50 nano-organization. Indeed, EBP50 expression is required for ICAM-1-mediated control of BC morphogenesis and actomyosin. Our findings indicate that ICAM-1 regulates the dynamics of epithelial apical membrane domains beyond its role as a heterotypic cell–cell adhesion molecule and reveal potential therapeutic strategies for preserving epithelial architecture during inflammatory stress