Postoperatorio del paciente pediátrico trasplantado renal

El trasplante renal es la modalidad de tratamiento sustitutivo que mejores resultados proporciona a niños afectos de insuficiencia renal crónica terminal, aunque no está exenta de una importante morbilidad y mortalidad. Se describen el protocolo para el postoperatorio adoptado en nuestro centro: monitorazación y soporte, variantes inmunopresoras, exploraciones complementarias, y las diversas complicaciones que pueden aparecer después del trasplante

Trasplantament renal pediàtric: experiència a l'Hospital Clínic de Barcelona

Resum Introducció. Amb la introducció de la ciclosporina A, el pronòstic dels trasplantaments d'òrgans ha variat radicalment. En aquest estudi es revisa el trasplantament renal pediàtrica des del punt de vista d'una UCIP centrada en la problemática postoperatória i en els resultats finals. Material i mètodes. Es revisen 27 trasplantaments renals que es van fer entre el 1986 i el 1994, la gran majoria entre els 10 i els 14 anys, amb un rang de 4 a 20 anys. Resultats. Quant a l'etiologia de la IRC: 8 casos de malformació quística, 6 de quadres amb patologia intersticial, 4 heredofamiliars i glomerulars i els 5 restants sistèmics o congènits. Tres quartes parts deis pacients (el 78%) ja estaven en diàlisi. Es va detectar risc immunológic elevat (presència l'anticossos limfocitotóxics o retrasplantacions) en el 38%. En l'evolució postoperatória immediata destaquen com a complicacions: un cas de trombosi renal i dos esclats renals; a curt termini es va detectar un rebuig en 16 casos i necrosi tubular aguda en 5, i van necessitar diàlisi el 18% del total. Als 5 anys la supervivència de l'empelt va ser del 78% i la del pacient del 100%. Conclusions. Comparant aquestes darreres dades amb registres similars nacionals, europeus i americans, s'han obtingut uns resultats equiparables

Reproductive strategies of common dentex Dentex dentex: management implications

The common dentex Dentex dentex is an iconic endangered species in the Mediterranean, where it is a target species that is sought after for small-scale, recreational and spearfishing fisheries. The reproductive biology of D. dentex in the natural environ¬ment is poorly known; therefore, the reproductive strategy of the species was assessed through a combination of reproductive traits and growth characteristics (estimated from length-at-age data), the size/age of sexual maturity and the energetic dynamics. A total of 358 wild fish, ranging in total length (LT) from 19 to 84.7 cm, was sampled at Mallorca Island (Western Mediterranean) from March 1996 to June 1999. The sex ratio was skewed towards females (1.361); however, the length composition was not different between sexes (p = 0.551). Three young immature individuals (< 28 cm LT, 0.8% individuals) were rudimentary hermaphrodites, offering support for classification as a late gonochoristic species. The age composition, determined based on the sagittal otolith, ranged from 0 to 26 years (yr). The von Bertalanffy growth function did not differ between sexes (F = 2.58, p = 0.762): L∞ =76.581 cm, K = 0.127 yr-1, t0 = -2.335 in a combined function. The maturity ogives for size and age showed that females achieved 50% maturity at 34.922 cm LT and 3.3 yr, and males, at 33.812 cm LT and 2.5 yrs. The onset of annual ripening took place in December, whereas vitellogenesis occurred from February to April. The spawning peak was in April and May for both males and females. A generalised linear model (GLM) showed that female size did not significantly affect the spawning season, whilst the seasonal component affected both the onset and end of spawning (GLM, p < 0.005). The gonadosomatic index (IG), hepatosomatic index (IH) and relative condition index (KR) varied significantly with the reproductive season for females, and IG varied for males. The microscopic observation of the gonads showed that fecundity is likely determinate, with an asynchronous oocyte development before spawning and a clear ovarian bimodal organization after the onset of spawning. The oocyte density variance of 85% was explained by the oocyte diameter, which also offered support for the trait of determinate fecundity. Female weight explained 84% of the observed variance for fecundity. Liver storage seemed to be the primary source of energy for maturity, which suggests a combination of capital and income breeding. The results suggested a reproductive strategy of type A, with balanced trade-offs be¬tween survival, growth and reproduction. At present, no management measures are being directed to D. dentex; herein, we suggest a minimum landing size of 35 cm LT to ensure a higher proportion of larger fish to preserve the stockVersión del editor0,568

Intermittent rivers and ephemeral streams: what water managers need to know

Peer reviewe

Knowing the past to improve the future: Estimating historical fishing catches to improve fisheries management in the Western Mediterranean Sea

We developed for the first time the commercial fishing catches reconstruction of the Balearic Islands (Western Mediterranean) between 1950 and 2010, by adding non-reported components, including unreported landings and discards, to the official reported landing data. To back‑estimate historical unreported landings and discards, collaboration and information acquired from fishermen were essential, as gathered through interviews and observer programs of the Spanish Oceanographic Institute (IEO) on board commercial bottom trawling fleet. We estimated a total catch of 511,500 t over the period 1950‑2010, of which official landings represented 49% (around 248,000 t), followed by unreported catches (32%) and discards (20%). A decrease in unreported catches was observed during the period 1950-2010 (from 58% to 38%) due to a reduction of unreported landings, but substantial efforts are still required to improve the recordings of actual fishing catches. This work contributes to the global assessment of fisheries removals led by the Sea Around Us and aims to provide the basis for an improved management of the Balearic Islands and Mediterranean Sea fisheries

Critical Elements in Supergene Phosphates: The Example of the Weathering Profile at the Gavà Neolithic Mines, Catalonia, Spain

The essential role of Critical Elements (CE) in 21st century economy has led to an increasing demand of these metals and promotes the exploration of non-conventional deposits such as weathering profiles. The present work is focused on the study of a weathering profile located at the Archaeological Park of the Gavà Neolithic Mines, Barcelona, Catalonia, Spain. In the Gavà deposit, acid and oxidising meteoric fluids generated intense weathering during the early Pleistocene, affecting series of Llandoverian black shales and associated syn-sedimentary phosphates. The circulation of these acid fluids at deeper levels of the profile generated supergene vein-like mineralisations comprised of secondary phosphates (e.g., variscite, perhamite, crandallite, phosphosiderite) and sulphates (e.g., jarosite, alunite). This supergene mineralisation is significantly enriched in certain CE (e.g., Ga, Sc, REE, In, Co and Sb) that were mobilised from host rock components and later hosted in the crystal lattice of supergene minerals. Weathering processes and corresponding supergene enrichment of CE at the Gavà deposit could be used as an example to determine exploration guidelines of CE in weathering profiles and associated supergene phosphates worldwide

Cognitive impairment induced by delta9-tetrahydrocannabinol occurs through heteromers between cannabinoid CB1 and serotonin 5-HT2A receptors

Delta-9-tetrahydrocannabinol (THC), the main psychoactive compound of marijuana, induces numerous undesirable effects, including memory impairments, anxiety, and dependence. Conversely, THC also has potentially therapeutic effects, including analgesia, muscle relaxation, and neuroprotection. However, the mechanisms that dissociate these responses are still not known. Using mice lacking the serotonin receptor 5-HT2A, we revealed that the analgesic and amnesic effects of THC are independent of each other: while amnesia induced by THC disappears in the mutant mice, THC can still promote analgesia in these animals. In subsequent molecular studies, we showed that in specific brain regions involved in memory formation, the receptors for THC and the 5-HT2A receptors work together by physically interacting with each other. Experimentally interfering with this interaction prevented the memory deficits induced by THC, but not its analgesic properties. Our results highlight a novel mechanism by which the beneficial analgesic properties of THC can be dissociated from its cognitive side effects

Uridine Metabolism in HIV-1-Infected Patients: Effect of Infection, of Antiretroviral Therapy and of HIV-1/ART-Associated Lipodystrophy Syndrome

Background Uridine has been advocated for the treatment of HIV-1/HAART-associated lipodystrophy (HALS), although its metabolism in HIV-1-infected patients is poorly understood. Methods Plasma uridine concentrations were measured in 35 controls and 221 HIV-1-infected patients and fat uridine in 15 controls and 19 patients. The diagnosis of HALS was performed following the criteria of the Lipodystrophy Severity Grading Scale. Uridine was measured by a binary gradient-elution HPLC method. Analysis of genes encoding uridine metabolizing enzymes in fat was performed with TaqMan RT-PCR. Results Median plasma uridine concentrations for HIV-1-infected patients were 3.80 µmol/l (interquartile range: 1.60), and for controls 4.60 µmol/l (IQR: 1.8) (P = 0.0009). In fat, they were of 6.0 (3.67), and 2.8 (4.65) nmol/mg of protein, respectively (P = 0.0118). Patients with a mixed HALS form had a median plasma uridine level of 4.0 (IC95%: 3.40-4.80) whereas in those with isolated lipoatrophy it was 3.25 (2.55-4.15) µmol/l/l (P = 0.0066). The expression of uridine cytidine kinase and uridine phosphorylase genes was significantly decreased in all groups of patients with respect to controls. A higher expression of the mRNAs for concentrative nucleoside transporters was found in HIV-1-infected patients with respect to healthy controls. Conclusions HIV-1 infection is associated with a decrease in plasma uridine and a shift of uridine to the adipose tissue compartment. Antiretroviral therapy was not associated with plasma uridine concentrations, but pure lipoatrophic HALS was associated with significantly lower plasma uridine concentrations

Carbon dioxide (CO2) emissions and adherence to Mediterranean diet in an adult population: the Mediterranean diet index as a pollution level index

Background Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment. Aim To assess the association between the adherence to an energy-restricted Mediterranean diet and the amount of CO2 emitted in an older adult population. Design and population Using a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary CO2 emissions in 6646 participants was assessed. Methods Food intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically CO2 emissions of each participant diet per day, using a European database. Participants were distributed in quartiles according to their estimated CO2 emissions expressed in kg/day: Q1 (= 2.80 kg CO2). Results More men than women induced higher dietary levels of CO2 emissions. Participants reporting higher consumption of vegetables, fruits, legumes, nuts, whole cereals, preferring white meat, and having less consumption of red meat were mostly emitting less kg of CO2 through diet. Participants with higher adherence to the Mediterranean Diet showed lower odds for dietary CO2 emissions: Q2 (OR 0.87; 95%CI: 0.76-1.00), Q3 (OR 0.69; 95%CI: 0.69-0.79) and Q4 (OR 0.48; 95%CI: 0.42-0.55) vs Q1 (reference). Conclusions The Mediterranean diet can be environmentally protective since the higher the adherence to the Mediterranean diet, the lower total dietary CO2 emissions. Mediterranean Diet index may be used as a pollution level index

The Effect of Physical Activity and High Body Mass Index on Health-Related Quality of Life in Individuals with Metabolic Syndrome

[EN] The main objective of this study was to examine the relationship between the level of physical activity (PA) and the degree of obesity with health-related quality of life (HRQoL) in individuals with metabolic syndrome (MetS) who participated in the Predimed-Plus study. A total of 6875 subjects between 55 and 75 years of age with MetS were selected and randomized in 23 Spanish centers. Subjects were classified according to categories of body mass index (BMI). PA was measured with the validated Registre Gironi del Cor (REGICOR) questionnaire and subjects were classified according to their PA level (light, moderate, vigorous) and the HRQoL was measured with the validated short-form 36 (SF-36) questionnaire. By using the ANOVA model, we found a positive and statistically significant association between the level of PA and the HRQoL (aggregated physical and mental dimensions p < 0.001), but a negative association with higher BMI in aggregated physical dimensions p < 0.001. Furthermore, women obtained lower scores compared with men, more five points in all fields of SF-36. Therefore, it is essential to promote PA and body weight control from primary care consultations to improve HRQoL, paying special attention to the differences that sex incurs.SIThe Predimed-Plus trial was supported by the Spanish government’s official funding agency for biomedical research, ISCIII, through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (three coordinated FIS projects led by Jordi Salas-Salvadó and Josep Vidal, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/0147, PI14/00636, PI14/00972, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01,332), the Special Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-PLUS grant to Jordi Salas-Salvadó, the European Research Council (Advanced Research Grant 2013–2018; 340918) grant to Miguel Ángel Martínez-Gonzalez, the Recercaixa grant to Jordi Salas-Salvadó (2013ACUP00194), grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013; PS0358/2016; PI0137/2018), the PROMETEO/2017/017 grant from the Generalitat Valenciana, the SEMERGEN grant and FEDER funds (CB06/03 and CB12/03), Olga Castaner is funded by the JR17/00,022 grant, ISCIII. Christopher Papandreou is supported by a postdoctoral fellowship granted by the Autonomous Government of Catalonia (PERIS 2016–2020 Incorporació de Científics i Tecnòlegs, SLT002/0016/00,428). María Rosa Bernal-Lopez was supported by “Miguel Servet Type I” program (CP15/00028) from the ISCIII-Madrid (Spain), cofinanced by the Fondo Europeo de Desarrollo Regional-FEDER, Ignacio M.Giménez-Alba is supported by a FPU predoctoral contract (reference FPU18/01703) from the Ministerio de Ciencia, Innovación y Universidades, Spain