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Bennett S, Alcoverro T, Kletou D, Antoniou C, Boada J, Buñuel X, Cucala L, Jorda G, Kleitou P, Roca G, Santana‐Garcon J, Savva I, Vergés A, Marbà N. Resilience of seagrass populations to thermal stress does not reflect regional differences in ocean climate. New Phytol 2022; 233:1657-1666. [PMID: 34843111 PMCID: PMC9299911 DOI: 10.1111/nph.17885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
The prevalence of local adaptation and phenotypic plasticity among populations is critical to accurately predicting when and where climate change impacts will occur. Currently, comparisons of thermal performance between populations are untested for most marine species or overlooked by models predicting the thermal sensitivity of species to extirpation. Here we compared the ecological response and recovery of seagrass populations (Posidonia oceanica) to thermal stress throughout a year-long translocation experiment across a 2800-km gradient in ocean climate. Transplants in central and warm-edge locations experienced temperatures > 29°C, representing thermal anomalies > 5°C above long-term maxima for cool-edge populations, 1.5°C for central and < 1°C for warm-edge populations. Cool-edge, central and warm-edge populations differed in thermal performance when grown under common conditions, but patterns contrasted with expectations based on thermal geography. Cool-edge populations did not differ from warm-edge populations under common conditions and performed significantly better than central populations in growth and survival. Our findings reveal that thermal performance does not necessarily reflect the thermal geography of a species. We demonstrate that warm-edge populations can be less sensitive to thermal stress than cooler, central populations suggesting that Mediterranean seagrasses have greater resilience to warming than current paradigms suggest.
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Affiliation(s)
- Scott Bennett
- Institute for Marine and Antarctic StudiesUniversity of TasmaniaHobartTas.7001Australia
- Global Change Research GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)Miquel Marquès 21Esporles07190Spain
| | - Teresa Alcoverro
- Centre d’Estudis Avançats de Blanes (CEAB‐CSIC)Carrer Accés a la Cala Sant FrancescBlanes17300Spain
| | - Demetris Kletou
- Marine & Environmental Research (MER) Laboratory Ltd202 Amathountos Avenue, Marina Gardens, Block BLimassol4533Cyprus
| | - Charalampos Antoniou
- Marine & Environmental Research (MER) Laboratory Ltd202 Amathountos Avenue, Marina Gardens, Block BLimassol4533Cyprus
| | - Jordi Boada
- Departament de Biologia Evolutiva, Ecologia i Ciències AmbientalsFacultat de BiologiaUniversitat de BarcelonaAv. Diagonal, 643Barcelona08028Spain
- Institut d’Ecologia AquàticaFacultat de CiènciesUniversitat de GironaGirona17003Spain
| | - Xavier Buñuel
- Centre d’Estudis Avançats de Blanes (CEAB‐CSIC)Carrer Accés a la Cala Sant FrancescBlanes17300Spain
| | - Lidia Cucala
- Global Change Research GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)Miquel Marquès 21Esporles07190Spain
| | - Gabriel Jorda
- Instituto Español de OceanografíaCentre Oceanogràfic de BalearsMoll de Ponent s/nPalma07015Spain
| | - Periklis Kleitou
- Marine & Environmental Research (MER) Laboratory Ltd202 Amathountos Avenue, Marina Gardens, Block BLimassol4533Cyprus
- School of Biological and Marine SciencesUniversity of PlymouthPlymouthPL4 8AAUK
| | - Guillem Roca
- Global Change Research GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)Miquel Marquès 21Esporles07190Spain
| | - Julia Santana‐Garcon
- Institute for Marine and Antarctic StudiesUniversity of TasmaniaHobartTas.7001Australia
- Global Change Research GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)Miquel Marquès 21Esporles07190Spain
| | - Ioannis Savva
- Marine & Environmental Research (MER) Laboratory Ltd202 Amathountos Avenue, Marina Gardens, Block BLimassol4533Cyprus
| | - Adriana Vergés
- Evolution & Ecology Research CentreCentre for Marine Science and InnovationSchool of Biological, Earth and Environmental SciencesUniversity of New South WalesSydneyNSW2033Australia
| | - Núria Marbà
- Global Change Research GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)Miquel Marquès 21Esporles07190Spain
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Rizzo G, Sionne F, Roca G, Pietricola G, Amodio L, Pafundi D, Valentini V, Coco C. Transanal endoscopic microsurgery vs total mesorectal excision in YPT0-1 rectal cancer after pre-operative radiochemotherapy: Post-operative morbidity, long-term oncologic outcome and functional results. European Journal of Surgical Oncology 2020. [DOI: 10.1016/j.ejso.2020.06.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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3
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Roca G, Martin L, Borraz D, Serrano L, Lynam B. A Spanish Intentional Mass-Casualty Incidents Medical Response Model: Delphi Consensus. J Spec Oper Med 2020; 20:95-99. [PMID: 33320320 DOI: 10.55460/v88f-n5ix] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
The increase in global violence in recent years has changed the paradigm of emergency health care, requiring early medical response to victims in hostile settings where the usual work cannot be done safely. In Spain, this specific role is provided by the Tactical Environment Medical Support Teams (in Spanish, EMAETs). The Victoria I Consensus document defines and recognizes this role, whose main lines of work are the emergency medical response to the tactical team and to the victims in areas under indirect threat, provided that the tactical operators can guarantee their safety. To reinforce the suitability of this approach, we submitted the possible outcomes of this response model to a panel of national experts to assess this proposal in the different areas of Spain. The chosen research design is a conventional Delphi method, based on the content of the Victoria I Consensus response model. The panel of 52 expert reviewers from 11 different regions were surveyed anonymously; a high degree of accord was recognized when the congruence of the responses exceeded 75%. Consensus agreement was reached in all sections of the survey after two iterations. Specific contributions and recommendations were made to achieve unanimous consensus despite the population and resource differences in the country. Our results suggest that the EMAET approach is useful in areas with short response times. However, in more sparsely populated areas, this may not be feasible, and a more pragmatic response model may be suitable.
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de Los Santos CB, Krause-Jensen D, Alcoverro T, Marbà N, Duarte CM, van Katwijk MM, Pérez M, Romero J, Sánchez-Lizaso JL, Roca G, Jankowska E, Pérez-Lloréns JL, Fournier J, Montefalcone M, Pergent G, Ruiz JM, Cabaço S, Cook K, Wilkes RJ, Moy FE, Trayter GMR, Arañó XS, de Jong DJ, Fernández-Torquemada Y, Auby I, Vergara JJ, Santos R. Recent trend reversal for declining European seagrass meadows. Nat Commun 2019; 10:3356. [PMID: 31350407 PMCID: PMC6659699 DOI: 10.1038/s41467-019-11340-4] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 07/03/2019] [Indexed: 12/05/2022] Open
Abstract
Seagrass meadows, key ecosystems supporting fisheries, carbon sequestration and coastal protection, are globally threatened. In Europe, loss and recovery of seagrasses are reported, but the changes in extent and density at the continental scale remain unclear. Here we collate assessments of changes from 1869 to 2016 and show that 1/3 of European seagrass area was lost due to disease, deteriorated water quality, and coastal development, with losses peaking in the 1970s and 1980s. Since then, loss rates slowed down for most of the species and fast-growing species recovered in some locations, making the net rate of change in seagrass area experience a reversal in the 2000s, while density metrics improved or remained stable in most sites. Our results demonstrate that decline is not the generalised state among seagrasses nowadays in Europe, in contrast with global assessments, and that deceleration and reversal of declining trends is possible, expectingly bringing back the services they provide. Seagrass meadows are important but one of the most threatened ecosystems globally. Here the authors analyse data about extent and density of seagrasses in Europe from 1869 to 2016, and find evidence of recent trend reversal for declining European seagrass meadows.
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Affiliation(s)
- Carmen B de Los Santos
- Centre of Marine Sciences of Algarve (CCMAR), University of Algarve, Gambelas, 8005-139, Faro, Portugal.
| | - Dorte Krause-Jensen
- Department of Bioscience, Aarhus University, Vejlsøvej 25, 8600, Silkeborg, Denmark.,Arctic Research Centre, Department of Bioscience, Aarhus University, Ny Munkegade 114, Building 1540, 8000, Århus C, Denmark
| | - Teresa Alcoverro
- Centre d'Estudis Avançats de Blanes (CEAB-CSIC), Carretera Acc, Cala Sant Francesc 14, 17300, Blanes, Girona, Spain
| | - Núria Marbà
- Global Change Research Group, Institut Mediterrani d'Estudis Avançats (IMEDEA, CSIC-UIB), Miquel Marquès 21, 07190, Esporles, Illes Balears, Spain
| | - Carlos M Duarte
- King Abdullah University of Science and Technology (KAUST), Red Sea Researh Center (RSRC) and Computational Bioscience Research Center (CBRC), Thuwal, 23955-6900, Saudi Arabia
| | - Marieke M van Katwijk
- Department of Environmental Science, Institute for Water and Wetland Research, Radboud University Nijmegen, Heyendaalseweg 135, 6525 AJ, Nijmegen, The Netherlands
| | - Marta Pérez
- Department of Evolutionary Biology, Ecology, and Environmental Sciences, University of Barcelona, Av. Diagonal 643, 08028, Barcelona, Spain
| | - Javier Romero
- Department of Evolutionary Biology, Ecology, and Environmental Sciences, University of Barcelona, Av. Diagonal 643, 08028, Barcelona, Spain
| | - José L Sánchez-Lizaso
- Department of Marine Sciences and Applied Biology, University of Alicante, PO BOX 99, 03080, Alicante, Spain
| | - Guillem Roca
- Global Change Research Group, Institut Mediterrani d'Estudis Avançats (IMEDEA, CSIC-UIB), Miquel Marquès 21, 07190, Esporles, Illes Balears, Spain
| | - Emilia Jankowska
- Institute of Oceanology, Polish Academy of Sciences, Powstańców Warszawy 55, 81-712, Sopot, Poland
| | - José Lucas Pérez-Lloréns
- Department of Biology, Faculty of Marine and Environmental Sciences, Marine Research Institute, University of Cádiz, 11510, Puerto Real, Cádiz, Spain
| | - Jérôme Fournier
- Muséum National d'Histoire Naturelle, CNRS UMR 7204 Centre d'Ecologie et des Sciences de la Conservation, Station de Biologie Marine, Place de la Croix BP225, 29182, Concarneau Cedex, France
| | - Monica Montefalcone
- DiSTAV, Department of Earth, Environment and Life Sciences, University of Genoa, Corso Europa 26, 16132, Genoa, Italy
| | - Gérard Pergent
- Coastal Ecosystem Team (FRES 3041/UMR 6134), University of Corsica, BP 52, 20250, Corte, France
| | - Juan M Ruiz
- Seagrass Ecology Group, Oceanographic Center of Murcia, Spanish Institute of Oceanography, C/Varadero, 30740, San Pedro del Pinatar, Murcia, Spain
| | - Susana Cabaço
- Centre of Marine Sciences of Algarve (CCMAR), University of Algarve, Gambelas, 8005-139, Faro, Portugal
| | - Kevan Cook
- Natural England, Pydar House, Truro, TR1 1XU, UK
| | - Robert J Wilkes
- Environmental Protection Agency, John Moore Road, Castlebar, F23 KT91, Co. Mayo, Ireland
| | - Frithjof E Moy
- Institute of Marine Research, P.O.Box 1870 Nordnes, 5817, Bergen, Norway
| | | | - Xavier Seglar Arañó
- Medi Ambient, Ajuntament de Badalona, Plaça de la Vila 1, 08911, Badalona, Barcelona, Spain
| | - Dick J de Jong
- Department Sea and Delta, Ministry of Infrastructure and the Environment, Rijkswaterstaat, 4330 KA, Middelburg, The Netherlands
| | | | - Isabelle Auby
- LER Arcachon-Anglet, IFREMER, Quai du commandant Silhouette, 33120, Arcachon, France
| | - Juan J Vergara
- Department of Biology, Faculty of Marine and Environmental Sciences, Marine Research Institute, University of Cádiz, 11510, Puerto Real, Cádiz, Spain
| | - Rui Santos
- Centre of Marine Sciences of Algarve (CCMAR), University of Algarve, Gambelas, 8005-139, Faro, Portugal
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Savva I, Bennett S, Roca G, Jordà G, Marbà N. Thermal tolerance of Mediterranean marine macrophytes: Vulnerability to global warming. Ecol Evol 2018; 8:12032-12043. [PMID: 30598797 PMCID: PMC6303755 DOI: 10.1002/ece3.4663] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 09/13/2018] [Accepted: 10/01/2018] [Indexed: 02/06/2023] Open
Abstract
The Mediterranean Sea is warming at three times the rate of the global ocean raising concerns about the vulnerability of marine organisms to climate change. Macrophytes play a key role in coastal ecosystems, therefore predicting how warming will affect these key species is critical to understand the effects of climate change on Mediterranean coastal ecosystems. We measured the physiological performance of six dominant native Mediterranean macrophytes under ten temperature treatments ranging from 12 to 34°C to examine their thermal niche, and vulnerability to projected warming in the western Mediterranean up until 2100. Among the macrophytes tested, Cymodocea nodosa was the species with the highest thermal optima and it was beyond current summer temperature. Therefore, C. nodosa may benefit from projected warming over the coming century. The optimal temperature for growth of the other species (Posidonia oceanica, Cystoseira compressa, Padina pavonica, Caulerpa prolifera, and Halimeda tuna) was lower. Similarly, the species presented different upper lethal limits, spanning at least across 5.1°C between 28.9°C (P. oceanica) and >34°C (C. nodosa). Our results demonstrate the variable physiological responses of species within the same local community to temperature changes and highlight important potential differences in climate change vulnerability, among species within coastal marine ecosystems.
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Affiliation(s)
- Ioannis Savva
- Global Change Research GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)EsporlesSpain
- Marine and Environmental Research (MER) LabLimassolCyprus
| | - Scott Bennett
- Global Change Research GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)EsporlesSpain
| | - Guillem Roca
- Global Change Research GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)EsporlesSpain
| | - Gabriel Jordà
- Marine Ecosystem Dynamics GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)EsporlesSpain
- Instituto Español de Oceanografía (IEO) Centre Oceanogràfic de BalearsPalmaSpain
| | - Núria Marbà
- Global Change Research GroupInstitut Mediterrani d’Estudis Avançats (CSIC‐UIB)EsporlesSpain
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Gimpel A, Stelzenmüller V, Töpsch S, Galparsoro I, Gubbins M, Miller D, Murillas A, Murray AG, Pınarbaşı K, Roca G, Watret R. A GIS-based tool for an integrated assessment of spatial planning trade-offs with aquaculture. Sci Total Environ 2018; 627:1644-1655. [PMID: 29463432 PMCID: PMC5891820 DOI: 10.1016/j.scitotenv.2018.01.133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 01/10/2018] [Accepted: 01/14/2018] [Indexed: 05/19/2023]
Abstract
The increasing demand for protein from aquaculture will trigger a global expansion of the sector in coastal and offshore waters. While contributing to food security, potential conflicts with other traditional activities such as fisheries or tourism are inevitable, thus calling for decision-support tools to assess aquaculture planning scenarios in a multi-use context. Here we introduce the AquaSpace tool, one of the first Geographic Information System (GIS)-based planning tools empowering an integrated assessment and mapping of 30 indicators reflecting economic, environmental, inter-sectorial and socio-cultural risks and opportunities for proposed aquaculture systems in a marine environment. A bottom-up process consulting more than 350 stakeholders from 10 countries across southern and northern Europe enabled the direct consideration of stakeholder needs when developing the GIS AddIn. The AquaSpace tool is an open source product and builds in the prospective use of open source datasets at a European scale, hence aiming to improve reproducibility and collaboration in aquaculture science and research. Tool outputs comprise detailed reports and graphics allowing key stakeholders such as planners or licensing authorities to evaluate and communicate alternative planning scenarios and to take more informed decisions. With the help of the German North Sea case study we demonstrate here the tool application at multiple spatial scales with different aquaculture systems and under a range of space-related development constraints. The computation of these aquaculture planning scenarios and the assessment of their trade-offs showed that it is entirely possible to identify aquaculture sites, that correspondent to multifarious potential challenges, for instance by a low conflict potential, a low risk of disease spread, a comparable high economic profit and a low impact on touristic attractions. We believe that a transparent visualisation of risks and opportunities of aquaculture planning scenarios helps an effective Marine Spatial Planning (MSP) process, supports the licensing process and simplifies investments.
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Affiliation(s)
- Antje Gimpel
- Thünen Institute (TI), Institute of Sea Fisheries, Palmaille 9, 22767 Hamburg, Germany.
| | - Vanessa Stelzenmüller
- Thünen Institute (TI), Institute of Sea Fisheries, Palmaille 9, 22767 Hamburg, Germany
| | - Sandra Töpsch
- Thünen Institute (TI), Institute of Sea Fisheries, Palmaille 9, 22767 Hamburg, Germany
| | - Ibon Galparsoro
- AZTI, Marine Research Division, Herrera Kaia z/g, 20110 Pasaia, Spain
| | - Matthew Gubbins
- Marine Scotland Science, Marine Laboratory, 375 Victoria Road, Aberdeen AB11 9DB, Scotland, Uk
| | - David Miller
- The James Hutton Institute, Invergowrie, Dundee DD2 5DA, Scotland, UK
| | - Arantza Murillas
- AZTI, Marine Research Division, Herrera Kaia z/g, 20110 Pasaia, Spain
| | - Alexander G Murray
- Marine Scotland Science, Marine Laboratory, 375 Victoria Road, Aberdeen AB11 9DB, Scotland, Uk
| | - Kemal Pınarbaşı
- AZTI, Marine Research Division, Herrera Kaia z/g, 20110 Pasaia, Spain
| | - Guillem Roca
- IMEDEA (CSIC-UIB), Department of Global Change Research, Miquel Marquès 21, 07190 Esporles, Illes Balears, Spain
| | - Robert Watret
- Marine Scotland Science, Marine Laboratory, 375 Victoria Road, Aberdeen AB11 9DB, Scotland, Uk
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Martin L, Roca G, Hernandez JM, Fernandez S, Lynam B. Victory I Consensus Document: Proposal for the Implementation of the Hartford Doctrine in the Spanish Context. J Spec Oper Med 2018; 18:27-29. [PMID: 30566720 DOI: 10.55460/tn52-5xez] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2018] [Indexed: 06/09/2023]
Abstract
Several international recommendations advise adapting military healthcare response models to intentional mass casualty incidents (IMCIs) in civil environments. The IMCI experience and associated published research from the United States, where these situations are frequent and properly analyzed more often, are, unfortunately, not directly applicable to the Spanish model of emergency medical services (EMS), where each autonomous region has its own competencies and protocols. However, there is a series of common elements that served as a reference for the development of an effective, evidence- based, IMCI consensus response plan called Victoria I. In this plan, we have tried to define each intervening role during an IMCI, from the occasional first responder to the final hospital staff at the reference trauma centers. We believe that each professional role in this response chain, on and off the scene, must have a clear mission and function to improve victim survival.
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Roca G, Romero J, Farina S, Martínez-Crego B, Alcoverro T. Using seagrasses to identify local and large-scale trends of metals in the Mediterranean Sea. Mar Pollut Bull 2017; 123:83-91. [PMID: 28916351 DOI: 10.1016/j.marpolbul.2017.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/08/2017] [Accepted: 09/09/2017] [Indexed: 06/07/2023]
Abstract
To manage trace metal pollution it is critical to determine how much temporal trends can be attributed to local or large-scale sources. We tracked changes in metal content in the seagrass Posidonia oceanica, along the NW Mediterranean from 2003 to 2010. While Cu, Cd and Ni showed a large inter-site variation, likely due to local factors, Fe, Mn and Pb showed little local variation and synchronous interannual variability across sites, most likely due to large-scale sources. Zn showed equal importance of local and large-scale sources of variation. Temporal trends of Ni, Zn, Cd, Cu remained almost stable. In contrast, Fe, Mn and Pb slightly increased in the last decade. These trends suggest that metals like Cu, Cd, Ni can be effectively managed at local scale. Whereas, elements like Fe, Mn and Pb have an important large-scale component that needs to be managed across the frontiers of national jurisdictions.
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Affiliation(s)
- Guillem Roca
- Departament d'Ecologia, Facultat de Biología, Universitat de Barcelona, Av. Diagonal 645, 08028 Barcelona, Spain; Centre d'Estudis Avançats de Blanes, CEAB-CSIC, C/Acc. Cala St. Francesc 14, 17300 - Blanes, Girona, Spain.
| | - Javier Romero
- Departament d'Ecologia, Facultat de Biología, Universitat de Barcelona, Av. Diagonal 645, 08028 Barcelona, Spain
| | - Simone Farina
- Centre d'Estudis Avançats de Blanes, CEAB-CSIC, C/Acc. Cala St. Francesc 14, 17300 - Blanes, Girona, Spain
| | - Begoña Martínez-Crego
- Centre of Marine Sciences (CCMAR), Universidade do Algarve-Campus Gambelas, 8005-139 Faro, Portugal
| | - Teresa Alcoverro
- Centre d'Estudis Avançats de Blanes, CEAB-CSIC, C/Acc. Cala St. Francesc 14, 17300 - Blanes, Girona, Spain; Nature Conservation Foundation (NCF), 3076/5, IV Cross, Gokulam Park, Mysore 570002, India
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Roca G, Mayol S, García E, Casajuana E, Quintana S. [Spanish versions of the Simplified Motor Score and the Glasgow Coma Scale in out-of-hospital treatment of head injury in adults: a preliminary study of each scale's ability to predict adverse events]. Emergencias 2015; 27:185-188. [PMID: 29077312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To determine the ability of the modified (Spanish) version of the Simplified Motor Score (mSMS) to predict adverse events during hospitalization and to compare its predictive ability to that of the Glasgow Coma Scale (GCS) in adults with head injuries treated outside the hospital. MATERIAL AND METHODS Observational study of retrospective cohorts including all patients over the age of 14 years attended for head injuries occurring within 24 hours of treatment by an advanced life-support unit staffed by nurses between May 1, 2013, and May 1, 2014. The mSMS was a translation of the English original, created through a process of discussions of direct and back translations to arrive at consensus. Out-of-hospital patient records were searched to find GCS and mSMS scores. To predict the ability of each scale to predict brain injuries, neurosurgery, intubation, and/or inhospital death, we calculated the area under the receiving operator characteristic curves (AUCs). RESULTS Of the total of 115 head-injury patients attended, 64 met the inclusion criteria. The mean (SD) age was 47 (24) years. Twelve (18.8%) patients developed some form of adverse event during hospitalization; 91.6% had brain damage, 58.3% required intubation, 8.3% required surgery, and 41.6% died. The AUC for the GCS was 0.907 (95% CI, 0.81-1.00; P<.001); the AUC for the mSMS was 0.796 (95% CI, 0.64-0.95; P=.001). CONCLUSION Although the ability of the mSMS to predict in-hospital adverse outcomes is good, it is inferior to the GCS in adults with head injuries attended outside the hospital.
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Affiliation(s)
- Guillem Roca
- Unidad de Soporte Vital Avanzado con Enfermería. Hospital Universitari Mútua de Terrassa. Barcelona, España
| | - Sergi Mayol
- Unidad de Soporte Vital Avanzado con Enfermería. Hospital Universitari Mútua de Terrassa. Barcelona, España
| | - Esteban García
- Sistema d'Emergències Mèdiques. Unidad de Soporte Vital Avanzado Medicalizado, Barcelona, España
| | - Edgar Casajuana
- Servicio de Neurocirugía. Hospital Universitari Mútua de Terrassa. Barcelona, España
| | - Salvador Quintana
- Servicio de Medicina Intensiva. Hospital Universitari Mútua de Terrassa. Barcelona, España
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Azagra R, Casado E, Encabo G, Aguyé A, Pujol-Salud J, Martín-Sánchez J, Gené E, Zwart M, Iglesias M, Lόpez-Expόsito F, Roca G, Güell S. SAT0348 The fridex model: Thresholds of frax to determine high-risk patients according to the actual data of fracture at 10 years from a cohort of spanish women:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Prado P, Tomas F, Pinna S, Farina S, Roca G, Ceccherelli G, Romero J, Alcoverro T. Habitat and scale shape the demographic fate of the keystone sea urchin Paracentrotus lividus in Mediterranean macrophyte communities. PLoS One 2012; 7:e35170. [PMID: 22536355 PMCID: PMC3335053 DOI: 10.1371/journal.pone.0035170] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 03/09/2012] [Indexed: 11/20/2022] Open
Abstract
Demographic processes exert different degrees of control as individuals grow, and in species that span several habitats and spatial scales, this can influence our ability to predict their population at a particular life-history stage given the previous life stage. In particular, when keystone species are involved, this relative coupling between demographic stages can have significant implications for the functioning of ecosystems. We examined benthic and pelagic abundances of the sea urchin Paracentrotus lividus in order to: 1) understand the main life-history bottlenecks by observing the degree of coupling between demographic stages; and 2) explore the processes driving these linkages. P. lividus is the dominant invertebrate herbivore in the Mediterranean Sea, and has been repeatedly observed to overgraze shallow beds of the seagrass Posidonia oceanica and rocky macroalgal communities. We used a hierarchical sampling design at different spatial scales (100 s, 10 s and <1 km) and habitats (seagrass and rocky macroalgae) to describe the spatial patterns in the abundance of different demographic stages (larvae, settlers, recruits and adults). Our results indicate that large-scale factors (potentially currents, nutrients, temperature, etc.) determine larval availability and settlement in the pelagic stages of urchin life history. In rocky macroalgal habitats, benthic processes (like predation) acting at large or medium scales drive adult abundances. In contrast, adult numbers in seagrass meadows are most likely influenced by factors like local migration (from adjoining rocky habitats) functioning at much smaller scales. The complexity of spatial and habitat-dependent processes shaping urchin populations demands a multiplicity of approaches when addressing habitat conservation actions, yet such actions are currently mostly aimed at managing predation processes and fish numbers. We argue that a more holistic ecosystem management also needs to incorporate the landscape and habitat-quality level processes (eutrophication, fragmentation, etc.) that together regulate the populations of this keystone herbivore.
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Affiliation(s)
- Patricia Prado
- Institut de Recerca i Tecnología Agroalimentàries (IRTA), Aquatic Ecosystems, Tarragona, Spain.
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Bennett S, Roca G, Romero J, Alcoverro T. Ecological status of seagrass ecosystems: An uncertainty analysis of the meadow classification based on the Posidonia oceanica multivariate index (POMI). Mar Pollut Bull 2011; 62:1616-1621. [PMID: 21723570 DOI: 10.1016/j.marpolbul.2011.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 06/07/2011] [Accepted: 06/13/2011] [Indexed: 05/31/2023]
Abstract
Quantifying the uncertainty associated with monitoring protocols is essential to prevent the misclassification of ecological status and to improve sampling design. We assessed the Posidonia oceanica multivariate index (POMI) bio-monitoring program for its robustness in classifying the ecological status of coastal waters within the Water Framework Directive. We used a 7-year data set covering 30 sites along 500 km of the Catalonian coastline to examine which version of POMI (14 or 9 metrics) maximises precision in classifying the ecological status of meadows. Five factors (zones within a site, sites within a water body, depth, years and surveyors) that potentially generate classification uncertainty were examined in detail. Of these, depth was a major source of uncertainty, while all the remaining spatial and temporal factors displayed low variability. POMI 9 matched POMI 14 in all factors, and could effectively replace it in future monitoring programs.
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Affiliation(s)
- Scott Bennett
- Centro de Estudios Avanzados de Blanes, CSIC, C/Acceso a la Cala St. Francesc 14, 17300 Blanes, Girona, Spain.
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Vagadia V, Bartholomew P, Kelly M, Handley G, Kelly C, Bridges M, Ruddick S, Malik R, Gilleece Y, Fisher M, Walker-Bone K, Selvan S, Collins DA, Meryon I, Pattle J, Scurr C, Davies G, Callan M, Mercieca C, Down M, Webb J, Shipley J, Bhalla AK, Poole KE, Treece GM, Ridgway GR, Mayhew PM, Borggrefe J, Gee AH, Mehta P, Nelson M, Boag F, Oldroyd AG, Halsey J, Goodson NJ, Greenbank C, Evans B, Bukhari M, Azagra R, Roca G, Encabo G, Aguye A, Zwart M, Casado E, Iglesias M, Puchol N, Sola S, Guell S, Harvey NC, Garrett E, Sheppard A, McLean C, Lillycrop K, Burdge G, Slater-Jefferies J, Rodford J, Crozier S, Inskip H, Starling Emerald B, Gale C, Hanson M, Gluckman P, Godfrey K, Cooper C, Edwards MH, Jameson K, Denison H, Aihie Sayer A, Cooper C, Dennison E, Cole Z, Harvey NC, Kim M, Robinson S, Inskip H, Godfrey KM, Cooper C, Dennison E, Clark EM, Morrison L, Gould V, Cuming M, Tobias J. Osteoporosis and metabolic bone disease: 73. Do Low Vitamin D Levels Predict Osteoporosis? Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rosales M, Fernandez M, Muñoz O, Roca G, Skodova M, Garcia P, Porta M. P14.20 Direct observation of hand hygiene in a teaching hospital. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60169-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Arias L, Planas N, Prades S, Caminal JM, Rubio M, Pujol O, Roca G. Intravitreal bevacizumab (Avastin) for choroidal neovascularisation secondary to pathological myopia: 6-month results. Br J Ophthalmol 2008; 92:1035-9. [PMID: 18653595 DOI: 10.1136/bjo.2007.130260] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND To determine the efficacy and safety of intravitreal Avastin (bevacizumab) in the treatment of choroidal neovascularisation (CNV) secondary to pathological myopia (PM). METHODS This paper reports on a consecutive prospective study of patients with CNV secondary to PM who were treated with intravitreal bevacizumab (1.25 mg/0.05 ml). Patients underwent complete ophthalmic evaluation, which included best-corrected visual acuity testing measured with Early Treatment Diabetic Retinopathy Study charts, optical coherence tomography (OCT), and fluorescein angiography. RESULTS There were 17 eyes of 17 patients, and the mean age was 55.4 (SD 10.0) years. At the 6-month follow-up, the mean visual acuity improved by 8.4 letters (p = 0.04). Forty-one per cent of patients increased at least one line, and 17% increased more than six lines. There were no cases of moderate vision loss (>or=3 lines) or severe vision loss (>or=6 lines). The mean OCT foveal thickness decreased by 79.6 mum (p = 0.002). Favourable outcomes were obtained in all subgroups. Patients received an average of one injection. As a complication, there was a tear of the retinal pigment epithelium. No other ocular or systemic side effects were observed. CONCLUSION In our study, intravitreal bevacizumab appeared to be safe and efficacious in eyes with CNV secondary to PM.
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Affiliation(s)
- L Arias
- Department of Ophthalmology, Hospital Universitari de Bellvitge, C/Feixa Llarga, sn, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
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Graell X, Caminal JM, Masuet C, Arias L, Rubio M, Pujol O, Roca G, Arruga J. [Age distribution of uveal melanoma and its relationship to survival]. ACTA ACUST UNITED AC 2008; 82:343-7. [PMID: 17573643 DOI: 10.4321/s0365-66912007000600005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To study the age distribution and survival in patients with uveal melanoma. METHODS A retrospective study was performed on 303 patients diagnosed with uveal melanoma. We analysed the clinical characteristics: age, gender, tumor size and origin, follow-up time, systemic state, survival time and cause of death. RESULTS The median age of the patients was 60.09 years. The 2-, 5-, and 10-year survival of patients less than 50 years of age at diagnosis was 91.41%, 81.83% and 61.45% respectively. The 2-, 5- and 10-year survival of patients equal to or older than 50 years was 90.86%, 73.18% and 58.28% respectively. No significant difference was found between these two age groups. When we considered a possible relationship between the sex factor and survival, in patients equal to or older than 50 years of age, we found a higher survival in men than in women (log-rank test; p=0.038). CONCLUSIONS Uveal melanoma in Spain has a similar age distribution to that of other countries, and it is not an infrequent diagnosis in patients under 40 years of age. Survival rates are also similar to that of other series. We have not found any significant difference between the age of our patients and the survival, although if we analysed the subgroups, we found that the men equal to or over 50 years of age had a better survival than the women of the same age.
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Affiliation(s)
- X Graell
- Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
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Abstract
PURPOSE To study the prevalence of multiple neoplasms in patients affected by uveal melanoma in Spain and to relate these with survival. METHOD We carried out a longitudinal prospective study of the prevalence of multiple neoplasms in patients diagnosed to have a uveal melanoma during the years 1984-2005. The data has been analysed for the following variables: age, sex, date of diagnosis, affected eye, origin and tumoral size, classification according to COMS (Collaborative Ocular Melanoma Study), time of follow-up, presence of other neoplasms, current clinical state, date and cause of death. RESULTS Three hundred and five patients affected by uveal melanoma have been studied in the Ocular Oncology Unit of our institution; 24 patients (7.9%) had evidence in their medical reports of one or more additional neoplasms. Excluding cutaneous neoplasms originating in basal cells, this number reduced to 22 patients (7.2%). We did not find any statistically significant differences among the presentation age, sex or localization of the melanoma (ciliary body or choroid) and the presence or absence of a second neoplasm. When we analysed the proportion of patients with metastatic disease (both alive and dead) who presented with a second neoplasm (40.9%), we found a statistically significant relationship between these variables (Chi-square test, p=0.004). CONCLUSIONS We have observed a percentage of second neoplasms similar to that described in other international studies. We did not find a larger proportion with a second neoplasm according to the sex, age, or tumoral localization, nor did we observe a higher frequency of any particular second neoplasm. We have defined a relationship between metastasic uveal melanoma, and the development of a second neoplasm, which clearly indicates a need for increased systemic follow-up in such patients.
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Affiliation(s)
- J M Caminal
- Hospital Universitario de Bellvitge, Barcelona, Spain.
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Arias L, Pujol O, Berniell J, Rubio M, Roca G, Castillo L, Acebes E. Impact of lesion size on photodynamic therapy with verteporfin of predominantly classic lesions in age related macular degeneration. Br J Ophthalmol 2005; 89:312-5. [PMID: 15722311 PMCID: PMC1772570 DOI: 10.1136/bjo.2004.050997] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To determine if photodynamic therapy (PDT) outcomes are related to lesion size in patients with subfoveal predominantly classic choroidal neovascularisation (CNV) secondary to age related macular degeneration (AMD). METHODS According to greatest linear dimension (GLD) of the entire lesion determined with fluorescein angiography (FA) patients were divided into two groups. In the first group GLD was <3000 microm and in the second one GLD was 3000-5000 microm. All eyes were treated with standard PDT with the verteporfin protocol. The primary outcome was the proportion of eyes in both groups that did not show significant leakage in FA at the end of follow up. Secondary outcomes were changes in GLD and in best corrected visual acuity (BCVA). RESULTS 64 patients (mean (SD) age, 76.7 (7.7) years; range 58-95 years) were recruited to participate in the study. All participants in the study completed the follow up time (mean 16.6 months). 24 patients (75%) in the group of smaller lesions (n = 32) compared with 15 patients (46.8%) in the group of larger lesions (n = 32) did not show significant leakage in FA at the end of follow up (p = 0.02). A GLD increase >1000 microm was recorded in nine eyes (28.1%) in the group of smaller lesions and in 16 eyes (50%) in the group of larger lesions (p = 0.07). 22 eyes (68.7%) in the group of smaller lesions compared with 19 eyes (59.3%) in the group of larger lesions lost less than three lines of vision (p = 0.06). Relevant side effects related to verteporfin therapy were not recorded, except for four patients (6.2%) with infusion related back pain. CONCLUSIONS These results suggest that lesion size at baseline may be a prognosis factor in PDT in patients with subfoveal predominantly classic CNV secondary to AMD. There are no relevant side effects or safety concerns derived from verteporfin therapy.
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Affiliation(s)
- L Arias
- Department of Ophthalmology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
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Roca G, Torres JM, Ruiz E, Ortega E. Crystalline dihydrotestosterone implants in the lateral septum of male rats. A positive effect on LH and FSH. Endocr Res 2001; 27:35-40. [PMID: 11428719 DOI: 10.1081/erc-100107167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Previous investigations in our laboratory have shown that testosterone implanted into the lateral septum in male rats increases LH and FSH secretion. However, it was unclear whether the effect of testosterone was direct via androgen receptor, or indirect via the estrogen receptor after conversion by aromatization to estradiol. To answer this question, we implanted either testosterone or the non-aromatizable androgen 5 alpha-dihydrotestosterone (DHT), into the lateral septum of adult male rats and measured plasma levels of LH and FSH by radioimmunoassay 2 days after implantation. Both testosterone and DHT significantly increased the plasma LH and FSH concentrations. Mean concentration of LH in control animals was 0.21 +/- 0.06 ng/ml, a figure that increased to 0.7 +/- 0.12 and 0.55 +/- 0.1 ng/ml after DHT or testosterone implantation respectively. Mean concentration of FSH in control animals was 1.5 +/- 0.3 ng/ml; this figure increased to 3 +/- 0.3 and 2.9 +/- 0.3 ng/ml after DHT or testosterone implantation. Neither plasma DHT (64.0 +/- 5.6 vs. 52 +/- 5 ng/100ml) nor plasma testosterone levels (4.1 +/- 0.38 vs. 3.3 +/- 0.18 ng/ml) were significantly affected by the implants. We conclude that androgens independently of conversion to estrogen acting in the lateral septum facilitates the release of LH and FSH.
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Affiliation(s)
- G Roca
- Department of Clinical Biochemistry, S. Cecilio University Hospital, Granada, Spain
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Moulard M, Lortat-Jacob H, Mondor I, Roca G, Wyatt R, Sodroski J, Zhao L, Olson W, Kwong PD, Sattentau QJ. Selective interactions of polyanions with basic surfaces on human immunodeficiency virus type 1 gp120. J Virol 2000; 74:1948-60. [PMID: 10644368 PMCID: PMC111673 DOI: 10.1128/jvi.74.4.1948-1960.2000] [Citation(s) in RCA: 249] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
It is well established that the gp120 V3 loop of T-cell-line-adapted human immunodeficiency virus type 1 (HIV-1) binds both cell-associated and soluble polyanions. Virus infectivity is increased by interactions between HIV-1 and heparan sulfate proteoglycans on some cell types, and soluble polyanions such as heparin and dextran sulfate neutralize HIV-1 in vitro. However, the analysis of gp120-polyanion interactions has been limited to T-cell-line-adapted, CXCR4-using virus and virus-derived gp120, and the polyanion binding ability of gp120 regions other than the V3 loop has not been addressed. Here we demonstrate by monoclonal-antibody inhibition, labeled heparin binding, and surface plasmon resonance studies that a second site, most probably corresponding to the newly defined, highly conserved coreceptor binding region on gp120, forms part of the polyanion binding surface. Consistent with the binding of polyanions to the coreceptor binding surface, dextran sulfate interfered with the gp120-CXCR4 association while having no detectable effect on the gp120-CD4 interaction. The interaction between polyanions and X4 or R5X4 gp120 was readily detectable, whereas weak or undetectable binding was observed with R5 gp120. Analysis of mutated forms of X4 gp120 demonstrated that the V3 loop is the major determinant for polyanion binding whereas other regions, including the V1/V2 loop structure and the NH(2) and COOH termini, exert a more subtle influence. A molecular model of the electrostatic potential of the conserved coreceptor binding region confirmed that it is basic but that the overall charge on this surface is dominated by the V3 loop. These results demonstrate a selective interaction of gp120 with polyanions and suggest that the conserved coreceptor binding surface may present a novel and conserved target for therapeutic intervention.
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Affiliation(s)
- M Moulard
- Centre d'Immunologie de Marseille-Luminy, 13288 Marseille Cedex 9, France
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Polo Friz H, Kremer L, Acosta H, Abdala O, Canova S, Rojo S, Roca G, Daín A. [Treatment with tuberculostatic drugs: compliance at a general hospital]. Rev Fac Cien Med Univ Nac Cordoba 1999; 55:21-5. [PMID: 10436613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
The purpose of this study was to assess the compliance with tuberculostatic drugs treatment in a public hospital from Córdoba City and to establish the causes of noncompliance. All the patients to which treatment with tuberculostatic drugs was indicated from January 1991 up to December 1994 were included. 45 patients were included: 18 females (40%) and 29 males. Sixteen (35.6%) did not complete the time of treatment indicated. Nine (56.3%) abandoned the treatment 2 months after having initiated it. In the group that did not complete the treatment there was a higher percentage of female patients (62.5%) than in the group that did complete it (27.6%), p = 0.02. There were not statistically significant differences in age, percentages of pulmonar and extrapulmonar tuberculosis and months of treatment indicated between both groups. Thirty-six percent of the patients who abandoned the treatment referred having interrupted it due to their own negligency, knowing the risk of such behavior; 36% suffered side effects and did not come back to hospital; 21% referred having consulted another physician who indicated to interrupt the treatment without performing other tests; and 7% misunderstood the indications. It is concluded that in a general hospital from Córdoba City, the percentage of patients who abandoned tuberculostatic treatment is high. In most cases the cause was related to failures in the conduct of patients, physicians or both.
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Affiliation(s)
- H Polo Friz
- Hospital Nacional de Clínicas-Facultad de Ciencias Médicas-Universidad Nacional de Córdoba, Argentina
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Soriano C, Ortiz M, Fas MJ, Escudero A, Roca G, Vidal F. [A possibility of central diffusion during stellate ganglion blockade: "the sheath of the spinal rachidian nerve"]. Rev Esp Anestesiol Reanim 1999; 46:123-5. [PMID: 10228377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Stellate ganglion block is a common treatment for neuropathic pain. The technique is not without potentially severe complications when a paratracheal approach is used. A 33-year-old woman complained of atypical facial pain of 15 years' duration with pain intensity of 6 to 8 on a visual analog scale and no pain-free periods upon use of inadequate analgesia. One minute after performing a second stellate ganglion block the patient showed signs of apnea and paralysis of the upper extremities and face, with no involvement of oculomotor muscles or the lower extremities, and no loss of consciousness. Assisted ventilation was started. Signs and symptoms resolved fully after 15 minutes. A few days later, the patient reported having perceived paresthesia in the affected zone during the procedure. Central spread of a portion of local anesthetic by way of the spinal nerve sheath toward the subarachnoid space may cause partial cervical and basal nuclear blockade. Signs would be apnea, involvement of the upper extremities and facial muscles, although paresthesia during the injection is the only evidence supporting this hypothesis. Bone contact and negative aspiration while performing a stellate ganglion block do not guarantee avoidance of complications.
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Affiliation(s)
- C Soriano
- Servicio de Anestesiología, Reanimación y Tratamiento del Dolor Hospital Germans Trias i Pujol, Badalona, Barcelona
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Roca G, Aguilar JL, Gomar C, Mazo V, Costa J, Vidal F. Nimodipine fails to enhance the analgesic effect of slow release morphine in the early phases of cancer pain treatment. Pain 1996; 68:239-43. [PMID: 9121810 DOI: 10.1016/s0304-3959(96)03186-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We assessed nimodipine's ability to increase the analgesic effect of morphine in 32 patients suffering from cancer pain in a double-blind, placebo controlled cross-over study. Morphine administration began a few days before the start of the study. The analgesic effects of two combinations were compared: morphine (M) plus placebo (P) and morphine plus 90 mg/24 h of nimodipine (N). The study lasted 8 days, including the wash-out period, and the following sequence of treatments was applied: M + P or M + N on days 1, 2 and 3; only M on days 4 and 5; and M + N or M + P on days 6, 7 and 8. Morphine dose was individualised according to the intensity of the patient's pain and the same dose was maintained throughout the study period. Analgesic response was evaluated using four 10 cm visual analogue scales of quantitative variables for pain intensity, pain relief, sleep quality and mood. A verbal rating of qualitative variables was also scored following validated descriptors of pain in the Spanish language. No significant statistical differences were found in analgesic effect between combined treatment with nimodipine or placebo, as measured on any of the scales. In order to take into account both the short duration of treatment (8 days), and nimodipine's pharmacokinetic characteristics (half-life of 6 h and steady state of 36 h), we compared treatment with nimodipine or placebo on the third day of use, at which time, likewise, there were no statistically significant differences on any of the scales. However, when the same statistical tests were used for comparison of results with pre-treatment baseline values, highly significant differences between mean scores on the scales for pain relief and pain intensity were found. Based on these negative results we conclude that nimodipine given orally at a dose of 30 mg every 8 h does not enhance analgesia when associated with morphine in the early phases of treatment for cancer pain. Our study also gives clear evidence of a placebo effect.
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Affiliation(s)
- G Roca
- Department of Anesthesia, Hospital Universitario de Badalona, Germans Trias i Pujop, Barcelona, Spain
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Monterisi A, Dain AA, Suárez de Basnec MC, Roca G, Trucchia R, Bantar C. [Native-valve endocarditis produced by Lactobacillus casei sub. rhamnosus refractory to antimicrobial therapy]. Medicina (B Aires) 1996; 56:284-6. [PMID: 9035486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Lactobacillus endocarditis is a rare infection. In fact, only 42 cases have been described in the literature from 1938 up to date. In only 17 previously reported cases have patients been cured with medical therapy alone. Although infections produced by Lactobacillus spp, have been described in our country, none of them included endocarditis. We report herein a case of endocarditis due to a vancomycin-resistant strain of Lactobacillus casei sub. rhamnosus in a 29-year-old man with prolapse of the mitral valve. He required surgical replacement of his valve because of the poor response to antimicrobial therapy with penicillin and gentamicin. The patient displayed a successful clinical outcome, with no evidence of recurrence along the subsequent 2 years. We point out the need to accurately identify Lactobacillus spp. in isolates from blood cultures of patients with endocarditis, since these bacteria may often be mistaken for other species more frequently associated to this infection, which usually respond to conventional antimicrobial therapy. Furthermore, we suggest that early surgical replacement should be considered when lactobacillus endocarditis is diagnosed.
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Affiliation(s)
- A Monterisi
- Laboratorio de Microbiologia, Hospital Nacional de Clínicas, Córdoba, Buenos Aires, Argentina
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Aguilar JL, Domingo V, Samper D, Roca G, Vidal F. Long-term brachial plexus anesthesia using a subcutaneous implantable injection system. Case report. Reg Anesth 1995; 20:242-5. [PMID: 7547663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND OBJECTIVES Continuous brachial plexus anesthesia with local anesthesia has been used since 1946 for prolonged surgical procedures, in postoperative pain relief, and in sympathetic nerve block. The benefit or effectiveness of this technique in the relief of sympathetically maintained pain has yet to be established. METHODS The following case report describes the placement of an axillary catheter connected to a port for the self-administration of local anesthesia to provide brachial plexus anesthesia in a 43-year-old woman suffering from sympathetically maintained pain. RESULTS The administration of local anesthesia through this injection system resulted in complete pain relief without motor impairment of the arm. The device functioned for 118 days, making physical therapy easier. An infection occurred at the entry site, requiring the removal of the port. CONCLUSIONS Controlled studies need to be done to establish the safety and efficacy of this form of therapy.
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Affiliation(s)
- J L Aguilar
- Department of Anesthesia, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain
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Aguilar JL, Espachs P, Roca G, Samper D, Cubells C, Vidal F. Difficult management of pain following sacrococcygeal chordoma: 13 months of subarachnoid infusion. Pain 1994; 59:317-320. [PMID: 7892030 DOI: 10.1016/0304-3959(94)90085-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We report on a patient suffering severe pain following a long-standing sacral chordoma in whom management of therapy and pain was extremely difficult. Because orally administered morphine was observed to be ineffective in the early stages of treatment, we tried to achieve pain relief by using epidural morphine. This was also unsatisfactory. Intrathecal infusion of morphine and bupivacaine through a catheter inserted at the L2-L3 level was also found to be ineffective; only a segment block was observed. A structural anomaly of the spine was suspected and confirmed by myelography, showing metastasis at L3. Pain relief improved when an infusion of morphine+bupivacaine was employed through a catheter placed at the L4-L5 level below the blockage. A major problem which continued throughout the course of the disease was the daily occurrence of episodes of unbearable sharp pain that required addition of midazolam to the local anesthetic/opioid subarachnoid infusion. The patient received this mixture through an intrathecal port during the last 13 months of life, a gradually increasing dose being necessary. Periods of analgesia were followed by occasional crises of intense sharp pain suggesting incomplete relief. No serious complications or meningitis occurred. This case emphasizes the difficulty in managing pain in this type of cancer.
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Affiliation(s)
- J L Aguilar
- Department of Anesthesia, Pain Clinic, Hospital Universitario de Badalona 'Germans Trias i Pujol', 08916 Badalona, BarcelonaSpain
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Aguilar JL, Samper D, Montes A, Llorente C, Roca G, Preciado MJ. [Influence of anesthetic technique in postoperative analgesia in thoracic surgery]. Rev Esp Anestesiol Reanim 1994; 41:278-81. [PMID: 7991907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To compare the intensity of postoperative pain after thoracotomy with 2 anesthetic techniques: 1) thoracic epidural block with bupivacaine administered before surgery (combined anesthesia with isoflurane) and 2) conventional balanced anesthesia with isoflurane and endovenous fentanyl. PATIENTS AND METHODS Thirty patients scheduled for thoracotomy by lateral incision (T5-T6) were randomly divided into 2 groups of 15. Group A received 8 ml of 0.5% bupivacaine with adrenalin 1:200.000 30 min before start of surgery while group B received 8 ml saline solution through an epidural catheter inserted to T4-T8. Combined anesthesia (4 ml 0.5% bupivacaine through an epidural catheter 150 min after the first dose and isoflurane in 100% oxygen) was used in group A. Group B received balanced anesthesia with endovenous fentanyl 2.5 micrograms/kg and isoflurane in 100% oxygen. The difference in pain intensity during postoperative recovery was assessed by way of the following variables: number of boluses administered by epidural patient-controlled analgesia (bupivacaine 0.0625% and fentanyl 6 micrograms/ml); score on a visual analog scale of 10 at baseline and at 1, 3, 7, 11, 19 and 43 hours after surgery; and need for additional analgesia (diclofenac) during the 43 hours of study. Arterial gases were measured during the preoperative period and at 1, 3, 7, 19 and 43 hours after surgery. RESULTS No significant differences in pain intensity measured on the visual analog scale, by the number of boluses per patients or by need for additional analgesia were found between the 2 groups. The total number of boluses administered and additional analgesic requirements were greater in the group receiving bupivacaine, although the difference was not significant (p = 0.095 and p = 0.056, respectively). Nor were there significant differences in pH and PaCO2 levels for the 2 groups. CONCLUSIONS Analgesic efficacy after thoracotomy was similar for our 2 groups receiving either combined anesthesia (epidural bupivacaine at 0.5% and isoflurane) or balanced anesthesia with isoflurane and endovenous fentanyl.
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Affiliation(s)
- J L Aguilar
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de Badalona Germans Trias i Pujol, Barcelona
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Aguilar JL, Montes A, Samper D, Roca G, Preciado MJ. [Comparison between fentanyl and a fentanyl-bupivacaine combination using epidural PCA for postoperative analgesia after thoracotomy]. Rev Esp Anestesiol Reanim 1994; 41:165-7. [PMID: 8059044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
HYPOTHESIS The association of opioids and local anesthetics for spinal analgesia appears to have a synergistic++ effect. OBJECTIVE To compare the efficacy of fentanyl in comparison with combined fentanyl and bupivacaine at low concentrations in a thoracic epidural system of patient-controlled analgesia (PCA) following thoracotomy. PATIENTS AND METHODS Twenty male patients scheduled for thoracotomy by postero-lateral (T5-T6) incision received analgesia after surgery through a thoracic (T4-T8) epidural catheter connected to a PCA pump (continuous infusion and boluses). They were randomly assigned to 2 groups as follows: group A (n = 10) received a baseline infusion of fentanyl 1 microgram/kg/h and bupivacaine 0.125% with boluses of 12.5 micrograms fentanyl and bupivacaine at 0.125%. The variables studied were: score on a visual analog scale (VAS) before treatment and at 12 and 24 h; the number of boluses administered through the PCA pump, forced vital capacity (FVC) and peak expiratory flow (PEF) before treatment and at 12 h. RESULTS Analgesia was satisfactory in both groups, with no significant differences in VAS and number of boluses administered. Nor were there significant differences in lung function tests. One instance of respiratory depression was recorded in group A. CONCLUSIONS The analgesic effect obtained with epidural fentanyl or fentanyl/bupivacaine is similar and adequate, and the association of fentanyl and bupivacaine can be considered safe.
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Affiliation(s)
- J L Aguilar
- Servicio de Anestesiología, Clínica del Dolor, Hospital Universitario de Badalona Germans Trias i Pujol, Universidad Autónoma de Barcelona
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Roca G, Nogués S, Faura A, Melero A. [The need for radiologic control of the therapeutic caudal approach in adults]. Rev Esp Anestesiol Reanim 1993; 40:100. [PMID: 8451465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Bassons MJ, Pintanel T, Roca G, Cubells C, Vidal F. [Structure and function of an outpatient surgery unit]. Rev Esp Anestesiol Reanim 1993; 40:81-5. [PMID: 8451473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
In order for a surgical intervention to be performed in an outpatient regime three basic requisites must be met: adequate patient selection, appropriate type of surgery and adequate unit. These factors are important for the surgical procedure to be carried out with identical safety and success as that undertaken in an admitted patient. In out patient surgery, early psychomotor recovery and slight or lack of secondary effects are fundamental; thus, anesthetic technique is selected keeping these two points in mind as they determine the criteria for the release of the patients from hospital.
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Affiliation(s)
- M J Bassons
- Servicio de Anestesiología y Reanimación, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona
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Abstract
BACKGROUND Pain, one of the most frequent symptoms of lung cancer, is difficult to control at times, not only because of the many structures involved but also because of the paths through which the pain is conveyed. METHODS When usual analgesic treatment did not alleviate pain after chemotherapy in a patient with lung adenocarcinoma, long-term interpleural analgesia was begun. A DuPen epidural catheter was inserted between the pleura parietalis and visceralis for the administration of bupivacaine in a bolus regimen every 6 hours. RESULTS Thoracic pain thus was controlled until the patient died 130 days after placement. CONCLUSIONS The long-term tunneled interpleural placement of DuPen catheters constitutes an alternative to systemic and spinal treatments for thoracic pain due to cancer.
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Affiliation(s)
- J L Aguilar
- Servicio de Anestesiologia, Hospital Universitario de Badalona, Universidad Autónoma de Barcelona, Badalona, Spain
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Aguilar JL, Roca G, Montes A, González-Carrasco FJ, Vallés J, Vidal F. [Experience with the Du Pen epidural catheter in chronic cancer pain]. Rev Esp Anestesiol Reanim 1992; 39:183-6. [PMID: 1410736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We evaluate the results obtained with the use of Du Pen's epidural catheter in a series of patients with chronic oncologic pain. There were 27 patients with neoplasms of different etiologies who received a total number of 30 catheters. Inclusion criteria were established. All patients received bolus of morphine chloride free of conservers. Follow-up controls were carried out at least every week and consisted on the evaluation the dosage efficacy, dose adjustments, catheter condition, physical activity, neurologic state, and requirements of adjuvant medication. The documented use of the 30 catheters implanted in this study lasted up to 1452 days with a mean of 48.5 days. There were no complications related to catheter insertion. However we observed complications related to the use of the catheter: reflow at the site of catheter implantation in 4 cases, infection of the external (one case) and internal (one case) catheter route without antibiotic resolution, and infection of the epidural space responding to antibiotherapy without catheter withdrawal in one patient. Twenty patients died. Mortality was not attributed to catheter complications in any case. The present study confirms that placement of the catheter is technically easy and provides an efficacious opiate analgesia with minimal complications.
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Affiliation(s)
- J L Aguilar
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Germans Trias i Pujol. Badalona, Barcelona
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Aguilar JL, Montes A, Montero A, Samper D, Roca G, Vidal F. Plasma bupivacaine levels after pleural block: the effect of epinephrine after unilateral or bilateral bupivacaine administration. Reg Anesth 1992; 17:99-101. [PMID: 1581268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVES To determine the effect of adding epinephrine (5 micrograms/ml) to bupivacaine during continuous spinal infusion and the effect of the administration of the same total dose of bupivacaine, in a bilateral or unilateral way, on its consequent plasma levels. METHODS Sixteen cholecystectomized patients were studied prospectively. In ten patients with midline incision, bilateral pleural infusion (half total unilateral dose in each hemithorax) was administered, and in six patients with subcostal incision, unilateral pleural infusion. The unilateral group received a loading dose of 20 ml 0.375% bupivacaine immediately followed by an infusion at a rate of 6 ml/hour. Three patients randomly received epinephrine (5 micrograms/ml) added to bupivacaine, whereas the other three remaining patients did not receive it. The bilateral group received 10 ml 0.375% bupivacaine followed by an infusion at a rate of 3 ml/hour in each hemithorax. Five patients randomly received epinephrine; five others did not. The plasma levels of bupivacaine were determined at 5, 15, 30, and 60 minutes and at 6 and 18 hours. RESULTS Plasma levels of bupivacaine were significantly lower (p less than 0.05) during the whole study in patients receiving epinephrine. For the same total dose, there were no statistical differences in the plasma levels of bupivacaine between unilateral and bilateral pleural groups. CONCLUSIONS The addition of epinephrine (5 micrograms/ml) to a continuous pleural infusion of bupivacaine diminishes the plasma levels of the local anesthetic. For the same total dose of bupivacaine, there are no differences in the plasma levels obtained between unilateral and bilateral administration.
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Affiliation(s)
- J L Aguilar
- Servicio de Anestesiología, Reanimacion y Terapeutica del Dolor, Hospital Universitario de Badalona Germans Trias i Pujol, Universidad Autonoma de Barcelona, Spain
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Santín M, Badrinas F, Mascaró J, Nolla JM, Pujol O, Roca G, Valverde J, Mañá J, Fernández-Nogués F. [Uveitis: an etiological study of 200 cases following a protocol]. Med Clin (Barc) 1991; 96:641-4. [PMID: 2056797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND To evaluate the usefulness of a systematic study of patients with uveitis and to assess the associated systemic diseases. METHODS 200 patients seen in an outpatient clinic for the evaluation of uveitis between 1981 and 1988 were included in the study. Patients with eye disease associated with drug abuse or human immunodeficiency virus were excluded. The study protocol included an initial clinical and ophthalmological evaluation followed by selected specific investigations. RESULTS Anatomical localization: anterior uveitis 122 (61%), posterior 41 (20.5%), panuveitis 30 (15%) and intermediate 7 (3.5%). ETIOLOGY 74 cases (37%) were secondary, 101 (50.5%) were idiopathic, and 25 (12.5%) were specific syndromes of uveitis of unknown cause. Toxoplasmosis was the most common cause of infective uveitis, and ankylosing spondylitis was the most common noninfective cause. Diagnostic process: group 1, diagnosed by the ophthalmological investigation (25 cases); group 2, diagnosed on the basis of the accompanying clinical features and/or specific investigations (66 cases); and group 3, diagnosed by wider detection methods (8 cases). CONCLUSIONS There was a remarkably high rate uveitis without etiological diagnosis. The evaluation of patients with uveitis requires a careful evaluation of ocular and systemic features, followed by selected specific investigation. The indiscriminate use of diagnostic tests is not warranted.
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Affiliation(s)
- M Santín
- Servicio de Medicina Interna, Hospital de Bellvitge-Prínceps d'Espanya, Barcelona
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Mazo V, Bertrán C, Llorente C, Salvadores M, Roca G, Vidal F. [Comparison of thiopental and propofol in short-duration anesthesia]. Rev Esp Anestesiol Reanim 1991; 38:149-52. [PMID: 1961957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Forty healthy females, 18 to 65 years, undergoing diagnostic or therapeutic uterine curettage were studied with the purpose of comparing anesthetic characteristics of thiopental and propofol as induction agents. They were randomly allocated in two groups: A propofol induction group (2.5 mg/kg), and a thiopental induction group (4-5 mg/kg). Fentanyl (2 micrograms/kg), was administered 2 minutes before anaesthesia, and N2O/O2 (66%/33%) by mask was maintained during surgery. Changes in systolic and diastolic BP were not significantly different in two groups. The HR decreased more significantly in the propofol group (20% vs 10%; p less than 0.005). Apnea was significantly greater in the propofol group, in term of incidence (50% vs 15%; p = 0.025), and duration (92 seg vs 17 seg; p = 0.20). The lapses of time to opening the eyes and response to a command were not significantly different, but the time to be able to seat was significantly lower in the propofol group (12 min vs 21 min; p = 0.0003). Anaesthesia was clinically satisfactory for most patients in both treatment groups.
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Affiliation(s)
- V Mazo
- Servicio de Anestesiología, Hospital Germans Trias i Pujol, Badalona
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Jaroudi KA, Hamilton CJ, Willemsen WN, Sieck UV, Roca G. Artificial endometrial stimulation for frozen embryo replacement. Fertil Steril 1991; 55:835-7. [PMID: 2010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In this study, 18 cycles initiated for the transfer of cryopreserved embryos. Endometrium was prepared using a uniform protocol of exogenous E and P. This approach eliminated cycle cancellations caused by ovulatory dysfunction and gave complete cycle control. Fourteen cycles had embryo division and replacement resulting in three pregnancies. In these conception cycles, E was discontinued at 12 days and P at 26 days after ET. One aborted at 6 weeks gestation, whereas the other two pregnancies progressed uneventfully into the third trimester.
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Affiliation(s)
- K A Jaroudi
- Department of Obstetrics and Gynaecology, King Faisal Specialist Hospital and Research Centre Riyadh, Saudi Arabia
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Roca G, Aguilar JL, Valls R, Olazábal A, García Guasch R. [Inadvertant placement of a feeding tube in the bronchial tree]. Rev Esp Anestesiol Reanim 1990; 37:378. [PMID: 2129139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Santin M, Mascaro J, Nolla JM, Roca G, Badrinas F. Uveitis associated with spondyloarthritis. J Rheumatol 1990; 17:854. [PMID: 2388213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Comerma J, Roca G. [Tuberculous sacroiliitis]. Aten Primaria 1990; 7:244-5. [PMID: 2151789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Roca G, Comerma J. [The medication sheet: a rational proposal for drug use]. Gac Sanit 1989; 3:442. [PMID: 2507466 DOI: 10.1016/s0213-9111(89)70968-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Comerma J, Roca G, Llibre J. [Changes in urinary sediment in occupational health tests]. Aten Primaria 1989; 6:62. [PMID: 2518887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Roca G, Barrueco JC, García Guasch R, Bassons J, Canet J, Vidal F. [Treatment of acute hyperpotassemia with salbutamol in 2 patients]. Rev Esp Anestesiol Reanim 1988; 35:100-3. [PMID: 3387624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Aguilar JL, Roca G, Samsó E, Donoso L, Samper D. [Migration of a thoracic epidural catheter]. Rev Esp Anestesiol Reanim 1987; 34:158-9. [PMID: 3589091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Bonet J, Lauzurica R, Roca G, Serra A, Bonal J, Teixidó J, Romero R, Caralps A. [Acute renal failure caused by obstruction of the renal arteries. Apropos of 2 cases]. Rev Clin Esp 1986; 179:451-3. [PMID: 3809677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
Syphilitic disease of the retina and/or the optic nerve head, without choroidal involvement, occurred in our 4 cases and in another 19 cases. The condition almost always takes place in the secondary stage, frequently associated with meningitis, and rarely in tertiary meningovascular syphilis. Fluctuating visual loss and floating spots without ocular pain are the presenting symptoms. Retinitis, papillitis, and neuroretinitis are accompanied by an inflammatory reaction in the vitreous and, sometimes, in the aqueous. Paracentral scotomas and blind spot enlargement, related with posterior pole and papillary edema, are the most usual visual field defects. Almost complete visual recovery is the rule in the treated cases, although in some instances cystoid macular edema and retinal ischemia due to endarteritis cause permanent visual loss. Treatment with crystalline penicillin is mandatory in patients with concomitant neurosyphilis, whereas procaine penicillin is seemingly sufficient in those with a normal cerebral spinal fluid examination.
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Ippolito A, Lavegas E, Roca G, La Gioia G. [Methampicillin in therapy of typhoid fever]. G Mal Infett Parassit 1971; 23:782-9. [PMID: 5136206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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