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Evidence regarding population trends of endangered species in special protection areas and their recovery ability from catastrophic disturbances is scarce. We assessed the population trend of the Gran Canaria blue chaffinch (Fringilla polatzeki), a habitat specialist endemic to the pine forest of Inagua in the Canary Islands, following a devastating wildfire in July 2007. Using a standardized census program that accounts for detectability, we have monitored the population trend of the species since Inagua was declared a Strict Nature Reserve in 1994. The breeding population density of the blue chaffinch remained stable in Inagua from the beginning of the monitoring program in 1994 until the year before the wildfire. However, in spring 2008, the population density decreased by half with respect to density in the preceding years. Since 2008, the population has gradually increased, reaching its highest recorded density in 2016 (15.8 birds/km2).This represents an average annual increase of 23.7 %, indicating impressive resilience to catastrophic events. The creation of Inagua as a strict nature reserve did not therefore increase the global population or protect the blue chaffinch against a demographic crisis but probably prevented a deepening of the demographic crisis or further declines. Except for the two years immediately after the severe wildfire of 2007, the population density of the blue chaffinch in Inagua has remained relatively stable at around 9–16 birds/km2, the lowest recorded abundance for a small woodland passerine in the Western Palearctic.

We studied bias in density estimations derived from strip transects in dry open-country in the Canary Islands. We also present some critical remarks on García-del-Rey’s (2005) paper regarding strip transects and the validity of comparisons based on population densities of birds in scrublands on Tenerife island using two different methods: territory mapping and strip transect sampling. Although strip transects with census belts of 25 m do not account for detectability, this method only slightly undervalues true density estimates, and allowed to detect more than 85% of birds present in poorly vegetated environments in the Canary Islands. Previously published works on distribution and abundance of terrestrial birds in the Canary Islands using the strip transect sampling with belts of 25 m on both sides of the observer, thus provide reliable information that only slightly underestimates true densities.

Background and Objectives: The COVID-19 pandemic has forced universities to move the completion of university studies online. Spain's National Conference of Medical School Deans coordinates an objective, structured clinical competency assessment called the Objective Structured Clinical Examination (OSCE), which consists of 20 face-to-face test sections for students in their sixth year of study. As a result of the pandemic, a computer-based case simulation OSCE (CCS-OSCE) has been designed. The objective of this article is to describe the creation, administration, and development of the test., Materials and Methods: This work is a descriptive study of the CCS-OSCE from its planning stages in April 2020 to its administration in June 2020., Results: The CCS - OSCE evaluated the competences of anamnesis, exploration, clinical judgment, ethical aspects, interprofessional relations, prevention, and health promotion. No technical or communication skills were evaluated. The CCS-OSCE consisted of ten test sections, each of which had a 12-minutes time limit and ranged from six to 21 questions (mean: 1.1 minutes/question). The CCS-OSCE used the virtual campus platform of each of the 16 participating medical schools, which had a total of 2,829 students in their sixth year of study. It was jointly held on two dates in June 2020., Conclusions: The CCS-OSCE made it possible to bring together the various medical schools and carry out interdisciplinary work. The CCS-OSCE conducted may be similar to Step 3 of the United States Medical Licensing Examination., (© 2021 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.)

The number of caesarean sections performed worldwide is increasing, and with it, the need for the optimal analgesia strategies. Deficient postoperative analgesia increases the need for opioids, delays recovery, and is associated with chronic pain and postpartum depression. It is essential to find good postoperative pain control strategies that facilitate early mobility, early recovery, and early hospital discharge with minimal side effects on the mother and infant. Multimodal analgesia based on neuroaxial anaesthesia with morphine in combination with non-opioids such as non-steroidal anti-inflammatory drugs and paracetamol, gives the best post-caesarean analgesia outcome, and allows anaesthesiologists to reserve opioids, corticoids, gabapentin, magnesium or ketamine for situations where neuroaxial anaesthesia cannot be performed, for high-risk patients, or when pain is difficult to control. Peripheral nerve block techniques can also be added, such as transverse abdominis plane block, erector spinae block, or continuous wound infiltration., (Copyright © 2019 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: The method for selecting medical graduates for residency positions has a strong influence on teaching and learning strategies in medical schools. The methodology currently used in Spain does not seem appropriate for ranking the candidates or improving curriculum development. Thus, and taking into account the most consistent methodologies used in the United Kingdom and USA, we have designed a new method to be used in our country., Objectives: To analyze the limitations of the methodology used in Spain, and propose a new one aimed to improve the accuracy of selection itself and avoiding the negative influence of the current method on curricular development. In addition, we emphasize the necessity of improving teaching and learning in the clinical context to assure that graduating students reach an adequate level of clinical competence., Conclusions: The method for selecting candidates to residency post currently used in Spain, which relies mainly on testing theoretical knowledge, should be changed for an alternative methodology taking into account student,s performance through the course and assessing his/her ability for clínical contextualization of knowledge and level of clinical competence., (Copyright © 2015 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.)

Introduction: The design of an appropriate method for the selection of medical graduates for residency posts is extremely important, not only for the efficiency of the method itself (accurate identification of most competent candidates), but also for its influence on the study and teaching methodologies operating in medical schools. Currently, there is a great variation in the criteria used in different countries and there is no definitively appropriate method. The use of isolated or combined criteria, such as the marks obtained by students in medical schools, their performance in tests of theoretical knowledge and evaluations of clinical competence, or personal interviews, have a limited value for identifying those candidates who will perform better during the residency and later on during independent practice., Objectives: To analyse the variability in the methodologies used for the selection of residents employed in different countries, in particular those used in the United Kingdom and USA, where external agencies and medical schools make systematic analyses of curriculum development. The advantages and disadvantages of national or transnational licensing examinations on the process of convergence and harmonization of medical degrees and residency programmes through Europe are discussed. The present analysis is used to design a new and more efficient multi-criteria methodology for resident selection in Spain, which will be published in the next issue of this journal., Conclusions: Since the multi-criteria methods used in UK and USA appear to be most consistent, these have been employed for designing the new methodology that could be applied in Spain. Although many experts in medical education reject national examinations for awarding medical degrees or ranking candidates for residency posts, it seems that, when appropriately designed, they can be used to verify the level of competence of graduating students without necessarily distorting curriculum implementation or improvement., (Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.)

Social changes and new technologies have brought new problems in doctor-patient relationship. In many clinical contexts conscientious objection is misused, with negative effects for patients, healthcare professionals and institutions. In this article an attempt will be made to clarify the problem from a clinical point of view, assessing the increase in risks in clinical praxis due to patient choice, the complexity of current clinical praxis, and the appropriate use of life support measures. Likewise, it analyses socially controversial ethical values and professional practices with no curative value and with no clinical indication in the physiological sense., (Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.)

On 4 April 2011, as part of the XVIII Conference in Law and the Human Genome, the official presentation took place of the first Spanish language Encyclopedia of Biolaw and Bioethics, in an event organised by the Inter-University Chair in Law and the Human Genome held, on this occasion, in the new Auditorium of the University of the Basque Country. The Encyclopedia of Biolaw and Bioethics is a project which was conceived and driven forward by the Inter-University Chair in Law and the Human Genome. It was an ambitious project which was supported by the Roche Institute Foundation. It was therefore a magnum opus which began more than three years ago and which has required the work of more than 200 professionals from various disciplines in Spain, Latin America and Portugal. The encyclopaedia tries to make up for the lack of a suitable publication in the Spanish language that could be used as a reference and be consulted by different experts who have to tackle controversies and doubts posed in the field of biolaw and bioethics as part of their everyday work. The work makes it possible to ascertain the situation in this field regarding the most controversial issues and emerging conflicts, find out which values, assets or rights are involved or confronted, what solutions have been proposed by bioethics and the social positions that have been established through legal regulations. All in all, the encyclopaedia was the culmination of an ambitious undertaking, a pioneering work in the Spanish speaking countries due to its characteristics and scope. It is essential to have such a resource in today's cultural environment. The presentation of the Encyclopedia of Biolaw and Bioethics given by Mr. Del Barrio Seoane as Director General of the Roche Institute Foundation during the Conference deservers a special mention. The project has been consolidated through the support of this institution.

Studies of the relationship between variations in DNA or RNA characteristics and drug response are yielding important advances, boosted by continuous improvements and decreasing costs of the techniques for large-scale analysis of genes and proteins. This is increasing current capabilities to discover new drugs and therapeutic targets, establish early and differential diagnosis of disease, and optimize the use of existing medicines. As Personalised Medicine continues to develop, the question arises as to when biomarkers and genomics should best be incorporated into the drug development process.

Plasma cell tumors are lymphoid neoplastic proliferations of B cells that may be classified as multiple myeloma (MM), solitary bone plasmacytoma (SBP) and extramedullary plasmacytoma (PEM). These types of neoplasia are typically found in adults and may occur as disseminated tumors of the bone marrow or in some cases as solitary bone or extramedullary tumors. Most SBP eventually develop into MM, whereas only 30% of the PEM do so. Oral manifestations in the form of oral and maxillofacial lesions are often the first sign of the disease. Treatment of these neoplastic tumors varies depending on the type of proliferation and may involve surgery, radiotherapy and chemotherapy, alone or combined. This paper reviews the main clinical and pathological aspects of these tumors and their relationship to the oral and maxillofacial area.

The anterior sacral meningocele is the congenital hernia of the thecal sac into the pelvis through a bone defect of the anterior wall of the sacrum. The association of anorectal anomaly, anterior sacral defect and presacral mass, known as Currarino's triad, can be diagnosed during the first decade of life in the eighty per cent of the cases However, in the incomplete syndrome, the symptoms appear in adults. In order to avoid late complications and due to the clear genetic origin of this uncommon pathology, the investigation of the family is of paramount importance for the early diagnosis and treatment. We review the literature and add two cases of anterior sacral meningocele with rectal fistula and incomplete Currarino's syndrome. In one of the cases the pathology is also present in another member of the same family and is complicated with meningitis. The importance of early diagnosis and treatment of these malformations and the need for fammily genetic investigation are discussed.

Platelet-Rich Plasma (PRP) concentrates have been widely used in the past decade as a complement to tissue regeneration procedures. The authors who have clinically used PRP refer no risk of infection, disease transmission, or undesirable effects. Nevertheless, there have been reports on the over-expression of growth factors (GFs) and their receptors related to tumour and dysplastic tissues. This has led to evaluation of the possible coincidences between carcinogenesis and the mitogenic pathways employed by GFs. The present study provides a review of the literature on the possible effects of the therapeutic uses of GFs (including PRP) in relation to carcinogenesis, their influence upon tissues with epithelial dysplasia or oral carcinoma, and their relation to tumour growth and infiltration.

Objectives: The aim of this study has been to define the prevalence of DM (considered according to the ADA-97 criteria) in OLP patients and also to investigate the existence of clinical and pathological differences between OLP patients with or without DM., Study Design: Sixty-two patients suffering from OLP according to clinical and pathological criteria were selected to enter the study and classified after the DM diagnosis guidelines suggested by The American Diabetes Association (ADA-1997). The variables considered for each patient were: age, sex, clinical presentation, extension of the lesions, location of the lesions, number of locations, Candida albicans colonization, and density of subepithelial inflammatory infiltrate., Results: Up to 27.4% of OLP cases were associated to type 2 DM (DM2) and 17.7% were related to an impaired fasting glucose (IFG). The mean age of the DM2-associated OLP group was significantly higher than the non-diabetic group's. No significant differences could be observed in terms of clinical and pathological features between diabetic and non-diabetic OLP patients., Conclusion: The high prevalence of hydrocarbonate metabolism disorders observed in OLP patients justify the use of FPG for screening of DM2 in these patients.

Objective: To analyse the results obtained by two systems of recruiting patients in terms of: number of patients recruited, number of consultations requested, and number of half-yearly check-ups performed., Design: Retrospective and observational., Setting: Primary care., Patients: 1868 school-children from 6 to 14 in the Burela Health Area (Lugo)., Main Results: The system based on the health centre recruited 616 children and led to 759 requests for consultation; whereas the system based on the school recruited 1252 children and 507 requests (123% vs 40%; p < 0.05). 23% of the school-children attended their half-yearly check-up under the first system, while 21% did so under the second., Conclusions: Check-ups of children at the health centre in their parents' presence seems to answer better the objective of introducing the bucco-dental health programme into the Health Area's child population.

Introduction: Knowledge of the chronic auto-immune acquired neuropathies has progressed rapidly since the recent description of the Lewis-Sumner syndrome and multifocal motor neuropathy. Some of the most interesting aspects of these conditions are the presence of persistent conduction blocks and the challenge of understanding the mechanisms involved. These blocks are difficult to identify., Clinical Case: We describe the case of a female patient with Lewis-Sumner syndrome, with persistent sensory and motor blocks. The electrophysiological characteristics and differential diagnosis of the two conditions are reviewed.

Disseminated extrapulmonary tuberculosis is uncommon in no immunocompromised hosts. We described the case of a 68-year-old HIV seronegative man, who presented with a 5 months history of constitutional symptoms, generalized lymphadenopathy, evening fever, osteomyelitis of the left fibula and cutaneous lesions (papules and pustules). There was neither clinical nor radiological evidence of pulmonary involvement. On the basis of bacteriological and pathological findings the diagnosis of disseminated extrapulmonary tuberculous was made.

The Sevilla Scale of Quality of Life is composed by two scales: the Scale F or scale of favourable aspects and the Scale D or scale of unfavourable aspects. This work elaborates some conceptual procedures and some operative strategies to interpret in a complex way the quality of life. We build a unique and global punctuation for the CSCV that we denominate PCV, and that it is the result of other partial scores; we also outline the analysis of the dispersion matrix of the PCV like a system to differentiate styles different from quality of life. We use the factor structure of the CSCV to represent each subject in a three-dimensional space by means of two points, the favourable aspect and the unfavourable one; the geometric distance between both points represent another conceptual shade to interpret of the types of quality of life. The necessity is underlined of guaranteeing the utility of these procedures by means of future empiric analysis, with samples of subject so much normal as pathological.

We present a case of polymyalgia-like syndrome in a 62-years-old woman with four month history of severe headache, muscular claudication, asthenia, normochromic, normocytic anaemia and elevation of erytrocyte sedimentation rate. A diagnosis of giant left atrial myxoma was made brought about by thoracoabdominal magnetic resonance. Their surgical exeresis was followed by gradual disappearance of symptoms and normalization of laboratory parameters.

Background: The aim of this study was to evaluate the etiology of phlebitis (chemical or infectious) and the prevalence of infections related to intravascular catheters (IRIC) in patients with HIV infection admitted to a 22-bed Infectious Disease Unit with a high rate of HIV infection., Material and Methods: A 3-month prospective study from November 1, 1994 to January 31, 1995 was carried out following a formula for data collection of all the intravenous catheters used during that time period. Cultures of the catheters withdrawn on Wednesdays and those with signs of phlebitis were performed., Results: One hundred fifty-two intravenous catheters in 71 patients with HIV infection with a mean age of 37 years (range: 21-73) and mean hospital stay of 10.2 days were reported. During the study period 42 phlebitis were produced, of which 37 catheters (7 central and 30 peripheral) were processed. Of the 37 phlebitis processed, 29 (78.9%) were considered to be of physiochemical origin. Of the 21 catheters withdrawn Wednesday, 18 were processed, 8 with phlogotic signs, 2 with IRCI, equivalent to 1.9 IRCI/100 days of catheterization. During the study period no local or severe systemic infections related to the catheter were reported. Staphylococcus epidermidis was the organism involved in all the cases of IRCI., Conclusions: Despite the high number of immunosuppressed patients in related to HIV infection, a greater incidence of IRCI was not found in these patients. The most frequent cause of phlebitis by catheter was of chemical origin.

The angiofollicular lymph node hyperplasia (Castleman's disease) is an entity of unknown etiology. Its diagnosis is based on clinical and histological criteria. We present the case of a 20-year-old male patient with asymmetric oligoarthritis and fever which response to nonsteroidal antiinflammatory drugs as onset of abdominal Castleman's disease mixed type.

Objective: The aim of this case-control study was to know possible correlates between distinctive pattern of hand arthrosis and length manual milking., Patients and Methods: Between January 1990 and January 1996, we retrospectively reviewed the patients with symptomatic arthrosis in whose hands was identified this pattern: degenerative disease of distal interphalangeal joints with radial deviation and flexion of distal phalanges in association to arthrosis involving metacarpophalangeal and interphalangeal joints of the thumb. The first 88 cases of hand arthrosis without this clinical and radiographic pattern make the control group. Patients suffering inflammatory rheumatic diseases were excluded., Results: 35 patients with this special pattern of hand arthrosis were recruited. The majority of patients were women (94.3%) and coming from rural environment (94.3%). 32 patients had performed daily manual milking over a period of 20 years, but in three patients the pattern was not related to this activity (odds ratio = 928: p < 0.001). Symptoms were more frequent in the control-group (57% versus 26%; p < 0.04), in which no characteristic pattern of alignment abnormality was found., Conclusion: A typical pattern of hand arthrosis was associated with prolonged manual milking: degenerative disease of metacarpophalangeal and interphalangeal joints of thumb, radial deviation associated with flexion of distal phalanges of second at fourth fingers and arthrosis involving their distal interphalangeal joints, often linked to sight ulnar deviation of middle phalanges.

Background: Septic bursitis usually affects subcutaneous localized bursae such the prepatellar and elbow bursae. This condition is infrequently reported in the spanish medical literature. The aim of this report was to study patients suffering from septic bursitis with regard to predisposing conditions, the causative agents, therapy and clinical outcome., Method: A retrospective study was undertaken in patients with infectious bursitis attended in the Service of Rheumatology of the POVISA Medical Centre (Vigo) and Juan Canalejo Hospital (La Coruña), Spain, from january 1989 to january 1995. The diagnosis of septic bursitis was confirmed with positive bursal fluid cultures in all cases., Results: We recovered forty cases of infectious bursitis (23 olecranon bursitis and 17 prepatellar bursitis). Most patients were male (80%), and patient mean age was 52 years (range: 14-94). The most common predisposing factors to bacterial infection were steroid therapy (15%) and alcoholism (8%), in addition to cutaneous lesions associated with occupational or recreational trauma (55%). Prepatellar septic bursitis was associated with a more aggressive clinical presentation with fever (71% vs 48%), leukocytosis (76% vs 52%), cellulitis (59% vs 48%) and positive blood cultures (25% vs 0%). Staphylococcus aureus was isolated from 87.5% of bursal fluid aspirations, the other etiologic microrganism were Staphylococcus epidermidis (2 cases), Streptococcus agalactiae (2 cases) and Streptococcus pneumoniae (1 case). The majority of patients (80%) required initial intravenous therapy of which average duration was 11 days (range: 5-21 days). Successful resolution of septic bursitis without open surgical drainage was seen in 38 patients (95%) and there ware no functional impairment, serious complications or recurrences., Conclusions: The majority of patients with septic bursitis suffered systemic and/or local predisposing illness. S. aureus is the commonest pathogen. Prepatellar septic bursitis is associated with a more aggressive clinical presentation and bacteremia. Usually, the prompt and proper antibiotic therapy make innecessary surgical drainage.

Focal myositis is a rare form of idiopathic inflammatory myopathy. We describe an additional case of focal myositis in a 54-years-old woman presenting as a painful pseudotumor of the left forearm. Muscle enzymes were normal but generalized electromyographic abnormalities were found. We consider that focal myositis is a heterogeneous clinical syndrome, and the cases showing only focal involvement can be different from those that evolve into polymyositis.

A case of chronic angular cheilitis is reported. Candida albicans was isolated repeatedly and the process developed into epitheliomatous carcinoma. The etiopathogenic role of Candida albicans and possible mechanism of action are discussed.

Systemic Lupus Erythematosus (SLE) is among the chronic diseases thought to predispose patients to severe Salmonella infections. However, arthritis and osteomyelitis due to this microorganisms are more frequently seen in patients with sickle-cell disease than SLE. We report two cases of SLE and osteoarticular infections by Salmonella enteritidis: A 36-years old woman with bilateral knee arthritis associated with femoral osteomyelitis and a 22-years-old woman who presented with left knee arthritis.