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Our aim is to describe clinical and optical coherence tomographic features of acute paraneoplastic focal outer retinitis associated with optic neuropathy in a patient diagnosed with small cell lung carcinoma. Bilateral focal outer retinitis, bilateral optic disc oedema and vitritis were identified in a patient with progressive bilateral visual loss and ataxia. Spectral domain optical coherence tomography (SD-OCT) revealed various extents of granular hyperreflectivity and atrophy of the macular outer retinal layers. Serum and cerebrospinal fluid positivity for anti-CRMP5, anti-HU and anti-amphiphysin antibodies intensified the search for an underlying malignancy, and a small cell lung carcinoma (SCLC) was finally diagnosed. Local and oral steroids along with systemic chemotherapy and radiotherapy achieved cancer remission and partial recovery from the ophthalmic manifestations. Focal outer retinitis associated with optic disc oedema and antibody positivity facilitated the diagnosis of SCLC in a localized stage. SD-OCT allowed the characterization of this entity, expanding the spectrum of paraneoplastic ophthalmological syndromes. [ABSTRACT FROM AUTHOR]

Since the beginning of the economic crisis in Spain young people have migrated abroad looking for job opportunities. In the meantime, after the 15-M movement in 2011, Spanish society created various social movements hoping to make change happen, as well as the pro-independence movement in Catalonia that gathered strength as a response to the Spanish economic and political crisis. This paper analyses how Spanish young people in London, as transmigrants rooted in two different countries, engage with the politics of their home country through two transnational social movements in London: ANC England and the Maroon Wave London. The article describes both local movements (comparing their goals, structure and activities), showing the reasons that young Spanish migrants get involved and their experiences within them. It also rethinks the nature and modalities of young diasporic identities and political engagement in the global age through the experiences of the young people interviewed. [ABSTRACT FROM AUTHOR]

Purpose: To help the ophthalmologist in the study and update of the exciting area of ocular inflammation and uveitis. Concerning the most recent clinical entities, diagnostic techniques and therapeutic options, we propose a review of the main international journals: Ophthalmology, American Journal of Ophthalmology, Retina, Ocular Immunology and Inflammation and Journal of Ophthalmic Infection and Inflammation. Methods: A descriptive bibliographic review of the papers published in 2017 in the previously mentioned journals. Results: Sorted in the following categories: pediatric uveítis, scleritis, infectious uveítis, non-infectious uveítis, diagnostic and treatment, the main outcomes are analyzed. Conclusion: Last year 2017 offers numerous papers of the highest interest and relevance in the field of ocular inflammation and uveítis. [ABSTRACT FROM AUTHOR]

Mobility is one of the buzzwords in political discourse regarding solutions for youth unemployment in times of crisis. Young Spaniards are seen to be leaving en masse. However, there is no statistical basis to confirm this hypothesis, especially regarding the Schengen Area, and little is known about the predisposition of highly skilled young people to move abroad. This paper answers the research questions: (1) How many university students consider emigrating?; (2) What are their profiles?; (3) What are their motivations and expectations?; and (4) Where do they want to go? Our results were obtained through an online survey on Catalan university students and contrasted with data from different Catalan youth services. Our results show a high predisposition to emigrate for temporary stays. The EU, in particular the UK, is the favourite destination; however, this situation could change drastically with Brexit. [ABSTRACT FROM AUTHOR]

Arteriovenous fistulas (AVFs) are abnormal shunts between the arterial and venous vascular systems. These usually produce ocular pain, increased intraocular pressure (IOP), and diplopia. Less frequently, they may cause retinal changes with visual impairment. Our purpose is to illustrate different retinal manifestations of AVF. We report the multimodal imaging study of three cases with retinal changes due to AVF, showing neurosensory retinal detachment, macular oedema, and macular ischemia. In conclusion, AVF may appear with different ophthalmic alterations. While usually increased IOP and diplopia are our main concerns, retinal study is mandatory, since a myriad of morphologic abnormalities might be present. [ABSTRACT FROM AUTHOR]

Purpose: to underline the importance of optical coherence tomography angiography (OCT‐A) in the diagnosis, assessment of final visual outcome and better understanding of the Purtscher like retinopathy, as well as to emphasize on performing an ophthalmologic evaluation in all patients with systemic lupus erythematosus, as eye involvement is closely related with disease activity. Methods: case report. Ophthalmologic multimodal imaging assessment of a patient short after experiencing a systemic lupus erythematosus severe outset. Results: fundus examination revealed multiple cotton‐wool exudates and sharp defined intraretinal white flecken lesions, concentrated in the posterior pole, which along macular edema and the context of lupus disease led to the diagnosis of Purtscher like retinopathy, raising concern about underlying disease activity. OCT‐A evidenced ischemic affront in the superficial and deep vascular plexuses but also at choroidal level, preconizing a poor visual outcome. Precapillary retinal vascular stops and choroid lobular ischemic images were of note. Six months after initial consultation, previously displayed ischemic images gave rise to retinal and choroidal atrophy translated in counting fingers best corrected visual acuity with the posterior ensue of retina neovascularization. Conclusions: This case proves ophthalmologic evaluation mandatory for all patients suffering from lupus and reveals OCT‐A as an imaging tool of great value in the assessment of Purtscher retinopathy. To our knowledge, this is would be the first report of a SLE Purtscher‐like retinopathy characterized by OCT‐A, matching graphically and unprecedently vascular micro‐embolism stops and ischemic areas, seen as void signals, with the pathognomonic Purtscher flecken and Paracentral Acute Middle Maculopathy (PAMM) lesions. [ABSTRACT FROM AUTHOR]

Siphonaria pectinata is a marine gastropod distributed across the shores of the Western and Eastern Atlantic. Although previous studies have indicated that the species could be a recent introduction to Central and North America from Western Africa and Europe, other authors have questioned this statement. In fact, a recent study has shown that individuals from both sides of the Atlantic are genetically disconnected, rejecting the idea of a recent invasion. However, genetic information on this species is very scarce and based only on a single study using a limited number of specimens and sites. The data reported in the present study represent one step forward, collecting information from 119 specimens from 22 sites that cover the entire distributional range of the species. Populations from the Western Atlantic separated from eastern ones around 1.4−1.9 Mya, whereas the centre of dispersion is located on the eastern side of the Atlantic. Siphonaria pectinata should be considered native to the Western Atlantic and cannot be considered as a species with an amphi-atlantic distribution owing to the lack of genetic connection between both sides of the Atlantic, as previous authors have pointed out. The presence of a star-shaped phylogeny is discussed in the context of Plio-Pleistocene glaciations. [ABSTRACT FROM AUTHOR]

Introduction: A comprehensive assessment of congestion, including circulating biomarkers, is recommended in patients with acute heart failure. The circulating biomarkers natriuretic peptides (NPs) and carbohydrate antigen-125 (CA125) could be useful for congestion assessment in ambulatory chronic heart failure (CHF), but there is only limited information about their applicability in this context. Therefore, this study aimed to examine the association of plasma CA125 and NP levels with clinical and ultrasound congestion parameters in CHF. Methods: This is a cross-sectional substudy of the Cardioren Spanish Registry, which enrolled 1,107 patients with CHF from 13 tertiary hospitals in Spain between October 2021 and February 2022. Through ambulatory visits, we performed a comprehensive assessment of congestion-related parameters, including clinical variables (orthopnea, peripheral edema, and jugular engorgement, represented by the composite congestion score [CCS]), echocardiography variables (lung B-lines and inferior vena cava [IVC] diameter), and circulating biomarkers (CA125 and NPs). The association of the NP and CA125 levels with the clinical and echocardiographic congestion parameters was examined by multiple linear and logistic regression analyses. Results: This substudy included 802 patients for whom all the biomarker parameters were available {median age, 74 (interquartile range [IQR], 63–81) years; 65% male}. The proportion of patients with left ventricular ejection fraction ≥50% and estimated glomerular filtration rate <60 was 34% and 58%, respectively. The median CCS was 0 (IQR: 0–1), with 45% of the sample exhibiting a median CCS of ≥1. The jugular engorgement, peripheral edema, and orthopnea rates were 32%, 21%, and 21%, respectively. A total of 35% of patients who underwent ultrasound examination showed lung B-lines, and the median IVC diameter was 16 mm. The median CA125 and NTproBNP levels were 14 U/mL (IQR: 9–28) and 1,382 pg/mL (IQR: 563–3,219), respectively. Multivariate analysis showed that higher CA125 levels were independently associated with higher odds of peripheral edema (p = 0.023) and lung B-lines (p < 0.001). Further, NTproBNP was positively associated with jugular engorgement (p < 0.001), orthopnea (p = 0.034), and enlarged IVC diameter (p = 0.031). Conclusions: Clinical signs of congestion are frequent in CHF. In the ambulatory setting, NTproBNP was associated with parameters linked to intravascular congestion such as orthopnea, jugular engorgement, and IVC diameter, whereas CA125 was associated with extravascular volume overload parameters (peripheral edema and lung B-lines). [ABSTRACT FROM AUTHOR]

Background: Studies suggest that cerebrospinal fluid (CSF) levels of amyloid-β (Aβ)42 and Aβ40 present a circadian rhythm. However sustained sampling of large volumes of CSF with indwelling intrathecal catheters used in most of these studies might have affected CSF dynamics and thereby confounded the observed fluctuations in the biomarker levels. Methods: We included 38 individuals with either normal (N = 20) or abnormal (N = 18) CSF Aβ42/Aβ40 levels at baseline. CSF and plasma were collected at two visits separated by an average of 53 days with lumbar punctures and venipunctures performed either in the morning or evening. At the first visit, sample collection was performed in the morning for 17 participants and the order was reversed for the remaining 21 participants. CSF and plasma samples were analyzed for Alzheimer' disease (AD) biomarkers, including Aβ42, Aβ40, GFAP, NfL p-tau181, p-tau217, p-tau231 and t-tau. CSF samples were also tested using mass spectrometry for 22 synaptic and endo-lysosomal proteins. Results: CSF Aβ42 (mean difference [MD], 0.21 ng/mL; p = 0.038), CSF Aβ40 (MD, 1.85 ng/mL; p < 0.001), plasma Aβ42 (MD, 1.65 pg/mL; p = 0.002) and plasma Aβ40 (MD, 0.01 ng/mL, p = 0.002) were increased by 4.2-17.0% in evening compared with morning samples. Further, CSF levels of 14 synaptic and endo-lysosomal proteins, including neurogranin and neuronal pentraxin-1, were increased by 4.5-13.3% in the evening samples (MDrange, 0.02-0.56 fmol/µl; p < 0.042). However, no significant differences were found between morning and evening levels for the Aβ42/Aβ40 ratio, different p-tau variants, GFAP and NfL. There were no significant interaction between sampling time and Aβ status for any of the biomarkers, except that CSF t-tau was increased (by 5.74%) in the evening samples compared to the morning samples in Aβ-positive (MD, 16.46 ng/ml; p = 0.009) but not Aβ-negative participants (MD, 1.89 ng/ml; p = 0.47). There were no significant interactions between sampling time and order in which samples were obtained. Discussion: Our findings provide evidence for diurnal fluctuations in Aβ peptide levels, both in CSF and plasma, while CSF and plasma p-tau, GFAP and NfL were unaffected. Importantly, Aβ42/Aβ40 ratio remained unaltered, suggesting that it is more suitable for implementation in clinical workup than individual Aβ peptides. Additionally, we show that CSF levels of many synaptic and endo-lysosomal proteins presented a diurnal rhythm, implying a build-up of neuronal activity markers during the day. These results will guide the development of unified sample collection procedures to avoid effects of diurnal variation for future implementation of AD biomarkers in clinical practice and drug trials. [ABSTRACT FROM AUTHOR]

Introduction Taxanes have demonstrated effectiveness in the treatment of breast cancer, the most common type of cancer in women. The toxicity profile of taxanes (including skin toxicities) induces dose adjustment, delay, or discontinuation, which prevents a sufficient dose intensity to achieve a response. Nanoparticle albumin-bound paclitaxel, a solvent-free form of paclitaxel, prevents toxicities and reduces the pharmacokinetic interferences between paclitaxel and other drugs. Case presentation We describe the case of a 55-year-old Caucasian woman with locally advanced breast cancer treated with neoadjuvant therapy who developed secondary skin toxicity due to delayed hypersensitivity to taxanes. She received Adriamycin® (doxorubicin), cyclophosphamide and docetaxel and developed toxicity that promoted treatment delay and a switch to weekly paclitaxel. After the third and fourth weeks of treatment, paclitaxel toxicities also induced treatment delay and paclitaxel was switched to nanoparticle albumin-bound paclitaxel. She completed the five planned nanoparticle albumin-bound paclitaxel cycles with acceptable tolerability (including persistent grade 2 neuropathy) and without dose delay or adjustments. Clinical response was achieved although pathological response was not good. Conclusions Nanoparticle albumin-bound paclitaxel treatment is a good option for patients with breast cancer with taxanes-related skin toxicity. This drug allows the treatment to be completed with acceptable tolerance in our case. [ABSTRACT FROM AUTHOR]

Purpose. To assess the risk for capsular rupture during routine phacoemulsification in patients with a history of anti-VEGF injections and other possible risk modifiers such as treatment patterns, type of anti-VEGF agent, and experience of the surgeon, among others. Methods. This study reviewed the medical records of 11,129 patients from 7 different hospitals in 5 countries. The study included 939 patients that underwent routine phacoemulsification and had a history of anti-VEGF therapy. We excluded patients with known risk factors for capsular rupture, as well as patients with a history of other retinal procedures. The study extracted data regarding general demographics, the number of previous injections, type of anti-VEGF agent, details of cataract surgery, and anti-VEGF treatment patterns. Results. Overall prevalence of posterior capsular rupture: 7.45% (95% CI: 5.9–9.32%). The mean number of injections per patient was 3.37 ± 2.8. More than 50% of the patients received their last anti-VEGF injection within three months before cataract surgery. The complication rate during intravitreal injections was 1.07%. In the univariate analysis, the experience of the cataract surgeon (inexperience surgeons; OR: 2.93) and the history of prior anti-VEGF therapy (OR: 1.77) were significant risk indicators for PCR (p < 0.05). However, after controlling for age in the multivariate analysis, the trend did not reach a statistical significance. Conclusion. The risk for capsular rupture is higher in patients with a history of intravitreal anti-VEGF injections. [ABSTRACT FROM AUTHOR]