1. The importance of leaf quality to the nutritional ecology of lotic shredders is well established for temperate species but virtually unknown for tropical taxa. In the present study, we compared the feeding behaviour and performance of two tropical and two temperate shredders in a series of pair‐wise experiments. 2. Specifically, we tested whether leaf conditioning status (stream‐conditioned versus unconditioned leaves) and geographical origin (temperate Alnus glutinosa versus tropical Hura crepitans leaves) affect the food preference, survivorship, and growth of selected shredders from low and high latitudes in a consistent manner. The animals used in experiments were the caddis‐flies Nectopsyche argentata and Phylloicus priapulus from Venezuela, Sericostoma vittatum from Central Portugal, and the amphipod Gammarus pulex from Northern Germany. 3. In general, all shredders exhibited the same high preference for conditioned over unconditioned leaves, irrespective of the geographical origin of the leaf or shredder species. 4. A corresponding tendency for higher growth was found for sets of animals offered conditioned leaves, with the differences in growth being clearer in the two tropical shredders. Survivorship of the two temperate species was consistently high (> 83%) regardless of the diet offered, whereas the tropical shredders survived better on conditioned (77–90%) as compared with unconditioned (54–87%) leaves, although not significantly so. 5. With the exception of the temperate S. vittatum, shredders did not select or perform better on leaves to which they had previously been exposed, indicating a potential adaptation to native leaf species is over‐ridden by intrinsic leaf properties. 6. Taken together, the results of this study suggest that tropical shredders may exhibit the same basic patterns of food exploitation as their temperate counterparts. Consequently, current concepts relating to the role of shredders in stream detritus dynamics may well be applicable to tropical streams, although essentially derived from temperate systems.

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.

Despite the fact that clinical profile of treated hypertensive patients has worsened in the past years in Spain, BP control rates have improved, particularly in women. This improvement was related with a higher use of combined therapy, regardless of sex.

A single nucleotide polymorphism (-1438 G/A) located 1438 base pairs upstream of the consensus start site of the 5-HT2A receptor gene has been reported. The hypothesis that this gene polymorphism may be a susceptibility factor in bulimia nervosa was explored in a female population of purgative bulimics. Bulimia nervosa patients who have suffered preceding anorexia nervosa episodes formed the so-called previous anorexia nervosa bulimic patient group. At variance with some previous reports, when the frequency distribution of genotypes and alleles was compared in patients and controls, no differences were detected regardless of whether the bulimia nervosa patients had suffered prior anorexia nervosa episodes.

The contribution of statins in the treatment of cardiovascular risk of lipid origin has been a determining factor in the reduction of morbimortality from cardiovascular diseases due to a decrease in risk. However, statins are not exempt from possible adverse effects. One of them is their capacity to cause disorders in the carbohydrate metabolism, increasing the risk of new-onset diabetes in patients treated with statins significantly, although the cardiovascular benefit of their use is always higher. Yet, especially in diabetic or pre-diabetic patients, the statin of choice may condition the safety in this area, given that the diabetogenic profile of the different molecules differ.In particular, the objectives of this study were to summarize the expert's opinion on whether all statins have a similar or different diabetogenic effect and to establish recommendations on the statin selection based on the patient characteristics.In order to ascertain the opinion of the experts (primary care physicians and other specialists with experience in the management of this type of patient) we conducted a Delphi study to evaluate the consensus rate on diverse aspects related to the diabetogenicity of different statins, and the factors that influence their choice.On the basis of the consensus agreements reached among practitioners of different specialities, and considering the availability of greater and better scientific evidence, this work groups together the recommendations to consider when selecting a statin in individuals with prediabetes or diagnosed diabetes. Such recommendations are grouped in relation with the patient, each individual's own carbohydrate metabolism, and the specific characteristics of every statin. These recommendations could facilitate the rational use of one statin or another in order diminish the diabetogenic potential shown by some of them.