Nursery areas are fundamental for the success of many marine species, particularly for large, slow-growing taxa with low fecundity and high age of maturity. Here, we examine the population size-class structure of the extinct gigantic shark Otodus megalodon in a newly described middle Miocene locality from Northeastern Spain, as well as in eight previously known formations (Temblor, Calvert, Pisco, Gatún, Chucunaque, Bahía Inglesa, Yorktown and Bone Valley). In all cases, body lengths of all individuals were inferred from dental parameters and the size-class structure was estimated from kernel probability density functions and Gaussian mixture models. Our analyses support the presence of five potential nurseries ranging from the Langhian (middle Miocene) to the Zanclean (Pliocene), with higher densities of individuals with estimated body lengths within the typical range of neonates and young juveniles. These results reveal, for the first time, that nursery areas were commonly used by O. megalodon over large temporal and spatial scales, reducing early mortality and playing a key role in maintaining viable adult populations. Ultimately, the presumed reliance of O. megalodon on the presence of suitable nursery grounds might have also been determinant in the demise of this iconic top predatory shark.

A 55-year-old man with a subacute onset of slurred speech, ataxia, nystagmus, extrapyramidal rigidity, decreased tendon reflexes, vomiting, bilateral optic atrophy, and clonic jerks died of bronchopneumonia and respiratory failure. Neuropathological examination showed lesions characteristic of subacute necrotizing encephalopathy. Clinicopathological observations of reported cases of Leigh's syndrome in the adult are reviewed.

No abstract

A case of multiple sclerosis and Hashimoto's thyroiditis confirmed by cytology is reported. The association of multiple sclerosis with other autoimmune diseases is infrequent but supports the immune hypothesis of the pathogenesis of multiple sclerosis. The authors suggest the inclusion of immunological tests in the screening of all patients diagnosed as having multiple sclerosis.

ObjectiveTo analyze the surgical outcomes and diaphragmatic involvement in stage III and IV ovarian cancer.Patients and methodsAll patients with stage III–IV ovarian cancer between January 2013 and January 2016 were included. The outcomes of interest reviewed were as follows: surgical (complications, mortality), peritoneal carcinomatosis index (PCI), rate of complete resection, and disease-free interval and survival.ResultsFifty-seven patients were included, 38 (67%) with diaphragmatic involvement; in 10 cases (18%), diaphragmatic resection was required. Optimal cytoreduction (OCR) was obtained in 49 cases (86%). The PCI was >10 in 31 cases (54%). Respiratory complications occurred in 10 cases (18%) and mortality in 3 (5%). Disease-free survival rate in 3 years was 53%, being 87% in cases without diaphragmatic involvement. The overall survival rate in 3 years is 46%, 83% in the cases without diaphragmatic involvement and 27% in cases with affectation (p<0.05). In cases of OCR, 3 year survival rate was 65%. In the multivariate analysis for the overall survival of cases with OCR, the only independent prognostic factor found was the operative PCI. A strong correlation was found between the total PCI and the diaphragmatic PCI (p<0.001). With a PCI >10, virtually all cases will present diaphragmatic involvement (p<0.05).ConclusionThe tumor burden is different in stages III and IV of advanced ovarian cancer and the PCI is an effective method to quantify it. The PCI constitutes an independent prognostic factor for the advanced stages of ovarian cancer. A PCI >10 constitutes a useful prognostic factor of the affectation and forces the surgeon to thoroughly review both diaphragms.