Abstract: Objectives. To report our experience, the efficiency, safety and results of endovascular mechanical thrombectomy with the Trevo device in acute ischemic cerebral stroke. Materials and Methods. We performed a retrospective study of 145 acute ischemic stroke patients treated with mechanical throm-bectomy using the Trevo system, between october 2008 and march 2012. 87.3% in anterior circulation and 12.7% in posterior circulation. Results. Mean age at presentation was 67 years (range 21-82, 54.5% males). The NIHSS presentation baseline was 17 (range, 18-22). The median interval from the onset of symptoms to arterial punction was 263 minutes (173-296). Satisfactory recanalization defined TICI (2-3) in 91% with 45% showing a good functional prognosis (mRS 0-2) at 90 days. 23% mortality at 90 days with 11% intracerebral haemorrage. Conclusions. In our experience, endovascular treatment of acute ischemic stroke with the Trevo device is safe and effective.

Objetivos. Reportar nuestra experiencia, eficacia, seguridad y resultados del tratamiento endovascular mediante trombectomía mecánica con el dispositivo Trevo en el ictus cerebral isquémico agudo. Materiales y Métodos. Realizamos un estudio retrospectivo de 145 pacientes con infarto cerebral isquémico agudo tratados mediante trombectomía mecánica con el dispositivo Trevo entre octubre del 2008 y marzo del 2012. 87,3% circulación anterior y 12,7% circulación posterior. Resultados. La edad media de presentación fue 67 años (rango 21-82; 54,5% sexo masculino). El NIHSS basal de presentación fue de 17 (rango, 18-22). La mediana desde el inicio de los síntomas a punción arterial fue de 263 minutos (173-296). Recanalización satisfactoria (TICI 2-3) del 91% con un 45% de buen pronóstico funcional (mRS de 0-2) a los 90 días. Mortalidad de 23% a los 90 días con 11% de sangrado intracerebral. Conclusiones. En nuestra experiencia, el tratamiento endovascular del ictus isquémico agudo con el dispositivo Trevo es seguro y eficaz.

Introduction: The aim was to study whether nocturnal penile rigidity (NPTR) correlates with metabolic syndrome (MetS) and testosterone in men consulting for erectile dysfunction (ED). Material and methods: 234 men were included in a prospective, cross-sectional pilot study. Serum total and bioavailable testosterone and other biochemical constituents were measured and compared with NPTR. Patients were classified by normal or low/abnormal penile rigidity (abnormal meaning predominant organic component of ED) and presence or absence of MetS to test the hypothesized correlations. Results: Application of the logistic regression model to rigidity as the dependent variable showed the risk of low penile rigidity to be significantly lower for patients with higher total (OR = 0.96, 95% CI = 0.92-0.99) or bioavailable testosterone (OR = 0.91, 95% CI = 0.84-0.99). Patients with testosterone levels between 8 and 12 mmol/L had a quadrupled risk of low penile rigidity compared with patients with higher levels (>12 mmol/L) (OR = 3.96, 95% CI = 1.89-8.31). Considering men without MetS, age and body mass index were associated as significant factors for low penile rigidity: age increased risk by 8% (OR = 1.08, 95% CI = 1.03-1.13) and BMI increased it by 18% (OR = 1.18, 95% CI = 1.01-1.38). Conclusion: Testosterone levels are weakly associated with penile rigidity and disappear when associated with MetS.

Introducción: El objetivo fue estudiar la relación entre la rigidez peneana nocturna (RPN) con el síndrome metabólico (SM) y la testosterona en varones que consultan por trastornos de erección (DE). Material y método: Se incluyeron 234 varones en un estudio piloto prospectivo y transversal. Se midieron los niveles séricos de testosterona total y biodisponible y otros parámetros bioquímicos relacionados con el SM y con las RPN. Los pacientes se agruparon según la rigidez de las erecciones: normales (alta rigidez, componente predominante psicológico de la disfunción) o anormales (baja rigidez, posible componente orgánico o físico de la DE) y por la presencia o ausencia de SM. Resultados: El modelo de regresión logística para la rigidez del pene como variable dependiente demostró que el riesgo de rigidez anormal es menor en individuos con mayor testosterona total (OR = 0,96; 95% CI = 0,92-0,99) o biodisponible (OR = 0,91; 95% CI = 0,84-0,99). Pacientes con niveles de testosterona entre 8 y 12 mmol/L presentaron un riesgo cuatro veces mayor de tener rigidez anormal comparados con aquellos con niveles superiores a 12 mmol/L (OR = 3,96; 95% CI = 1,89, 8,31). Si se consideraban únicamente aquellos varones sin SM, solo la edad y el índice de masa corporal (IMC) aparecían como factores de riesgo asociados a la rigidez anormal. La edad aumentó el riesgo de rigidez anormal en un 8% (OR=1,08; 95% CI = 1,03-1,13) y el IMC lo aumentó en un 18% (OR = 1,18; 95% CI = 1,01-1,38). Conclusión: La asociación de niveles de testosterona con la rigidez del pene fue baja y desaparece si se asocia con SM.

Some arguments currently used to support breed conservation are examined. The central point is that we cannot conserve all breeds because we do not have financial resources enough to keep everything (mainly in developing countries) and in many cases we do not have special reasons to conserve breeds. A breed is a human product and it should not be confused with specie. A breed can be generated or transformed. We can create synthetic breeds with the best characteristics of several breeds. Selection is not exhausting genetic variability (there are several experiments showing that), and genetic variability within breeds is large. We need reasons to keep breeds in danger in extinction. A breed is a tool, and we can decide to keep it when it is useful because it is specially adapted to some environments (although in this case it should not be in danger of extinction), it can be useful in crossbreeding to shorten the way of obtaining response to selection, or it has some extreme values for traits that may be useful in the future (in this case we have to define clearly which traits and how we expect the future to be). We can add cultural reasons when we have money enough to spend in culture.