Communicating climate change and biodiversity loss with local populations: exploring communicative utopias in eight transdisciplinary case studies.

Climate change and biodiversity loss trigger policies targeting and impacting local communities worldwide. However, research and policy implementation often fail to sufficiently consider community responses and to involve them. We present the results of a collective self-assessment exercise for eight case studies of communications with regard to climate change or biodiversity loss between project teams and local communities. We develop eight indicators of good stakeholder communication, reflecting the scope of Verran's (2002) concept of postcolonial moments as a communicative utopia. We demonstrate that applying our indicators can enhance communication and enable community responses. However, we discover a divergence between timing, complexity and (introspective) effort. Three cases qualify for postcolonial moments, but scrutinising power relations and genuine knowledge co-production remain rare. While we verify the potency of various instruments for deconstructing science, their sophistication cannot substitute trust building and epistemic/transdisciplinary awareness. Lastly, we consider that reforming inadequate funding policies helps improving the work in and with local communities.

Immune response induced by coinfection of the sea louse Caligus rogercresseyi and the intracellular bacteria Piscirickettsia salmonis in vaccinated Atlantic salmon.

Recently, we showed that Atlantic salmon vaccinated against Piscirickettsia salmonis lose their protection upon coinfection with Caligus rogercresseyi (sea lice). However, the causes of the overriding effect of C. rogercresseyi infection have not been elucidated, and the molecular basis of the cellular and humoral immune responses upon C. rogercresseyi infection has not been described for vaccinated salmon. Therefore, we studied changes in the transcription of immune genes in vaccinated Atlantic salmon that were experimentally challenged by co-infecting them with C. rogercresseyi and P. salmonis. In general, coinfection treatments showed immune gene expression similar to treatments with a single P. salmonis infection, showing a decreased cellular response. However, a high variance was found between individual fish in the case of crucial cellular immune genes, with a few fish reacting overwhelmingly highly compared to the majority. This supports our previous findings on vaccination response variation and reinforces the idea that vaccination failures in the field might be caused by an overwhelming amount of vaccinated fish that display a deficient immune response to the infection.

Why vaccines fail against Piscirickettsiosis in farmed salmon and trout and how to avoid it: A review.

Piscirickettsiosis is the most severe, persistent, and damaging disease that has affected the Chilean salmon industry since its origins in the 1980s. As a preventive strategy for this disease, different vaccines have been developed and used over the last 30 years. However, vaccinated salmon and trout frequently die in the sea cages and the use of antibiotics is still high demonstrating the low efficiency of the available vaccines. The reasons why the vaccines fail so often are still debated, but it could involve different extrinsic and intrinsic factors. Among the extrinsic factors, mainly associated with chronic stress, we can distinguish: 1) biotic including coinfection with sea lice, sealions attacks or harmful algal blooms; 2) abiotic including low oxygen or high temperature; and 3) farm-management factors including overcrowding or chemical delousing treatments. Among the intrinsic factors, we can distinguish: 1) fish-related factors including host's genetic variability (species, population and individual), sex or age; 2) pathogen-related factors including their variability and ability to evade host immune responses; and 3) vaccine-related factors including low immunogenicity and poor matches with the circulating pathogen strain. Based on the available evidence, in order to improve the development and the efficacy of vaccines against P. salmonis we recommend: a) Do not perform efficacy evaluations by intraperitoneal injection of pathogens because they generate an artificial protective immune response, instead cohabitation or immersion challenges must be used; b) Evaluate the diversity of pathogen strains in the field and ensure a good antigenic match with the vaccines; c) Investigate whether host genetic diversity could be improved, e.g. through selection, in favor of better and longer responses to vaccination; d) To reduce the stressful effects at the cage level, controlling the co-infection of pathogens and avoiding fish overcrowding. To date, we do not know the immunological mechanisms by which the vaccines against P. salmonis may or may not generate protection. More studies are required to identify what type of response, cellular or molecular, is required to develop effective vaccines.

Commercial Vaccines Do Not Confer Protection against Two Genogroups of Piscirickettsia salmonis, LF-89 and EM-90, in Atlantic Salmon.

In Atlantic salmon, vaccines have failed to control and prevent Piscirickettsiosis, for reasons that remain elusive. In this study, we report the efficacy of two commercial vaccines developed with the Piscirickettsia salmonis isolates AL100005 and AL 20542 against another two genogroups which are considered highly and ubiquitously prevalent in Chile: LF-89 and EM-90. Two cohabitation trials were performed to mimic field conditions and vaccine performance: (1) post-smolt fish were challenged with a single infection of LF-89, (2) adults were coinfected with EM-90, and a low level coinfection of sea lice. In the first trial, the vaccine delayed smolt mortalities by two days; however, unvaccinated and vaccinated fish did not show significant differences in survival (unvaccinated: 60.3%, vaccinated: 56.7%; p = 0.28). In the second trial, mortality started three days later for vaccinated fish than unvaccinated fish. However, unvaccinated and vaccinated fish did not show significant differences in survival (unvaccinated: 64.6%, vaccinated: 60.2%, p = 0.58). Thus, we found no evidence that the evaluated vaccines confer effective protection against the genogroups LF-89 and EM-90 of P. salmonis with estimated relative survival proportions (RPSs) of -9% and -12%, respectively. More studies are necessary to evaluate whether pathogen heterogeneity is a key determinant of the lack of vaccine efficacy against P. salmonis.

Conocimientos, actitudes y prácticas en pacientes con tuberculosis: una revisión sistemática de literatura / Knowledge, attitudes and practices in patients with tuberculosis: a systematic literature review

Introducción: La tuberculosis es una enfermedad infectocontagiosa de fácil tras-misión. Para su control, los conocimientos, actitudes y prácticas adecuadas son indis-pensables, así como los factores relevantes para la adherencia al tratamiento. Objetivo: Caracterizar las definiciones o los conceptos de las dimensiones de cono-cimientos, actitudes y prácticas en tuberculosis reportados en la literatura durante los últimos diez años. Materiales y métodos: Se realizó una revisión sistemática de la literatura bajo la metodología "Preferred Reporting Items for Systematic Reviews and Meta-Analy-ses". Inicialmente, se encontraron 1.720 posibles publicaciones, de las cuales, luego de la aplicación de los criterios de exclusión, quedaron 34 para ser incluidas en el análisis de esta revisión. Resultados: La mayoría de los estudios fueron publicados en el año 2018 y pre-dominaron las publicaciones en el continente africano. La caracterización de las di-mensiones se relaciona así: los conocimientos se definen como características de la enfermedad, las actitudes se relacionan con el estigma social hacia el paciente y las prácticas corresponden con la búsqueda de atención médica por parte del paciente. Conclusión: Se identificó la escasez de producción científica en donde se especifi-quen los conceptos de las dimensiones de conocimientos, actitudes y prácticas, que a su vez permitan el desarrollo de investigaciones de alto rigor y alcance metodológico, ya que las publicaciones realizadas e incluidas para este estudio tuvieron una evalua-ción de baja calidad.

Introduction: Tuberculosis is an infectious disease of easy transmission. For tuber-culosis's control, appropriate knowledge, attitudes, and practices are essential, as well as relevant factors for treatment adherence. Objective: To characterize the concepts of three dimensions ­knowledge, atti-tudes, and practices­ in tuberculosis reported in the literature during the last ten years. Materials and methods: A systematic review of the literature was carried out under the methodology "Preferred Reporting Items for Systematic Reviews and Me-ta-Analyzes". Initially, 1.720 possible publications were found, of which, after apply-ing the exclusion criteria, 34 remained to be included in this review. Results: Most studies were published in 2018, and publications on the African con-tinent predominated. The characterization of the dimensions is related as follows: knowledge was defined as the characteristics of the disease, attitudes were related with the social stigma towards the patient with TB, and practices were associated with seeking medical care by the patients with TB. Conclusion: There is a lack of publications on the definition of knowledge, atti-tudes and practices on tuberculosis, which hampers developing high impact research.

Mieloma múltiple. Experiencia de 9 años en el Hospital Naval Almirante Nef / Multiple myeloma. Nine years' experience at the Hospital Naval Almirante Nef

Introducción: el mieloma múltiple (MM) continúa siendo una enfermedad incurable sin embargo, el trasplante autólogo de médula ósea (TAH), y las drogas antineoplásicas han permitido mejorar la sobrevida global (SG) de los pacientes. Materiales y métodos: estudio de cohorte retrospectivo de 50 pacientes con diagnóstico de MM en el hospital Naval Almirante Nef, desde 2005 a 2013. Los pacientes se dividieron en dos cohortes, según la eligibilidad a trasplante, y analizados acordes a la primera línea de tratamiento y la sobrevida global (SG) hasta abril de 2019. Resultados: mediana de edad 73 años (47-88 años), SG 49 meses, y 50% en etapa-II del Sistema de Etapificación Internacional. La SG de los 39 no candidatos a TAH fue 46 meses; con un mayor número de respuestas completas y sobrevida, con el esquema melfalán-prednisona-talidomida. La SG de los 11 candidatos a TAH fue 66 meses, siendo el esquema bortezomib-ciclofosfamida-dexame-tasona el que concentró un mayor número de respuestas completas libres de progresión. Se trasplantó el 45% de los candidatos, con una mediana de sobrevida de 79 meses versus a los 51 meses de aquellos no trasplantados. Tres casos de neuropatía asociada a talidomida y uno a bortezomib. La SG a los seis meses y a los cinco años de todos los pacientes fue 86% y 44%, respectivamente. Conclusión: la incorpo-ración de nuevos fármacos permitió obtener mejores resultados de sobrevida lo que se condice con estudios nacionales e internacionales.

Introduction: Multiple myeloma (MM) is still an incurable disease however, autologous stem cell transplantation (ASCT), and antineo-plastic drugs have allowed improving the overall survival (OS) of patients. Materials and methods: A retrospective cohort study of 50 patients diagnosed with MM at the Hospital Naval Almirante Nef, from 2005 to 2013. The patients were divided into two cohorts according to transplantation eligibility and analyzed about first-line treatment and overall survival (OS) up to April 2019. Results: Median age 73 years (47-88 years), OS 49 months, and 50% in stage-II International Staging System. OS of the 39 non-candidates for ASCT was 46 months: with a higher number of complete responses and survival, with the melphalan-prednisone-thalidomide scheme. The OS of the 11 candidates for ASCT was 66 months, with the bortezomib-cyclophosphamide-dexamethasone scheme being the one with the highest number of progression-free complete responses. Forty-five percent of the candidates were transplanted, with a median survival of 79 months versus 51 months for those not transplanted. Three cases of neuropathy were associated with thalidomide and one with bortezomib. OS at six months and five years for all patients was 86% and 44%, respectively. Conclusion: The incorporation of new drugs allowed to obtain better survival results, which is by national and international studies.

Pregnancy in Inflammatory Bowel Disease: Experience of a Chilean cohort. / Embarazo en enfermedad inflamatoria intestinal: experiencia en una cohorte chilena.

BACKGROUND: In inflammatory bowel disease (IBD) a high percentage of women are diagnosed during their reproductive age. IBD in remission is the ideal scenario when planning a pregnancy. AIMS: To describe the clinical characteristics of pregnancy/newborn and assess disease activity at the time of conception and throughout the pregnancy in patients with IBD treated at a tertiary centre in Chile. METHODS: We retrospectively reviewed women diagnosed with IBD who were pregnant or delivered between 2017 and 2020. Demographic, clinical, obstetric and delivery data were obtained from the IBD registry, approved by the local IRB. Descriptive statistics and association tests were performed (χ2, p ≤ 0.05). RESULTS: Sixty women with IBD were included. At the beginning of pregnancy, 21 (35%) had active disease and 39 (65%) were in remission. Of those with active disease, 16 (66%) remained active and 6 had spontaneous abortions. In those who were in remission, 26 (69%) remained in this condition. Nine patients (15%) discontinued treatment, and 6 of these had inflammatory activity during pregnancy. Preconception counselling was performed in 23 of the 60 patients, being higher in the group that remained in remission during pregnancy (65% vs. 35%, p = 0.02). Patients who had a flare during pregnancy had more probability of preterm birth (<37 weeks) and newborn with lower weight compared with the group that always remained in remission (89% vs. 74%, p = 0.161) and (2.885 vs 3.370 g; p = 0.0014). CONCLUSION: Remission presents better outcomes in pregnancy and preconception counselling would allow a better IBD control during pregnancy.

Hemorragia fatal de una ulcera venosa crónica: Reporte de un caso / Fatal bleeding from a chronic venous ulcer: case report

Resumen La enfermedad venosa crónica es un trastorno común que se manifiesta con una amplia gama de signos. En casos en los que la enfermedad adquiere gravedad se le denomina insuficiencia venosa crónica y esta puede llevar al desarrollo de una úlcera venosa. Un trauma directo o la erosión de una vena varicosa pueden llevar a una hemorragia que, aunado a enfermedades crónicas concomitantes, factores toxicológicos, sociales o primeros auxilios inadecuados pueden llevar a la muerte en pocos minutos y en un escenario del crimen que puede ser confuso a primera vista para el equipo forense. Se reporta un caso valorado en la Sección de Patología Forense del Departamento de Medicina Legal del Poder Judicial de Costa Rica en el que se realizó una autopsia completa. Dentro de los hallazgos más importantes a nivel macróscopico se evidenció una úlcera cónica de características venosas en la pierna derecha en la cual, mediante la disección por planos y la inyección de colorante en la vena safena magna, se observó la salida de este por una vena varicosa relacionada con la úlcera.

Abstract Chronic venous disease is a common disorder that shows a large spectrum of signs. In cases in which the disease acquires severity it is named chronic venous insufficiency, and it can cause the development of a venous ulcer. Direct trauma to or erosion of a varicose vein can lead to a hemorrhage that, in combination with coexistent conditions, toxicologic or social factors, or inadequate first aid can produce death in few minutes and a crime scene which might be confusing at first sight to the forensics team. We present a case handled by the Forensic Pathology Section of the Department of Legal Medicine of the Judicial Power of Costa Rica in which a complete autopsy was performed. Among the most relevant macroscopic findings was evidence of a chronic ulcer with venous characteristics on the right leg, in which dissection by planes and dye injection into the great saphenous vein showed leakage of this dye out of a varicose vein related to the ulcer.

Infliximab in inflammatory bowel disease. Is premedication necessary? / Infliximab en enfermedad inflamatoria intestinal. ¿Es necesario premedicar?

BACKGROUND: The use of infliximab (IFX) in inflammatory bowel disease (IBD) has been associated with a 1-6% risk of infusion reactions. The usefulness of premedication with corticosteroids, paracetamol and /or antihistamines is controversial. AIM: The aim of this study is to assess, in IBD patients on IFX, whether there are differences in secondary reactions to the infusion between those who use premedication or not. METHODS: A retrospective cohort study was performed identifying patients with a diagnosis of IBD who received IFX at our institution between January 2009 and July 2019. Acute reactions were defined as those that occurred in the first 24 hours postinfusion and late reactions for more than 24 hours. Infusion reactions were classified as mild, moderate and severe. Descriptive and association statistics were used (χ2; p < 0.05). RESULTS: Sixty-four patients were included with 1,263 infusions in total, 52% men. Median infusions per patient was 22 (2-66). All induction infusions were administered with premedication, and in maintenance in 57% of them. Premedication was given with hydrocortisone, chlorphenamine and paracetamol. Most of reactions were acute, mild or moderate in severity and no patient needed to discontinue IFX. In the maintenance group, there were 9/718 (1.2%) infusion reactions with premedication and 4/358 (1.1%) without it (p = 0.606). In the induction group, there were 8/187 (4.3%) infusion reactions, significantly higher when compared with both maintenance groups. CONCLUSIONS: In this group, premedication use during maintenance was not effective at reducing the rate of infusion reactions. These results suggest that premedication would not be necessary.

Are patients with inflammatory bowel disease receiving adequate immunisation? / ¿Están recibiendo los pacientes con enfermedad inflamatoria intestinal una adecuada inmunización?

INTRODUCTION: Inflammatory Bowel Disease (IBD) treatment may increase the risk of infections. Vaccines are part of the comprehensive IBD patient care. The aim of this study was to describe indications and adherence of immunizations in IBD and identify possible associated factors. METHODS: A cross-sectional, analytic study was conducted in patients from an IBD Program of a tertiary center in Chile, between April - June 2019. Patients were asked to answer a vaccine survey and information also was obtained from the National Immunization Registry. Descriptive and association statistic were used (χ2; p<0.05). RESULTS: A total of 243 patients were included (148 ulcerative colitis (UC), 86 Crohn's disease (CD) and 9 non-classifiable IBD). Only six patients (2%) of IBD patients received a complete immunization schedule. The highest vaccine rates were against influenza (67%), hepatitis B virus (40%), 13-valent pneumococcal (34%) and 23-polysaccharide pneumococcal (16%). The influenza vaccine rate has significantly increased, reaching 67% in 2019. The survey showed that 23% of patients have not been immunized with any vaccine, mainly due to lack of time, lack of medical prescription and high cost. CONCLUSIONS: In this cohort, although vaccination rates are higher than previously reported, adherence to IBD immunization program would be improved, being considered since diagnosis by the multidisciplinary team.

Fracturas atípicas de fémur asociadas al uso de bifosfonatos / Bisphosphonate associated atypical femur fractures

Resumen Los bifosfonatos son medicamentos ampliamente conocidos por su efecto antagonista de la resorción ósea y la consecuente reducción del riesgo de fracturas en los pacientes con osteoporosis. La literatura actual provee evidencia en términos de datos clínicos y experimentales que asocian el uso prolongado de estos medicamentos con un aumento en el riesgo de fracturas atípicas de fémur. Para establecer si esta asociación es clínicamente relevante, se requiere realizar estudios posteriores que incluyan la relación entre otros factores que podrían influir en la aparición de este tipo de fracturas como lo es la propia enfermedad osteoporótica, el tipo de bifosfonato utilizado, el mecanismo lesional que originó la fractura, medicamentos concomitantes y patologías asociadas.

Abstract Bisphosphonates are medications that are widely known for their antagonizing effect on bone resorption and their consequent reduction in the risk of fractures in patients with osteoporosis. Current literature provides evidence in terms of experimental and clinical data associating prolonged use of these drugs with an increase in the risk of atypical femur fractures. To establish if this association is clinically relevant, there lies a need for further studies that take into account other factors that might influence the occurrence of these type of fractures, like the osteoporotic disease itself, age, intake of other drugs and associated systemic illnesses.

Host genetic variation explains reduced protection of commercial vaccines against Piscirickettsia salmonis in Atlantic salmon.

Vaccination is a widely used control strategy to prevent Piscirickettsia salmonis causing disease in salmon farming. However, it is not known why all the currently available commercial vaccines generally fail to protect against this pathogenic bacteria. Here, we report, from two different populations, that between-family variation is a strong intrinsic factor that determines vaccine protection for this disease. While in some full-sib families, the protection added by vaccination increased the survival time in 13 days in comparison with their unvaccinated siblings; in other families, there was no added protection by vaccination or even it was slightly negative. Resistance to P. salmonis, measured as days to death, was higher in vaccinated than unvaccinated fish, but only a moderate positive genetic correlation was obtained between these traits. This disputes a previous hypothesis, that stated that both traits were fully controlled by the same genes, and challenges the use of unvaccinated fish as gold standard for evaluating and selecting fish resistant to P. salmonis, particularly if the offspring will be vaccinated. More studies are necessary to evaluate if variation in the host immune response to vaccination could explain the between-family differences in resistance observed in vaccinated fish.

Validación clínica de enfermería en cicatrización de úlceras venosas con miel nativa chilena suplementada / Clinical validation nursing in healing of venous ulcers with supplemented Chilean native honey / Validação clínica de enfermagem na cicatrização de úlceras venosas com mel nativo chileno suplementado

El objetivo de este estudio longitudinal fue validar clínica y planimétricamente la cicatrización de úlceras venosas con un prototipo de miel médica suplementada, nativa de Chile. La cicatrización de la úlcera venosa, demanda recursos sanitarios y tiempo de enfermería. Las terapias naturales, como la miel, son consideradas cicatrizantes, siendo el enfermero/a el profesional encargado de incorporarlas en la gestión del cuidado de personas con heridas. Participaron 22 pacientes con úlceras venosas, de centros de salud de Padre las Casas, Chile, voluntarios del proyecto CORFO 13IDL2-2329, tratados con un prototipo médico de miel nativa con actividad antibacteriana y suplementada con antioxidantes. Se realizó seguimiento clínico y planimétrico de la disminución del área y perímetro, asociados al uso del producto bajo un protocolo de gestión del cuidado de enfermería. El análisis de imágenes fue con el Software ImageJ®, cuyos datos fueron sometidos a estadística no paramétrica con el Software IBMSPSS-21.0. La reducción del área y perímetro fueron estadísticamente significativos para las úlceras tipo 3 y 4, con una mediana de reducción de área de 95.41 % y 84.40 % para perímetro, ambos entre el segundo y tercer contraste de mediciones. Destacó también la mediana de días de cicatrización en úlceras tipo 4 con 124 días. Se concluyó que la aplicación de miel clínica y un protocolo de gestión del cuidado de enfermería, basado en un tratamiento multifactorial y un criterio uniforme de curación, demostraron reducción de las áreas y perímetros de cicatrización, con énfasis en el desbridamiento.

The objective of the longitudinal study was to validate clinically and planimetrically the healing of venous ulcers with a prototype of upplemented medical honey, native to Chile. Healing of venous ulcer requires health resources and nursing time. Natural therapies, such as honey, are considered healing, and the nurse is responsible for incorporating them in the management of the care of people with injuries. 22 patients with venous ulcers participated, from health centers of Padre las Casas, Chile, volunteers of the CORFO 13IDL2-2329 project, treated with a medical prototype of native honey, supplemented with antioxidants and certified antibacterial activity. Clinical and planimetric follow-up of the area and perimeter decrease, associated with the use of the prototype was carried out under a nursing care management protocol. The analysis of images was with the Software ImageJ® , whose data were subjected to non-parametric statistics with the Software IBMSPSS-21.0. The area and perimeter reduction were statistically significant for type 3 and 4 ulcers, with a median area reduction of 95.41 % and 84.40 % for perimeter, both between the second and third measurements contrast. It also highlighted the median number of days of healing in type 4 ulcers with 124 days. It was concluded that the application of clinical honey and a nursing care management protocol, based on a multifactorial treatment and a uniform cure criterion, demonstrated reduction of the areas and perimeters of healing, with emphasis on debridement.

O objetivo deste estudo longitudinal foi validar clínica e planimetricamente a cicatrização de úlcerações venosas com um protótipo de mel medicinal suplementado, nativo do Chile. A cicatrização da úlcera venosa exige recursos de saúde e tempo de enfermagem. As terapias naturais, como o mel, são consideradas cicatrizantes, e o enfermeiro é o profissional encarregado de incorporá-las ao gerenciamento do cuidado de pessoas com feridas. Participaram 22 pacientes com úlcerações venosas dos centros de saúde de Padre las Casas, Chile, voluntários do projeto CORFO 13IDL2-2329, tratados com um protótipo médico de Mel nativo com atividade antibacteriana e suplementado com antioxidantes. Foi realizado monitoramento clínico e planimétrico da área e diminuição do perímetro, associado ao uso do produto sob um protocolo de gerenciamento de cuidados de enfermagem. A análise das imagens foi realizada com o software ImageJ®, cujos dados foram submetidos a estatística não paramétrica com o software IBMSPSS-21.0. A redução de área e perímetro foi estatisticamente significante para as úlceras tipo 3 e 4, com uma redução mediana da área de 95,41% e 84,40% para o perímetro, ambos entre o segundo e o terceiro contraste da medida. Também se destacaram os dias medianos de cicatrização em úlceras tipo 4 com 124 dias. Concluiu-se que a aplicação do mel clínico e um protocolo de gestão da assistência de enfermagem, baseado em tratamento multifatorial e critério uniforme de cicatrização, demonstraram redução das áreas e perímetros da cicatrização, com ênfase no desbridamento.

Deletion of α-Synuclein in Prrx1-positive cells causes partial loss of function in the central nervous system (CNS) but does not affect ovariectomy induced bone loss.

α-Synuclein is a small 140 amino acid polypeptide encoded by the Snca gene that is highly expressed in neural tissue, but it is also found in osteoblasts, erythroblasts, macrophages, and adipose tissue. Previously, using co-expression network analysis we found that Snca was a key regulator of skeletal homeostasis, and its deletion partially prevented bone loss after ovariectomy (OVX). Here we tested the hypothesis that Snca deletion in mesenchymal progenitors using the Prrx1Cre (Prrx1, Paired-related homeobox 1) limb enhancer would protect bone mass after OVX. Prrx1Cre;Sncafl/fl and littermate controls (Sncafl/fl) were sham operated or ovariectomized (OVX) at 8 weeks of age and sacrificed at 20 weeks. Independently, eight-week female and male Prrx1Cre;Sncafl/fl mice and littermate controls were administered a high fat (60% fat) or low fat (10% fat) diet for 15 weeks. Bone loss was not prevented in either genotype after ovariectomy, but the Prrx1Cre;Sncafl/fl. mice were partially protected from weight gain after OVX and high fat diet (HFD). Serum catecholamine levels were lower in the Prrx1Cre;Sncafl/fl both on a low fat diet (LFD) and HFD versus fl/fl controls. Importantly, mutant mice exhibited a number of physical and behavioral phenotypes that were associated with conditional deletion of Snca in several brain regions. Cells labeled with Prrx1 were noted throughout the central nervous system (CNS). These data support earlier preliminary reports of Prrx1 expression in neural progenitors, and raise a cautionary note about the evaluation of skeletal and body composition phenotypes when using this Cre driver to study osteoprogenitor development.

Parkinson's disease and osteoporosis: basic and clinical implications.

Introduction: Parkinson's disease (PD) is the second most frequent neurodegenerative disease. Lewy bodies, the hallmark of this disease due to an accumulation of α-synuclein, lead to loss of dopamine-regulated motor circuits, concomitantly progressive immobilization and a broad range of nonmotor features. PD patients have more hospitalizations, endure longer recovery time from comorbidities, and exhibit higher mortality than healthy controls. Although often overlooked, secondary osteoporosis has been reported frequently and is associated with a worse prognosis.Areas covered: In this review, we discuss the pathophysiology of PD from a systemic perspective. We searched on PubMed articles from the last 20 years in PD, both clinical features and bone health status. We discuss possible neuro/endocrine mechanisms by which PD impacts the skeleton, review available therapy for osteoporotic fractures and highlight evidence gaps in defining skeletal co-morbid events.Expert opinion: Future research is essential to understand the local and systemic effects of dopaminergic signaling on bone remodeling and to determine how pathological α-synuclein deposition in the central nervous system might impact the skeleton. It is hoped that a systematic approach to the pathogenesis of this disease and its treatment will allow the informed use of osteoporotic drugs to prevent fractures in PD patients.

Análisis de los efectos del consumo de alcohol en la morbi-mortalidad por trauma craneoencefálico / Analysis of the effects of alcohol consumption in traumatic brain injury´s morbidity and mortality

Resumen La intoxicación con alcohol está frecuentemente asociada con trauma craneoencefálico (TCE), pero el impacto del alcohol en la patogénesis y el pronóstico del TCE sigue siendo poco clara. La literatura actual provee evidencia en términos de datos clínicos y experimentales que respaldan los efectos neuroprotectores del alcohol en pacientes con TCE. Para establecer de manera significativa esta relación es necesario el desarrollo de estudios prospectivos observacionales fuertes, con el fin de comprender los efectos del alcohol en los resultados clínicos a largo plazo (incluyendo el resultado neurológico) en pacientes con TCE con una apropiada selección y ajuste del riesgo basal.

Abstract Alcohol intoxication is often associated with traumatic brain injuries (TBIs), but the impact of alcohol on the pathogenesis and prognosis of TBIs remains unclear. Current literature provides evidence in terms of experimental and clinical data supporting alcohol's neuroprotective effects in patients with TBIs. To establish in a significative way this association, there lies a need for strong prospective observational studies, in order to comprehend the effects of alcohol on the long-term outcomes (including the neurological outcome) in patients with TBI with proper selection and baseline risk adjustment.