Repeated exposure to MDMA triggers long-term plasticity of noradrenergic and serotonergic neurons.

3,4-Methylenedioxymethamphetamine (MDMA or 'ecstasy') is a psychostimulant drug, widely used recreationally among young people in Europe and North America. Although its neurotoxicity has been extensively described, little is known about its ability to strengthen neural circuits when administered in a manner that reproduces human abuse (i.e. repeated exposure to a low dose). C57BL/6J mice were repeatedly injected with MDMA (10 mg kg(-1), intraperitoneally) and studied after a 4-day or a 1-month withdrawal. We show, using in vivo microdialysis and locomotor activity monitoring, that repeated injections of MDMA induce a long-term sensitization of noradrenergic and serotonergic neurons, which correlates with behavioral sensitization. The development of this phenomenon, which lasts for at least 1 month after withdrawal, requires repeated stimulation of α(1B)-adrenergic and 5-hydroxytryptamine (5-HT)(2A) receptors. Moreover, behavioral and neuroendocrine assays indicate that hyper-reactivity of noradrenergic and serotonergic networks is associated with a persistent desensitization of somatodendritic α(2A)-adrenergic and 5-HT1A autoreceptor function. Finally, molecular analysis including radiolabeling, western blot and quantitative reverse transcription-polymerase chain reaction reveals that mice repeatedly treated with MDMA exhibit normal α(2A)-adrenergic and 5-HT(1A) receptor binding, but a long-lasting downregulation of Gαi proteins expression in both locus coeruleus and dorsal raphe nucleus. Altogether, our results show that repeated MDMA exposure causes strong neural and behavioral adaptations and that inhibitory feedback mediated by α(2A)-adrenergic and 5-HT(1A) autoreceptors has an important role in the physiopathology of addictive behaviors.

Combined Raman and IR spectroscopic study on the radical-based modifications of methionine.

Among damages reported to occur on proteins, radical-based changes of methionine (Met) residues are one of the most important convalent post-translational modifications. The combined application of Raman and infrared (IR) spectroscopies for the characterisation of the radical-induced modifications of Met is described here. Gamma-irradiation was used to simulate the endogenous formation of reactive species such as hydrogen atoms (•H), hydroxyl radicals (•OH) and hydrogen peroxide (H(2)O(2)). These spectroscopic techniques coupled to mass experiments are suitable tools in detecting almost all the main radical-induced degradation products of Met that depend on the nature of the reactive species. In particular, Raman spectroscopy is useful in revealing the radical-induced modifications in the sulphur-containing moiety, whereas the IR spectra allow decarboxylation and deamination processes to be detected, as well as the formation of other degradation products. Thus, some band patterns useful for building a library of spectra-structure correlation for radical-based degradation of Met were identified. In particular, the bands due to the formation of methionine sulfoxide, the main oxidation product of Met, have been identified. All together, these results combine to produce a set of spectroscopic markers of the main processes occurring as a consequence of radical stress exposure, which can be used in a spectroscopic protocol for providing a first assessment of Met modifications in more complex systems such as peptides and proteins, and monitoring their impact on protein structure.

Effect of androgens combined with hormone therapy on quality of life in post-menopausal women with sexual dysfunction.

AIM: To evaluate with validated instruments changes in quality of life and sexuality in women receiving hormonal replacement therapy (AHT). DESIGN: Randomised, double-blind, double-dummy study with two parallel treatment arms. PATIENTS AND METHODS: Forty-seven healthy post-menopausal women, aged 45-64 years, were evaluated using the Female Sexual Function Index (FSFI) and the menopause-specific quality of life questionnaire (MENQOL). Of them, 40 diagnosed with sexual dysfunction were randomised (1:1) to receive daily 0.625 mg of conjugated estrogens plus 1.25 mg of methyl-testosterone and 100 mg of micronised progesterone or placebo. After 3 months follow-up, FSFI and MENQOL questionnaires were administered for a second time. RESULTS: Quality of life was unchanged in the placebo group whereas AHT significantly improved scores of vasomotor, psychological, physical and sexual symptoms. As expected, FSFI was not modified in the placebo group while in AHT group the FSFI score improved significantly. In addition, at the end of the study, 68.7% of subjects of the AHT group did not fit did not fit the criteria for sexual dysfunction as per the FSFI (p < 0.0001). CONCLUSIONS: Adding methyl-testosterone to hormone therapy improves quality of life and sexuality in post-menopausal women with sexual dysfunction.

Hemorragia del tracto digestivo superior, enfoque para el médico general / Upper digestive tract bleeding, approach for the general Practitioner / Hemorragia do trato digestivo superior, enfoque para o médico geral

La hemorragia del tracto digestivo superior (HTDS) es el sangrado originado por encima del ángulo de Treitz. A pesar del aumento en las estrategias de prevención, del incremento en los tratamientos con Inhibidor de bomba de protones (IBP) y de la intervención endoscópica temprana, esta patología sigue siendo una causa frecuente de consulta a urgencias, con una morbimortalidad no despreciable y alta carga para el sistema de salud. Esta revisión se enfoca en la HTDS de causa diferente a las varices. La principal causante de esta entidad es la enfermedad ácido-péptica, que es consecuencia del gran consumo de antiinflamatorios no esteroideos (AINES) y de la infección por Helicobacter Pylori. Otras causas son el síndrome de Mallory Weiss, la esofagitis erosiva, las malformaciones arteriovenosas y la malignidad.

Upper gastrointestinal bleeding (UGIB) refers to any bleeding originating above the angle of Treitz. Despite an increase in prevention strategies, proton pump inhibitor (PPI) therapy and early endoscopic intervention, this pathology continues to be an important cause of admission to the emergency department for gastrointestinal causes, having a pretty high morbidity and mortality in addition to a high burden on the health system. This review focuses on non-variceal UGIB. The main cause of this entity being peptic acid disease, due to great consumption of NSAIDs and Helicobacter Pylori infection. Other causes are Mallory Weiss syndrome, erosive esophagitis, arteriovenous malformations, and malignancy.

A hemorragia do trato digestivo superior (HTDS) é o sangrado originado acima do ângulo de Treitz. Apesar do aumento nas estratégias de prevenção, do incremento nos tratamentos com Inibidor da bomba de prótons (IBP) e da intervenção endoscópica precoce, esta patologia segue sendo uma causa frequente de consulta a urgências, com uma morbimortalidade não depreciável e alta carga para o sistema de saúde. Esta revisão se enfoca na HTDS de causa diferente às varizes. A principal causante desta entidade é a doença ácido-péptica, que é consequência do grande consumo de anti-inflamatórios não esteróideos (AINES) e da infecção por HelicobacterPylori. Outras causas são a síndrome de Mallory Weiss, a esofagites erosiva, as malformações arteriovenosas e a malignidade. Palavras-chave: hemorragia gastrointestinal; úlcera péptica; endoscopia gastrointestinal; inibidores da bomba de prótons; medicina geral.

Pro-inflammatory effects of early non-enzymatic glycated proteins in human mesothelial cells vary with cell donor's age.

BACKGROUND AND PURPOSE: Diabetes mellitus is prevalent in the elderly population. It is also a disease causing tissue damage through several different mechanisms. Some of these mechanisms are also activated by ageing and this overlap raises questions about how diabetes induces damage in the elderly. Early products of non-enzymatic glycation of proteins (Amadori adducts), and the ageing process share the capacity to induce oxidative stress and inflammation in human peritoneal mesothelial cells (HPMCs). We have evaluated the interactions between the age of the donor of the HPMCs and the pro-inflammatory effects of Amadori adducts in those cells. EXPERIMENTAL APPROACH: HPMCs were isolated from 20 individuals (age range 21-81 years) and grown in culture. Using different experimental approaches we determined NF-kappaB dependent transcriptional activity and different NF-kappaB-related pro-inflammatory gene and protein expressions in basal (or non-stimulated) conditions and after stimulation with two Amadori adducts; highly-glycated haemoglobin and glycated bovine serum albumin. KEY RESULTS: Amadori-induced effects on NF-kappaB dependent-transcription and on the activity of NOS, COX and several NF-kappaB-related pro-inflammatory genes (iNOS, COX-2, TNF-alpha, IL-1beta, and IL6) diminished as the donor's age increased, being practically absent in cells from donors more than 65 years old. Such decreased effects were inversely correlated with an increased basal expression and activity of these pro-inflammatory markers with age. CONCLUSIONS AND IMPLICATIONS: Pro-inflammatory effects of Amadori-adducts in HPMCs were strongly dependent on cell donor's age. This may have significant implications for the mechanisms underlying diabetes-induced tissue damage in patients of different ages.

Frequency of anergy in a group of patients with rheumatoid arthritis on immunosuppressive therapy / Frecuencia de anergia en un grupo de pacientes con artritis reumatoide y terapia inmunosupresora

ABSTRACT Background: Tuberculin is the globally accepted delayed cutaneous hypersensitivity test for the diagnosis of latent tuberculosis. The alteration of cellular immunity induced by disease-modifying drugs used in rheumatoid arthritis may give a false negative result, also known as cutaneous anergy. There are no studies that determine the frequency of anergy in patients with rheumatoid arthritis and on immunosuppressive therapy. Objective: To determine the frequency and possible factors associated with cutaneous anergy in a group of patients with rheumatoid arthritis and on immunosuppressive therapy. Methods: Cross-sectional analytical observational study including 100 patients with rheumatoid arthritis on immunosuppressive therapy. They were tested for delayed cutaneous hypersensitivity with tuberculin, and a control test with tetanus toxoid. The non-reactivity of both tests was defined as anergy. Results: The overall frequency of cutaneous anergy was 9% (n = 11). It occurred in 33% of men versus 6% of women. The mean age was 57 years, and 89% were over 50 years-old. Being female behaved as a protective variable for the generation of anergy, OR 0.795 [95% CI, 0.658 - 0.959, P<.05]. All patients with anergy were being treated with corticosteroids, 44% with methotrexate, and 33% with biological therapy. Treatment with moderate to high dose prednisone and biological therapy were independently associated as risk factors for presenting with anergy, OR 1.044 [95% CI, 1.008-1.080 P<.05] and OR 1.096 [95% CI, 1.016-1.182, P<.05], respectively. The overall positivity for tuberculin was 13%. Symptoms associated with disease activation were present in 38% of these. All cases (n= 1) of confirmed active tuberculosis were excluded. Conclusions: The high prevalence of cutaneous anergy in patients with RA in the present study, and the evidence presented here, supports the recommendation of a second diagnostic test (tuberculin booster or Interferon-Gamma Release Assays) for the diagnosis of latent TB in patients with RA on immunosuppressive therapy.

RESUMEN Antecedentes: La tuberculina es la prueba de hipersensibilidad cutánea tardía mundialmente aceptada para el diagnóstico de tuberculosis latente. La alteración de la inmunidad celular inducida por los fármacos modificadores de la enfermedad utilizados en la artritis reumatoide puede dar un resultado falso negativo, también conocido como anergia cutánea. No hay estudios que determinen la frecuencia de anergia en pacientes con artritis reumatoide y terapia inmunosupresora. Objetivo: Determinar la frecuencia y los posibles factores asociados con la anergia cutánea en un grupo de pacientes con artritis reumatoide y terapia inmunosupresora. Métodos: Estudio observacional analítico transversal que incluyó a 100 pacientes con artritis reumatoide con terapia inmunosupresora. Se les realizó una prueba de hipersensibilidad cutánea tardía con tuberculina y una prueba de control con toxoide tetánico. La no reactividad de ambas pruebas se definió como anergia. Resultados: La frecuencia general de anergia cutánea fue del 9% (n = 11). Ocurrió en el 33% de los hombres versus el 6% de las mujeres, la edad promedio fue de 57 anos y el 89% tenía más de 50 anos. El sexo femenino se comportó como una variable protectora para la generación de anergia (OR 0,795; IC 95%: 0,658-0,959; p < 0,05). Todos los pacientes con anergia usaron corticosteroides, el 44% fue tratado con metotrexato y el 33% con terapia biológica. El tratamiento con dosis de moderadas a altas de prednisona y terapia biológica se asoció de manera independiente como factor de riesgo para la presentación de anergia: OR 1,044 (IC 95%: 1,008-1,080; p < 0,05) y OR 1,096 (IC 95%: 1,016-1,182; p < 0,05), respectivamente. La positividad general para la tuberculina fue del 13%. Los síntomas asociados con la activación de la enfermedad estaban presentes en el 38% de ellos. Se excluyeron todos los casos de tuberculosis activa confirmada (n = 1). Conclusiones: La alta prevalencia de anergia cutánea en pacientes con artritis reumatoide en el presente estudio y la evidencia presentada respaldan la recomendación de una segunda prueba de diagnóstico (refuerzo de tuberculina o IGRA) para el diagnóstico de tuberculosis latente en pacientes con artritis reumatoide y terapia inmunosupresora.

Vascular smooth muscle cell hypertrophy induced by glycosylated human oxyhaemoglobin.

1. Nonenzymatic protein glycosylation is a possible mechanism contributing to oxidative stress and vascular disease in diabetes. In this work, the influence of 14%-glycosylated human oxyhaemoglobin (GHHb), compared to the non-glycosylated protein (HHb), was studied on several growth parameters of rat cultured vascular smooth muscle cells (VSMC). A role for reactive oxygen species was also analysed. 2. Treatment of VSMC for 48 h with GHHb, but not with HHb, increased planar cell surface area in a concentration dependent manner. The threshold concentration was 10 nM, which increased cell size from 7965+/-176 to 9411+/-392 microm2. Similarly, only GHHb enhanced protein content per well in VSMC cultures. 3. The planar surface area increase induced by 10 nM GHHb was abolished by superoxide dismutase (SOD; 50 200 u ml(-1)), deferoxamine (100 nM-100 microM), or dimethylthiourea (1 mM), while catalase (50 200 u ml(-1)) or mannitol (1 mM) resulted in a partial inhibition of cell size enhancement. 4. When a known source of oxygen free radicals was administered to VSMC, the xanthine/xanthine oxidase system, the results were analogous to those produced by GHHb. Indeed, enhancements of cell size were observed, which were inhibited by SOD, deferoxamine, or catalase. 5. These results indicate that, at low concentrations, GHHb induces hypertrophy in VSMC, this effect being mediated by superoxide anions, hydrogen peroxide, and/or hydroxyl radicals. Therefore, glycosylated proteins can have a role in the development of the structural vascular alterations associated to diabetes by enhancing oxidative stress.

High glucose induces cell death of cultured human aortic smooth muscle cells through the formation of hydrogen peroxide.

Alterations of the vessel structure, which is mainly determined by smooth muscle cells through cell growth and/or cell death mechanisms, are characteristic of diabetes complications. We analysed the influence of high glucose (22 mM) on cultured human aortic smooth muscle cell growth and death, as hyperglycaemia is considered one of the main factors involved in diabetic vasculopathy. Growth curves were performed over 96 h in medium containing 0.5% foetal calf serum. Cell number increased by 2 - 4 fold over the culture period in the presence of 5.5 mM (low) glucose, while a 20% reduction in final cell number was observed with high glucose. Under serum-free conditions, cell number remained constant in low glucose cultures, but a 40% decrease was observed in high glucose cultures, suggesting that high glucose may induce increased cell death rather than reduced proliferation. Reduced final cell number induced by high glucose was also observed after stimulation with 5 or 10% foetal calf serum. The possible participation of oxidative stress was investigated by co-incubating high glucose with different reactive oxygen species scavengers. Only catalase reversed the effect of high glucose. Intracellular H(2)O(2) content, visualized with 2',7'-dichlorofluorescein and quantified by flow cytometry, was increased after high glucose treatment. To investigate the cell death mechanism induced by high glucose, apoptosis and necrosis were quantified. No differences were observed regarding the apoptotic index between low and high glucose cultures, but lactate dehydrogenase activity was increased in high glucose cultures. In conclusion, high glucose promotes necrotic cell death through H(2)O(2) formation, which may participate in the development of diabetic vasculopathy.

Pharmacological interference of vascular smooth muscle cell hypertrophy induced by glycosylated human oxyhaemoglobin.

Nonenzymatically glycosylated human oxyhaemoglobin induces vascular smooth muscle cell hypertrophy by releasing reactive oxygen species. We analysed the ability of drugs with antihypertrophic properties for the vascular wall and/or antioxidant activity, such as captopril, losartan, and nifedipine, or gliclazide, carvedilol, and ascorbic acid, to interfere with 10 nM glycosylated human oxyhaemoglobin-induced increase in vascular smooth muscle cell size (118+/-0.5% of basal). Vascular smooth muscle cell hypertrophy was abolished concentration-dependently, with pD(2) values over a 100-fold interval: 6.4+/-0.3, 7.7+/-0.4, 7.3+/-0.4, 7.4+/-0.6, 8. 8+/-0.2, and 9.0+/-0.2 for captopril, losartan, nifedipine, ascorbic acid, carvedilol and gliclazide, respectively. Drugs with powerful antioxidant properties, especially carvedilol and gliclazide, are particularly effective in preventing glycosylated human oxyhaemoglobin-induced vascular smooth muscle cell hypertrophy.

Prevention of endothelial dysfunction in streptozotocin-induced diabetic rats by gliclazide treatment.

The aim of the present work was to analyze whether the oral hypoglycemic drug gliclazide affects diabetic endothelial dysfunction in streptozotocin-induced diabetic rats. Gliclazide was compared with glibenclamide, ascorbic acid, and aminoguanidine. An insulin-dependent model of diabetes was selected to exclude insulin-releasing effects of the drugs. Both in isolated aortic segments and mesenteric microvessels, endothelium-dependent relaxation evoked by acetylcholine (ACh, 1 nM to 10 microM) was significantly reduced in vessels from diabetic animals. This impairment was reversed when the segments were previously incubated with 100 U/ml superoxide dismutase. When streptozotocin-induced diabetic rats were orally treated from the time of diabetes induction with gliclazide (10 mg/kg) or ascorbic acid (250 mg/kg), ACh-induced endothelium-dependent relaxation was well preserved both in aortic segments and mesenteric microvessels. In addition, the impaired vasodilatation to exogenous nitric oxide (NO) in aortic segments was also improved in gliclazide-treated diabetic rats. On the other hand, oral treatment with glibenclamide (1 and 10 mg/kg) or aminoguanidine (250 mg/kg) did not produce significant improvements in diabetic endothelial dysfunction. We conclude that gliclazide reverses the endothelial dysfunction associated with diabetes. This effect appears to be due not to the metabolic actions of the drug but rather to its antioxidant properties, as it can be mimicked by other antioxidants. We propose that the mechanism involved is the inactivation of reactive oxygen species, which are increased in diabetes probably as a result of increased early protein glycosylation products, such as glycosylated hemoglobin (HbA(1c)). These effects of gliclazide are not shared by other oral hypoglycemic agent such as glibenclamide, or by blockade of advanced glycosylation end product (AGE) generation with aminoguanidine.

Correction of glycosylated oxyhemoglobin-induced impairment of endothelium-dependent vasodilatation by gliclazide.

We have investigated whether gliclazide, a second-generation sulfonylurea hypoglycemic agent, interferes with the impairment of endothelium-dependent nitric-oxide-mediated relaxation produced by 14%-glycosylated human oxyhemoglobin (GHHb). For comparative purposes, other agents, like glibenclamide, aminoguanidine, ascorbic acid or superoxide dismutase (SOD), were also tested. GHHb (10 nM) caused a reduction in endothelium-dependent relaxation induced by acetylcholine (1 nM to 10 microM) in both isolated aortic segments and mesenteric microvessels from normoglycemic nondiabetic rats. Preincubation of the vessels with gliclazide (100 nM to 10 microM) prevented the impairment of endothelial relaxation, the threshold concentration of gliclazide being 300 nM. In addition, 10 microM gliclazide also prevented the reduction by 10 nM GHHb of the relaxation induced by exogenous nitric oxide (NO, 10 nM to 100 microM). Determination of superoxide anion release measured by the reduction in ferricytochrome c indicated that GHHb produced significant amounts of these free radicals that were concentration-dependently inhibited by gliclazide. The impairment of endothelium-mediated responses was also prevented by 100 U/ml SOD or 10 microM ascorbic acid, but not by 10 microM glibenclamide or 100 microM aminoguanidine. We conclude that gliclazide can reduce the impairment of nitric-oxide-mediated endothelium-dependent relaxation produced by GHHb. This reduction is likely related to the antioxidant properties of the drug, a mechanism suggested by these studies which demonstrate the inactivation of superoxide anions produced by the glycosylated protein by gliclazide.

[Our experience in endourology]. / Nuestra experiencia en endourología.

Exposition of the experience accrued over 8 years in endo-urological procedures performed to 303 patients divided in 2 groups: Lithiasic (Group I) and Non-lithiasic (Group II) patients. Ninety-two (92) percutaneous nephrostomies in 69 patients and 235 ureteroscopies in 234 patients were accomplished, removing 324 calculi and resolving other obstructive conditions. The rate of success was 85% and 98% for the percutaneous nephrostomies and ureteroscopies, respectively. Complications were reported in 7 patients after percutaneous nephrostomy and in 14 patients during ureteroscopy. Most of these complications resolved with the use of endoscopic techniques except in two patients who required open surgery. There were no deaths in the present series. The advantages of applying this technique over the conventional one are discussed.

[Progebiophilus bruscai (Isopoda:Bopyridae) parasitizing the shrimp Upogebia dawsoni (Thalassinoidea:Upogebiidae), in Baja California Sur, Mexico)]. / Parasitismo de Progebiophilus bruscai (Isopoda:Bopyridae) sobre el camarón Upogebia dawsoni (Thalassinoidea:Upogebiidae), en Baja California Sur, México.

Parasitism of the isopod Progebiophilus bruscai Salazar-Vallejo & Leija-Tristán over the common mud shrimp, Upogebia dawsoni Williams, was analysed in the Ensenada and Bahia de La Paz, Baja California Sur, Mexico. Mud-shrimps were collected in three similar sites that differ in grain size and in the anthropogenic organic matter enrichment. Four-hundred-nine mud-shrimps were collected; the largest abundance was registered in the organically enriched site, but they were significantly smaller and more heavily parasited than the animals from the site lacking such organic enrichment. The size of the parasite is clearly dependent on the size of the mud-shrimp. This is the first study of the upogebiid-bopyris relationship in Mexico.

[Exogoninae (Polychaeta: Syllidae) from the Mexican Caribbean region with a key for the Gran Caribbean species]. / Exogoninae (Polychaeta: Syllidae) del Caribe mexicano con una clave para las especies del Gran Caribe.

This paper identifies the Exogoninae (Syllidae) from the Mexican Caribbean coasts and includes a key to identify all the species recorded from the Grand Caribbean Sea. The classification of the family and the composition of Exogoninae are briefly examined; the correct names of the subfamilies are Syllinae Grube, 1850, Eusyllinae Malaquin, 1893, Autolytinae Malaquin, 1893 and Exogoninae Langerhans, 1879. Exogoninae includes Anguillosyllis Day, 1963, Brania de Quatrefages, 1866, Braniella Hartman, 1963, Exogone Ørsted, 1845, Exogonella Hartman, 1961, Exogonoides Day, 1963, Parapionosyllis Fauvel, 1923, Psammosyllis Westheide, 1990, Spermosyllis Claparède, 1864, and Sphaerosyllis Claparède, 1863. Pseudexogone Augener, 1922, formerly included in the group, is not a syllid; it belongs to Pilargidae. We collected 814 specimens belonging to 3 genera, 3 subgenera and 13 species as Brania (4), Exogone (4) and Sphaerosyllis (5); five new species are described: Brania russelli n. sp, Brania uebelackerae n. sp, Brania westheidei n. sp., Exogone (Exogone) bondi n. sp. and Exogone (Parexogone) sanmartini n. sp. For each species, selected references, diagnostic features, observations on morphological variability, distribution and illustrations are provided; new species also have an english diagnosis. Most abundant species were B. uebelackerae n. sp. (295), S. taylori Perkins (169), E. (E.) dispar Webster (76), and E. (E.) bondi n sp. (72).

[Serpulids (Polychaeta: Serpulidae) from the Northwestern Caribbean with keys to the Grand Caribbean region: Salmacina, Ficopomatus, Pomatoceros, Pomatostegus, Protula, Pseudovermilia, Spirobranchus and Vermiliopsis]. / Serpúlidos (Polychaeta: Serpulidae) del Caribe noroccidental con claves para la región del Gran Caribe: Salmacina, Ficopomatus, Pomatoceros, Pomatostegus, Protula, Pseudovermilia, Spirobranchus y Vermiliopsis.

From the revision of more than 1,250 serpulids, 15 species from the Grand Caribbean Region were identified and characterized. Thirteen species were collected along the shores of the Yucatan Peninsula and eight were found in other localities in the Gulf of Mexico, seven others are from Cuba and comments on type specimens of two species are also included. Three morphometric analyses were made to evaluate some characters. The first on Pomatostegus stellatus (Abildgaard), and related species and subspecies: P. brachysoma Schmarda, P. macrosoma Schmarda, P. s. fruticosa Mörch, P. s. pentapoma Mörch and P. s. tetrapoma Mörch, indicated that they are conspecific. Another one on Spirobranchus de Blainville species: S. dendropoma Mörch, S. giganteus (Pallas), S. polycerus (Schmarda) and S. polycerus augeneri ten Hove; indicated that S. giganteus differs from the other three taxa. The third analysis was made on Vermiliopsis annulata (Schmarda) sensu lato; it allowed the recognition of three different forms. Several incomplete specimens might belong to an undescribed genus. A key for identification of all the species recorded in the Grand Caribbean Region is also included.

[Serpulids (Polychaeta: Serpulidae) from the Northwestern Caribbean: Hydroides and Serpula]. / Serpúlidos (Polychaeta: Serpulidae) del Caribe noroccidental: Hydroides y Serpula.

From the study of more than 450 specimens of Hydroides and Serpula, 12 species from the Grand Caribbean Region were identified and characterized. Eight species were collected along the shores of the Yucatan Peninsula and five were found in other localities in the Gulf of Mexico, seven others are from Cuba and comments on type specimens of five species are also included. One morphometric analysis made on Hydroides mucronatus Rioja and Hydroides cf. mucronatus, indicated several differences among them. Comments on all species are also included.

Hipocondría en la infancia y adolescencia. Revisión bibliográfica / Hypochondriasis in children and adolescents. A review of the literature

El trastorno hipocondríaco se describe como la preocupación excesiva por padecer una enfermedad. Como ocurre con otros trastornos psiquiátricos, la ausencia de pruebas complementarias analíticas o de imagen para el diagnóstico complica su estudio, y el debate acerca de sus características es constante. En el caso de niños y adolescentes, los estudios son aún más escasos, dificultando la tarea de psiquiatras y pediatras cuando se encuentran ante sintomatología compatible con diagnóstico de hipocondría. Por ello, hemos querido realizar una revisión de las publicaciones más recientes en relación con este trastorno en población infantojuvenil. Tras explorar los artículos publicados en los últimos años, y a pesar de la limitación de estudios en esta población específica, es de relieve la importancia de un abordaje multidisciplinar. Una vez descartadas otras patologías, el objetivo principal es recuperar y mantener la funcionalidad propia de la edad, implicando al grupo primario de apoyo

Hypochondriasis is a condition in which a person is inordinately worried about having a serious illness. As for many other psychiatric disorders, the lack of an objective method for its diagnosis hampers the investigation of this disease, and turns its features into subject of controversy and continuous discussion. These limitations become more relevant when children and adolescents are affected. This, together with the low number of published works covering hypochondriasis in these populations, poses extreme difficulties to pediatricians and child psychiatrists. Here, the most recent studies covering the causes, diagnosis, symptoms, treatment and prevention of hypochondriasis in children and adolescents are reviewed. The systematic revision of the literature suggests that an accurate diagnosis and management requires a multidisciplinary approach. After discarding other pathologies, appropriate managing should involve the main support group and focus in the recovery of the functionality according to the age of the patient

The US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III): prevalence of the metabolic syndrome in postmenopausal Latin American women.

BACKGROUND: Metabolic syndrome (METS) is a strong predictor of cardiovascular risk. Since the prevalence of METS increases after menopause, gynecological routine consultation offers an excellent screening opportunity. OBJECTIVES: To assess the prevalence of METS in Latin American postmenopausal women and factors modifying its risk; as well as to assess the role of simple routine care measurements in the diagnosis of the METS. METHODS: A total of 3965 postmenopausal women, aged 45-64 years, seeking health care at 12 gynecological centers in major Latin American cities were included in this cross-sectional study. The US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) guidelines were applied to assess METS. This was present if three or more of the following conditions were present: waist circumference > or = 88 cm; blood pressure > or = 130/85 mmHg; fasting plasma triglycerides > or = 150 mg/dl; high density lipoprotein (HDL) cholesterol < 50 mg/dl; glucose > or = 110 mg/dl or subjects were receiving treatment for their condition. RESULTS: The prevalences of having at least two, three, four or five components were 62.5, 35.1, 13.5 and 3.2%, respectively. The prevalence increased from 28.1% in those aged 40-44 years to 42.9% in those aged 60-64 years. The risk of METS detection (multivariate analysis) increased with age (odds ratio (OR) 1.22, 95% confidence interval (CI) 1.03-1.43), time elapsed since menopause (OR 1.18, 95% CI 1.00-1.38), smoking cigarettes (OR 1.40, 95% CI 1.19-1.65), obesity (OR 13.01, 95% CI 10.93-15.49) and hypertension (OR 9.30, 95% CI 7.91-10.94). In contrast, hormone therapy reduces this risk (OR 0.59, 95% CI 0.51-0.70). CONCLUSION: There is a high prevalence of the metabolic syndrome in postmenopausal Latin American women seeking gynecologic health care. Age, years since menopause, obesity and hypertension are strong predictors of this condition.

Changes in the human peritoneal mesothelial cells during aging.

The number of older patients admitted to peritoneal dialysis (PD) programmes is growing. At the same time, there is increasing data about the role of mesothelial cells in determining the functional alteration of the peritoneum during PD. However, little is known about the functional changes accompanying the ageing process in mesothelial cells. We aimed to evaluate whether the aging process is accompanied by changes in some functional characteristic of the human peritoneal mesothelial cells (HPMC), which could account for the poor prognosis observed in old patients with PD. HPMCs were isolated from patients undergoing a nonurgent, nonseptic abdominal surgical procedure, without renal, vascular or inflammatory disease. Cytokine levels (by enzyme-linked immunosorbent assay (ELISA)), nitrates+nitrites, and cyclooxygenase (COX) activity (by a chemiluminescence assay), cytokines, COX, nitric oxide synthase (NOS), and nuclear factor (NF)-kappaB1, two messenger ribonucleic acid (mRNA) gene expressions (by reverse transcriptase (RT)-Multiplex PCR), COX, and NOS promoter gene activities, and NF-kappaB-dependent transcription (by transient transfection assays) were determined. Our data show a significant increase in cytokines, COX, and NOS activities, and mRNA expression of cytokines, COX-2, inducible nitric oxide synthase (iNOS) and precursors of NF-kappaB in HPMCs from old people. This was also the case for COX-2 and iNOS promoter gene activities and NF-kappaB-dependent transcription. There was a positive correlation between the age of the donor's cell and the proinflammatory profile of the HPMCs. Such age-dependent increase (around two-three times) is partially abolished by different antioxidant or free-radical scavengers. Thus, aging is accompanied by the presence of an inflammatory state in HPMCs, which involves the participation of different reactive oxygen species.

[Prevalence of problem drinkers among users of a health center]. / Prevalencia de bebedor problema en los usuarios de un centro de salud.

OBJECTIVE: To know the prevalence of problem drinker in adult users of a health center, their personal features and the recording of alcohol consumption in the clinical record. DESIGN: Descriptive crossover. SETTING: Health Center of Deusto, Bilbao. PATIENTS: 163 users, aged 14 to 65, obtained by systematic sampling. MEASUREMENTS AND MAIN RESULTS: For data collection we used an inquest that included the MALT questionnaire. The population consisted of 44% of males and 56% of females. The prevalence of problem drinker was of 11 + 4.8% (CI 95%), made up of 6% of suspects and 5% of alcoholics. 19.4% of males and 4.4% of females was problem drinker (p = 0.002). Alcohol consumption was recorded in 35 + 8% (CI 95%); in 67% of problem drinker and in 31% of the remainder (p = 0.0014). Four out of 8 people self-considered as ex alcoholics were problem drinker. CONCLUSIONS: Important problem in Primary Health Care with a prevalence similar to Spanish studies made with MALT. Alcohol consumption should be recorded in clinical records. It would be interesting to investigate the evolution of MALT in ex-alcoholics.