Clinical ethics protocols in the clinical ethics committees of Madrid.

INTRODUCTION: Currently, The nature and scope of Clinical Ethics Protocols (CEPs) in Madrid (Spain) are not well understood. OBJECTIVES: The main objective is to describe the features of 'guideline/recommendation' type CEPs that have been or are being developed by existing Clinical Ethics Committees (CECs) in Madrid. Secondary objectives include characterisation of those CECs that have been the most prolific in reference to CEP creation and implementation and identification of any trends in future CEP development. METHODS: We collected CEPs produced and in process by CECs accredited in the public hospitals in Madrid, Spain, from 1996 to 2008. RESULTS: CECs developed 30 CEPs, with 10 more in process. The most common topic is refusal of treatment (seven CEPs developed; two in process). If CEPs addressing terminal illness, Do-Not-Resuscitate orders and advance directives are placed into a separate 'ethical problems at the end of life' category, this CEP subject emerges as the most common (eight developed; four in process). There is a relationship between the age of the CEC and the development of CEPs (the oldest CECs have developed more CEPs). CECs now seem to be more likely to engage in CEP development. CONCLUSIONS: The CECs in Madrid, Spain, have developed a significant number of CEPs (30 in total and 10 in process) and there is a trend towards continued development. The most frequent topics are ethical problems at the end of life and refusal of treatment by the patient.

Anatomy of olivocochlear neurons in the hamster studied with FluoroGold.

The golden hamster (Mesocricetus auratus) is often used in auditory research, but little is known about the anatomical organization of its olivocochlear (OC) neurons, the source of the efferent innervation of the organ of Corti. Accordingly, we labeled the OC neurons projecting to one cochlea by means of retrograde axonal transport of FluoroGold. In four animals, all labeled OC neurons were counted and digital images of the labeling were captured and analyzed morphometrically. In one case, a 3D computer reconstruction of the bilateral distribution of OC neurons was made. The largest group of OC neurons was comprised by small, intrinsic lateral OC neurons within the ipsilateral lateral superior olivary nucleus (LSO), almost all of which (97%) were located ipsilaterally. The second largest group consisted of medial OC neurons in the ventral nucleus of the trapezoid body, 75% of which were located contralaterally. The smallest group consisted of shell neurons surrounding the LSO, 80% of which projected ipsilaterally. These three types of neurons are generally similar in morphology and distribution to those previously described in the rat and the chinchilla. However, there were several unique findings, including the fact that the hamster possesses the smallest total number of OC neurons (mean 341) of any rodent yet studied.

Inter-hemispheric asymmetry of nigrostriatal dopaminergic lesion: a possible compensatory mechanism in Parkinson's disease.

The onset of Parkinson's disease (PD) is characterized by focal motor features in one body part, which are usually correlated with greater dopaminergic depletion in the contralateral posterior putamen. The role of dopamine (DA) hemispheric differences in the onset and progression of motor symptoms of PD, however, remains undefined. Previous studies have demonstrated that unilateral manipulations of one nigrostriatal system affect contralateral DA turnover, indicating a functional and compensatory inter-dependence of the two nigrostriatal systems. In preliminary data obtained by our group from asymmetric PD patients, a higher asymmetry index as measured by 6-[(18)F]fluoro-L-dopa ((18) F-DOPA) positron emission tomography (PET) was associated with a higher threshold (i.e., greater dopaminergic loss) for the onset of motor symptoms in the less-affected side. To further elucidate the underlying basis for this, we carried out a complementary study in monkeys using PET to assess and correlate the degree of dopaminergic striatal depletion with motor activity. Control and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-intoxicated monkeys with symmetrical lesions were characterized behaviorally and with (18)F-DOPA PET. In parallel, an acute lesion was inflicted in the nigrostriatal projection unilaterally in one monkey, generating a 30% dopaminergic depletion in the ipsilateral striatum, which was not associated with any noticeable parkinsonian feature or deficit. The monkey remained asymptomatic for several months. Subsequently, this monkey received systemic MPTP, following which motor behavior and PET were repeatedly evaluated during progression of parkinsonian signs. The brains of all monkeys were processed using immunohistochemical methods. Our results suggest that the onset of motor signs is related to and influenced by the dopaminergic status of the less-affected, contralateral striatum. Although this work is still preliminary, the study agrees with our general hypothesis of hemispheric inter-dependence in the compensation of striatal DA deficit in PD.

Persistent penetration of MPTP through the nasal route induces Parkinson's disease in mice.

The aetiology of idiopathic Parkinson's disease (PD) is poorly defined but environmental aggression may be relevant. Here, we report a new model of PD in mice, based on chronic inoculation with neurotoxins in the nasal cavity, which is a natural route of contact with the environment. C57BL/6 mice, submitted to daily intranasal inoculation with MPTP for 30 days, developed motor deficits that correlated with a progressive and severe depletion of striatal dopamine levels, and loss of tyrosine hydroxylase and dopamine transporter staining in substantia nigra and striatum. Moreover, mice intranasally inoculated with MPTP developed strong astrogliosis and microgliosis in substantia nigra and striatum. Consistent with these observations, a role for oxidant aggression was demonstrated by increased levels of Mn-superoxide dismutase. However, alpha-synuclein aggregation was not observed. This new animal model provides a new tool for studying PD symptoms that develop slowly over time, and it may be used to asses risk from environmental neurotoxins.

La ética del uso de animales con fines científicos / Animals use's ethical with scientific purpose

La cultura occidental ha aceptado pocas restricciones a su derecho a disponer de otros seres vivos. En este artículo se revisan primeramente las ideas que han tenido mayor influencia, y se ofrece una historia de los mivimientos de defensa de los animales. A continuación se justifica la pretensión de que actuar sobre los animales es una cuestión ética. Y se afirma la necesidad de ampliar las éticas tradicionales en un momento de poderío tecnológico y crisis ecológica. Debe desarrollarse una ética ambiental promotora de un desarrollo sostenible, que tenga en cuenta a las generaciones futuras y a la vida en general. Se examina también el problema de la existencia de derechos en los animales. Y se admite que puede hablarse de esos derechos como una forma de reconocer las obligaciones "prima facie" que tienen los seres humanos. Seguidamente se reconoce la validez de las críticas que denuncian el "especieísmo" como un análogo del "racismos". Aunque se advierte que reconocer los intereses de los animales es compatible con el reconocimiento de la superioridad de ciertos intereses del hombre. También se afirma la existencia de ciertas obligaciones del hombre hacia los animales de laboratorio. Se describen algunas de ellas, y se mencionan los principales marcos legales que han llegado a estar vigentes en el mundo. Finalmente se postula la necesidad de desarrollar una nueva actitud hacia los animales, basada en el respeto y la responsabilidad. Esta actitud es necesaria para la supervivencia del ser humano como especie biológica y como comunidad ética