Oral health in Alzheimer's disease: a multicenter case-control study.

OBJECTIVES: The aim of this case-control study was to carry out an oral health assessment on a group of Alzheimer's patients and to establish a hypothesis regarding the implication of the characteristics of the disease and the treatment of oral health. MATERIALS AND METHODS: A total of 70 Alzheimer's patients, residents at the Alzheimer Center Reina Sofia Foundation (Madrid, Spain) and at the Alzheimer State Reference Center (Salamanca, Spain), and 36 controls (companions/acquaintances), were studied by oral examination and saliva sampling. The oral health indices DMFT/DMFS, CPI, the prosthetic condition, oral hygiene, saliva volume, and pH, as well as the specific microbiological parameters governing the risk of developing caries were assessed. RESULTS: Alzheimer's patients exhibited, as compared to the control group, (1) fewer teeth (10.9 ± 10.5 vs 23.7 ± 6.5), (2) fewer obturations (2.2 ± 3.4 vs 6.6 ± 5.6), (3) fewer periodontally healthy sextants (0.1 ± 0.4 vs 1.4 ± 2.2), (4) worse oral hygiene (43.1 vs 72.2% brushed), (5) greater use of removable prostheses (47.8 vs 8.4%), (6) higher incidence of candida infection (11.8 vs 0.0%) and cheilitis (15.9 vs 0.0%), (7) lower salivary flow (0.6 ± 0.6 vs 1.1 ± 0.6), and (8) lower buffering capacity (46 vs 80%). CONCLUSIONS: After taking into account the influence of age, Alzheimer's patients had worse oral health (caries and periodontal disease), more mucosal lesions (cheilitis and candidiasis), and worse saliva quantity and quality. CLINICAL RELEVANCE: Clinicians should be aware of the implications of Alzheimer's disease in oral health, in order to stablish the effective preventive measures and the optimal treatment plan.

Psychometric properties of a new short version of the State-Trait Anxiety Inventory (STAI) for the assessment of anxiety in the elderly.

INTRODUCTION: Anxiety has negative effects on the cognitive performance and psychosocial adjustment of elderly people. Given the high prevalence of anxiety symptoms in patients suffering from cognitive impairment, it has been suggested that these symptoms may be an early marker of dementia. The State-Trait Anxiety Inventory (STAI) is one of the most widely-used scales for evaluating anxiety in elderly people. However, inasmuch as the STAI may be difficult to apply to older people, having a short form of it would be desirable. METHODS: The participants comprised 489 community-dwelling individuals aged 68 years and over. All of them were volunteers in a longitudinal study for early detection of Alzheimer' Disease (Proyecto Vallecas). The full sample was divided in two homogeneous subgroups: Group A, used to reduce the number of items and response options, and Group B, the group used to determine the psychometric properties of the new short form (STAIr). RESULTS: A dichotomous Rasch model was used to obtain the STAIr. No statistically significant differences for STAIr scores were found with respect to sociodemographic variables. Psychometric properties and normative data were obtained for the new short version. CONCLUSIONS: The STAIr is composed of 13 items and data fits the model well. Since it is short and easy to apply to elderly people, STAIr will be very useful in clinical and research settings.

[The new age of neurodegenerative diseases. The basis of the new approaches]. / La nueva era de las enfermedades neurodegenerativas. La base de los nuevos abordajes.

The detection by biomarkers of the pathophysiological and molecular processes involved in misfolding protein diseases making it possible to delineate the natural history of these processes. The great majority of protein misfolding diseases have a prolonged preclinical phase, in which the biological changes are patent. The clinical manifestations (i.e., phenotypes) do not have a univocal correspondence with the underlying pathology, despite the fact that pathological eponyms have been used for the description of the clinical syndromes, which has favored diagnostic inaccuracy. In order to perform an adequate clinical management, we must know the 3 planes that currently define the most common neurodegenerative processes. Diagnostic accuracy will be a prerequisite for new therapies aimed at modifying the course of brain protein misfolding diseases.

TITLE: La nueva era de las enfermedades neurodegenerativas. La base de los nuevos abordajes.La detección por biomarcadores de los procesos fisiopatológicos y moleculares implicados en las enfermedades cerebrales por plegamiento anormal de proteínas está permitiendo delinear la historia natural de estos procesos. La gran mayoría de ellos tiene una fase preclínica prolongada, en la que los cambios biológicos son patentes. Las manifestaciones clínicas (fenotipos) no tienen una correspondencia unívoca con la patología subyacente, a pesar de que se han utilizado los epónimos anatomopatológicos para la descripción de los síndromes clínicos, lo que ha favorecido la imprecisión diagnóstica. Para realizar un adecuado manejo clínico debemos conocer los tres planos que definen actualmente los procesos neurodegenerativos más frecuentes. La precisión diagnóstica será un prerrequisito para las nuevas terapias dirigidas a modificar el curso de las enfermedades por plegamiento proteico cerebrales.

Neuroanatomy of financial decisions.

INTRODUCTION: Neuroeconomics is a new science that studies the brain processes involved in taking decisions, particularly related to economy and it has experienced an important advance in the recent years due to the development of the new neuroimaging techniques, basically functional magnetic resonance imaging. The aim of this paper it to carry out a review of the literature on the different neurological mechanisms involved in taking financial decisions, the concerned brain structures and the diseases that can affect them. SOURCES: We made a non systematic review of the literature in primary (PubMed) and secondary (Tripdatabase and Cochrane Library) bibliographic databases. We also used bibliography given by the Asociación Española de Neuroeconomía. DEVELOPMENT: Brain reward and loss aversion systems suppose a balance that makes us take one or another decision. Dopamine plays an important role on it and several brain structures have been involved in this balance such as the amygdale, the insula, the medial prefrontal cortex, the anterior and posterior cingulated cortex, the accumbens nucleus and the ventral tegmental area. The alteration of this balance may produce inappropriate financial behaviors what may occur in common diseases including depression, mania, alcoholism, gambling and several impulse control disorders. CONCLUSIONS: Neurologists should define our role in this interdisciplinary field due to the privileged position of our specialty to study how the brain works and due to the potential growing of this science in the near future.

Identification of a novel locus, BPH38(t), conferring resistance to brown planthopper (Nilaparvata lugens Stal.) using early backcross population in rice (Oryza sativa L.).

Rice is the most important staple food crop, and it feeds more than half of the world population. Brown planthopper (BPH) is a major insect pest of rice that causes 20-80% yield loss through direct and indirect damage. The identification and use of BPH resistance genes can efficiently manage BPH. A molecular marker-based genetic analysis of BPH resistance was carried out using 101 BC1F5 mapping population derived from a cross between a BPH-resistant indica variety Khazar and an elite BPH-susceptible line Huang-Huan-Zhan. The genetic analysis indicated the existence of Mendelian segregation for BPH resistance. A total of 702 high-quality polymorphic single nucleotide polymorphism (SNP) markers, genotypic data, and precisely estimated BPH scores were used for molecular mapping, which resulted in the identification of the BPH38(t) locus on the long arm of chromosome 1 between SNP markers 693,369 and id 10,112,165 of 496.2 kb in size with LOD of 20.53 and phenotypic variation explained of 35.91%. A total of 71 candidate genes were predicted in the detected locus. Among these candidate genes, LOC_Os01g37260 was found to belong to the FBXL class of F-box protein possessing the LRR domain, which is reported to be involved in biotic stress resistance. Furthermore, background analysis and phenotypic selection resulted in the identification of introgression lines (ILs) possessing at least 90% recurrent parent genome recovery and showing superior performance for several agro-morphological traits. The BPH resistance locus and ILs identified in the present study will be useful in marker-assisted BPH resistance breeding programs.

La nueva era de las enfermedades neurodegenerativas. La base de los nuevos abordajes / The new age of neurodegenerative diseases. The basis of the new approaches

La detección por biomarcadores de los procesos fisiopatológicos y moleculares implicados en las enfermedades cerebrales por plegamiento anormal de proteínas está permitiendo delinear la historia natural de estos procesos. La gran mayoría de ellos tiene una fase preclínica prolongada, en la que los cambios biológicos son patentes. Las manifestaciones clínicas (fenotipos) no tienen una correspondencia unívoca con la patología subyacente, a pesar de que se han utilizado los epónimos anatomopatológicos para la descripción de los síndromes clínicos, lo que ha favorecido la imprecisión diagnóstica. Para realizar un adecuado manejo clínico debemos conocer los tres planos que definen actualmente los procesos neurodegenerativos más frecuentes. La precisión diagnóstica será un prerrequisito para las nuevas terapias dirigidas a modificar el curso de las enfermedades por plegamiento proteico cerebrales. (AU)

The detection by biomarkers of the pathophysiological and molecular processes involved in misfolding protein diseases making it possible to delineate the natural history of these processes. The great majority of protein misfolding diseases have a prolonged preclinical phase, in which the biological changes are patent. The clinical manifestations (i.e., phenotypes) do not have a univocal correspondence with the underlying pathology, despite the fact that pathological eponyms have been used for the description of the clinical syndromes, which has favored diagnostic inaccuracy. In order to perform an adequate clinical management, we must know the 3 planes that currently define the most common neurodegenerative processes. Diagnostic accuracy will be a prerequisite for new therapies aimed at modifying the course of brain protein misfolding diseases. (AU)

Implantación y desarrollo de un programa de conciliación farmacoterapéutica en paciente prequirúrgico del Servicio de Otorrinolaringología: proyecto QonciliaX / Implantation and development of a pharmacotherapy reconciliation program in the presurgery otorhinolariyngology patient: QonciliaX program

Introducción: El objetivo del estudio es diseñar un procedimiento normalizado de trabajo (PNT) de conciliación prequirúrgica en paciente de otorrinolaringología (ORL) con hospitalización convencional. Material y métodos: El diseño del PNT se realizó en varias fases. Fase 1: revisión bibliográfica; Fase 2: selección de pacientes candidatos, definición de responsabilidades, establecimiento del circuito de trabajo y elaboración del PNT, planificación de la consulta de farmacia; Fase 3: aprobación del PNT; Fase 4: sesiones informativas/formativas a los servicios implicados. Resultados: 1. La selección de pacientes candidatos será realizada por ORL; 2. Citación de pacientes candidatos en la consulta de farmacia previa a la consulta de preanestesía; 3. Consulta de farmacia, se obtendrá el listado farmacoterapéutico y se valorará la adherencia junto con recomendaciones dirigidas al anestesista, otorrino y médico de primaria (MAP); 4. Elaboración de un informe de conciliación; 5. En la consulta de preanestesia, el anestesista podrá consultar el informe de farmacia; 6. Durante el ingreso del paciente en el hospital, el otorrino podrá consultar el informe de farmacia; 7. Alta del paciente, en la que se le entregará un informe con recomendaciones para el MAP y un plan horario con indicaciones sobre administración de medicación. Discusión: La elección de pacientes de otorrino se basa en el hecho de tratarse de pacientes con patologías crónicas y comorbilidades y podrían beneficiarse por tanto de una atención farmacéutica. La integración de diversos profesionales en un equipo multidisciplinar permite mejorar y protocolizar el procedimiento de trabajo. Integra el ámbito de primaria y especializada mejorando de este modo la continuidad asistencial. (AU)

Introduction: The main target of the proyect is to design a Standard Operational Process (SOP) of presurgery medication reconciliation on otorhinolaryngology patients with coventional hospitalization Material and methods: The SOP design was performed in several stages. Stage 1: bibliography review; Stage 2: candidate patient selection, responsability assignments, establishment of a working circuit, SOP elaboration, pharmacy consultory planification; Stage 3: SOP approval; Stage 4: informative/formative sessions directed to the involved departments. Results: 1. Otorhinolaringoloty department will carry candidate patient selection; 2. Candidate patients pharmacy consultory appointment previous to preanesthetic consultory; 3. Pharmacy consultory, in which it will be acquired the pharmacotherapy patient list and adherence evaluation along with pharmacology recommendations directed to the anesthesiologist, otolaryngologist and primary care physician; 4. Medication reconciliation report preparation; 5. In the preanesthesic consultory, the anesthesiologist will be able to consult the pharmacy report; 6. Patient admission, during this period, the otolaryngologist may use of the pharmacy report; 7. During patient hospital discharge, the patient will be delivered a report with recommendations for the primary care physician and a mediation schedule with medication administration indactions. Discussion: Otolaryngologist patients selection is based on the fact that it is a group of patients with chronic pathologies and comorbilities and therefore, they could benefit from a pharmaceutical care. Divers professionals integration in a multidisciplinary work team, allows to improve and protocolize a Standard Operational Process. It integrates primary and specialist care, improving care continuity. (AU)

JB-9322, a new selective histamine H2-receptor antagonist with potent gastric mucosal protective properties.

1. JB-9322 is a selective histamine H2-receptor antagonist with gastric antisecretory activity and mucosal protective properties. 2. The affinity of JB-9322 for the guinea-pig atria histamine H2-receptor was approximately 2 times greater than that of ranitidine. 3. In vivo, the ID50 value for the inhibition of gastric acid secretion in pylorus-ligated rats was 5.28 mg kg-1 intraperitoneally. JB-9322 also dose-dependently inhibited gastric juice volume and pepsin secretion. In gastric lumen-perfused rats, intravenous injection of JB-9322 dose-dependently reduced histamine-, pentagastrin- and carbachol-stimulated gastric acid secretion. 4. JB-9322 showed antiulcer activity against aspirin and indomethacin-induced gastric lesions and was more potent than ranitidine. 5. JB-9322 effectively inhibited macroscopic gastric haemorrhagic lesions induced by ethanol. Intraperitoneal injection was effective in preventing the lesions as well as oral treatment. The oral ID50 value for these lesions was 1.33 mg kg-1. By contrast, ranitidine (50 mg kg-1) failed to reduce these lesions. In addition, the protective effect of JB-9322 was independent of prostaglandin synthesis. 6. These results indicate that JB-9322 is a new antiulcer drug that exerts a potent cytoprotective effect in addition to its gastric antisecretory activity.

Inflatable catheter for dacryocystorhinostomy.

A silicone catheter with an inflatable balloon was used as a temporary stent for dacryocystorhinostomy. The inflated balloon was positioned in the patient's lacrimal sac, and the catheter remained in the nasal fossa. This device maintained an open lacrimal sac-nasal mucosa communication during the healing period. Postoperative removal was performed by deflating the balloon and gently pulling the catheter through the patient's nostril.

Mg,Al layered double hydroxides with intercalated indomethacin: synthesis, characterization, and pharmacological study.

Magnesium aluminium layered double hydroxides (LDH) with a molar Mg/Al ratio of 2.0 have been prepared with intercalated indomethacin following two routes: reconstruction from a previously calcined Mg(2)Al-CO(3) LDH, and coprecipitation from the corresponding chlorides. The solids have been characterized by powder X-ray diffraction, FTIR, and (13)C CP/MAS NMR spectroscopies and thermal stability (differential thermal analysis and thermogravimetric analysis). Intercalation of the drug is attained by both routes; however, while coprecipitation leads to a single layered structure, contamination with another layered MgAl-CO(3) phase occurs by the reconstruction method. The amount of drug intercalated, as well as the height of the gallery, are larger by the coprecipitation than by the reconstruction one. The data obtained support a somewhat tilted, upwards orientation of the drug molecules forming an interdigited bilayer, in the case of the sample prepared by coprecipitation, with the carboxylate groups pointing towards the hydroxyl layers. However, in the case of the sample prepared by reconstruction, the molecules are forming a tilted, upwards monolayer. The solids prepared are stable up to 250 degrees C. Pharmacological studies in vivo show that intercalation of the drug in the LDH reduces the ulcerating damage of the drug.

Antihistaminic activity of pulegone on the guinea-pig ileum.

Pulegone, a natural monoterpene compound, has an antihistamine effect on guinea-pig ileum. Its antagonism is of the competitive type (PA2 = 6.35) like that of mepyramine and dexchlorpheniramine, two H1-antagonists, with PA2 values of 10.15 and 8.74, respectively.

Pharmacological study of certain extracts of Laurobasidium lauri.

On the basis of observational screening in conscious rats, the essential oil of Laurobasidium lauri seems to be the main agent responsible for the sedating and analgesic effects of this fungus. The inhibitory activity observed in isolated rat uterus with the butanol and alkaloid-rich fractions of this species appears to be related to a decrease in the calcium available for contraction.

Analgesic, antipyretic and anti-inflammatory activity of the essential oil of Artemisia caerulescens subsp. gallica.

The essential oil of Artemisia caerulescens subsp. gallica was observed to have analgesic, antipyretic and anti-inflammatory actions when administered intraperitoneally to rats and mice at doses one-fourth to one-third that of its LD50 of 1.35 ml/kg. Lysine acetylsalicylate was used as a reference compound.

Brain Donation by Proxy: Are There Predictors in Neurodegenerative Dementia?

OBJECTIVES: To describe the frequency and predictors of brain donation by relatives in patients with neurodegenerative dementia. DESIGN: Database review and quantitative analysis. SETTING: The Alzheimer Center Reina Sofia Foundation (ACRSF), a center devoted to the care and research of patients with neurodegenerative dementia. PARTICIPANTS: Patients with signed consent for participation in the ACRSF research program. MEASUREMENTS: A set of 38 demographic, clinical, and social variables related to patient and closest relative, which were collected by the ACRSF multidisciplinary team upon patient admission. RESULTS: Admission data were available for 198 patients who entered the ACRSF research program; 85 of them (42.9%) died during follow-up. Mean age (SD) at admission was 82.3 (6.8) years and 80.8% of the patients were female. Family link between patient and closest relative was spouse or partner (12.0%), son or daughter (74.9%), or other link (13.1%). Brain was obtained from 56 patients (65.9%). Consent by legal representative and patient's depressive symptoms were more frequent in the donors (p<0.05, corrected) and trend was observed for more aberrant motor symptoms in the donors (p<0.05, uncorrected). CONCLUSION: A high rate of brain donation was achieved, probably due to the unique characteristics of the ACRSF and consent for research policy. Wish of alleviating suffering, as well as general interest in dementia research, possibly exerted an influence in brain donation. More research is needed to ascertain the values, motivations, and circumstances that may lead to brain donation by proxy in neurodegenerative dementia.

[Development of integrated support software for drug validation]. / Desarrollo de un software integrado de ayuda a la validación farmacéutica.

OBJECTIVE: To describe the development of a tool to automate detection of adverse drug-related events (ADRE) in all patients in a hospital. METHOD: We selected the ADRE that we wished to detect (administering drugs to patients with kidney failure and/or by enteral feeding tube) We designed software to record, process and integrate analytical results from SELENE(®) clinical history programme, treatment prescribed using Farmatools(®), and the information included in the tables we designed. RESULTS: The programme allows us to automatically detect patients likely to experience the ADRE we defined, and recommends a modified treatment to the pharmacist. This new tool enables us to search for all patients who might have a specific ADRE. CONCLUSIONS: The software we designed may be a useful drug validation tool.

Chronic treatment with pravastatin prevents early cardiovascular changes in spontaneously hypertensive rats.

BACKGROUND AND PURPOSE: This study investigates the effect of pravastatin on blood pressure, cardiovascular remodelling and impaired endothelial function induced as early signs of cardiovascular disease in young spontaneously hypertensive rats (SHR). EXPERIMENTAL APPROACH: Eight-week-old SHR were treated for 4 weeks with pravastatin (20 mg kg(-1) day(-1)). Systolic blood pressure was measured periodically during the study using the tail-cuff method. At the end of the study, the left ventricular weight /body weight ratio was used as an index of left ventricular hypertrophy (LVH). Vascular function, superoxide (O(2)(-*)) production and structure were studied in aortic rings. Lipid peroxidation was measured in plasma (thiobarbituric acid reactive substances assay). KEY RESULTS: Systolic blood pressure was lower in treated SHR than in control SHR, at the end of the study (171 +/- 1 vs. 159 +/- 2 mmHg, P < 0.05), and LVH was significantly reduced by pravastatin (2.7 +/- 0.02 vs. 2.5 +/- 0.01 mg g(-1), P < 0.05). Vascular responses to sodium nitroprusside and phenylephrine were similar in both groups; nevertheless, the relaxation response to acetylcholine was higher in the treated rats (45.6 +/- 2.6 vs. 58.1 +/- 3.2 %, P < 0.05). Vascular O(2)(-*) and plasma thiobarbituric acid reactive substances were reduced by pravastatin treatment, and urinary nitrites was elevated. Finally aortic wall became thinner after pravastatin treatment. CONCLUSIONS AND IMPLICATIONS: Chronic treatment with pravastatin attenuated the increase of systolic blood pressure in SHR, prevented early LVH and improved vascular structure and function. These effects were accompanied by decreased measures of oxidative stress and improvements in NO production.

Cardiovascular changes in spontaneously hypertensive rats are improved by chronic treatment with zofenopril.

BACKGROUND AND PURPOSE: The aim of this study was to investigate the effect of chronic treatment with antihypertensive and non-antihypertensive doses of zofenopril on cardiovascular changes in spontaneously hypertensive rats (SHR). EXPERIMENTAL APPROACH: Male SHR were treated with 0.5 or 10 mg kg(-1) per day of zofenopril (Z(0.5) and Z(10)) for 3 months. SHR and Wistar-Kyoto rats (WKY) receiving vehicle were used as controls. Systolic blood pressure was measured using the tail cuff method. Left ventricular weight/body weight ratio was calculated as cardiac hypertrophy index. Angiotensin converting enzyme (ACE) activity was determined in plasma and tissues by a fluorimetric method. Vascular reactivity was evaluated on aortic rings by acetylcholine and sodium nitroprusside relaxations. Effects on vascular structure were assessed by lumen diameter, wall thickness and medial cross-sectional area determination. Superoxide anion generation was quantified using lucigenin-amplified chemiluminescence in aorta. RESULTS: Long-term daily administration of zofenopril (10 mg kg(-1)) to SHR reduced blood pressure to WKY values, decreased cardiac hypertrophy, improved the acetylcholine-induced relaxant response and reversed the vascular remodelling. ACE inhibition and antioxidant activity were involved in these effects. 0.5 mg kg(-1) per day of zofenopril slightly modified blood pressure and the other effects were weaker. CONCLUSIONS AND IMPLICATIONS: Antihypertensive effects of chronic treatment with zofenopril were accompanied by recovery of endothelial function and improvement of cardiovascular structure. Low-dose zofenopril had little effect on blood pressure, with some benefits on cardiovascular structure and function. Inhibition of ACE and antioxidant activity were involved in these effects.

Chromium(III) determination without sample treatment by batch and flow injection potentiometry.

A new and easy device for direct detection of chromium(III) in batch and flow analysis without previous oxidation/reduction or preconcentration steps of samples is designed and evaluated. For this purpose a potentiometric sensor with solid state membrane based on carbon paste matrix is developed. The sensor is modified with di(2-hydroxyphenylimino)ethane and the principal analytical parameters of the potentiometric response in batch and flow analysis are optimized and calculated. Optimal detection limits (1.4 x 10(-7)M in static mode and 5.4 x 10(-7)M in on-line analysis) and selectivity to trivalent chromium are obtained in both analysis modes. The use of this device to direct detection of chromium(III) in real samples is tested using a sediment Certified Reference Material. Chromium(III) determination is also carried out with successful results in environmental samples such as extracts from soils used as barriers in landfills and industrial samples such as waste waters from electroplating industries.