Comments on evolution of sleep and the palliopallial connectivity in mammals and birds.

This commentary is referred to the review signed by Rattemborg [N.C. Rattenborg, Evolution of slow wave sleep and palliopallial connectivity in mammals and birds. A hypothesis. Brain Res. Bull. 69 (2006) 20-29]. We propose that the review missed important aspects in relation to the characteristics of sleep in poikilotherm vertebrates and in the evolution of sleep. Poikilotherms continuously show an EEG dominated by slow waves, but its highest amplitude appears not during sleep, but during active waking. In addition, they show an arousal reaction which consists in an increase in EEG amplitude and synchrony, opposite to mammals and birds. As a consequence, most of the conclusions proposed in the review should be rejected.

Improved circadian sleep-wake cycle in infants fed a day/night dissociated formula milk.

On the basis of the circadian nutritional variations present in breast milk, and of the implications for the sleep/wake cycle of the nutrients present in infant formula milks, we designed a formula milk nutritionally dissociated into a Day/Night composition. The goal was to improve the bottle-fed infant's sleep/wake circadian rhythm. A total of 21 infants aged 4-20 weeks with sleeping difficulties were enrolled in the three-week duration study. The sleep analysis was performed using an actimeter (Actiwatch) placed on an ankle of each infant to uninterruptedly record movements during the three weeks. The dissociated Day milk, designed to be administered from 06:00 to 18:00, contained low levels of tryptophan (1.5g/100g protein) and carbohydrates, high levels of proteins, and the nucleotides Cytidine 5 monophosphate, Guanosine 5 monophosphate and Inosine 5 monophosphate. The dissociated Night milk, designed to be administered from 18.00 to 06.00, contained high levels of tryptophan (3.4g/100g protein) and carbohydrates, low levels of protein, and the nucleotides Adenosine 5 monophosphate and Uridine 5 monophosphate. Three different milk-feeding experiments were performed in a double-blind procedure covering three weeks. In week 1 (control), the infants received both by day and by night a standard formula milk; in week 2 (inverse control), they received the dissociated milk inversely (Night/Day instead of Day/Night); and in week 3, they received the Day/Night dissociated formula concordant with the formula design. When the infants were receiving the Day/Night dissociated milk in concordance with their environment, they showed improvement in all the nocturnal sleep parameters analyzed: total hours of sleep, sleep efficiency, minutes of nocturnal immobility, nocturnal awakenings, and sleep latency. In conclusion, the use of a chronobiologically adjusted infant formula milk seems to be effective in improving the consolidation of the circadian sleep/wake cycle in bottle-fed infants.

[The evolution of sleep: birds at the crossroads between mammals and reptiles]. / La evolución del sueño: las aves en la encrucijada entre mamíferos y reptiles.

INTRODUCTION: The evolution of sleep is one of the mysteries surrounding the sleep. Since the discovery of the two phases in the mammalian sleep, NREM and REM, the sleep researchers have unsuccessfully tried to understand their origin and the causes of the sleep duality. Looking for an answer to these questions, the sleep of reptiles (the parental group of mammals) and birds (also descending from reptiles) has been studied. As a result, NREM and REM were found in birds but not in reptiles, and the question remains thus unresolved. DEVELOPMENT AND CONCLUSIONS: This review presents a critical analysis of the published sleep studies developed in birds and points to a possible cause of the conflict: considerable doubts can be cast on the existence of the two sleep phases in birds. If birds turn to have only one sleep phase, they would have a very similar sleep to that of reptiles. As a consequence, the two phases, REM and NREM, would be exclusive of mammals, and both would have appeared as a consequence of the evolutionary changes in the development of the brain from reptiles to mammals.

The effect of chronic treatment with GH on gonadal function in men with isolated GH deficiency.

Eleven adult males, previously submitted to neurosurgery because of a pituitary lesion (three with craniopharyngioma, three with clinically non-functioning adenoma and five with macroprolactinoma) were treated with recombinant GH for 12 months after the diagnosis of GH deficiency was made. Circulating FSH, LH, prolactin, testosterone, 17 beta-estradiol (E2), dehyroepiandrosterone (DHEA-S), androstenedione. 17-OH-progesterone (17OHP), IFG-I, and steroid hormone-binding protein (SHBG) levels were assayed before and after CG test at study entry and 6 and 12 months after GH treatment. A significant increase in plasma IGF-I levels was obtained after 6 and 12 months of GH treatment. In addition, CG-stimulated, but not baseline, testosterone levels showed a significant increase after 6 and 12 months of GH treatment when compared with study entry (9.6 +/- 0.5 and 9.9 +/- 0.5 vs 7.9 +/- 0.5 ng/ml; P < 0.05). Baseline, but not CG-stimulated, serum 17OHP levels were significantly increased only after 12 months of GH treatment (1.7 +/- 0.1 vs 1.4 +/- 0.1 ng/ml; P < 0.05). No significant difference was found as far as both basal and CG-stimulated E2, androstenedione, DHEA-S and SHBG were concerned. With regards to the semen analysis, only seminal plasma volume was significantly increased after 12 months of GH treatment (2.9 +/- 0.3 vs 1.7 +/- 0.3 ml; P < 0.05). No significant change in sperm count, motility and abnormal forms was observed. These data show that GH treatment displays a clear-cut effect upon Leydig cell function and increases the production of seminal plasma volume in fertile adult males with isolated GH deficiency.

Intake of melatonin increases tryptophan hydroxylase type 1 activity in aged rats: Preliminary study.

Pineal melatonin is important not only for synchronization of biological rhythms, but also in the ageing process as a potential drug to relieve oxidative damage. During ageing, the nocturnal melatonin production decreases resulting in an increased incidence of disorders. Present in vivo experiments were performed to study the effects of exogenous melatonin chronically administered to old rats on the pineal biosynthesis of melatonin and the precursor serotonin (5-HT) mediated by tryptophan hydroxylase type 1 (TPH-1). Accumulation of 5-hydroxytryptophan (5-HTP) after decarboxylase inhibition was used as a measure of the TPH-1 activity. 5-HT and its metabolite 5-HIAA were also quantified by HPLC-ED. As expected, ageing resulted in worsening of different neurochemical parameters. However, chronic intake of melatonin (1mg/kg/day, diluted in drinking water, 4 weeks) increased TPH-1 activity and significantly improved the age-induced deficits in nocturnal melatonin content in the pineal gland. Results suggest that melatonin intake (or melatonin rich foods) may contribute to recover the pineal function preventing the nocturnal descent of 5-HT and melatonin biosynthesis that normally occur in pineal gland as a consequence of ageing.

Results of retrograde intrarenal surgery in the treatment of renal stones greater than 2 cm.

OBJECTIVE: To analyze the results of retrograde intrarenal surgery (RIRS) in patients with ≥2 cm stones treated in our center. MATERIAL AND METHODS: A retrospective review of 106 patients with renal calculi underwent RIRS ≥2 cm (period January 2009-December 2011). The procedures were performed under general anesthesia as a source of fragmentation using the holmium laser (30 W Litho Quantasystem) and flexible ureteroscopes (X2 Flex Storz, Olympus P5) through ureteral access sheaths. It discusses demographic variables (age, medical history, antiplatelet or anticoagulant treatment, treatment of urolithiasis, BMI, ASA), treated stones variables (size, number, Hounsfield units, biochemical composition) and intra-and postoperative variables (operative time, number of pulses, hospital stay, complications) with the completion of a descriptive analysis of the same. To define our results we consider success to the complete absence of fragments or residual <5 mm posterior imaging tests. RESULTS: The mean stone size was 2.46 cm treated, being the only stone in 87.7% of cases. The most frequent location was the renal pelvis stones (44%) followed by the lower calyx (39%). The postoperative complication rate was 6.7%, with all of little relevance. The success rate with a single procedure was 79.4% to 94.1% with retreatment. CONCLUSION: RIRS is a valid alternative for the treatment of kidney stones ≥2 cm for its high success rate and few complications if performed in specialized centers.

Resultados de la cirugía retrógrada intrarrenal en el tratamiento de litiasis renales mayores de 2 cm / Results of retrograde intrarenal surgery in the treatment of renal stones greater than 2 cm

Objetivo: Analizar los resultados de la cirugía retrógrada intrarrenal (CRIR) en pacientes con litiasis ≥ 2 cm tratados en nuestro centro. Material y métodos: Revisión retrospectiva de 106 pacientes con litiasis renales ≥ 2 cm sometidos a RIRS (período comprendido entre enero de 2009 y diciembre de 2011). Los procedimientos se realizaron bajo anestesia general utilizando como fuente de fragmentación el láser Holmium (Litho 30 W Quantasystem) y ureteroscopios flexibles (Storz Flex X2, Olympus P5) a través de vainas de acceso ureteral.Se analizan variables demográficas (edad, antecedentes patológicos, tratamientos antiagregantes o anticoagulantes, tratamiento de litiasis, IMC, ASA), variables de litiasis tratada (tamaño, número, unidades Hounsfield, composición bioquímica) y variables intra y postoperatorias (tiempo quirúrgico, número de pulsos, estancia hospitalaria, complicaciones) con la realización de un análisis descriptivo de las mismas. Para definir nuestros resultados consideramos éxito la ausencia completa de restos litiásicos o residuales < 5 mm en las pruebas de imagen posteriores. Resultados: La media de tamaño de las litiasis tratadas fue de 2,46 cm, siendo la litiasis única en el 87,7% de los casos. La localización más frecuente de la litiasis fue la pelvis renal (44%) seguida del cáliz inferior (39%). La tasa de complicaciones postoperatoria fue del 6,7%, siendo todas de escasa relevancia. El porcentaje de éxito con un único procedimiento fue de un 79,4%, alcanzando el 94,1% con retratamiento. Conclusión: La CRIR es una alternativa válida para el tratamiento de litiasis renales ≥ 2 cm por su alta tasa de éxito y escasas complicaciones si se realiza en centros especializados

Objective: To analyze the results of retrograde intrarenal surgery (RIRS) in patients with ≥2 cm stones treated in our center. Material and methods: A retrospective review of 106 patients with renal calculi underwent RIRS ≥2 cm (period January 2009-December 2011). The procedures were performed under general anesthesia as a source of fragmentation using the holmium laser (30 W Litho Quanta system) and flexible ureteroscopes (X2 Flex Storz, Olympus P5) through ureteral access sheaths. It discusses demographic variables (age, medical history, antiplatelet or anticoagulant treatment, treatment of urolithiasis, BMI, ASA), treated stones variables (size, number, Hounsfield units, biochemical composition) and intra-and postoperative variables (operative time, number of pulses, hospital stay, complications) with the completion of a descriptive analysis of the same. To define our results we consider success to the complete absence of fragments or residual <5 mm posterior imaging tests. Results: The mean stone size was 2.46 cm treated, being the only stone in 87.7% of cases. The most frequent location was the renal pelvis stones (44%) followed by the lower calyx (39%).The postoperative complication rate was 6.7%, with all of little relevance. The success rate with a single procedure was 79.4% to 94.1% with retreatment. Conclusion: RIRS is a valid alternative for the treatment of kidney stones ≥ 2 cm for its high success rate and few complications if performed in specialized centers

La evolución del sueño: las aves en la encrucijada entre mamíferos y reptiles / The evolution of sleep: birds at the crossroads between mammals and reptiles

Introducción. La evolución del sueño es uno más de los misterios que envuelven el sueño. Desde el descubrimiento de las dos fases del sueño de mamíferos, REM y no REM, se intentó –con pocos resultados– comprender el origen de las dos fases y las razones por las cuales se mantiene la dualidad del sueño. Buscando la respuesta a estas preguntas se estudió el sueño de los reptiles, el grupo antecesor de los mamíferos, y de las aves, otro grupo que también desciende de los reptiles. El resultado es que las dos fases se han hallado en las aves, pero no han podido demostrarse en los reptiles, por lo que el misterio sigue sin resolverse. Desarrollo y conclusiones. En la presente revisión se analizan de forma crítica los resultados más conocidos del sueño de las aves y se apunta una solución para el conflicto: es posible que las dos fases de sueño tampoco existan en este grupo y, en consecuencia, su sueño sería similar al de los reptiles. Con esto, las dos fases, REM y no REM, serían exclusivas de los mamíferos y se habrían desarrollado como consecuencia de los cambios evolutivos en la estructura del cerebro

Introduction. The evolution of sleep is one of the mysteries surrounding the sleep. Since the discovery of the two phases in the mammalian sleep, NREM and REM, the sleep researchers have unsuccessfully tried to understand their origin and the causes of the sleep duality. Looking for an answer to these questions, the sleep of reptiles (the parental group of mammals) and birds (also descending from reptiles) has been studied. As a result, NREM and REM were found in birds but not in reptiles, and the question remains thus unresolved. Development and conclusions. This review presents a critical analysis of the published sleep studies developed in birds and points to a possible cause of the conflict: considerable doubts can be cast on the existence of the two sleep phases in birds. If birds turn to have only one sleep phase, they would have a very similar sleep to that of reptiles. As a consequence, the two phases, REM and NREM, would be exclusive of mammals, and both would have appeared as a consequence of the evolutionary changes in the development of the brain from reptiles to mammals