Uric acid and acute kidney injury in high-risk patients for developing acute kidney injury undergoing cardiac surgery: A prospective multicenter study.

PURPOSE: It is unclear whether preoperative serum uric acid (SUA) elevation may play a role in the development of acute kidney injury (AKI) associated with cardiac surgery (CSA-AKI). We conducted a cohort study to evaluate the influence of preoperative hyperuricemia on AKI in patients at high risk for developing SC-AKI. DESIGN: Multicenter prospective international cohort study. SETTING: Fourteen university hospitals in Spain and the United Kingdom. PARTICIPANTS: We studied 261 consecutive patients at high risk of developing CSA-AKI, according to a Cleveland score ≥ 4 points, from July to December 2017. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: AKIN criteria were used for the definition of AKI. Multivariable logistic regression models and propensity score-matched pairwise analysis were used to determine the adjusted association between preoperative hyperuricemia (≥7 mg/dL) and AKI. Elevated preoperative AUS (≥7 mg/dL) was present in 190 patients (72.8%), whereas CSA-AKI occurred in 145 patients (55.5%). In multivariable logistic regression models, hyperuricemia was not associated with a significantly increased risk of AKI (adjusted Odds Ratio [OR]: 1.58; 95% confidence interval [CI]: 0.81-3; P = .17). In propensity score-matched analysis of 140 patients, the hyperuricemia group experienced similar adjusted odds of AKI (OR 1.05, 95%CI 0.93-1.19, P = .37). CONCLUSIONS: Hyperuricemia was not associated with an increased risk of AKI in this cohort of patients undergoing cardiac surgery at high risk of developing CSA-AKI.

Identification of a new hormone-binding site on the surface of thyroid hormone receptor.

Thyroid hormone receptors (TRs) are members of the nuclear receptor superfamily of ligand-activated transcription factors involved in cell differentiation, growth, and homeostasis. Although X-ray structures of many nuclear receptor ligand-binding domains (LBDs) reveal that the ligand binds within the hydrophobic core of the ligand-binding pocket, a few studies suggest the possibility of ligands binding to other sites. Here, we report a new x-ray crystallographic structure of TR-LBD that shows a second binding site for T3 and T4 located between H9, H10, and H11 of the TRα LBD surface. Statistical multiple sequence analysis, site-directed mutagenesis, and cell transactivation assays indicate that residues of the second binding site could be important for the TR function. We also conducted molecular dynamics simulations to investigate ligand mobility and ligand-protein interaction for T3 and T4 bound to this new TR surface-binding site. Extensive molecular dynamics simulations designed to compute ligand-protein dissociation constant indicate that the binding affinities to this surface site are of the order of the plasma and intracellular concentrations of the thyroid hormones, suggesting that ligands may bind to this new binding site under physiological conditions. Therefore, the second binding site could be useful as a new target site for drug design and could modulate selectively TR functions.

Characterization of the human dynein light chain Rp3 and its use as a non-viral gene delivery vector.

Dynein light chains mediate the interaction between the cargo and the dynein motor complex during retrograde microtubule-mediated transport in eukaryotic cells. In this study, we expressed and characterized the recombinant human dynein light chain Rp3 and developed a modified variant harboring an N-terminal DNA-binding domain (Rp3-Db). Our approach aimed to explore the retrograde cell machinery based on dynein to enhance plasmid DNA (pDNA) traffic along the cytosol toward the nucleus. In the context of non-viral gene delivery, Rp3-Db is expected to simultaneously interact with DNA and dynein, thereby enabling a more rapid and efficient transport of the genetic material across the cytoplasm. We successfully purified recombinant Rp3 and obtained a low-resolution structural model using small-angle X-ray scattering. Additionally, we observed that Rp3 is a homodimer under reducing conditions and remains stable over a broad pH range. The ability of Rp3 to interact with the dynein intermediate chain in vitro was also observed, indicating that the recombinant Rp3 is correctly folded and functional. Finally, Rp3-Db was successfully expressed and purified and exhibited the ability to interact with pDNA and mediate the transfection of cultured HeLa cells. Rp3-Db was also capable of interacting in vitro with dynein intermediate chains, indicating that the addition of the N-terminal DNA-binding domain does not compromise its function. The transfection level observed for Rp3-Db is far superior than that reported for protamine and is comparable to that of the cationic lipid Lipofectamine™. This report presents an initial characterization of a non-viral delivery vector based on the dynein light chain Rp3 and demonstrates the potential use of modified human light chains as gene delivery vectors.

Tris[2-(1,3-thiazol-2-yl-κN)-1H-benzimidazole-κN3]zinc(II) dinitrate ethanol hemisolvate monohydrate at 100 K.

The Zn(II) center in the dicationic complex of the title compound, [Zn(C(10)H(7)N(3)S)(3)](NO(3))(2)·0.5C(2)H(5)OH·H(2)O, is in a distorted octahedral environment with imperfect noncrystallographic C(3) symmetry. Each 2-(1,3-thiazol-2-yl)-1H-benzimidazole ligand coordinates in a bidentate manner, with the Zn-N(imidazole) bond lengths approximately 0.14 Å shorter than the Zn-N(thiazole) bond lengths. Charge-assisted hydrogen bonds connect cations, anions and water molecules. A lattice void is occupied by an ethanol solvent molecule disordered about a crystallographic inversion center and π-stacking is observed between one type of symmetry-related benzene rings.

Small-angle X-ray scattering and in silico modeling approaches for the accurate functional annotation of an LysR-type transcriptional regulator.

Xylella fastidiosa is a xylem-limited, Gram-negative phytopathogen responsible for economically relevant crop diseases. Its genome was thus sequenced in an effort to characterize and understand its metabolism and pathogenic mechanisms. However, the assignment of the proper functions to the identified open reading frames (ORFs) of this pathogen was impaired due to a lack of sequence similarity in the databases. In the present work, we used small-angle X-ray scattering and in silico modeling approaches to characterize and assign a function to a predicted LysR-type transcriptional regulator in the X. fastidiosa (XfLysRL) genome. XfLysRL was predicted to be a homologue of BenM, which is a transcriptional regulator involved in the degradation pathway of aromatic compounds. Further functional assays confirmed the structural prediction because we observed that XfLysRL interacts with benzoate and cis,cis-muconic acid (also known as 2E,4E-hexa-2,4-dienedioic acid; hereafter named muconate), both of which are co-factors of BenM. In addition, we showed that the XfLysRL protein is differentially expressed during the different stages of X. fastidiosa biofilm formation and planktonic cell growth, which indicates that its expression responds to a cellular signal that is likely related to the aromatic compound degradation pathway. The assignment of the proper function to a protein is a key step toward understanding the cellular metabolic pathways and pathogenic mechanisms. In the context of X. fastidiosa, the characterization of the predicted ORFs may lead to a better understanding of the cellular pathways that are linked to its bacterial pathogenicity.

Fijación quirúrgica de fracturas costales con placas de titanio: reporte de dos casos / Surgical repair of rib fractures using titanium plates: report of two cases

Rib fractures are common lesions in blunt chest trauma. Disregarding the severity of other high energy associated lesions, chest wall trauma characteristically causes intense pain, respiratory complications and long-term disability. Pain relief and chest wall function restoration are obtained by surgical stabilization of rib fractures. In nowdays still there is a considerable variability in surgical techniques and devices, as well as in their results and clinical indications. We report two cases of chest wall trauma and rib fractures repaired with osteosynthesis (Synthes® system MatrixRIB. Solothurn, Switzerland) and we discuss their new clinical indications and results.

Las fracturas costales son lesiones frecuentes en los traumatismos torácicos contusos. Sin contar aquellas lesiones asociadas con la alta absorción de energía, las fracturas costales causan característicamente dolor intenso, complicaciones respiratorias y ausentismo laboral significativo. Una de las estrategias terapéuticas es la estabilización quirúrgica del foco de fractura, la cual tiene múltiples ventajas teóricas como la disminución del dolor y la restauración de la función de la pared costal. Existen múltiples formas de fijación costal, pero su indicación, técnica quirúrgica y resultados son muy disímiles. Presentamos dos casos de reparación de pared torácica con material de osteosíntesis especialmente diseñado para este efecto (Synthes® MatrixRIB, Solothurn, Suiza), y se discuten sus alcances en las indicaciones y resultados clínicos.

(1S,2E,6R,7aR)-1,6-Dihy-droxy-2-(4-nitro-benzyl-idene)-2,3,5,6,7,7a-hexa-hydro-1H-pyrrolizin-3-one.

The crystal structure of the title compound, C(14)H(14)N(2)O(5), contains two distinct conformers in the asymmetric unit. The compound has three defined stereocenters, two of them contiguous, and a C=C double bond with an E conformation. The stereocenters exhibit the same chirality in both conformers, with significant differences in the conformation of the five-membered rings of the pyrrolizine unit (both either in a twist or in an envelope form) and in the dihedral angles between the corresponding mean planes and the benzene rings. A prominent feature is a change from almost coplanar rings in one conformer to a new conformation in the second conformer, in which the mean plane of a five-membered ring is almost perpendicular to the benzene ring, with a dihedral angle 87.19 (8)°; the corresponding angle in the first conformer is 14.02 (10)°. In the crystal, molecules are linked by O-H⋯O and C-H⋯O hydrogen bonds. Crystallographic data were essential to confirm the configuration of the double bond, which was unclear from the available two-dimensional NMR data. In addition, reliable Flack and Hooft parameters were obtained, allowing for the correct absolute structure to be determined.

(1S,2E,6R,7aR)-2-Benzyl-idene-1,6-dihy-droxy-2,3,5,6,7,7a-hexa-hydro-1H-pyrrolizin-3-one.

In the title compound, C(14)H(15)NO(3), the conformation of the double bond was determined to be E, confirming the result obtained from two-dimensional NMR data. The five-membered rings of the pyrrolizine unit exhibit C-envelope conformations, with C atoms displaced from the mean planes formed by the remaining rings atoms by 0.1468 (15) and 0.5405 (17) Å. The mean planes of these rings (through all ring atoms) have a dihedral angle of 49.03 (10)°. In the crystal, mol-ecules are linked by O-H⋯O hydrogen bonds. The absolute configuration of the mol-ecule was established, as judged by the, as judged by the obtained values for the Hooft and Flack parameters.

(1S,2S,6R,7aR)-2-Benzyl-1,6-dihy-droxy-hexa-hydro-pyrrolizin-3-one.

In the title compound, C(14)H(17)NO(3), the dihedral angles show that the H atoms at two stereocenters are in a trans-diaxial configuration. In the crystal, the molecules are linked by O-H⋯O hydrogen bonds. The absolute configuration of the molecule has been established on the basis of refinement of the Hooft and Flack parameters.

(1S,2R,6R,7aS)-1,2,6-Trihy-droxy-hexa-hydro-1H-pyrrolizin-3-one.

In the title compound, C(7)H(11)NO(4), prepared via a Morita-Baylis-Hillman adduct, the five-membered ring bearing three O atoms approximates to a twisted conformation, whereas the other ring is close to an envelope, with a C atom in the flap position. The dihedral angle between their mean planes (all atoms) is 23.11 (9)°. The new stereocenters are created in a trans-diaxial configuration. In the crystal, O-H⋯O and O-H⋯(O,O) hydrogen bonds link the mol-ecules, generating a three-dimensional network. A weak C-H⋯O inter-action also occurs.

Enoyl-coenzyme A hydratase and antigen 85B of Mycobacterium habana are specifically recognized by antibodies in sera from leprosy patients.

Leprosy is an infectious disease caused by Mycobacterium leprae, which is a noncultivable bacterium. One of the principal goals of leprosy research is to develop serological tests that will allow identification and early treatment of leprosy patients. M. habana is a cultivable nonpathogenic mycobacterium and candidate vaccine for leprosy, and several antigens that cross-react between M. leprae and M. habana have been discovered. The aim of the present study was to extend the identification of cross-reactive antigens by identifying M. habana proteins that reacted by immunoblotting with antibodies in serum samples from leprosy patients but not with antibodies in sera from tuberculosis (TB) patients or healthy donors (HDs). A 28-kDa antigen that specifically reacted with sera from leprosy patients was identified. To further characterize this antigen, protein spots were aligned in two-dimensional polyacrylamide gels and Western blots. Spots cut out from the gels were then analyzed by mass spectrometry. Two proteins were identified: enoyl-coenzyme A hydratase (lipid metabolism; ML2498) and antigen 85B (Ag85B; mycolyltransferase; ML2028). These proteins represent promising candidates for the design of a reliable tool for the serodiagnosis of lepromatous leprosy, which is the most frequent form in Mexico.

Mice lacking the peroxisome proliferator-activated receptor α gene present reduced number of dopamine neurons in the substantia nigra without altering motor behavior or dopamine neuron decline over life.

Peroxisome proliferator-activated receptor alpha (PPAR-α), which is expressed by neurons of the nigrostriatal circuit, plays a prominent role in oxidative stress and neuroinflammation. The objectives were: (i) to discern if levels of antioxidant molecules and pro-inflammatory cytokines, along with PPAR-γ expression are modified in the nigrostriatal region of null PPAR-α mice, (ii) to discern whether dopaminergic neuronal features of the substantia nigra pars compacta (SNpc) and dorsal striatum are affected in null mice, and (iii) to establish if aging-induced decline of nigral neurons is different in null PPAR-α mice relative to wild-type littermates. A substantial decrease in antioxidant molecules was found in SNpc of null mice, by using ELISA. The pro-inflammatory factors TNF-α and IL-3 were found to be reduced in the substantia nigra, suggesting dual and opposite effects of PPAR-α deficiency on oxidative and pro-inflammatory molecules. Immunohistological and stereological studies revealed that young null mice present a smaller SNpc (-19.8%; TH downregulation was discarded). Normal locomotion in an open-field was not affected in null mice. Dopamine cell death could be caused by reduced protection against oxidative stress. Old null mice showed a percentage reduction of nigral dopamine neurons similar to that of young null animals, with a rate of decline over life of around 44%, the same value than that of wild-type littermates. These findings suggest that nuclear PPAR-α is necessary for the normal development of the substantia nigra along with normal levels of antioxidant molecules. Lack of PPAR-α does not modify the normal motor behavior of mice or decline of nigral dopamine neurons throughout life.

Valoración de la adecuación del traslado en ambulancia al área médica de un servicio de urgencias pediátricas / Study on the suitability of ambulance transportation to a paediatric medical emergency department

Objetivos: Determinar si el transporte en ambulancia a urgencias es adecuado y valorar si condiciona una visita preferencial y mayor gravedad de los pacientes. Pacientes y método: Se incluyen los pacientes que consultaron a urgencias de pediatría durante el 2008, se establecen 2 grupos, los que acudieron en ambulancia (Grupo 1) y los que lo hicieron por otros medios (Grupo 2). Para valorar la adecuación, se extrae del Grupo 1 una muestra aleatoria de 300 pacientes; se revisa el informe de alta y se aplica la «Pediatric Ambulance Need Evaluation Tool». Para valorar el trato preferencial, se compara la proporción de pacientes valorados en triaje, el tiempo hasta triaje y asistencia; y para determinar diferencias respecto a la gravedad, se analizan los pacientes con nivel de triaje≤3 y los que requirieron exámenes complementarios e ingreso. Resultados: Se atendieron 80.537 pacientes, el 2,5% acudieron en ambulancia, estimándose que el 31% (IC 95% 26,2–35,8%) podría haber empleado otro transporte. Los principales diagnósticos de los clasificados como transporte inadecuado fueron: trastorno epiléptico (23–24,7%), crisis de ansiedad (12–12,9%) y síndrome febril (12–12,9%). Se observó que la proporción de valorados en triaje, el tiempo hasta triaje y asistencia fue menor en el Grupo 1, y que la proporción de niños con nivel de triaje≤3, y la de pacientes que recibieron alguna exploración complementaria y/o ingresaron fue mayor que en el Grupo 2. Conclusiones: Una proporción elevada de pacientes trasladados en ambulancia podrían haber utilizado otro tipo de transporte. Sin embargo, la mayor gravedad de un número importante de pacientes justifica la visita preferencial detectada en los transportados en este medio. El uso del triaje en todos los pacientes transportados en ambulancia ayudaría a detectar los casos realmente prioritarios y mejorar el funcionamiento de los servicios de urgencias (AU)

Objectives: To evaluate the appropriateness of ambulance use as transport to Emergency Medical Services and to determine if ambulance use is associated with preferential attention and to illness severity. Patients and method: All patients attended in a Paediatric Emergency Department during 2008 were included. Two groups were defined: Group 1, patients arriving by ambulance and Group 2, patients arriving by any other means of transport. In order to evaluate the appropriateness of ambulance use, a random sample of 300 patients from the Group 1 was selected; the "Paediatric Ambulance Need Evaluation tool" was applied to final diagnosis. To assess the preferential attention, the rate of patients with triage evaluation, time to triage and time to medical attention were compared. Finally, to determine differences in the severity of illness, patients with triage level ≤3 and patients needing complementary examinations and/or hospital admission were analysed. Results: A total of 80537 patients were included, of which 2.5% arrived by ambulance. Estimation of the prevalence of inappropriate transport use was 31 % (95 CI%: 26.2–35.8%). Their main diagnoses were: epileptic attack (23–24.7%), panic attack (12–12.9%) and fever (12–12.9%). It was observed that triage evaluation, time to triage and time to medical attention was shorter in Group 1. The proportion of children with triage level ≤3, needing complementary examinations and/or hospital admission was higher in-Group 1. Conclusion: A high number of patients arriving by ambulance could have used another means of transport. However, the greater severity of a significant number of patients justifies the preferential attention given. Triage use in all patients arriving by ambulance would help in the detection of high priority cases and to improve the Emergency Department performance (AU)

[Study on the suitability of ambulance transportation to a paediatric medical emergency department]. / Valoración de la adecuación del traslado en ambulancia al área médica de un servicio de urgencias pediátricas.

OBJECTIVES: To evaluate the appropriateness of ambulance use as transport to Emergency Medical Services and to determine if ambulance use is associated with preferential attention and to illness severity. PATIENTS AND METHOD: All patients attended in a Paediatric Emergency Department during 2008 were included. Two groups were defined: Group 1, patients arriving by ambulance and Group 2, patients arriving by any other means of transport. In order to evaluate the appropriateness of ambulance use, a random sample of 300 patients from the Group 1 was selected; the "Paediatric Ambulance Need Evaluation tool" was applied to final diagnosis. To assess the preferential attention, the rate of patients with triage evaluation, time to triage and time to medical attention were compared. Finally, to determine differences in the severity of illness, patients with triage level < or =3 and patients needing complementary examinations and/or hospital admission were analysed. RESULTS: A total of 80537 patients were included, of which 2.5% arrived by ambulance. Estimation of the prevalence of inappropriate transport use was 31 % (95 CI%: 26.2-35.8%). Their main diagnoses were: epileptic attack (23-24.7%), panic attack (12-12.9%) and fever (12-12.9%). It was observed that triage evaluation, time to triage and time to medical attention was shorter in Group 1. The proportion of children with triage level < or =3, needing complementary examinations and/or hospital admission was higher in-Group 1. CONCLUSION: A high number of patients arriving by ambulance could have used another means of transport. However, the greater severity of a significant number of patients justifies the preferential attention given. Triage use in all patients arriving by ambulance would help in the detection of high priority cases and to improve the Emergency Department performance.

Introducción a la farmacia galénica: un reto en primer año de farmacia / Introduction to galenic pharmacy: a challenge in the first year of pharmacy

Este curso académico 2009-2010 se implanta el nuevo plan de estudios de Farmacia en la Universidad de Barcelona, diseñado según los planteamientos del EEES. Como consecuencia, y por primera vez en la historia de la Facultad de Farmacia de la UB, se imparte una asignatura troncal de cariz galénico en el primer año de la carrera. Esto constituye un nuevo reto para el Grupo de Innovación Docente de Tecnología Farmacéutica (GIDTF), dado que la asignatura Introducción a la Farmacia Galénica se ha de impartir a grandes grupos de estudiantes, al inicio de su carrera, mediante sesiones teóricas de 1,5 h. Excepcionalmente en este curso académico, la asignatura se imparte en el primer semestre y se repite en el segundo.En este trabajo se presenta el planteamiento metodológico presencial diseñado para esta asignatura, apoyado en estrategias no presenciales como foro de debate, recursos on-line, cuestionarios y tareas de autoevaluación a través de la plataforma Moodle del Campus Virtual de la UB, puesto que el equipo docente considera prioritario iniciar al estudiante en el uso de la misma en el primer año de carrera. Se han efectuado encuestas de satisfacción a los estudiantes que se han evaluado, así también como los resultados académicos obtenidos. En el análisis de los puntos fuertes y débiles de la metodología empleada, se han detectado evaluaciones positivas y también aspectos que podrían mejorarse, estableciendo las medidas correctoras adecuadas. En cuanto a los resultados académicos, han sido muy satisfactorios(AU)

This academic year 2009-2010, the new curriculum of Pharmacy according to the premises of the EHEA is started at the University of Barcelona. As a result, for the first time in the history of the Faculty of Pharmacy of UB, an obligatory galenic subject will be given during the first year of the career. This is a new challenge for Teaching Innovation Group of Pharmaceutical Technology (GIDTF), as the subject Introduction to Galenic Pharmacy is given by a team of teachers to large groups of students who began its career, through theoretical sessions of 1.5 h. The subject will be taught exceptionally this academic year in the first semester and repeated in the second.In this paper we present the methodological approach designed to face this subject, supported by virtual strategies as discussion forum, online resources, self-assessment test and work through the platform Moodle of the Virtual Campus UB, as the team considers it a priority to initiate the student in using it in the first year of pharmacy study.Were carried out satisfaction surveys to students and we have evaluated them, as well as academic performance. Through the analysis of the methodology, we detected positive evaluations and areas for improvement that have been used to establish appropriate corrective measures. Academic results have been very satisfactory(AU)

[Mortality following cardiac surgery in the National Health Service Hospitals of the Community of Valencia in 2007: a descriptive analysis]. / Análisis descriptivo de mortalidad en cirugía cardiaca en los hospitales públicos de la Comunidad Valenciana en el año 2007.

OBJECTIVE: To analyze clinical records of cardiac surgery patients in an attempt to identify factors associated with mortality in the postoperative critical care units of the public health service hospitals in the Community of Valencia, Spain, in 2007. METHODS: Retrospective study of cases from January 1, 2007 to December 31, 2007. The charts of all patients who underwent cardiac surgery with or without extracorporeal circulation were reviewed. A data collection protocol was followed to obtain information on age, sex, body mass index (BMI), presurgical risk factors, type of surgery, duration of extracorporeal circulation, duration of ischemia, cause of death, and length of stay in the postoperative critical care unit. RESULTS: The study population consisted of 2113 patients at 5 public hospitals; 124 patients (70 men, 54 women) died. The mean (SD) age was 70 (9.43) years (range, 36-91 years). The mean BMI was 28.19 kg/m2 (maximum, 42 kg/m2). The mean Euroscore was 21.92 (maximum, 94.29). Hypertension was present as a preoperative risk factor in most patients (74.2%); dyslipidemia was present in 51.6%, diabetes mellitus in 38.7%, stroke in 73%, and renal failure in 2.4%. It was noteworthy was that the group who underwent coronary revascularization had the highest mortality rate (nearly 35% of the 124 patients). The next highest mortality rate (19.4%) was in patients who had combined procedures (valve repair or substitution plus coronary revascularization). Mortality was 18.5% in the group undergoing aortic valve surgery and 11.3% in those undergoing mitral valve surgery. The mean duration of extracorporeal circulation was 148.63 minutes. The mean duration of myocardial ischemia was 94.91 minutes. The most frequent cause of death was cardiogenic shock (54.8%). This was followed by distributive shock (29.8%) and hemorrhagic shock (8.9%). The mean length of stay in the postoperative critical care unit was 13.6 days. Overall mortality was 5.87%. CONCLUSIONS: The highest mortality rate among cardiac surgery patients in postoperative critical care units in hospitals in the Community of Valencia in 2007 was in patients who underwent coronary revascularization. The most prevalent preoperative risk factor was hypertension. Cardiogenic shock and distributive shock were the most frequent causes of death in these patients. A system for classifying risk is needed in order to predict mortality in critical care units and improve perioperative care.

Análisis descriptivo de mortalidad en cirugía cardiaca en los hospitales públicos de la Comunidad Valenciana en el año 2007 / Mortality following cardiac surgery in the national health service hospitals of the Community of Valencia in 2007: a descriptive analysis

OBJETIVO: Analizar los datos clínicos y tratar de identificarlos factores asociados que pudieran haber influidoen la mortalidad postoperatoria de los pacientes decirugía cardiaca durante su permanencia en la Unidadde Cuidados Críticos de los hospitales de la sanidadpública de la Comunidad Valenciana durante el 2007.MÉTODO: Estudio retrospectivo desde 1 enero de 2007hasta 31 diciembre del 2007. Se revisaron todas las historiasclínicas de los pacientes operados de cirugía cardiacacon y sin circulación extracorpórea y se aplicó unformulario de recogida de datos que permitió obtener lainformación necesaria para determinar edad, sexo, índicede masa corporal, factores de riesgo prequirúrgicos,tipo de intervención quirúrgica realizada, tiempo de circulaciónextracorpórea, tiempo de isquemia, causa demortalidad y tiempo de estancia en la Unidad de CuidadosCríticos.RESULTADOS: En los 5 centros públicos donde se realizacirugía cardiaca la población estudiada fue de 2.113pacientes. El número de pacientes fallecidos fue de 124,de ellos 70 fueron hombres y 54 mujeres. La media deedad fue 70 años (DE 9,43) oscilando entre 36 y 91 años.El valor medio del índice de masa corporal fue de 28,19kg/m2 con un máximo de 42 kg/m2. El valor medio delEuroscore fue de 21,92 con un máximo de 94,29. Entrelos factores de riesgo estudiados la hipertensión arterialestaba presente en la mayoría de los pacientes (74,2%),dislipemia en el 51,6% de los casos, diabetes mellitus enel 38,7%, accidentes cerebrovasculares previos en el7,3% e insuficiencia renal previa a la cirugía en el 2,4%...(AU)

OBJETIVE: To analyze clinical records of cardiacsurgery patients in an attempt to identify factorsassociated with mortality in the postoperative criticalcare units of the public health service hospitals in theCommunity of Valencia, Spain, in 2007.METHODS: Retrospective study of cases from January1, 2007 to December 31, 2007. The charts of all patientswho underwent cardiac surgery with or without miocárdiextracorporealcirculation were reviewed. A datacollection protocol was followed to obtain informationon age, sex, body mass index (BMI), presurgical riskfactors, type of surgery, duration of extracorporealcirculation, duration of ischemia, cause of death, andlength of stay in the postoperative critical care unit.RESULTS: The study population consisted of 2113patients at 5 public hospitals; 124 patients (70 men, 54women) died. The mean (SD) age was 70 (9.43) years(range, 36-91 years). The mean BMI was 28.19 kg/m2(maximum, 42 kg/m2). The mean Euroscore was 21.92(maximum, 94.29). Hypertension was present as apreoperative risk factor in most patients (74.2%);dyslipidemia was present in 51.6%, diabetes mellitus in38.7%, stroke in 7.3%, and renal failure in 2.4%. It wasnoteworthy was that the group who underwent coronaryrevascularization had the highest mortality rate (nearly35% of the 124 patients). The next highest mortality rate(19.4%) was in patients who had combined procedures(valve repair or substitution plus coronaryrevascularization). Mortality was 18.5% in the groupundergoing aortic valve surgery and 11.3% in thoseundergoing mitral valve surgery. The mean duration ofextracorporeal circulation was 148.63 minutes...(AU)

Chain dynamics of poly(ethylene-alt-propylene) melts by means of coarse-grained simulations based on atomistic molecular dynamics.

We present coarse-grained molecular dynamics simulations of poly(ethylene-alt-propylene) (PEP) melts, ranging in chain length from about N(e) (the entanglement length) to N=6N(e). The coarse-grained parameters, potential of mean force and bare friction, were determined from fully atomistic molecular dynamics simulations carried out on a PEP cell containing 12 chains of 80 monomers each and subjected to periodic boundary conditions. These atomistic simulations were previously validated by means of extensive neutron scattering measurements. Uncrossability constrains were also introduced in the coarse-grained model to prevent unphysical bond crossing. The coarse-grained simulations were carried out at 492 K and focus on chain dynamics. The results obtained were analyzed in terms of Rouse coordinates and Rouse correlators. We observe deviations from Rouse behavior for all chain lengths investigated, even when the chain stiffness is incorporated in the Rouse model. These deviations become more important as the chain length increases. The general scenario emerging from the results obtained is that the deviations from Rouse-like behavior are due to correlations among the forces acting upon a chain bead, which seem to be related with the constraint of uncrossability among the chains. As consequence, nonexponentiality of the Rouse correlators and mode- and time-dependent friction are observed. It seems that, in the molecular weight explored, these effects still give not raise to reptation behavior but to a crossover regime between Rouse and reptation. On the other hand, the results obtained are in qualitative agreement with those expected from the so-called generalized Rouse models, based on memory function formalisms.

Oleoylethanolamide exerts partial and dose-dependent neuroprotection of substantia nigra dopamine neurons.

Oleoylethanolamide (OEA), agonist of nuclear PPAR-alpha receptors and antagonist of vanilloid TRPV1 receptors, has been reported to show cytoprotective properties. In this study, OEA-induced neuroprotection has been tested in vitro and in vivo models of 6-OHDA-induced degeneration of substantia nigra dopamine neurons. First, PPAR-alpha receptors were confirmed to be located in the nigrostriatal circuit, these receptors being expressed by dopamine neurons of the substantia nigra, and intrinsic neurons and fibers bundles of the dorsal striatum. In the substantia nigra, their location was confined to the ventral tier. The in vitro study showed that 1 microM OEA exerted a significantly neuroprotective effect on cultured nigral dopamine neurons, effects following U-shaped dose-response curves. Regarding the in vivo study, rats were locally injected with OEA into the right striatum and vehicle into the left striatum 30 min before 6-OHDA-induced striatal lesion. In the short term, signals of heme oxygenase-1 (oxidation marker, 24 and 48 h post-lesion) and OX6 (reactive microglia marker, 96 h post-lesion) were found to be significantly less intense in the striatum pretreated with 5 microM OEA. In the long term (1 month), reduction in striatal TH and synaptophysin was less intense whether the right striatum was pretreated with 5 microM OEA, and nigral TH+ neuron death was significantly reduced after pretreatment with 1 and 5 microM OEA. In vivo effects also followed U-shaped dose-response curves. In conclusion, OEA shows U-shaped partial and dose-dependent neuroprotective properties both in vitro and in vivo models of substantia nigra dopamine neuron degeneration. The occurrence of U-shaped dose-response relationships normally suggests toxicity due to high drug concentration or that opposing intracellular pathways are activated by different OEA doses.

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