Factors related to the development of high antibody titres against SARS-CoV-2 in convalescent plasma donors from the ConPlas-19 trial.

BACKGROUND AND OBJECTIVES: The efficacy of COVID-19 convalescent plasma (CP) associates with high titres of antibodies. ConPlas-19 clinical trial showed that CP reduces the risk of progression to severe COVID-19 at 28 days. Here, we aim to study ConPlas-19 donors and characteristics that associate with high anti-SARS-CoV-2 antibody levels. MATERIALS AND METHODS: Four-hundred donors were enrolled in ConPlas-19. The presence and titres of anti-SARS-CoV-2 antibodies were evaluated by EUROIMMUN anti-SARS-CoV-2 S1 IgG ELISA. RESULTS: A majority of 80.3% of ConPlas-19 donor candidates had positive EUROIMMUN test results (ratio ≥1.1), and of these, 51.4% had high antibody titres (ratio ≥3.5). Antibody levels decline over time, but nevertheless, out of 37 donors tested for an intended second CP donation, over 90% were still EUROIMMUN positive, and nearly 75% of those with high titres maintained high titres in the second sample. Donors with a greater probability of developing high titres of anti-SARS-CoV-2 antibodies include those older than 40 years of age (RR 2.06; 95% CI 1.24-3.42), with more than 7 days of COVID-19 symptoms (RR 1.89; 95% CI 1.05-3.43) and collected within 4 months from infection (RR 2.61; 95% CI 1.16-5.90). Male donors had a trend towards higher titres compared with women (RR 1.67; 95% CI 0.91-3.06). CONCLUSION: SARS-CoV-2 CP candidate donors' age, duration of COVID-19 symptoms and time from infection to donation associate with the collection of CP with high antibody levels. Beyond COVID-19, these data are relevant to inform decisions to optimize the CP donor selection process in potential future outbreaks.

Plasticity of the hypocretinergic/orexinergic system after a chronic treatment with suvorexant in rats. Role of the hypocretinergic/orexinergic receptor 1 as an autoreceptor.

The hypothalamic hypocretinergic/orexinergic (Hcrt/Ox) system is involved in many physiological and pathophysiological processes. Malfunction of Hcrt/Ox transmission results in narcolepsy, a sleep disease caused in humans by progressive neurodegeneration of hypothalamic neurons containing Hcrt/Ox. To explore the Hcrt/Ox system plasticity we systemically administered suvorexant (a dual Hcrt/Ox receptor antagonist) in rats to chronically block Hcrt/Ox transmission without damaging Hcrt/Ox cells. Three groups of eight rats (four males and four females) received daily i.p. injections of suvorexant (10 or 30 mg/kg) or vehicle (DMSO) over a period of 7 days in which the body weight was monitored. After the treatments cerebrospinal fluid (CSF) Hcrt1/OxA concentration was measured by ELISA, and hypothalamic Hcrt/OxR1 and Hcrt/OxR2 levels by western blot. The systemic blockade of the Hcrt/Ox transmission with the suvorexant high dose produced a significant increase in body weight at the end of the treatment, and a significant decrease in CSF Hcrt1/OxA levels, both features typical in human narcolepsy type 1. Besides, a significant overexpression of hypothalamic Hcrt/OxR1 occurred. For the Hcrt/OxR2 two very close bands were detected, but they did not show significant changes with the treatment. Thus, the plastic changes observed in the Hcrt/Ox system after the chronic blockade of its transmission were a decrease in CSF Hcrt1/OXA levels and an overexpression of hypothalamic Hcrt/OxR1. These findings support an autoregulatory role of Hcrt/OxR1 within the hypothalamus, which would induce the synthesis/release of Hcrt/Ox, but also decrease its own availability at the plasma membrane after binding Hcrt1/OxA to preserve Hcrt/Ox system homeostasis.

Designing a Person-Centred Integrated Care Programme for People with Complex Chronic Conditions: A Case Study from Catalonia.

INTRODUCTION: The prevalence of people with complex chronic conditions is increasing. This population's high social and health needs require person-centred integrated approaches to care. METHODS: To collect data about experiences with the health system and identify priorities for care, we conducted 2 focus groups and 15 semi-structured interviews involving patients with multimorbidity and advanced conditions, caregivers, and representatives of patients' associations. To design the programme, we combined this information with evidence-based recommendations from local healthcare and social care professionals. RESULTS: Patients' and caregivers' main priorities were to ensure (a) comprehension of information provided by healthcare professionals; (b) coordination between patients, caregivers, and professionals; (c) access to social services; (d) support to caregivers in managing situations; (e) perceived support throughout the healthcare process; (f) home care, when available; and (d) a patient-centred approach. These dimensions were included in 37 of 63 clinical actions of the programme to cover the whole care trajectory: identifying high needs, defining, and providing care plans, managing crises, and providing transitional care and end-of-life care. CONCLUSION: We developed an evidence-based integrated care programme tailored to high-need patients combining input from patients, caregivers, and healthcare and social care professionals.

Retrospective comparison between COBE SPECTRA and SPECTRA OPTIA apheresis systems for hematopoietic progenitor cells collection for autologous and allogeneic transplantation in a single center.

INTRODUCTION: COBE SPECTRA [COBE] (Terumo, BCT Lakewood CO) apheresis system has been the most used device for hematopoietic progenitor cells (HPC) collection. Recently, it has been replaced by the SPECTRA OPTIA [OPTIA] (Terumo, BCT Lakewood CO) apheresis system. The aim of our study is to compare both methods for HPC collection. MATERIAL AND METHODS: We retrospectively compared 302 HPC collection apheresis procedures (115 allogeneic donors and 187 autologous). The study cohort was divided according to the apheresis system used to analyze the differences between COBE and OPTIA, specifically efficacy of apheresis procedure and product characteristics. RESULTS: OPTIA collections result in a higher CD34+ collection efficiency in both groups (autologous 45.3% vs 41%, P < .006; allogeneic 54.9% vs 45%, P < .0001). The total of CD34+ cells ×106 /kg recipient collected in the product were comparable in both groups (autologous 2.9 in OPTIA group vs 2.8 in COBE group, P = .344; allogeneic 6.2 in OPTIA group vs 5.8 in COBE group, P = .186). The percentage of platelet loss in autologous donors was significantly lower (35.7% vs 40.8%, P < .01). Regarding quality of the product, we observed a significantly lower hematocrit in products collected with OPTIA in both groups (1.8% vs 4%, P < .0001) as well as significantly lower amount of leukocytes (median 153.4 vs 237.2 × 109 /L in autologous, P < .0001; 239.5 vs 340.2 × 109 /L in allogeneic P < .0001). CONCLUSION: Both apheresis systems are comparable in collection of hematopoietic progenitor cells, with significantly higher collection efficiency with the OPTIA system. Collection products obtained with OPTIA contain significantly lower hematocrit and leukocytes.

[HOSPITALS AS PROMOTERS OF SMOKELESS SPACES: STRATEGIES AIMED AT SMOKING CONTROL] / El hospital como centro promotor de espacios sin humo: estrategias dirigidas al control del tabaquismo.

The objective of this study was to describe the measures introduced at the Hospital Germans Trias i Pujol, Barcelona, aimed at achieving a smoke-free environment, and encouraging research, training, and clinical approaches with respect to smoking. The experience gained as a center attached to the Catalan Network of Smokeless Hospitals since 2002 shows that preventing and controlling smoking requires a specific agenda developed by a competent committee comprising workers from all hospital areas. Likewise, coordination with other centers in the network is essential as it permits the sharing of experiences. The involvement of hospital management is critical for the effective introduction of health protection and promotion strategies, both in workers and in users. The raising of awareness and the ongoing training of all health workers and coordination with other health care providers in the Health network are the main aspects that require strengthening in the future.

El objetivo de este trabajo fue describir las medidas llevadas a cabo en el Hospital Germans Trias i Pujol de Barcelona, destinadas a conseguir un entorno libre de humo, así como al desarrollo de actividades de investigación, formación y abordaje clínico en relación al tabaquismo. La experiencia como centro adherido a la Red Catalana de Hospitales Sin Humo desde 2002 nos revela que para la prevención y control del tabaquismo es necesaria una agenda específica desarrollada por un Comité competente, compuesto por trabajadores de diferentes estamentos y servicios del centro. Del mismo modo, consideramos fundamental la coordinación con otros centros de la Red que permita compartir experiencias, así como la implicación de la Dirección del Centro para la implementación efectiva de las estrategias de promoción y protección de la salud, tanto en los trabajadores como en los usuarios. La sensibilización y formación continuada de todo el personal sanitario y la coordinación con otros servicios proveedores de salud de la red sanitaria se perfilan como los principales puntos a reforzar en el futuro.

El hospital como centro promotor de espacios sin humo: estrategias dirigidas al control del tabaquismo / Hospitals as promoters of smokeless spaces: strategies aimed at smoking control

El objetivo de este trabajo fue describir las medidas llevadas a cabo en el Hospital Germans Trias I Pujol de Barcelona, destinadas a conseguir un entorno libre de humo, así como al desarrollo de actividades de investigación, formación y abordaje clínico en relación al tabaquismo. La experiencia como centro adherido a la Red Catalana de Hospitales Sin Humo desde 2002 nos revela que para la prevención y control del tabaquismo es necesaria una agenda específica desarrollada por un Comité competente, compuesto por trabajadores de diferentes estamentos y servicios del centro. Del mismo modo, consideramos fundamental la coordinación con otros centros de la Red que permita compartir experiencias, así como la implicación de la Dirección del Centro para la implementación efectiva de las estrategias de promoción y protección de la salud, tanto en los trabajadores como en los usuarios. La sensibilización y formación continuada de todo el personal sanitario y la coordinación con otros servicios proveedores de salud de la red sanitaria se perfilan como los principales puntos a reforzar en el futuro

The objective of this study was to describe the measures introduced at the Hospital Germans Trias I Pujol, Barcelona, aimed at achieving a smoke-free environment, and encouraging research, training, and clinical approaches with respect to smoking. The experience gained as a center attached to the Catalan Network of Smokeless Hospitals since 2002 shows that preventing and controlling smoking requires a specific agenda developed by a competent committee comprising workers from all hospital areas. Likewise, coordination with other centers in the network is essential as it permits the sharing of experiences. The involvement of hospital management is critical for the effective introduction of health protection and promotion strategies, both in workers and in users. The raising of awareness and the ongoing training of all health workers and coordination with other health care providers in the health network are the main aspects that require strengthening in the future

The Transition Between Slow-Wave Sleep and REM Sleep Constitutes an Independent Sleep Stage Organized by Cholinergic Mechanisms in the Rostrodorsal Pontine Tegmentum.

There is little information on either the transition state occurring between slow-wave sleep (SWS) and rapid eye movement (REM) sleep, as well as about its neurobiological bases. This transition state, which is known as the intermediate state (IS), is well-defined in rats but poorly characterized in cats. Previous studies in our laboratory demonstrated that cholinergic stimulation of the perilocus coeruleus α nucleus (PLCα) in the pontine tegmentum of cats induced two states: wakefulness with muscle atonia and a state of dissociated sleep we have called the SPGO state. The SPGO state has characteristics in common with the IS, such including the presence of ponto-geniculo-occipital waves (PGO) and EEG synchronization with δ wave reduction. Therefore, the aims of the present study were (1) to characterize the IS in the cat and, (2), to study the analogy between the SPGO and the different sleep stages showing PGO activity, including the IS. Polygraphic recordings of 10 cats were used. In seven cats carbachol microinjections (20-30 nL, 0.01-0.1 M) were delivered in the PLCα. In the different states, PGO waves were analyzed and power spectra obtained for the δ, θ, α, and ß bands of the EEG from the frontal and occipital cortices, and for the θ hippocampal band. Statistical comparisons were made between the values obtained from the different states. The results indicate that the IS constitutes a state with characteristics that are distinct from both the preceding SWS and the following REM sleep, and that SPGO presents a high analogy with the IS. Therefore, the SPGO state induced by administering carbachol in the PLCα nucleus seems to be an expression of the physiological IS of the cat. Consequently, we propose that the PLCα region, besides being involved in the mechanisms of muscle atonia, may also be responsible for organizing the transition from SWS to REM sleep.

Día Internacional de la Hepatitis C. Avanzando hacia la eliminación como problema de salud pública en España / No disponible

No disponible

Análisis de género en la concordancia entre profesionales y progenitores en la valoración de los signos del trastorno por déficit de atención con o sin hiperactividad de los hijos / Gender analysis in the agreement in assessing the signs between professionals and parents whose children have attention deficit and/or hyperactivity disorder

El Trastorno por Déficit de Atención con o sin Hiperactividad (TDAH) es la enfermedad neuropsiquiátrica crónica más prevalente en pediatría, interfiere en el desarrollo normal del niño y trasciende a la adolescencia y la vida adulta. El diagnóstico se desarrollará si el niño muestra los síntomas principales de falta de atención o hiperactividad-impulsividad, con consecuencias en distintos aspectos de la vida cotidiana, tales como los logros académicos, la vida familiar o las interacciones sociales con los otros niños. Estos síntomas aparecerán a lo largo de la vida de diferentes maneras. Cuando el niño es pequeño, la hiperactividad y la impulsividad prevalecerán, pero a medida que el niño crece, será más evidentes la distraibilidad y la dificultad para recordar cosas y hechos. El objetivo de este estudio ha sido analizar si hay diferencias en la valoración de los signos del TDAH entre padres y madres en comparación con el diagnóstico del profesional sanitario, según el sexo de los niños y el subtipo del trastorno. Se llevó a cabo un estudio observacional y descriptivo de la información proporcionada por padres y madres en el cuestionario Vanderbilt. Participaron un total de 78 casos de niños y niñas diagnosticados de TDAH con edades entre los 6 y 16 años que acudieron a la Consulta de Neuropediatría del Hospital Valle del Nalón (Asturias) entre octubre de 2011 y marzo de 2013. Respecto al diagnóstico de déficit de atención, la media de respuestas positivas otorgadas por las madres (7.38 ± 1.81) es superior a la de los padres (6.47 ± 2.46). Lo mismo sucede en el caso del diagnóstico de hiperactividad/impulsividad, con una media de puntuaciones de las madres (5.80 ± 2.90) con una respuesta positiva superior a las de los padres (4.74 ± 3.04). Se ha observado que las madres muestran un mayor porcentaje de concordancia con el diagnóstico médico (86.3 %) cuando el hijo es una niña que cuando es un niño (66 %), mientras que para los padres el porcentaje de concordancia fue menor, del 50 %, cuando el hijo es niña, y del 44.6 % cuando es niño (AU)

The attention deficit hyperactivity disorder (ADHD) is the most prevalent chronic neuropsychiatric illness in childhood. It interferes with normal development of children. Its impact transcends childhood to appear in adolescence and adulthood. Diagnosis would be developed if the child shows the main symptoms of inattention and/or hyperactivity-impulsivity, with consequences in different aspects of daily life, such as academic achievements, family life or social interactions with other children. These symptoms will come up along life in different ways. When the child is young, hyperactivity and impulsivity prevail, but as he/she grows, the dispersion and difficulty to remember things and facts will become more evident. The aim of the study was to assess with the Vanderbilt scale, based on DSM-IV diagnostic criteria, the differences of the impact of ADHD among parents, in comparison to the medical diagnosis. A retrospective study was carried out by using this questionnaire, which completed by both parents individually. A total of 78 children took part in this study, all of them diagnosed with ADHD, with ages ranging from 6 to 16 years old, who attended to Neuropedriatics at Valle del Nalón Hospital (Asturias), between October 2011 and March 2013. Regarding attention deficit, the average of positive responses given by mothers (7.38 ± 1.81) was higher than that offered by fathers (6.47 ± 2.46). The same is true for hyperactivity/impulsivity, with average scores of mothers (5.80 ± 2.90) which were one positive response higher than those given by male parents (4.74 ± 3.04). Mothers show a higher percentage of agreement with the medical diagnosis (86.3 %) when the child was a girl and 66 % with boys, whereas for fathers the percentage of agreement was less than 50 % female children and 44.6 % for male children (AU)

[Gender Analysis in the Agreement in Assessing the Signs Between Professionals and Parents Whose Children Have Attention Deficit and/or Hyperactivity Disorder]. / Análisis de género en la concordancia entre profesionales y progenitors en la Valoración de los Signos del Trastorino por Déficit de Atención Con o sin Hiperactividad de los Hijos.

The attention deficit hyperactivity disorder (ADHD) is the most prevalent chronic neuropsychiatric illness in childhood. It interferes with normal development of children. Its impact transcends childhood to appear in adolescence and adulthood. Diagnosis would be developed if the child shows the main symptoms of inattention and/or hyperactivity-impulsivity, with consequences in different aspects of daily life, such as academic achievements, family life or social interactions with other children. These symptoms will come up along life in different ways. When the child is young, hyperactivity and impulsivity prevail, but as he/she grows, the dispersion and difficulty to remember things and facts will become more evident. The aim of the study was to assess with the Vanderbilt scale, based on DSM-IV diagnostic criteria, the differences of the impact of ADHD among parents, in comparison to the medical diagnosis. A retrospective study was carried out by using this questionnaire, which completed by both parents individually. A total of 78 children took part in this study, all of them diagnosed with ages ranging from 6 to 16 years old, who attended to Neuropedriatics at VAlle del Nalón Hospital(Asturias), between October 2011 and March 2013. Regarding attention deficit, the average responses given by mothers (7.38 ± 1.81) was higher than that offered by fathers (647 ± 2/46). The same is true for hyperactivity/impulsivity, with average scores of mothers (5.80 ± 2.90) which were one positive response higher than those given by male patients (4.74 ± 3.04). Mothers show a higher percentage of agreement with the medical diagnosis (86.3%) when the child was a girl and 66% with boys, whereas for fathers the percentage of agreement was less than 50% female children and 44.6% for male children.

Balanced gene losses, duplications and intensive rearrangements led to an unusual regularly sized genome in Arbutus unedo chloroplasts.

Completely sequenced plastomes provide a valuable source of information about the duplication, loss, and transfer events of chloroplast genes and phylogenetic data for resolving relationships among major groups of plants. Moreover, they can also be useful for exploiting chloroplast genetic engineering technology. Ericales account for approximately six per cent of eudicot diversity with 11,545 species from which only three complete plastome sequences are currently available. With the aim of increasing the number of ericalean complete plastome sequences, and to open new perspectives in understanding Mediterranean plant adaptations, a genomic study on the basis of the complete chloroplast genome sequencing of Arbutus unedo and an updated phylogenomic analysis of Asteridae was implemented. The chloroplast genome of A. unedo shows extensive rearrangements but a medium size (150,897 nt) in comparison to most of angiosperms. A number of remarkable distinct features characterize the plastome of A. unedo: five-fold dismissing of the SSC region in relation to most angiosperms; complete loss or pseudogenization of a number of essential genes; duplication of the ndhH-D operon and its location within the two IRs; presence of large tandem repeats located near highly re-arranged regions and pseudogenes. All these features outline the primary evolutionary split between Ericaceae and other ericalean families. The newly sequenced plastome of A. unedo with the available asterid sequences allowed the resolution of some uncertainties in previous phylogenies of Asteridae.

Adenosina y control homeostático del sueño. Acciones en estructuras diana de los circuitos de vigilia y sueño / Adenosine and homeostatic control of sleep. Actions in target structures of the sleep-wake circuits

La homeostasis del sueño se manifiesta ante situaciones de vigilia prolongada de forma natural o experimentalmente. En estos casos, se presenta somnolencia (o presión de sueño) y, cuando se permite dormir, hay un rebote del sueño en duración e intensidad que compensa la pérdida del mismo. Entre las moléculas que pueden intervenir en la regulación homeostática del sueño, se encuentra la adenosina, cuyos antagonistas, la cafeína y la teofilina, consume la población humana ampliamente como estimulantes. La adenosina es un factor endógeno resultante del metabolismo del ATP en neuronas y glía que se acumula en el medio extracelular y que es capaz de ejercer acciones reguladoras sobre circuitos del ciclo vigilia sueño. Actúa a través de los receptores purinérgicos A1 y A2. En este trabajo se presenta una revisión de las vías metabólicas de la adenosina cerebral y de su liberación por neuronas y glía, y se exponen las acciones de la adenosina y de sus antagonistas en regiones del sistema nervioso central de naturaleza hipnogénica y relacionadas con la vigilia. Se exponen, además, los mecanismos sinápticos involucrados en estas acciones (AU)

Sleep homeostasis occurs during prolonged wakefulness. Drowsiness and sleep pressure are its behavioral manifestations and, when sleep is allowed, there is a sleep rebound of sufficient duration and intensity to compensate for the previous deprivation. Adenosine is one of the molecules involved in sleep homeostasic regulation. Caffeine and theophylline, stimulants widely consumed by the humans, are antagonists. It is an endogenous factor, resulting from ATP metabolism in neurons and glia. Adenosine accumulates in the extracellular space, where it can exert regulatory actions on the sleep-wakefulness cycle circuits. Adenosine acts through the purinergic receptors A1 and A2. This paper reviews: 1) the metabolic pathways of cerebral adenosine, and the mechanisms of its release by neurons and glia to the extracellular space; 2) the actions of adenosine and its antagonists in regions of the central nervous system related to wakefulness, non-REM sleep, and REM sleep, and 3) the synaptic mechanisms involved in these actions (AU)

[Adenosine and homeostatic control of sleep. Actions in target structures of the sleep-wake circuits]. / Adenosina y control homeostático del sueño. Acciones en estructuras diana de los circuitos de vigilia y sueño.

Sleep homeostasis occurs during prolonged wakefulness. Drowsiness and sleep pressure are its behavioral manifestations and, when sleep is allowed, there is a sleep rebound of sufficient duration and intensity to compensate for the previous deprivation. Adenosine is one of the molecules involved in sleep homeostasic regulation. Caffeine and theophylline, stimulants widely consumed by the humans, are antagonists. It is an endogenous factor, resulting from ATP metabolism in neurons and glia. Adenosine accumulates in the extracellular space, where it can exert regulatory actions on the sleep-wakefulness cycle circuits. Adenosine acts through the purinergic receptors A1 and A2. This paper reviews: 1) the metabolic pathways of cerebral adenosine, and the mechanisms of its release by neurons and glia to the extracellular space; 2) the actions of adenosine and its antagonists in regions of the central nervous system related to wakefulness, non-REM sleep, and REM sleep, and 3) the synaptic mechanisms involved in these actions.

Functional Anatomy of Non-REM Sleep.

The state of non-REM sleep (NREM), or slow wave sleep, is associated with a synchronized EEG pattern in which sleep spindles and/or K complexes and high-voltage slow wave activity (SWA) can be recorded over the entire cortical surface. In humans, NREM is subdivided into stages 2 and 3-4 (presently named N3) depending on the proportions of each of these polygraphic events. NREM is necessary for normal physical and intellectual performance and behavior. An overview of the brain structures involved in NREM generation shows that the thalamus and the cerebral cortex are absolutely necessary for the most significant bioelectric and behavioral events of NREM to be expressed; other structures like the basal forebrain, anterior hypothalamus, cerebellum, caudal brain stem, spinal cord and peripheral nerves contribute to NREM regulation and modulation. In NREM stage 2, sustained hyperpolarized membrane potential levels resulting from interaction between thalamic reticular and projection neurons gives rise to spindle oscillations in the membrane potential; the initiation and termination of individual spindle sequences depends on corticothalamic activities. Cortical and thalamic mechanisms are also involved in the generation of EEG delta SWA that appears in deep stage 3-4 (N3) NREM; the cortex has classically been considered to be the structure that generates this activity, but delta oscillations can also be generated in thalamocortical neurons. NREM is probably necessary to normalize synapses to a sustainable basal condition that can ensure cellular homeostasis. Sleep homeostasis depends not only on the duration of prior wakefulness but also on its intensity, and sleep need increases when wakefulness is associated with learning. NREM seems to ensure cell homeostasis by reducing the number of synaptic connections to a basic level; based on simple energy demands, cerebral energy economizing during NREM sleep is one of the prevalent hypotheses to explain NREM homeostasis.

Functional anatomy of the sleep-wakefulness cycle: wakefulness.

Sleep is a necessary, diverse, periodic, and an active condition circadian and homeostatically regulated and precisely meshed with waking time into the sleep-wakefulness cycle (SWC). Photic retinal stimulation modulates the suprachiasmatic nucleus, which acts as the pacemaker for SWC rhythmicity. Both the light period and social cues adjust the internal clock, making the SWC a circadian, 24-h period in the adult human. Bioelectrical and behavioral parameters characterize the different phases of the SWC. For a long time, lesions and electrical stimulation of brain structures, as well as connection studies, were the main methods used to decipher the foundations of the functional anatomy of the SWC. That is why the first section of this review presents these early historical studies to then discuss the current state of our knowledge based on our understanding of the functional anatomy of the structures underlying the SWC. Supported by this description, we then present a detailed review and update of the structures involved in the phase of wakefulness (W), including their morphological, functional, and chemical characteristics, as well as their anatomical connections. The structures for W generation are known as the "ascending reticular activating system", and they keep and maintain the "thalamo-cerebral cortex unit" awake. This system originates from the neuronal groups located within the brainstem, hypothalamus, and basal forebrain, which use known neurotransmitters and whose neurons are more active during W than during the other SWC states. Thus, synergies among several of these neurotransmitters are necessary to generate the cortical and thalamic activation that is characteristic of the W state, with all the plastic qualities and nuances present in its different behavioral circumstances. Each one of the neurotransmitters exerts powerful influences on the information and cognitive processes as well as attentional, emotional, motivational, behavioral, and arousal states. The awake "thalamo-cerebral cortex unit" controls and adjusts the activation pattern through a top-down action on the subcortical cellular groups that are the origin of the "ascending reticular activating system".

Premisas para la elaboraciónde una herramienta para valorarla calidad de vida en las personasmayores / Prerequisites for the development of a tool to assess the quality of life in the elderly

El interés por la calidad de vida ha existido desde tiemposinmemorables. Sin embargo, la aparición del concepto y lapreocupación por su evaluación sistemática y científica esrelativamente reciente. La idea, que comienza a popularizarseen la década de los años 60 del siglo XX, se ha convertidohoy en un concepto utilizado en ámbitos muy diversos, comola salud, la educación, la economía, la política y el mundode los servicios en general. Pero aún existe una falta deconsenso sobre la definición del constructo. La calidad de vidatiene una dimensión objetiva y otra subjetiva. Ésta últimaestá estrechamente vinculada a la satisfacción con la vidaexperimentada por las personas mayores tanto desde unpunto de vista sincrónico como diacrónico, y tiene caráctermultidimensional, complejidad y coyunturalidad. Las principalesdificultades para la construcción de instrumentosque valoren la calidad de vida de las personas mayores sepresentan desde las vías conceptual, metodológica e instrumental.No obstante, el término calidad de vida debe empaparlas intervenciones sobre estos grupos de edad, por lo queofrecemos algunas recomendaciones para su elaboración

Interest in quality of life has existed since timeimmemorial, however, the emergence of the concept assuch, and concern for the systematic and scientificevaluation of it is relatively recent. The idea, which beginsto become popular in the 60s, has now become a conceptused in very diverse areas such as health, education,economics, politics and the world of services in general.But in the twenty-first century, there remains a lack ofconsensus on the definition of the concept. The quality oflife has an objective and a subjective dimension. The latteris closely linked to life satisfaction experienced by theelderly both from a synchronic point of view as diachronic,and is considered multidimensional, complex andsituational. The main difficulties for the construction ofinstruments to assess quality of life of older people from thestreet presents conceptual, methodological andinstrumental. However, the term quality of lifeinterventions should soak these age groups, so we offer somerecommendations for its development (AU)

Sleep-wakefulness effects after microinjections of hypocretin 1 (orexin A) in cholinoceptive areas of the cat oral pontine tegmentum.

Hypocretinergic/orexinergic neurons, which are known to be implicated in narcolepsy, project to the pontine tegmentum areas involved in the control of rapid eye movement (REM) sleep. Here, we report the effects on sleep-wakefulness produced by low-volume microinjections of hypocretin (Hcrt)1 (20-30 nL, 100, 500 and 1000 microm) and carbachol (20-30 nL, 0.1 m) delivered in two areas of the oral pontine tegmentum of free-moving cats with electrodes for chronic sleep recordings: in the dorsal oral pontine tegmentum (DOPT) and in the ventral part of the oral pontine reticular nucleus (vRPO). Carbachol in the DOPT produced dissociate polygraphic states, with some but not all REM sleep signs. In contrast, carbachol in the vRPO produced a shift with short latency from wakefulness (W) to REM sleep with all of its polygraphic and behavioral signs. Hcrt-1 in the DOPT increased W and decreased both slow-wave sleep (SWS) and REM sleep during the first 3 h post-drug. The same doses of Hcr-1 in the vRPO produced a significant suppression of REM sleep without a definitive trend for changes in the other states. Both groups showed significant decreases in the number of transitions from SWS to REM sleep. Thus, Hcrt-1 produced distinct effects in cholinoceptive areas of the oral pontine tegmentum; in the DOPT it promoted W, suppressed SWS and probably defacilitated REM sleep, and in the vRPO it directly inhibited REM sleep. Hypocretinergic/orexinergic signaling is lost in narcoleptics and this absence would mean that pontine defacilitation/inhibition of REM sleep would also be absent, explaining why these patients can fall directly into REM sleep from W.

Efficient secretion of Bacillus subtilis lipase A in Saccharomyces cerevisiae by translational fusion to the Pir4 cell wall protein.

Both the secretion and the cell surface display of Bacillus subtilis lipase A (Lip A) in Saccharomyces cerevisiae was investigated using different domains of the cell wall protein Pir4 as translational fusion partners. LipA gene minus its leader peptide was fused inframe in two places of PIR4 to achieve cell wall targeting, or substituting most of the PIR4 sequence, after the signal peptide and the Kex2 processed subunit I of Pir4 to achieve secretion to the growth medium. Expression of the recombinant fusion proteins was investigated in a standard and a glycosylation-deficient strain of S. cerevisiae, grown in selective or rich medium. Fusion proteins intended to be retained at the cell wall were secreted to the growth medium, most likely as result of the degradation of the Pir4 moiety containing the cell wall retention domain, giving low levels of lipase activity. However, the fusion intended for secretion was efficiently secreted in a percentage of close to 90% and remained stable even in rich medium at high cell density cultures, yielding values of over 400 IU of lipase activity per milliliter of cell supernatant. This is, to our knowledge, the first report of the efficient production, as a secreted protein, of lipase A of B. subtilis in baker's yeast.

Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus carriage at hospital admission.

To determine the prevalence of and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) carriage at the time of admission to our hospital, we screened the medical records of 1,128 patients for demographic and clinical data. The antimicrobial resistance pattern and genotype of MRSA isolates were studied. The prevalence of MRSA carriage at hospital admission was 1.4%. Older patients and patients previously admitted to healthcare centers were the most likely to have MRSA carriage at admission.

Yeast expression of the VP8* fragment of the rotavirus spike protein and its use as immunogen in mice.

The VP8* fragment from the rotavirus spike protein was expressed as a fusion protein with two different cell wall proteins of Saccharomyces cerevisiae, Icwp (Ssr1p) and Pir4, to achieve cell wall targeting or secretion to the growth medium of the fusion proteins. Two different host strains were used for the expression of the fusion proteins, a standard S. cerevisiae strain and a mnn9 glycosylation deficient strain, the later to reduce hyper-glycosylation. The Icwp-VP8* fusion could only be detected in the growth medium, indicating that the presence of the VP8* moiety interferes with the anchorage of Icwp to the cell wall. In the case of the Pir4-VP8* fusion proteins, we achieved cell wall targeting or secretion depending on how the gene fusion had been performed. In all cases, the fusion proteins expressed in the mnn9 strain showed a reduced level of glycosylation. Mice were inoculated intraperitoneally either with Pir4-VP8* or Icwp-VP8* fusion proteins purified from the growth medium of mnn9 strains expressing them or with whole cells of an mnn9 strain expressing a Pir4-VP8 fusion protein on its cell walls. Hundred percent of mice inoculated with the Pir4-VP8* fusion protein and 25% of those inoculated with the Icwp-VP8* fusion protein showed high titers of anti-VP8* antibodies. No specific immune response was detected in those mice inoculated with whole cells. Finally, susceptibility to rotavirus infection of the offspring of immunized dams was determined and protection was found in a percentage of approximately 60% with respect to the control group.