ABSTRACT
Brain aging is a natural process that involves structural and functional changes that lead to cognitive decline, even in healthy subjects. This detriment has been associated with N-methyl-D-aspartate receptor (NMDAR) hypofunction due to a reduction in the brain levels of D-serine, the endogenous NMDAR co-agonist. However, it is not clear if D-serine supplementation could be used as an intervention to reduce or reverse age-related brain alterations. In the present work, we aimed to analyze the D-serine effect on aging-associated alterations in cellular and large-scale brain systems that could support cognitive flexibility in rats. We found that D-serine supplementation reverts the age-related decline in cognitive flexibility, frontal dendritic spine density, and partially restored large-scale functional connectivity without inducing nephrotoxicity; instead, D-serine restored the thickness of the renal epithelial cells that were affected by age. Our results suggest that D-serine could be used as a therapeutic target to reverse age-related brain alterations.SIGNIFICANT STATEMENTAge-related behavioral changes in cognitive performance occur as a physiological process of aging. Then, it is important to explore possible therapeutics to decrease, retard or reverse aging effects on the brain. NMDA receptor hypofunction contributes to the aging-associated cognitive decline. In the aged brain, there is a reduction in the brain levels of the NMDAR co-agonist, D-Serine. However, it is unclear if chronic D-serine supplementation could revert the age-detriment in brain functions. Our results show that D-serine supplementation reverts the age-associated decrease in cognitive flexibility, functional brain connectivity, and neuronal morphology. Our findings raise the possibility that restoring the brain levels of D-serine could be used as a therapeutic target to recover brain alterations associated with aging.
ABSTRACT
Los carcinomas verrugosos de vagina son neoplasias poco frecuentes, con un crecimiento lento, localmente invasivo, que no suelen metastatizar y con unas características macro y microscópicas específicas. Describimos un caso de carcinoma verrugoso de cúpula vaginal en paciente postmenopáusica histerectomizada 4 años antes por prolapso uterino grado IV, discutiéndose su diagnóstico diferencial y tratamiento. El carcinoma verrugoso de vagina es un tumor poco frecuente que plantea el diagnóstico diferencial con el condiloma acuminado, el carcinoma escamoso clásico y el condilomatoso, siendo el tratamiento de elección la exéresis quirúrgica completa (AU)
Verrucous carcinoma of the vagina is a rare neoplasm. This entity is a slow-growing, locally invasive but generally nonmetastasizing neoplasm, with a characteristic gross and microscopic appearance.We report a case of verrucous carcinoma of the vagina in a postmenopausal woman diagnosed 4 years after transvaginal hysterectomy for grade 4 uterine prolapse. We also discuss the differential diagnosis and treatment.Verrucous carcinoma of the vagina is a rare neoplasm. The differential diagnosis includes typical squamous cell carcinoma, warty carcinoma, and condyloma acuminatum. Surgery remains the most effective treatment (AU)
Subject(s)
Humans , Female , Aged , Carcinoma, Verrucous/complications , Carcinoma, Verrucous/diagnosis , Uterine Prolapse/complications , Uterine Prolapse/diagnosis , Uterine Prolapse/surgery , Vaginal Neoplasms/diagnosis , Vaginal Neoplasms/surgery , Carcinoma, Verrucous/physiopathology , Carcinoma, Verrucous , Uterine Prolapse/physiopathology , Uterine Prolapse , Vaginal Neoplasms , Epithelial Cells/pathology , Epithelial Cells , Epithelial Cells/ultrastructure , Diagnosis, DifferentialABSTRACT
El caso que exponemos se inicia con la detección de una serie de signos y síntomas que fueron clínicamente la tríada clásica de exoftalmos, bocio y taquicardia, además de linfedema. Se confirmó una hiperfunción tiroidea mediante estudio hormonal (AU)
We report the case of a pregnant woman who presented with the classical triad of exophthalmos, goiter and tachycardia, as well as lymphedema. Thyroid hyperfunction was confirmed by hormone study (AU)
Subject(s)
Male , Female , Pregnancy , Infant, Newborn , Adult , Humans , Pregnancy Complications/diagnosis , Graves Disease/diagnosis , Pregnancy OutcomeABSTRACT
El desprendimiento de placenta normalmente inserta (DPPNI) se considera a partir de las 20 semanas de gestación; es responsable de un tercio de las hemorragias en el segundo y el tercer trimestre del embarazo, y es una de las causas más importantes de morbimortalidad maternofetal. En nuestro servicio se ha estudiado a 22 pacientes entre los años 2001 y 2003: gestantes que presentaron desprendimiento de placenta. Esto representa una incidencia del 0,56%. El factor principal de riesgo que se ha encontrado asociado a esta enfermedad es la enfermedad hipertensiva del embarazo (HIE), con 3 casos (13,6%). Ninguno de los casos se ha relacionado con el hábito tabáquico ni con el consumo de cocaína; ambos factores favorecen la vasoconstricción. Igualmente, a lo largo del embarazo en 4 de estas pacientes se diagnosticaron cuadros sugestivos de cólicos nefríticos, a los que en ninguna revisión bibliográfica se hace referencia como causa de DPPNI. Puede ser una coincidencia, dada la alta frecuencia de los cólicos nefríticos en la gestación. La presencia de hemorragia en el tercer trimestre fue del 100%, y hubo antecedentes de desprendimiento placentario y de cesárea anterior en 3 (13,6%) y tan sólo 6 (27,2%) casos, respectivamente. El diagnóstico se realizó anteparto, de forma temprana, ante la evidencia de la clínica en el 100% de los casos. Clínicamente, basándonos en la tríada sintomatológica, el signo más frecuente fue la hemorragia, por lo que las gestaciones terminaron por cesárea en el 100% de los casos, dado el compromiso y el riesgo de morbimortalidad maternofetal. Las complicaciones maternas observadas con más frecuencia fueron la anemia de moderada a grave, que requirió transfusión sanguínea en 8 (36,3%) pacientes, sin evidenciarse otra afección; en estos casos se descartó una alteración de la coagulación intravascular diseminada. La morbilidad perinatal fue considerable, y destaca la prematuridad, en 11 casos (50%) sin evidenciarse mortalidad alguna, posiblemente, a causa del diagnóstico temprano obstétrico realizado en nuestro servicio. Todos los casos se trataron de forma expectante y con excelentes resultados perinatales (AU)
Placental abruption (DPNNI) is usually considered from the 20th week of pregnancy, and it is responsible for a third of the haemorrhages in the second and third trimesters of pregnancy. It is one of the most important causes of maternal and foetal morbidity and mortality. In our Department 22 patients have been studied during the years 2001-2003, that represent an incidence of placental abruption of 0.56%. The main risk factor found was associated with HIE pathology, hypertensive diseases in pregnancy, 3cases (13.6%). None of the cases were related to smoking or using cocaine, both of which cause vasoconstriction. Equally, four patients were diagnosed with nephritic colic type diseases throughout pregnancy, which does is not referred to in any literature review as a cause of DPNNI. I t may be only a coincidence, given the high frequency of nephritic colic during pregnancy. Haemorrhage in the third trimester was present in100% of the cases, and there were antecedents of placental abruption and previous caesarean section in 3 cases (13.6%) and 6 cases (27.2%) respectively All cases were diagnosed before labour, due to clinical signs in 100% of the cases. Clinically based on a triad of symptoms; the most frequent sign was haemorrhage and all pregnancies were terminated with caesarean section given the risk of maternal and foetal morbidity and mortality. The most frequent maternal complications were moderate to severe anaemia in 8 patients that required blood transfusion (36.3%), no other pathology was encountered or disseminated intravascular coagulation disease. Perinatal morbidity was high, mainly prematurity in 11 cases (50%) with no mortality, possibly due to early obstetric diagnosis in this department. All cases were monitored closely, with excellent perinatal results (AU)
Subject(s)
Female , Pregnancy , Humans , Infant, Premature/metabolism , Infant, Premature/physiology , Infant, Premature, Diseases/etiology , Infant, Premature, Diseases/pathology , Abruptio Placentae/etiology , Abruptio Placentae/pathology , Infant, Premature, Diseases/prevention & control , Hypertension/complications , Hypertension/pathology , Abruptio Placentae/complicationsABSTRACT
El tratamiento de la gestación extrauterina depende del diagnóstico precoz que se realice, conjuntamente con métodos de diagnóstico como determinaciones de valores de -HCG, sonografía transvaginal y culdocentesis previa a una intervención quirúrgica, laparoscópica o laparotomía y actitud expectante. El embarazo ectópico tiene una incidencia del 0,942,6 por ciento de gestaciones. Entre el 4 al 8 por ciento de embarazos ectópicos se producen tras el tratamiento por estimulación ovárica, y dentro de la reproducción asistida programa FIV, su incidencia está entre el 2,1 y el 9,4 por ciento, frecuencia muy superior a la observada en la población general fértil. El pronóstico de embarazo ectópico es responsable del 2 al 5 por ciento de las muertes maternas por complicaciones, como shock hemorrágico (AU)
Subject(s)
Adult , Female , Humans , Pregnancy, Ectopic/etiology , Fertilization in Vitro/adverse effects , Methotrexate/therapeutic use , Salpingostomy/adverse effects , Pregnancy, Abdominal/etiology , Risk Factors , Pregnancy, Tubal/etiologyABSTRACT
BACKGROUND: Short-term administration of 17beta-estradiol improves effort-induced myocardial ischemia in female patients with coronary artery disease. 17Beta-estradiol also has direct and indirect coronary vascular smooth muscle relaxing properties. The aim of the present study was to evaluate the effect of short-term administration of 17beta-estradiol on pacing-induced myocardial ischemia by means of continuous monitoring of coronary sinus pH in 16 postmenopausal female patients with coronary artery disease. METHODS AND RESULTS: Patients underwent incremental atrial pacing starting at a rate of 100 bpm and increments of 20 bpm every 2 minutes up to 160 bpm before and 20 minutes after either 17beta-estradiol (1 mg sublingual, 9 patients) or placebo (sublingual, 7 patients). The time to the onset of myocardial ischemia during pacing was significantly increased by 17beta-estradiol (mean+/-SD, 254+/-36 versus 298+/-23 seconds; P<.02) but not by placebo (262+/-45 versus 256+/-34 seconds; P=NS) The pH shift was significantly reduced by 17beta-estradiol but not by placebo at every step of the pacing protocol. The maximum pH shift at peak pacing was significantly reduced by the administration of 17beta-estradiol by 0.022 pH units (95% CI, 0.001, 0.043; P<.04) but not by sublingual placebo (-0.002 pH units; 95% CI, -0.0073, 0.0021; P=NS). The maximum pH shift at maximum comparable pacing was also reduced by 17beta-estradiol by 0.015 pH units (95% CI, 0.012, 0.017; P<.001) but not by placebo (-0.0022 pH units; 95% CI, -0.006, 0.0015; P=NS). CONCLUSIONS: 17Beta-estradiol reduces the degree of pacing-induced myocardial ischemia in postmenopausal patients with coronary artery disease. The reduction of pacing-induced coronary sinus pH shift is consistent with an anti-ischemic effect of the hormone and is not due to preconditioning, as evidenced by the absence of improvement after placebo.
