[Cognitive-behavioural group therapy for insomnia: evaluation of the results after its implementation in a health department]. / Terapia grupal cognitivo-conductual para el insomnio: evaluación de resultados tras su introducción en un departamento de salud.

INTRODUCTION: Cognitive-behavioural therapy (CBT) is the preferred treatment in cases of chronic insomnia disorder in adults. PATIENTS AND METHODS: Open pragmatic study of 32 patients after eight sessions of group CBT for insomnia. RESULTS: Remission (insomnia severity index: 0-7 points) and response (insomnia severity index drops to > 8) were 31.3% and 46.9% at one month (n = 32) and 42.8% and 52.4% at one year (n = 21), respectively, with an effect size of 1.9 at one month and 2.3 at one year. At one month, 40.6% met the criteria for a case of insomnia (according to the insomnia symptoms questionnaire), and at one year, 19%, with a significant improvement in the symptoms at night and the consequences during the day. The questions of the Pittsburgh Sleep Quality Index on insomnia and sleep efficiency also improved. The pre-sleep arousal scale (n = 7) showed a shift from significant somatic and cognitive arousal to no arousal at one month. In the sleep diaries, total sleep time increased by an average of 53 minutes at one month (n = 14) and 76 minutes at one year (n = 10), with an increase of more than 10% in 71.4% of patients at one month and at one year, and an average sleep efficiency of more than 85%. The effect size for total sleep time and sleep efficiency was between 0.7 and 1. CONCLUSIONS: Group CBT for insomnia appears to be an effective treatment option in a clinical setting.

TITLE: Terapia grupal cognitivo-conductual para el insomnio: evaluación de resultados tras su introducción en un departamento de salud.Introducción. La terapia cognitivo-conductual (TCC) es el tratamiento de elección en el trastorno de insomnio crónico en adultos. Pacientes y métodos. Estudio pragmático abierto de 32 pacientes tras ocho sesiones de TCC grupal para el insomnio. Resultados. La remisión (índice de gravedad del insomnio: 0-7 puntos) y la respuesta (caída del índice de gravedad del insomnio > 8) fue del 31,3% y 46,9% al mes (n = 32) y del 42,8% y 52,4% al año (n = 21), respectivamente, con un tamaño del efecto de 1,9 al mes y 2,3 al año. Al mes, el 40,6% cumplía criterios de caso de insomnio (según el cuestionario de síntomas de insomnio), y al año, el 19%, con una mejoría significativa de síntomas nocturnos y consecuencias diurnas. También mejoraron las preguntas del índice de calidad de sueño de Pittsburgh sobre el insomnio y la eficiencia del sueño. La escala de activación previa al sueño (n = 7) mostró un trasvase desde activación significativa somática y cognitiva a ausencia de activación al mes. En los diarios de sueño, el tiempo total de sueño aumentó 53 minutos de media al mes (n = 14) y 76 al año (n = 10), con un aumento superior al 10% en el 71,4% de los pacientes al mes y al año, y una eficiencia del sueño media superior al 85%. El tamaño del efecto para el tiempo total de sueño y la eficiencia del sueño estuvo entre 0,7 y 1. Conclusiones. La TCC grupal para el insomnio parece una opción terapéutica eficaz en un entorno clínico.

Prediction of the potential biological activity of novel spiropyrazolo[3,4-b]pyridines and spiropyrazolo[3,4-b]pyridine-5,5'-pyrimidines by a ligand-protein inverse-docking approach.

The interaction of a series of spiropyrazolo[3,4-b]pyridines and spiropyrazolo[3,4-b]pyridine-5,5'-pyrimidines with 975 molecular targets involved in different diseases and biochemical alterations in humans was assessed. In-silico and in-vivo methods were used to predict the potential biological activity of these compounds. The exposure of several individuals of C. elegans to these compounds shows that their lethality would be less than 10% and that they do not induce any alteration in their locomotion. The compounds identified as PRV-8 and 13-G were the most bioactive, and also showed other advantages such as; better structural properties, adequate pharmacokinetic and pharmacodynamic properties, and good flexibility and unsaturation, which placed them as the compounds of greatest interest to be tested in-vitro and in-vivo. The series of compounds described here exhibited significant interactions with the estrogen signaling pathway.

tDCS recovers depth perception in adult amblyopic rats and reorganizes visual cortex activity.

Amblyopia or lazy eye is a neurodevelopmental disorder that arises during the infancy and is caused by the interruption of binocular sensory activity before maturation of the nervous system. This impairment causes long-term deterioration of visual skills, particularly visual acuity and depth perception. Although visual function recovery has been supposed to be decreased with age as consequence of reduced neuronal plasticity, recent studies have shown that it is possible to promote plasticity and neurorestoration in the adult brain. Thus, transcranial direct current stimulation (tDCS) has been shown effective to treat amblyopia in the adulthood. In the present work we used postnatal monocular deprivation in Long Evans rats as an experimental model of amblyopia and the cliff test task to assess depth perception. Functional brain imaging PET was used to assess the effect of tDCS on cortical and subcortical activity. Visually deprived animals ability to perceive depth in the cliff test was significantly reduced in comparison to their controls. However, after 8 sessions of tDCS applied through 8 consecutive days, depth perception of amblyopic treated animals improved reaching control level. PET data showed 18F-FDG uptake asymmetries in the visual cortex of amblyopic animals, which disappeared after tDCS treatment. The possibility of cortical reorganization and stereoscopy recovery following brain stimulation points at tDCS as a useful strategy for treating amblyopia in adulthood. Furthermore, monocular deprivation in Long Evans rats is a valuable research model to study visual cortex mechanisms involved in depth perception and neural restoration after brain stimulation.

Transcranial direct-current stimulation (tDCS) improves detection of simple bright stimuli by amblyopic Long Evans rats in the SLAG task and produces an increase of parvoalbumin labelled cells in visual cortices.

In this work visual functional improvement of amblyopic Long Evans rats treated with tDCS has been assessed using the "slow angled-descent forepaw grasping" (SLAG) test. This test is based on an innate response that does not requires any memory-learning component and has been used before for measuring visual function in rodents. The results obtained show that this procedure is useful to assess monocular but not binocular deficits, as controls and amblyopic animals showed significant differences during monocular but not during binocular assessment. On the other hand, parvoalbumin labelling was analysed in three areas of the visual cortex (V1M, V1B and V2L) before and after tDCS treatment. No changes in labelling were observed after monocular deprivation. However, tDCS treatment significantly improved vision through the amblyopic eye, and a significant increase of parvoalbumin-positive cells was observed in the three areas, both in the stimulated hemisphere but also in the non-stimulated hemisphere. This effect occurred both in control and amblyopic animals. Thus, tDCS induced changes are similar in controls and amblyopic animals, although only the last one showed a functional improvement.

Faecal contamination in public pools in Barcelona province: Cryptosporidium spp. and bacterial indicators.

A study was conducted of the occurrence of Cryptosporidium in indoor heated public swimming pools and of three bacterial indicators (Escherichia coli, faecal enterococci and Clostridium perfringens) on pool surrounds. Although all examined pools adhered strictly to the Spanish regulations, the influence of several parameters related to water conditions, pool structure, users and location on the presence of protozoa and bacteria was analysed. Cryptosporidium was detected in 18.8% of pools in 60% of the five towns studied. The maximum concentration was 13 oocysts/L in one swimming pool and one Jacuzzi. The bacterial indicators' prevalence on pool surrounds was higher than 50%, being present in all of the towns. Plastic surfaces presented the lowest bacterial prevalence, whereas painted surfaces were 100% positive. No differences were observed for pool surrounds with autonomous or disabled users. Risk of cryptosporidiosis in pool vessels indicated that concentrations over 1 oocyst/10 L enhance the risk of infection, even in one exposure. Guidelines for managing faecal accidents and public information on the importance of good hygiene behaviours in and around swimming pools are recommended to limit oocysts' presence.

Effects of policosanol in the functional recovery of non-cardioembolic ischemic stroke hypertensive patients. / Efectos del policosanol en la recuperacion funcional de pacientes hipertensos con ictus isquemico no cardioembolico.

INTRODUCTION: Clinical studies results show that policosanol (20 mg/day) + aspirin therapy had benefits versus placebo + aspirin to patients with recent non-cardioembolic ischemic stroke. AIM: To analyze the policosanol treatment effects in the hypertensive patients included in two non-cardioembolic ischemic stroke recovery trials. PATIENTS AND METHODS: Hypertensive patients with a modified Rankin Scale (mRS) score 2 to 4 were randomized, within 30 days of onset, to policosanol + aspirin or placebo + aspirin, for six months. The primary outcome was mRS score reduction. RESULTS: One hundred forty two hypertensive patients (mean age: 66 years) were included in the analysis. Policosanol + aspirin decreased significantly the mRS score mean from the first interim check-up. The policosanol treatment effect did not wear off, on the contrary, even improved after six months therapy. More over, policosanol + aspirin (80.3%) treatment achieved significant results (mRS <= 1), whereas the placebo + aspirin did not (8.5%). Two patients discontinued and four (two from each group) referred mild adverse events. CONCLUSIONS: The treatment for six months with policosanol + aspirin in hypertensive patients who had suffered a non-cardioembolic ischemic stroke proved to be more effective than the placebo + aspirin treatment in the functional recovery of these patients.

TITLE: Efectos del policosanol en la recuperacion funcional de pacientes hipertensos con ictus isquemico no cardioembolico.Introduccion. Los resultados de los estudios clinicos muestran que el tratamiento con policosanol (20 mg/dia) + aspirina produce beneficios frente a placebo + aspirina en pacientes con ictus isquemico no cardioembolico reciente. Objetivo. Analizar los efectos del tratamiento con policosanol en pacientes hipertensos incluidos en dos ensayos de recuperacion de ictus isquemico no cardioembolico. Pacientes y metodos. Pacientes hipertensos que sufrieron un ictus en los 30 dias previos y que, con una puntuacion de 2 a 4 en la escala de Rankin modificada (mRS), se distribuyeron aleatoriamente en dos grupos y recibieron policosanol + aspirina o placebo + aspirina durante seis meses. La variable primaria de eficacia fue la reduccion de la puntuacion en la mRS. Resultados. Se incluyo a un total de 142 pacientes hipertensos (edad media: 66 años) en el analisis. El policosanol + aspirina disminuyo significativamente la puntuacion de la mRS desde el primer chequeo intermedio. El efecto del tratamiento con policosanol no desaparecio, sino que incluso mejoro despues de seis meses de tratamiento. El numero de pacientes que alcanzaron valores de la mRS <= 1 fue mayor en el grupo de policosanol + aspirina (80,3%) que en el de placebo + aspirina (8,5%). Dos pacientes causaron baja del estudio y cuatro (dos de cada grupo) refirieron efectos adversos leves. Conclusiones. El tratamiento durante seis meses con policosanol + aspirina a pacientes hipertensos que habian sufrido un ictus isquemico no cardioembolico demostro ser mas efectivo que el tratamiento con placebo + aspirina en su recuperacion funcional.

Transcranial direct current stimulation improves visual acuity in amblyopic Long-Evans rats.

Transcranial direct current stimulation (tDCS) has proved to increase brain cortex plasticity and different models of brain damage. In this work, we have analyzed the effects of tDCS in an experimental model of amblyopia using Long-Evans rats. Animals were monocularly deprived between 12 and 75 postnatal days and visual cortex contralateral to the deprived eye was stimulated using anodal tDCS during 8days (20min/day). The effects of tDCS treatment on the visual function were evaluated by using the optomotor reflex of the animals as a measure of visual acuity. Results obtained indicate that monocular occlusion during the critical period lead to a reduction of visual acuity in monocular and binocular conditions. Stimulation with anodal tDCS produced a nearly full recovery in visual acuity of amblyopic animals. However, same stimulation protocol in healthy control animals produced a decrease of binocular visual acuity. These data indicate that tDCS can reverse the effects of monocular deprivation on visual acuity, although it is essential to use this technique in a controlled way due to the possible adverse effects on healthy individuals.

Structure and interaction with lipid membrane models of Semliki Forest virus fusion peptide.

Semliki Forest virus (SFV) is a well-characterized alphavirus that infects cells via endocytosis and an acid-triggered fusion step using class II fusion proteins. Membrane fusion is mediated by the viral spike protein, a heterotrimer of two transmembrane subunits, E1 and E2, and a peripheral protein, E3. Sequence analysis of the E1 ectodomain of a number of alphaviruses demonstrated the presence of a highly conserved hydrophobic domain on the E1 ectodomain. This sequence was proposed to be the fusion peptide of SFV and is believed to be the domain of E1 that interacts with the target membrane and triggers fusion. Here, we investigate the structure and the interaction with lipid membrane models of 76YQCKVYTGVYPFMWGGAYCFC96 sequence from SFV, named SFV21, using optical method (ellipsometry) and vibrational spectroscopiy approaches (Polarization Modulation infra-Red Reflection Absorption Spectroscopy, PMIRRAS, and polarized ATR-FTIR). We demonstrate a structural flexibility of SFV21 sequence whether the lateral pressure and the lipid environment. In a lipid environment that mimics eukaryotic cell membranes, a conformational transition from an α-helix to a ß-sheet is induced in the presence of lipid by increasing the peptide to lipid ratio, which leads to important perturbations in the membrane organisation.

Denitrification in a hypersaline lake-aquifer system (Pétrola Basin, Central Spain): the role of recent organic matter and Cretaceous organic rich sediments.

Agricultural regions in semi-arid to arid climates with associated saline wetlands are one of the most vulnerable environments to nitrate pollution. The Pétrola Basin was declared vulnerable to NO3(-) pollution by the Regional Government in 1998, and the hypersaline lake was classified as a heavily modified body of water. The study assessed groundwater NO3(-) through the use of multi-isotopic tracers (δ(15)N, δ(34)S, δ(13)C, δ(18)O) coupled to hydrochemistry in the aquifer connected to the eutrophic lake. Hydrogeologically, the basin shows two main flow components: regional groundwater flow from recharge areas (Zone 1) to the lake (Zone 2), and a density-driven flow from surface water to the underlying aquifer (Zone 3). In Zones 1 and 2, δ(15)NNO3 and δ(18)ONO3 suggest that NO3(-) from slightly volatilized ammonium synthetic fertilizers is only partially denitrified. The natural attenuation of NO3(-) can occur by heterotrophic reactions. However, autotrophic reactions cannot be ruled out. In Zone 3, the freshwater-saltwater interface (down to 12-16 m below the ground surface) is a reactive zone for NO3(-) attenuation. Tritium data suggest that the absence of NO3(-) in the deepest zones of the aquifer under the lake can be attributed to a regional groundwater flow with long residence time. In hypersaline lakes the geometry of the density-driven flow can play an important role in the transport of chemical species that can be related to denitrification processes.

Stra6, a retinoic acid-responsive gene, participates in p53-induced apoptosis after DNA damage.

Stra6 is the retinoic acid (RA)-inducible gene encoding the cellular receptor for holo-retinol binding protein. This transmembrane protein mediates the internalization of retinol, which then upregulates RA-responsive genes in target cells. Here, we show that Stra6 can be upregulated by DNA damage in a p53-dependent manner, and it has an important role in cell death responses. Stra6 expression induced significant amounts of apoptosis in normal and cancer cells, and it was also able to influence p53-mediated cell fate decisions by turning an initial arrest response into cell death. Moreover, inhibition of Stra6 severely compromised p53-induced apoptosis. We also found that Stra6 induced mitochondria depolarization and accumulation of reactive oxygen species, and that it was present not only at the cellular membrane but also in the cytosol. Finally, we show that these novel functions of Stra6 did not require downstream activation of RA signalling. Our results present a previously unknown link between the RA and p53 pathways and provide a rationale to use retinoids to upregulate Stra6, and thus enhance the tumour suppressor functions of p53. This may have implications for the role of vitamin A metabolites in cancer prevention and treatment.

[Diagnosis of acute myocarditis with cardiac magnetic resonance imaging]. / Miocarditis aguda: diagnóstico mediante resonancia magnética cardiaca.

Cardiomyopathies are a common cause of morbidity and mortality. Myocarditis, which is included among specific cardiomyopathies, frequently presents non-specific clinical manifestations and thus may be difficult to diagnose, or even be misdiagnosed. Traditionally employed diagnostic techniques, including endomyocardial biopsy, have been shown to be of limited value. Following its overall implantation in clinical practice, cardiac magnetic resonance imaging (MRI) is nowadays widely considered to be the best non-invasive diagnostic tool available for diagnosing myocarditis.

Miocarditis aguda: diagnóstico mediante resonancia magnética cardiaca / Diagnosis of acute myocarditis with cardiac magnetic resonance imaging

Las miocardiopatías son una causa frecuente demorbimortalidad. Entre las miocardiopatías específicasse incluye la miocarditis, una entidad que confrecuencia se presenta con manifestaciones clínicasinespecíficas y puede resultar de difícil diagnóstico oincluso pasar desapercibida. El éxito de las técnicastradicionalmente empleadas para el diagnóstico demiocarditis, incluyendo la biopsia endomiocárdica, eslimitado. Tras su implantación en la práctica clínica, laresonancia magnética (RM) cardiaca se ha convertidoen la mejor técnica diagnóstica no invasiva disponiblepara el diagnóstico de miocarditis aguda (AU)

Cardiomyopathies are a common cause of morbidityand mortality. Myocarditis, which is includedamong specific cardiomyopathies, frequently presentsnon-specific clinical manifestations and thus may bedifficult to diagnose, or even be misdiagnosed. Traditionallyemployed diagnostic techniques, includingendomyocardial biopsy, have been shown to be of limitedvalue. Following its overall implantation in clinicalpractice, cardiac magnetic resonance imaging (MRI) isnowadays widely considered to be the best non-invasivediagnostic tool available for diagnosing myocarditis (AU)

Organization of beta-cyclodextrin under pure cholesterol, DMPC, or DMPG and mixed cholesterol/phospholipid monolayers.

The complexation of beta-cyclodextrin with monolayers of cholesterol, DMPC, DMPG, and mixtures of those lipids has been studied using Brewster microscopy, PMIRRAS, and ab initio calculations. An oriented channel-like structure of beta-cyclodextrin, perpendicular to the air/water interface, was observed when some cholesterol molecules were present at the interface. This channel structure formation is the first step in the cholesterol dissolution in the subphase. With pure DMPC and DMPG monolayers, weaker, less organized complexes are formed, but they disappear almost completely at high surface pressure, and only a small amount of phospholipid is dissolved in the subphase.

Principios básicos de resonancia magnética cardiovascular (RMC): secuencias, planos de adquisición y protocolo de estudio / Basic principles of cardiovascular magnetic resonance (CMR): sequences, acquisition planes and study protocol

El estudio de la patología del sistema cardiovascular por resonancia magnética (RMC) es una de las aplicaciones más actuales de esta técnica diagnóstica, ya que permite estudiar la anatomía y función del corazón y grandes vasos de forma exacta y reproducible. La complejidad de la técnica viene dada por la localización y orientación anatómica de las estructuras cardiovasculares, las secuencias específicas que se deben emplear y la ausencia de familiarización por parte de los radiólogos con la patología cardiovascular. En este trabajo se describen los principios básicos de la RMC. Se exponen la utilidad clínica de las secuencias anatómicas, funcionales y secuencias de flujo, se describen los planos de adquisición en un estudio de RMC convencional y se propone un protocolo de estudio sencillo

Evaluation of the cardiovascular system with magnetic resonance (CMR) has become one of the most relevant and up-to-the-minute clinical applications of this diagnostic technique, as CMR makes possible an exact and reproducible study of the anatomy and function of the heart and great vessels. The complexity of this technique is mainly due to the anatomical location and orientation of the cardiovascular structures, the specific CMR sequences that have to be used and a lack of familiarity amongst radiologists regarding cardiovascular pathology. In this report the most basic principles of CMR are described. The clinical usefulness of anatomical, functional, and flow quantification sequences are discussed, conventional CMR acquisition planes are described, and an easy CMR study protocol is proposed

Impact on renal function of the use of sirolimus in cardiac transplantation.

INTRODUCTION: During the last few years sirolimus has been introduced as an alternative to preserve renal function in transplant recipients receiving calcineurin inhibitors. MATERIALS AND METHODS: We reviewed our results on the use of sirolimus in cardiac transplant recipients. RESULTS: Twenty-seven patients with an average age of 63 years received sirolimus. The average time after transplantation was 73.4 +/- 58.9 months and the average follow-up was 31.7 +/- 18.01 months. Sirolimus was prescribed in 37% of cases due to chronic renal failure (CRF), 14.8% because of cardiac allograft vasculopathy (CAV), 11.1% for tumors, 22.2% de novo, 7.4% for CRF and tumor, and 7.4% for CRF and CAV. Among the patients with CRF (n = 14), there were 5 (35%) on dialysis at the moment of starting the treatment and 1 was retired from dialysis. The other 4 (28.5%) patients had to be treated with dialysis after starting the treatment. In all, 42.8% of the patients with nephropathy maintained stable renal function or improved. Among the 17 (63%) patients who did not require dialysis, there was no significant change in renal function after 6 months or 1, 2, and 3 years follow-up. CONCLUSIONS: The use of sirolimus in cardiac transplantation maintains stable renal function in the majority of patients in the medium term.

The O3-Vet project: a veterinary electronic patient record based on the web technology and the ADT-IHE actor for veterinary hospitals.

A veterinary electronic patient record, compliant with the IT standards (HL7, DICOM and IHE), was developed at the School of Veterinary Medicine, University of Milan (Italy) in order to improve the veterinary hospital workflows, making the stored clinical data more homogenous and sharable, thereby increasing the integration with current and future software applications. The system was developed by open-source software in order to reduce the implementation and maintenance costs and to make the system sharable with other veterinary hospitals or research centers without additional costs. The system was tested from May to October 2006. Results show that the majority of the veterinarians involved in the test agreed on the advantages obtained by the use of application software concerning the availability of all the useful clinical data [71.4%], the quality of the diagnostic procedures [78.58%] and the efficiency [85.58%] of hospital activities.

[Basic principles of cardiovascular magnetic resonance (CMR): sequences, acquisition planes and study protocol]. / Principios básicos de resonancia magnética cardiovascular (RMC): secuencias, planos de adquisición y protocolo de estudio.

Evaluation of the cardiovascular system with magnetic resonance (CMR) has become one of the most relevant and up-to-the-minute clinical applications of this diagnostic technique, as CMR makes possible an exact and reproducible study of the anatomy and function of the heart and great vessels. The complexity of this technique is mainly due to the anatomical location and orientation of the cardiovascular structures, the specific CMR sequences that have to be used and a lack of familiarity amongst radiologists regarding cardiovascular pathology. In this report the most basic principles of CMR are described. The clinical usefulness of anatomical, functional, and flow quantification sequences are discussed, conventional CMR acquisition planes are described, and an easy CMR study protocol is proposed.