Prevalencia del cáncer del tracto urinario. Análisis de la cohorte española del estudio IDENTIFY / Prevalence of urinary tract cancer in the Spanish cohort of the IDENTIFY study

Introducción Los tumores malignos del tracto urinario están asociados a gran morbimortalidad siendo su prevalencia variable a nivel global. Recientemente el estudio IDENTIFY ha publicado resultados sobre la prevalencia del cáncer del tracto urinario a nivel internacional. Este estudio evalúa la prevalencia de cáncer dentro de la cohorte española del estudio IDENTIFY para determinar si los resultados publicados son extrapolables a nuestra población. Material y métodos Se realizó un análisis de los datos de la cohorte de pacientes españoles del estudio IDENTIFY. Se trata de una cohorte prospectiva de pacientes derivados al hospital con sospecha de cáncer, predominantemente por hematuria. Los pacientes fueron reclutados entre diciembre de 2017 y diciembre de 2018. Resultados En total 706 pacientes procedente de 9 centros españoles fueron analizados. Doscientos setenta y siete pacientes (39,2%) fueron diagnosticados de cáncer, 259 (36,7%) de cáncer vejiga, 10 (1,4%) de tracto urinario superior, 9 (1,2%) renal y 5 (0,7%) de próstata. El aumento de la edad (OR: 1,05; IC 95%: 1,03-1,06; p<0,001), presencia de hematuria visible (OR: 2,19; IC 95%: 1,13-4,24; p=0,02) y el hábito tabáquico (exfumadores: OR: 2,11; IC 95%: 1,30-3,40; p=0,002; fumadores: OR: 2,36; IC 95%: 1,40-3,95; p=0,001) se asocia con mayor probabilidad de cáncer vesical. Conclusión Este estudio resalta el riesgo que existe en pacientes con HV y hábito tabáquico de presentar cáncer de vejiga. El cáncer de vejiga presentó la mayor prevalencia, siendo esta mayor que la expuesta en series previas y la presentada en el estudio IDENTIFY. Trabajos futuros deben evaluar otros factores asociados que permitan crear modelos de predicción de cáncer para seguir aumentando la detección de estos en nuestros pacientes. (AU)

Introduction Malignant tumors of the urinary tract are associated with high morbidity and mortality, and their prevalence can vary worldwide. Recently, the IDENTIFY study has published results on the prevalence of urinary tract cancer at a global level. This study evaluates the prevalence of cancer within the Spanish cohort of the IDENTIFY study to determine whether the published results can be extrapolated to our population. Patients and methods An analysis of the data from the Spanish cohort of patients in the IDENTIFY study was performed. This is a prospective cohort of patients referred to secondary care with suspected cancer, predominantly due to hematuria. Patients were recruited between December 2017 and December 2018. Results A total of 706 patients from 9 Spanish centers were analyzed. Of these, 277 (39.2%) were diagnosed with cancer: 259 (36.7%) bladder cancer, 10 (1.4%) upper tract urothelial carcinoma, 9 (1.2%) renal cancer and 5 (0.7%) prostate cancer. Increasing age (OR: 1.05; 95% CI: 1.03-1.06; P<.001), visible hematuria (VH) OR: 2.19; 95% CI: 1.13-4.24; P=.02)and smoking (ex-smokers: OR: 2.11; 95% CI: 1.30-3.40; P=.002); (smokers: OR: 2.36; 95% CI: 1.40-3.95; P=.001) were associated with higher probability of bladder cancer. Conclusion This study highlights the risk of bladder cancer in patients with VH and smoking habits. Bladder cancer presented the highest prevalence; higher than the prevalence reported in previous series and presented in the IDENTIFY study. Future work should evaluate other associated factors that allow us to create cancer prediction models to improve the detection of cancer in our patients. (AU)

Prevalence of urinary tract cancer in the Spanish cohort of the IDENTIFY study.

INTRODUCTION: Malignant tumors of the urinary tract are associated with high morbidity and mortality, and their prevalence can vary worldwide. Recently, the IDENTIFY study has published results on the prevalence of urinary tract cancer at a global level. This study evaluates the prevalence of cancer within the Spanish cohort of the IDENTIFY study to determine whether the published results can be extrapolated to our population. PATIENTS AND METHODS: An analysis of the data from the Spanish cohort of patients in the IDENTIFY study was performed. This is a prospective cohort of patients referred to secondary care with suspected cancer, predominantly due to hematuria. Patients were recruited between December 2017 and December 2018. RESULTS: A total of 706 patients from 9 Spanish centers were analyzed. Of these, 277 (39.2%) were diagnosed with cancer: 259 (36.7%) bladder cancer, 10 (1.4%) upper tract urothelial carcinoma, 9 (1.2%) renal cancer and 5 (0.7%) prostate cancer. Increasing age (OR 1.05 (95% CI 1.03-1.06; P < 0.001)), visible hematuria (VH) OR 2.19 (95% CI 1.13-4.24; P = 0.02)) and smoking (ex-smokers: OR 2.11(95% CI 1.30-3.40; P = 0.002); smokers: OR 2.36 (95% CI 1.40-3.95; P = 0.001)) were associated with higher probability of bladder cancer. CONCLUSION: This study highlights the risk of bladder cancer in patients with VH and smoking habits. Bladder cancer presented the highest prevalence; higher than the prevalence reported in previous series and presented in the IDENTIFY study. Future work should evaluate other associated factors that allow us to create cancer prediction models to improve the detection of cancer in our patients.

Sequencing paired tumor DNA and white blood cells improves circulating tumor DNA tracking and detects pathogenic germline variants in localized colon cancer.

BACKGROUND: In the setting of localized colon cancer (CC), circulating tumor DNA (ctDNA) monitoring in plasma has shown potential for detecting minimal residual disease (MRD) and predicting a higher risk of recurrence. With the tumor-only sequencing approach, however, germline variants may be misidentified as somatic variations, precluding the possibility of tracking in up to 11% of patients due to a lack of known somatic mutations. In this study, we assess the potential value of adding white blood cells (WBCs) to tumor tissue sequencing to enhance the accuracy of sequencing results. PATIENTS AND METHODS: A total of 148 patients diagnosed with localized CC were prospectively recruited at the Hospital Clínico Universitario in Valencia (Spain). Employing a custom 29-gene panel, sequencing was conducted on tumor tissue, plasma and corresponding WBCs. Droplet digital PCR and amplicon-based NGS were performed on plasma samples post-surgery to track MRD. Oncogenic somatic variants were identified by annotating with COSMIC, OncoKB and an internal repository of pathogenic mutations database. A variant prioritization analysis, mainly characterized by the match of oncogenic mutations with the evidence levels defined in OncoKB, was carried out to select specific targeted therapies. RESULTS: Utilizing paired tumor and WBCs sequencing, we identified somatic mutations in all patients (100%) within our cohort, compared to 89% using only tumor tissue. Consequently, the top 10 most frequently mutated genes for plasma monitoring were altered. The sequencing of WBCs identified 9% of patients with pathogenic mutations in the germline, with APC and TP53 being the most frequently mutated genes. Additionally, mutations in genes related to clonal hematopoiesis of indeterminate potential were detected in 27% of the cohort, with TP53, KRAS, and KMT2C being the most frequently altered genes. There were no observed differences in the sensitivity of monitoring MRD using ddPCR or amplicon-based NGS (p = 1). Ultimately, 41% of the patients harbored potentially targetable alterations at diagnosis. CONCLUSION: The germline testing method not only enhanced sequencing results and raised the proportion of patients eligible for plasma monitoring, but also uncovered the existence of pathogenic germline variations, thereby aiding in the identification of patients at a higher risk of hereditary cancer syndromes.

Adverse effects of iron-based nanoparticles on freshwater phytoplankton Scenedesmus armatus and Microcystis aeruginosa strains.

Zero-valent nano-iron particles (nZVI) are increasingly present in freshwater aquatic environments due to their numerous applications in environmental remediation. However, despite the broad benefits associated with the use and development of nZVI nanoparticles, the potential risks of introducing them into the aquatic environment need to be considered. Special attention should be focused on primary producer organisms, the basal trophic level, whose impact affects the rest of the food web. Although there are numerous acute studies on the acute effects of these nanoparticles on photosynthetic primary producers, few studies focus on long-term exposures. The present study aimed at assessing the effects of nZVI on growth rate, photosynthesis activity, and reactive oxygen activity (ROS) on the freshwater green algae Scenedesmus armatus and the cyanobacteria Microcystis aeruginosa. Moreover, microcystin production was also evaluated. These parameters were assessed on both organisms singly exposed to 72 h-effective nZVI concentration for 10% maximal response for 28 days. The results showed that the cell growth rate of S. armatus was initially significantly altered and progressively reached control-like values at 28 days post-exposure, while M. aeruginosa did not show any significant difference concerning control values at any time. In both strains dark respiration (R) increased, unlike net photosynthesis (Pn), while gross photosynthesis (Pg) only slightly increased at 7 days of exposure and then became equal to control values at 28 days of exposure. The nZVI nanoparticles generated ROS progressively during the 28 days of exposure in both strains, although their formation was significantly higher on green algae than on cyanobacteria. These data can provide additional information to further investigate the potential risks of nZVI and ultimately help decision-makers make better informed decisions regarding the use of nZVI for environmental remediation.

The complete chloroplast genome of 'biasong' (Citrus micrantha Wester), a native species from the Southern Philippines.

'Biasong' (Citrus micrantha), native to the Southern Philippine Islands, is an important cultivated fruit tree but has no published plastome sequence. We assembled and characterized the C. micrantha chloroplast genome from accession in the germplasm collection of the Institute of Crop Science, University of the Philippines Los Baños. The complete chloroplast (cp) genome sequence is 159,928-bp long with 128 coding genes comprising 83 mRNA genes, 37 tRNA genes, and eight rRNA genes. Out of the mRNA genes, 45 genes code for photosynthesis, 30 genes code for self-replication, and five genes code for other functions. A phylogenetic analysis of the assembled genome, along with 24 Citrus species and three other Rutaceae species, identified Citrus aurantiifolia as its closest relative with available complete cpDNA sequence.

Prediction of the impact induced by Cd in binary interactions with other divalent metals on wild-type and Cd-resistant strains of Dictyosphaerium chlorelloides.

The metals present in freshwater have a toxic profile with bioaccumulation and are biomagnified along the aquatic food chain. The metals induce high sensitivity in most aquatic organisms, while others, such as some microalgae species, evolve towards resistance. Therefore, this research predicted through the Combination Index method the binary interaction exposed to divalent metals by inhibiting population growth in a Cd-resistant strain (DcRCd100) compared to the wild-type strain (Dc1Mwt) of Dictyosphaerium chlorelloides and evaluate the specific resistance level obtained by DcRCd100 to Cd relative to other divalent metals.The results showed that DcRCd100 presents resistance compared to Dc1Mwt in individual exposure in the order of Fe2+ > Ni2+ > Cd2+ > Co2+ > Zn2+ > Cu2+ > Hg2+ with 50% inhibitory concentration at 72 h of exposure (IC50(72)) values 1253, 644.4, 423, 162.7, 141.3, 35.1, and 9.9 µM, respectively. It induces cross-resistance with high antagonistic rates (Combination Index (CI); CI > > 1) in the Cd/Zn and Cd/Cu. Cd/Ni, its initial response, is antagonistic, and it ends in an additive (CI = 1). DcRCd100 showed a lower resistance in Co, and Cd/Fe resistance was reduced individually. The interaction with Hg increased its resistance ten times more than individually.This research highlights the use of the CI as a highly efficient prediction method of the binary metal interactions in wild-type and Cd-resistant strains of D. chlorelloides. It may have the potential for metal accumulation, allowing the development of new methods of bioremediation of metals in effluents, and to monitor the concentration of metals in wastewater, its relative availability, transport, and mechanisms on resistant strains of microalgae.

Receptor Tyrosine Kinases ror1/2 and ryk Are Co-expressed with Multiple Wnt Signaling Components During Early Development of Sea Urchin Embryos.

AbstractA combination of receptors, co-receptors, and secreted Wnt modulators form protein complexes at the cell surface that activate one or more of the three different Wnt signaling pathways (Wnt/ß-catenin, Wnt/JNK, and Wnt/Ca2+). Two or more of these pathways are often active in the same cellular territories, forming Wnt signaling networks; however, the molecular mechanisms necessary to integrate information from these pathways in these situations are unclear in any in vivo model system. Recent studies have implicated two Wnt binding receptor tyrosine kinases, receptor tyrosine kinase-like orphan receptor (Ror) and related-to-receptor tyrosine kinase (Ryk), in the regulation of canonical and non-canonical Wnt signaling pathways, depending on the context; however, the spatiotemporal expression of these genes in relation to Wnt signaling components has not been well characterized in most deuterostome model systems. Here we use a combination of phylogenetic and spatiotemporal gene expression analyses to characterize Ror and Ryk orthologs in sea urchin embryos. Our phylogenetic analysis indicates that both ror1/2 and ryk originated as single genes from the metazoan ancestor. Expression analyses indicate that ror1/2 and ryk are expressed in the same domains of many Wnt ligands and Frizzled receptors essential for the specification and patterning of germ layers along the early anterior-posterior axis. In addition, both genes are co-expressed with Wnt signaling components in the gut, ventral ectoderm, and anterior neuroectoderm territories later in development. Together, our results indicate that Ror and Ryk have a complex evolutionary history and that their spatiotemporal expression suggests that they could contribute to the complexity of Wnt signaling in early sea urchin embryogenesis.

Building on gAMBI in ports for a challenging biological invasions scenario: Blue-gNIS as a proof of concept.

The status of aquatic ecosystems has historically been monitored by the use of biotic indices. However, few biotic measures consider the presence of non-indigenous species as a sign of anthropogenic pollution and habitat disturbance even when this may seriously affect the metric scores and ecological status classifications of an environment. Today, biological invasions are currently one of the greatest threats to biodiversity and sustainable blue economies around the world. In this work, environmental assessments were conducted in the Port of Gijon, Northern Spain, using eDNA metabarcoding, and the gAMBI (genetics based AZTI Marine Biotic Index) was estimated. Results indicate a high/good ecological status within the port. However, nine non-indigenous species and five invasive species were found, and a modification of the gAMBI that includes species invasiveness was proposed: Blue-gNIS. The index was preliminary tested against existing validated indices such as gAMBI, BENTIX (based on the ecology of macroinvertebrates) and ALEX (based on the invasiveness of the species). Blue-gNIS classified the port in a good ecological status and showed its potential usefulness to achieve more complete water quality assessments of ports.

El juego como factor motivador en la enseñanza de la anatomía humana / Game as a motivating factor in the teaching of human anatomy

INTRODUCCIÓN: Con la llegada a la universidad de una nueva generación de alumnos, la 'generación Z', considerada como la primera generación nativa digital, se hace necesario implantar nuevas metodologías docentes en el ámbito universitario para mejorar el proceso de enseñanza-aprendizaje y conseguir una mayor motivación en el alumno. Para ello, el uso de nuevas tecnologías de la información y de la comunicación ha permitido dinamizar estos procesos y aumentar la motivación del alumnado en todos los niveles educativos, incluyendo la docencia universitaria. SUJETOS Y MÉTODOS: Utilización de la aplicación educativa Kahoot a través de dispositivos móviles, con los alumnos matriculados de la asignatura de 'Anatomía Humana II (Esplacnología)', de segundo curso del Grado de Medicina en la Universidad de Zaragoza. RESULTADOS: El impacto que la experiencia ha causado en los estudiantes se ha medido a través de encuestas de valoración cualitativas, analizando sus resultados de aprendizaje. Estos resultados han sido valorados de manera muy positiva por el alumnado, tanto en lo referente a utilidad en la enseñanza-aprendizaje como a motivación. CONCLUSIÓN: Kahoot es una herramienta digital interactiva, gratuita y de manejo sencillo tanto para el docente como para los alumnos, que permite que éstos mejoren en su aprendizaje haciendo uso de nuevas tecnologías y se sientan así más motivados

INTRODUCTION: The need to face a new generation of students, the 'Z generation', considered as the first digital native generation, makes it necessary to implement new teaching methodologies in the university field to improve the teaching-learning process and above all achieve greater motivation in the student. To this end, the use of new information and communication technologies has enabled the dynamics of these processes and increasing student motivation at all educational levels, including university teaching. SUBJECTS AND METHODS: Use of the Kahoot educational app was raised through mobile devices as an innovative tool that enhances motivation and learning process, participating students enrolled in the subject of 'Human Anatomy II (Esplacnology)', second course of the Degree of Medicine in the University of Zaragoza. RESULTS: The impact that the experience has caused students has been studied through qualitative assessment surveys, analyzing the learning outcomes obtained by students. The results achieved in terms of implementation of these new teaching-learning methodologies have been valued by students, in a very positive way both at the level of usefulness in learning teaching and at the level of motivation. CONCLUSION: Kahoot is an interactive digital tool, free and easy to use for both teachers and students, and which allows the latter to improve their learning using new technologies, feeling more motivated

Myofibroblastic sarcoma of the breast. Report of a case induced by radiotherapys.

Myofibroblastic sarcoma (MFS) is an uncommon tumor rarely located in the breast. Ionizing radiation is a carcinogen capable of inducing sarcomas through DNA damage. A 42-year-old woman was diagnosed with synchronous bilateral breast infiltrating ductal carcinoma with axillary lymph node metastases on the left side. After modified left radical mastectomy and simple right mastectomy, she underwent postoperative radiation with a total volume dose of 50 Gy that included the thoracic wall and the left axillary-supraclavicular region. After a latency period of 6 years and 4 months, the patient developed an MFS in the area of radiation (mammary upper outer quadrant). To our knowledge, only 11 cases of MFS have been previously published in the breast. The study of the 12 cases including the present one revealed that the ages of the patients ranged from 42 to 86 years (mean 60.3 years). There was a clear difference concerning sex (M:F, 1:5). The average duration of the lesion varied from 1 week to 8 months (mean 3.3 months). The size ranged from 2.2 to 22 cm (average 5.1 cm). The tumors showed frequent mitosis and areas of necrosis. The percentage of recurrences, metastasis, and death due to the tumor was 27.3%, 36.4%, and 27.3% respectively. MFS cases differ from those affecting extramammary regions. They are more common in females and show a greater degree of aggressiveness. Correct diagnosis of mammary MFS requires morphological and immunohistochemical study. We present for the first time a case of MFS of the breast induced by radiotherapy.

¿Es segura la coleciestectomía laparoscópica ambulatoria en turno de tarde? / Is ambulatory laparoscopic cholecystectomy safe to perform on the afternoon shift?

INTRODUCCIÓN: La colecistectomía laparoscópica (CL) se considera el tratamiento quirúrgico recomendable para los pacientes portadores de esta entidad clínica. Uno de los beneficios es la pronta recuperación. Objetivos: El objetivo general de este estudio fue el de determinar la utilidad del régimen ambulatorio en pacientes sometidos a CL, bajo control perioperatorio. MATERIAL Y MÉTODOS: Se realizó un estudio de serie de casos en 150 pacientes programados para CL. Se analizaron las variables hemodinámicas en dos fases: Chi cuadrado, con p < 0,05. También se abordó el análisis del tiempo de duración de la intervención quirúrgica, el tiempo de recuperación posoperatoria y la valoración de Aldrete para cirugía ambulatoria. RESULTADOS: Fueron evaluados como: ASA I = 87 (58 %), ASA II = 63 (42 %). Las variables antropométricas: edad: X = 37,7 ± 15 DE. Peso: X = 70,88 ± 26. La duración de la cirugía fue: X = 66,5 ± 22 minutos. El tiempo de estancia posoperatoria fue: X = 5,55 ± 1,2 horas. Las variables hemodinámicas analizadas con T Pareada no muestran diferencias estadísticamente significativas. La valoración de Aldrete para pacientes ambulatorios fue de X = 19 puntos. CONCLUSIONES: El 100 % de los pacientes controló el dolor y fueron ambulatorios. De acuerdo con nuestros hallazgos, nos permitimos proponer a la colecistectomía laparoscópica para su adecuación en el régimen ambulatorio bajo manejo perioperatorio

INTRODUCTION: Laparoscopic Cholecystectomy (LC) is considered the recommended surgical treatment for patients with this clinical entity. One of the benefits is the speedy recovery.Objectivs: The general objective of this study was to determine the utility of the ambulatory regimen in patients undergoing CL, under perioperative control. MATERIAL AND METHOD: A case series study was carried out on 150 patients scheduled for LC. The hemodynamic variables were analyzed in two phases; when entering the unit and being discharged (through Paired T, with p < 0,05), the presence of pain (analysed visual scale) was also analyzed using Chi Square (X2), with p < 0,05. The analysis of the duration of the surgical intervention, the postoperative recovery time and the evaluation of Aldrete for Ambulatory Surgery were also addressed. RESULTS: They were evaluated as: ASA I = 87 (58 %), ASA II = 63 (42 %). The anthropometric variables: age: X = 37.7 years ± SD 15. Weight: X = 70,88 kg ± SD 26. The duration of the surgery was: X = 66.5 ± 22 minutes. The postoperative stay time was: X = 5.55 ± SD 1.2 hours. The hemodynamic variables analyzed with Paired T, do not show statistically significant differences. The Aldrete assessment for outpatients was X = 19 points. CONCLUSIONS: 100 % of the patients had pain control and were ambulatory. According to our findings, we allow us to propose laparoscopic cholecystectomy for its adaptation in the ambulatory regimen under perioperative managemen

Mercury levels in blood, urine and hair in a nation-wide sample of Spanish adults.

Mercury (Hg) is among the top 10 environmental chemicals of major public health concern (WHO). The Minamata Convention on Mercury (United Nations Environment Program, 2017), commits signing countries to control anthropogenic mercury emissions and reduce human exposure. Human biomonitoring (HBM) programs, are the most straight-forward approaches to get information on the actual exposure levels in the population and assess over time. We report here the results of a HBM study in a nationwide cross-section of Spanish adults (18-65y) as baseline values obtained before the Minamata Convention entered into force. Subsequent follow-ups will show if the Convention has been successful. The study includes 1880 blood samples, 1704 urine samples and 577 hair samples from all Spanish regions collected and analysed under a strictly quality controlled and quality assured protocol. The EU-DEMOCOPHES project demonstrated that fish and seafood are the major sources of mercury exposure and that the Spanish as well as the Portuguese populations have higher levels than other European countries. The data from the present study confirms this pattern at national level and that inhabitants in coastal regions have higher values than from inland regions. The geometric mean (GM) for blood is 6.35 µg Hg/l, in urine is 1.11 µg Hg/l and for hair is 1.91 µg Hg/g. In an international comparison these values are not exceptional. Spanish concentrations fall into the group of Easter Mediterranean populations. Although information on gender, age, occupational sector, geographical area, sampling period and frequency of fish consumption is reported in the tables, the purpose of this paper has not been to analyse the determinants of exposure in detail but to provide baseline data for future assessments and for regional authorities.

Usability study and pilot validation of a computer-based emotion recognition test for older adults with Alzheimer's disease and amnestic mild cognitive impairment.

OBJECTIVES: This study aimed to carry out a pilot validation of Affect-GRADIOR, a computer-based emotion recognition test, with older adults. The study evaluated its usability, reliability and validity for the screening of people with Alzheimer´s disease (AD) and amnestic mild cognitive impairment (aMCI). METHODS: The test was administered to 212 participants (76.37 ± 6.20 years) classified into three groups (healthy controls, n = 69; AD, n = 84; and aMCI, n = 59) on the basis of detailed neurological, neuropsychological, laboratory and neuro-imaging evidence. Data on usability were collected by means of a questionnaire and automated evaluation. RESULTS: The validated test comprised 53 stimuli and 7 practice items (one per emotion). Participants reported that Affect-GRADIOR was accessible and user-friendly. It had high internal consistency (ordinal Cronbach's α = 0.96). Test-retest reliability correlations were significant and robust (r = 0.840, p < 0.001). Exploratory factor analysis supported a seven-factor model of the emotions assessed (neutral expression, happiness, surprise, disgust, sadness, anger and fear). Receiver operating characteristic curve analyses suggested that the test discriminated healthy older adults from AD and aMCI cases. Correct answer score improved MMSE predictive power from 0.547 to 0.560 (Cox & Snell R2, p = 0.012), and Affect-GRADIOR speed of processing score improved MMSE predictive power from 0.547 to 0.563 (Cox & Snell R2, p = 0.010). CONCLUSIONS: Affect-GRADIOR is a valid instrument for the assessment of the facial recognition of emotions in older adults with and without cognitive impairment.

The impact of obesity in the cardiac lipidome and its consequences in the cardiac damage observed in obese rats / El impacto de la obesidad sobre el lipidoma cardiaco y sus consecuencias en el daño cardiaco en ratas obesas

Aims: To explore the impact of obesity on the cardiac lipid profile in rats with diet-induced obesity, as well as to evaluate whether or not the specific changes in lipid species are associated with cardiac fibrosis. Methods: Male Wistar rats were fed either a high-fat diet (HFD, 35% fat) or standard diet (3.5% fat) for 6 weeks. Cardiac lipids were analyzed using by liquid chromatography-tandem mass spectrometry. Results: HFD rats showed cardiac fibrosis and enhanced levels of cardiac superoxide anion (O2), HOMA index, adiposity, and plasma leptin, as well as a reduction in those of cardiac glucose transporter (GLUT 4), compared with control animals. Cardiac lipid profile analysis showed a significant increase in triglycerides, especially those enriched with palmitic, stearic, and arachidonic acid. An increase in levels of diacylglycerol (DAG) was also observed. No changes in cardiac levels of diacyl phosphatidylcholine, or even a reduction in total levels of diacyl phosphatidylethanolamine, diacyl phosphatidylinositol, and sphingomyelins (SM) was observed in HFD, as compared with control animals. After adjustment for other variables (oxidative stress, HOMA, cardiac hypertrophy), total levels of DAG were independent predictors of cardiac fibrosis while the levels of total SM were independent predictors of the cardiac levels of GLUT 4. Conclusions: These data suggest that obesity has a significant impact on cardiac lipid composition, although it does not modulate the different species in a similar manner. Nonetheless, these changes are likely to participate in the cardiac damage in the context of obesity, since total DAG levels can facilitate the development of cardiac fibrosis, and SM levels predict GLUT4 levels (AU)

Objetivos: Explorar el impacto de la obesidad sobre el perfil lipídico cardiaco en ratas con obesidad inducida por dieta. Se evaluó, además, si estos cambios se asocian con fibrosis cardiaca. Métodos: Ratas macho Wistar fueron alimentadas con una dieta con alto contenido en grasa (HFD; 35% grasa) o con una dieta estándar (3,5% grasa) durante 6 semanas. El análisis del lipidoma cardiaco se realizó mediante cromatografía líquida en tándem con espectrofotometría de masas. Resultados: Las ratas HFD presentaron fibrosis cardiaca, estrés oxidativo y un aumento en el índice HOMA, adiposidad y los niveles circulantes de leptina así como una reducción en los niveles cardiacos del transportador de glucosa (GLUT 4) en comparación con las ratas controles. El análisis del lipidoma cardiaco mostró un aumento de los niveles de triglicéridos especialmente los que contenían ácido palmítico, esteárico o araquidónico, un incremento en los de diacilglicerol (DAG) aunque no cambios en los de diacilfosfatidilcolina y una reducción en los de diacilfosofatidiletanolamina, diacilfosfatidilinositol o de esfingomielinas (SM) en las ratas HFD en comparación con las control. Después del ajuste por otras variables (estrés oxidativo, hipertrofia cardiaca, índice HOMA), los niveles de DAG fueron predictores independientes de fibrosis cardiaca mientras que los de SM fueron de los de niveles de GLUT4. Conclusiones: La obesidad ejerce un impacto importante sobre el lipidoma cardiaco. Estos cambios parecen participar en el daño cardiaco en el contexto de la obesidad ya que los niveles de DAG podrían facilitar el desarrollo de fibrosis miocárdica y los de SM los de GLUT 4 (AU)

ELECTRONIC DEVICES FOR COGNITIVE IMPAIRMENT SCREENING: A SYSTEMATIC LITERATURE REVIEW.

OBJECTIVES: The reduction in cognitive decline depends on timely diagnosis. The aim of this systematic review was to analyze the current available information and communication technologies-based instruments for cognitive decline early screening and detection in terms of usability, validity, and reliability. METHODS: Electronic searches identified 1,785 articles of which thirty-four met the inclusion criteria and were grouped according to their main purpose into test batteries, measures of isolated tasks, behavioral measures, and diagnostic tools. RESULTS: Thirty one instruments were analyzed. Fifty-two percent were personal computer based, 26 percent tablet, 13 percent laptop, and 1 was mobile phone based. The most common input method was touchscreen (48 percent). The instruments were validated with a total of 4,307 participants: 2,146 were healthy older adults (M = 73.59; SD = 5.12), 1,104 had dementia (M = 74.65; SD = 3.98) and 1,057 mild cognitive impairment (M = 74.84; SD = 4.46). Only 6 percent were administered at home, 19 percent reported outcomes about usability, and 22 percent about understandability. The methodological quality of the studies was good, the weakest methodological area being usability. Most of the instruments obtained acceptable values of specificity and sensitivity. CONCLUSIONS: It is necessary to create home delivered instruments and to include usability studies in their design. Involvement of people with cognitive decline in all phases of the development process is of great importance to obtain valuable and user-friendly products. It would be advisable for researchers to make an effort to provide cutoff points for their instruments.

Rehabilitación del reconocimiento de emociones combinada con estimulación cognitiva para personas con enfermedad de Alzheimer. Eficacia sobre aspectos cognitivos y funcionales / Emotion recognition rehabilitation combined with cognitive stimulation for people with Alzheimer’s disease. Efficacy for cognition and functional aspects

Introducción. Se han encontrado déficits en el reconocimiento de emociones en personas con enfermedad de Alzheimer (EA), pero no se ha informado de ningún tratamiento rehabilitador de esta capacidad en esta población. Objetivo. Evaluar la eficacia de un tratamiento combinado de rehabilitación del reconocimiento de emociones (RRE) y estimulación cognitiva (EsC) sobre las funciones cognitivas, el estado de ánimo, la anosognosia, la capacidad funcional y el reconocimiento de emociones de personas con EA. Sujetos y métodos. En un diseño cuasi experimental, 36 pacientes con EA fueron asignados a tres condiciones: un grupo experimental, que recibió 20 sesiones de RRE y 20 sesiones de EsC; un grupo control, que recibió 40 sesiones de EsC, y un grupo que recibió tratamiento usual (GTU). Resultados. Completaron el estudio 32 pacientes, con una edad media de 77,53 ± 5,43 años. Se observó mejoría en el Minimental State Examination en su versión de 30 ítems (F = 5,10; p = 0,013) y en la de 35 (F = 4,16; p = 0,026), reconocimiento de afectos (Z = -2,81; p = 0,005) y actividades básicas de la vida diaria (Z = -2,27; p = 0,018) a favor del grupo experimental. El grupo que recibió tratamiento usual empeoró en depresión (Z = -1,99; p = 0,048), apatía (Z = -2,30; p = 0,022) y anosognosia (Z = -2,19; p = 0,028). Conclusiones. El tratamiento combinado de RRE y EsC fue más eficaz que la EsC y que el tratamiento usual. Es la primera vez que se informa de un tratamiento rehabilitador del reconocimiento de emociones en personas con EA (AU)

Introduction. The ability to recognize facial emotional expression is essential for social interactions and adapting to the environment. Emotion recognition is impaired in people with Alzheimer’s disease (AD), thus rehabilitation of these skills has the potential to elicit significant benefits. Aim. To assess the efficacy of a combined treatment of rehabilitation of emotion recognition (RER) and cognitive stimulation (CS) for people with AD, due to its potential implications for more effective psychosocial interventions. Subjects and methods. 36 patients were assigned to one of three experimental conditions: an experimental group (EG) that received 20 sessions of RER and 20 sessions of CS; a control group (CG) that received 40 sessions of CS, and a treatment as usual group (TAU). Results. 32 patients completed the treatment (77.53 ± 5.43 years). Significant differences were found in MMSE30 (F = 5.10; p = 0.013), MMSE35 (F = 4.16; p = 0.026), affect recognition (Z = -2.81; p = 0.005) and basic activities of daily living (Z = -2.27; p = 0.018) favouring the efficacy of the combined treatment. The TAU group showed a decline in depression (Z = -1.99; p = 0.048), apathy (Z = -2.30; p = 0.022) and anosognosia (Z = -2.19; p = 0.028). Conclusions. The combined treatment of RER + CS was more effective than TAU and CS alone for the treatment of patients with AD. This is the first study about the rehabilitation of affect recognition in AD (AU)

[Emotion recognition rehabilitation combined with cognitive stimulation for people with Alzheimer's disease. Efficacy for cognition and functional aspects]. / Rehabilitacion del reconocimiento de emociones combinada con estimulacion cognitiva para personas con enfermedad de Alzheimer. Eficacia sobre aspectos cognitivos y funcionales.

INTRODUCTION: The ability to recognize facial emotional expression is essential for social interactions and adapting to the environment. Emotion recognition is impaired in people with Alzheimer's disease (AD), thus rehabilitation of these skills has the potential to elicit significant benefits. AIM: To assess the efficacy of a combined treatment of rehabilitation of emotion recognition (RER) and cognitive stimulation (CS) for people with AD, due to its potential implications for more effective psychosocial interventions. SUBJECTS AND METHODS: 36 patients were assigned to one of three experimental conditions: an experimental group (EG) that received 20 sessions of RER and 20 sessions of CS; a control group (CG) that received 40 sessions of CS, and a treatment as usual group (TAU). RESULTS: 32 patients completed the treatment (77.53 ± 5.43 years). Significant differences were found in MMSE30 (F = 5.10; p = 0.013), MMSE35 (F = 4.16; p = 0.026), affect recognition (Z = -2.81; p = 0.005) and basic activities of daily living (Z = -2.27; p = 0.018) favouring the efficacy of the combined treatment. The TAU group showed a decline in depression (Z = -1.99; p = 0.048), apathy (Z = -2.30; p = 0.022) and anosognosia (Z = -2.19; p = 0.028). CONCLUSIONS: The combined treatment of RER + CS was more effective than TAU and CS alone for the treatment of patients with AD. This is the first study about the rehabilitation of affect recognition in AD.

TITLE: Rehabilitacion del reconocimiento de emociones combinada con estimulacion cognitiva para personas con enfermedad de Alzheimer. Eficacia sobre aspectos cognitivos y funcionales.Introduccion. Se han encontrado deficits en el reconocimiento de emociones en personas con enfermedad de Alzheimer (EA), pero no se ha informado de ningun tratamiento rehabilitador de esta capacidad en esta poblacion. Objetivo. Evaluar la eficacia de un tratamiento combinado de rehabilitacion del reconocimiento de emociones (RRE) y estimulacion cognitiva (EsC) sobre las funciones cognitivas, el estado de animo, la anosognosia, la capacidad funcional y el reconocimiento de emociones de personas con EA. Sujetos y metodos. En un diseño cuasi experimental, 36 pacientes con EA fueron asignados a tres condiciones: un grupo experimental, que recibio 20 sesiones de RRE y 20 sesiones de EsC; un grupo control, que recibio 40 sesiones de EsC, y un grupo que recibio tratamiento usual (GTU). Resultados. Completaron el estudio 32 pacientes, con una edad media de 77,53 ± 5,43 años. Se observo mejoria en el Minimental State Examination en su version de 30 items (F = 5,10; p = 0,013) y en la de 35 (F = 4,16; p = 0,026), reconocimiento de afectos (Z = ­2,81; p = 0,005) y actividades basicas de la vida diaria (Z = ­2,27; p = 0,018) a favor del grupo experimental. El grupo que recibio tratamiento usual empeoro en depresion (Z = ­1,99; p = 0,048), apatia (Z = ­2,30; p = 0,022) y anosognosia (Z = ­2,19; p = 0,028). Conclusiones. El tratamiento combinado de RRE y EsC fue mas eficaz que la EsC y que el tratamiento usual. Es la primera vez que se informa de un tratamiento rehabilitador del reconocimiento de emociones en personas con EA.