Expression of neurokinin B/NK3 receptor and kisspeptin/KISS1 receptor in human granulosa cells.

STUDY QUESTION: Are neurokinin B (NKB), NK3 receptor (NK3R), kisspeptin (KISS1) and kisspeptin receptor (KISS1R) expressed in human ovarian granulosa cells? SUMMARY ANSWER: The NKB/NK3R and kisspeptin/KISS1R systems are co-expressed and functionally active in ovarian granulosa cells. WHAT IS KNOWN ALREADY: The NKB/NK3R and KISS1/KISS1R systems are essential for reproduction. In addition to their well-recognized role in hypothalamic neurons, these peptide systems may contribute to the control of fertility by acting directly on the gonads, but such a direct gonadal role remains largely unknown. STUDY DESIGN, SIZE, DURATION: This study analyzed matched mural granulosa cells (MGCs) and cumulus cells (CCs) collected from preovulatory follicles of oocyte donors at the time of oocyte retrieval. PARTICIPANTS/MATERIALS, SETTING, METHODS: The samples were provided by 56 oocyte donor women undergoing ovarian stimulation treatment. Follicular fluid samples containing MGCs and cumulus-oocyte complexes were collected after transvaginal ultrasound-guided oocyte retrieval. RT-PCR, quantitative real-time PCR, immunocytochemistry and western blot were used to investigate the pattern of expression of the NKB/NK3R and KISS/KISS1R systems in MGCs and CCs. Intracellular free Ca(2+) levels, [Ca(2+)]i, in MGCs after exposure to NKB or KISS1, in the presence or not of tachykinin receptor antagonists, were also measured. MAIN OUTCOME AND THE ROLE OF CHANCE: NKB/NK3R and KISS1/KISS1R systems were expressed, at the mRNA and protein levels, in MGCs and CCs, with significantly higher expression in CCs. Kisspeptin increased the [Ca(2+)]i in the cytosol of human MGCs while exposure to NKB failed to induce any change in [Ca(2+)]i. However, the [Ca(2+)]i response to kisspeptin was reduced in the presence of NKB. The inhibitory effect of NKB was only partially mimicked by the NK3R agonist, senktide and marginally suppressed by the NK3R-selective antagonist SB 222200. Yet, a cocktail of antagonists selective for the NK1, NK2 and NK3 receptors blocked the effect of NKB. LIMITATIONS, REASONS FOR CAUTION: The granulosa and cumulus cells were obtained from oocyte donors undergoing ovarian stimulation, which in comparison with natural cycles, may have affected gene and protein expression in granulosa cells. WIDER IMPLICATIONS OF THE FINDINGS: Our data demonstrate that, in addition to their indispensable effects at the central nervous system, the NKB/NK3R and kisspeptin/KISS1R systems are co-expressed and are functionally active in non-neuronal reproductive cells of the female gonads, the ovarian granulosa cells. STUDY FUNDING/ COMPETING INTERESTS: This work was supported by grants from Ministerio de Economía y Competitividad (CTQ2011-25564 and BFI2011-25021) and Junta de Andalucía (P08-CVI-04185), Spain. J.G.-O., F.M.P., M.F.-S., N.P., A.C.-R., T.A.A., M.H., M.R., M.T.-S. and L.C. have nothing to declare.

Mortalidad innecesariamente prematura y sanitariamente evitable en un Hospital General Básico / Unnecessary and avoidable healthcare-wise premature death in a basic general hospital

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[Readmission rate at a regional hospital]. / Tasa de reingresos de un hospital comarcal.

BACKGROUND: The purpose of this study is that of describing the frequency of re-admissions at the "Punta de Europa" Hospital in Algeciras. METHODS: The source of information employed was that of the Minimal Basic Hospital Admission Data Set (MBHADS) for 1995-1996, a total of 24,613 cases of hospitalization being analyzed. Re-admission has been defined as any admission entailing an identical major diagnosis within the 30 days following release from the hospital. A descriptive analysis has been made of the variables of age, sex, the unit/ward to which admitted and major diagnosis involved employing conventional single-variable techniques. RESULTS: The 30-day re-admissions rate was 5% (IC95% 4.8-5.2), totaling 3.4% (IC95% 3.2-3.6) if only the emergency re-admissions are taken into account. A higher probability of re-admission is related to males, to an older age to certain diagnoses and to the units/wards to which admitted. The units/wards showing the highest percentage of re-admissions were the Psychiatric Ward, Hematology and the Otolaryngology. The Units/Wards showing the lowest percentages of re-admissions were Ophthalmology, Traumatology and Obstetrics. The most frequent re-admissions diagnoses were: impending childbirth, AIDS and complications thereof, neoplasia of the bladder, unstable angina pectoris and paranoid schizophrenia. CONCLUSIONS: Hospital re-admissions are a useful indicator of the quality of health care which must be continued to be researched in our country, particularly after its having been included as an indicator of the public hospital program contracts in Andalusia. It is also deemed necessary to improve the definition of re-admission in said program contracts.

[Specific mortality rates at the Algeciras hospital during 1995-1996]. / Tasas específicas de mortalidad en el hospital de Algeciras durante el período 1995-1996.

BACKGROUND: In-hospital mortality has been proposed as an indicator of health care quality. It is also a fact that should be used for epidemiological monitoring and health planning. The aim of this work is to analyse the mortality in Algeciras Hospital, belonging to the Andalusia Health Authority. METHODS: A descriptive study was carried out of the patients discharged from hospital between January 1995 and December 1996, using discharge data and/or their medical record. The structure of the joint basic minimum data report on hospital discharge was used. The periods of hospitalisation were grouped into the diagnosis-related groups (DRGs). Following an initial analysis of all the periods of hospitalisation, the discharges of patients under 80 years of age were analysed and the risk of death in hospital in line with the reason for admission was set. RESULTS: In Algeciras Hospital between January 1995 and December 1996 a total of 24,194 episodes of hospitalisation and a 4.1% death rate were recorded. A higher death rate was observed for males (5.3%), as opposed to females (3.2%). (P < 0.01). There were 750 in-hospital deaths in patients under 80 years of age, with a continued higher mortality rate for males. The most frequent causes of deaths in this age group are: 66 deaths caused by cerebro-vascular disease (the probability of dying in this age group if the patients were admitted to hospital because of cerebro-vascular disease IC95% 0.12-0.19), 58 deaths due to AIDS (IC95% 0.09-0.15), 51% due to bronchial and lung neoplasias (IC95% 0.18-0.30), 49 deaths from acute myocardial infarction (IC95% 0.12-0.21), 39% as a result of chronic obstructive pulmonary disease (IC95% 0.07-0.14). CONCLUSIONS: The abundant information supplied by hospital mortality statistics is confirmed, especially if the age and illness of the patients involved is taken into account. There is an evident need for health policies to prevent HIV/AIDS, cerebro-vascular disease, lung cancer and ischaemic heart disease to be adopted in the Algeciras catchment area. Thus, there is a need to monitor and draw up new indicators of hospital mortality and to expand the list of unnecessarily premature and avoidable deaths with strictly hospital causes.

Absceso hipofisario. Comunicacion del caso de un paciente diagnosticado y operado con buenos resultados y revision de la literatura. / Hypophyseal abscess. Report of a case of a patient diagnosed and operated with satisfactory resutls. Review of the literature

Se presenta el caso de una paciente con un abscesso hipofisario, el cual fue diagnosticado durante el periodo preoperatorio y drenado por via transesfenoidal con buenos resultados. En la literatura medica se han comunicado 57 casos y, ademas del que se presenta, solamente hay uno en que fue diagnosticado antes de la operacion o la necropsia. La asociacion de manifestaciones de hipofuncion hipofisaria a la imagem radiografica de un tumor sillar y a meningoencefalitis repetida, es muy sugestiva de abscesso hipofisario. El tratamiento de eleccion es el drenaje transesfenoidal

Hipertension ortostatica primaria (sindrome de Shy-Drager). Estudio clinico-patologico de un caso. / Primary orthostatic hypotension (Shy-Drager syndrome). Clinico-pathological study of a case

Se presentan y discuten los resultados del estudio clinico-patologico realizado a un paciente que presentaba hipotension ortostatica primaria o idiopatica (HOI), enfermedad degenerativa poco frecuente del sistema nervioso en la cual se observa un cuadro clinico y patologico reconocible.Se llega a la conclusion de que la HOI se caracteriza por in cuadro clinico de curso progresivo y fatal en el cual se asocian a la hipotension ortostatica diversos sintomas y signos neurologicos que varian de un caso a otro. Desde el punto de vista patologico predominan las severas alteraciones degenerativas cronicas con perdida de neuromas, sobre todo en los nucleos pigmentados del tallo cerebral y en la porcion posterior de las columnas intermediolaterales de la medula espinal

Mielopatia por radiacion.Estudio clinicopatologico de un caso y revision de la literatura. / Myelopathy due to radiation: clinicopathologic study of a case and review of the literature

Se plantea que a un paciente de 58 anos de edad se le desarrollo mielopatia por radiacion al ano de ser operado e irradiado (6000r) por un carcinoma de amigdala y fallecio 2,5 meses despues por un tromboembolismo pulmonar. Tenia una hemiplejia de instalacion intermitente y progresiva, nivel sensitivo espinotalamico bilateral, y sensibilidad profunda normal. El estudio del LCR y la mielografia fueron normales.En la necropsia se encontro una lesion de la medula espinal desde C2 hasta C5; el dano afectaba predominantemente la sustancia blanca, sobre todo en los cordones laterales y de forma asimetrica.La lesion de los cordones anteriores, posteriores y de la sustancia gris eran de menor intensidad Habia graves lesiones en las pequenas arterias y arteriolas, muchas de las cuales estaban trombosadas. En el caso que presentamos, la forma de aparicion de los sintomas neurologicos orienta hacia un trastorno vascular, y la intensidad del dano de los vasos puede explicar la extension de la necrosis. Se discute el caso y se revisa la literatura

Degeneración hapatolenticular (enfermedad de Wilson). Estudio de 7 casos / Hepatolenticular degeneration (Wilson's disease). A report of seven cases

Se realiza un estudio de siete pacientes con el diagnóstico de degeneración hepatolenticular (enfermedad de Wilson). La edad de comienzo de los síntomas en todos los casos siempre fue por debajo de los 30 años. En 5 de los pacientes se recogen antecedentes familiares de enfermedad similar y en dos de ellos había consanguinidad entre los padres. El síntoma inicial más frecuente fue el temblor, en tres casos. Se encontraron alteraciones del sistema extrapiramidal en todos los casos y el patognomónico anillo corneal de Kayser-Fleischer en 6 casos. En tres casos se detectan signos y síntomas de hepatopatía. La inteligencia estaba disminuida en tre casos. Los valores de la ceruloplasmina estuvieron por debajo de los 10 mg en 5 casos(AU)

[Primary amebic meningoencephalitis. Report of a suspicious case and review of the medical literature]. / Meningoencefalitis amebiana primaria. Estudio de un caso sospechoso y revisión de la literatura médica.

The case of a 24-year old patient who, in July 1976, submerged into a canal of Guanimar river and, five days later, had a febrile meningoencephalitic clinical picture, is presented; he was in a very severe condition and recovered without sequelae with a treatment based on amphotericin B. The negative cultures for bacteria, fungi and viruses, the characteristics of cerebrospinal fluid and the observation of free-life amebae in the water of the wash of rhinopharynx and pharingeal cavity allowed to establish, with great accuracy, the presuntive diagnosis of primary amebic meningoencephalitis.