Realistic scenarios of pesticide exposure alters multiple biomarkers in BOANA PULCHELLA (ANURA) Adult Frogs.

Imazethapyr, a post-emergent herbicide used in worldwide soybean and corn crops, induces genetic and biochemical alterations in aquatic vertebrates. This study examined the relationship between biomarkers at different organization levels and imazethapyr real-life route exposure in Boana pulchella adults. Frogs were exposed to imazethapyr-based formulation Pivot® H (10.59%) at concentrations representing possible acute routes: field runoff (S1:10 mg.L-1), exposure after direct foliar application (S2:100 mg.L-1) and during direct foliar application (S3:1000 mg.L-1). Post-exposure, endpoints levels were evaluated: organism alterations, biochemical activities and cytogenetic assays. Forty-eight hours post-exposure, antioxidant enzymes decrease, micronuclei induction and DNA damage were observed in all scenarios, while cholinesterase activity increase and body condition reduction were observed in frog-exposed to S3. Ninety-six hours post-exposure, frogs showed glutathione-S-transferase inhibition in S1, micronuclei induction in S2 and S3, and DNA-damage increase in S3. Herbicides routes of exposures in real-life could indicate that authorized applications have a risk to amphibian populations.

Multiple Level Effects of Imazethapyr on Leptodactylus latinasus (Anura) Adult Frogs.

Imazethapyr is an herbicide that is used in a variety of crops worldwide, including soybean and corn. The aim of the present study was to evaluate the biomarkers responses of adult Leptodactylus latinasus exposed to the formulation Pivot® H (10.59% imazethapyr) in the laboratory at concentrations and under conditions that simulate two potential field exposure scenarios: an immersion in field runoff (Scenario 1: 10 mg/L) and a direct exposure to the droplets emitted by spray noozles (Scenario 2: 1000 mg/L). In both scenarios, the experimental procedure involved completely immersing the frogs over a period of 15 s. Different endpoints were evaluated at several ecotoxicological levels 48 and 96 h after the herbicide exposure. These included individual (biometric indices and behavior alterations), histological (liver pigments and lesions), biochemical (catalase, glutathione system and cholinesterase activities) and genotoxic effects (micronuclei induction and nuclear abnormalities). Forty-eight hours after imazethapyr exposure, frogs submitted to Scenario 1 presented an inhibition of liver glutathione-S-transferase activity, whereas histological alterations and increased hepatic cholinesterase levels were observed in frogs exposed under Scenario 2. Ninety-six hours after exposure to the imazethapyr formulation, frogs from the Scenario 1 treatment presented a decrease in liver melanin and hemosiderin, increased hepatic catalase activity and micronuclei induction. For their part, frogs exposed to Scenario 2 presented a decrease in the hepatosomatic index, an increase in liver alterations, melanin reduction and micronuclei induction. The multivariate analysis enables correlations to be made between biomarkers of different organizational level in exposed anurans. Our result indicates that real exposure to imazethapyr formulations under field conditions may pose a risk to Leptodactylus latinasus populations living in the agroecosystems.

Epidemiologic changes in bloodstream infections in Andalucía (Spain) during the last decade.

OBJECTIVES: During the last decade, some changes in the epidemiology of invasive infections have been reported; however, specific studies with patient-level data are scarce. The aim of this study was to describe and evaluate the epidemiologic changes in bloodstream infections (BSI) during the last decade in Andalucía, Spain. METHODS: Data from two prospective cohorts of BSI in adults with the same methodology performed 10 years apart in 11 hospitals (eight tertiary and three community) in Andalucía, Spain, were compared; the 2006-7 cohort study was performed between October 2006 and March 2007, and the 2016-17 cohort study was performed between October 2016 and March 2017. Population-based incidence rates were calculated and extrapolated for 1 year. Relative risk ratios were calculated between the 2 periods. Multivariate analyses were performed by logistic regression. RESULTS: Overall, 1262 episodes of BSI were included, 563 (44.6%) in 2006-7 and 699 (55.3%) in 2016-17. Multivariate models selected the following changes in patients' features in 2016-17, after controlling for type of acquisition: higher age (odds ratio (OR) = 1.02; 95% confidence interval [CI] 1.01-1.03), lower urinary catheter (OR = 0.37; 95% CI, 0.26-0.48) and lower Pitt score (OR = 0.76; 95% CI, 0.71-0.82). Adjusted estimations considering patients' features and exposure to procedures showed a reduction in coagulase-negative staphylococci (OR = 0.47; 95% CI, 0.32-0.69), and an increase in Proteus spp. (OR = 3.12; 95% CI, 1.18-8.23) and Candida spp. (OR = 3.01; 95% CI, 1.03-8.86). CONCLUSIONS: We found relevant epidemiologic changes in BSI in our area, including rates, frequency of acquisition types, changes in patient's profiles and aetiologic agents.

A pragmatic approach for mortality prediction after surgery in infective endocarditis: optimizing and refining EuroSCORE.

OBJECTIVE: To simplify and optimize the ability of EuroSCORE I and II to predict early mortality after surgery for infective endocarditis (IE). METHODS: Multicentre retrospective study (n = 775). Simplified scores, eliminating irrelevant variables, and new specific scores, adding specific IE variables, were created. The performance of the original, recalibrated and specific EuroSCOREs was assessed by Brier score, C-statistic and calibration plot in bootstrap samples. The Net Reclassification Index was quantified. RESULTS: Recalibrated scores including age, previous cardiac surgery, critical preoperative state, New York Heart Association >I, and emergent surgery (EuroSCORE I and II); renal failure and pulmonary hypertension (EuroSCORE I); and urgent surgery (EuroSCORE II) performed better than the original EuroSCOREs (Brier original and recalibrated: EuroSCORE I: 0.1770 and 0.1667; EuroSCORE II: 0.2307 and 0.1680). Performance improved with the addition of fistula, staphylococci and mitral location (EuroSCORE I and II) (Brier specific: EuroSCORE I 0.1587, EuroSCORE II 0.1592). Discrimination improved in specific models (C-statistic original, recalibrated and specific: EuroSCORE I: 0.7340, 0.7471 and 0.7728; EuroSCORE II: 0.7442, 0.7423 and 0.7700). Calibration improved in both EuroSCORE I models (intercept 0.295, slope 0.829 (original); intercept -0.094, slope 0.888 (recalibrated); intercept -0.059, slope 0.925 (specific)) but only in specific EuroSCORE II model (intercept 2.554, slope 1.114 (original); intercept -0.260, slope 0.703 (recalibrated); intercept -0.053, slope 0.930 (specific)). Net Reclassification Index was 5.1% and 20.3% for the specific EuroSCORE I and II. CONCLUSIONS: The use of simplified EuroSCORE I and EuroSCORE II models in IE with the addition of specific variables may lead to simpler and more accurate models.

Toxic and genotoxic effects of the imazethapyr-based herbicide formulation Pivot H® on montevideo tree frog Hypsiboas pulchellus tadpoles (Anura, Hylidae).

Acute lethal and sublethal toxicity of the imidazolinone imazethapyr (IMZT)-based commercial formulation herbicide Pivot H® (10.59% IMZT) was evaluated on Hypsiboas pulchellus tadpoles. Whereas mortality was used as the end point for lethality, frequency of micronuclei (MNs) and other nuclear abnormalities as well as DNA single-strand breaks evaluated by the single cell gel electrophoresis assay were employed to test genotoxicity. Behavioral, growth, developmental, and morphological abnormalities were also employed as sublethal end points. Mortality studies revealed equivalent LC50 (96h) values of 1.49mg/L (confidence limit, 1.09-1.63) and 1.55mg/L (confidence limit, 1.51-1.60) IMZT for Gosner stage (GS) 25 and GS36, respectively. Behavioral changes, i.e., irregular swimming and immobility, as well as a decreased frequency of keratodonts were observed. The herbicide increased the frequency of MNs in circulating erythrocytes of tadpoles exposed for 48h to the highest concentration assayed (1.17mg/L). However, regardless of the concentration of the herbicide assayed, an enhanced frequency of MNs was observed in tadpoles exposed for 96h. The herbicide was able to induce other nuclear abnormalities, i.e., blebbed and notched nuclei, only when tadpoles were exposed for 96h. In addition, we observed that exposure to IMZT within the 0.39-1.17mg/L range increased the genetic damage index in treatments lasting for both 48 and 96h. This study represents the first evidence of acute lethal and sublethal effects exerted by IMZT on amphibians. Finally, our findings highlight the properties of this herbicide that jeopardize nontarget living species exposed to IMZT.

The genotoxic effects of the imidacloprid-based insecticide formulation Glacoxan Imida on Montevideo tree frog Hypsiboas pulchellus tadpoles (Anura, Hylidae).

The neonicotinoid insecticide imidacloprid (IMI) affects the insect central nervous system and is successfully applied to control pests for a variety of agricultural crops. In the current study, acute toxicity and genotoxicity of the IMI-containing commercial formulation insecticide Glacoxan Imida (35 percent IMI) was evaluated on Hypsiboas pulchellus (Anura: Hylidae) tadpoles exposed under laboratory conditions. A lethal effect was evaluated as the end point for lethality, whereas micronucleus (MN) frequency and DNA single-strand breaks evaluated by the single cell gel electrophoresis (SCGE) assay were employed as end points for genotoxicity. Sublethal end points were assayed within the 12.5-37.5mg/L IMI concentration range. Experiments were performed on tadpoles at stage 36 (range, 35-37) according to the classification proposed by Gosner. Lethality studies revealed an LC50 96h value of 52.622mg/L IMI. Increased frequency of MNs was only observed when 25.0mg/L was assayed for 96h, whereas no other nuclear abnormalities were induced. Increase of the genetic damage index was observed at 48h of treatment within the 12.5-37.5mg/L concentration range, whereas an increased frequency of DNA damage was observed only in tadpoles treated with 37.5mg/L IMI for 96h. This study represents the first evidence of the acute lethal and genotoxic effects exerted by IMI on tadpoles of an amphibian species native to Argentina under laboratory conditions.

Effectiveness of a colonoscopic screening programme in first-degree relatives of patients with colorectal cancer.

AIM: The study aimed to assess the diagnostic yield of a colonoscopy screening programme in first-degree relatives of colorectal cancer (CRC) patients and to identify factors associated with advanced neoplasia. METHOD: We conducted a cross-sectional study. Individual characteristics, family trees and colonoscopy findings of asymptomatic first-degree relatives of CRC patients were collected. The findings were classified into cancer (invasive carcinoma and/or non-invasive high-grade neoplasia), high-risk adenomas (≥ 10 mm and/or a villous component) and low-risk adenomas (tubular < 10 mm). The dependent variable was the presence of advanced neoplasia, defined as cancer and/or high-risk adenoma. RESULTS: Two hundred and sixty-three relatives (147 females), 50.0 ± 11.5 (range, 25-75) years of age, agreed to participate out of a total of 618 who were invited (acceptance rate 42.5%). Index cases were diagnosed at 63.8 ± 12.4 (range, 37-88) years of age. The closest familial relationship was parent/offspring in 168 (63.9%) participants and sibling in 95 (36.1%) participants; 14.8% had three or more relatives with CRC/cancer associated with Lynch syndrome, and two or more affected generations were identified in 24.0%. Advanced neoplasia was found in 56 (21.3%) participants. Of these, invasive cancer, non-invasive high-grade neoplasia and high-risk adenomas were detected in five (1.9%), six (2.3%) and 45 (17.1%) participants, respectively. Low-risk adenomas were detected in 20 (7.6%) participants. Male sex (odds ratio, 2.59; P = 0.003) and sibling relationship (odds ratio, 2.74; P = 0.001) were independently associated with advanced neoplasia. CONCLUSION: We detected advanced neoplasia in a considerable number of participants. Our data support colonoscopy screening in first-degree relatives of patients with CRC at an earlier age than in the medium-risk population. Male sex and sibling relationship were predictors of advanced neoplasia.

Bloqueadores del sistema renina angiotensina en pacientes con nefropatía por IgA: metanálisis de ensayos clínicos controlados / Renin angiotensin system blockers in patients with IgA nephropathy: Meta-analysis of controlled clinical trials

Antecedentes: No existe evidencia sólida sobre la eficacia del bloqueo del sistema renina angiotensina en la preservación de la función renal y en la disminución de la proteinuria y en la nefropatía por IgA. Método Se realizó un metanálisis de los ensayos clínicos controlados presentes en las bases de datos MEDLINE y Cochrane diseñados para demostrar la eficacia de los inhibidores de la enzima convertidora de angiotensina (IECA) y/o antagonistas de los receptores tipo 1 de la angiotensina ii (ARA II) en la preservación de la función renal y la reducción de la proteinuria en pacientes con nefropatía por IgA. Se excluyeron los que emplearan inmunosupresores. Se aplicó el índice de Jadad. Resultados Se seleccionaron 9 ensayos clínicos; de ellos 5 con Jadad de 3 o más. No se demostró reducción de la declinación del filtrado glomerular con IECA/ARA II cuando se analizaron todos los ensayos (DEM=−0,5415; IC 95%: −1,6057 a 0,5227); sin embargo, al repetir el análisis con los de más calidad sí se demostró (DEM=−1,1459; IC 95%: −2,2125 a −0,0794). El riesgo de progreso del daño renal fue menor en el grupo con IECA/ARA II utilizando el criterio de aumento del 50% de la creatinina (RR=0,28; IC 95%: 0,16 a 0,48) y llegada a enfermedad renal crónica terminal (RR=0,44; IC 95%: 0,26 a 0,73). Se observó reducción de la proteinuria a favor del tratamiento con IECA/ARA II (DEM=−2,94; IC 95%: −4,00 a −1,88) Se reportaron pocos acontecimientos adversos en relación a las diferentes opciones terapéuticas. Conclusiones Los IECA/ARA II, en monoterapia o combinados, parecen ser eficaces en la preservación de la función renal y en la reducción de la proteinuria en pacientes con nefropatía por IgA; aunque existe heterogeneidad entre los ensayos clínicos y sesgo de publicación (AU)

Background: No solid evidence has been found on the effectiveness of reninangiotensin system blockade in preserving renal function, in decreasing proteinuria and in IgAnephropathy. Method: A meta-analysis of controlled clinical trials found in MEDLINE and Cochranedatabases designed to demonstrate the efficacy of angiotensin converting enzyme (ACE) inhibitors and/or of the type I angiotensin II receptor antagonists (ARB) in preserving renal function and reducing proteinuria in patients with IgA nephropathy. Trials with immunosuppressants were excluded. We applied the Jadad index. Results: We selected 9 clinical trials; 5 with Jadad’s rating of 3 or more. No reduction in the glomerular filtration rate was demonstrated with ACEI/ARB when all the trials were analyzed (MSD¼ 0.5415, 95% CI: 1.6057 to 0.5227), however, when the analysis was repeated with better clinical trial quality, a decrease in the glomerular filtration rate was observed with these drugs (MSD¼ 1.1459, 95% CI: 2.2125 to 0.0794). The risk of progression of renal damage was lower in the ACE inhibitor/ARB group using the criterion of 50% increase in creatinine (RR¼0.28, 95% CI 0.16 to 0.48) and reaching the chronic end stage kidney disease (RR¼0.44, 95% CI 0.26 to 0.73). A reduction of proteinuria in favor of treatment with ACEI/ARB (MSD¼ 2.94, 95% CI: 4.00 to 1.88) was observed. Few adverse events were reported in relation to the different therapeutic options. Conclusions: ACE inhibitors/ARBs alone or in combination appear to be effective inpreserving renal function and in reducing proteinuria in patients with IgA nephropathy, although there is heterogeneity between clinical trials and publication bias (AU)

Síndrome metabólico en pacientes tratados con antipsicóticos de segunda generación en monoterapia / Metabolic syndrome in patients treated with second-generation antipsychotic medication monotherapy

Introducción: El objetivo de este trabajo es determinarla presencia de síndrome metabólico en pacientes atratamiento con nuevos antipsicóticos y comprobar quétratamiento reciben con el fin de corregir estas alteracionesmetabólicas.Métodos: Son seleccionados 44 pacientes en una unidadde salud mental, con diagnósticos de patologíasmentales diversos. Se diagnostican de síndrome metabólicosegún los criterios de la ATP-III.Resultados: Cumple criterios diagnósticos para síndromemetabólico un 25% de los pacientes incluidos enel estudio. Al menos el 80% de los pacientes con algunaalteración metabólica no recibe el tratamiento adecuado.Conclusiones: En caso de evidenciarse datos similaresen muestras de este tipo de población, implicaría lanecesidad de aplicar protocolos de tratamiento paramejorar la salud física de pacientes

Introduction: The aim of this study is to clarify thepresence of metabolic syndrome in patients treated withsecond-generation antipsychotic medication and tocheck what therapy they are having for these metabolicabnormalities.Methods: 44 patients at a mental health unit areincluded, with different mental disorders diagnosis.They are diagnosed with metabolic syndrome accordingto ATP-III diagnostic criteria.Results: Among the patients included in the study25% conform to the metabolic syndrome diagnostic criteria.At least 80% of the patients with some metabolicabnormality are not being appropriately treated.Conclusions: These data would imply the need toapply treatment guidelines In case of evidence of similardata in the same kind of population samples toimprove patients’ physic health (AU)

Pancreatitis autoinmune. A propósito de un caso / Autoimmune pancreatitis. Related to a case

La pancreatitis autoinmune es una reciente entidad a tener en cuenta en el diagnóstico diferencial de pancreatits crónica-masa pancreática. La presencia de estenosis difusa e irregular del Wirsung, junto con niveles elevados de IgG4, presencia de determinados autoanticuerpos e infiltración linfoplasmocitaria de páncreas son la clave del diagnóstico. La sospecha diagnóstica precoz y la colaboración multidisciplinar es vital en estos casos, ya que puede evitar cirugía innecesaria, puesto que el diagnóstico diferencial se establece con entidades entre las que se encuentra cáncer de páncreas, pancreatitis crónica, cirrosis biliar primaria o colangitis esclerosante primaria. Además, la pancreatitis autoinmune tiene excelente respuesta a tratamiento esteroideo, con resolución completa de parámetros clínicos, analíticos y radiológicos, como ocurría en nuestro paciente. Debido al escaso número de casos descritos en la Literatura, sería necesario la elaboración de estudios con seguimiento largo plazo para conocer pronóstico y frecuencia de asociación a otras patologías

Autoimmune pancreatitis is an entity that has recently been included in the differential diagnosis of chronic pancreatitis-pancreatic mass. The presence of diffuse, irregular Wirsung’s duct stenosis, together with high levels of IgG4, the existence of certain autoantibodies and lymphoplasmacytic infiltration of the pancreas are key factors in the diagnosis. An early diagnostic suspicion and multidisciplinary collaboration are vital in these cases to avoid unnecessary surgery as the differential diagnosis is established with such entities as pancreas cancer, chronic pancreatitis, primary biliary cirrhosis or primary sclerosing cholangitis. Autoimmune pancreatitis has an excellent response to steroid therapy, with complete resolution of clinical, analytical and radiological parameters, as occurred in our patient. The very few cases reported sofar suggest the need for the elaboration of long-term follow-up studies to determine the prognosis and frequency of its association with other diseases

[Autoimmune pancreatitis. Related to a case]. / Pancreatitis autoinmune. A propósito de un caso.

Autoimmune pancreatitis is an entity that has recently been included in the differential diagnosis of chronic pancreatitis-pancreatic mass. The presence of diffuse, irregular Wirsung's duct stenosis, together with high levels of IgG4, the existence of certain autoantibodies and lymphoplasmacytic infiltration of the pancreas are key factors in the diagnosis. An early diagnostic suspicion and multidisciplinary collaboration are vital in these cases to avoid unnecessary surgery as the differential diagnosis is established with such entities as pancreas cancer, chronic pancreatitis, primary biliary cirrhosis or primary sclerosing cholangitis. Autoimmune pancreatitis has an excellent response to steroid therapy, with complete resolution of clinical, analytical and radiological parameters, as occurred in our patient. The very few cases reported so far suggest the need for the elaboration of long-term follow-up studies to determine the prognosis and frequency of its association with other diseases.

Relación entre consumo de alcohol y rasgos atológicos de personalidad en una muestra de alumnos universitarios / Relationship between alcohol consumption and personality pathological traits in a sample of university students

Objetivo. La comorbilidad entre el abuso de alcohol y los trastornos de personalidad es un hecho frecuente. La mayor parte de los estudios investigan esta relación en poblaciones clínicas. El objetivo de este trabajo es establecer la prevalencia de consumo de alcohol entre una muestra sana compuesta por estudiantes universitarios. Material y métodos. Se obtiene una muestra de 240 estudiantes. Todos ellos completan el test de personalidad IDPE y el test para valorar el consumo de alcohol AUDIT. Resultados. Las mayores puntuaciones que relacionan rasgos de personalidad y consumo de alcohol ocurren en la personalidad paranoide, antisocial, límite e histriónica. Conclusiones. La prevalencia de probable dependencia de alcoholismo entre la muestra estudiada es escasa. Patrones de personalidad patológica y mayor consumo de alcohol también se observan en poblaciones sanas

Objetive. Comorbidity between alcohol abuse and personality disorders is a common fact. Research on this subject usually focuses on clinic populations. The objective is to establish the prevalence of alcohol use in a sample of healthy university students. Material and methods. A sample of 240 students was obtained. All of them had to complete the IPDE personality test and the AUDIT test in order to asses the alcohol use. Results. The highest scores relating personality traits to alcohol use were observed in paranoid, antisocial, borderline and histrionic personalities. Conclusions. Prevalence of probable alcohol abuse was low in the subject sample. Pathologic personality patterns and high alcohol use were also reported in healthy populations

Tratamiento de psicosis aguda con olanzapina en un paciente con agenesia del cuerpo calloso: un hallazgo incidental / Treatment of psychosis with olanzapine in a patient with agenesis of the corpus callosum: an incidental fiding

La agenesia del cuerpo calloso puede ser asintomática en algunos de los individuos con esta malformación cerebral. Se han descrito casos sobre la asociación de agenesia del cuerpo calloso y enfermedades mentales. Describimos el caso de un varón de 31 años con el hallazgo de agenesia del cuerpo calloso en la resonancia magnética y psicosis aguda según los criterios de la CIE 10, tratada con éxito con olanzapina

The agenesis of the corpues callosum may be asymptomatic in some of the individuals with this brain malformation. Cases about association of the agenesis of the corpus callosum and mental disorders have been reported. We report a case of 31 years old man with the finding of agenesis of the corpus callosum on magnetic resonance and acute psychosis using theICD 10ª diagnostic criteria, successfully treated with olanzapine

Mejoría de la asistencia a las primeras citas en psiquiatría tras aviso telefónico / Improvement of the attendance to the first psychiatric appointments after telephone reminder

Introducción: el incumplimiento de la cita en las consultas de psiquiatría y los factores relacionados con mayor riesgo de no asistencia han sido investigados. Se pretende valorar si una llamada telefónica recordatoria mejora el cumplimiento por parte de los pacientes en las primeras consultas de psiquiatría. Materia y método: Se diseña un estudio experimental aleatorizado, comparando la asistencia entre el grupo de intervención (n=106) y el grupo control (n=108). La muestra se obtiene de la totalidad de pacientes que se encuentran citados para una consulta de psiquiatría durante un período de tres meses. La intervención consiste en una llamada telefónica recordándole al paciente el día, hora y luegar de la consulta. Resultados: De los pacientes incluidos en el grupo llamada no acuden el 16,9% y en el grupo control el 34.3% (Chi2= 8,363; p= 0,004). En el análisis de regresión logística esta diferencia se mantiene significativa. Otras variables que se asocian a un mayor riesgo de incumplimiento son la edad temprana, sexo varón, y el hecho de no estar deacuerdo con la derivación al especialista. Conclusiones: La llamada telefónica realizada en los día previos a la consulta es una medida eficaz para mejorar la asistencia de los pacientes a su primera cita de psiquiatría programada. Aún así, un considerable número de pacientes no acude a la consulta a pesar de recibir este aviso. Las causas del incumplimiento son múltiples, y otras estrategias deben plantearse para disminuir la no asistencia

Introduction: The non attendance of the psychiatric appointment of the related factors with high risk of non attendance have been researched. It is sought to value if telephone reminders improves the compliance by the patients in the first psychiatric visits. Material and methods: An experimental, randomized study is designed, comparing the attendance among the intervention group (n=106) and the control group (n=108). The sample is obtained of all of the patients who have an appointment for a psychiatric consultation during a period of three months. The intervention consists on a telephone call reminding the patient the day moment and place of the appointment. Results: In the called group 16.9% of the patients did not attend and in the control group 34.3% (Chi2= 8,363; P=0,004). This difference stays significant in a logistical regression analysis. Other variables associated to a high risk of non attendance are the young age, male sex and the fact of not agreeing with be send to the specialist. Conclusions: The telephone call carried out in the previous days to the visit is an effective measure to improve the attendance for the first programmed psychiatric appointments. Even so, a considerable number of patients does not go to the appointment in spite of receiving this reminder. There are multiple causes of the non attendance, and other strategies should be designed to decrease the non compliance

Hipertensión arterial y su repercusión cardiovascular en pacientes con enfermedad renal poliquística autosómica dominante / High blood pressure and its cardiovascular repercussion in patients with autosomal dominant polycystic kidney disease

Introducción. La enfermedad renal poliquística autosómica dominante tiene una prevalencia del 10 % en los pacientes en hemodiálisis y se asocia frecuentemente a hipertensión arterial. El daño cardiovascular constituye la primera causa de muerte de estos pacientes. Material y método. Realizamos un estudio descriptivo mediante la revisión de 107 historias clínicas de pacientes con enfermedad renal poliquística autosómica dominante atendidos en el Instituto de Nefrología, entre octubre de 2004 y marzo de 2005, a fin de caracterizar las complicaciones de la hipertensión arterial. Resultados. Encontramos hipertensión arterial en el 82,2 % de los casos, 48,9 % en estadio 1 y 51,1 % en 2 atendiendo a las cifras de presión. La frecuencia de hipertensión arterial aumentó de forma evidente a medida que declinó la función renal (p = 0,024); el riesgo de tener deterioro significativo de la aclaración de creatinina fue mayor en los hipertensos (OR: 2,80 [IC 95 %: 1,01-7,70]; p = 0,041). El riesgo de daño cardiovascular también fue mayor en los hipertensos (OR: 3,58 [IC 95%: 1,02-9,08]; p = 0,027). A medida que aumentó el deterioro de la función renal hubo mayor frecuencia de daño cardiovascular, con una relación estadísticamente significativa (p = 0,001) y el riesgo de tener daño cardiovascular fue mayor en los pacientes con deterioro significativo de aclaración de creatinina (OR: 6,39 [IC 95%: 2,36-17,29]; p = 0,000). Discusión. La hipertensión arterial es frecuente en la enfermedad renal poliquística autosómica dominante y se asocia al deterioro de la función renal y al daño cardiovascular

Introduction. Autosomal dominant polycystic kidney disease has a prevalence of 10 % of patients in hemodialysis. It is frequently associated with high blood pressure. Cardiovascular damage is the first cause of these patients' death. Material and method. We carried out a descriptive study by means of the review of 107 clinic histories of patients with autosomal dominant polycystic kidney disease seen in the Institute of Nephrology, between October 2004 and March 2005, in order to characterize complications of high blood pressure. Result. We found high blood pressure in 82.2 % of cases, 48.9 % in stage 1 and 51.1 % in 2 according to pressure values. The frequency of high blood pressure clearly increased as renal function declined (p = 0,024). Likewise, the risk of having significant deterioration of creatinine clearance was greater in patients with high blood pressure [OR: 2.8 (95 % CI: 1.01-7.70); p = 0.041]. The risk of cardiovascular damage was also great in hypertensive patients (OR: 3.58 [95% CI: 1.02-9.08]; p = 0.027). As deterioration of renal function increased, there was greater frequency of cardiovascular damages, with statistically significant relationship (p = 0.001) and the risk of having cardiovascular damage increased in patients with significant deterioration of creatinine clearance (OR: 6.39 [95% CI: 2.36-17.29]; p = 0.000). Discussion. High blood pressure is frequent in patents with autosomal dominant polycystic kidney disease and it is associated with decreased renal function and cardiovascular damage

[Assessing the sexual functioning of chronic inpatients at a psychosocial rehabilitation unit]. / Valoración de la función sexual en pacientes psiquiátricos crónicos ingresados en una unidad de rehabilitación psicosocial.

INTRODUCTION: Most chronic inpatients at psychosocial rehabilitation units in our environment suffer some kind of psychosis. The sexual function in these patients has been studied little and the rate of sexual dysfunction studied in similar populations is very high. OBJECTIVES: To assess the sexual function of the inpatients at a psychosocial rehabilitation unit and to measure other clinical and demographic variables of these patients. METHODS: A sample of 46 inpatients was obtained in the psychosocial rehabilitation unit. Sexual function was assessed using the Changes in the Sexual Function Questionnaire (CSFQ). RESULTS: A high number of patients scored below the minimal normal score in the CSFQ (males: 87.9%; women: 87.5%). This implies a high prevalence of sexual dysfunction. CONCLUSIONS: The high percentage of patient with sexual dysfunction can be in connection with the severity of the disease that these patients suffer and with the side effects of the medication.

Valoración de la función sexual en pacientes psiquiátricos crónicos ingresados en una unidad de rehabilitación psicosocial / Assessing the sexual functioning of chronic inpatients

Introducción. La mayoría de pacientes crónicos ingresados en unidades de rehabilitación psicosocial en nuestro entorno padecen algún tipo de psicosis. La función sexual en estos pacientes está poco estudiada y la tasa de disfunción sexual estudiada en poblaciones similares es muy elevada. Objetivos. Valorar la función sexual de los pacientes internados en una unidad de rehabilitación psicosocial y medir otras variables clínicas y demográficas de estos pacientes. Métodos. Se obtiene una muestra de 46 pacientes ingresados en la unidad de rehabilitación. La función sexual se valora utilizando el Cuestionario para Cambios en la Función Sexual (CSFQ). Resultados. Un elevado número de pacientes puntúa en el CSFQ por debajo de los puntos de corte propuestos como normalidad (87,9 % de los varones y 87,5 % de las mujeres), lo que implica una alta prevalencia de disfunción sexual. Conclusiones. El alto porcentaje de pacientes con disfunción sexual puede estar en relación con la gravedad de la patología que padecen estos pacientes y con los efectos secundarios de la medicación

Introduction. Most chronic inpatients at psychosocial rehabilitation units in our environment suffer some kind of psychosis. The sexual function in these patients has been studied little and the rate of sexual dysfunction studied in similar populations is very high. Objectives. To assess the sexual function of the inpatients at a psychosocial rehabilitation unit and to measure other clinical and demographic variables of these patients. Methods. A sample of 46 inpatients was obtained in the psychosocial rehabilitation unit. Sexual function was assessed using the Changes in the Sexual Function Questionnaire (CSFQ). Results. A high number of patients scored below the minimal normal score in the CSFQ (males: 87.9 %; women: 87.5 %). This implies a high prevalence of sexual dysfunction. Conclusions. The high percentage of patient with sexual dysfunction can be in connection with the severity of the disease that these patients suffer and with the side effects of the medication

Polyinosinic acid induces TNF and NO production as well as NF-kappaB and AP-1 transcriptional activation in the monocytemacrophage cell line RAW 264.7.

OBJECTIVE: This study evaluates the poly inosinic acid (poly I)-induced activation in the murine monocytemacrophage cell line RAW 264.7, which led to an inflammatory phenotype. MATERIAL: RAW 264.7, and WEHI 164 cell lines were used. RESULTS: The activation process is characterized by the acquisition of a mature macrophage morphology and the production of inflammatory mediators tumor necrosis factor (TNF) and nitric oxide (NO). The activation by poly I has distinctive features. Thus, poly I induced an increase in nuclear factor kappaB (NF-kappaB) transcriptional activity due to a long-term degradation of inhibitory NF-kappaB (IkappaB) beta while lipopolysaccharide (LPS) induced the degradation of both IkappaBalpha and IkappaBbeta. Poly I also induced an increase in activator protein 1 (AP-1) transcriptional activity, possibly due to the activation of the mitogen activated protein kinases (MAPKs) ERK, Jun N terminal kinase (JNK) and p38. Dextran sulphate (DS) efficiently inhibited the activation induced by poly I including the production of the inflammatory mediators. Dextran sulphate also inhibited AP-1 and NF-kappaB transcriptional activities in poly I-stimulated cells. RAW 264.7 cells express macrophage scavenger receptor 1 (Msr1) type I and Msr1 type II that are differently up-regulated upon treatment with poly I. CONCLUSIONS: The results presented demonstrate that the well-known blocker of scavenger receptors poly I activates macrophages to produce TNF and NO, triggering specific signal transduction pathways.

Alcohol y abusos infantiles: la transmisión intergeneracional del alcoholismo / Alcohol abuse and child maltreatment: the intergenerational transmission of alcoholism

El objetivo del trabajo es presentar una breve revisión de la asociación entre abuso de alcohol, maltrato infantil y género y, por otra parte, la transmisión intergeneracional del alcoholismo

The objective of this study is to present a brief examination of the association between alcohol abuse, child maltreatment and gender and, by the other hand, the intergenerational transmission of alcoholism