Urban environment and health: a cross-sectional multiregional project based on population health surveys in Spain (DAS-EP project) - study protocol.

INTRODUCTION: The European Environment Agency estimates that 75% of the European population lives in cities. Despite the many advantages of city life, the risks and challenges to health arising from urbanisation need to be addressed in order to tackle the growing burden of disease and health inequalities in cities. This study, Urban environment and health: a cross-sectional multiregional project based on population health surveys in Spain (DAS-EP project), aims to investigate the complex association between the urban environmental exposures (UrbEEs) and health. METHODS AND ANALYSIS: DAS-EP is a Spanish multiregional cross-sectional project that combines population health surveys (PHS) and geographical information systems (GIS) allowing to collect rich individual-level data from 17 000 adult citizens participating in the PHS conducted in the autonomous regions of the Basque Country, Andalusia, and the Valencian Community, and the city of Barcelona in the years 2021-2023. This study focuses on the population living in cities or metropolitan areas with more than 100 000 inhabitants. UrbEEs are described by objective estimates at participants' home addresses by GIS, and subjective indicators present in PHS. The health outcomes included in the PHS and selected for this study are self-perceived health (general and mental), prevalence of chronic mental disorders, health-related quality of life, consumption of medication for common mental disorders and sleep quality. We aim to further understand the direct and indirect effects between UrbEEs and health, as well as to estimate the impact at the population level, taking respondents' sociodemographic and socioeconomic characteristics, and lifestyle into consideration. ETHICS AND DISSEMINATION: The study was approved by the regional Research Ethics Committee of the Basque Country (Ethics Committee for Research Involving Medicinal Products in the Basque Country; PI2022138), Andalusia (Biomedical Research Ethics Committee of the Province of Granada; 2078-N-22), Barcelona (CEIC-PSMar; 2022/10667) and the Valencian Community (Ethics Committee for Clinical Research of the Directorate General of Public Health and Center for Advanced Research in Public Health; 20221125/04). The results will be communicated to the general population, health professionals, and institutions through conferences, reports and scientific articles.

Heteropteran Bugs Assemblage Associated to Organic Tomato Farms: Knowledge for Pest Management.

The suborder Heteroptera (Hemiptera) includes zoophagous and zoophytophagous species which conform diverse natural enemies' systems with potential to control several horticultural pests. In this study, we report the assemblage structure of heteropteran bugs species inhabiting open-field and greenhouse organic tomato crops and one common adjacent non-crop solanaceous plant, Solanum sisymbriifolium, in North Buenos Aires province, Argentina, aimed to select promissory biocontrol species. Biweekly direct inspection of selected plants was carried out during a 3-year period (2017-2019) to collect hemipteran nymphs and adults. As a result, nine species and morphospecies belonging to Berytidae (zoophytophagous), Lygaeidae (phytophagous), and Miridae (phytophagous and zoophytophagous) were found, with ≥ 75% of species belonging to the latter family. The zoophytophagous mirid Tupiocoris cucurbitaceus (Spinola) was the most frequent and dominant species in all sites studied. Among the phytophagous species, Nysius simulans Stål was mostly present in greenhouse crops. The community found in greenhouse tomato crops was more diverse than that registered in open-field crops. The characterization of the heteropteran complex in organic tomato farms provides basic knowledge necessary to design pest control strategies in the region studied.

Efectos neurobiológicos del estrés prenatal sobre el nuevo ser / Neurobiological effects of prenatal stress on the newborn

Prenatal stress (PS) has been mainly investigated in animal models. It could trigger permanent neurobiological changes in the offpring through fetal programming, displayed as behavioral, cognitive, anxious, affective and psychotic disorders during infancy and adulthood. Main effects of PS have been related to the functioning of hypothalamic-pituitary-adrenal axis (HPA), serotonergic, glutamatergic and GABAergic systems, cortical (prefrontal, temporal and insular cortex) and subcortical structures (amygdala, hippocampus), cerebellum and placenta. Glucocorticoids are the most recognized transmission factors of maternal-fetal stress, with distinctive effects according to the moment of action, developmental stage and fetal gender. Alteration pattern of the HPA axis by PS would be similar to the one observed in some mental disorders. Other neuromodulators involved in the neurotoxicity of PS are nitric oxide and brain derived neurotrophic factor, associated to synaptic potentiation and depression. Also, serotonergic system has an important relationship with HPA axis, verifyinga decreased number of serotonin transporters and an impaired placental synthesis of the neurotransmitter, essential for fetal neurodevelopment. Other epigenenomic mechanisms would be the modulation of synaptic plasticity by neurotrophins, adhesion and membrane molecules. Treatment with selective serotonin reuptake inhibitors has shown controversial outcomes. PS would affect fetal programming causing significant and permanent neurobiological alterations with clinical manifestations. This complex phenomenon must be further investigated, especially in human models.

El estrés prenatal (EP), investigado mayoritariamente en modelos animales, podría desencadenar modificaciones neurobiológicas permanentes en la descendencia mediante la programación fetal, manifestadas como alteraciones conductuales, cognitivas, ansiosas y afectivas, hasta trastornos psiquiátricos durante la niñez y la adultez. Los principales efectos del EP se han hallado en el eje hipotalámico-hipofisiario-adrenal (HHA), los sistemas serotoninérgicos, glutamatérgicos y GABAérgicos, y en estructuras nerviosas corticales (corteza prefrontal, temporal, insular), subcorticales (amígdala, hipocampo), cerebelo y placenta. Los glucocorticoides son los factores de transmisión de estrés materno-fetal más estudiados, con efectos diferenciales según la temporalidad de su acción, la fase del desarrollo y el sexo fetal. El patrón de alteración del eje HHA ante el EP sería similar al observado en algunos desórdenes mentales. Otros neuromoduladores involucrados en la neurotoxicidad del EP son el óxido nítrico y el factor neurotrófico derivado del cerebro, implicados en los procesos de potenciación y depresión sináptica. A su vez, el sistema serotoninérgico posee una relación intrínseca con el eje HHA, verificándose una disminución en la cantidad de transportadores de serotonina y una alteración de la síntesis placentaria del neurotransmisor, esencial para el neurodesarrollo fetal. Otros mecanismos epigenéticos serían la modulación de la plasticidad sináptica mediante neurotrofinas, moléculas de adhesión y de membrana. El tratamiento con inhibidores selectivos de la recaptura de serotonina ha demostrado resultados controvertidos. El EP afectaría a la programación fetal provocando alteraciones neurobiológicas significativas y permanentes con un correlato clínico. Mayor investigación y difusión es necesaria en este complejo fenómeno, sobre todo, en modelos humanos.

Mujer joven con nefritis lúpica y dengue / Young woman with lupus nephritis and dengue

Se reporta caso clínico de una mujer de 21 años con lupus eritematoso sistémico (LES) de diagnóstico reciente complicada con nefritis lúpica (NL) tratada en nuestro centro, con evolución favorable con inmunosupresores. Pero reingresa por dengue con signos de alarma del cual se recupera satisfactoriamente.

Clinical case of a 21 year old woman with complicated systemic lupus erythem atosus (SLE) recently diagnosed with lupus nephritis (LN) treated at our center, with favorable evolution immunosuppression reported. But readmitted because dengue of with warning signs, at present he is recovering satisfactorily

[Comparison of the use of isoproterenol or nitroglycerine during the Tilt test]. / Prueba de basculación (Tilt Table Testing): Comparación de dos protocolos: isoproterenol versus nitroglicerina.

BACKGROUND: There is debate about the advantages of different protocols usefulness of tilt test for the diagnosis of vasovagal collapse. AIM: To compare the sensitivity, specificity, adverse reactions, complications and time requirements of two different Tilt test protocols. MATERIAL AND METHODS: A Tilt test using isoproterenol in progressive doses (2 µg for 10 min and 5 µg for 5 min posteriorly was performed in 159 patients aged 9 to 84 years (59 males). Another Tilt test using sublingual nitroglycerine in doses of 0.3 mg was performed in 201 patients aged 8 to 87 years (62 males). Also, 20 healthy volunteers were tested. RESULTS: The positivity rates of the tests using isoproterenol and nitroglycerin were 75.5 and 77.6% respectively (NS). The figures for sensitivity were 98.4 and 99.3% (NS). The figures for specificity were 93.2 and 98.4% (NS). The test using isoproterenol requires 15 more minutes. As adverse reactions, 38% of participants experienced palpitations with isoproterenol and 22% experienced headache with nitroglycerin. CONCLUSIONS: The Tilt test with nitroglycerin is shorter, simpler, painless, with less personnel involved and has the same diagnostic accuracy than the test with isoproterenol.

Prueba de basculación (Tilt Table Testing): Comparación de dos protocolos: isoproterenol versus nitroglicerina / Comparison of the use of isoproterenol or nitroglycerine during the Tilt test

Background: There is debate about the advantages of different protocols usefulness of tilt test for the diagnosis of vasovagal collapse. Aim: To compare the sensitivity, specificity, adverse reactions, complications and time requirements of two different Tilt test protocols. Material and Methods: A Tilt test using isoproterenol in progressive doses (2 μg for 10 min and 5 μg for 5 min posteriorly was performed in 159 patients aged 9 to 84 years (59 males). Another Tilt test using sublingual nitroglycerine in doses of 0.3 mg was performed in 201 patients aged 8 to 87 years (62 males). Also, 20 healthy volunteers were tested. Results: The positivity rates of the tests using isoproterenol and nitroglycerin were 75.5 and 77.6% respectively (NS). The figures for sensitivity were 98.4 and 99.3% (NS). The figures for specificity were 93.2 and 98.4% (NS). The test using isoproterenol requires 15 more minutes. As adverse reactions, 38% of participants experienced palpitations with isoproterenol and 22% experienced headache with nitroglycerin. Conclusions: The Tilt test with nitroglycerin is shorter, simpler, painless, with less personnel involved and has the same diagnostic accuracy than the test with isoproterenol.

Factores clínico-epidemiológicos del síndrome del hombro doloroso en pacientes hemipléjicos. Instituto Nacional de Rehabilitación 2007 - 2011 / Factors clinical and epidemiological of the painful shoulder syndrome in hemiplegic patients. National Institute of Rehabilitation 2007 – 2011

Objetivos: Identificar y describir los factores clínicos y epidemiológicos del síndrome del hombro doloroso en pacientes hemipléjicos en el Instituto Nacional de Rehabilitación en el periodo comprendido del 2007-2011. Material y métodos: Estudio observacional, retrospectivo, transversal. Se estudiaron a 1138 pacientes y muestra de 278 (24.5 por ciento), con diagnóstico de hemiplejía con síndrome de hombro doloroso. Resultados: La etiología del hombro doloroso más frecuente fue tendinitis bicipital; intensidad EVA moderada. La etiología más frecuente del ECV fue isquémica, de tipo espástica; izquierdo. El factor de riesgo más frecuente fue hipertensión; de sexo varón. Conclusiones: La etiología del hombro doloroso más frecuente fue tendinitis bicipital, dolor moderado. La hemiplejia más frecuente fue espástica, izquierdo, isquémica, severa. Más frecuente en hipertensos, varones.

Objective: Identify and describe the clinical and epidemiological factors of the painful shoulder syndrome in hemiplegic patients at the National Institute of Rehabilitation in the period from 2007 to 2011. Material and Methods: A cross-sectional retrospective observational study was performed we studied 278 patients of the National Rehabilitation Institute diagnosed with hemiplegia and painful shoulder syndrome. Results: The etiology of shoulder pain was mostly by tendinitis bicipital. Most patients had moderate EVA (47.8 per cent). The most frequent etiology of hemiplegia was ischemic (67.3 per cent). had chronic at 36.2 per cent. 56.1 per cent had affected the left side of the body. 61.5 per cent had spastic. The gender were 57.6 per cent male. The mean age of patients studied was 62.9 years, 79.5 per cent of patients were hypertensive. Conclusions: The etiology of shoulder pain was mostly by tendinitis bicipital and moderate pain. Most patients had spastic hemiplegia of the left side of the body, ischemic, chronic. The greatest risk factor was hypertension, were men over 60 years.