Evaluation of the catalytic activity of Zn-MOF-74 for the alcoholysis of cyclohexene oxide.

In the present work, nanocrystalline Zn-MOF-74 is shown to be a heterogeneous catalyst for the acid-catalyzed ring-opening alcoholysis of cyclohexene oxide. The results corroborated that accessible open metal sites within the material are critical conditions (Zn(ii) Lewis acid sites) for this reaction. Zn-MOF-74 was tested at three different temperatures (30, 40, and 50 °C) for the alcoholysis reaction. Furthermore, the cyclohexene oxide conversion was 94% in less than two days. A comparison of the catalytic activity with different crystal sizes of Zn-MOF-74 and the homogenous phase, zinc acetate, was conducted. Zn-MOF-74 exhibited excellent catalytic cyclability for three cycles without losing its activity. The material showed chemical stability by retaining its crystalline structure after the reaction and cyclability process.

SU-101: a Bi(III)-based metal-organic framework as an efficient heterogeneous catalyst for the CO2 cycloaddition reaction.

A non-porous version of SU-101 (herein n-SU-101) was evaluated for the CO2 cycloaddition reaction. The findings revealed that open metal sites (Bi3+) are necessary for the reaction. n-SU-101 displays a high styrene oxide conversion of 96.6% under mild conditions (3 bar and 80 °C). The catalytic activity of n-SU-101 demonstrated its potential application for the cycloaddition of CO2 using styrene oxide.

Eficacia y distribución de los golpes finalistas de ataque en pádel profesional / Effectiveness and Distribution of Attack Strokes to Finish the Point in Professional Padel

El objetivo de este estudio fue analizar la distribución y la eficacia de los golpes finalistas de ataque en el pádel profesional en función de la distancia de golpeo a la red y el género de los jugadores. La muestra incluyó 633 acciones técnico-tácticas de ataque que finalizaron el punto. Las variables analizadas fueron: acciones técnico-tácticas de ataque, eficacia del golpe y distancia a la red. Los partidos fueron analizados a través de observación sistemática. Los resultados mostraron que los hombres utilizan significativamente más el remate potente para finalizar el punto, mientras que las mujeres utilizan significativamente más la bandeja. Además, el mayor porcentaje de acciones finalistas se produce en zonas cercanas a la red (2-4metros), en ambos géneros. Finalmente, las acciones de ataque más efectivas para conseguir punto son los remates, aunque la eficacia de las acciones disminuye a medida que los jugadores se alejan de la red. (AU)

The aim of this study was to analyze the distribution and efficacy of technical attack actions on professional padel regarding to net distance and to compare the results with players’ gender. The sample included 633 attack strokes used to finish the point in padel, corresponding to 8 matches during the official World Padel Tour 2019. The variables analyzed were: attack strokes, effectiveness and net distance. Matches were analyzed through systematic observation. The results showed that men use significantly more powerful smash to finish the point in padel, while women use significantly more tray strokes. In addition, the highest percentage of strokes to finish the point appears in areas close to the net, between 2 and 4 meters from the net distance, in both the men's and women's categories. Finally, the most effective attack actions to achieve success in paddle tennis is the smash, well above the volleys, although the effectiveness of the actions is lower when players move away from the net. (AU)

El modelo Clinical outcomes, healthcare resource utilization, and related costs (COHERENT). Aplicación en pacientes con insuficiencia cardiaca / The Clinical outcomes, healthcare resource utilization, and related costs (COHERENT) model. Application in heart failure patients

Introducción y objetivos: Los resultados combinados se utilizan ampliamente, pero tienen diversas limitaciones. El modelo Clinical outcomes, healthcare resource utilization and related costs (COHERENT) es una aproximación nueva para presentar y comparar visualmente todos los componentes de los resultados combinados (incidencia, tiempo, duración) y los costes relacionados. El objetivo es evaluar su utilidad en una cohorte de pacientes. Métodos: Se diseñó un sistema de colores que representa gráficamente el porcentaje de pacientes en cada situación clínica (estado vital y ubicación: domicilio, urgencias, hospital), codificada jerárquicamente, en cada momento del seguimiento. Se aplicó a 1.126 pacientes con insuficiencia cardiaca aguda de 25 hospitales seguidos durante 30 días tras su visita a urgencias, y se calculó el tiempo en cada situación clínica y sus costes sanitarios. Resultados: El modelo ilustra visualmente los componentes del objetivo combinado a los 30 días (el 2,12% en urgencias, el 23,6% en hospitalización índice, el 2,7% en reingresos, el 65,5% vivo en casa y el 6,02% fallecido) y muestra diferencias significativas entre grupos de pacientes, hospitales o sistemas sanitarios. El instrumento también calcula y muestra los costes diarios y acumulados (total, 4.895.070 euros; media, 144,91 euros/paciente/día). Conclusiones: El modelo COHERENT es un nuevo método para mostrar visualmente resultados combinados y sus costes que permite comparar grupos de pacientes y cohortes. El nuevo sistema puede ser útil como un nuevo criterio de valoración para ensayos clínicos o estudios observacionales, y un instrumento para la evaluación comparativa, la planificación clínica, el análisis económico y la implementación de la atención sanitaria basada en valor (AU)

Introduction and objectives: Composite endpoints are widely used but have several limitations. The Clinical outcomes, healthcare resource utilization and related costs (COHERENT) model is a new approach for visually displaying and comparing composite endpoints including all their components (incidence, timing, duration) and related costs. We aimed to assess the validity of the COHERENT model in a patient cohort. Methods: A color graphic system displaying the percentage of patients in each clinical situation (vital status and location: at home, emergency department [ED] or hospital) and related costs at each time point during follow-up was created based on a list of mutually exclusive clinical situations coded in a hierarchical fashion. The system was tested in a cohort of 1126 patients with acute heart failure from 25 hospitals. The system calculated and displayed the time spent in each clinical situation and health care resource utilization-related costs over 30 days. Results: The model illustrated the times spent over 30 days (2.12% in ED, 23.6% in index hospitalization, 2.7% in readmissions, 65.5% alive at home, and 6.02% dead), showing significant differences between patient groups, hospitals, and health care systems. The tool calculated and displayed the daily and cumulative health care-related costs over time (total, €4 895 070; mean, €144.91 per patient/d). Conclusions: The COHERENT model is a new, easy-to-interpret, visual display of composite endpoints, enabling comparisons between patient groups and cohorts, including related costs. The model may constitute a useful new approach for clinical trials or observational studies, and a tool for benchmarking, and value-based health care implementation (AU)

Comorbidity, poverty and social vulnerability as risk factors for mortality in pregnant women with confirmed SARS-CoV-2 infection: analysis of 13 062 positive pregnancies including 176 maternal deaths in Mexico.

OBJECTIVE: Mortality in pregnancy due to coronavirus disease 2019 (COVID-19) is a current health priority in developing countries. Identification of clinical and sociodemographic risk factors related to mortality in pregnant women with COVID-19 could guide public policy and encourage such women to accept vaccination. We aimed to evaluate the association of comorbidities and socioeconomic determinants with COVID-19-related mortality and severe disease in pregnant women in Mexico. METHODS: This is an ongoing nationwide prospective cohort study that includes all pregnant women with a positive reverse-transcription quantitative polymerase chain reaction result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the Mexican National Registry of Coronavirus. The primary outcome was maternal death due to COVID-19. The association of comorbidities and socioeconomic characteristics with maternal death was explored using a log-binomial regression model adjusted for possible confounders. RESULTS: There were 176 (1.35%) maternal deaths due to COVID-19 among 13 062 consecutive SARS-CoV-2-positive pregnant women. Maternal age, as a continuous (adjusted relative risk (aRR), 1.08 (95% CI, 1.05-1.10)) or categorical variable, was associated with maternal death due to COVID-19; women aged 35-39 years (aRR, 3.16 (95% CI, 2.34-4.26)) or 40 years or older (aRR, 4.07 (95% CI, 2.65-6.25)) had a higher risk for mortality, as compared with those aged < 35 years. Other clinical risk factors associated with maternal mortality were pre-existing diabetes (aRR, 2.66 (95% CI, 1.65-4.27)), chronic hypertension (aRR, 1.75 (95% CI, 1.02-3.00)) and obesity (aRR, 2.15 (95% CI, 1.46-3.17)). Very high social vulnerability (aRR, 1.88 (95% CI, 1.26-2.80)) and high social vulnerability (aRR, 1.49 (95% CI, 1.04-2.13)) were associated with an increased risk of maternal mortality, while very low social vulnerability was associated with a reduced risk (aRR, 0.47 (95% CI, 0.30-0.73)). Being poor or extremely poor were also risk factors for maternal mortality (aRR, 1.53 (95% CI, 1.09-2.15) and aRR, 1.83 (95% CI, 1.32-2.53), respectively). CONCLUSION: This study, which comprises the largest prospective consecutive cohort of pregnant women with COVID-19 to date, has confirmed that advanced maternal age, pre-existing diabetes, chronic hypertension, obesity, high social vulnerability and low socioeconomic status are risk factors for COVID-19-related maternal mortality. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

An study on the influence of collagen fiber directions in TAVs performance using FEM.

Transcatheter Aortic Valve Implantation (TAVI) or Replacement (TAVR) is a promising treatment for aortic valve stenosis, consisting of a procedure to replace a damaged native aortic valve by a bioprosthetic one. This replacement valve control the flow of blood using leaflets that are similar to the ones of a native aortic valve. Commonly manufactured using bovine or porcine pericardium, it is a tissue histologically composed of collagen fibers embedded into a nearly-isotropic matrix, where their distribution makes the pericardium behave as an anisotropic hyperelastic material. Because of such complicated behavior, bioprosthetic pericardium valves are, as expected, sensitive to the distribution and orientation of these fibers in such device. Therefore, the objective of this work is a thorough systematic study on the influence of these fibers' distribution. First, a Finite Element model of a bioprosthetic valve is generated; then, a material routine to accurately describe the behavior of pericardium is implemented in a commercial software package; in addition, a dedicated algorithm to specify the direction of fibers is developed. Finally, a systematic study on the influence that fiber orientations have on the overall behavior of the TAV is performed. As a result of this study, two extreme behaviors are highlighted depending on the preferential orientation of collagen fibers; namely, one with fibers in circumferential direction and the opposite with fibers in an axial orientation. Then, it is concluded that the behavior of fibers in circumferential direction is very sensitive to small variations of the orientation angle, whereas such orientation is not as determining when the aim is to achieve a behavior near to the one corresponding with axial orientation.

The Mars Environmental Dynamics Analyzer, MEDA. A Suite of Environmental Sensors for the Mars 2020 Mission.

NASA's Mars 2020 (M2020) rover mission includes a suite of sensors to monitor current environmental conditions near the surface of Mars and to constrain bulk aerosol properties from changes in atmospheric radiation at the surface. The Mars Environmental Dynamics Analyzer (MEDA) consists of a set of meteorological sensors including wind sensor, a barometer, a relative humidity sensor, a set of 5 thermocouples to measure atmospheric temperature at ∼1.5 m and ∼0.5 m above the surface, a set of thermopiles to characterize the thermal IR brightness temperatures of the surface and the lower atmosphere. MEDA adds a radiation and dust sensor to monitor the optical atmospheric properties that can be used to infer bulk aerosol physical properties such as particle size distribution, non-sphericity, and concentration. The MEDA package and its scientific purpose are described in this document as well as how it responded to the calibration tests and how it helps prepare for the human exploration of Mars. A comparison is also presented to previous environmental monitoring payloads landed on Mars on the Viking, Pathfinder, Phoenix, MSL, and InSight spacecraft.

Pregnant women with SARS-CoV-2 infection are at higher risk of death and pneumonia: propensity score matched analysis of a nationwide prospective cohort (COV19Mx).

OBJECTIVE: There are limited, unmatched data reporting low complication rates in pregnant women with coronavirus disease 2019 (COVID-19). The aim of this study was to compare COVID-19-related outcomes between pregnant and non-pregnant women after adjusting for potential risk factors for severe outcomes. METHODS: Data were obtained from the COVID-19 National Data Registry of Mexico, which is an ongoing prospective cohort of people of any age with clinically suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and admitted to 475 monitoring hospitals. This study included pregnant and non-pregnant women of reproductive age (15-45 years) with COVID-19 confirmed by reverse transcription polymerase chain reaction. To adjust for underlying risk factors, propensity score matching was conducted for chronic obstructive pulmonary disease, asthma, smoking, hypertension, cardiovascular disease, obesity, diabetes, chronic renal disease, immunosuppression, age, language, nationality and level of health insurance. The primary outcome was death. Secondary outcomes were pneumonia, intubation and intensive care unit (ICU) admission. RESULTS: The cohort comprised 5183 pregnant and 175 905 non-pregnant women with COVID-19. The crude (unmatched) rates of death, pneumonia, intubation and ICU admission in pregnant compared with non-pregnant women were 1.5% vs 1.5%, 9.9% vs 6.5%, 8.1% vs 9.9% and 13.0% vs 6.9%, respectively. After propensity score matching (5183 pregnant and 5183 non-pregnant matched women), pregnant women had a higher odds of death (odds ratio (OR), 1.84; 95% CI, 1.26-2.69), pneumonia (OR, 1.86; 95% CI, 1.60-2.16) and ICU admission (OR, 1.86; 95% CI, 1.41-2.45) than non-pregnant women, but similar odds of intubation (OR, 0.93; 95% CI, 0.70-1.25). CONCLUSION: After adjusting for background demographic and medical factors, pregnancy is a risk factor for death, pneumonia and ICU admission in SARS-CoV-2-infected women of reproductive age. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.

In cardiac fibroblasts, interferon-beta attenuates differentiation, collagen synthesis, and TGF-ß1-induced collagen gel contraction.

Cardiac fibroblasts (CF) play a key role in the homeostasis of the extracellular matrix in cardiac tissue and are newly recognized as inflammatory supporter cells. Besides, CF-to-Cardiac myofibroblast differentiation is commanded by TGF-b, through SMAD signaling pathways, and these last cells are strongly implicated in cardiac fibrosis. In the heart IFN-ß is produced by CF; however, the role of IFN-ß, STAT proteins, and STAT-homo or heterodimers in the regulation of CF function with or without a fibrotic environment is unknown. CF were isolated from hearts of adult rats, and by western blot analysis we studied STAT1, STAT2, and STAT3 phosphorylation and through specific siRNA against these proteins we analyzed their role in CF functions such as differentiation (α-SMA expression); and pro-collagen type-I synthesis and secretion expression levels; collagen gels contraction and CF migration. In cultured adult rats CF, IFN-ß increases phosphorylation of STAT1, STAT2, and STAT3. Both STAT1 and STAT2 were involved in decreasing α-SMA and CF migration induced by TGF-ß1. Also, IFN-ß through STAT1 regulated pro-collagen type-I protein expression levels, and collagen gels contraction induced by TGF-ß1. STAT3 was not involved in any effects of IFN-ß studied. In conclusion, IFN-ß through STAT1 and STAT2 shows antifibrotic effects on CF TGF-ß1-treated, whereas STAT3 did not participate in such effect.

TGF-ß1 decreases CHOP expression and prevents cardiac fibroblast apoptosis induced by endoplasmic reticulum stress.

Transforming growth factor-beta 1 (TGF-ß1) is a cytokine with marked pro-fibrotic action on cardiac fibroblasts (CF). TGF-ß1 induces CF-to-cardiac myofibroblast (CMF) differentiation, defined by an increase in α-smooth muscle cells (α-SMA), collagen secretion and it has a cytoprotective effect against stimuli that induce apoptosis. In the Endoplasmic Reticulum (ER) lumen, misfolded protein accumulation triggers ER stress and induces apoptosis, and this process plays a critical role in cell death mediated by Ischemia/Reperfusion (I/R) injury and by ER stress inducers, such as Tunicamycin (Tn). Here, we studied the regulation of CHOP, a proapoptotic ER-stress-related transcription factor in CF under simulated I/R (sI/R) or exposed to Tn. Even though TGF-ß1 has been shown to participate in ER stress, its regulatory effect on CF apoptosis and ER stress-induced by sI/R or TN has not been evaluated yet. CF from neonatal rats were exposed to sI/R, and cell death was evaluated by cell count and apoptosis by flow cytometry. ER stress was assessed by western blot against CHOP. Our results evidenced that sI/R (8/24) h or Tn triggers CF apoptosis and an increase in CHOP protein levels. TGF-ß1 pre-treatment partially prevented apoptosis induced by sI/R or Tn. Furthermore, TGF-ß1 pre-treatment completely prevented CHOP increase by sI/R or Tn. Additionally, we found a decrease in α-SMA expression induced by sI/R and in collagen secretion induced by Tn, which were not prevented by TGF-ß1 treatment. In conclusion, TGF-ß1 partially protects CF apoptosis induced by sI/R or Tn, through a mechanism that would involve ER stress.

Infarto talámico en un paciente con aneurisma del septo interventricular / Thalamic stroke in a patient with membranous interventricular septal aneurysm

No disponible

Mitogenome of the blood feeding leech Haementeria acuecueyetzin (Hirudinida: Glossiphoniidae) from Tabasco, Mexico.

Here, we present the mitogenome of the blood feeding leech Haementeria acuecueyetzin (Hirudinida: Glossiphoniidae) based on specimens collected in Tabasco, Mexico. The circular genome is 14,985 bp in length, and consists of 13 protein-coding genes, 22 tRNA genes, two rRNA genes, and an AT-rich control region. Phylogenetic analysis based on the 13 protein-coding genes and two rRNA genes places H. acuecueyetzin sister to H. officinalis within the family Glossiphoniidae. Mitochondrial gene order in H. acuecueyetzin is consistent with other members of Clitellata with no evidence of gene gain/loss, duplication, or rearrangement.

Emergence of inflammatory bowel disease during treatment with sitagliptin / Debut de enfermedad inflamatoria intestinal durante el tratamiento con sitagliptina

We present one clinical case of diagnosed inflammatory bowel disease, as a probable adverse reaction to sitagliptin. Sitagliptin is a dipeptidylpeptidase (DPP)-4 inhibitor authorised for the type II diabetes mellitus treatment in adult patients who do not achieve good blood glucose control and if other therapeutic alternatives are not correctly tolerated. In addition to the DPP-4 role in the gastric hormones release and glucose homeostasis, the DPP-4 involvement in the inflammatory response is known. However, the relationship between inflammatory bowel disease (IBD) and inhibition of PPD-4 is controversial. On the one hand, the T lymphocytes of patients with this pathology seem to express high levels of the enzyme DPP-4, so their inhibition could be associated with a decrease in the activity of IBD. On the other hand, in a cohort study of patients treated with oral antidiabetics an increased risk of IBD was observed and there are different published cases of IBD occurrence during the use of sitagliptin

Presentamos un caso de debut de enfermedad inflamatoria intestinal (EII) como probable reacción adversa a la administración de sitagliptina. Sitagliptina es un inhibidor de la dipeptidilpeptidasa 4 (DPP-4) autorizado para el tratamiento de la diabetes mellitus tipo II en pacientes adultos que no consiguen buen control de la glucemia, o si el resto de alternativas terapéuticas no son bien toleradas. Además del papel de la DPP-4 en la liberación de hormonas gástricas y en la homeostasis de la glucosa, se sabe que esta enzima también está implicada en la respuesta inflamatoria. Sin embargo, la relación entre la EII y la inhibición de la DPP-4 es controvertida. Por un lado, los linfocitos T de los pacientes con esta patología parecen expresar altos niveles de la enzima DPP-4, por lo que su inhibición se podría asociar a un descenso en la actividad de la EII. Por otro lado, en un estudio de cohortes de pacientes tratados con antidiabéticos orales se observó un aumento del riesgo de EII y existen diferentes casos publicados de aparición de IBD durante el uso de sitagliptina

Calidad de vida relacionada con la salud en pacientes oncológicos con enfermedad tromboembólica venosa aguda sintomática. Diseño del estudio qca (quality of life in cancer). Estudio de casos y controles / Health-related quality of life in cancer patients with acute symptomatic venous thromboembolic disease. Design of the QCa (quality of life in cancer) study. Case-control study

La asociación entre cáncer y enfermedad tromboembólica (ETV) se encuentra bien establecida. La ETV presenta una elevada morbimortalidad, objetivándose un incremento del riesgo de ETV hasta 4 veces mayor en aquellos pacientes con cáncer respecto a la población general. Sin embargo, existe poca evidencia científica sobre la CVRS (calidad de vida relacionada con la salud) en pacientes oncológicos con ETV, cuando es presumible que esta patología suponga un agravante sobre la percepción del estado de salud de los pacientes oncológicos. Nuestro objetivo es presentar el estudio "QCa Study", el cual pretende evaluar la CVRS de los pacientes oncológicos con ETV aguda sintomática en comparación con pacientes oncológicos sin ETV. "QCa study" es un estudio nacional de cohortes, prospectivo, de casos y controles en pacientes con cáncer activo. Definimos "caso" como aquel paciente oncológico con ETV aguda sintomática, y "control" aquel paciente oncológico sin ETV aguda sintomática. Los criterios de inclusión son: para los casos: presentar cáncer activo al momento de la inclusión. Tener más de 18 años, pacientes diagnosticados de trombosis venosa profunda (TVP) en miembros inferiores aguda sintomática o de embolia de pulmón (EP) confirmado de forma objetiva mediante pruebas de imagen y firma del consentimiento informado. Para los controles; presentar cáncer activo. Tener más de 18 años. Firma del consentimiento informado. Dado los escasos datos publicados respecto a la CVRS en pacientes con ETV, hemos diseñado el estudio Qca, para poder determinar el impacto que genera la ETV en la calidad de vida de los pacientes con cáncer

The association between cancer and venous thromboembolic disease (VTD) is well established. VTD presents a high rate of morbidity and mortality, with patients with cancer showing an increased risk of VTD that is up to 4 times greater than the general population. However, there is little scientific evidence on HRQoL (health-related quality of life) in cancer patients with VTD when this disease is likely to be an aggravating factor in perceived state of health among cancer patients. Our objective is to present the QCa study, which aims to evaluate the HRQoL of cancer patients with acute symptomatic VTD in comparison with cancer patients without VTD. The QCa study is a prospective, case-control national cohort study in patients with active cancer. We define "case" as a cancer patient with acute symptomatic VTD and "control" as a cancer patient without acute symptomatic VTD. Inclusion criteria for cases were: having active cancer at the time of inclusion, being over the age of 18, patients diagnosed with acute symptomatic deep vein thrombosis (DVT) in the lower extremities or pulmonary embolism (EP) that was objectively confirmed through imaging tests, and having signed the informed consent. For the controls: having active cancer, being over the age of 18, and having signed the informed consent. Given the scarce data published with regard to HRQoL in patients with VTD, we designed the QCa study to determine the impact VTD has on the quality of life of patients with cancer

A biosensor capable of identifying low quantities of breast cancer cells by electrical impedance spectroscopy.

Breast cancer (BC) is a malignant disease with a high prevalence worldwide. The main cause of death is not the primary tumor, but instead the spread of tumor cells to distant sites. The aim of the present study was to examine a new method for the detection of cancer cells in aqueous medium using bioimpedance spectroscopy assisted with magnetic nanoparticles (MNP's) exposure to a constant magnetic field. The spectroscopic patterns were identified for three breast cancer cell lines. Each BC cell line represents a different pathologic stage: the early stage (MCF-7), invasive phase (MDA-MB-231) and metastasis (SK-BR-3). For this purpose, bioimpedance measurements were carried out at a certain frequency range with the aid of nanoprobes, consisting of magnetic nanoparticles (MNPs) coupled to a monoclonal antibody. The antibody was specific for the predominant cell surface protein for each cell line, which was identified by using RT-qPCR and flow cytometry. Accordingly, EpCAM corresponds to MCF-7, MUC-1 to MDA-MB-231, and HER-2 to SK-BR-3. Despite their low concentrations, BC cells could be detected by impedance spectroscopy. Hence, this methodology should permit the monitoring of circulating tumor cells (CTC) and therefore help to prevent recurrences and metastatic processes during BC treatment.

Synaptic adaptations in the central amygdala and hypothalamic paraventricular nucleus associated with protracted ethanol abstinence in male rhesus monkeys.

Alcohol use disorder is a significant global burden. Stress has been identified as an etiological factor in the initiation and continuation of ethanol consumption. Understanding adaptations within stress circuitry is an important step toward novel treatment strategies. The effects of protracted abstinence following long-term ethanol self-administration on the central nucleus of the amygdala (CeA) and the hypothalamic paraventricular nucleus (PVN) were evaluated in male rhesus monkeys. Using whole-cell patch-clamp electrophysiology, inhibitory GABAergic transmission in the CeA and excitatory glutamatergic transmission in the PVN were measured. CeA neurons from abstinent drinkers displayed an elevated baseline spontaneous inhibitory postsynaptic current (sIPSC) frequency compared with controls, indicating increased presynaptic GABA release. Application of acute ethanol significantly increased the frequency of sIPSCs in controls, but not in abstinent drinkers, suggesting a tolerance to ethanol-enhanced GABA release in abstinent rhesus monkeys with a history of chronic ethanol self-administration and repeated abstinence. In the PVN, the frequency of spontaneous excitatory postsynaptic currents (sEPSC) was elevated in abstinent drinkers compared with controls, indicating increased presynaptic glutamate release. Notably, acute ethanol decreased presynaptic glutamate release onto parvocellular PVN neurons in both controls and abstinent drinkers, suggesting a lack of tolerance to acute ethanol among PVN neurons. These results are the first to demonstrate distinct synaptic adaptations and ethanol sensitivity in both the extrahypothalamic and hypothalamic stress circuits in abstinent rhesus males. Importantly, our findings describe adaptations in stress circuitry present in the brain at a state during abstinence, just prior to relapse to ethanol drinking.

Programa de transición de nefrología pediátrica a la medicina del adulto: "Conduce tu salud" / Pediatric nephrology transition program to adult medicine: "Conduce tu salud"

Introducción: El adecuado seguimiento de los pacientes con una enfermedad renal crónica desde pediatría a la nefrología de adultos y/o atención primaria constituye un reto de coordinación y planificación. El objetivo de este trabajo es presentar el diseño del programa de transición de nefrología "Conduce tu salud", elaborado en el Hospital Clínico Universitario Virgen de la Arrixaca de Murcia. Material y métodos: Los pacientes incluidos en la transición son adolescentes seguidos en la consulta de nefrología pediátrica que comienzan el programa a partir de los 15-16 años. Es un programa integrativo y multidisciplinario que realiza una valoración global de la familia y de las necesidades del paciente de forma conjunta entre el nefrólogo pediatra y el de adultos. Incluye una valoración psicosocial y medioambiental para establecer patrones y planificar necesidades específicas del adolescente y su familia. En función de las habilidades y la madurez del paciente para "conducir su salud", el tránsito se realiza entre los 15 y los 18 años de edad (formularios evolutivos de bicicleta, moto y coche). Conclusiones: El programa "Conduce tu salud" establece un proceso planificado, coordinado y multidisciplinario, que se realiza de forma personalizada, integrativa, progresiva y consensuada con el adolescente, la familia y los profesionales. El programa permite una adecuada transferencia de una unidad pediátrica a una de adultos, especializada y de atención primaria

Introduction: The adequate follow-up of patients with chronic kidney disease from pediatrics to adult nephrology and/or primary care is a challenge of coordination and planning. Objective: Present the design of the nephrology transition program "Conduce tu salud" drawn up at the Hospital Clínico Universitario Virgen de la Arrixaca in Murcia. Material and methods: Patients included in the transition are adolescents followed in the pediatric nephrology clinic who begin the program from 15-16 years of age. It is an integrative and multidisciplinary program that makes a global assessment of the family and the needs of the patient together with a pediatric and adult nephrologist. It includes a psychosocial and environmental assessment to establish patterns and plan specific needs of adolescents and their families. Depending on the abilities and maturity of the patient to "lead their health", the transition is performed between 15 and 18 years of age (evolutionary forms of bicycle, motorcycle and car). Conclusions: The program "Conduce tu salud" establishes a planned, coordinated and multidisciplinary process that is carried out in a personalized, integrative, progressive and consensual way with the adolescent, family and professionals. The program allows adequate transition from pediatric to adult unit, specialized and primary care