Tryptophan-enriched diet or 5-hydroxytryptophan supplementation given in a randomized controlled trial impacts social cognition on a neural and behavioral level.

Understanding of emotions and intentions are key processes in social cognition at which serotonin is an important neuromodulator. Its precursor is the essential amino acid tryptophan (TRP). Reduced TRP availability leads to weaker impulse control ability and higher aggression, while TRP supplementation promotes confidence. In a double-blind placebo-controlled fMRI study with 77 healthy adults, we investigated the influence of a 4 week TRP enriched diet and an acute 5-hydroxytryptophan (5-HTP) intake on two social-cognitive tasks, a moral evaluation and an emotion recognition task. With 5-HTP, immoral behavior without negative consequences was rated as more reprehensible. Additionally, during story reading, activation in insula and supramarginal gyrus was increased after TRP intake. No significant effects of TRP on emotion recognition were identified for the whole sample. Importantly, emotion recognition ability decreased with age which was for positive emotions compensated by TRP. Since the supramarginal gyrus is associated with empathy, pain and related information integration results could be interpreted as reflecting stricter evaluation of negative behavior due to better integration of information. Improved recognition of positive emotions with TRP in older participants supports the use of a TRP-rich diet to compensate for age related decline in social-cognitive processes.

Manejo clínico de la neoplasia trofoblástica gestacional: presentación de un caso / Clinical management of gestational trophoblastic neoplasia: presentation of a case

La enfermedad trofoblástica gestacional es una entidad poco frecuente que se produce por una proliferación anormal de la placenta. Engloba un diverso espectro de entidades histológicas, que conllevan a su vez diversas implicaciones clínicas. Unas son de carácter benigno (mola parcial y mola completa, placentomegalia, nódulo del sitio placentario) y otras de carácter maligno, estas últimas reciben en común la denominación de Neoplasia Tofoblástica Gestacional (NTG) y tienen un alto potencial de metastatización. Forman parte de las NTG: la mola invasiva, el tumor trofoblástico del sitio placentario, el tumor trofoblástico epitelioide y el coriocarcinoma gestacional. Lo más común es que la NTG debute tras la aparición de una gestación molar, pero también es posible que ocurra tras otro tipo de evento obstétrico como una gestación a término, o una gestación ectópica. Es pues de vital importancia realizar un correcto seguimiento tras evacuar una gestación molar, realizando una monitorización de los valores séricos de la BhcG y sospechando una enfermedad trofoblástica persistente ante los supuestos que posteriormente describiremos.La principal herramienta terapéutica para la NTG es el uso de la quimioterapia, aunque también se puede optar por la cirugía endeterminados casos. Habrá que valorar de modo individualizado en función de la histología, score pronóstico y deseos genésicos futuros de la paciente. Afortunadamente, la tasa de supervivencia y de curación de la NTG con un tratamiento y seguimiento adecuado es muy elevada. (AU)

Gestational trophoblastic disease is a rare entity that is caused by an abnormal proliferation of the placenta. It encompasses adiverse spectrum of histological entities, which carry various clinical implications. Some of them are benign (partial mole and complete mole, placentomegaly, placental site nodule) and others of a malignant nature, which are known as Gestational TrophoblasticNeoplasia (GTN) and have a high potential for metastasization. Are part of the GTN: invasive mole, trophoblastic tumor of theplacental site, trophoblastic tumor epithelioid and gestational choriocarcinoma. The most common is that NTG debuts after theappearance of a molar gestation, but it also may occur after another type of obstetric event such as a term gestation, or an ectopicgestation. It is therefore of vital importance to carry out a correct follow-up after evacuating a molar gestation, monitoring the serumvalues of BhcG and suspecting a persistent trophoblastic disease in the event that we will later describe. The main therapeutic toolfor NTG is the use of chemotherapy, although surgery can also be chosen in certain cases. It will be necessary to assess individuallyaccording to histology, prognostic score and future genetic desires of the patient. Fortunately, the survival and cure rate of NTG with proper treatment and follow-up is very high. (AU)

"Influence of diet on mood and social cognition: a pilot study".

Recently, a relationship has been observed between nutrition and social cognition. In this aspect, several dietary patterns, or even some probiotics, have been reported as social cognition modulators. However, to date, no studies have reported the effects of specific nutrients. Our aim was to evaluate the relationship between dietary macronutrients and the processing of social and affective information. Participants were undergraduates from the University of Extremadura (Badajoz, Spain) aged 21.3 ± 2.9 years., with a BMI of 22.8 ± 3.9 (kg m-2). The students' social cognition and diet were analysed through questionnaires and a dietary record. The diets were analysed with DIAL v.1.18® software (Alce Ingeniería®). The participants filled out the WHO-5 well-being index, Beck's anxiety inventory, Beck's depression inventory, ruminative response scale (RSS), Leiden index of depression sensitivity (LEIDS-r), empathy quotient (EQ), and interpersonal reactivity index (IRI). To analyse the data, nutrients were grouped through principal component analysis (PCA) into lipids, carbohydrates and proteins. Additionally, we assayed if these principal components were associated with psychological questionnaire scores using multiple linear regression analyses. The dietary pattern differed from the traditional Mediterranean diet due to high intake of proteins and saturated fatty acids. Regarding social cognition and macronutrients, we found a positive association between lipids, specifically cholesterol, and the Perspective-Taking Scale (an IRI component). Carbohydrates influenced the RSS, indicating that complex carbohydrates may be a risk factor for depression. Moreover, the brooding factor, a component of the RRS, was negatively affected by dietary carbohydrates and proteins, specifically by fiber and aspartate. Diet may influence several variables related to social cognition and mood. Particularly, a low-cholesterol diet rich in fiber, complex carbohydrates, and aspartate apparently provides benefits, improving the processing of social and affective information and psychic well-being.

Coastal sedimentation across North America doubled in the 20th century despite river dams.

The proliferation of dams since 1950 promoted sediment deposition in reservoirs, which is thought to be starving the coast of sediment and decreasing the resilience of communities to storms and sea-level rise. Diminished river loads measured upstream from the coast, however, should not be assumed to propagate seaward. Here, we show that century-long records of sediment mass accumulation rates (g cm-2 yr-1) and sediment accumulation rates (cm yr-1) more than doubled after 1950 in coastal depocenters around North America. Sediment sources downstream of dams compensate for the river-sediment lost to impoundments. Sediment is accumulating in coastal depocenters at a rate that matches or exceeds relative sea-level rise, apart from rapidly subsiding Texas and Louisiana where water depths are increasing and intertidal areas are disappearing. Assuming no feedbacks, accelerating global sea-level rise will eventually surpass current sediment accumulation rates, underscoring the need for including coastal-sediment management in habitat-restoration projects.

The sex differences of the behavior response to early Life immune stimulation: Microglia and astrocytes involvement.

It is well known that inflammatory challenge during the prenatal period results in permanent changes in glial cells and behavior in adulthood. However, it is unknown whether inflammatory challenge during the infantile period may have permanent sexually-dimorphic effects on microglia and astrocytes in vivo, which in turn may be associated with sex differences in adult behavior. In this study, we have evaluated whether postnatal injection of lipopolysaccharide (LPS; 250µg/kg, i.p. on postnatal day 14) induces depressive and less anxiety-like behaviors, glial cell activation, pro-inflammatory cytokine (TNF-alpha) secretion and sexually dimorphic responses in adulthood. Postnatal day 14 (P14) male and female Wistar rats received an intraperitoneal (ip) injection of LPS or PBS. Three months later, animals were tested in the Open Field (OF), the Elevated Plus Maze (EPM) and the Forced Swimming Test (FST) to assess the level of anxiety and depression-like behavior. Hippocampal proinflammatory cytokine TNF-alpha concentration and the number of astrocytes and microglia were estimated in the dentate gyrus, CA1, and CA3 in two regions of the hippocampus (ventral and dorsal). Our results showed that the administration of LPS resulted in less anxiety and depression-like behavior in males but not in females. However, the LPS-administration increased the number of microglia in the dorsal and ventral hippocampus areas in females more than male, while no significant differences in TNFα level had been detected between the LPS-rats treated and their controls. Interestingly, LPS resulted in an increase in the number of astrocytes in both areas of the hippocampus in a female. While in a male, our results showed a decrease in astrocytes number in the dorsal hippocampus, but no significant differences observed in ventral hippocampus. These findings indicate that an immune challenge in infantile rats induces a ventral and dorsal hippocampus damage in female more than in male, without affecting significantly the affective behavior changes in the female. The results also showed that small changes in the male hippocampus can affect the behavior and induce a depression-like behavior.

Effects of a respiratory functional training program on pain and sleep quality in patients with fibromyalgia: A pilot study.

OBJECTIVE: To evaluate the effect of 8-week respiratory functional training program on pain tolerance, sleep, and urinary antioxidant and cortisol levels in 18 patients with fibromyalgia. METHODS: Participants underwent a 12-week intervention: 4 weeks as control and 8 weeks of breathing exercises. Pain tolerance assay was done by using an algometer, whereas sleep quality was evaluated by actigraphy and by the Pittsburgh Sleep Quality Index. Cortisol and antioxidant levels were determined using commercial assay kits. RESULTS: Increases in the pain tolerance threshold were detected in the occiput point after one month of intervention as well as in the low cervical and second rib points after one and two months. Actigraphy revealed a decrease in sleep latency, whereas sleep questionnaire showed improvements in sleep quality, sleep duration and sleep efficiency. No changes in cortisol and antioxidant levels were detected. CONCLUSION: The 8-week breathing exercise intervention reduced pain and improved sleep quality.

Aging leads to inferior Achilles tendon mechanics and altered ankle function in rodents.

Spontaneous rupture of the Achilles tendon is increasingly common in the middle aged population. However, the cause for the particularly high incidence of injury in this age group is not well understood. Therefore, the objective of this study was to identify age-specific differences in the Achilles tendon-muscle complex using an animal model. Functional measures were performed in vivo and tissues were harvested following euthanasia for mechanical, structural, and histological analysis from young, middle aged, and old rats. Numerous alterations in tendon properties were detected across age groups, including inferior material properties (maximum stress, modulus) with increasing age. Differences in function were also observed, as older animals exhibited increased ankle joint passive stiffness and decreased propulsion force during locomotion. Macroscale differences in tendon organization were not observed, although cell density and nuclear shape did vary between age groups. Muscle fiber size and type distribution were not notably affected by age, indicating that other factors may be more responsible for age-specific Achilles tendon rupture rates. This study improves our understanding of the role of aging in Achilles tendon biomechanics and ankle function, and helps provide a potential explanation for the disparate incidence of Achilles tendon ruptures in varying age groups.

Activity/inactivity circadian rhythm shows high similarities between young obesity-induced rats and old rats.

The objective of the present study was to compare differences between elderly rats and young obesity-induced rats in their activity/inactivity circadian rhythm. The investigation was motivated by the differences reported previously for the circadian rhythms of both obese and elderly humans (and other animals), and those of healthy, young or mature individuals. Three groups of rats were formed: a young control group which was fed a standard chow for rodents; a young obesity-induced group which was fed a high-fat diet for four months; and an elderly control group with rats aged 2.5 years that was fed a standard chow for rodents. Activity/inactivity data were registered through actimetry using infrared actimeter systems in each cage to detect activity. Data were logged on a computer and chronobiological analysis were performed. The results showed diurnal activity (sleep time), nocturnal activity (awake time), amplitude, acrophase, and interdaily stability to be similar between the young obesity-induced group and the elderly control group, but different in the young control group. We have concluded that obesity leads to a chronodisruption status in the body similar to the circadian rhythm degradation observed in the elderly.

Effect of non-alcoholic beer on Subjective Sleep Quality in a university stressed population.

Sleep deprivation affects the homeostasis of the physiological functions in the human organism. Beer is the only beverage that contains hops, a plant which has a sedative effect. Our objective is to determine the improvement of subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI). The sample was conducted among a population of 30 university students. The study took place during a period of 3 weeks, the first 7 days were used for the Control, and during the following 14 days the students ingested beer (were asked to drink non-alcoholic beer) while having dinner. The results revealed that Subjective Sleep Quality improved in the case of those students who drank one beer during dinner compared to the Control, this is corroborated by the fact that Sleep Latency decreased (p < 0.05) compared to their Control. The overall rating Global Score of Quality of Sleep also improved significantly (p < 0.05). These results confirm that the consumption of non-alcoholic beer at dinner time helps to improve the quality of sleep at night.

TNFα-induced apoptosis in human myeloid cell lines HL-60 and K562 is dependent of intracellular ROS generation.

The present study determines the role of reactive oxygen species (ROS) production and calcium signaling evoked by the tumor necrosis factor-alpha (TNFα) on apoptosis in the human leukemia HL-60 and K562 cell lines. The results show that treatment of both cell lines cells with 10 ng/mL TNFα resulted in a rise in the percentage of apoptotic cells after 6 h of treatment. It was also observed that the administration of 10 ng/mL TNFα increased intracellular ROS production, as well as a time-dependent increase in caspase-8, -3, and -9 activities. The present results also show that the pretreatment with well-known antioxidants such as trolox and N-acetyl cysteine partially reduced the caspase activation caused by the administration of TNFα. The findings suggest that TNFα-induced apoptosis is dependent on alterations in intracellular ROS generation in human leukemia HL-60 and K562 cells.

[Does Alzheimer's disease exist in all primates? Alzheimer pathology in non-human primates and its pathophysiological implications (II)]. / ¿Existe la enfermedad de Alzheimer en todos los primates? Patología Alzheimer en primates no humanos y sus implicaciones fisiopatológicas (II).

INTRODUCTION: In the ageing process there are some species of non-human primates which can show some of the defining characteristics of the Alzheimer's disease (AD) of man, both in neuropathological changes and cognitive-behavioural symptoms. The study of these species is of prime importance to understand AD and develop therapies to combat this neurodegenerative disease. DEVELOPMENT: In this second part of the study, these AD features are discussed in the most important non-experimental AD models (Mouse Lemur -Microcebus murinus, Caribbean vervet -Chlorocebus aethiops, and the Rhesus and stump-tailed macaque -Macaca mulatta and M. arctoides) and experimental models (lesional, neurotoxic, pharmacological, immunological, etc.) non-human primates. In all these models cerebral amyloid neuropathology can occur in senility, although with different levels of incidence (100% in vervets;<30% in macaques). The differences between normal and pathological (Alzheimer's) senility in these species are difficult to establish due to the lack of cognitive-behavioural studies in the many groups analysed, as well as the controversy in the results of these studies when they were carried out. However, in some macaques, a correlation between a high degree of functional brain impairment and a large number of neuropathological changes ("possible AD") has been found. CONCLUSIONS: In some non-human primates, such as the macaque, the existence of a possible continuum between "normal" ageing process, "normal" ageing with no deep neuropathological and cognitive-behavioural changes, and "pathological ageing" (or "Alzheimer type ageing"), may be considered. In other cases, such as the Caribbean vervet, neuropathological changes are constant and quite marked, but its impact on cognition and behaviour does not seem to be very important. This does assume the possible existence in the human senile physiological regression of a stable phase without dementia even if neuropathological changes appeared.

Chrononutrition against oxidative stress in aging.

Free radicals and oxidative stress have been recognized as important factors in the biology of aging and in many age-associated degenerative diseases. Antioxidant systems deteriorate during aging. It is, thus, considered that one way to reduce the rate of aging and the risk of chronic disease is to avoid the formation of free radicals and reduce oxidative stress by strengthening antioxidant defences. Phytochemicals present in fruits, vegetables, grains, and other foodstuffs have been linked to reducing the risk of major oxidative stress-induced diseases. Some dietary components of foods possess biological activities which influence circadian rhythms in humans. Chrononutrition studies have shown that not only the content of food, but also the time of ingestion contributes to the natural functioning of the circadian system. Dietary interventions with antioxidant-enriched foods taking into account the principles of chrononutrition are of particular interest for the elderly since they may help amplify the already powerful benefits of phytochemicals as natural instruments with which to prevent or delay the onset of common age-related diseases.

A Jerte valley cherry product provides beneficial effects on sleep quality. Influence on aging.

OBJECTIVE: In the present work, we evaluated the effect of the intake of a Jerte Valley cherry-based product (JVCP), compared to a placebo product, on sleep quality, urinary 6-sulfatoxymelatonin (aMT6-s) levels and the serum concentration of interleukin-1ß (IL-1ß), tumor necrosis factor α (TNF-α) and interleukin-8 (IL-8). DESIGN: This was a blind, placebo-controlled, randomized, crossover study. SETTING: University of Extremadura (Spain). PARTICIPANTS: Ten young (20-30 years old), ten middle-aged (35-55 years old), and ten elderly (65-85 years old) participants. INTERVENTION: A placebo (Kool-Aid®) or JVCP (patent no. ES 2342141 B1) were consumed twice a day, as lunch and dinner desserts. MEASUREMENTS: Actigraphic monitoring was used to record and display the temporal patterns of the individuals' activity and rest. Urinary aMT6-s and serum cytokines (IL-1ß, TNF-α and IL-8) were also determined. RESULTS: The consumption of the JVCP improved the nocturnal rest, measured by sleep efficiency, number of awakenings, total nocturnal activity, sleep latency, assumed sleep, actual sleep time and immobility. Moreover, it was detected an increase in both the levels of aMT6-s found in first-void morning urine and the concentrations of serum pro-somnogenic cytokines obtained from samples collected at the acrophase of the melatonin rhythm (1.00 am) in all experimental age groups after the JVCP consumption. Generally, better results were obtained with advancing age. CONCLUSION: The ingestion of the JVCP may contribute to establish a high-quality sleep and be used as a potential nutraceutical tool to prevent sleep disorders with the advance of age.

Melatonin reduces body weight gain and increases nocturnal activity in male Wistar rats.

AIM: This study evaluated the effect of the administration of melatonin, the chief secretory product of the pineal gland, on the body weight in male Wistar rats. MAIN METHODS: The animals were housed for 4months in cages equipped to log horizontal activity within a thermostatically-controlled chamber, under a 12h/12h light/dark photoperiod (lights on at 08:00h). After acclimatization, the animals were divided into two groups: (1) control animals, and (2) melatonin-treated animals. Melatonin was administered in tap water (20µg/ml), and fresh drinking fluid was changed twice weekly. Rats were fed a standard diet ad libitum. KEY FINDINGS: Food and water intake, body weight, the amplitude of the activity/rest rhythm (motor activity), and blood melatonin and glucose concentrations were measured. The administration of melatonin did not influence either food or water intake or glucose levels relative to those found in the control animals. However, melatonin administration reduced body weight gain and increased nocturnal locomotor activity. The peak concentration of melatonin was found at night coinciding with the increase in nocturnal activity. SIGNIFICANCE: The results show that exogenous melatonin reduces body weight gain without having marked effects on metabolism. This may be due in part to the increased nocturnal activity shown by the animals treated with the indoleamine.

Contribución del bloqueo del plano transverso abdominal guiado por ultrasonidos a la analgesia postoperatoria tras la cesárea / Contribution to post-caesarean analgesia of ultrasound-guided transversus abdominis plane block

Objetivo. El objetivo principal de nuestro estudio fue valorar la contribución de la analgesia producida por el bloqueo del plano transverso abdominal (TAP), mediante punción ecoguiada, a la calidad analgésica obtenida con opioides intratecales, en cesáreas programadas. Material y métodos. Estudio prospectivo, aleatorizado en pacientes programadas para cesárea electiva con anestesia intradural con bupivacaína 0,5% hiperbara. Las pacientes se distribuyeron aleatoriamente en 3 grupos, según el fármaco complementario añadido para analgesia. En el grupo A 0,1mg de morfina, en el grupo B 10μg de fentanilo y en el grupo C 10μg de fentanilo y bloqueo TAP bilateral. El bloqueo TAP bilateral consistió en la inyección tras la cirugía de 20ml de levobupivacaína 0,5% a cada lado. En los grupos A y B, se inyectaron 20ml de suero salino. La analgesia postoperatoria se llevó a cabo con morfina iv en bolos, mediante un sistema de analgesia controlada por la paciente. Se estudió el dolor según una escala visual analógica a las 12 y 24h en reposo y movimiento, el tiempo en que se administró el primer bolo de analgesia y el número de bolos en 24h. También se valoraron los efectos adversos como: náuseas/vómitos, somnolencia y prurito. Se preguntó por el grado de satisfacción de la paciente. Resultados. Se incluyó a 90 pacientes. En reposo, el valor en la escala visual analógica 12/24h fue: grupo A, a las 12h 2,1±1,2, a las 24h 4,7±1,6; en el grupo B, a las 12h 4,3±2,9, a las 24h 4,8±2,0; y en el grupo C, a las 12h 1,9±1,1, y a las 24h 2,3±1,2 (p<0,05). En movimiento, la analgesia fue mejor en el grupo C (p≤0,02). El tiempo en solicitar el primer bolo fue inferior en el grupo B: en el grupo A 9,3±4,9 (p=0,02 respecto al grupo C); en el grupo B 2,0±1,8 (p<0,001 respecto al grupo C); y en el grupo C 13,2±2,1h. El número de bolos en 24h fue: en el grupo B de 38±5, en el grupo A de 10±2 (p<0,05) y en el grupo C de 5±2 (p<0,001). La incidencia de náuseas fue superior en el grupo B (36,6%) y la de prurito fue mayor en el grupo A (36,6%). Conclusiones. El bloqueo TAP mediante ultrasonidos (US), mejoró la eficacia de los opioides intratecales, reduciendo el dolor en las primeras 24h del postoperatorio, el consumo de opiáceos y los efectos secundarios(AU)

Objective. The aim of this study was to evaluate the contribution made by ultrasound-guided transversus abdominis plane block (TAP) to the quality of the analgesia with intrathecal opioids obtained in patients undergoing elective caesarean delivery. Material and methods. A prospective, randomized study in patients submitted to elective caesarean section with spinal anaesthesia with 0.5% hyperbaric bupivacaine. The patients were randomized into 3 groups according to the added complementary drug for analgesia: group A morphine 0.1mg; group B fentanyl 10μg; group C 10μg fentanyl+bilateral TAP block. The TAP block with 20ml of 0.5% levobupivacaine on each side, after surgery. Groups A and B, were injected with 20ml of saline. Postoperative analgesia was performed with morphine bolus through a system of patient-controlled analgesia (PCA). We studied the pain on a visual analogue scale at 12 and 24h at rest and movement, the time elapsed to require the first bolus, and morphine bolus in 24h. Secondary effects such as nausea, vomiting, pruritus, and drowsiness, were also evaluated. The level of patient satisfaction was also recorded. Results. A total of 90 patients were included. At rest the 12/24h VAS score was: group A, at 12h 2.1±1.2, at 24h 4.7±1.6; group B at 12h 4.3±2.9, at 24h 4.8±2; group C at 12h 1.9±1.09, at 24h 2.3±1.2 (P<.05). Walking improved analgesia more in group C (P≤.02). The time of asking for the first bolus was lower in group B: group A 9.3±4.9h (P=.02 compared to group C), in group B 2±1.8h (P<.001 compared to group C) and group C 13.2±2.1h. The number of bolus in 24h in group B was 38±5, in group A 10±2 (P<.05), group C 5±2 (P<.001). Delayed nausea was increased in group B (36.6%) and pruritus was greater in group A (36.6%). Conclusions. Ultrasound (US)-guided TAP block improves spinal opioid analgesia, with a decrease in VAS scores in the first 24h, and reduces opioid requirement and secondary effects after caesarean delivery(AU)

Diets enriched with a Jerte Valley cherry-based nutraceutical product reinforce nocturnal behaviour in young and old animals of nocturnal (Rattus norvegicus) and diurnal (Streptopelia risoria) chronotypes.

The decline in melatonin secretion with age seems to be one of the major reasons for increased sleep disruption in older animals. Previously, we showed that the administration with melatonin or its precursor, tryptophan, improved activity/rest rhythms in aged individuals. Here, it was evaluated the effect of a 10-day consumption of a Jerte Valley cherry-based nutraceutical product (patent no. ES2342141B1), which contains high levels of tryptophan, serotonin and melatonin, on the activity/rest rhythms of young and old rats (Rattus norvegicus) and ringdoves (Streptopelia risoria) as representatives of animals with nocturnal and diurnal habits, respectively, and its possible relationship with the serum levels of melatonin and glucose. Total diurnal and nocturnal activity pulses were logged at control, during, and up to 3 days after the treatment. Melatonin and glucose were measured with ELISA and testing kits respectively. In both young and old rats, the intake of the cherry nutraceutical decreased diurnal activity, whereas nocturnal activity increased. The opposite effect was observed for ringdoves. The treatment increased the circulating levels of melatonin in both species and restored the amplitude of the activity rhythm in the old animals to that of the non-treated young groups. The consumption of a Jerte Valley cherry-based nutraceutical product may help to counteract the impaired activity/rest rhythm found in aged animals.

Tryptophan-enriched cereal intake improves nocturnal sleep, melatonin, serotonin, and total antioxidant capacity levels and mood in elderly humans.

Melatonin and serotonin rhythms, which exhibit a close association with the endogenous circadian component of sleep, are attenuated with increasing age. This decrease seems to be linked to sleep alterations in the elderly. Chrononutrition is a field of chronobiology that establishes the principle of consuming foodstuffs at times of the day when they are more useful for health, improving, therefore, biorhythms and physical performance. Our aim was to analyze whether the consumption of cereals enriched with tryptophan, the precursor of both serotonin and melatonin, may help in the reconsolidation of the sleep/wake cycle and counteract depression and anxiety in 35 middle-aged/elderly (aged 55-75 year) volunteers in a simple blind assay. Data were collected for 3 weeks according to the following schedule: The control week participants consumed standard cereals (22.5 mg tryptophan in 30 g cereals per dose) at breakfast and dinner; for the treatment week, cereals enriched with a higher dose of tryptophan (60 mg tryptophan in 30 g cereals per dose) were eaten at both breakfast and dinner; the posttreatment week volunteers consumed their usual diet. Each participant wore a wrist actimeter that logged activity during the whole experiment. Urine was collected to analyze melatonin and serotonin urinary metabolites and to measure total antioxidant capacity. The consumption of cereals containing the higher dose in tryptophan increased sleep efficiency, actual sleep time, immobile time, and decreased total nocturnal activity, sleep fragmentation index, and sleep latency. Urinary 6-sulfatoxymelatonin, 5-hydroxyindoleacetic acid levels, and urinary total antioxidant capacity also increased respectively after tryptophan-enriched cereal ingestion as well as improving anxiety and depression symptoms. Cereals enriched with tryptophan may be useful as a chrononutrition tool for alterations in the sleep/wake cycle due to age.

[Contribution to post-caesarean analgesia of ultrasound-guided transversus abdominis plane block]. / Contribución del bloqueo del plano transverso abdominal guiado por ultrasonidos a la analgesia postoperatoria tras la cesárea.

OBJECTIVE: The aim of this study was to evaluate the contribution made by ultrasound-guided transversus abdominis plane block (TAP) to the quality of the analgesia with intrathecal opioids obtained in patients undergoing elective caesarean delivery. MATERIAL AND METHODS: A prospective, randomized study in patients submitted to elective caesarean section with spinal anaesthesia with 0.5% hyperbaric bupivacaine. The patients were randomized into 3 groups according to the added complementary drug for analgesia: group A morphine 0.1mg; group B fentanyl 10 µg; group C 10 µg fentanyl+bilateral TAP block. The TAP block with 20 ml of 0.5% levobupivacaine on each side, after surgery. Groups A and B, were injected with 20 ml of saline. Postoperative analgesia was performed with morphine bolus through a system of patient-controlled analgesia (PCA). We studied the pain on a visual analogue scale at 12 and 24h at rest and movement, the time elapsed to require the first bolus, and morphine bolus in 24h. Secondary effects such as nausea, vomiting, pruritus, and drowsiness, were also evaluated. The level of patient satisfaction was also recorded. RESULTS: A total of 90 patients were included. At rest the 12/24h VAS score was: group A, at 12h 2.1 ± 1.2, at 24h 4.7 ± 1.6; group B at 12h 4.3 ± 2.9, at 24h 4.8 ± 2; group C at 12h 1.9 ± 1.09, at 24h 2.3 ± 1.2 (P<.05). Walking improved analgesia more in group C (P ≤.02). The time of asking for the first bolus was lower in group B: group A 9.3 ± 4.9h (P=.02 compared to group C), in group B 2 ± 1.8h (P<.001 compared to group C) and group C 13.2 ± 2.1h. The number of bolus in 24h in group B was 38 ± 5, in group A 10 ± 2 (P<.05), group C 5 ± 2 (P<.001). Delayed nausea was increased in group B (36.6%) and pruritus was greater in group A (36.6%). CONCLUSIONS: Ultrasound (US)-guided TAP block improves spinal opioid analgesia, with a decrease in VAS scores in the first 24h, and reduces opioid requirement and secondary effects after caesarean delivery.

Tratamiento del dolor irruptivo / No disponible

La Sociedad Española de Oncología Médica (SEOM), la Sociedad Española de Cuidados Paliativos (SECPAL) y la Sociedad Española de Dolor (SED), establecieron un documento de consenso en el que asumieron el término "dolor irruptivo", para definir una exacerbación del dolor de forma súbita y transitoria, de gran intensidad (EVA > 7) y de corta duración (usualmente inferior a 20-30 minutos), que aparece sobre la base de un dolor persistente estable, cuando este se encuentra reducido a un nivel tolerable (EVA < 5) mediante el uso fundamental de opioides mayores. La clasificación del dolor irruptivo más utilizada es la que distingue entre dolor irruptivo incidental (predecible o impredecible), idiopático y relacionado con el final de dosis. El manejo adecuado del dolor irruptivo se basa en tres aspectos: prevención, anticipación y uso de la medicación adecuada. Existen formulaciones de opioides de inicio de acción rápida y duración de acción corta (ROOs) que se ajustan mucho mejor al perfil y al tratamiento de este tipo de dolor. Todas ellas contienen citrato de fentanilo y se administran a través de la mucosa oral (transmucosa oral, bucal o sublingual) o nasal. Todos tienen un inicio precoz del efecto, entre 5-15 minutos tras la administración y un tiempo de duración entre 2-4 h y una biodisponibilidad que puede variar según la presentación. Fentanilo sublingual, bucal e intranasal tienen un inicio de acción más rápido y una mayor biodisponibilidad que fentanilo transmucosa oral. Aunque la mayoría de los estudios controlados publicados al respecto, sobre la utilización de ROOs en el dolor irruptivo, recomiendan la necesidad de titulación de dosis (sobre todo los que incluyen CFOT y fentanilo bucal), la elección de una dosis eficaz sigue siendo dificultosa (AU)

Breakthrough pain is defined as an exacerbation of the pain of sudden and transient, high intensity (VAS > 7) and short duration (usually less than 20-30 minutes), which appears on the basis of a stable persistent pain, when this is reduced to a tolerable level (VAS < 5) by using strong opioids. The classification most used is the classification based on the following: Incident (predictable, unpredictable), idiopathic and end-of-dose. Proper management of breakthrough pain is based on three aspects: prevention, early and appropriate medication use. There are formulations of opioids rapid onset and short duration of action (ROOS) that better fit the profile and treatment of this type of pain. Everyone has an early onset of effect, between 5-15 minutes after dosing and a duration of 2-4 h and a bioavailability which may vary according to the filing. Fentanyl buccal tablets, sublingual fentanyl and intranasal nasal fentanyl have a faster onset of action and greater bioavailability of fentanyl transmucosal oral. Although most published controlled studies on this question, the use of de ROOs in the breakthrough pain, indicate the need for dose titration (especially fentanyl OTFC and oral), the choice of an effective dose is still difficult (AU)

¿La enfermedad de Alzheimer existe en todos los primates? Alzheimer patología en los primates no humanos y sus implicaciones fisiopatológicas (I) / Does Alzheimer's disease exist in all primates? Alzheimer pathology in non-human primates and its pathophysiological implications (I)

Introducción: Muchas publicaciones consideran que la enfermedad de Alzheimer (EA) es exclusivo de la especie humana, y que ningún otra especie animal sufre de la enfermedad. Sin embargo, diversos estudios han demostrado que algunas especies pueden presentar algunas de las características definitorias de la enfermedad humana, incluyendo tanto los cambios neuropatológicos y síntomas cognitivo-conductuales. Desarrollo: En este trabajo, los resultados publicados (PubMed) sobre cambios en el cerebro senil en los primates no humanos con diferentes grados de evolución, se revisan. Los cambios neuropatológicos asociados con la acumulación de amiloide o proteína tau fosforilada altamente son raras fuera del orden de los primates, pero en todos los sub-órdenes, familias, géneros y especies de primates no humanos que se han estudiado, algunos individuos seniles han demostrado amiloide acumulación en el cerebro. De hecho, en algunas especies la presencia de estos depósitos en la senilidad es constante. Cambios relacionados con la acumulación de la proteína tau son siempre de muy poca importancia, y se han detectado sólo en algunas especies de primates no humanos, tanto poco evolucionados y altamente evolucionada. En diferentes especies de primates no humanos, algunos tipos de cambios cognitivo-conductuales son más comunes en algunos individuos seniles en comparación con los individuos adultos normales y otras personas seniles de la especie. La importancia de determinar la longevidad de la especie en hábitats diferentes hábitats naturales, los hábitats nuevos, semi-cautividad, cautividad) se hace hincapié en estos estudios. Conclusiones: Las características morfológicas, histoquímicas y cognitivo-conductuales similares a los observados en los seres humanos de edad avanzada están presentes en seniles los primates no humanos. Además, otras características se observan en los primates no humanos podría ser indicativo de una patología «tipo Alzheimer» envejecimiento (AU)

Introduction: Many publications consider that Alzheimer's disease (AD) is exclusive to the human species, and that no other animal species suffers from the disease. However, various studies have shown that some species can present with some of the defining characteristics of the human disease, including both neuropathological changes and cognitive-behavioural symptoms. Development: In this work, the results published (PubMed) on senile brain changes in non-human primates of different degrees of evolution, are reviewed. The neuropathological changes associated with the accumulation of amyloid or highly phosphorylated tau protein are rare outside the primate order, but in all the sub-orders, families, genera and species of non-human primates that have been studied, some senile individuals have shown amyloid accumulation in the brain. In fact, in some species the presence of these deposits in senility is constant. Changes related to the accumulation of tau protein are always of very little significance, and have been detected only in some non-human primate species, both little evolved and highly evolved. In different species of non-human primates, some types of cognitive-behavioural changes are more common in some senile individuals when compared with both normal adult individuals and other senile individuals of the species. The importance of determining the longevity of the species in different habitats (natural habitats, new habitats, semi-captivity, captivity) is stressed in these studies. Conclusions: Morphological, histochemical and cognitive-behavioural features similar to those observed in elderly humans are present in senile non-human primates. Moreover, other characteristics seen in non-human primates could be indicative of a pathological «Alzheimer type» ageing (AU)