Three-dimensional structure and molecular dynamics studies of prorrenin/renin receptor: description of the active site.

The recent finding of a specific receptor for prorrenin/renin (PRR) has brought new insights into the physiology of the renin-angiotensin-aldosterone system. No undoubtable role has been described for this receptor so far. Its role seems to be important in chronic illnesses such as hypertension, possibly participating in the cardiovascular remodeling process, and diabetes where participation in inflammation development has been described. It is not possible, however, to explore the PRR function using classical pharmacological approaches due to the lack of specific agonists or antagonists. Two synthetic peptides have been described to accomplish these roles, but no conclusive data have been provided. There are no X-ray crystallography studies available to describe the structure and potential sites for drug development. So, the aim of this work was to model and theoretically describe the PRR. We describe and characterize the whole receptor protein, its spatial conformation and the potential interactions of PRR with the synthetic peptides available, describing the amino acid residues responsible for these interactions. This information provides the basis for directed development of drugs, seeking to agonize or antagonize PRR activity and study its function in health and ill stages.

EGFR and the complexity of receptor crosstalk in the cardiovascular system.

Signaling pathways play a critical role in the maintenance of cellular structure and function. These pathways can act together with synergistic or antagonistic outcome. Cooperative and integrative cellular communication networks, otherwise known as crosstalk can amplify signaling cascades. Here, we focus on receptor crosstalk in the context of cardiovascular pathologies, mainly involving the epidermal growth factor receptor (EGFR), a critical mediator of multiple receptor pathways in normal physiological and pathophysiological processes. Considerable experimental evidence suggests that the uncontrolled expression of EGFR contributes to tumorigenesis through inhibition of apoptosis, angiogenesis, anchorage-independent growth and tumor-associated inflammation. Abnormal activation of the intrinsic tyrosine kinase of EGFR through mutation or overexpression is observed in various human cancer types. On the other hand, the role of EGFR in vascular biology is not well understood. In cardiovascular pathologies, such as atherosclerosis and restenosis, vascular smooth muscle cells (SMCs) migrate and proliferate, contributing to neointima formation, whilst apoptosis may cause plaque instability. EGFR can be transactivated by numerous pathologic stimuli that regulate SMC behaviour. This review describes our current understanding of the role of EGFR in SMC biology and pathology.

Beta1-integrins shedding in a guinea-pig model of chronic asthma with remodelled airways.

BACKGROUND: A hallmark of airway remodelling in asthma is subepithelial fibrosis, but its relation with airway dysfunction is still controversial. OBJECTIVE: To describe airway functional abnormalities and subepithelial remodelling induced by repetitive antigenic challenges. METHODS: Nine inhaled antigenic challenges were applied every 10 days to guinea-pigs sensitized to ovalbumin (OVA). Antigen-induced airway hyperresponsiveness (AI-AHR) to histamine and its immunohistopathological relationship was evaluated at the first, third and ninth OVA challenges. RESULTS: From the first challenge on, OVA induced acute transient bronchoobstruction followed by development of AI-AHR. A progressive rise in baseline Penh (a bronchoobstruction index) and granulocyte airway infiltration was also observed. After the ninth OVA challenge, the amount of extracellular matrix in the subepithelial region (SER) of bronchi and bronchioles was increased. Immunohistochemistry analysis showed that this SER fibrosis was associated to beta1-integrin subunit overexpression, even in acellular areas. Immunoelectronmicroscopy corroborated the location of beta1-integrin in extracellular matrix, essentially in types l and II collagen fibres. Presence of alpha1- and alpha2-integrin subunits in these areas was also corroborated. AI-AHR was correlated with degree of SER increment, cell infiltration, and beta1-integrin expression. CONCLUSION: Our data suggested that beta1-integrin shedding produced by repetitive allergen challenges in guinea-pigs was associated with collagen deposition in SER of bronchi and bronchioles, along with inflammatory cells infiltration and AI-AHR development.

Enfermedades psicosomáticas musculoesqueléticas en cuidadores de enfermos de Alzheimer: necesidades de fisioterapia / Musculoskeletal psychosomatic diseases in caregivers of Alzheimer’s patients: physical therapy needs

Introducción. Las alteraciones en la rutina de laspersonas que cuidan a un familiar afectado de unaenfermedad crónica son la causa de un gran númerode enfermedades psicosomáticas (EP).Objetivos. Determinar si existen diferenciasen la incidencia de enfermedades psicosomáticasmusculoesqueléticas (EPM) entre cuidadores deenfermos crónicos (no-EA) y cuidadores de enfermosde Alzheimer (EA).Material y métodos. Estudio multicéntrico, descriptivo,prospectivo y cuantitativo sobre 121 cuidadoresde dos grupos diferenciados: cuidadores de no-EAy cuidadores de EA.Resultados. Total de encuestas válidas: 117. El númeromedio del total de EP detectadas: 13,38 para loscuidadores de EA y 8,1 para los cuidadores deno-EA. El 43,6 % de los cuidadores de EA padecíancontracturas musculares, frente al 26,5% delos cuidadores no-EA (p = 0,02). El 87,2 % de loscuidadores de EA presentaba alguna EPM, frenteal 70,6% de los no-EA (Fisher: p = 0,024).Conclusiones. Se produce mayor número de EPM entrecuidadores de EA, sobre todo contracturas musculares.Es necesaria mayor actuación fisioterapéutica en laatención psicosomática de los cuidadores de enfermoscrónicos

Introduction. The environmental alterations of thecaregivers of family members suffering chronic diseasescause many psychosomatic diseases (PD).Objectives. To determine if there are differences in theincidence of muscular psychosomatic diseases (MPD)among caregivers of chronic patients (No-AD) andcaregivers of patients with Alzheimer’s (AD).Material and methods. Multicentrer, descriptive,prospective and quantitative study on 121 caregivers intwo differentiated populations: No-AD caregivers andAD caregivers.Results. Total surveys valid: 117. The mean numberof the total of detected PD: 13.38 for the ADcaregivers and 8.1 for No-AD caregivers. A totalof 43.6 % of the AD caregivers suffered muscularcramps compared to 26.5% of the No-AD caregivers(p = 0.02) and 87.2 % of the AD caregivers presentedsome MPD compared to 70.6% of the No-AD (Fisher:p = 0,024).Conclusions. A greater number of MPD are causedamong AD caregivers, above all muscle cramps. Greaterpresence of physical therapy is required for thepsychosomatic care of caregivers of chronic patients

Intervención estratégica del fisioterapeuta en el entorno familiar del paciente discapacitado / Physiotherapist's strategical intervention in the family environment of the disabled patient

La discapacidad implica un estado bio-psico-social en el que se encuentran claramente implicados tanto el paciente como los familiares que le rodean. En pacientes discapacitados el "cuidador" ocupa un aspecto clave en el proceso terapéutico, por ello tiene que favorecer las necesidades tanto del paciente como de su entorno. El cuidador padece un alto número de problemas físicos y psicológicos ocasionados, en gran parte, por la situación de cuidados continuada que debe proporcionar a su familiar discapacitado. La estrategia que se presenta en este artículo ayudaría al fisioterapeuta a entender mejor la importancia del entorno familiar en la intervención fisioterápica. Dicha estrategia tiene una base psicopedagógica que incentiva el aprendizaje de nuevas habilidades en todos los aspectos de la vida familiar

Disability implicates a bio-psycho-social state in which are involved both, the patient and the family members around. In disabled patients, the caregiver plays a key role in the therapeutic process, so that he/she must take after the patient and his environment needs. The caregiver suffers a high number of physical and psychological problems ocassionated mostly by the permanent attention to his/her disabled family member. The strategy that we propose in this essay would help the physiotherapist to a better understanding the importance of the family environment in the physiotherapist intervention. This strategy is based on psychopedagogy that increases the learning of new habilities in all the family aspects of life

Reeducación sensitiva de la mano / Sensitive reeducation of the hand

En este trabajo se realiza un estudio sobre la importancia del aspecto evolutivo, social, cultural y por supuesto físico de la reeducación sensitiva de la mano, además de realizar un análisis del aspecto neurofisiológico de la misma, en función a los receptores, inervación y circuitos nerviosos, tanto a nivel medular como central. Posteriormente se muestran los diferentes procedicimientos de valoración del aspecto sensitivo de la mano, mediante técnicas analíticas. Por último se incluye un breve repaso por el Método Perfetti en la reeducación de la mano, basado principalmente en los avances neurofisiológicos y en la utilización de las funciones cognitivas o superiores del hombre. Este método, desarrollado en su inicio para el paciente neurológico, se aplica en otras afecciones, resaltando la importancia del componente sensitivo como primordial en la reeducación de la mano (AU)

Estudio transversal de las algias vertebrales en los fisioterapeutas / Cross-over study of vertebral pain in physiotherapists

Fundamento. El objetivo del presente estudio es estudiar la prevalencia del dolor vertebral en los fisioterapeutas, analizar cómo los factores personales, sociales, profesionales y ocupacionales pueden relacionarse con la aparición de dicho dolor. Metodología. Estudio transversal preliminar de la población de fisioterapeutas que trabajan en centros privados de Málaga, 41 profesionales. Se realizó un análisis comparativo entre distintas variables utilizando los contrastes estadísticos chi-cuadrado de independencia. Resultados. El 78 por ciento de la muestra presenta dolor de espalda, de ellos el 62 por ciento son mujeres. La localización del dolor es más frecuente en las regiones cervical y lumbar. El 93 por ciento relacionó dicho dolor directamente con su actividad laboral. Conclusiones. El grupo de población más afectado por las algias vertebrales es el de mujer - joven, cuya situación laboral es inestable, realiza tareas extraprofesionales y con pocos períodos de descanso durante el día. La jornada laboral en este grupo es extensa sin períodos de descanso y exceso número de pacientes en poco tiempo. Alta prevalencia del dolor vertebral repartido por igual en la región cervical y lumbar y con una intensidad moderada-alta(AU)

Nuevas tecnologías aplicadas a la docencia en fisioterapia / New technologies applied to teaching in physiotherapy

En este trabajo se analiza la aplicación de las nuevas tecnologías (NNTT) a la enseñanza universitaria. Se describen técnicas más significativas y su relación con la Fisioterapia. También se muestran las ventajas e inconvenientes de la adaptación de estas nuevas tecnologías. Por último se recuerda que las nuevas tecnologías complementan a los medios didácticos ya existentes y no los sustituyen (AU)

Relevancia del abordaje biopsicosocial en el diagnóstico y tratamiento de los desórdenes psicosomáticos / The relevance of biopsychosocial approach in the diagnosis and the treatment of psychosomatic disorders

Con este trabajo se pretende lograr un doble objetivo. En primer lugar, analizar los datos referidos a las bases biológicas, psicológicas y sociales relacionadas con los desórdenes, agrupados bajo la denominación de psicosomáticos, así como las investigaciones sobre otros trastornos que desde hace tiempo se están estudiando desde una aproximación biopsicosocial. En segundo lugar, destacar los efectos de diversas modalidades de tratamiento de eficacia reconocida en los órdenes correspondientes y en otros diferentes relacionados con estos desórdenes, comprobados con procedimientos científicos. Igualmente, forma parte de este estudio recoger los datos actuales sobre los efectos de las técnicas de tratamiento fisioterápico en los trastornos y enfermedades psicosomáticos (AU)

Niveles de acción de las técnicas de tratamiento fisioterápico en las afecciones psicosomáticas / Physical therapy effects in the psicosomatic disorders

En este trabajo se proponen los objetivos siguientes: analizar las bases neuroendocrinoinmunológicas, psicológicas y psicosociales de la enfermedad psicosomática, las clasificaciones actuales generales y específicas, los criterios diagnósticos y las modalidades de tratamiento de estas afecciones. En segundo lugar, destacar los datos recogidos en aquellas publicaciones sobre los efectos de los distintos tratamientos fisioterápicos sobre los sustratos neuroendocrinoinmunológicos, psicológico y psicosocial relacionados con la enfermedad psicosomática, cuya actuación se desarrolla en diferentes niveles, apuntando incluso a sistemas moleculares y subcelulares. (AU)

Sarcoplasmic reticulum Ca2+ depletion by caffeine and changes of [Ca2+](i) during refilling in bovine airway smooth muscle cells.

BACKGROUND: In airway smooth muscle (ASM), Ca2+ influx in response to the Ca2+ depletion of the sarcoplasmic reticulum (SR) seems to play a role in the regulation of intracellular free Ca2+ concentrations ([Ca2+](i)). This study evaluates some possible Ca2+ entry pathways activated during SR-Ca2+ depletion induced by 10 mM caffeine. METHODS: Enzymatically dispersed bovine ASM cells were loaded with Fura-2/AM to permit measurement of [Ca2+](i) changes in single cells. RESULTS: Caffeine (10 mM) induced a transient increase in [[Ca2+](i) that depleted SR-Ca(2)+ content. After caffeine washout, a decrease in basal [Ca2+](i) (undershoot) was invariably observed, followed by a slow recovery. This phenomenon was inhibited by cyclopiazonic acid (5 microM). External Ca(2)+ removal in depolarized and nondepolarized cells induced a decrease in basal [Ca2+](i) that continued until depletion of the SR-Ca2+ content. The decrease in [Ca2+](i) induced by Ca2+-free physiological saline solution (PSS) was accelerated in caffeine-stimulated cells. Recovery from undershoot was not observed in Ca2+-free PSS. Depolarization with KCl and addition of D600 (30 microM) did not modify recovery. Similar results were obtained when the Na(+)/Ca2+ exchanger was blocked by substituting NaCl with KCl in normal PSS (Na(+)-free PSS) or by adding benzamil amiloride (25 microM). CONCLUSIONS: SR-Ca2+ content plays an important role in the Ca2+ leak induced by Ca2+-free medium, and does not depend on membrane potential. Additionally, recovery from undershoot after caffeine depends on extracellular Ca2+, and neither voltage-dependent Ca2+ channels nor the Na(+)/Ca2+ exchanger are involved.

Individual and group training program.

We describe the experience of a didactic analysis group during a 3-year period in the Academy of Analytical Psychotherapy placing special emphasis on the training of the psychoanalyst, who, apart from carrying out his individual analysis, must complement it with group training. The advantages of the group analysis are given particular attention when evaluating the training of the candidate from the point of view of the psychoanalyst and the 6 doctors who have received this education. In this type of training for individuals and groups the program aims at a deeper study of the aspects of narcissism, the formation of the self and the social ego which we consider to be the fundamental elements in the development of this didactic experience.