[Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention]. / Comentario del CEIPV a las nuevas Guías Europeas de Prevención Cardiovascular 2021.

Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention. We present the Spanish adaptation of the 2021 European Guidelines on Cardiovascular Disease (CVD) prevention in clinical practice. The current guidelines besides the individual approach greatly emphasize on the importance of population level approaches to the prevention of cardiovascular diseases. Systematic global CVD risk assessment is recommended in individuals with any major vascular risk factor. Regarding LDL-Cholesterol, blood pressure, and glycemic control in patients with diabetes mellitus, goals and targets remain as recommended in previous guidelines. However, it is proposed a new, stepwise approach (Step 1 and 2) to treatment intensification as a tool to help physicians and patients pursue these targets in a way that fits patient profile. After Step 1, considering proceeding to the intensified goals of Step 2 is mandatory, and this intensification will be based on 10-year CVD risk, lifetime CVD risk and treatment benefit, comorbidities and patient preferences. The updated SCORE algorithm-SCORE2, SCORE-OP- is recommended in these guidelines, which estimates an individual's 10-year risk of fatal and non-fatal CVD events (myocardial infarction, stroke) in healthy men and women aged 40-89 years. Another new and important recommendation is the use of different categories of risk according different age groups (< 50, 50-69 ≥ 70 years). Different flow charts of CVD risk and risk factor treatment in apparently healthy persons, in patients with established atherosclerotic CVD, and in diabetic patients are recommended. Patients with chronic kidney disease are considered high risk or very high-risk patients according to the levels of glomerular filtration rate and albumin-to-creatinine ratio. New lifestyle recommendations adapted to the ones published by the Spanish Ministry of Health as well as recommendations focused on the management of lipids, blood pressure, diabetes and chronic renal failure are included.

Acute changes in serum gonadotrophins and steroids following orchidectomy in the rat: role of the adrenal gland.

Orchidectomy in male rats leads to a) an increase in serum LH and FSH within 9 h; b) a decrease in serum testosterone to baseline levels by 30 min; c) an increase in serum progesterone (for 30 to 120 min), in the presence of the adrenals. If adrenalectomy is performed simultaneously with orchidectomy, the LH and FSH rises at 9 and 12 h are abolished, and the rises at 24 h are attenuated or abolished. By 48 h, the orchidectomized-adrenalectomized rat has achieved a rise in serum LH and FSH equal to that found in gonadectomy alone. Two hypotheses are offered to explain the abolition of the early gonadotrophin rises after combined orchidectomy-adrenalectomy treatment: a) the early responses are due to increased serum progesterone, on a background of decreased testosterone; b) the early responses are abolished because of the missing corticosterone, which either forces competition between pituitary secretion of ACTH and LH/FSH, or is necessary for rapid gonadotroph-secretory response. The differences and similarities between male and female rats, in the response of LH and FSH to gonadectomy, in the presence or absence of the adrenals, are discussed.

[Rehabilitation work in a psychiatric service]. / Tareas de rehabilitación en un servicio psiquiátrico.

A description of rehabilitation work at a psychiatric ward with all the benefits specific modalities, and results involved is offered. Focusing from a multidisciplinary angle the authors aim at laying the foundations for the setting up of rehabilitation workteams, in the frame of psychiatric hospitals in our country. At the same time clinical examples are submitted to illustrate situations which had to be met during the work and their linking to setting and transference as well.

Effect of serotoninergic system on FSH secretion in male and female rats: evidence for stimulatory and inhibitory actions.

The present experiments were designed to assess the effect of the serotoninergic system on FSH secretion in prepubertal (16-, 18-, 20-, 26- and 30-day-old) and adult (60-day-old) male and female rats. The intraperitoneal administration of 5-hydroxytryptophan (5-HTP), a serotonin (5-HT) precursor, induced a significant increase of FSH levels in male rats at 16, 26, 30 and 60 days of age (p less than 0.01) but not at 18 and 20 days. In the females, no modifications in FSH concentrations in prepubertal and adult rats were observed after 5-HTP injection. These results indicate that there are sexual differences in the effect of the serotoninergic system on FSH secretion. Orchidectomy performed in prepubertal (30-day-old) and adult rats (60 days) besides increasing FSH levels, reversed the response of this hormone to 5-HTP administration, since in castrated rats the 5-HT precursor induced a significant decrease in serum FSH concentrations. The administration of 5-HTP to 30 day-old castrated rats treated with testosterone induced FSH release as it did in control animals of this age. In the adult castrated rats the administration of testosterone abolished the inhibitory effect of 5-HTP observed in castrated rats but did not invoke the stimulatory action of 5-HTP observed in the controls. This difference between prepubertal and adult rats appears to be related to a decrease in the sensitivity to testosterone of the central mechanism which controls FSH secretion. These results indicate that 5-HTP stimulates FSH release in normal rats and inhibits FSH release in castrated rats, testosterone concentration being a relevant factor in determining the 'type' of effect produced. The hypothalamic concentrations of 5-HT and 5-hydroxy-indoleacetic acid (5-HIAA) are significantly higher at the ages at which 5-HTP induces FSH release than at other ages suggesting that hypothalamic turnover of these substances is related is related to the releasing effect of 5-HTP on FSH.

Modulatory effect of testosterone on the serotoninergic control of prolactin secretion in prepubertal rats.

The administration of 5-hydroxytryptophan (5-HTP) induced a prolactin release in male and female prepubertal rats at 20 days of age. This response was significantly higher in male than in female rats. Neonatal androgenization of the females significantly increased the release of prolactin induced by 5-HTP treatment compared to the values observed in males; thus, the neonatal exposure to androgens seems to be responsible for the sexual differences in the prolactin response to 5-HTP. In a second series of experiments the effect of this serotoninergic precursor on prolactin release in prepubertal (16, 26, and 30 days of age), peripubertal (45-day-old) and adult male rats was studied. Castration significantly decreased the prolactin release response to 5-HTP in prepubertal rats. The administration of testosterone to castrated rats markedly increased the prolactin release response to 5-HTP. Neither castration nor testosterone administration modified the prolactin response to 5-HTP in peripubertal and adult rats. These results appear to indicate that testosterone modulates the serotoninergic control of prolactin secretion during the prepubertal stage. The control of prolactin levels could be one of the mechanisms by which testosterone participates in the sexual maturation.

Peripheral autonomic regulation of gonadotropin secretion in pubertal rats. Inhibition of post-castration rise of gonadotropins during wallerian degeneration after sympathetic superior cervical ganglionectomy.

Shortly after superior cervical ganglionectomy (SCGx) peripheral sympathetic nerve terminals in the median eminence degenerate, the neurotransmitter is released, and a transient period of increased postsynaptic ensues. The present experiments were undertaken to examine, in the anterograde degeneration paradigm after SCGx, the participation of peripheral sympathetic nerves in feedback regulation of gonadotropin release in pubertal rats. Groups of 18 days old or 26 days old rats of both sexes were subjected to castration or its sham-operation, and 4 h later to SCGx or sham-SCGx. Twenty-four h later, the rats were decapitated and serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were measured by RIA. In 19 days old male rats, the post-castration increase of circulating LH, but not of FSH, was prevented by the wallerian degeneration of sympathetic nerves after acute SCGx. At the 27th day of life, acute SCGx prevented FSH, but not LH, post-orchidectomy rise. In female rats, SCGx blunted the oophorectomy-induced increase of gonadotropin levels at both examined ages. SCGx brought about a significant decrease of serum LH levels in 19 days old, sham-castrated female rats. At the 19th day of life, acute SCGx decreased serum LH and FSH in neonatally orchidectomized rats, but not in neonatally androgenized female rats. The data are in favor of a negative influence of peripheral sympathetic neurons on gonadotropin release in prepubertal rats, predominantly in female rats.

Tareas de rehabilitación en un servicio psiquiátrico. / [Rehabilitation work in a psychiatric service]

A description of rehabilitation work at a psychiatric ward with all the benefits specific modalities, and results involved is offered. Focusing from a multidisciplinary angle the authors aim at laying the foundations for the setting up of rehabilitation workteams, in the frame of psychiatric hospitals in our country. At the same time clinical examples are submitted to illustrate situations which had to be met during the work and their linking to setting and transference as well.