Risk factors for pressure ulcer development in Intensive Care Units: A systematic review. / Factores de riesgo asociados al desarrollo de úlceras por presión en unidades de cuidados intensivos de adultos: revisión sistemática.

INTRODUCTION: Pressure ulcers represent a significant problem for patients, professionals and health systems. Their reported incidence and prevalence are significant worldwide. Their character iatrogenic states that its appearance is preventable and its incidence is an indicator of scientific and technical quality both in primary care and specialized care. The aim of this review was to identify risk factors associated with the occurrence of pressure ulcers in critically ill patients. METHODOLOGY: The PRISMA Declaration recommendations have been followed and adapted to studies identifying risk factors. A qualitative systematic review of primary studies has been performed and a search was conducted of the PubMed, The Cochrane Library, Scopus and Web of Science databases. Methodological limitations in observational studies have been considered. RESULTS: From 200 references, 17 fulfilled the eligibility criteria. These studies included 19,363 patients admitted to intensive care units. Six studies were classified as high quality and 11 were classified as moderate quality. Risk factors that emerged as predictive of pressure ulcers development more frequently included age, length of ICU stay, diabetes, time of MAP <60-70mmHg, mechanical ventilation, length of mechanical ventilation, intermittent haemodialysis or continuous veno-venous haemofiltration therapy, vasopressor support, sedation and turning. CONCLUSIONS: There is no single factors which can explain the occurrence of pressure ulcers. Rather, it is an interplay of factors that increase the probability of its development.

Transcultural validation and adaptation of the Pedi-IKDC scale for the functional assessment of children that undergo knee surgery. / Validación y adaptación transcultural de la escala Pedi-IKDC para la evaluación funcional de niños llevados a cirugía de rodilla.

INTRODUCTION: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. METHODOLOGY: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. RESULTS: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. CONCLUSION: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.

[Translated article] Transcultural validation and adaptation of the Pedi-IKDC scale for the functional assessment of children that undergo knee surgery.

INTRODUCTION: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. METHODOLOGY: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. RESULTS: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. CONCLUSION: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.

Optimal sampling locations to reduce uncertainty in contamination extent in water distribution systems.

Drinking water utilities rely on samples collected from the distribution system to provide assurance of water quality. If a water contamination incident is suspected, samples can be used to determine the source and extent of contamination. By determining the extent of contamination, the percentage of the population exposed to contamination, or areas of the system unaffected can be identified. Using water distribution system models for this purpose poses a challenge because significant uncertainty exists in the contamination scenarios (e.g., injection location, amount, duration, customer demands, contaminant characteristics). This article outlines an optimization framework to identify strategic sampling locations in water distribution systems. The framework seeks to identify the best sampling locations to quickly determine the extent of the contamination while considering uncertainty with respect to the contamination scenarios. The optimization formulations presented here solve for multiple optimal sampling locations simultaneously and efficiently, even for large systems with a large uncertainty space. These features are demonstrated in two case studies.

Predictive validity and reliability of the Braden scale for risk assessment of pressure ulcers in an intensive care unit. / Validez predictiva y fiabilidad de la escala de Braden para valoración del riesgo de úlceras por presión en una unidad de cuidados intensivos.

OBJECTIVE: Contribution to validation of the Braden scale in patients admitted to the ICU, based on an analysis of its reliability and predictive validity. DESIGN: An analytical, observational, longitudinal prospective study was carried out. SETTING: Intensive Care Unit, Hospital Virgen del Rocío, Seville (Spain). PATIENTS: Patients aged 18years or older and admitted for over 24hours to the ICU were included. Patients with pressure ulcers upon admission were excluded. A total of 335 patients were enrolled in two study periods of one month each. INTERVENTIONS: None. VARIABLES OF INTEREST: The presence of gradei-iv pressure ulcers was regarded as the main or dependent variable. Three categories were considered (demographic, clinical and prognostic) for the remaining variables. RESULTS: The incidence of patients who developed pressure ulcers was 8.1%. The proportion of gradei andii pressure ulcer was 40.6% and 59.4% respectively, highlighting the sacrum as the most frequently affected location. Cronbach's alpha coefficient in the assessments considered indicated good to moderate reliability. In the three evaluations made, a cutoff point of 12 was presented as optimal in the assessment of the first and second days of admission. In relation to the assessment of the day with minimum score, the optimal cutoff point was 10. CONCLUSIONS: The Braden scale shows insufficient predictive validity and poor precision for cutoff points of both 18 and 16, which are those accepted in the different clinical scenarios.

[Adaptation and validation of five scales to measure determinants of binge drinking in adolescents]. / Adaptación y validación al español de cinco escalas para evaluar los determinantes del consumo de alcohol en adolescentes.

BACKGROUND: The aim of this study was to validate five scales, based on a theoretical framework for the adoption of behaviours, designed to assess the determinants in binge drinking in adolescents, namely: attitude, social influence (model, norm and pressure) and self-efficacy. METHODS: Observational, cross-sectional and multicentre study. Through convenience sampling, 397 adolescents between 15 to 18 years old enrolled in secondary schools in Seville and Huelva were included. After translation and review of the original instrument by a panel of experts, a questionnaire was obtained in Spanish that was administered to a pilot sample to assess comprehensibility and, subsequently, the participants completed the five scales to check the structural validity (factor analysis and reliability) and construct validity. RESULTS: On the five scales, the first factor explained at least 28% of the variance and the total variance explained was always greater than 60%. After rotation, all items had weights >0.40 for the factor to which they belonged. Cronbach´s alpha ranged from 0.62 to 0.91. Spearman's coefficient was lower than 0.7 when correlating the sub-dimensions of the scales, except on the self-efficacy scale, assuming multidimensionality with certain limitations. CONCLUSIONS: Five scales are presented with indications of reliability and validity, their items reflect the theoretical frame of reference and can evaluate the determinants of binge drinking. In the future, validation could be continued to determine its reproducibility, its criterion validity with a "gold standard" or objective measure. Key words. Adolescents. Health behaviour. Binge drinking. RISK FACTORS: Validation studies.

Paternal line multigenerational passage of altered risk assessment behavior in female but not male rat offspring of mothers fed a low protein diet.

Maternal low protein (MLP) diets in pregnancy and lactation impair offspring brain development and modify offspring behavior. We hypothesized multigenerational passage of altered behavioral outcomes as has been demonstrated following other developmental programming challenges. We investigated potential multigenerational effects of MLP in rat pregnancy and/or lactation on offspring risk assessment behavior. Founder generation mothers (F0) ate 20% casein (C) or restricted (R) 10% casein diet, providing four groups: CC, RR, CR, and RC (first letter pregnancy, second letter lactation diet) to evaluate offspring (F1) effects influenced by MLP in F0. On postnatal day (PND 250), F1 males were mated to non-colony siblings producing F2. On PND 90, F2 females (in diestrous) and F2 males were tested in the elevated plus maze (EPM) and open field. Corticosterone was measured at PND 110. Female but not male CR and RC F2 made more entries and spent more time in EPM open arms than CC females. Overall activity was unchanged as observed in male F1 fathers. There were no open field differences in F2 of either sex, indicating that multigenerational MLP effects are due to altered risk assessment, not locomotion. MLP in pregnancy reduced F1 male and F2 female corticosterone. We conclude that MLP in pregnancy and/or lactation increases the innate tendency to explore novel environments in F2 females via the paternal linage, suggesting lower levels of caution and/or higher impulsiveness to explore unknown spaces. Further studies will be necessary to identify the epigenetic modifications in the germ line through the paternal linage.

The mitochondrial membrane permeability transition induced by inorganic phosphate or inorganic arsenate. A comparative study.

The membrane permeability transition (MPT) induced by Ca2+ and Pi or Asi was studied in rat kidney mitochondria. Membrane potential, Ca2+ transport and swelling were used to monitor the MPT. Asi promoted a faster and more extensive collapse of membrane potential, Ca2+ release and swelling than Pi. The MPT induced by Pi was fully blocked by Mg(2+)+ADP, spermine+ADP, Mg(2+)+ cyclosporin A (CSA), and ADP+CSA. In contrast, the MPT induced by Asi was only prevented, although not completely, by CSA+Mg2+ or ADP+CSA. Asi, but not Pi, was able to cause collapse of membrane potential in the presence of Sr2+. Carboxyatractyloside (CAT) produced collapse of membrane potential at a lower concentration in the presence of Asi+Ca(2+)+ADP than with Pi+Ca(2+)+ADP. The addition of Pi+Ca2+ to [14C]-ADP loaded mitochondria brought about a greater ADP release than Asi+Ca2+. The ADP release was CAT-sensitive with Pi but it was only partially blocked by Asi. The diminution of external pH did not inhibit the MPT induced by Pi or Asi. The results of this study suggest that the adenine nucleotide translocase does not have an essential role in the MPT induced by Asi+Ca2+.

[Design and validation of scales to measure adolescent attitudes toward sexuality, addictive substances and road safety. Are they related to behaviour?]. / Diseño y validación de escalas para medir la actitud adolescente hacia: sexualidad, sustancias adictivas y seguridad vial ¿se relacionan con los comportamientos?

BACKGROUND: To validate scales to measure adolescent attitudes toward sexuality (EAS), toward addictive substances (EASA) and toward vial security (EASV), and to examine their correlations with behaviour on these areas. METHODS: We designed the scales by literature review; we validated their content using a Delphi-on-line panel with 18 experts, and a pre-test with a sample of 21 fourth-grade high-school students (similar to 10th in US) in Seville, Spain. The scales were administered to 188 fourth-grade high-school students in order to test their construct validity (exploratory factor analysis), their reliability (Alpha Cronbach test), and to determinate their correlations with age, gender, experience of sexual intercourse, substance use and road behaviour. RESULTS: EAS-10 obtained α=0.73, EASA-12 obtained α=0.80, EASV-12 obtained α=0.79. They showed evidence of one-dimensional interpretation after factor analysis, a) all items achieved weights r>0.30 in the first factor, which explained a significant proportion of variance before rotations, and b) total variance explained by the main factors extracted was greater than 50%. We found correlations between EASA-12 and tobacco use (r=-0.43, p<0.001), alcohol use (r=-0.30, p<0.001), age of alcohol initiation (r=0.32, p=0.003), and substance use (r=-0.55, p<0.001), and between EASV-12 and safe road behaviour (r=0.41, p<0.001), tobacco use (r=-0.23, p=0.003), alcohol use (r=-0,22, p=0,003), age of first experience of drunkenness (r=0.22, p=0.003), and substance use (r=-0.27, p=0.013). CONCLUSIONS: The scales showed their reliability and validity. They could be employed for assessing adolescent attitudes to these priority intervention areas, for carrying out studies on their mediating role on adopting behaviour, and for designing and evaluating health programs.

Maternal protein restriction in the rat during pregnancy and/or lactation alters cognitive and anxiety behaviors of female offspring.

Maternal protein deficiencies can developmentally program offspring to lifelong dysfunction of many physiological systems. We hypothesized that maternal isocaloric low protein diet during fetal and early postnatal development would negatively affect female offspring anxiety, exploration, associative learning and motivation as measured by the elevated plus maze (EPM), open field test (OFT), operant conditioning and the progressive ratio task, respectively. Control mothers (C) received a 20% casein diet and restricted mothers (R) a 10% casein diet to provide four groups: CC, RR, CR, and RC (first letter pregnancy diet and second lactation diet) to enable evaluation of offspring effects influenced by maternal diet during pregnancy and lactation. Maternal protein restriction decreased open arm time and distance in RR and RC offspring, increased anxiety behavior, in the EPM. In the OFT, the RR and RC offspring displayed decreased exploration (increased stress) as indexed by decreased distance in the center zone. These behaviors in the EPM and OFT was associated with increased corticosterone levels during an immobilization test in the RR offspring with intermediary effects in the RC offspring. Learning impairment was observed in the RR, CR and RC offspring during fixed ratio 5 schedule of reinforcement. Motivational effects were measured in RR offspring responding less, decreased motivation, and CR offspring making more responses, increased motivation, than CC offspring. These findings reveal the negative effects of developmental protein restriction on female offspring behavior. The underlying basis for these negative outcomes remains to be elucidated.

Factores de riesgo asociados al desarrollo de úlceras por presión en unidades de cuidados intensivos de adultos: revisión sistemática / Risk factors associated with the development of pressure ulcers in intensive care units of adults: systematic review

Introducción Las úlceras porpresión representan un significativo problema para pacientes, profesionales y sistemas sanitarios. Presentan una incidencia y una prevalencia importantes a nivel mundial. Su carácter iatrogénico plantea que su aparición es evitable y su incidencia es un indicador de calidad científico-técnica tanto en el ámbito de la atención primaria como en el de la especializada. El objetivo de esta revisión ha sido identificar los factores de riesgo relacionados con la aparición de úlceras por presión en pacientes críticos. Metodología Se siguieron las recomendaciones de la declaración PRISMA adaptadas a la identificación de estudios sobre factores de riesgo. Se ha realizado una revisión sistemática cualitativa de estudios primarios a través de una búsqueda en Pubmed, The Cochrane Library, Scopus y Web of Science. Se consideraron las limitaciones metodológicas en estudios observacionales. Resultados De 200 referencias bibliográficas, 17 cumplieron nuestros criterios de selección. Estos estudios incluyeron 19.363 pacientes ingresados en unidades de cuidados intensivos. Seis se clasificaron como de calidad fuerte y 11 de calidad moderada. Los factores de riesgo que aparecieron más frecuentemente asociados al desarrollo de úlceras por presión incluyeron: edad, tiempo de estancia en UCI, diabetes, tiempo de PAM <60-70mmHg, ventilación mecánica, duración de la ventilación mecánica, terapia de hemofiltración venovenosa continua o diálisis intermitente, tratamiento con drogas vasoactivas, con sedantes y cambios posturales. Conclusiones No aparecen factores de riesgo que por sí mismos puedan predecir la aparición de la úlcera por presión. Más bien se trata de una interrelación de factores que incrementan la probabilidad de su desarrollo.

Pre- and/or postnatal protein restriction developmentally programs affect and risk assessment behaviors in adult male rats.

Developmental programming resulting from a suboptimal intrauterine environment can predispose offspring to a wide-range of lifelong health complications. Little is known about the effects maternal protein restriction during pregnancy and/or lactation has on offspring neurodevelopment. We hypothesized that maternal isocaloric low protein diet during pregnancy and/or lactation would negatively influence male offspring affect and risk assessment behaviors as measured by elevated plus maze and open field tests. Control mothers received 20% casein (C) and restricted mothers (R) 10% casein to provide four groups: CC, RR, CR, and RC (first letter pregnancy diet and second letter lactation diet) to evaluate effects of maternal diet on offspring risk assessment, anxiety and exploratory behaviors. Elevated plus maze results showed an effect of pre- and/or postnatal diet manipulation in open arm time (p<0.05) with increases seen in the RR (157±22.7s), CR (137±23.2s) and RC (146.8±10.8s) offspring relative to CC (52±8.6s) offspring. This behavior indicates decreased avoidance (less anxiety) and increased exploration by experimental groups. However, in the open field test the RR (17±4.2 entries) offspring entered the center zone less than the CC (35±6.6 entries) offspring thus exhibiting increased anxiety with no other groups showing effects. Elevated levels of corticosterone were measured before, during and after immobilization in the RR compared to CC offspring. These findings show protein restriction during critical periods of development negatively program offspring behavior. The underlying anatomical structures affected remain to be elucidated.

Maternal obesity in the rat programs male offspring exploratory, learning and motivation behavior: prevention by dietary intervention pre-gestation or in gestation.

We studied the effects of maternal high fat diet (HFD, 25% calories from fat administered before and during pregnancy and lactation) and dietary intervention (switching dams from HFD to control diet) at different periconceptional periods on male offspring anxiety related behavior, exploration, learning, and motivation. From weaning at postnatal day (PND) 21, female subjects produced to be the mothers in the study received either control diet (CTR - 5% calories from fat), HFD through pregnancy and lactation (MO), HFD during PNDs 21-90 followed by CTR diet (pre-gestation (PG) intervention) or HFD from PND 21 to 120 followed by CTR diet (gestation and lactation (G) intervention) and bred at PND 120. At 19 days of gestation maternal serum corticosterone was increased in MO and the PG and G dams showed partial recovery with intermediate levels. In offspring, no effects were found in the elevated plus maze test. In the open field test, MO and G offspring showed increase zone entries, displaying less thigmotaxis; PG offspring showed partial recuperation of this behavior. During initial operant conditioning MO, PG and G offspring displayed decreased approach behavior with subsequent learning impairment during the acquisition of FR-1 and FR-5 operant conditioning for sucrose reinforcement. Motivation during the progressive ratio test increased in MO offspring; PG and G intervention recuperated this behavior. We conclude that dietary intervention can reverse negative effects of maternal HFD and offspring outcomes are potentially due to elevated maternal corticosterone.

Multivariate analysis to determine the factors affecting the attitudes toward organ donation of healthcare assistants in Spanish and Mexican healthcare centers.

BACKGROUND: Healthcare assistants are an important group of workers who can influence public opinion. Their attitudes toward organ donation may influence public awareness of healthcare matters; negative attitudes toward donation and transplantation could have a negative impact on public attitudes. Our objective was analyze the attitudes of healthcare assistants, in Spanish and Mexican healthcare centers toward organ donation and determine factors affecting them using a multivariate analysis. MATERIAL AND METHODS: As part of the "International Collaborative Donor Project," 32 primary care centers and 4 hospitals were selected in Spain and 5 hospitals in Mexico. A randomized sample of healthcare assistants was stratified according to healthcare services. Attitudes were evaluated using a validated questionnaire of the psychosocial aspects of donation, which was self-completed anonymously by the respondent. Statistical analysis used the chi-square test, Student t test, and logistic regression analysis. RESULTS: Of 532 respondents, 66% in favored donation and 34% were against it or undecided. Upon multivariate analysis, the following variables had the most weight: 1) country of origin (Mexicans were more in favor than Spanish; odds ratio [OR]) = 1.964; P = .014); 2) a partner with a favorable attitude (OR = 2.597; P = .013); 3) not being concerned about possible bodily mutilation after donation (OR = 2.631; P = .006); 4) preference for options apart from burial for handling the body after death (OR = 4.694; P < .001) and 5) accepting an autopsy if one was needed (OR = 3.584; P < .001). CONCLUSIONS: The attitudes of healthcare assistants toward organ donation varied considerably according to the respondent's country of origin. The psycho-social profile of a person with a positive attitude to donation was similar to that described within the general public.

Multivariate analysis of the factors affecting attitude toward living liver donation among workers in surgical services in Spanish, Mexican, and Cuban hospitals.

INTRODUCTION: Current liver donation rates are insufficient to cover transplant needs. Therefore, it is essential to promote living liver donation (LLD) given the ever decreasing morbidity and mortality in the donor and the improving results in the recipient. LLD is becoming increasingly accepted. However, in the health care system, a percentage of the personnel are not in favor. OBJECTIVE: To analyze the attitude of personnel in surgical services in Spain and Latin-America hospitals toward LLD. MATERIALS AND METHODS: As part of the "International Collaborative Donor Project," a random sample was taken and stratified according to surgical service and job category in 10 hospitals; three in Spain, five in Mexico, and two in Cuba (n = 496). Attitude was evaluated using a validated survey that was completed anonymously and self-administered. RESULTS: Eighty-six percent (n = 425) of respondents were in favor of related living liver donation, and 30% (n = 147) were in favor if it were not related. According to country, 88% of the Mexican respondents were in favor of living liver donation, 85% of the Cubans, and 82% of the Spanish (P > .05). In the multivariate analysis of the variables with most weight affecting attitude toward LLD, the following significant associations were found: (1) a favourable attitude toward living kidney donation (odds ratio [OR] = 91; P < .001); (2) acceptance of a donated living liver if one were needed (OR = 11; P < .001); and (3) family discussion about donation and transplantation (OR = 2.581; P = .037). CONCLUSIONS: Attitude toward related living liver donation was very favorable among hospital personnel in Spanish and Latin American surgical services.

Pre- and/or postnatal protein restriction in rats impairs learning and motivation in male offspring.

Suboptimal developmental environments program offspring to lifelong health complications including affective and cognitive disorders. Little is known about the effects of suboptimal intra-uterine environments on associative learning and motivational behavior. We hypothesized that maternal isocaloric low protein diet during pregnancy and lactation would impair offspring associative learning and motivation as measured by operant conditioning and the progressive ratio task, respectively. Control mothers were fed 20% casein (C) and restricted mothers (R) 10% casein to provide four groups: CC, RR, CR, and RC (first letter pregnancy diet and second letter lactation diet), to evaluate effects of maternal diet on male offspring behavior. Impaired learning was observed during fixed ratio-1 operant conditioning in RC offspring that required more sessions to learn vs. the CC offspring (9.4±0.8 and 3.8±0.3 sessions, respectively, p<0.05). Performance in fixed ratio-5 conditioning showed the RR (5.4±1.1), CR (4.0±0.8), and RC (5.0±0.8) offspring required more sessions to reach performance criterion than CC offspring (2.5±0.5, p<0.05). Furthermore, motivational effects during the progressive ratio test revealed less responding in the RR (48.1±17), CR (74.7±8.4), and RC (65.9±11.2) for positive reinforcement vs. the CC offspring (131.5±7.5, p<0.05). These findings demonstrate negative developmental programming effects due to perinatal isocaloric low protein diet on learning and motivation behavior with the nutritional challenge in the prenatal period showing more vulnerability in offspring behavior.

Donation and transplantation among personnel in the hospital emergency department: a multicenter study conducted in Spain and Mexico.

INTRODUCTION: The promotion of different means of procuring both deceased and living organs (kidney and liver) is a necessity given the current organ shortage. Emergency department personnel are involved in the donation and transplantation process. Our objective was to analyze the attitude to the different kinds of organ donation of emergency services personnel in hospital centers in Spain and Mexico. MATERIALS AND METHODS: A randomized sample was obtained from the "International Collaborative Donor Project" and was stratified according to emergency services and job category in nine hospitals, in Spain and in Mexico (n = 22). Attitude was evaluated using a validated survey. RESULTS: Of the respondents, 76% were in favor of deceased organ donation and 24% were not in favor. This attitude toward deceased donation was associated with the respondent's country of origin, age, and job category; Mexicans (P = .036), younger respondents (P = .023), and physicians were most in favor (P < .001). With regard to attitude toward living kidney donation, 89% were in favor of related donation. Regarding living liver donation, 85% were in favor of related donation. In attitude toward living kidney and liver donation, relevant factors were related to donation and transplantation. CONCLUSIONS: Professionals in emergency departments in hospital centers in Spain and Mexico had a favorable attitude toward the different kinds of donation, although it was less favorable than the attitude reported in other professional hospital groups.

The effects of chronic methylphenidate administration on operant test battery performance in juvenile rhesus monkeys.

Methylphenidate (MPH) is an amphetamine derivative widely prescribed for the treatment of attention deficit-hyperactivity disorder. Recent concern over its genotoxic potential in children [11] spurred a study on the effects of chronic MPH treatment in a nonhuman primate population and the studies reported here were conducted in conjunction with that study in the same animals. Here, the focus was on the ability of juvenile rhesus monkeys to learn how to perform a battery of operant behavioral tasks while being treated chronically with MPH. Performance of the National Center for Toxicological Research (NCTR) Operant Test Battery (OTB) was used to quantify the learning of tasks thought to model specific aspects of cognitive function including learning, motivation, color and position discrimination, and short-term memory. The OTB tasks designed to assess these specific behaviors included Incremental Repeated Acquisition (IRA), Progressive Ratio (PR), Conditioned Position Responding (CPR), and Delayed Matching-to-Sample (DMTS), respectively. Juvenile males (n=10/group) pressed levers and press-plates for banana-flavored food pellets. Subjects were treated orally, twice a day, five days per week (M-F) for 66 weeks with escalating doses (0.15 mg/kg initially, increased to 2.5 mg/kg for the low dose group and to 12.5 mg/kg for the high dose group) and tested in OTB tasks 30 to 60 min after the morning dose. The findings indicate that MPH at doses up to 2.5 mg/kg twice per day were well tolerated (performance was no different than controls) but at doses of 12.5 mg/kg twice per day there was a significant decrement in OTB performance, characterized by decreases in both percent task completed and response rates for all tasks. These effects of MPH seem primarily due to decreases in motivation to perform for food, which is not surprising given the well known appetite suppressing effects of amphetamine-like stimulants. Thus, the current data do not strongly suggest cognitive impairments following chronic MPH administration.

Attitudes of Spanish and Mexican resident physicians faced with solid organ donation and transplantation.

INTRODUCTION: The attitudes of specialist physicians toward organ donation and transplantation are of great interest because promotion of this activity depends on them. Our objective was to analyze the attitudes of residents in health centers in Spain (MIR) and in Mexico (ENARM). MATERIALS AND METHODS: A random stratified sample was obtained in six teaching hospitals: two in Spain (n = 246) and four in Mexico (n = 139) as part of the International Collaborative Program "Proyecto Donante, Murcia." The sample consisting of 385 trainee physicians completed a psychosocial questionnaire as the instrument to test their opinions. RESULTS: Most residents (93%; n = 359), were in favor of deceased organ donation with 90% (n = 348) in favor of living kidney donation and 87% (n = 335) in favor of liver donation. Attitudes toward donation were similar among Spanish and Mexican residents regarding deceased donation (93% vs 94%; P > .05), living kidney donation (88% vs 94%; P > .05), and living liver donation (86% vs 89%; P > .05). None of the attitudes toward donation was associated with the classic psychosocial factors related to attitudes toward donation or job factors. Discussion within the family was associated with more positive attitudes toward deceased donation (P < .001), living donation of the kidney (P = .01), and of the liver (P = .019). CONCLUSION: Attitudes toward various types of donation were favorable among both Spanish and Mexican trainee physicians, so that they could potentially act as a group to promote this activity, raising hopes for increased donation rates in the future.

Induction of tolerance in renal transplantation using splenic transplantation: experimental study in a canine model.

OBJECTIVE: To evaluate in a canine model the induction of tolerance to renal transplantation after splenectomy and splenosis. MATERIALS AND METHODS: This prospective, experimental, comparative, longitudinal study included 4 experimental groups, each comprising 4 dogs. Group 1 (control group) underwent renal transplantation only; group 2 underwent renal transplantation and splenectomy; group 3 underwent renal transplantation and splenosis; and group 4 underwent renal transplantation, splenectomy, and splenosis. Survival and degree of rejection were compared between the 4 groups. RESULTS: Splenosis improved renal function after transplantation, as indicated by increased serum creatinine concentration (group 3, 6.2 mg/dL vs group 1, 12.9 mg/dL). Comparison of weighted survival curves (corrected for degree of rejection) demonstrated a significant difference between group 2 (66.0 days) and group 4 (66.2 days) vs group 1 (52.7 days) and group 3 (41.2 days) (P = .05, Wilcoxon rank sum test). CONCLUSION: These results suggest that in this experimental model of renal transplantation, splenosis and splenectomy induce clinical tolerance, as indicated by improved renal function and prolonged recipient survival.