Vasopressina, un nou biomarcador en insuficiència cardíaca

Introducció. Les concentracions plasmàtiques dels pèptids natriürètics són biomarcadors útils en el diagnòstic i en el maneig de la insuficiència cardíaca (IC). L'objectiu de l'estudi va consistir en avaluar un nou biomarcador, la vasopressina, per predir la mortalitat i el reingrés a mig termini dels pacients que ingressen per IC aguda. Mètodes. Des del novembre de 2004 fins setembre de 2010 s'estudien de forma prospectiva el pacients que ingressen al Servei de Cardiologia per IC aguda i es distribueixen en dos grups: grup 1, pacients amb nivells baixos de vasopressina ( ≤ 2'9 pg/mL) i grup 2, pacients amb nivells alts de vasopressina ( 2'9 pg/mL). Es realitza una anàlisi multivariada de Cox i es construeixen corbes de Kaplan-Meier. Resultats. S'inclouen 322 pacients, amb una mediana de seguiment de 14,6 mesos. Els pacients del grup 1 presenten una major supervivència als 12 i 24 mesos del 93% i 72% respecte els pacients del grup 2 que és del 75% i 61% amb una HR 2.90 (IC 95%: 1.47-5.75, p=0.002), respectivament. Tanmateix s'aprecia una major supervivència cardiovascular en els pacients del grup 1 (97% vs. 87% al 12 mesos i de 87% vs. 75% als 24 mesos) amb HR 2.72 (IC 95%: 1.97 - 6.73, p 0.031). Un 56% i 29% dels pacients del grup 1 estaven lliures de reingrés als 12 i 24 mesos, respectivament, versus el 49% i el 21% del grup 2 amb una HR 1.48 (IC 95%: 1.04 - 2.11, p 0.02). Igualment pel primer reingrés per IC , el 71% i 46% del grup 1 respecte del 60% i 39% del grup 2 als 12 i 24 mesos, respectivament (HR 1.57 (IC 95%: 1.03 - 2.41, p 0.038). Conclusions. Els nivells alts de vasopressina en pacients amb insuficiència cardíaca aguda estabilitzats són un predictor independent de mortalitat i de reingressos als 12 i 24 mesos de seguiment

Espais agraris, assentaments andalusins i la ciutat de Tortosa (Baix Ebre)

La distribució dels assentaments rurals andalusins al Baix Ebre, a l'entorn de Madîna Turtûša (Tortosa), així com el desenvolupament de la ciutat estan estretament vinculats a la creació d'espais de cultiu en els marges del riu. Els llocs d'habitació ocupen petits pujols o se situen en la terrassa fluvial, preferentment en els esperons que forma aquesta a la desembocadura dels torrents de muntanya i a la vora dels espais de cultiu. Aquests es caracteritzen per ocupar les zones de deposició de sediments fluvials o dels torrents on, eventualment s'utilizaven pous i sínies per regar, o bé s'hi van realitzar operacions de drenatge. Madîna Turtûša estava vinculada a dos espais, un d'horta, al nord, regat també amb sínies, i un dedicat sobretot al cereal, al sud, on es va realitzar una operació de drenatge de l'aiguamoll fluvial.The distribution of rural islamic settlements in the Baix Ebre (the final stretch of Ebro River), nearby Madîna Turtûša (Tortosa), and the development of the city are closely connected with the construction of cultivation areas in both riversides. The inhabited nucleus are located on the fluvial terrace or in small hills, always nearby the cultivation areas. At the mouth of these torrents and in areas of fluvial sediment deposition we find the cultivation areas where wells and water elevation wheels were used to irrigate. There are also, wetlands that had been drained by means of channels. Madîna Turtûša had an orchard area northwards, irrigated by means of wells and water elevation wheels and a drained area southwards where cereals were grown

Protocol d'actuació clinicoassistencial de maltractaments aguts a la infància

Maltractaments aguts a la infància; Protocols d'actuació; Detecció de maltractaments infantilsMaltratos agudos a niños; Protocolos de actuación; Detección de maltratos infantilesAcute child abuse; Protocols; Detection of child abuseEl Protocol d’actuació clinicoassistencial de maltractaments aguts a la infància pretén, en primer lloc, homogeneïtzar els criteris clínics de detecció del maltractament infantil recollint l’experiència dels diferents centres que tenen més casuística. En segon lloc, és el resultat del treball conjunt dels professionals del Departament de Salut i del Departament d'Acció Social i Ciutadania per posar al dia les pautes professionals de detecció i valoració en l’entorn hospitalari. Amb aquest nou protocol hem de poder tenir criteris més clars per valorar, criteris compartits per saber quan cal actuar amb immediatesa i quan cal —sense deixar de protegir— esperar a tenir noves certeses

Mapping brain activity with flexible graphene micro-transistors

Establishing a reliable communication interface between the brain and electronic devices is of paramount importance for exploiting the full potential of neural prostheses. Current microelectrode technologies for recording electrical activity, however, evidence important shortcomings, e.g. challenging high density integration. Solution-gated field-effect transistors (SGFETs), on the other hand, could overcome these shortcomings if a suitable transistor material were available. Graphene is particularly attractive due to its biocompatibility, chemical stability, flexibility, low intrinsic electronic noise and high charge carrier mobilities. Here, we report on the use of an array of flexible graphene SGFETs for recording spontaneous slow waves, as well as visually evoked and also pre-epileptic activity in vivo in rats. The flexible array of graphene SGFETs allows mapping brain electrical activity with excellent signal-to-noise ratio (SNR), suggesting that this technology could lay the foundation for a future generation of in vivo recording implants

Mapping brain activity with flexible graphene micro-transistors

Establishing a reliable communication interface between the brain and electronic devices is of paramount importance for exploiting the full potential of neural prostheses. Current microelectrode technologies for recording electrical activity, however, evidence important shortcomings, e.g. challenging high density integration. Solution-gated field-effect transistors (SGFETs), on the other hand, could overcome these shortcomings if a suitable transistor material were available. Graphene is particularly attractive due to its biocompatibility, chemical stability, flexibility, low intrinsic electronic noise and high charge carrier mobilities. Here, we report on the use of an array of flexible graphene SGFETs for recording spontaneous slow waves, as well as visually evoked and also pre-epileptic activity in vivo in rats. The flexible array of graphene SGFETs allows mapping brain electrical activity with excellent signal-to-noise ratio (SNR), suggesting that this technology could lay the foundation for a future generation of in vivo recording implants

Soluble Transferrin Receptor as Iron Deficiency Biomarker: Impact on Exercise Capacity in Heart Failure Patients

The soluble transferrin receptor (sTfR) is a marker of tissue iron status, which could indicate an increased iron demand at the tissue level. The impact of sTfR levels on functional capacity and quality of life (QoL) in non-anemic heart failure (HF) patients with otherwise normal systemic iron status has not been evaluated. We conducted an observational, prospective, cohort study of 1236 patients with chronic HF. We selected patients with normal hemoglobin levels and normal systemic iron status. Tissue iron deficiency (ID) was defined as levels of sTfR > 75th percentile (1.63 mg per L). The primary endpoints were the distance walked in the 6 min walking test (6MWT) and the overall summary score (OSS) of the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The final study cohort consisted of 215 patients. Overall QoL was significantly worse (51 +/- 27 vs. 39 +/- 20, p-value = 0.006, respectively), and the 6 MWT distance was significantly worse in patients with tissue ID when compared to patients without tissue ID (206 +/- 179 m vs. 314 +/- 155, p-value < 0.0001, respectively). Higher sTfR levels, indicating increased iron demand, were associated with a shorter distance in the 6 MWT (standardized beta = -0.249, p < 0.001) and a higher MLHFQ OSS (standardized fi = 0.183, p-value = 0.008). In this study, we show that in patients with normal systemic iron parameters, higher levels of sTfR are strongly associated with an impaired submaximal exercise capacity and with worse QoL

A retrospective cohort study of risk factors for mortality among nursing homes exposed to COVID-19 in Spain

Long-term care (LTC) facilities have shown remarkably high mortality rates during the coronavirus disease 2019 (COVID-19) outbreak in many countries1, and different risk factors for mortality have been identified in this setting2–5. Using facilities as the unit of analysis, we investigated multiple variables covering facility characteristics and socioeconomic characteristics of the geographic location to identify risk factors for excess mortality from a comprehensive perspective. Furthermore, we used a clustering approach to detect patterns in datasets and generate hypotheses regarding potential relationships between types of nursing homes and mortality trends. Our retrospective analysis included 167 nursing homes providing LTC to 8,716 residents during the COVID-19 outbreak in Catalonia (northeast Spain). According to multiple regression analysis, COVID-19-related and overall mortality at the facility level were significantly associated with a higher percentage of patients with complex diseases, lower scores on pandemic preparedness measures and higher population incidence of COVID-19 in the surrounding population. When grouping nursing homes into eight clusters based on common features, we found higher mortality rates in four clusters, mainly characterized by a higher proportion of residents with complex chronic conditions or advanced diseases, lower scores on pandemic preparedness, being located in rural areas and larger capacity, respectively

26th Annual Computational Neuroscience Meeting (CNS*2017): Part 3 - Meeting Abstracts - Antwerp, Belgium. 15–20 July 2017

This work was produced as part of the activities of FAPESP Research,\ud Disseminations and Innovation Center for Neuromathematics (grant\ud 2013/07699-0, S. Paulo Research Foundation). NLK is supported by a\ud FAPESP postdoctoral fellowship (grant 2016/03855-5). ACR is partially\ud supported by a CNPq fellowship (grant 306251/2014-0)

Transfer entropy, symbolic transfer entropy and transcript mutual information indicators reveal a leading role of infragranular layers during slow oscillations

The recurrent circuitry of the cerebral cortex generates an emergent pattern of activity that is organized into rhythmic periods of firing and silence referred to as slow oscillations (ca 1 Hz). Slow oscillations not only are dominant during slow wave sleep and deep anaesthesia, but also can be generated by the isolated cortical network in vitro, being a sort of default activity of the cortical network. The cortex is densely and reciprocally connected with subcortical structures and, as a result, the slow oscillations in situ are the result of an interplay between cortex and thalamus. Due to this reciprocal connectivity and interplay, the mechanism responsible for the initiation of waves in the corticothalamocortical loop during slow oscillations is still a matter of debate. The prevalent view is that infragranular layers of the cortex, where the highest firing rates are found, are leading the periods of activity or Up states, from where activity rapidly spreads to all cortical layers and subcortical structures such as the thalamus. However, other authors support that the slow wave activity is an emergent property of corticothalamocortical networks defining the origin of this activity as a balance between cortical and thalamic contributions. To determine the directionality of the information flow between different layers of the cortex and the connected thalamus during spontaneous activity we obtained multilayer local field potentials from the rat visual cortex and from its connected thalamus, the lateral geniculate nucleus, during deep anaesthesia. We analyzed directionality of information flow between thalamus, cortical infragranular layers (5 and 6) and supragranular layers (2/3) by means of three information theoretical indicators: transfer entropy, symbolic transfer entropy and transcript mutual information. These three indicators coincided in finding that infragranular layers lead the information flow during slow oscillations both towards supragranular layers and towards the thalamus

Gradual emergence of spontaneous correlated brain activity during fading of general anesthesia in rats: Evidences from fMRI and local field potentials

Intrinsic brain activity is characterized by the presence of highly structured networks of correlated fluctuations between different regions of the brain. Such networks encompass different functions, whose properties are known to be modulated by the ongoing global brain state and are altered in several neurobiological disorders. In the present study, we induced a deep state of anesthesia in rats by means of a ketamine/medetomidine peritoneal injection, and analyzed the time course of the correlation between the brain activity in different areas while anesthesia spontaneously decreased over time. We compared results separately obtained from fMRI and local field potentials (LFPs) under the same anesthesia protocol, finding that while most profound phases of anesthesia can be described by overall sparse connectivity, stereotypical activity and poor functional integration, during lighter states different frequency-specific functional networks emerge, endowing the gradual restoration of structured large-scale activity seen during rest. Noteworthy, our in vivo results show that those areas belonging to the same functional network (the default-mode) exhibited sustained correlated oscillations around 10 Hz throughout the protocol, suggesting the presence of a specific functional backbone that is preserved even during deeper phases of anesthesia. Finally, the overall pattern of results obtained from both imaging and in vivo-recordings suggests that the progressive emergence from deep anesthesia is reflected by a corresponding gradual increase of organized correlated oscillations across the cortex.The research reported herein was supported by the ERC Advanced Grant DYSTRUCTURE (No. 295129), FET Flagship Human Brain Project, Brain Network Recovery Group through the James S. McDonnell Foundation (220020255), FP7-ICT BrainScales (No. 269921), CORONET (No. 269459), Ministerio de Economia y Competitividad (MINECO-PSI2013-42091-P), and Agència Gestió d'Ajuts Universitaris i de Recerca (2009SGR292) to G.D. M.V.S.V. was supported by the Ministerio de Economía y Competitividad (Spain)BFU2011-27094 and EU project CORTICONIC Contract number 600806