Plasticity of Dendritic Spines. Not Only for Cognitive Processes

Excitatory synaptic transmission is associated with the input of “new” information at synaptic junctions established by dendritic spines. The role that each type of spine plays in the transmission of the synaptic impulses is different. Indeed, there is a close relationship between the shape of spines and the differential processing of the excitatory synaptic information that is relayed to them, influencing in turn the transmission of synaptic information related to several psychoneural processes

Real world data in primary care: validation of diagnosis of atrial fibrillation in primary care electronic medical records and estimated prevalence among consulting patients

Primary care electronic medical records contain clinical-administrative information on a high percentage of the population. Before this information can be used for epidemiological purposes, its quality must be verified. This study aims to validate diagnoses of atrial fibrillation (AF) recorded in primary care electronic medical records and to estimate the prevalence of AF in the population attending primary care consultations. Methods: We performed a cross-sectional validation study of all diagnoses of AF recorded in primary care electronic medical records in Madrid (Spain). We also performed simple random sampling of diagnoses of AF (ICPC-2 code K78) registered by 55 physicians and random age- and sex-matched sampling of the records that included a diagnosis of AF. Electrocardiograms, echocardiograms, and hospital discharge or cardiology clinic reports were matched. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and overall agreement were calculated using the kappa statistic (κ). The prevalence of AF in the community of Madrid was estimated considering the sensitivity and specificity obtained in the validation. All calculations were performed overall and by sex and age groups. Results: The degree of agreement was very high (κ = 0.952), with a sensitivity of 97.84%, specificity of 97.39%, PPV of 97.37%, and NPV of 97.85%. The prevalence of AF in the population aged over 18 years was 2.41% (95%CI 2.39–2.42% [2.25% in women and 2.58% in men]). This increased progressively with age, reaching 16.95% in those over 80 years of age (15.5% in women and 19.44% in men). Conclusions: The validation results obtained enable diagnosis of AF recorded in primary care to be used as a tool for epidemiological studies. A high prevalence of AF was found, especially in older patientsThis study forms part of research funded by the FIS (Fondo de Investigaciones Sanitarias—Health Research Fund, Instituto de Salud Carlos III) grants no. PI13/00632, and co-funded by the European Union through the Fondo Europeo de Desarrollo Regional (FEDER, “A way of shaping Europe”. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

La resolución enfermera en la atención de la demanda espontánea: clave para el funcionamiento de un CUAP

Introducción: los centros de urgencia de atención primaria (CUAP) surgen con el objetivo de abordar la patología de bajo y medio nivel de urgencia. La utilización por enfermería de algoritmos de actuación validados de los problemas de salud agudos leve (PSAL) incrementa la resolución enfermera. Objetivos: describir los problemas de salud agudos leves en personas adultas resueltos por el personal de enfermería en el CUAP de Manso mediante algoritmos de actuación. Justificación: la implicación de la enfermera en la atención a los problemas de salud agudos leves en los CUAP consolida su cartera de servicios y la sitúa en la puerta de entrada al sistema sanitario. Los algoritmos de actuación otorgan a la enfermera la capacidad de gestionar hasta el final la resolución de la demanda del usuario. Material y método: la recogida de datos se llevó a cabo durante 6 meses y se analizó el uso de los 20 algoritmos de actuación. La extracción de datos se realizó a partir de la historia clínica informatizada. Resultados: la utilización de los algoritmos de actuación permitió resolver por enfermería un total de 1575 demandas sanitarias. Los algoritmos más utilizados en la resolución fueron los correspondientes a: 27 %, heridas; 20 %, aplicación de técnicas, y en un 13 %, educación sanitaria. La edad media es de 40 años. El 43 % fueron hombres y el 57 % mujeres. Conclusiones: la utilización de algoritmos de actuación en la toma de decisiones permite que el personal de enfermería resuelva un gran número de problemas de salud aumentando su protagonismo en la actividad asistencial e incrementando su cartera de servicios. La educación sanitaria basada en las recomendaciones prescritas en los algoritmos puede ayudar a resolver un porcentaje elevado de consultas

Mural Endocarditis: The GAMES Registry Series and Review of the Literature

Spanish Collaboration on Endocarditis—Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España (GAMES).[Introduction] Mural infective endocarditis (MIE) is a rare type of endovascular infection. We present a comprehensive series of patients with mural endocarditis.[Methods] Patients with infectious endocarditis (IE) from 35 Spanish hospitals were prospectively included in the GAMES registry between 2008 and 2017. MIEs were compared to non-MIEs. We also performed a literature search for cases of MIE published between 1979 and 2019 and compared them to the GAMEs series.[Results] Twenty-seven MIEs out of 3676 IEs were included. When compared to valvular IE (VIE) or device-associated IE (DIE), patients with MIE were younger (median age 59 years, p < 0.01). Transplantation (18.5% versus 1.6% VIE and 2% DIE, p < 0.01), hemodialysis (18.5% versus 4.3% VIE and 4.4% DIE, p = 0.006), catheter source (59.3% versus 9.7% VIE and 8.8% DIE, p < 0.01) and Candida etiology (22.2% versus 2% DIE and 1.2% VIE, p < 0.01) were more common in MIE, whereas the Charlson Index was lower (4 versus 5 in non-MIE, p = 0.006). Mortality was similar. MIE from the literature shared many characteristics with MIE from GAMES, although patients were younger (45 years vs. 56 years, p < 0.001), the Charlson Index was lower (1.3 vs. 4.3, p = 0.0001), catheter source was less common (13.9% vs. 59.3%) and there were more IVDUs (25% vs. 3.7%). S. aureus was the most frequent microorganism (50%, p = 0.035). Systemic complications were more common but mortality was similar.[Conclusion] MIE is a rare entity. It is often a complication of catheter use, particularly in immunocompromised and hemodialysis patients. Fungal etiology is common. Mortality is similar to other IEs.Peer reviewe

Clinico-pathological characteristics and outcomes of patients with early-onset colorectal cancer

[Background]: The rising incidence of colorectal cancer (CRC) among young patients is alarming. We aim to characterize the clinico-pathological features and outcomes of patients with early-onset CRC (EOCRC). [Methods]: We included all of the patients with pathologically confirmed diagnosis of CRC at Hospital Universitario La Paz from October 2016 to September 2020. EOCRC age cut-off was 50 years. All statistical analyses were carried out using SPSS v.25. [Results]: A total of 1152 patients were diagnosed with CRC, fifty-nine (5,1%) of them were After a median follow-up of 24 months, 279 patients have died. Median overall survival (OS) was not reached in either group (p = 0,06). Three-year OS was 80% (95%CI: 73-87) and 67 (95%CI: 65-69) in the younger and older group, respectively. In patients with localized disease that underwent surgery or other antineoplastic treatment ( n = 856), 159 events for disease-free survival (DFS) were observed. Median DFS was [Conclusions]: Patients with EOCRC are diagnosed at a more advanced stage and display distinct biological features (more prevalence of dMMR and WT tumors among others). Studies focusing on screening in this population and deeper molecular profiling are needed

Clinico-pathological characteristics and outcomes of patients with early-onset colorectal cancer

[Background]: The rising incidence of colorectal cancer (CRC) among young patients is alarming. We aim to characterize the clinico-pathological features and outcomes of patients with early-onset CRC (EOCRC).[Methods]: We included all of the patients with pathologically confirmed diagnosis of CRC at Hospital Universitario La Paz from October 2016 to September 2020. EOCRC age cut-off was 50 years. All statistical analyses were carried out using SPSS v.25. [Results]: A total of 1152 patients were diagnosed with CRC, fifty-nine (5,1%) of them were After a median follow-up of 24 months, 279 patients have died. Median overall survival (OS) was not reached in either group (p ¼ 0,06). Three-year OS was 80% (95% CI: 73-87) and 67 (95%CI: 65-69) in the younger and older group, respectively. In patients with localized disease that underwent surgery or other antineoplastic treatment ( n ¼ 856), 159 events for disease-free survival (DFS) were observed. Median DFS was not reached in either group (p ¼0,144). Three-year DFS was 86% (95%CI: 79-93) and 73% (95%CI: 71-75, respectively). In patients with metastatic disease (n ¼ 332; synchronous or metachronic), median OS was not reach in the EOCRC group vs 18,1 (95%CI: 13,8-22,4), p ¼ 0,05). In those patients with metastatic EOCRC with mutational status assessed (n ¼23), no difference in OS according to RAS was observed (p ¼ 0,55).[Conclusions]: Patients with EOCRC are diagnosed at a more advanced stage and display distinct biological features (more prevalence of dMMR and WT tumors among others). Studies focusing on screening in this population and deeper molecular profiling are needed.Peer reviewe

Evaluación de la sintomatología negativista desafiante en niños de seis a ocho años : concordancia entre padres y maestros

El objetivo principal de este estudio es conocer el grado de concordancia entre los informes proporcionados por padres y maestros acerca de la sintomatología negativista desafiante en niños en edad escolar (6-8 años). Además, se pretende analizar si la edad y el sexo del niño afectan el nivel de acuerdo entre informantes. Padres y maestros evaluaron a 702 niños y niñas de 25 escuelas de la Comarca de Osona, Barcelona (España), mediante el Child Sympton Inventory-4 (versión padres y maestros). Los resultados indican una concordancia muy baja, casi nula, entre las valoraciones de ambos informantes; además, las variables edad y sexo de los niños no representan una diferencia significativa en dichas valoraciones. Los padres tienden a evaluar más síntomas del Trastorno Negativista Desafiante como presentes, y a percibir con mayor intensidad su severidadThe main goal of this study is to determine the degree of agreement between the reports provided by parents and teachers about oppositional defiant symptoms in school children between the ages of 6 and 8 years. In addition, it attempts to determine whether children's age and sex affect the level of agreement between informants. Parents and teachers assessed 702 girls and boys at 25 schools in the Region of Osona, Barcelona (Spain) with the Child Symptom Inventory-4 (parents' and teachers' version). The results indicate a very low agreement -practically null-between the valuations of both informants; furthermore, no significant difference due to the variables age and sex of the children was observed in the above-mentioned valuations. The parents tended to appraise most of the symptoms of the Oppositional Defiant Disorder as present and to evaluate their severity as being more intens

Contamination level and spatial distribution of heavy metals in water and sediments of El Guájaro Reservoir, Colombia

Heavy metals have become a subject of special concern worldwide, mainly due to high persistence in the environment, toxicity, biogeochemical recycling and ecological risk. Therefore, the objective of this investigation was to analyze the spatial–temporal distribution of heavy metals in water and sediments to determine the environmental status of El Guájaro Reservoir, where such studies have not been developed. Two measurement campaigns (dry and wet period) were carried out and eight sampling stations were selected. A comparison of water and sediment quality parameters with existing national and international regulations was done. Also, heavy metal distribution maps were generated, and the geoaccumulation index was calculated to identify sources and sediments contamination level. Based on the obtained results, agriculture and mining activities are the main causes of the reservoir contamination. This metals levels could be a potential risk for the aquatic life and the populations that are supplied from this water body