Health-related quality of life and mortality in the 'Seguimiento Universidad de Navarra' prospective cohort study

Objective: To study the association between health-related quality of life (HRQoL) and all-cause mortality in a healthy middle-aged Mediterranean cohort. Methods: We included 15,390 participants –mean age 42.8 years at first HRQoL ascertainment, all university graduates–. HRQoL was assessed with the self-administered Medical Outcomes Study Short Form-36 (SF-36) twice, with a 4-year gap. We used multivariable-adjusted Cox regression models to address the relation between self-reported health and Physical or Mental Component Summary (PCS-36 or MCS-36) and mortality, and their interaction with prior comorbidities or adherence to the Mediterranean diet (MedDiet). Results: Over 8.7 years of median follow-up time, 266 deaths were identified. Hazard ratio (HR) for the excellent vs. poor/fair category in self-reported health was 0.30 (95 % confidence interval (CI), 0.16–0.57) in the model with repeated measurements of HRQoL. Both the PCS-36 (HRquartile4(Q4)vs.Q1 0.57 [95%CI, 0.36–0.90], ptrend < 0.001; HRper+10points: 0.64 [95%CI, 0.54–0.75]) and the MCS-36 (HRQ4vs.Q1 0.67 [95%CI, 0.46–0.97], ptrend = 0.025; HRper+10points: 0.86 [95%CI, 0.74–0.99]) were inversely associated with mortality in the model with repeated measurements of HRQoL. Previous comorbidities or adherence to the MedDiet did not modify these associations. Conclusions: Self-reported HRQoL –assessed as self-reported health, PCS-36 and MCS-36– obtained with the Spanish version of the SF-36 were inversely associated with mortality risk, regardless of the presence of previous comorbidities or adherence to the MedDiet.This project was made possible by funding from the Spanish Government-Instituto de Salud Carlos III, and the European Regional Development Fund (FEDER) (RD 06/0045, CIBER-OBN, Grants PI10/02658, PI10/02293, PI13/00615, PI14/01668, PI14/01798, PI14/01764, PI17/01795, PI18/00631, PI20/00564 and G03/140), from the Government of Navarra (27/2011, 45/2011, 122/2014), from the National Plan on Drugs (2020/021) as well as from the University of Navarra

Monitoring synaptic function at the neuromuscular junction of a mouse expressing synaptopHluorin

We monitored presynaptic exocytosis and vesicle recycling at neuromuscular junctions of transgenic mice expressing synaptopHluorin (spH), using simultaneous optical and electrophysiological recordings. Synaptic transmission was indistinguishable from that in wildtype controls. Fluorescence rose during and decayed monotonically after stimulus trains to the nerve, with amplitudes and decay times increasing with the amount of stimulation. The relatively large size of synaptic terminals allowed us to examine the spatial profile of fluorescence changes. We identified hot spots of exocytosis, which were stable with repeated trains. Photobleach experiments showed that spH freshly exposed by nerve stimulation was not preferentially retrieved by compensatory endocytosis; instead, most retrieved spH preexisted in the surface membrane. Finally, we compared fluorescence and electrical [summed end-plate potentials (EPPs)] estimates of exocytosis, which diverged during repeated trains, as fluorescence exceeded summed EPPs, although the average amplitude of miniature EPPs was unchanged. This might reflect exocytosis of spH-containing, acetylcholine-free (“empty”) vesicles or other organelles during intense stimulation

Papel de la eminencia talámica, el sistema olfativo principal y el sistema olfativo accesorio en la maduración sexual del encéfalo y las manifestaciones clínico-morfológicas del síndrome de Kallmann

El desarrollo de sistema olfativo y la diferenciación sexual del encéfalo, tanto en el hombre como en los animales, están estrechamente relacionados. Actualmente, se describe la imbricación entre la formación del sistema olfativo principal y la migración de las neuronas que sintetizan la hormona liberadora de gonadotrofinas (GnRF). Estas neuronas GnRF se desplazan por los nervios olfatorios, desde la parte medial del epitelio nasal al bulbo olfatorio, continúan por el encéfalo rostral hasta alcanzar el hipotálamo anterior. Por otro lado, el síndrome de Kallmann es un trastorno genético en el cual se combina el hipogonadismo hipogonadotrópico y la anosmia. El hipogonadismo se caracteriza por la ausencia o reducción de los niveles de hormona liberadora de gonadotrofinas y la anosmia la aplasia del bulbo olfatorio. En esta revisión se analizan las estructuras responsables de la maduración del sistema olfativo principal y accesorio, la diferenciación sexual del encéfalo y su relación con todas las manifestaciones clínicas y morfológicas del síndrome Kallmann. The olfactory system development and brain sexual maturation, in man and animals, are closely related. Currently the overlap between the formation of the olfactory system and the migration of neurons that synthesize gonadotropin-releasing hormone (GnRF) are described. The GnRF neurons migrate from the medial portion of the nasal epithelium through the olfactory nerves and the main olfactory bulb to the anterior hypothalamus. Furthermore, Kallmann syndrome (KS) is a genetic disorder in which combines hypogonadotropic hypogonadism and anosmia. Hypogonadism is characterized by the absence or reduced levels of gonadotropin-releasing hormone and anosmia is due to aplasia of the olfactory bulb. The basic clinical manifestations of KS are: anosmia and the absence of puberty. The structures responsible for the maturation of the main and accessory olfactory systems, the sexual differentiation of the brain and its relationship with all the clinical manifestations of Kallmann syndrome are analyzed in this revie

Dietary Fat Intake and the Risk of Depression: The SUN Project

Emerging evidence relates some nutritional factors to depression risk. However, there is a scarcity of longitudinal assessments on this relationship. Objective: To evaluate the association between fatty acid intake or the use of culinary fats and depression incidence in a Mediterranean population. Material and Methods: Prospective cohort study (1999–2010) of 12,059 Spanish university graduates (mean age: 37.5 years) initially free of depression with permanently open enrolment. At baseline, a 136-item validated food frequency questionnaire was used to estimate the intake of fatty acids (saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), trans unsaturated fatty acids (TFA) and monounsaturated fatty acids (MUFA) and culinary fats (olive oil, seed oils, butter and margarine) During follow-up participants were classified as incident cases of depression if they reported a new clinical diagnosis of depression by a physician and/or initiated the use of antidepressant drugs. Cox regression models were used to calculate Hazard Ratios (HR) of incident depression and their 95% confidence intervals (CI) for successive quintiles of fats. Results: During follow-up (median: 6.1 years), 657 new cases of depression were identified. Multivariable-adjusted HR (95% CI) for depression incidence across successive quintiles of TFA intake were: 1 (ref), 1.08 (0.82–1.43), 1.17 (0.88–1.53), 1.28 (0.97–1.68), 1.42 (1.09–1.84) with a significant dose-response relationship (p for trend = 0.003). Results did not substantially change after adjusting for potential lifestyle or dietary confounders, including adherence to a Mediterranean Dietary Pattern. On the other hand, an inverse and significant dose-response relationship was obtained for MUFA (p for trend = 0.05) and PUFA (p for trend = 0.03) intake. Conclusions: A detrimental relationship was found between TFA intake and depression risk, whereas weak inverse associations were found for MUFA, PUFA and olive oil. These findings suggest that cardiovascular disease and depression may share some common nutritional determinants related to subtypes of fat intake

Dietary patterns and difficulty conceiving: a nested case–control study

Objective: To investigate potential associations between dietary patterns (defined using factor analysis) and difficulty conceiving. Design: Case–control study nested in a Spanish cohort of university graduates (Seguimiento Universidad de Navarra [SUN] Project). Setting: Female university graduates all over Spain participating in the SUN Project. Patient(s): A total of 485 women, aged 20–45 years, reporting having presented with difficulty getting pregnant, and 1,669 age-matched controls who had at least one child. Intervention(s): None. Main Outcome Measure(s): Reported difficulty getting pregnant. Data were collected from baseline and follow-up questionnaires of the SUN Project. Results: Two dietary patterns were identified. They were labeled as “Mediterranean-type” and “Western-type” patterns. A lower risk of difficulty getting pregnant was apparent in the highest quartile of adherence to the Mediterranean-type pattern compared with the lowest quartile (odds ratio 0.56, 95% confidence interval 0.35–0.95). Greater adherence to the Western-type dietary pattern showed no association with this outcome. Conclusion: A greater adherence to the Mediterranean-type dietary pattern may enhance fertility. Further evidence about the relationship between this dietary pattern and fertility is needed to develop nutritional interventions for women desiring to get pregnant

The omega rho pi coupling in the VMD model revisited

We determine the value of the \omega -\rho- \pi mesons coupling (g_{\omega\rho\pi}), in the context of the vector meson dominance model, from radiative decays, the \omega \rightarrow 3\pi decay width and the e^+e^- \rightarrow 3\pi cross section. For the last two observables we consider the effect of either a heavier resonance (\rho'(1450)) or a contact term. A weighted average of the results from the set of observables yields g_{\omega\rho\pi} =14.7 \pm 0.1 GeV^{-1} in absence of those contributions, and g_{\omega\rho\pi} =11.9 \pm 0.2 GeV^{-1} or g_{\omega\rho\pi} =11.7 \pm 0.1 GeV^{-1} when including the \rho' or contact term respectively. The inclusion of these additional terms makes the estimates from the different observables to lay in a more reduced range. Improved measurements of these observables and the \rho'(1450) meson parameters are needed to give a definite answer on the pertinence of the inclusion of this last one in the considered processes.Comment: 14 pages, 5 figures. Extended analysis including SND and CMD2 data. References added. Matches published versio

Paediatricians provide higher quality care to children and adolescents in primary care: A systematic review

Aim: The number of primary care paediatricians is decreasing in Europe without a justifiable reason. We aimed to compare the clinical practice of paediatricians and family doctors attending children and adolescents in primary care. Methods: MEDLINE, Embase, CENTRAL, TRIP and Google Scholar were searched from December 2008 to February 2018. No language or study design restrictions were applied. Three reviewers assessed eligibility of the studies. Seven pairs of reviewers performed the data extraction and assessed the methodological quality independently. Discrepancies were resolved by consensus. Results: Fifty-four, out of 1150 studies preselected, were included. We found that paediatricians show more appropriate pharmacology prescription patterns for the illness being treated; they achieve higher vaccination rates and have better knowledge of vaccines and fewer doubts about vaccine safety; their knowledge and implementation of different screening tests are better; they prescribe psychoactive drugs more cautiously and more in line with current practice guidelines; their evaluation and treatment of obesity and lipid disorders follow criteria more consistently with current clinical practice guidelines; and they perform fewer diagnostic test, show a more suitable use of the test and request fewer referrals to specialists. Conclusion: According to published data, in developed countries, paediatricians provide higher quality care to children than family doctors

Electrochemical, spectroscopic and electrochemiluminescent characterization of self-assembled 3-aminopropyltriethoxysilane/CdTe quantum dots hybrids on screen-printed electrodes

This work describes the electrochemical, spectroscopic and electrochemiluminescent (ECL) characterization of graphite screen-printed electrodes (SPE) modified with a multilayer electrostatic assembly between 3-aminopropyltriethoxysilane (APTES) and CdTe quantum dots stabilized with glutathione (GSH) as the cationic and the negative layers, respectively. The characterization of the obtained system was performed by cyclic voltammetry, electrochemical impedance spectroscopy, scanning electron microscopy and Raman spectroscopy, which confirm the homogeneous presence of CdTe quantum dots on the multilayer assembly. The electrochemiluminescent properties were measured in a potentiostat coupled with a photodiode detector, showing stable and repetitive electrochemiluminescent signals. The ECL response was studied using potassium persulfate and hydrogen peroxide as co-reactants, and the measurements were carried out at different scan rates, pH values and concentrations. The ECL properties of the studied system at specific experimental conditions demonstrated different mechanisms by changing the co-reactants associated with the electrochemical step to generate the radical species and its interaction with the SPE/APTES/CdTe (GSH) reduced system, obtaining a more intense ECL signal with H2O2 than with S2O82-. Some analytical parameters, such as the linear range and the limit of detection for SPE/APTES/CdTe (GSH) in ECL H2O2 detection, were obtaine

BRIVA-LIFE–A multicenter retrospective study of the long-term use of brivaracetam in clinical practice

Objectives: Evaluate long-term effectiveness and tolerability of brivaracetam in clinical practice in patients with focal epilepsy. Materials and Methods: This was a multicenter retrospective study. Patients aged =16 years were started on brivaracetam from November 2016 to June 2017 and followed over 1 year. Data were obtained from medical records at 3, 6 and 12 months after treatment initiation for evaluation of safety- and seizure-related outcomes. Results: A total of 575 patients were included in analyses; most had been treated with =4 lifetime antiepileptic drugs. Target dosage was achieved by 30.6% of patients on the first day. Analysis of primary variables at 12 months revealed that mean reduction in seizure frequency was 36.0%, 39.7% of patients were =50% responders and 17.5% were seizure-free. Seizure-freedom was achieved by 37.5% of patients aged =65 years. Incidence of adverse events (AEs) and psychiatric AEs (PAEs) was 39.8% and 14.3%, respectively, and discontinuation due to these was 8.9% and 3.7%, respectively. Somnolence, irritability, and dizziness were the most frequently reported AEs. At baseline, 228 (39.7%) patients were being treated with levetiracetam; most switched to brivaracetam (dose ratio 1:10-15). Among those who switched because of PAEs (n = 53), 9 (17%) reported PAEs on brivaracetam, and 3 (5.7%) discontinued because of PAEs. Tolerability was not highly affected among patients with learning disability or psychiatric comorbidity. Conclusions: In a large population of patients with predominantly drug-resistant epilepsy, brivaracetam was effective and well-tolerated; no unexpected AEs occurred over 1 year, and the incidence of PAEs was lower compared with levetiracetam