GABAergic Projections to the Oculomotor Nucleus in the Goldfish (carassius Auratus)

The mammalian oculomotor nucleus receives a strong γ-aminobutyric acid (GABA)ergic synaptic input, whereas such projections have rarely been reported in fish. In order to determine whether this synaptic organization is preserved across vertebrates, we investigated the GABAergic projections to the oculomotor nucleus in the goldfish by combining retrograde transport of biotin dextran amine, injected into the antidromically identified oculomotor nucleus, and GABA immunohistochemistry. The main source of GABAergic afferents to the oculomotor nucleus was the ipsilateral anterior octaval nucleus, with only a few, if any, GABAergic neurons being located in the contralateral tangential and descending nuclei of the octaval column. In mammals there is a nearly GABAergic inhibitory inputs; thus, the vestibulooculomotor GABAergic circuitry follows a plan that appears to be shared throughout the vertebrate phylogeny. The second major source of GABAergic projections was the rhombencephalic reticular formation, primarily from the medial area but, to a lesser extent, from the inferior area. A few GABAergic oculomotor projecting neurons were also observed in the ipsilateral nucleus of the medial longitudinal fasciculus. The GABAergic projections from neurons located in both the reticular formation surrounding the abducens nucleus and the nucleus of the medial reticular formation have primarily been related to the control of saccadic eye movements. Finally, all retrogradely labeled internuclear neurons of the abducens nucleus, and neurons in the cerebellum (close to the caudal lobe), were negative for GABA. These data suggest that the vestibuloocular and saccadic inhibitory GABAergic systems appear early in vertebrate phylogeny to modulate the firing properties of the oculomotor nucleus motoneurons

Detection of human cytomegalovirus in bronchoalveolar lavage of intensive care unit patients

The seroprevalence of human cytomegalovirus (CMV) is very high worldwide [1, 2] and the spectrum of disease caused by it ranges from an asymptomatic state to a mononucleosis-like syndrome to severe diseases such as pneumonia, retinitis or gastrointestinal infection. The most severe disease occurs in congenital infection and in immunosuppressed patients, in whom the virus acts as an opportunistic pathogen. However, the role of CMV in other populations is less clear and is controversial [3]. Some studies in critical patients describe a relationship between CMV and increased mortality rates, longer length of stay and prolonged need for mechanical ventilation [3-5]. The incidence of active CMV infection depends on the diagnostic method used. Several epidemiological studies and systematic reviews have assessed the incidence of CMV infection in mechanically ventilated, critically ill patients, finding values ranging from 0-36% [5-7]. In this study, we aimed to assess the incidence, clinical characteristics, risk factors and outcomes for intensive care unit (ICU) patients with CMV detection by bronchoalveolar lavage (BAL)

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Implicaciones de las fusiones sobre la eficiencia de las entidades financieras Un enfoque de globalidad

Centro de Informacion y Documentacion Cientifica (CINDOC). C/Joaquin Costa, 22. 28002 Madrid. SPAIN / CINDOC - Centro de Informaciòn y Documentaciòn CientìficaSIGLEESSpai

La publicidad de bebidas alcohólicas en España y su repercusión en la población adolescente

: El consumo de alcohol entre jóvenes es un problema de salud pública, condicionado en gran parte por los medios de comunicación y la publicidad. El objetivo de este estudio es analizar los mensajes publicitarios de alcohol difundidos en radio y televisión en España y conocer su potencial influencia en los adolescentes. Métodos: Análisis cuantitativo y cualitativo de la publicidad emitida en radio y TV, entre 1 de diciembre de 2006 y 9 de enero de 2007, a través de los siguientes pasos: seleccionar emisoras y canales TV; identificar y grabar la publicidad de programas de radio y TV dirigidos a los y las adolescentes; seleccionar y analizar los spots y cuñas radiofónicas. Las variables del estudio cuantitativo han sido: minutos dedicados a la publicidad de alcohol; análisis de audiencias en la población adolescente; y análisis del número de cuñas emitidas. La parte cualitativa se ha centrado en: marca y eslogan, público al que se dirige, estética, protagonistas del anuncio, valores que se transmiten, carga emocional del mensaje. Resultados: Se detectan 914 anuncios publicitarios de bebidas alcohólicas en TV. El 100% de los programas y eventos deportivos analizados presentan marcas de alcohol. El 26% de los spots y el 50% de las cuñas radiofónicas se dirigen específicamente a los jóvenes y todos muestran una imagen positiva del alcohol, valores de libertad, rebeldía y éxito. Conclusiones: Los adolescentes están expuestos a recurrentes mensajes positivos sobre el alcohol. La información y prevención son medidas claves para combatir la convivencia naturalizada con el alcohol.Alcohol drinking among adolescents is a problem of public health and it is highly conditioned by media and advertising. The objective of this study is to analyze Spanish television and radio alcohol advertising and promotions and to identify their potential influence on adolescents. Methods: A qualitative and quantitative analysis was made of radio and TV alcohol advertising, emitted between 1 December 2006 and 9 January 2007. The methodological steps were: channel and radio station selection; recording of radio and TV programmes directed to adolescents; selection and analysis of TV and radio spots. The variables in the quantitative analysis were: minutes of advertising, audience analysis in the young people; number of radio spots. The qualitative study referred to: brand and slogan, public to which it is directed, advertising protagonists, values and emotional content of the message. anuncio Results: There were identified 914 TV alcohol advertising. 100% of analyzed programs and sport events included alcohol advertise, with spots being the most usual strategy. 26% of spots were specifically directed to adolescents and all showed a positive image of alcohol. 50% of radio commercials sent values like freedom, diversion, social and sexual success. Conclusions: Adolescents are exposed to recurrent positive messages about alcohol, so information and prevention turn extremely important to reduce the naturalized image of alcohol drinking

Action potential firing frequency is increased in CA1 pyramidal cells of <i>Fmr1</i> KO mice.

<p>(A) Firing frequency depended on injected current in both WT and <i>Fmr1</i> KO cells, but in response to the same current intensity the number of spikes was higher in <i>Fmr1</i> KO cells. (B) Histogram showing firing frequency (spikes s^-1) evoked by current steps of 100, 200, 300 and 400 pA in WT and <i>Fmr1</i> KO cell groups. (C) Plot of the firing frequency versus injected current relationship for representative WT and <i>Fmr1</i> KO cells. The gain corresponds to the slope of the linear relationships. (D, E) Linear relationships between injected current and firing frequency for WT and <i>Fmr1</i> KO cells are represented in grey color. The black lines correspond to the mean fits for each group: WT, firing frequency = 0.12 ∙ injected current—2.7; <i>Fmr1</i> KO, firing frequency = 0.15∙ injected current—3.7. Calibrations as indicated. Asterisks (*) indicate statistically significant differences (P<0.05).</p

Action potential duration is increased in CA1 pyramidal cells of <i>Fmr1</i> KO mice.

<p>(A) Single action potential in a WT and a <i>Fmr1</i> KO cell generated by a short pulse (100 μs) with an intensity that was adjusted to the spike voltage threshold. The recordings also depict the half-width (dashed line) of the spike for the measurement of action potential duration. St indicates the onset of the stimulus. (B) Train of action potentials (8–12 spikes) produced by applying 500 ms current injections at 200 pA in a WT cell and at 100 pA in a <i>Fmr1</i> KO cell. The durations of the first spike (▼), the spike in the middle of the train (250 ms after stimulus onset; ■) and the last spike of the train (●) were measured in both cell groups. (C) Histogram showing action potential duration evoked in a single action potential and in trains of action potentials in WT and <i>Fmr1</i> KO cell groups. Calibrations as indicated. Asterisks (*) indicate statistically significant differences (P<0.05).</p