Grado de cubrimiento neointimal tardío en segmentos coronarios tratados mediante implantación de stents farmacoactivos: estudio de coherencia óptica

La trombosis tardía y muy tardía de stents farmacoactivos (DES) es motivo actual de preocupación. Los segmentos coronarios tratados con estos dispositivos sufren un proceso de neoendotelización, que podría ser diferente dependiendo del tipo de DES utilizado y estar implicado en el desarrollo de la trombosis de stent. Objetivos: Analizar y cuantificar mediante tomografía de coherencia óptica intracoronaria (OCT) el grado de cubrimiento neointimal tardío (al menos tras un año desde su implantación) de los struts de DES utilizados en la práctica clínica habitual: paclitaxel (TaxusTM), sirolimus (CypherTM) y everolimus (Xience VTM), para encontrar aquellas diferencias en el proceso de neoendotelización que ayuden a identificar los modelos de DES con un mejor perfil de seguridad. Material y métodos: Se evaluaron mediante OCT un total de 66 DES (21 stents XienceTM, 22 stents TaxusTM y 23 stents CypherTM) que presentaron ausencia de reestenosis angiográfica tras al menos un año desde su implantación, en 40 pacientes con cardiopatía isquémica que fueron sometidos a reevaluación angiográfica. Resultados: Las características clínicas de los pacientes portadores de los DES evaluados, así como las características de las lesiones coronarias tratadas con estos DES fue similar entre los 3 modelos de stent comparados. Se analizaron un total de 35061 struts, de los cuales 11967 correspondieron a stent Xience VTM, 11239 a stent TaxusTM y 11855 a stent CypherTM. La mayoría de los struts estaban cubiertos (91,4%), siendo bajo el porcentaje global de struts descubiertos (6,8%) y mal aposicionados (1,8%). El porcentaje de struts descubiertos o mal aposicionados promediado por stent fue inferior en el modelo Xience VTM (0,1%) en comparación con los modelos TaxusTM (0,5%) y CypherTM(0,57%) (p<0,001 en ambas comparaciones), sin haber diferencias entre estos dos últimos modelos de stent (p=0,64). Conclusiones: La OCT es una herramienta esencial para la correcta caracterización en vivo de la neoendotelización tardía de los DES. Existen diferencias muy significativas en el patrón de neoendotelización de los struts de los modelos de DES evaluados. Los mejores resultados tardíos los obtuvo el stent Xience VTM, con un menor porcentaje tanto de struts descubiertos como mal aposicionados tras al menos un año de seguimiento, lo que puede sugerir un menor riesgo de trombosis tardía con el uso de este stent en comparación con los otros dos modelos estudiados

Clinical and economic implications of epilepsy management across treatment lines in Spain: a real-life database analysis

Antiseizure medications; Drug-resistant epilepsyMedicamentos anticonvulsivos; Epilepsia resistente a los medicamentosMedicaments anticonvulsius; Epilèpsia resistent als fàrmacsBackground Epilepsy is a chronic brain disease characterized by recurrent seizures. We investigated real-world management of epilepsy across treatment lines in Spain, including healthcare resource use (HRU) and associated costs. Methods This was a retrospective study of real-life data from epilepsy patients prescribed antiseizure medication (ASM) between January 2016 and December 2021. Patients were grouped according to their line of treatment (1st, 2nd, 3rd and 4th +) during the recruitment period. Demographic and clinical characteristics, comorbidities and concomitant medications were analyzed during the baseline period (6 months before starting treatment line); antiepileptic treatments, concomitant medications, HRU and associated costs were analyzed during follow-up. Results The study included 5006 patients. Treatment duration decreased as treatment lines progressed (mean ± SD progression time: 523.2 ± 279.1 days from 1st to 2nd line, 351.6 ± 194.4 days from 2nd to 3rd line; 272.7 ± 139.3 days from 3rd to 4th + line). Significant HRU differences were found with subsequent treatment lines, including an increase in hospital admissions and patients on sick leave. Mean (95% CI) adjusted total costs per patient were €2974/year (2773–3175) in the 1st line and €5735/year (5043–6428) in the 4th + line. There was an increase in adjusted direct and total costs with subsequent treatment lines; the mean difference in total costs between cohorts was €2761 (p < 0.001). The highest direct costs were associated with epilepsy medication, days at the hospital and specialist visits. Conclusion Our data revealed a progressive increase in the use of resources and associated costs across subsequent epilepsy treatment lines.The study was funded by Angelini Pharma

Del desecho al tesoro: explorando el mercado de productos de segunda mano

La importancia del mercado de segunda mano ha crecido en las últimas décadas unida al desarrollo tecnológico y la creciente preocupación de la población por el medio ambiente. Son diferentes los factores y motivaciones que afectan al crecimiento de este mercado y existen varias teorías que ayudan a explicar el comportamiento de los consumidores y porqué deciden hacer este tipo de compras. Dada pues la importancia del tema, en el presente trabajo se realizará un estudio teórico y práctico sobre el mercado de segunda mano, analizando los resultados obtenidos y extrayendo las debidas conclusione

Murine Models for the Study of Fetal Alcohol Spectrum Disorders: An Overview.

Prenatal alcohol exposure is associated to different physical, behavioral, cognitive, and neurological impairments collectively known as fetal alcohol spectrum disorder. The underlying mechanisms of ethanol toxicity are not completely understood. Experimental studies during human pregnancy to identify new diagnostic biomarkers are difficult to carry out beyond genetic or epigenetic analyses in biological matrices. Therefore, animal models are a useful tool to study the teratogenic effects of alcohol on the central nervous system and analyze the benefits of promising therapies. Animal models of alcohol spectrum disorder allow the analysis of key variables such as amount, timing and frequency of ethanol consumption to describe the harmful effects of prenatal alcohol exposure. In this review, we aim to synthetize neurodevelopmental disabilities in rodent fetal alcohol spectrum disorder phenotypes, considering facial dysmorphology and fetal growth restriction. We examine the different neurodevelopmental stages based on the most consistently implicated epigenetic mechanisms, cell types and molecular pathways, and assess the advantages and disadvantages of murine models in the study of fetal alcohol spectrum disorder, the different routes of alcohol administration, and alcohol consumption patterns applied to rodents. Finally, we analyze a wide range of phenotypic features to identify fetal alcohol spectrum disorder phenotypes in murine models, exploring facial dysmorphology, neurodevelopmental deficits, and growth restriction, as well as the methodologies used to evaluate behavioral and anatomical alterations produced by prenatal alcohol exposure in rodents

Models for the Study of Fetal Alcohol Spectrum Disorders: An Overview

Prenatal alcohol exposure is associated to different physical, behavioral, cognitive, and neurological impairments collectively known as fetal alcohol spectrum disorder. The underlying mechanisms of ethanol toxicity are not completely understood. Experimental studies during human pregnancy to identify new diagnostic biomarkers are difficult to carry out beyond genetic or epigenetic analyses in biological matrices. Therefore, animal models are a useful tool to study the teratogenic effects of alcohol on the central nervous system and analyze the benefits of promising therapies. Animal models of alcohol spectrum disorder allow the analysis of key variables such as amount, timing and frequency of ethanol consumption to describe the harmful effects of prenatal alcohol exposure. In this review, we aim to synthetize neurodevelopmental disabilities in rodent fetal alcohol spectrum disorder phenotypes, considering facial dysmorphology and fetal growth restriction. We examine the different neurodevelopmental stages based on the most consistently implicated epigenetic mechanisms, cell types and molecular pathways, and assess the advantages and disadvantages of murine models in the study of fetal alcohol spectrum disorder, the different routes of alcohol administration, and alcohol consumption patterns applied to rodents. Finally, we analyze a wide range of phenotypic features to identify fetal alcohol spectrum disorder phenotypes in murine models, exploring facial dysmorphology, neurodevelopmental deficits, and growth restriction, as well as the methodologies used to evaluate behavioral and anatomical alterations produced by prenatal alcohol exposure in rodents

Bisphenol A Induces Accelerated Cell Aging in Murine Endothelium.

Bisphenol A (BPA) is a widespread endocrine disruptor affecting many organs and systems. Previous work in our laboratory demonstrated that BPA could induce death due to necroptosis in murine aortic endothelial cells (MAECs). This work aims to evaluate the possible involvement of BPA-induced senescence mechanisms in endothelial cells. The β-Gal assays showed interesting differences in cell senescence at relatively low doses (100 nM and 5 µM). Western blots confirmed that proteins involved in senescence mechanisms, p16 and p21, were overexpressed in the presence of BPA. In addition, the UPR (unfolding protein response) system, which is part of the senescent phenotype, was also explored by Western blot and qPCR, confirming the involvement of the PERK-ATF4-CHOP pathway (related to pathological processes). The endothelium of mice treated with BPA showed an evident increase in the expression of the proteins p16, p21, and CHOP, confirming the results observed in cells. Our results demonstrate that oxidative stress induced by BPA leads to UPR activation and senescence since pretreatment with N-acetylcysteine (NAC) in BPA-treated cells reduced the percentage of senescent cells prevented the overexpression of proteins related to BPA-induced senescence and reduced the activation of the UPR system. The results suggest that BPA participates actively in accelerated cell aging mechanisms, affecting the vascular endothelium and promoting cardiovascular diseases.post-print3206 K

Análisis evolutivo económico-financiero de las empresas del servicio público de tranporte urbano en España. 2008-2013

El Observatorio de Costes y Financiación del Transporte Urbano Colectivo, desde su creación en noviembre de 2009, además de la realización de informes bianuales de la situación del sector español, ha realizado otros trabajos específicos en el sector del transporte en superficie ampliando año tras año la información a la que tiene acceso. En este sentido, y tras un acuerdo establecido con la Asociación del Transporte Urbano Colectivo, se ha elaborado un informe evolutivo del período 2008-2013. En la presente comunicación se muestran algunas de las conclusiones obtenidas al analizar una serie de elementos clave para observar las necesidades de financiación, la gestión competitiva y la correcta aplicación de los recursos por parte de las empresas gestoras de los transportes colectivos urbanos.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Exploring the link between self‑compassion and compulsive exercise amongst women

Objectives Self-compassion, defned as the ability to be accepting and loving towards oneself, has been identifed as a potential protective factor against the development of body dissatisfaction and eating disorders (ED). In contrast, compulsive exercise is a core feature in the development and progression of EDs and is often employed as a maladaptive coping strat egy for negative emotions and body image concerns. However, the relationships between self-compassion and compulsive exercise attitudes and behaviours are as yet unexplored. Methods A total of 539 Spanish female university students (Mage=20.03, SD=2.22) completed measures of compulsive exercise, frequency of compensatory exercise, self-compassion, eating disorder symptoms, and anxiety and depression. Results Hierarchical multiple regressions showed that lower levels of self-compassion signifcantly predicted some compul sive exercise elements (namely, weight control exercise and lack of exercise enjoyment) after controlling for ED symptoms, anxiety, depression and age. However, frequency of compensatory exercise was unrelated to self-compassion elements. Findings from the mediation models suggest an indirect efect of self-compassion on the association between compulsive exercise and ED symptoms. Conclusions The fndings suggest a signifcant link between low self-compassion and greater harmful exercise attitudes and behaviours towards exercise. Further research is needed to clarify whether self-compassion may be a core feature in the development and maintenance of harmful attitudes and behaviours towards exercis

A Somatostatin Receptor Subtype-3 (SST3) Peptide Agonist Shows Antitumor Effects in Experimental Models of Nonfunctioning Pituitary Tumors

[Purpose] Somatostatin analogues (SSA) are efficacious and safe treatments for a variety of neuroendocrine tumors, especially pituitary neuroendocrine tumors (PitNET). Their therapeutic effects are mainly mediated by somatostatin receptors SST2 and SST5. Most SSAs, such as octreotide/lanreotide/pasireotide, are either nonselective or activate mainly SST2. However, nonfunctioning pituitary tumors (NFPTs), the most common PitNET type, mainly express SST3 and finding peptides that activate this particular somatostatin receptor has been very challenging. Therefore, the main objective of this study was to identify SST3-agonists and characterize their effects on experimental NFPT models.[Experimental Design] Binding to SSTs and cAMP level determinations were used to screen a peptide library and identify SST3-agonists. Key functional parameters (cell viability/caspase activity/chromogranin-A secretion/mRNA expression/intracellular signaling pathways) were assessed on NFPT primary cell cultures in response to SST3-agonists. Tumor growth was assessed in a preclinical PitNET mouse model treated with a SST3-agonist. [Results] We successfully identified the first SST3-agonist peptides. SST3-agonists lowered cell viability and chromogranin-A secretion, increased apoptosis in vitro, and reduced tumor growth in a preclinical PitNET model. As expected, inhibition of cell viability in response to SST3-agonists defined two NFPT populations: responsive and unresponsive, wherein responsive NFPTs expressed more SST3 than unresponsive NFPTs and exhibited a profound reduction of MAPK, PI3K-AKT/mTOR, and JAK/STAT signaling pathways upon SST3-agonist treatments. Concurrently, SSTR3 silencing increased cell viability in a subset of NFPTs. [Conclusions] This study demonstrates that SST3-agonists activate signaling mechanisms that reduce NFPT cell viability and inhibit pituitary tumor growth in experimental models that expresses SST3, suggesting that targeting this receptor could be an efficacious treatment for NFPTs.This work has been funded by the following grants: Junta de Andalucía [CTS-1406 (R.M. Luque), BIO-0139 (J.P. Castaño)]; Ministerio de Ciencia, Innovación y Universidades [BFU2016-80360-R (J.P. Castaño)] and Instituto de Salud Carlos III, co-funded by European Union [ERDF/ESF, “Investing in your future”: PI16/00264 (R.M. Luque), CP15/00156 (M.D. Gahete) and CIBERobn]. CIBER is an initiative of Instituto de Salud Carlos III

Hospitales verdes : un nuevo desafío para América Latina

286 páginas : tablas, gráficos ; 28 cm.Con el presente libro, de una manera práctica y gracias a los autores, se ha querido llevar a los lectores una visión amplia y clara del tema de los hospitales verdes. Los temas que a continuación están desarrollados presentan la base fundamental de lo que es un hospital verde, desde un panorama amplio de los hospitales verdes, las características que debe tenerse en cuenta en el momento de la construcción de uno de estos hospitales, su impacto en la salud, así como experiencias exitosas de estos. El lector encontrará un libro de consulta para adentrarse en el tema de los hospitales verdes saludables, el cual podrá servirle de guía para ampliar su conocimiento sobre el asunto y cómo este concepto de contribuye al mejoramiento del medio ambiente y la conservación del mismo.Panorama de la salud ambiental hospitalaria y política ambiental en instituciones de salud. --Hospitales sustentables: criterios generales para el diseño. -- Hospitales sustentables: construcción y operación. -- Hospitales verdes: ¿aporte real a la salud pública?. -- La cultura verde como estrategia para la gestión ambiental de los hospitales. -- Relación de las acciones de los hospitales verdes en el marco de las dimensiones del desarrollo sostenible. -- Análisis de experiencias de gestión hídrica en las instituciones vinculadas a la Red Global de Hospitales Verdes en Colombia. -- Posicionamiento ambiental de la Red Hospitalaria Española y su relación con Salud sin Daño: hospitales verdes y saludables. -- Proyecto Eco-hospital Guadarrama, España. -- Acciones de cultivos saludables reportadas por los miembros de la Red Global de Hospitales Verdes y Saludables. -- Avances de la vinculación del componente ambiental y hospitales verdes en carreras de ciencias de la salud