The role of sex hormones in aldosterone biosynthesis and their potential impact on its mineralocorticoid receptor.

Blood pressure (BP) regulation is a complex process involving various hormones, including aldosterone and its mineralocorticoid receptor. Mineralocorticoid receptor is expressed in several tissues, including the kidney, and plays a crucial role in regulating BP by controlling the sodium and water balance. During different stages of life, hormonal changes can affect mineralocorticoid receptor activity and aldosterone levels, leading to changes in BP. Increasing evidence suggests that sex steroids modulate aldosterone levels. Estrogens, particularly estradiol, mediate aldosterone biosynthesis by activating classical estrogen receptors and the G protein-coupled receptor. Progesterone acts as an anti-mineralocorticoid by inhibiting the binding of aldosterone to the mineralocorticoid receptor. Moreover, progesterone inhibits aldosterone synthase enzymes. The effect of testosterone on aldosterone synthesis is still a subject of debate. However, certain studies show that testosterone downregulates the mRNA levels of aldosterone synthase, leading to decreased plasma aldosterone levels.

Universal Access to On-Demand Treatment of Patients with Hereditary Angioedema, the Chilean Experience.

Background: In Chile, patients with hereditary angioedema (HAE) type I and type II are protected under Ley Ricarte Soto (LRS), which guarantees access to on demand plasma-derived C1-INH (pdC1-INH) since 2018. We aimed to analyze the first 3 years of LRS. Methods: Review of the LRS database between 2018 and 2021. Results: During the study period, 154 patients were covered by LRS, with an estimated prevalence of HAE in Chile at 0.8:100,000 inhabitants. A delay in diagnosis of 22 years was noted, 50 patients received epinephrine during an attack before the diagnosis of HAE. Mean number of attacks per year was 8, with 50% of adults and 42% of children experiencing more than 1 attack per month. Conclusion: Disease awareness must improve to reduce the diagnostic delay of HAE. Long-term prophylactic medications should be included in LRS to treat patients with high attack rates and control the costs of frequent on-demand treatment with pdC1-INH.

The Role of Experiential Avoidance in the Performance on a High Cognitive Demand Task

The aim of the study is to analyze the relation between experiential avoidance and the per- formance on a working-memory task. In Phase 1, 24 participants were selected according to high and low scores in the Acceptance and Action Questionnaire-II (AAQ-II), an experiential avoidance measure. Participants then responded to the White Bear Suppression Inventory (WBSI), the accepting without judgment scale of the Kentucky Inventory of Mindfulness Skills (KIMS) and the problem solving and cognitive reappraisal scales of the Coping Stra- tegies Inventory (CSI). In Phase 2, participants followed this sequence: (a) viewed a film with neutral content (neutral film), (b) responded to a mood inventory, (c) were exposed to a working-memory task in which they had to press the space bar when recalling something about the film (thought intrusions) and, finally, (d) reported their level of concentration on the task and the perceived interference of having viewed the film. Phase 3 was identical except that a new film with highly emotional content (discomforting film) was used. Results showed that experiential avoidance and accepting without judgment scores showed the highest correlations with the experimental variables. High AAQ-II participants showed a higher level of negative emotions after viewing both films. After viewing the discomforting film, these participants showed a higher number of thought intrusions, a higher level of interference of the film and a lower level of concentration on the task. High AAQ-II participants did not improve their performance on the task, however, low AAQ-II participants did. The mediational analysis revealed that experiential avoidance scores had an effect over the working-memory task through its effect over participants’ informed level of concentration. Results are discussed highlighting the role of experiential avoidance in the performance of high cognitive demand tasks while participants are experiencing discomfort (AU)

El objetivo del estudio es analizar la relación entre la evitación experiencial y el rendimiento en una tarea de alta demanda cognitiva. En la Fase 1, se seleccionaron 24 participantes con puntuaciones altas y bajas en el Cuestionario de Aceptación y Acción (Acceptance and Action Questionnaire-II, AAQ-II), una medida de evitación experiencial. Posteriormente, los parti- cipantes contestaron el White Bear Suppression Inventory (WBSI), la escala de Aceptación sin Juicio del Kentucky Inventory of Mindfulness Skills (KIMS) y las escalas de Solución de Problemas y Reevaluación Cognitiva del Coping Strategies Inventory (CSI). En la Fase 2, los participantes siguieron la siguiente secuencia: (a) vieron un video de contenido neutro (video neutro), (b) contestaron un inventario de estado de ánimo, (c) realizaron una tarea de memoria de trabajo en la que pulsaban la barra espaciadora cuando recordaban algo referido al video (intrusión de pensamientos), y (d) informaron el grado de concentración en la tarea y la interferencia percibida que les produjo ver el video previo. La Fase 3 fue idéntica, con excepción de que el video tenía contenido altamente emocional (video desagradable). Las pun- tuaciones en evitación experiencial y aceptación sin juicio fueron las que mostraron mayores correlaciones con las variables experimentales. Los participantes con alto AAQ-II mostraron mayor grado de emociones negativas tras ver ambos videos. Asimismo, tras el visionado del video desagradable, mostraron mayor número de intrusiones de pensamientos relacionados con los videos, mayor interferencia del video y menor grado de concentración en la tarea. Los participantes con alto AAQ-II no mejoraron su rendimiento en la tarea de memoria, mientras que sí lo hicieron los participantes con bajo AAQ-II. El análisis de mediación reveló que las puntuaciones en evitación experiencial afectaron al rendimiento a través de su efecto sobre el nivel de concentración informada por los participantes en la tarea. Se discuten los resulta- dos resaltando la relevancia de la evitación experiencial en el rendimiento en tareas de alta demanda cognitiva, cuando los participantes están en presencia de malestar (AU)