Chronic stress and high sucrose intake cause distinctive morphometric effects in the adrenal glands of post-weaned rats.

We investigated the effects of chronic stress combined with high sucrose intake on the morphology of the adrenal glands in young rats. Male Wistar rats were fed a standard chow diet and allocated into control (C; tap water), chronic restraint stress (St), 30% sucrose diet (S30) and 30% sucrose diet + chronic restraint stress (S30 + St) groups. St consisted of 1 h daily sessions, 5 days/week for 4 weeks. Chronic stress reduced the thickness of the zona glomerulosa (ZG) and zona fasciculata (ZF) in both right and left glands; the thickness of the zona reticularis (ZR) was increased in the right gland. Cell density was greater in the ZF and medulla of both right and left glands, whereas cell density increased in the ZR of only the left gland. The percentage of small cells was lower in the ZG, whereas more large cells were found in the left gland. A similar result was obtained for the ZF, ZR and medulla in both right and left glands. Chronic stress increased the area covered by blood vessels in the ZR of the right gland, but decreased the area in the ZR of the left gland. The area covered by blood vessels was reduced in the medulla of both right and left glands in rats subjected to chronic stress. Infiltration of immune cells was increased by chronic stress in all layers of the cortex of the left gland, but was reduced in the medulla of the right gland. A high sucrose diet reduced the thickness of the medulla in the left gland. Cell proliferation increased in the ZG of the right gland and the weight of the right adrenal gland increased. Reduced cell proliferation in the ZG of the left gland was associated with a reduction in the area covered by blood vessels. In addition, the area covered by blood vessels decreased in the medulla of both glands. Our findings demonstrate that exposure to chronic stress during early life causes morphometric changes in adrenal glands.

Hitting a triple in the non-alcoholic fatty liver disease field: sucrose intake in adulthood increases fat content in the female but not in the male rat offspring of dams fed a gestational low-protein diet.

The excessive consumption of carbohydrates is related to non-alcoholic fatty liver disease (NAFLD) in infants and adults. The effect of combining maternal malnutrition and a high carbohydrate intake on the development of NAFLD in adulthood remains unknown. We therefore hypothesized that consumption of 5% sucrose by the offspring of dams fed a low-protein diet during pregnancy promotes liver fat accumulation and oxidative damage differently in females and males. To test this, 12-month-old female and male offspring of mothers fed a Control (C) or low-protein diet (Restricted, R) were provided with either tap water or 5% sucrose for a period of 10 weeks. Livers were excised to measure the fat content and 3-nitrotyrosine (3-NTyr) immunostaining; serum samples were also obtained to measure the concentration of malondialdehyde (MDA). Data were analyzed using a non-repeated measures three-way analysis of variance to determine significant differences (P<0.05) regarding to the interaction among maternal diet, sucrose consumption and sex. Results showed that the liver fat content of females from R mothers was higher than that of their male counterpart. Hepatic 3-NTyr immunostaining and serum MDA concentrations were not affected by the interaction involving maternal diet, sucrose consumption and sex. Otherwise, liver fat content was correlated with the hepatic 3-NTyr immunostaining and serum MDA concentrations only in females. Thus, sucrose intake in adulthood increases fat content in the female but not in the male rat offspring of dams fed with a low-protein diet during pregnancy. This research emphasizes the importance of a balanced diet during pregnancy and the influence of the diet on the adult offspring.

Fibromuscular dysplasia: unusual cause of abdominal pain.

Spontaneous dissection of the renal artery is a rare phenomenon, and is more common amongst men. It is not a frequent cause of abdominal pain², which is why diagnosis is often late. The case under study is a 45 year old patient that presented sudden pain in the left renal fossa of 12 hours evolution, with no findings from the basic laboratory tests (lab testing, urinary sediment and ultrasound), an abdominal CAT was therefore carried out, which showed areas of renal infarction, as well as an emergency arteriogram, which gave findings of a possible Fibromuscular Dysplasia of the left intrarenal artery as the first diagnostic probability with a partially thrombosed focal dissection.

Hypothyroidism Reduces the Size of Ovarian Follicles and Promotes Hypertrophy of Periovarian Fat with Infiltration of Macrophages in Adult Rabbits.

Ovarian failure is related to dyslipidemias and inflammation, as well as to hypertrophy and dysfunction of the visceral adipose tissue (VAT). Although hypothyroidism has been associated with obesity, dyslipidemias, and inflammation in humans and animals, its influence on the characteristics of ovarian follicles in adulthood is scarcely known. Control and hypothyroid rabbits were used to analyze the ovarian follicles, expression of aromatase in the ovary, serum concentration of lipids, leptin, and uric acid, size of adipocytes, and infiltration of macrophages in the periovarian VAT. Hypothyroidism did not affect the percentage of functional or atretic follicles. However, it reduced the size of primary, secondary, and tertiary follicles considered as large and the expression of aromatase in the ovary. This effect was associated with high serum concentrations of total cholesterol and low-density lipoprotein cholesterol (LDL-C). In addition, hypothyroidism induced hypertrophy of adipocytes and a major infiltration of CD68+ macrophages into the periovarian VAT. Our results suggest that the reduced size of ovarian follicles promoted by hypothyroidism could be associated with dyslipidemias, hypertrophy, and inflammation of the periovarian VAT. Present findings may be useful to understand the influence of hypothyroidism in the ovary function in adulthood.

Health education for prevalent problems in prison, Ocaña-I proyect (Spain).

OBJECTIVE: Pilot project focusing on the implementation and evaluation of a health education (HE) program for inmates of the prison of Ocaña I (Spain). The objective was to analyze the intentions for change in health habits and perceptions, and to assess whether the HE-program had differential effects depending on whether the participants belonged to the PAIEM or not and their socio-demographic characteristics. METHODOLOGY: The participants were 65 men, who answered an ad hoc questionnaire at the end of each session. Data analysis applied was univariate and bivariate (one-way ANOVA, t-test for Equality of Means and Chi-Square test). RESULTS: The average rating of the sessions was 3.51 out of 4 (SD = 0.62). The percentage of positive answers about the intention to adopt healthy habits was higher among non-PAIEM subjects (84.8%) than among those who were part of this program (57.9%). All subjects having a couple indicated an intention to change negative habits, compared to 67.3% for those without a couple. The percentage of subjects who said that their perception on the issue had changed was highest among those without education (89.7%) than among those with education (61.5%). CONCLUSIONS: The evaluation of implanted HE-program implemented in the Ocaña I prison was very positive, there are differences between subjects belonging to the PAIEM and those who do not.

Hospital clinical trial: Homeopathy (Agraphis nutans 5CH, Thuya occidentalis 5CH, Kalium muriaticum 9CH and Arsenicum iodatum 9CH) as adjuvant, in children with otitis media with effusion.

BACKGROUND: Otitis media with effusion (OME) is the most common cause of paediatric hearing loss. No single treatment has proved its effectiveness. There is a lack of evidence-based medicine studies in the area of homeopathy. METHOD: A prospective randomized, double blinded interventional placebo control study was conducted. Patients, from 2 months to 12 years, with OME diagnosed by pneumatic otoscopy (PNO) and tympanometry, were randomized into two groups. Both groups received aerosol therapy (mucolytics and corticosteroids). In addition, the experimental group (EG) received homeopathy (Agraphis nutans 5CH, Thuya Occidentalis 5CH, Kalium muriaticum 9CH and Arsenicum iodatum), and the placebo group (PG) placebo, both of them for 3 months. Patients were evaluated by PNO examination and tympanometry at baseline, at 45 and 90 days. RESULTS: 97 patients were enrolled. In the EG, 61.9% of individuals were cured (PNO went from negative in the 1st visit to positive in the 3rd visit) compared with 56.8% of patients treated with placebo. 4.8% of patients in the EG suffered a recurrence (positive PNO in the 2nd visit changed to negative in the 3rd visit) while 11.4% did in the PG. No significant difference was found. Adverse events were distributed similarly, except in the case of upper respiratory tract infections, which were less frequent in EG (3 vs. 13, p: 0.009). CONCLUSION: The homeopathic scheme used as adjuvant treatment cannot be claimed to be an effective treatment in children with OME. TRIAL REGISTRATION: EUDRACT number: 2011-006086-17, PROTOCOL code: 55005646.

Hemoglobinuria paroxística nocturna en una mujer de 86 años / Paroxysmal nocturnal hemoglobinuria in an 86 year old woman

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Sugared water consumption by adult offspring of mothers fed a protein-restricted diet during pregnancy results in increased offspring adiposity: the second hit effect.

Poor maternal nutrition predisposes offspring to metabolic disease. This predisposition is modified by various postnatal factors. We hypothesised that coupled to the initial effects of developmental programming due to a maternal low-protein diet, a second hit resulting from increased offspring postnatal sugar consumption would lead to additional changes in metabolism and adipose tissue function. The objective of the present study was to determine the effects of sugared water consumption (5% sucrose in the drinking-water) on adult offspring adiposity as a 'second hit' following exposure to maternal protein restriction during pregnancy. We studied four offspring groups: (1) offspring of mothers fed the control diet (C); (2) offspring of mothers fed the restricted protein diet (R); (3) offspring of control mothers that drank sugared water (C-S); (4) offspring of restricted mothers that drank sugared water (R-S). Maternal diet in pregnancy was considered the first factor and sugared water consumption as the second factor - the second hit. Body weight and total energy consumption, before and after sugared water consumption, were similar in all the groups. Sugared water consumption increased TAG, insulin and cholesterol concentrations in both the sexes of the C-S and R-S offspring. Sugared water consumption increased leptin concentrations in the R-S females and males but not in the R offspring. There was also an interaction between sugared water and maternal diet in males. Sugared water consumption increased adipocyte size and adiposity index in both females and males, but the interaction with maternal diet was observed only in females. Adiposity index and plasma leptin concentrations were positively correlated in both the sexes. The present study shows that a second hit during adulthood can amplify the effects of higher adiposity arising due to poor maternal pregnancy diet in an offspring sex dependent fashion.

Jensen-Tsallis divergence and atomic dissimilarity for position and momentum space electron densities.

Quantifying the dissimilarity among two or more many-electron systems by means of their one-particle densities is a hot topic within the physical applications of the information theory. This is a relevant achievement of the so-called "divergence measures," for which several definitions have been considered, each one with its own advantages and difficulties. Nevertheless, all of them are considered in order to disclose the differences among the involved systems, neutral atoms in the present work, according to their densities in the position and momentum spaces. The pioneering Jensen-Shannon divergence (JSD) constitutes a particular case of the one-parameter Jensen-Tsallis divergence (JTD). The analysis here provided for the JTD of atomic systems generalizes and improves some previous results on the JSD one. Such an improvement mainly arises from the capability of JTD to modify, by means of its characteristic parameter, the relative contribution of relevant specific regions of the atomic densities in both conjugated spaces.

Fisher and Jensen-Shannon divergences: Quantitative comparisons among distributions. Application to position and momentum atomic densities.

The Fisher divergence (FD) and Jensen-Shannon divergence (JSD) are used in this work with the aim of providing quantitative measures of the discrepancies between two arbitrary D-dimensional distribution functions, the FD being of local character and the JSD of global one. In doing so, the concepts of Fisher information and Shannon entropy associated to a distribution are the essential quantities for building up these comparative functionals. This kind of relative measures are here applied to the study of the one-particle densities in both conjugated spaces (position and momentum) of neutral atoms, discussing the results as compared to those provided by other previous functional measures. It is clearly shown how these divergences provide relevant information on the atomic shell structure, up to a level which depends on the considered space and measure.

Atomic complexity measures in position and momentum spaces.

Fisher-Shannon (FS) and Lopez-Ruiz, Mancini, and Calbet (LMC) complexity measures, detecting not only randomness but also structure, are computed by using near Hartree-Fock wave functions for neutral atoms with nuclear charge Z=1-103 in position, momentum, and product spaces. It is shown that FS and LMC complexities are qualitatively and numerically equivalent for these systems. New complexity candidates are defined, computed, and compared by using the following information-theoretic magnitudes: Shannon entropy, Fisher information, disequilibrium, and variance. Localization-delocalization planes are constructed for each complexity measure, where the subshell pattern of the periodic table is clearly shown. The complementary use of r and p spaces provides a compact and more complete understanding of the information content of these planes.

Endocarditis due to Listeria: description of two cases and review of the literature.

Endocarditis due to Listeria monocytogenes is a very uncommon and very serious disease that may lead to valve dysfunction and cardiac arrest. We report two cases of endocarditis caused by L. monocytogenes and review the papers previously published on the subject.

[Nasal T lymphoma]. / Linfoma T nasal.

Nasal T lymphoma constitute a type of lymphoproliferative very infrequent symdrome. One of the fondamental problems it presents to bring a high probability of survival obtain a precocious diagnose. It is due that it originates inespecific histologic lesions, and to its clinic. Only the close cooperation between the otorhinolaryngologist and the anatomopathologist can arrive to obtain a very speedy diagnose and in that way the possibility of a correct treatment, because newly treatments appear, to which this type of disease every day better respond. We present the cases of nasal T lymphomas diagnosticated in the ORL Service of the Toledo area during 15 years, their symptomotology, treatment, evolution and survival. Besides a up to date bibliographic revision on this controversial syndrome.

[Parotid tuberculosis simulating neoplasia. Presentation of a case and review of literature]. / Tuberculosis parotídea, simulando neoplasia. Presentación de un caso y revisión de la literatura.

A case ofparotid tuberculosis (PTB) that during its clinical presentation complementary proofs, exploration and realised treatment made suspect as first possibility a parotid tumor is presented. After an histologic study, it could be proved that the real problem of the patient was that she had suffered a parotid tuberculosis. An exposition of the case is made with the different technics that must be realised facing a patient of these caracteristics, before thinking in surgery, although secure, but with its mortal risks in these times where the incidence of tuberculosis is increasing in the first world.

[Training in the care of the critical and multiple-injured patient: role of clinical simulation]. / Formación en la asistencia al paciente crítico y politraumatizado: papel de la simulación clínica.

Clinical simulation is suggested as a new educational instrument to learn and train in different medical skills. It is conceived as a new method that integrates scientific knowledge and human factors. Experience with these systems has been limited up to now, but it is now being widely accepted since it seems to accelerate acquisition of skills and knowledge in a safe setting, that is, without risk for the patient. However, its effect on clinical performance has not been validated yet. They are two types of simulators for intensive cares: screen based and human patient simulator (HPS). These systems make it possible to simulate different situations that require the application of action protocols or the management of new drugs in the clinical practice, promoting the rational use of resources in urgent care of the critical and multiple-injured patients. The limiting factors that prevent the expansion of the simulation for clinical training are its high cost, human resources needed, and the difficulties to assess the effectiveness of the training in real situations.

[Laryngeal leishmaniasis]. / Leishmaniasis laríngea.

Leishmaniasis consists in a zoonotic infection, that means affect animals. Due to the puncture of the female sand fly type Phlebotomus (Ancient World) or Lutzomya (New World) the human being can be also affected. The clinical manifestations are very varied, depending to factors related with host, vector and the proper parasit. In this present work, we expose the three unic cases of Leishmaniasis affecting the larynx, diagnosticated in the sanitary area of Toledo. Due to the specific characteristics that present each case different treatments for each one have been realised, and its results and treatment exposed.

Tuberculosis parotídea, simulando neoplasia. Presentación de un caso y revisión de la literatura / Parotid tuberculosis simulating neoplasia. Presentation of a cse review of literature

Se presenta un caso de tuberculosis parotídea (PTB), que durante su presentación clínica, pruebas complementarias exploratorias y tratamientos realizados; hizo sospechar como primera posibilidad, que presentaba un tumor en dicha glándula. Una vez estudiada histológicamente, se pudo comprobar como realmente el problema de la paciente era que había padecido una tuberculosis parotídea. Se hace una exposición del caso, así como las diferentes técnicas que se deben realizar ante un paciente de estas características, antes de llegar a someterle a una cirugía, que aunque segura, siempre entraña cierto riesgo de morbilidad. Sobre todo en estos tiempos en los que de nuevo la incidencia de tuberculosis está aumentando en el “primer mundo”

A case of parotid tuberculosis (PTB) that during its clinical presentation complementary proofs, exploration and realised treatment made suspect as first possibility a parotid tumor is presented. After and histologic study, it could be proved that the real problem of the patient was that she had suffered a parotid tuberculosis. An exposition of the case is made with the different technics that must be realised facing a patient of these characteristics, before thinking in surgery, although secure, but with its mortal risks in these times where the incidence of tuberculosis is increasing in the first world

Atomic quantum similarity indices in position and momentum spaces.

Quantum similarity for atoms is investigated using electron densities in position and momentum spaces. Contrary to the results in position space, the analysis in the momentum space shows how the momentum density carries fundamental information about periodicity and structure of the system and reveals the pattern of Mendeleev's table. A global analysis in the joint r-p space keeps this result.

[Laryngeal tuberculosis. Incidence between 1994 and 2004]. / Tuberculosis laríngea. Casos incidentes entre 1994-2004.

Tuberculosis is the chronic granulomatose most common infection of the larynx. It appears generally from pulmonary tuberculosis. It prevails in men. The most habitual symptomatology includes dysphony, odinophagy, referred otalgy and sometimes dispnea. The majority of patients use to have radiological pulmonary affectation to the diagnosis. The nodular exophitic or ulcerous lesions can be confused with carcinoma, therefore in these cases the anatomopathologic study is essential. The diagnosis is made with positive spit samples, specific characteristics of the thorax radiography and the positive biopsies of acid-alcohol resistant bacillus. We present the patients diagnosed with laryngeal tuberculosis in our hospital between 1994 and 2004. We describe the diagnostic procedures realised and the adopted therapeutic attitude in every case and results.