Systematic Review and Meta-Analysis Provide no Guidance on Management of Asymptomatic Bacteriuria within the First Year after Kidney Transplantation.

(1) Background: Urinary tract infections (UTIs) are among the most frequent complications in kidney transplant (KT) recipients. Asymptomatic bacteriuria (ASB) may be a risk factor for UTIs and graft rejection. We aimed to evaluate available evidence regarding the benefit of screening and treatment of ASB within the first year after KT. (2) Evidence acquisition: A systematic literature search was conducted in MEDLINE, the Cochrane Library CENTRAL and Embase. Inclusion criteria were manuscripts in English addressing the management of ASB after KT. The PICO questions concerned Patients (adults receiving a KT), Intervention (screening, diagnosis and treatment of ASB), Control (screening and no antibiotic treatment) and Outcome (UTIs, sepsis, kidney failure and death). (3) Evidence synthesis: The systematic review identified 151 studies, and 16 full-text articles were evaluated. Seven were excluded because they did not evaluate the effect of treatment of ASB. There was no evidence for a higher incidence of lower UTIs, acute pyelonephritis, graft loss, or mortality in patients not treated with antibiotics for ASB. Analysis of comparative non-randomized and observational studies did not provide supplementary evidence to guide clinical recommendations. We believe this lack of evidence is due to confounding risk factors that are not being considered in the stratification of study patients.

Non-Antibiotic Prophylaxis for Recurrent UTIs in Neurogenic Lower Urinary Tract Dysfunction (NAPRUN): Study Protocol for a Prospective, Longitudinal Multi-Arm Observational Study.

INTRODUCTION: Patients with neurogenic lower urinary tract dysfunction (NLUTD) reliant on intermittent self-catheterization for bladder emptying are at an increased risk of recurrent urinary tract infections (rUTI). So far, the most common practice in the prevention of rUTIs is long-term low-dose antibiotic prophylaxis, phytotherapy, and immunomodulation, whereby antibiotic prophylaxis inevitably leads to the emergence of drug-resistant pathogens and difficulty in treating infections. Therefore, non-antibiotic alternatives in the prevention of rUTIs are urgently required. We aim to identify the comparative clinical effectiveness of a non-antibiotic prophylaxis regimen in the prevention of recurrent urinary tract infections in patients with neurogenic bladder dysfunction who practice intermittent self-catheterization. METHODS AND ANALYSIS: In this multi-centre, prospective longitudinal multi-arm observational study, a total of 785 patients practising intermittent self-catheterisation due to NLUTD will be included. After inclusion, non-antibiotic prophylaxis regimens will be instilled with either UroVaxom® (OM-89) standard regimen, StroVac® (bacterial lysate vaccine) standard regimen, Angocin®, D-mannose (oral dose 2 g), bladder irrigation with saline (once per day). The management protocols will be pre-defined, but the selection of the protocol will be at the clinicians' discretion. Patients will be followed for 12 months from the onset of the prophylaxis protocol. The primary outcome is to identify the incidence of breakthrough infections. The secondary outcomes are adverse events associated with the prophylaxis regimens and the severity of breakthrough infections. Other outcomes include the exploration of change in susceptibility pattern via the optional rectal and perineal swab, as well as health-related quality of life over time (HRQoL), which will be measured in a random subgroup of 30 patients. ETHICS AND DISSEMINATION: Ethical approval for this study has been granted by the ethical review board of the University Medical Centre Rostock (A 2021-0238 from 28 October 2021). The results will be published in a peer-reviewed journal and presented at relevant meetings. STUDY REGISTRATION NUMBER: German Clinical Trials Register: Number DRKS00029142.

Los desafíos de la gestión del cuidado de los profesionales de enfermería / The challenges of care management for nursing professionals

RESUMEN Objetivo: Describir los desafíos de la gestión del cuidado de los profesionales de enfermería. Metodología: El presente trabajo investigativo se desarrolla desde un enfoque cuantitativo con una metodología descriptiva con diseño no experimental, la cual se apoya en el análisis documental-bibliográfico. Se organizó un proceso investigativo en donde la población de estudio se basó, primordialmente, en documentos escritos como tesis, revistas arbitradas y artículos científicos. En conclusión: Los desafíos a los que se enfrentan los profesionales de enfermería en la gestión del cuidado, en esta época involucran el aspecto económico, social y político en un mundo en constantes cambios, en donde la tecnología juega un gran papel que permite mejorar los servicios inter hospitalarios como red de comunicación, mejoras en las condiciones laborales, incorporación de nuevo talento humano y disminución en la deficiencia a nivel mundial, fortalecimiento y replanteamiento de los planes de formación y estudio de enfermería.

ABSTRACT Objective: To describe the challenges of care management of nursing professionals. Methodology: This research work is developed from a quantitative approach with a descriptive methodology with non-experimental design, which is supported by documentary-bibliographic analysis. A research process was organized in which the study population was based primarily on written documents such as theses, peer-reviewed journals and scientific articles. In conclusion: The challenges faced by nursing professionals in the management of care at this time involve economic, social and political aspects in a world in constant change, where technology plays a great role in improving inter-hospital services as a communication network, improvements in working conditions, incorporation of new human talent and reducing the deficiency worldwide, strengthening and rethinking of training plans and nursing studies.

Practice Patterns in Fournier's Gangrene in Europe and Implications for a Prospective Registry Study.

BACKGROUND: Fournier's gangrene (FG) is a life-threatening, necrotizing infection. Due to the rareness of the disease, it is challenging to plan robust prospective studies. This study aims to describe current practice patterns of FG in Europe and identify implications for planning a prospective FG registry. METHODS: Online non-validated 17-items survey among urologists treating FG in in European hospitals. Questionnaires were analyzed with LimeSurvey (LimeSurvey GmbH Hamburg, Germany). RESULTS: 229 responses from ten different European countries were submitted, and 117 (51.1%) urologists completed the questionnaire. The departments treat a mean of 4.2 (SD 3.11) patients per year. The urology department mostly takes the lead in treating FG patients (n = 113; 96.6%). The practice in FG is very heterogenic and mostly case-based all over Europe, e.g., vacuum-assisted wound closure (VAC) is mostly used (n = 50; 42.7%) as adjunct wound. The biggest challenges in FG are the short time to diagnosis and treatment, standardization and establishment of guidelines, and disease awareness. Additionally, participants stated that an international registry is an outstanding initiative, and predictive models are needed. CONCLUSIONS: There is no standard of care in the diagnosis, treatment, and long-term care of FG all over Europe. Further research could be conducted with a prospective registry.

Validation of the Spanish Acute Cystitis Symptoms Score (ACSS) in native Spanish-speaking women of Europe and Latin America.

INTRODUCTION AND OBJECTIVES: The Acute Cystitis Symptom Score (ACSS) is a patient self-reporting questionnaire for clinical diagnostics and patient-reported outcome (PRO), which may assess the symptoms and the effect on the quality of life in women with acute cystitis (AC). The current study aimed to create a validated Spanish version of the ACSS questionnaire. MATERIAL AND METHODS: The process of linguistic validation of the Spanish version of the ACSS consisted of the independent forward and backward translations, revision and reconciliation, and cognitive assessment. Clinical evaluation of the study version of the ACSS was carried out in clinics in Spain and Latin America. Statistical tests included the calculation of Cronbach's α, split-half reliability, specificity, sensitivity, diagnostic odds ratio, positive and negative likelihood ratio, and area under the receiver-operating characteristic curve (AUC). RESULTS: The study was performed on 132 patients [age (mean;SD) 45.0;17.8 years] with AC and 55 controls (44.5;12.2 years). Cronbach's α of the ACSS was 0.86, and the split-half reliability was 0.82. The summary scores of the ACSS domains were significantly higher in patients than in controls, 16.0 and 2.0 (p < 0.001), respectively. The predefined cut-off point of ≥6 for a summary score of the "Typical" domain resulted in a specificity of 83.6% and a sensitivity of 99.2% for the Spanish version of the ACSS. AUC was 0.91 [0.85; 0.97]. CONCLUSIONS: The validated Spanish ACSS questionnaire evaluates the symptoms and clinical outcomes of patients with AC. It can be used as a patient's self-diagnosis of AC, as a PRO measure tool, and help to rule out other pathologies in patients with voiding syndrome.

Caracterización de los determinantes sociales de la salud del envejecimiento activo en estudios enfocados a la calidad de vida: mapeo sistemático / Characterization of the social determinants of health in active aging in studies focused on quality of life: systematic mapping

Resumen El aumento demográfico de adultos mayores se está presentando acompañado de condiciones socioeconómicas y de salud desfavorables, que afectan su calidad de vida. Esta situación puede paliarse a través del marco del envejecimiento activo, el cual aporta lineamientos alternativos que pueden resultar eficaces para contrarrestarlos. La Organización Mundial de la Salud establece que el envejecimiento activo tiene seis Determinantes Sociales de la Salud (DSS) que han sido abordados desde diferentes áreas por la comunidad científica. El objetivo del presente trabajo fue identificar y caracterizar el tipo de estudios enfocados a la calidad de vida, desde el envejecimiento activo, y clasificarlos de acuerdo con los DSS. Se revisaron las bases de datos Ebscohost, Scopus, Oxford, Redalyc y Sage Journals. Los descriptores utilizados fueron "envejecimiento activo" y "calidad de vida", en inglés y español. La búsqueda del mapeo sistemático comprendió enero 2015 a marzo 2022. Se localizaron 91 artículos en los que se evaluó la calidad de vida, desde la perspectiva del envejecimiento activo y la mayoría (81.3 %) fueron estudios transversales. Se identificaron 3 intervenciones psicológicas, con evaluación antes y después de las sesiones, abordando los DSS relacionados con los factores personales, como salud psicológica, percepción positiva con la actividad física y función cognitiva. Así mismo, los factores conductuales, como estilos de vida para la prevención de riesgo de caídas y mejora de la vida en general, que podrían condicionar la calidad de vida. El principal alcance temático de los estudios fue la vinculación existente entre la calidad de vida y los DSS relacionados con los factores personales y con el entorno social. Se requieren más estudios interdisciplinarios que ayuden a generar políticas públicas que impacten favorablemente en este sector poblacional.

Abstract The demographic increase of elderly people is taking place along with unfavorable socioeconomic and health conditions, which affect their quality of life. This situation can be alleviated through an active aging framework, which provides alternative guidelines that can be effective in counteracting them. The World Health Organization establishes that active aging has six Social Determinants of Health (SDH) that have been approached from different areas by the scientific community. The objective of this work was to identify and characterize the type of studies focused on quality of life, from active aging, and classify them according to the SDH. Ebscohost, Scopus, Oxford, Redalyc and Sage Journals databases were reviewed. The descriptors used were "active aging" and "quality of life", in English and Spanish. The systematic mapping search comprised from January 2015 to March 2022. 91 articles were located where quality of life was evaluated from the perspective of active aging and the majority (81.3 %) were cross-sectional studies. Three psychological interventions were identified, with an evaluation before and after the sessions, comprising the SDH related to personal factors, such as psychological health, positive perception with physical activity and cognitive function. Likewise, behavioral factors such as lifestyles for the prevention of risk of falls and general life improvement which could condition the quality of life. The main thematic scope of the analyzed studies was the existing relationship between quality of life and the SDH related to personal factors and the social environment. Further interdisciplinary studies are required to contribute to the creation of public policy that impacts favorably this sector of the population.

Funcionamiento de las redes atencionales en la adultez joven y el nivel de educación / Functioning of attentional networks in young adulthood and level of education

Resumen El objetivo del presente estudio fue observar el efecto de las variables nivel de estudios y adultez joven en la tarea de redes atencionales. Para ello, participaron 58 personas de población general separados en grupos de estudiantes y no estudiantes, y en adultez emergente y temprana, con los cuales se llevó a cabo un diseño experimental, utilizando como paradigma principal la tarea de redes atencionales. Los resultados mostraron que los grupos de estudiantes y no estudiantes no difirieron en rendimiento en ninguna de las condiciones de las redes, pero que, en cuanto a la variable adultez joven, hubo un efecto de interacción entre el tipo de adultez y la red de orientación, siendo el grupo adulto emergente más rápido que el grupo adulto temprano. Además, un análisis correlacional demostró que la edad correlacionó moderada y positivamente con el tiempo de reacción de todas las condiciones de la tarea atencional. Al final se discute la importancia del nivel de educación superior y la adultez joven sobre el funcionamiento de las redes atencionales en el campo de la psicología diferencial, y se mencionan las implicaciones de estos resultados en el ámbito clínico.

Abstract The aim of this study was to observe the effect of the variables educational level and young adulthood on the attentional networks task. Fifty-eight people from the general population were divided into groups of students and non-students, and in emerging and early adulthood, with whom an experimental design was carried out, using the Attentional Networks task as the main paradigm. The results showed that the student and non-student groups did not differ in performance in any of the network conditions, but regarding the young adulthood variable, there was an interaction effect between the type of adulthood and the orienting network, with the emerging adult group being faster than the early adult group. In addition, a correlational analysis showed that age was moderately and positively correlated with reaction time for all attentional task conditions. In the end, the importance of higher education level and young adulthood on the functioning of attentional networks in the field of differential psychology is discussed, and the implications of these results in the clinical setting are mentioned.

Probability of hospitalisation and death among COVID-19 patients with comorbidity during outbreaks occurring in Mexico City.

Background: We compared the probability of hospitalization and death caused by COVID-19 in patients with comorbidities during three periods defined for this study: first-wave (FW), interwave period (IP), and second-wave (SW) observed in Mexico City. Methods: In this registry-based study, we included individuals over 20 years of age. During the FW (symptomatic), the IP, and the SW (symptomatic and asymptomatic), participants were diagnosed using nasopharyngeal swabs. Symptomatic individuals with risk factors for serious disease or death were referred to the hospital. SARS-CoV-2 infection was defined by RT-qPCR in all hospitalized patients. All data were added to the SISVER database. Bayesian analysis and False Discovery Rate were used for further evaluation. Results: The study included 2 260 156 persons (mean age of 43.1 years). Of these, 8.6% suffered from DM, 11.6% arterial hypertension, and 9.7% obesity. Of the total, 666 694 persons tested positive (29.5%). Of the infected persons, a total of 85 587 (12.8%) were hospitalized: 24 023 in the FW; 16 935 in the IP, and 44 629 in the SW. Of the hospitalized patients, there were 42 979 deaths (50.2%), in the FW, 11 964 (49.8%), in the IP, 6794 (40.1%), and in the SW 24 221 (54.3%). The probability of death among individuals hospitalized with or without comorbidities increased consistently in all age groups. A significant increase in the Fatality Rate was observed in individuals with comorbidities (1.36E-19< = FDR< = 3.36E-2). A similar trend was also observed in individuals without comorbidities (1.03E-44< = FDR< = 5.58E-4). Conclusions: The data from this study show a considerable increase in the number of detected cases of infection between the FW and SW. In addition, 12.8% of those infected were hospitalized for severe COVID-19. A high mortality rate was observed among hospitalized patients (>50%). An age-dependent probability of death was observed with a positive trend in hospitalized patients with and without comorbidities.

Population trends of seabirds in Mexican Islands at the California Current System.

The Baja California Pacific Islands (BCPI) is a seabird hotspot in the southern California Current System supporting 129 seabird breeding populations of 23 species and over one million birds annually. These islands had a history of environmental degradation because of invasive alien species, human disturbance, and contaminants that caused the extirpation of 27 seabird populations. Most of the invasive mammals have been eradicated and colonies have been restored with social attraction techniques. We have recorded the number of breeding pairs annually for most of the colonies since 2008. To assess population trends, we analyzed these data and show results for 19 seabird species on ten island groups. The maximum number of breeding pairs for each nesting season was used to estimate the population growth rate (λ) for each species at every island colony. We performed a moving block bootstrap analysis to assess whether seabird breeding populations are increasing or decreasing. San Benito, Natividad, and San Jerónimo are the top three islands in terms of abundance of breeding pairs. The most widespread species is Cassin's Auklet (Ptychoramphus aleuticus) with 14 colonies. Thirty-one populations of 14 species are significantly increasing while eleven populations of seven species are decreasing. We did not find statistical significance for 19 populations, however, 15 have λ>1 which suggest they are growing. Twelve of the 18 species for which we estimated a regional population trend are significantly increasing, including seven surface-nesting species: Brandt's Cormorant (Phalacrocorax penicillatus), Brown Pelican (Pelecanus occidentalis), Caspian Tern (Hydroprogne caspia), Double-crested Cormorant (P. auritus), Elegant Tern (Thalasseus elegans), Laysan Albatross (Phoebastria immutabilis) and Western Gull (Larus occidentalis), and five burrow-nesting species: Ainley's (Hydrobates cheimomnestes), Ashy (H. homochroa) and Townsend's (H. socorroensis) Storm-Petrels, and Craveri's (Synthliboramphus craveri) and Guadalupe (S. hypoleucus) Murrelets. The BCPI support between 400,000 and 1.4 million breeding individuals annually. Our results suggest that these islands support healthy and growing populations of seabirds that have shown to be resilient to extreme environmental conditions such as the "Blob", and that such resilience has been strengthen from conservation and restoration actions such as the eradication of invasive mammals, social attraction techniques and island biosecurity.

Acts of appetite: neural circuits governing the appetitive, consummatory, and terminating phases of feeding.

The overconsumption of highly caloric and palatable foods has caused a surge in obesity rates in the past half century, thereby posing a healthcare challenge due to the array of comorbidities linked to heightened body fat accrual. Developing treatments to manage body weight requires a grasp of the neurobiological basis of appetite. In this Review, we discuss advances in neuroscience that have identified brain regions and neural circuits that coordinate distinct phases of eating: food procurement, food consumption, and meal termination. While pioneering work identified several hypothalamic nuclei to be involved in feeding, more recent studies have explored how neuronal populations beyond the hypothalamus, such as the mesolimbic pathway and nodes in the hindbrain, interconnect to modulate appetite. We also examine how long-term exposure to a calorically dense diet rewires feeding circuits and alters the response of motivational systems to food. Understanding how the nervous system regulates eating behaviour will bolster the development of medical strategies that will help individuals to maintain a healthy body weight.

Territorial Strategy of Medical Units for Addressing the First Wave of the COVID-19 Pandemic in the Metropolitan Area of Mexico City: Analysis of Mobility, Accessibility and Marginalization.

BACKGROUND: The COVID-19 pandemic has caused an exponential increase in the demand for medical care worldwide. In Mexico, the COVID Medical Units (CMUs) conversion strategy was implemented. OBJECTIVE: To evaluate the CMU coverage strategy in the Mexico City Metropolitan Area (MCMA) by territory. MATERIALS: The CMU directory was used, as were COVID-19 infection and mobility statistics and Mexican 2020 census information at the urban geographic area scale. The degree of urban marginalization by geographic area was also considered. METHOD: Using descriptive statistics and the calculation of a CMU accessibility index, population aggregates were counted based on coverage radii. In addition, two regression models are proposed to explain (1) the territorial and temporal trend of COVID-19 infections in the MCMA and (2) the mobility of the COVID-infected population visiting medical units. RESULTS: The findings of the evaluation of the CMU strategy were (1) in the MCMA, COVID-19 followed a pattern of contagion from the urban center to the periphery; (2) given the growth in the number of cases and the overload of medical units, the population traveled greater distances to seek medical care; (3) after the CMU strategy was evaluated at the territory level, it was found that 9 out of 10 inhabitants had a CMU located approximately 7 km away; and (4) at the metropolitan level, the lowest level of accessibility to the CMU was recorded for the population with the highest levels of marginalization, i.e., those residing in the urban periphery.

Long-Lived Organotypic Slice Culture Model of the Rat Basolateral Amygdala.

Organotypic slice cultures (OTCs) have been employed in the laboratory since the early 1980s and have proved to be useful for the study of a number of neural systems. Our recent work focuses on the development of behavioral stress resilience induced by repeated daily injections of neuropeptide Y into the basolateral amygdala (BLA). Resilience develops over weeks, persisting to 8 weeks. To unravel the cellular mechanisms underlying neuropeptide Y-induced stress resilience we developed in vitro OTCs of the BLA. Here, we provide an optimized protocol that consistently yields viable and healthy OTCs containing the BLA and surrounding tissue using the interface method, prepared with slices taken from postnatal (P) day 14 rats. We explain key points to optimizing tissue viability and discuss mitigation or avoidance of pitfalls that can arise to aid in successful implementation of this technique. We show that principal neurons in BLA OTCs (8 weeks in vitro = equivalent postnatal day 70) develop into networks that are electrophysiologically very similar to those from acute slices obtained from older rats (P70) and respond to pharmacological treatments in a comparable way. Furthermore, we highlight how these cultures be used to further understand the molecular, cellular, and circuit-level neuropathophysiological changes underlying stress disorders. BLA OTCs provide long-term physiological and pharmacological results whose predictions were borne out in vivo, supporting the validity of the BLA OTC as a model to unravel BLA neurocircuitry. Recent preliminary results also support the successful application of this approach to preparing long-lived OTCs of BLA and neocortex from mice. © 2021 Wiley Periodicals LLC. Basic Protocol 1: Organotypic slice culture Support Protocol 1: Changing medium Support Protocol 2: Drug incubations Basic Protocol 2: Excision of OTC slices from inserts Support Protocol 3: Fixation of slices.

Treating Acute Leukemia During the COVID-19 Pandemic in an Environment With Limited Resources: A Multicenter Experience in Four Latin American Countries.

PURPOSE: The COVID-19 pandemic is a colossal challenge for global health; nonetheless, specific subgroups face considerably higher risks for infection and mortality. Among patients with malignant diseases, those with hematologic neoplasms are at a higher risk for poor outcomes. The objective of this study was to register treatment modifications associated with the COVID-19 pandemic and their short-term consequences in Latin America. METHODS: Multicenter, prospective, observational, cohort study including patients older than 14 years from 14 centers in four countries (Mexico, Peru, Guatemala, and Panama) who had a confirmed diagnosis of acute leukemia, and who were undergoing active treatment since the first COVID-19 case in each country until the cutoff on July 15, 2020. RESULTS: We recruited 635 patients. Treatment modifications because of the COVID-19 pandemic were reported in 40.8% of cases. The main reason for such modifications was logistic issues (55.0%) and the most frequent modification was chemotherapy delay (42.0%). A total of 13.1% patients developed COVID-19 disease, with a mortality of 37.7%. Several factors were identified as independently associated with mortality, including a diagnosis of acute myeloid leukemia (odds ratio 2.38 [95% CI, 1.47 to 3.84]; P < .001), while the use of telemedicine was identified as a protective factor (odds ratio 0.36 [95% CI, 0.18 to 0.82]; P = .014). CONCLUSION: These results highlight the collateral damage of COVID-19 in oncology patients.

Contribution of NPY Y5 Receptors to the Reversible Structural Remodeling of Basolateral Amygdala Dendrites in Male Rats Associated with NPY-Mediated Stress Resilience.

Endogenous neuropeptide Y (NPY) and corticotrophin-releasing factor (CRF) modulate the responses of the basolateral amygdala (BLA) to stress and are associated with the development of stress resilience and vulnerability, respectively. We characterized persistent effects of repeated NPY and CRF treatment on the structure and function of BLA principal neurons in a novel organotypic slice culture (OTC) model of male rat BLA, and examined the contributions of specific NPY receptor subtypes to these neural and behavioral effects. In BLA principal neurons within the OTCs, repeated NPY treatment caused persistent attenuation of excitatory input and induced dendritic hypotrophy via Y5 receptor activation; conversely, CRF increased excitatory input and induced hypertrophy of BLA principal neurons. Repeated treatment of OTCs with NPY followed by an identical treatment with CRF, or vice versa, inhibited or reversed all structural changes in OTCs. These structural responses to NPY or CRF required calcineurin or CaMKII, respectively. Finally, repeated intra-BLA injections of NPY or a Y5 receptor agonist increased social interaction, a validated behavior for anxiety, and recapitulated structural changes in BLA neurons seen in OTCs, while a Y5 receptor antagonist prevented NPY's effects both on behavior and on structure. These results implicate the Y5 receptor in the long-term, anxiolytic-like effects of NPY in the BLA, consistent with an intrinsic role in stress buffering, and highlight a remarkable mechanism by which BLA neurons may adapt to different levels of stress. Moreover, BLA OTCs offer a robust model to study mechanisms associated with resilience and vulnerability to stress in BLA.SIGNIFICANCE STATEMENT Within the basolateral amygdala (BLA), neuropeptide Y (NPY) is associated with buffering the neural stress response induced by corticotropin releasing factor, and promoting stress resilience. We used a novel organotypic slice culture model of BLA, complemented with in vivo studies, to examine the cellular mechanisms associated with the actions of NPY. In organotypic slice cultures, repeated NPY treatment reduces the complexity of the dendritic extent of anxiogenic BLA principal neurons, making them less excitable. NPY, via activation of Y5 receptors, additionally inhibits and reverses the increases in dendritic extent and excitability induced by the stress hormone, corticotropin releasing factor. This NPY-mediated neuroplasticity indicates that resilience or vulnerability to stress may thus involve neuropeptide-mediated dendritic remodeling in BLA principal neurons.

¿En qué medida la adversidad temprana y la depresión explican la satisfacción de pareja? / How does early adversity and depression explain satisfaction of a couple?

Las experiencias adversas durante la infancia pueden constituirse en eventos traumáticos que impactan la calidad de los vínculos y la salud mental a lo largo del ciclo vital, siendo la depresión un trastorno frecuente en quienes reportan estas vivencias. La depresión ha sido asociada positivamente a la adversidad temprana y negativamente con la satisfacción de pareja durante la adultez, pero se desconoce el valor explicativo de la adversidad temprana y la depresión en los niveles de satisfacción de pareja. Considerando estos antecedentes, se desarrolló un estudio transversal, correlacional y comparativo en 160 madres y padres chilenos(as). Los resultados mostraron altos niveles de satisfacción de pareja y una asociación positiva entre las experiencias adversas y la depresión en padres y madres. Las madres presentaron mayores puntajes que los padres en depresión [t(79) =4.72, p<.001] y en experiencias adversas tempranas [t(79)= 3.468, p<.001], explicando la depresión materna y paterna junto a la satisfacción de pareja paterna un 51.8% de la satisfacción de pareja en las mujeres. En cuanto a los padres, su sintomatología depresiva y la satisfacción de la madre, explicaron un 58.9% de su satisfacción de pareja. Se discute la relevancia y las implicancias clínicas de los resultados

Adverse experiences in childhood are often traumatic events that affect relationships and mental health throughout the life cycle, with depression being a prevalent disorder in those who report them. Although depression has been positively associated with early adver-sity and negatively with couple satisfaction during adulthood, there are no studies that evaluate the explanatory value of both variables at the level of couple satisfaction. Therefore, a cross-sectional, correlational and comparative study was carried out in 160 fathers and mothers. The results showed high levels of couple satisfaction and a positive association between childhood adverse experiences and depression in parents. Mothers showed higher scores than fathers in depression [t(79) = 4.72; p <, 001] and in childhood adverse experiences [t(79) = 3,468 p <.001]. Moreover, for them, depression explained 53% of couple satisfaction. As for the father, a depressive symptomatology, childhood adverse experiences and the mother's depressive symptomatology explained 35% of his couple satisfaction

The Purinome and the preBötzinger Complex - A Ménage of Unexplored Mechanisms That May Modulate/Shape the Hypoxic Ventilatory Response.

Exploration of purinergic signaling in brainstem homeostatic control processes is challenging the traditional view that the biphasic hypoxic ventilatory response, which comprises a rapid initial increase in breathing followed by a slower secondary depression, reflects the interaction between peripheral chemoreceptor-mediated excitation and central inhibition. While controversial, accumulating evidence supports that in addition to peripheral excitation, interactions between central excitatory and inhibitory purinergic mechanisms shape this key homeostatic reflex. The objective of this review is to present our working model of how purinergic signaling modulates the glutamatergic inspiratory synapse in the preBötzinger Complex (key site of inspiratory rhythm generation) to shape the hypoxic ventilatory response. It is based on the perspective that has emerged from decades of analysis of glutamatergic synapses in the hippocampus, where the actions of extracellular ATP are determined by a complex signaling system, the purinome. The purinome involves not only the actions of ATP and adenosine at P2 and P1 receptors, respectively, but diverse families of enzymes and transporters that collectively determine the rate of ATP degradation, adenosine accumulation and adenosine clearance. We summarize current knowledge of the roles played by these different purinergic elements in the hypoxic ventilatory response, often drawing on examples from other brain regions, and look ahead to many unanswered questions and remaining challenges.

Correlation between Anatomical Segments of the Pudendal Nerve and Clinical Findings of the Patient with Pudendal Neuralgia.

BACKGROUND: The objective was to describe clinical findings and outcomes of patients with pudendal neuralgia in relation with the anatomical segment affected. METHODS: Fifty-one consecutive patients with chronic perineal pain (CPP) located in the areas supplied by the pudendal nerve (PN), from January 2011 to June 2012, were analyzed. RESULTS: The distribution of pain at perineal, dorsal clitoris and inferior anal nerves was 92.2, 31.4 and 25.5% respectively. The duration of pain was longer when the dorsal clitoris nerve (DCN) was affected (p < 0,003). The pain in the pudendal canal was frequently associated with the radiation of pain to the inferior members (p < 0.043). CONCLUSION: CPP and radiation of pain to lower limbs suggest a disorder at the second segment of PN. A positive Tinel sign in the third segment indicates a nerve entrapment. In terminal branches, pain was more frequent at the perineal nerve and more persistent at the DCN.

NPY Induces Stress Resilience via Downregulation of Ih in Principal Neurons of Rat Basolateral Amygdala.

Neuropeptide Y (NPY) expression is tightly linked with the development of stress resilience in rodents and humans. Local NPY injections targeting the basolateral amygdala (BLA) produce long-term behavioral stress resilience in male rats via an unknown mechanism. Previously, we showed that activation of NPY Y1 receptors hyperpolarizes BLA principal neurons (PNs) through inhibition of the hyperpolarization-activated, depolarizing H-current, Ih The present studies tested whether NPY treatment induces stress resilience by modulating Ih NPY (10 pmol) was delivered daily for 5 d bilaterally into the BLA to induce resilience; thereafter, the electrophysiological properties of PNs and the expression of Ih in the BLA were characterized. As reported previously, increases in social interaction (SI) times persisted weeks after completion of NPY administration. In vitro intracellular recordings showed that repeated intra-BLA NPY injections resulted in hyperpolarization of BLA PNs at 2 weeks (2W) and 4 weeks (4W) after NPY treatment. At 2W, spontaneous IPSC frequencies were increased, whereas at 4W, resting Ih was markedly reduced and accompanied by decreased levels of HCN1 mRNA and protein expression in BLA. Knock-down of HCN1 channels in the BLA with targeted delivery of lentivirus containing HCN1-shRNA increased SI beginning 2W after injection and induced stress resilience. NPY treatment induced sequential, complementary changes in the inputs to BLA PNs and their postsynaptic properties that reduce excitability, a mechanism that contributes to less anxious behavior. Furthermore, HCN1 knock-down mimicked the increases in SI and stress resilience observed with NPY, indicating the importance of Ih in stress-related behavior.SIGNIFICANCE STATEMENT Resilience improves mental health outcomes in response to adverse situations. Neuropeptide Y (NPY) is associated with decreased stress responses and the expression of resilience in rodents and humans. Single or repeated injections of NPY into the basolateral amygdala (BLA) buffer negative behavioral effects of stress and induce resilience in rats, respectively. Here, we demonstrate that repeated administration of NPY into the BLA unfolds several cellular mechanisms that decrease the activity of pyramidal output neurons. One key mechanism is a reduction in levels of the excitatory ion channel HCN1. Moreover, shRNA knock-down of HCN1 expression in BLA recapitulates some of the actions of NPY and causes potent resilience to stress, indicating that this channel may be a possible target for therapy.

"The impact of debulking surgery in patients with node-positive epithelial ovarian cancer: Analysis of prognostic factors related to overall survival and progression-free survival after an extended long-term follow-up period".

OBJECTIVE: to estimate the prognostic factors associated with survival and progression free survival (PFS) in patients with node-positive epithelial ovarian cancer (EOC) after an extended long-term follow-up period. METHODS: Data was provided by the Tumor Registry of the Mayo Clinic, Scottsdale, Arizona on 116 node-positive EOC patients who underwent primary cytoreductive surgery observed over the period 1996-2014. RESULTS: At censoring date, 21 patients were alive (18%), 95 dead (82%), 18 without evidence of disease (NED) (15 alive, 3 dead) and 76 with evidence of disease (ED) (2 alive, 74 dead). Twenty-nine ED patients (38.2%) experienced a recurrence within 2 years, 53 patients (69.7%) before 5 years. No recurrences were recorded after 10 years. The median follow-up in alive patients was 169.8 months (1.20-207.9 months), 34.9 months (0.30-196.2 months) in dead patients, 128.4 months for NED patients (72.8-202.5 months) and 34.6 months (0.1-106.9 months) in ED patients. Multivariate analysis showed an increased risk of dead in patients with age ≥ 60 years (HR: 3.20; p < 0.002), stage IVA/B (compared with stage IIIA1/2, HR: 4.31; p < 0.001 and stage IIIB/C, HR: 5.31; p < 0.010) and incomplete surgery (compared with complete surgery, HR: 3.10; 95% CI, 1.41-6.77; p < 0.003) and a decreased PFS in stage IVA/B (compared with stages IIIB/C; p = 0.003 and stage IIIA; p = 0.000) and residual volume after surgery >0.6 cm (compared with residual disease <0.5 cm; p < 0.023). CONCLUSIONS: prognostic factors for an extended long-term PFS are similar as those for survival, because after 17-year follow-up period, the majority of alive patients are NED patients.

Shade Effects on the Dispersal of Airborne Hemileia vastatrix Uredospores.

Hemileia vastatrix caused a severe epidemic in Central America in 2012-13. The gradual development of that epidemic on nearly a continental scale suggests that dispersal at different scales played a significant role. Shade has been proposed as a way of reducing uredospore dispersal. The effect of shade (two strata: Erythrina poeppigiana below and Chloroleucon eurycyclum above) and full sun on H. vastatrix dispersal was studied with Burkard traps in relation to meteorological records. Annual and daily patterns of dispersal were observed, with peaks of uredospore capture obtained during wet seasons and in the early afternoon. A maximum of 464 uredospores in 1 day (in 14.4 m(3) of air) was recorded in October 2014. Interactions between shade/full sun and meteorological conditions were found. Rainfall, possibly intercepted by tree cover and redistributed by raindrops of higher kinetic energy, was the main driver of uredospore dispersal under shade. Wind gusts reversed this effect, probably by inhibiting water accumulation on leaves. Wind gusts also promoted dispersal under dry conditions in full sun, whereas they had no effect under shaded conditions, probably because the canopy blocked the wind. Our results indicate the importance of managing shade cover differentially in rainy versus dry periods to control the dispersal of airborne H. vastatrix uredospores.