Campus node-based wastewater surveillance enables COVID-19 case localization and confirms lower SARS-CoV-2 burden relative to the surrounding community.

Wastewater-based surveillance (WBS) has been established as a powerful tool that can guide health policy at multiple levels of government. However, this approach has not been well assessed at more granular scales, including large work sites such as University campuses. Between August 2021 and April 2022, we explored the occurrence of SARS-CoV-2 RNA in wastewater using qPCR assays from multiple complimentary sewer catchments and residential buildings spanning the University of Calgary's campus and how this compared to levels from the municipal wastewater treatment plant servicing the campus. Real-time contact tracing data was used to evaluate an association between wastewater SARS-CoV-2 burden and clinically confirmed cases and to assess the potential of WBS as a tool for disease monitoring across worksites. Concentrations of wastewater SARS-CoV-2 N1 and N2 RNA varied significantly across six sampling sites - regardless of several normalization strategies - with certain catchments consistently demonstrating values 1-2 orders higher than the others. Relative to clinical cases identified in specific sewersheds, WBS provided one-week leading indicator. Additionally, our comprehensive monitoring strategy enabled an estimation of the total burden of SARS-CoV-2 for the campus per capita, which was significantly lower than the surrounding community (p≤0.001). Allele-specific qPCR assays confirmed that variants across campus were representative of the community at large, and at no time did emerging variants first debut on campus. This study demonstrates how WBS can be efficiently applied to locate hotspots of disease activity at a very granular scale, and predict disease burden across large, complex worksites.

Surveillance for SARS-CoV-2 and its variants in wastewater of tertiary care hospitals correlates with increasing case burden and outbreaks.

Wastewater-based SARS-CoV-2 surveillance enables unbiased and comprehensive monitoring of defined sewersheds. We performed real-time monitoring of hospital wastewater that differentiated Delta and Omicron variants within total SARS-CoV-2-RNA, enabling correlation to COVID-19 cases from three tertiary-care facilities with >2100 inpatient beds in Calgary, Canada. RNA was extracted from hospital wastewater between August/2021 and January/2022, and SARS-CoV-2 quantified using RT-qPCR. Assays targeting R203M and R203K/G204R established the proportional abundance of Delta and Omicron, respectively. Total and variant-specific SARS-CoV-2 in wastewater was compared to data for variant specific COVID-19 hospitalizations, hospital-acquired infections, and outbreaks. Ninety-six percent (188/196) of wastewater samples were SARS-CoV-2 positive. Total SARS-CoV-2 RNA levels in wastewater increased in tandem with total prevalent cases (Delta plus Omicron). Variant-specific assessments showed this increase to be mainly driven by Omicron. Hospital-acquired cases of COVID-19 were associated with large spikes in wastewater SARS-CoV-2 and levels were significantly increased during outbreaks relative to nonoutbreak periods for total SARS-CoV2, Delta and Omicron. SARS-CoV-2 in hospital wastewater was significantly higher during the Omicron-wave irrespective of outbreaks. Wastewater-based monitoring of SARS-CoV-2 and its variants represents a novel tool for passive COVID-19 infection surveillance, case identification, containment, and potentially to mitigate viral spread in hospitals.

Molecular neurobiological markers in the onset of sodium appetite.

Sodium appetite is a motivational state involving homeostatic behavior, seeking the ingest of salty substances after sodium loss. There is a temporal dissociation between sodium depletion (SD) and the appearance of sodium appetite. However, the responsible mechanisms for this delay remain poorly elucidated. In the present study, we measured the temporal changes at two and 24 h after SD in the gene expression of key elements within excitatory, inhibitory, and sensory areas implicated in the signaling pathways involved in the onset of sodium appetite. In SD rats, we observed that the expression of critical components within the brain control circuit of sodium appetite, including Angiotensin-type-1 receptor (Agtr1a), Oxytocin-(OXT-NP)-neurophysin-I, and serotonergic-(5HT)-type-2c receptor (Htr2c) were modulated by SD, regardless of time. However, we observed reduced phosphorylation of mitogen-activated protein kinases (MAPK) at the paraventricular nucleus (PVN) and increased oxytocin receptor (Oxtr) mRNA expression at the anteroventral of the third ventricle area (AV3V), at two hours after SD, when sodium appetite is inapparent. At twenty-four hours after SD, when sodium appetite is released, we observed a reduction in the mRNA expression of the transient receptor potential channel 1gene (Trpv1) and Oxtr in the AV3V and the dorsal raphe nucleus, respectively. The results indicate that SD exerts a coordinated timing effect, promoting the appearance of sodium appetite through changes in MAPK activity and lower Trpv1 channel and Oxtr expression that trigger sodium consumption to reestablish the hydroelectrolytic homeostasis.

Tracking Emergence and Spread of SARS-CoV-2 Omicron Variant in Large and Small Communities by Wastewater Monitoring in Alberta, Canada.

Wastewater monitoring of SARS-CoV-2 enables early detection and monitoring of the COVID-19 disease burden in communities and can track specific variants of concern. We determined proportions of the Omicron and Delta variants across 30 municipalities covering >75% of the province of Alberta (population 4.5 million), Canada, during November 2021-January 2022. Larger cities Calgary and Edmonton exhibited more rapid emergence of Omicron than did smaller and more remote municipalities. Notable exceptions were Banff, a small international resort town, and Fort McMurray, a medium-sized northern community that has many workers who fly in and out regularly. The integrated wastewater signal revealed that the Omicron variant represented close to 100% of SARS-CoV-2 burden by late December, before the peak in newly diagnosed clinical cases throughout Alberta in mid-January. These findings demonstrate that wastewater monitoring offers early and reliable population-level results for establishing the extent and spread of SARS-CoV-2 variants.

La gestión del liderazgo enfermero y la cultura de seguridad del paciente en las organizaciones sanitarias / Nursing leadership management and patient safety culture in healthcare organizations

Objetivo: actualizar el análisis de la relación del liderazgo enfermero con la seguridad del paciente diferenciando entre los distintos tipos de liderazgo. Método: revisión narrativa realizada entre marzo y diciembre de 2021. Se consultaron las bases de datos PubMed, IBECS y CINAHL, utilizando los términos: Leadership, Patient Safety, Risk Management y Nursing, Supervisory, entre otros. Se incluyeron artículos de los últimos cinco años publicados en español o inglés. La selección se llevó a cabo entre tres investigadoras. Resultados: se encontraron 294 registros de los que 13 fueron incluidos finalmente en la revisión. Tres tipos de liderazgo (auténtico, transformacional y ético) tuvieron asociación con la disminución de eventos adversos. El liderazgo auténtico se mostró como predictor del aumento del clima de seguridad. El liderazgo ético se asoció con mayor notificación de errores. Se identificaron aspectos importantes de la persona que lidera para mejorar la seguridad: en la retroalimentación no asigna culpas, es capaz de transmitir los mensajes de forma adecuada, establece un clima de confianza y una comunicación continuada con el personal, es accesible, motivadora, tiene inteligencia emocional, promueve el trabajo en equipo. Conclusiones: distintos tipos de liderazgo se asocian a beneficios en la seguridad del paciente. Que las supervisoras desarrollen un liderazgo eficaz y basado en las relaciones positivas favorece una adecuada cultura de seguridad lo que ha de tenerse en cuenta a la hora de promoverla.(AU)

Objective: to update the analysis of the relationship between nursing leadership and patient safety, differentiating between types of leadership. Method: a narrative review conducted between March and December 2021. The PubMed, IBECS and CINAHL databases were consulted, using the terms Leadership, Patient Safety, Risk Management and Nursing, Supervisory, among others. Articles from the past five years published in Spanish or English were included. Three female researchers were in charge of selection. Results: there were 294 records retrieved, 13 of which were finally included in the review. Three types of leadership (authentic, transformational and ethical) were associated with a reduction in adverse events. Authentic leadership appeared as a predictor for an increase in safety environment. The ethical leadership was associated with a higher report of errors. Important aspects of the leader person were identified in order to improve safety: not assigning blame during feedback, being able to convey messages adequately, establishing a trust environment and continuous communication with staff, being accessible and motivating, having emotional intelligence, and promoting teamwork. Conclusions: different types of leadership are associated with benefits in patient safety. Supervisors developing an effective leadership based on positive relationships will encourage an adequate safety culture, which must be taken into account at the time of promotion.(AU)

Oclusión vascular mixta de la retina en una paciente con síndrome antifosfolípido. Reporte de caso / Mixed retinal vascular occlusion secondary to antiphospholipid antibody syndrome. A case report

Introducción: La oclusión combinada de la arteria y la vena central de la retina es un evento vascular poco frecuente, caracterizado por pérdida visual súbita y pronóstico reservado. Los pocos casos reportados se asocian con antecedentes de patología sistémica vasculítica, reumatológica, infecciosa o tumoral. Objetivo: Describir un caso de doble oclusión vascular retiniana secundario a síndrome de anticuerpos antifosfolípidos. Resumen del caso: Se reporta el caso de una paciente de 31 años con oclusión de vena y arteria central de la retina, con historia clínica y paraclínicos compatibles con un síndrome de anticuerpos antifosfolípidos de base, enfermedad de difícil manejo con un pobre pronóstico visual, con secuelas visuales graves, rápidas e irreversibles. Conclusiones: Las oclusiones vasculares combinadas de arteria y vena central de la retina son poco frecuentes. Se caracterizan por pérdida súbita de la visión y hallazgos clínicos propios de ambos tipos de oclusiones: palidez retinal, mancha de color rojo cereza, dilatación venosa, hemorragias en llama, edema de disco, etc. Por lo regular tiende a relacionarse con patologías infecciosas, autoinmunitarias o tumorales, entre otras, como es el caso del síndrome antifosfolípido. Las opciones terapéuticas son limitadas y la respuesta es incierta, con un mal pronóstico visual y secuelas irreversibles

Introduction: Combined vascular occlusion of the central retinal artery and vein is a rare vascular event, characterized by sudden visual loss and uncertain prognosis. The few cases reported in literature are associated with a history of vasculitic, rheumatological, infectious or tumoral pathology. Objective: To describe a mixed retinal vascular occlusion secondary to antiphospholipid antibody syndrome. Case summary: We report a case with mixed retinal vascular occlusion in a patient with history of antiphospholipid antibody syndrome , with poor visual prognosis, difficult treatment and severe irreversible sequelae. Conclusions: Combined retinal vascular occlusions are rare entities characterized by sudden vision loss and clinical findings of both types of occlusions: retinal pallor, cherry red spot, venous dilatation, hemorrhages, disc edema, etc. Usually, these are related to infectious, autoimmune or neoplasic diseases, like antiphospholipid syndrome. The therapeutic options are limited and their effectiveness is vague, leading to poor visual prognosis and irreversible sequelae

Toward Understanding Complex Spin Textures in Nanoparticles by Magnetic Neutron Scattering.

In the quest to image the three-dimensional magnetization structure we show that the technique of magnetic small-angle neutron scattering (SANS) is highly sensitive to the details of the internal spin structure of nanoparticles. By combining SANS with numerical micromagnetic computations we study the transition from single-domain to multidomain behavior in nanoparticles and its implications for the ensuing magnetic SANS cross section. Above the critical single-domain size we find that the cross section and the related correlation function cannot be described anymore with the uniform particle model, resulting, e.g., in deviations from the well-known Guinier law. In the simulations we identify a clear signature for the occurrence of a vortexlike spin structure at remanence. The micromagnetic approach to magnetic SANS bears great potential for future investigations, since it provides fundamental insights into the mesoscale magnetization profile of nanoparticles.

Atención y notificación de un paciente NN / Care and notice of unidentified patients

Introducción: los pacientes NN "Nomen Nescio" constituyen un reto para los profesionales de la salud, descifrar su identidad, encontrar a la familia e informar la situación puede ser tan complicado como el diagnóstico de su patología. Incluso desde el punto de vista psicosocial la falta de identificación puede llevar a un problema adicional para la prestación de los servicios en salud. Caso clínico: hombre de 36 años llevado al servicio de urgencias del Hospital de San José en Bogotá con politrauma al ser arrollado en calidad de peatón; al ingreso sin pertenencias, con Glasgow 11 lo que imposibilitó su identificación. Ante la evidencia de una lesión clasificada como urgencia, se llevó a procedimiento quirúrgico requiriendo soporte vasopresor y respiratorio. Se trasladó a la unidad de cuidado intensivo y fue declarado como NN hombre, por lo que se debió aplicar el protocolo para identificación del paciente. Discusión: en Colombia existe un protocolo para la atención en salud de los pacientes ingresados a un hospital como NN "Nomen Nescio", es importante el conocimiento del mismo por parte de los profesionales de la salud, en especial el personal médico; debido a que su labor debe ir más allá del manejo o prevención del padecimiento bioclínico, enfocándolo a la notificación ante las entidades correspondientes y la articulación con otras disciplinas para identificar al paciente, porque ante un NN probablemente hay una persona en búsqueda de su familiar, que se puede encontrar en nuestras manos.

Introduction: unidentified N.N "Nomen nescio" patients pose a challenge for healthcare providers. To determine their identity, find their family and inform about the situation may be as complicated as diagnosing their illness. Even from the psychosocial perspective the lack of identity may lead to additional problems for the provision of healthcare services. Clinical case: a 36 year-old male trauma patient who was hit by a car as a pedestrian arrives to the emergency room of Hospital de San José in Bogotá; at the time of admission, his Glasgow coma scale score is 11 and has no belongings that might reveal his identity. He undergoes a surgical procedure in which he requires vasopressor and respiratory support as his lesion was classified as an emergency. He was admitted to the Intensive Care Unit and was declared an unidentified male patient, thus the protocol to uncover his identity must be applied. Discussion: Colombia has a protocol regarding provision of healthcare services to patients admitted to a hospital as unidentified N.N "Nomen nescio" patients. Knowing about this protocol is important among healthcare providers, especially among the medical staff; for their work must go beyond the management and prevention of the bio-clinical affection, focusing in notifying the corresponding entities and articulating with other disciplines to establish patient ́s identity, for there may probably be someone inquiring for a missing relative who might be the unidentified patient who is under our care.

Whole body sodium depletion modifies AT1 mRNA expression and serotonin content in the dorsal raphe nucleus.

Angiotensin II (Ang II) acts on Ang II type 1 (AT1) receptors located in the organum vasculosum and subfornical organ (SFO) of the lamina terminalis as a main facilitatory mechanism of sodium appetite. The brain serotonin (5-HT) system with soma located in the dorsal raphe nucleus (DRN) provides a main inhibitory mechanism. In the present study, we first investigated the existence of Ang II AT1 receptors in serotonergic DRN neurones. Then, we examined whether whole body sodium depletion affects the gene expression of the AT1a receptor subtype and the presumed functional significance of AT1 receptors. Using confocal microscopy, we found that tryptophan hydroxylase-2 and serotonin neurones express AT1 receptors in the DRN. Immunofluorescence quantification showed a significant reduction in 5-HT content but no change in AT1 receptor expression or AT1/5-HT colocalisation in the DRN after sodium depletion. Whole body sodium depletion also significantly increased Agtr1a mRNA expression in the SFO and DRN. Oral treatment with the AT1 receptor antagonist losartan reversed the changes in Agtr1a expression in the SFO but not the DRN. Losartan injection into either the DRN or the mesencephalic aqueduct had no influence on sodium depletion-induced 0.3 mol L-1 NaCl intake. The results indicate the expression of Agtr1a mRNA in the DRN and SFO as a marker of sodium depletion. They also suggest that serotonergic DRN neurones are targets for Ang II. However, the function of their AT1 receptors remains elusive.

Publisher Correction: Small-angle neutron scattering modeling of spin disorder in nanoparticles.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has not been fixed in the paper.

Role of Oxytocin in Prolactin Secretion during Late Pregnancy.

BACKGROUND/AIMS: During late pregnancy, the blockade of progesterone action by mifepristone (Mp) treatment induces a dopaminergic tone fall that enables naloxone (NAL) administration to release pituitary prolactin (PRL). We determined whether oxytocin (OT), which stimulates PRL secretion acting directly on anterior pituitary lactotrophs, mediates the stimulatory action of Mp and NAL on PRL secretion during late pregnancy. METHODS: On day 19 of pregnancy, circulating and pituitary OT and PRL levels were measured by radioimmunoassay, 10, 20, and 30 min after NAL (given at 17:30 h) in rats pretreated with Mp (at 08:00 h). Pituitary OT receptor (OTR) expression in Mp-treated rats was evaluated by RT-PCR. Activation of OT neurons in Mp-NAL-treated rats was measured counting double immunoreactive neurons for Fos and OT (Fos-OT-ir) in supraoptic nuclei (SON), and medial (PaMM) and lateral magnocellular divisions of paraventricular nuclei. RESULTS: Elevated serum OT and decreased pituitary OT were observed 10 min after NAL administration in both vehicle- and Mp-treated rats. This PRL increase was prevented by previous i.p. administration of an OTR antagonist, but intracerebroventricular OT administration was ineffective. Mp increased pituitary OTR expression at 18:00 h. Only Mp-NAL increased Fos-OT-ir neurons in the PaMM and SON. CONCLUSIONS: These findings suggest that PRL secretion induced by Mp-NAL treatment is preceded by OT release. These results, together with the activation of hypothalamic OT neurons and the higher expression of pituitary OTR, support the hypothesis that, during late pregnancy, OT may act at the pituitary level to facilitate PRL secretion if the inhibitory action of progesterone is blocked.

Small-angle neutron scattering modeling of spin disorder in nanoparticles.

Magnetic small-angle neutron scattering (SANS) is a powerful technique for investigating magnetic nanoparticle assemblies in nonmagnetic matrices. For such microstructures, the standard theory of magnetic SANS assumes uniformly magnetized nanoparticles (macrospin model). However, there exist many experimental and theoretical studies which suggest that this assumption is violated: deviations from ellipsoidal particle shape, crystalline defects, or the interplay between various magnetic interactions (exchange, magnetic anisotropy, magnetostatics, external field) may lead to nonuniform spin structures. Therefore, a theoretical framework of magnetic SANS of nanoparticles needs to be developed. Here, we report numerical micromagnetic simulations of the static spin structure and related unpolarized magnetic SANS of a single cobalt nanorod. While in the saturated state the magnetic SANS cross section is (as expected) determined by the particle form factor, significant deviations appear for nonsaturated states; specifically, at remanence, domain-wall and vortex states emerge which result in a magnetic SANS signal that is composed of all three magnetization Fourier components, giving rise to a complex angular anisotropy on a two-dimensional detector. The strength of the micromagnetic simulation methodology is the possibility to decompose the cross section into the individual Fourier components, which allows one to draw important conclusions regarding the fundamentals of magnetic SANS.

Sex chromosome complement involvement in angiotensin receptor sexual dimorphism.

This study aimed to define whether sex chromosome complement (SCC) may differentially modulate sex differences in relative gene expression of basal Agtr1a, Agtr2, and Mas1 receptors at fore/hindbrain nuclei and at medulla/cortical kidney. Samples were collected from gonadectomized male (XX and XY) and female (XX and XY) mice of the "four core genotypes" model. At brain level, a SCC effect at the area postrema was demonstrated. An increase in mRNA level of Agtr1a and Agtr1a/Agtr2 ratio in XY-SCC mice was associated with a decrease in Mas1 compared to XX-SCC mice. In the renal cortex, a SCC effect for Agtr2 and Mas1 was observed. Regardless of sex (male or female), XX-SCC mice expressed higher levels of mRNA Agtr2 and Mas1 than XY-SCC mice {F(1,12) = 6,126,p < 0.05; F(1,21) = 5,143,p < 0.05}. Furthermore, XX-female mice showed a significant increase in Mas1 expression compared to XY-female mice. These results reveal a SCC modulatory effect at central and kidney level on angiotensin receptor expression, with an enhancement of the vasodilatory arm in XX-mice and an increase in the vasoconstriction arm in XY-mice, which may underlie sex differences in the regulation of arterial pressure.

Increased exposure to sodium during pregnancy and lactation changes basal and induced behavioral and neuroendocrine responses in adult male offspring.

Excessive sodium (Na+) intake in modern society has been associated with several chronic disorders such as hypertension. Several studies suggest that early life events can program physiological systems and lead to functional changes in adulthood. Therefore, we investigated behavioral and neuroendocrine responses under basal conditions and after 48 h of water deprivation in adult (60-day-old Wistar rats) male, Wistar rats originating from dams were offered only water or 0.15 mol/L NaCl during pregnancy and lactation. Early life salt exposure induced kidney damage, as shown by a higher number of ED-1 positive cells (macrophages/monocytes), increased daily urinary volume and Na+ excretion, blunted basal water intake and plasma oxytocin levels, and increased plasma corticosterone secretion. When challenged with water deprivation, animals exposed to 0.15 mol/L NaCl during early life showed impaired water intake, reduced salt preference ratio, and vasopressin (AVP) secretion. In summary, our data demonstrate that the perinatal exposure to excessive Na+ intake can induce kidney injury in adult offspring and significantly affect the key mechanisms regulating water balance, fluid intake, and AVP release in response to water deprivation. Collectively, these novel results highlight the impact of perinatal programming on the homeostatic mechanisms regulating fluid and electrolyte balance during exposure to an environmental stress (i.e. dehydration) in later life.

Single crystalline cylindrical nanowires - toward dense 3D arrays of magnetic vortices.

Magnetic vortex-based media have recently been proposed for several applications of nanotechnology; however, because lithography is typically used for their preparation, their low-cost, large-scale fabrication is a challenge. One solution may be to use arrays of densely packed cobalt nanowires that have been efficiently fabricated by electrodeposition. In this work, we present this type of nanoscale magnetic structures that can hold multiple stable magnetic vortex domains at remanence with different chiralities. The stable vortex state is observed in arrays of monocrystalline cobalt nanowires with diameters as small as 45 nm and lengths longer than 200 nm with vanishing magnetic cross talk between closely packed neighboring wires in the array. Lorentz microscopy, electron holography and magnetic force microscopy, supported by micromagnetic simulations, show that the structure of the vortex state can be adjusted by varying the aspect ratio of the nanowires. The data we present here introduce a route toward the concept of 3-dimensional vortex-based magnetic memories.

Mapping brain Fos immunoreactivity in response to water deprivation and partial rehydration: Influence of sodium intake.

Water deprivation (WD) followed by water intake to satiety, produces satiation of thirst and partial rehydration (PR). Thus, WD-PR is a natural method to differentiate thirst from sodium appetite. WD-PR also produces Fos immunoreactivity (Fos-ir) in interconnected areas of a brain circuit postulated to subserve sodium appetite. In the present work, we evaluated the effect of sodium intake on Fos-ir produced by WD-PR in brain areas operationally defined according to the literature as either facilitatory or inhibitory to sodium intake. Isotonic NaCl was available for ingestion in a sodium appetite test performed immediately after a single episode of WD-PR. Sodium intake decreased Fos-ir in facilitatory areas such as the lamina terminalis (particularly subfornical organ and median preoptic nucleus), central amygdala and hypothalamic parvocellular paraventricular nucleus in the forebrain. Sodium intake also decreased Fos-ir in inhibitory areas such as the area postrema, lateral parabrachial nucleus and nucleus of the solitary tract in the hindbrain. In contrast, sodium intake further increased Fos-ir that was activated by water deprivation in the dorsal raphe nucleus, another inhibitory area localized in the hindbrain. WD-PR increased Fos-ir in the core and shell of the nucleus accumbens. Sodium intake reduced Fos-ir in both parts of the accumbens. In summary, sodium intake following WD-PR reduced Fos-ir in most facilitatory and inhibitory areas, but increased Fos-ir in another inhibitory area. It also reduced Fos-ir in a reward area (accumbens). The results suggest a functional link between sodium intake and the activity of the hindbrain-forebrain circuitry subserving reward and sodium appetite in response to water deprivation.

Developmental programing of thirst and sodium appetite.

Thirst and sodium appetite are the sensations responsible for the motivated behaviors of water and salt intake, respectively, and both are essential responses for the maintenance of hydromineral homeostasis in animals. These sensations and their related behaviors develop very early in the postnatal period in animals. Many studies have demonstrated several pre- and postnatal stimuli that are responsible for the developmental programing of thirst and sodium appetite and, consequently, the pattern of water and salt intake in adulthood in need-free or need-induced conditions. The literature systematically reports the involvement of dietary changes, hydromineral and cardiovascular challenges, renin-angiotensin system and steroid hormone disturbances, and lifestyle in these developmental factors. Therefore, this review will address how pre- and postnatal challenges can program lifelong thirst and sodium appetite in animals and humans, as well as which neuroendocrine substrates are involved. In addition, the possible epigenetic molecular mechanisms responsible for the developmental programing of drinking behavior, the clinical implications of hydromineral disturbances during pre- and postnatal periods, and the developmental origins of adult hydromineral behavior will be discussed.

Effect of sex chromosome complement on sodium appetite and Fos-immunoreactivity induced by sodium depletion.

Previous studies indicate a sex chromosome complement (SCC) effect on the angiotensin II-sexually dimorphic hypertensive and bradycardic baroreflex responses. We sought to evaluate whether SCC may differentially modulate sexually dimorphic-induced sodium appetite and specific brain activity due to physiological stimulation of the rennin angiotensin system. For this purpose, we used the "four core genotype" mouse model, in which the effect of gonadal sex and SCC is dissociated, allowing comparisons of sexually dimorphic traits between XX and XY females as well as in XX and XY males. Gonadectomized mice were sodium depleted by furosemide (50 mg/kg) and low-sodium diet treatment; control groups were administered with vehicle and maintained on normal sodium diet. Twenty-one hours later, the mice were divided into two groups: one group was submitted to the water-2% NaCl choice intake test, while the other group was perfused and their brains subjected to the Fos-immunoreactivity (FOS-ir) procedure. Sodium depletion, regardless of SCC (XX or XY), induced a significantly lower sodium and water intake in females than in males, confirming the existence in mice of sexual dimorphism in sodium appetite and the organizational involvement of gonadal steroids. Moreover, our results demonstrate a SCC effect on induced brain FOS-ir, showing increased brain activity in XX-SCC mice at the paraventricular nucleus, nucleus of the solitary tract, and lateral parabrachial nucleus, as well as an XX-SCC augmented effect on sodium depletion-induced brain activity at two circumventricular organs, the subfornical organ and area postrema, nuclei closely involved in fluid and blood pressure homeostasis.

Body sodium overload modulates the firing rate and fos immunoreactivity of serotonergic cells of dorsal raphe nucleus.

In order to determine whether serotonergic (5HT) dorsal raphe nucleus (DRN) cells are involved in body sodium status regulation, the effect of a s.c. infusion of either 2 M or 0.15 M NaCl on 5HT DRN neuron firing was studied using single unit extracellular recordings. In separate groups of 2 M and 0.15 M NaCl-infused rats, water intake, oxytocin (OT) plasma concentration, urine and plasma sodium and protein concentrations were also measured. Also, to determine the involvement of particular brain nuclei and neurochemical systems in body sodium overload (SO), animals from both groups were perfused for brain immunohistochemical detection of Fos, Fos-OT and Fos-5HT expression. SO produced a significant increase in serotonergic DRN neuron firing rate compared to baseline and 0.15 M NaCl-infused rats. As expected, 2 M NaCl s.c. infusion also induced a significant increase of water intake, diuresis and natriuresis, plasma sodium concentration and osmolality, even though plasma volume did not increase as indicated by changes in plasma protein concentration. The distribution of neurons along the forebrain and brainstem expressing Fos after SO showed the participation of the lamina terminalis, extended amygdala, supraoptic and paraventricular hypothalamic nuclei in the neural network that controls osmoregulatory responses. Both Fos-OT immunoreactive and plasma OT concentration increased after s.c. hypertonic sodium infusion. Finally, matching the "in vivo" electrophysiological study, SO doubled the number of Fos-5HT immunolabeled cells within the DRN. In summary, the results characterize the behavioral, renal and endocrine responses after body sodium overload without volume expansion and specify the cerebral nuclei that participate at different CNS levels in the control of these responses. The electrophysiological approach also allows us to determine in an "in vivo" model that DRN 5HT neurons increase their firing frequency during an increase in systemic sodium concentration and osmolality, possibly to modulate sodium and water intake/excretion and avoid extracellular volume expansion.

El perfil psicosocial de los estudiantesde medicina de la Universidad de Manizales (Colombia) y su relación con el rendimiento académico, 2011 / Psychosocial profile of medicine students from the Universidad de Manizales (Colombia) and its relationship with academic performance. 2011

Antecedentes: Se espera que las escuelas de Medicina formen médicos compasivos, empáticos y altruistas. El presente estudio identifica, el nivel de empatía e inteligencia emocional en los estudiantes del Programa de Medicina de la Universidad de Manizales (Manizales, Colombia) y la relación con su rendimiento académico. Materiales y métodos: Estudio de corte transversal, con 233 estudiantes. Se empleó el cuestionario de Jefferson para medir la empatía médica, el TMMS para inteligencia emocional, además de otras pruebas para medir funcionalidad familiar (APGAR), ansiedad, depresión, y otras variables. Resultados: El TMMS mostró que el 51,1% de los estudiantes deben mejorar la percepción de sus emociones, el 53,2% tienen comprensión adecuada de sus sentimientos,y un 63,5% adecuada regulación emocional. Referente a las subescalas de empatía presentan en promedio 83,18% de toma de perspectiva, un 38,05% de cuidado con compasión, y un 51,38% de habilidad para ponerse en los zapatos del paciente. El promedio simple de notas presentó relación con empatía total (p=0,04), y cuidado con compasión (p=0,004), y al nivel p<0,1 con la subescala del cuestionario TMMS para medir la percepción de sus emociones (p=0,083). Se encontró relación significativa entre la percepción de las emociones con género (p=0.033), y con ansiedad (p=0,034), género con regulación de las emociones (0,026), ansiedad con comprensión de las emociones (0,032). La empatía mostró relación significativa con género (p=0,01),semestre (p=0,003), ansiedad (p=0,033) y depresión (p=0,001). Conclusión: Se demuestra la importancia de la relación médico-paciente medida como empatía en la formación del estudiante de Medicina...