Adverse cardiovascular, obstetric and perinatal events during pregnancy and puerperium in patients with heart disease.

BACKGROUND AND OBJECTIVES: cardiovascular changes during pregnancy carry greater risk in heart disease. We analyze cardiovascular, obstetric and perinatal adverse effects associated with congenital and acquired heart disease during pregnancy and postpartum. MATERIALS AND METHODS: Cross-sectional and retrospective study, which included the 2017-2023 registry of pregnant or postpartum patients hospitalised with diagnosis of congenital or acquired heart disease. Adverse events (heart failure, stroke, acute pulmonary edema, maternal death, obstetric haemorrhage, prematurity and perinatal death) were compared with the clinical variables and the implemented treatment. RESULTS: 112 patients with a median age of 28 years (range 15-44) were included. Short circuits predominated 28 (25%). Thirty-six patients (32%) were classified in class IV of the modified WHO scale for maternal cardiovascular risk. Heart failure occurred in 39 (34.8%), acute lung edema 12 (10.7%), stroke 2 (1.8%), maternal death 5 (4.5%), obstetric haemorrhage 4 (3.6%), prematurity 50 (44.5%) and perinatal death 6 (5.4%). Shunts were associated with prematurity (adjusted odds ratio 4; 95% CI: 1.5-10, p = 0.006). Peripartum cardiomyopathy represented higher risk of pulmonary edema (adjusted OR 34; 95% CI: 6-194, p = 0.001) and heart failure (adjusted OR 16; 95% CI: 3-84, p = 0.001). An increased risk of obstetric haemorrhage was observed in patients with prosthetic valves (adjusted OR 30; 95% CI: 1.5-616, p = 0.025) and with the use of acetylsalicylic acid (adjusted OR 14; 95% CI: 1.2-16, p = 0.030). Furthermore, the latter was associated with perinatal death (adjusted OR 9; 95% CI: 1.4-68, p = 0.021). CONCLUSIONS: severe complications were found during pregnancy and postpartum in patients with heart disease, which is why preconception evaluation and close surveillance are vital.

Substance use disorders in patients with intellectual disability admitted to psychiatric hospitalisation.

BACKGROUND: Few studies have looked at the prevalence of substance use disorders (SUD) in people with intellectual disability (ID). The results range between 1% and 6.4% and go up to 20% in people with ID and psychiatric disorders, probably underestimating real prevalence due to several limitations in these studies. ID confers risk for the development of SUD, which in turn will involve negative psychosocial and clinical consequences. We aimed to study the prevalence of SUD in a sample of patients with ID admitted to a brief hospitalisation psychiatric unit, describing them by type and severity and analysing their relationship with clinical, prognostic and access to treatment variables. METHODS: We undertook a descriptive, cross-sectional and retrospective study by means of a review of clinical histories of all patients with a diagnosis of ID, admitted in a period of 10 years. RESULTS: Among the final sample of patients included, 52.3% had a mild ID, 40.9% an unspecified ID, 3.4% a moderate ID and another 3.4% a severe ID. More than one third of the sample met criteria for a SUD. The main SUD was cannabis use disorder (25%), followed by alcohol use disorder (22.7%) and cocaine use disorder (13.6%). The use of more than one substance was the most frequent pattern. Cannabis use disorder and cocaine use disorder were overrepresented in the group with mild ID. A greater number of psychiatric admissions was observed for the group with SUD. Specialised mental health services for ID and specialised addiction network facilities were much less involved in the care of these patients that could be expected according to good clinical practice recommendations. CONCLUSIONS: Substance use disorder in patients with ID and mental health disorders admitted to psychiatric hospitalisation are prevalent, which makes this issue an area of interest for future improvements in case identification, proper referring to specialised treatment resources and an increasing research focusing on specific therapeutic approaches.

The role of disorder on the electronic structure of conjugated polymers. The case of poly-2,5-bis(phenylethynyl)-1,3,4-thiadiazole.

Insight into the electronic structure of disordered poly-2,5-bis(phenylethynyl)-1,3,4-thiadiazole in an amorphous region, in comparison to an ideal two-planar cofacial oligomer system, is pursued. The atomic structure of the amorphous polymer was obtained from classical molecular dynamics. It was subsequently used to calculate the electronic states and inter- and intrachain electronic coupling integrals using the density functional theory based charge patching method. The interchain electronic coupling integrals in the amorphous system were found to be an order of magnitude smaller than in the ordered system with similar distances between the chains. The results also suggest that the electronic structure of the whole system cannot be understood as a collection of the electronic structures of individual chains. The band gap of the whole system is significantly smaller than the band gaps of individual chains. This decrease originates from the disordered long range electrostatic potential created by the dipole moments of polymer repeat units, which should be minimized if one seeks good transport properties.

Cuadros depresivos en la fase aguda del ictus isquémico. ¿Una reacción de duelo? / Post-stroke depression. A grief reaction?

Realizamos un estudio prospectivo para valorar la depresión en la fase aguda del ictus, y hallamos similitudes con una reacción de duelo (AU)

We performed a prospective research with the aim to assess the depression in acute stroke, and we identified resemblances between poststroke depression and the grief (AU)

Dormancy and proliferation in Saccharum officinarumxS. spontaneum hybrids which differ in the number of the introgressed S. spontaneum chromosomes.

Proliferating cells remain transiently blocked at different cycle compartments until specific stressors are removed or until the cells become adapted to their presence. This paper investigates the efficiency of cycle blocks in three sugarcane hybrids with the full noble cane (Saccharum officinarum) genome (2n=8x=80) but differing in the number of introgressed S. spontaneum (2n=8x=64) chromosomes. The My5514, B42231 and C236-51 cultivars possess 20, 30 and 40 additional S. spontaneum chromosomes, respectively. Flow cytometry showed that over 90% of cells were accumulated with a 2C DNA content in their dormant primordia. The presence of S. spontaneum chromosomes decreased the low stringency of the 4C block. The greater the number of these chromosomes, the lower was the number of quiescent cells with a 4C DNA content (P<0.05). Shortly after stimulation of the primordia (85% relative humidity and 30 degrees C), i.e. in the 2 mm long roots, a negative correlation was found between the number of introgressed S. spontaneum chromosomes and the frequency of cells undergoing replication and mitosis. On the other hand, when roots were already proliferating under steady-state conditions (15 mm long roots) the more S. spontaneum chromosomes the cells possessed, the longer the relative time it took for all chromosomes to replicate and segregate, and the longer the relative time they spent in G(2), with the 4C DNA content. The presence of S. spontaneum chromosomes seems to be recognized by these proliferating cells as a stressor which preferentially activates checkpoint pathways operating at the second half of the cycle, but not at its onset.

Caracterizacion del pie del deportista universitario: su relacion con el esguince de tobillo / Characterisation of university sportsmen's feet: relationship with sprained ankles

Las diferencias anatómicas existentes en los atletas pueden implicar cambios importantes en el gesto deportivo. Los distintos gestos deportivos pueden influir de forma positiva, con la mejora del rendimiento físico, o de forma negativa, disminuyéndolo o favoreciendo la aparición de lesiones. Sabemos de la existencia de cierta predisposición anatómica y funcional a la hora de sufrir determinadas lesiones. De este punto, se deriva la importancia de realizar una valoración apropiada de las distintas estructuras anatómicas del atleta para actuar en consecuencia, bien con medidas preventivas, paliativas o terapéuticas. Entre las lesiones deportivas hemos estudiado el esguince lateral externo del tobillo por ser la más frecuente de la extremidad inferior. El análisis de la huella plantar en estática nos puede dar información sobre el comportamiento funcional de la extremidad inferior. Así mismo, diferentes anomalías funcionales van a presentar su reflejo en una alteración del apoyo en dinámica. En nuestro estudio, realizado a una población de deportistas universitarios de alto nivel (n=70), la exploración clínica nos permitió hacer una clasificación según las diferentes alteraciones en el apoyo (pie plano, pie normal y pie cavo). Se hizo también un registro de otras anomalías qué no atendían a tal clasificación (Rotaciones tibiales, genus de rodilla, hallux abductus valgus...).Los esguinces de tobillo presentaron una mayor incidencia en aquellos sujetos en los que la huella se desviaba de los criterios de normalidad, tanto para los pies cavos como los pies planos. El 33 por ciento de sujetos con un apoyo normal sufrieron esguince de tobillo en comparación con el 66 de sujetos con pies cayos o planos que también padecieron dicha lesión. Es curioso observar que en el grupo con otras anomalías sólo el 23 por ciento de sujetos presentaron esguinces. Las alteraciones del apoyo no se presentaron aisladas, sino asociadas a otros factores determinantes en el aumento de la incidencia por grupos. Así los sujetos con pie plano presentaban una hiperlaxitud ligamentaria que los predisponían a sufrir dicha lesión. Basándose en los resultados obtenidos, se proponen una serie de exploraciones básicas encaminadas a descartar las principales alteraciones morfofuncionales en la estática del pie (AU)

Experimental and theoretical vibrational study of silyl trifluoromethanesulfonate, CF3SO2OSiH3.

Infrared and Raman spectra were obtained for liquid silyl trifluoromethanesulfonate, a silylating agent of limited stability. The molecular geometry was optimized by means of density functional theory and Möller-Plesset second order perturbation theory methods, using different basis sets. The optimized structure presents a gauche conformation, similar to that adopted by methyl trifluoromethanesulfonate, which was determined experimentally a short time ago. The wavenumbers for the normal modes of vibration and the corresponding force constants were also calculated, facilitating the interpretation of the vibrational data. The harmonic force constants given by theory were scaled to reproduce adequately the experimental wavenumbers.

[Pyeloureterostomy in stenosis of the pyeloureteral junction of an incomplete collecting system]. / Pieloreterostomía en estenosis de la unión pieloureteral de un doble sistema colector incompleto.

OBJECTIVES: The possible solutions to a case of ureteral duplication complicated by obstruction of one of the collecting systems are reviewed. METHODS/RESULTS: We report an uncommon case of ureteropelvic junction obstruction in the lower system of an incomplete duplication of the collecting systems that was resolved by pyeloureterostomy. CONCLUSIONS: Anastomosis of the lower renal pelvis to the upper ureter may provide a simple solution for the functional recovery of an important renal segment.

Components of the nucleolar processing complex (Pre-rRNA, fibrillarin, and nucleolin) colocalize during mitosis and are incorporated to daughter cell nucleoli.

We have traced in onion root cells the mitotic course of rRNA, of the RNA synthesized in the G2 period of the preceding interphase, and of the nucleolar proteins fibrillarin and nucleolin. The rRNA was detected by ultrastructural in situ hybridization with a rDNA probe capable of hybridizing mature rRNAs and also the intermediate forms of pre-rRNA processing. The RNA synthesized in the preceding G2 (which, according to classical data, is mostly rRNA) was revealed by autoradiography on synchronous cells labeled in G2 by tritiated uridine. Fibrillarin was detected by immunofluorescence in both mammalian and onion cells; the results in the latter cells were compared with those obtained after AgNOR staining. Electron microscopical immunocytochemistry was used to detect fibrillarin and nucleolin in onion cells. In all cases, following nucleolar dispersion in prophase, the signal was detected in the chromosome periphery during metaphase and anaphase, in irregular fibrillar masses located between chromosomes in ana-telophase, in prenucleolar bodies during telophase, and in the newly formed nucleoli, after nucleologenesis. Moreover, as expected, ribosomes appeared labeled after in situ hybridization, but a dispersed cytoplasmic labeling was observed in all experiments, mainly during metaphase and anaphase. These results demonstrate that nucleolar components involved in pre-rRNA processing, including rRNA itself, probably in an incompletely processed form, are transferred from the parental to the daughter cell nucleoli by means of transient structures, such as the perichromosomal sheath and prenucleolar bodies. Since these macromolecular components are assembled in the interphase nucleolus, forming the RNP processing complex, their colocalization during mitosis in the same transient structures strongly suggests that at least a subset of these complexes does not disaggregate during cell division, but remains assembled and becomes incorporated to the new nucleolus. Therefore, ribosome biogenesis restarts not only after mitosis at the level of transcription, but also at the intermediate levels of pre-rRNA processing.

[Factors relating to the cost and quality of drug prescriptions in primary care]. / Factores relacionados con el gasto y la calidad de la prescripción farmacéutica en atención primaria.

OBJECTIVES: To analyse, quantitatively and qualitatively, the pharmaceuticals prescribed by doctors within two models of Primary Care: the reformed (RM) and non-reformed (NRM). To study which variables of the doctor, work-centre or community attended explain prescription variations. DESIGN: An observational crossover study. SETTING: Primary Health Care centres in the province of Málaga. PARTICIPANTS: The prescriptions of 454 doctors were studied: 259 RM and 195 NRM. A univariant analysis was performed on the indicators of prescription of both health-care models, with afterwards a multiple linear regression analysis to study the effect of the rest of the variables. RESULTS: There were differences in two of the quantitative indicators studied, with more prescriptions and expense per insured person per day in the NRM, as well as higher prescription for several therapeutic groups, mainly of drugs against flu, and also of drugs against infections, tonics, restoratives and capillary protectors. The variables which best explained prescriptions in the multivariant analysis were: consultations per insured person per day and the percentage of pensioners on the doctor's list. CONCLUSIONS: We thought that the differences between the two health-care models in the quantitative analysis were of very little relevance. They were greater in the qualitative one and suggested higher quality of prescription in the RM. Pressure of numbers was identified as, among the studied variables, that which best explains prescription, over and above others like the health-care model or medical training. As for the percentage of pensioners on the doctor's list, it should be borne in mind at the hour of evaluating his/her prescriptions.

"Ag-NOR" proteins are present when transcription is impaired.

The use of nucleolar silver staining in plant cells in conditions of impaired transcription, either natural (quiescent cells) or induced (actinomycin D, ethidium bromide and cordycepin treatments), shows that nucleoli with very low transcription rates, compared with controls, contain similar amounts of argyrophilic proteins, as well as the same structural location. This demonstrates the absence of correlation between silver staining and present transcriptional activity. The effects of conditions used on the structure of nucleolar chromatin support our previous suggestion on the involvement of "Ag-NOR" proteins in the process of decondensation of NOR chromatin.

Occurrence of nucleolar material in the cytoplasm of plant cells.

This paper deals with the induction of cytoplasmic nucleolar bodies in meristematic Allium cepa L. cells after treatment with drugs which interfere with nucleolar functionality. The drugs which interfere with protein synthesis failed to produce these bodies. The ultrastructure origin and physiological significance of these bodies are discussed here, as well as their relation with the mitotic prenucleolar bodies (Moreno-Díaz de la Espina et al., 1976).

Alteration of nucleolar dispersion in prophase by 5-FUdR treatment.

The action of 5-Fluorodeoxyuridine (FUdR) used as an inhibitor of RNA synthesis on the nucleolar evolution during mitosis, has been studied in meristematic cells. Under FUdR treatment the nucleolar dispersion appears as a continuous process, but generally it is not completed and nucleolar remnants remain throughout the whole mitosis. The nucleolar material which was dispersed is transported by the mitotic chromosomes, and in telophase contributed to the formation of the new nucleolus. The non-dispersed part persisted in the cytoplasm during telophase, coexisting with both the prenucleolar bodies and the new nucleolus which was being formed. Our results suggest the necessity of some kind of RNA synthesis, preferentially blocked by FUdR, for nucleolar dispersion to take place.

Action of bleomycin on proliferating plant cells.

Bleomycin (10-(6) M) has been tested in Allium cepa L. meristems which are formed by a proliferating cell population growing under steady state conditions. Chromosome breaks were apparently induced by the antibiotic in cells in G2 period since anaphases with chromatid breaks were formed at a time shorter than G2 + prophase duration. Stimulation of entrance of G2 cells into mitosis is suggested both by an increase in the frequency of early prophases and by the study of waves of prophases in a synchronous subpopulation labelled by caffeine. Progression of other mitotic phases was unaffected. Nucleologenesis rate was increased by the antibiotic in a fashion resembling protein synthesis inhibitors. Protein synthesis is inhibited by 10-(6) M bleomycin to the same extent as 4 X 10(-6) M anisomycin. Both facts suggest that bleomycin has a direct inhibitory effect on protein synthesis in meristems. Given the nucleologenesis sensitivity to nucleolar RNA inhibition it is suggested that the antibiotic activity on nucleolar transcription is mediated through DNA.