[Tools available in Spanish for clinical assessment of delirium. Systematic review]. / Herramientas disponibles en español para la valoración clínica del delirium. Revisión sistemática.

INTRODUCTION: Delirium assessment is difficult because it involves the alteration of different mental functions in patients of any age who have serious medical-surgical conditions or dementia. Therefore, concrete assessment tools for specific needs are required. This systematic review synthetizes the information about the tools available in Spanish for delirium clinical assessment. MATERIALS AND METHODS: This is a systematic review that follows the PRISMA Diagnostic Test Accuracy guideline. Using a search algorithm, two researchers assessed five scientific indexing systems and searched for additional papers and grey literature. Other two researchers recorded in a standardized way the data of the papers included. The quality of translations, cultural adaptations, and validations were assessed. RESULTS: We identified 21 reports on translation, cultural adaptation, or validation of 14 tools for 1) detailed evaluation, diagnosis, and quantification of severity by experts, 2) assessment of concrete aspects of delirium, 3) screening in adults, 4) pediatric screening, and 5) diagnosis and weighting of severity by treating staff. 78.6% of translations and all adaptations are of good quality. 52.9% of validations have a low risk of bias, 41.2% have a moderate risk, and only 5.9% have a high risk. CONCLUSIONS: As the first step to correctly treat patients is an accurate diagnosis, and the selection of the appropriate instruments is essential for the validity of any study, the available tools should be chosen according to the specific clinical and research needs.

TITLE: Herramientas disponibles en español para la valoración clínica del delirium. Revisión sistemática.Introducción. La evaluación del delirium es difícil, porque implica la alteración de diferentes funciones mentales en pacientes de cualquier edad con patologías medicoquirúrgicas graves o demencia. Por tanto, se requieren herramientas de evaluación concretas para necesidades específicas. Esta revisión sistemática sintetiza la información sobre las herramientas disponibles en español para la evaluación clínica del delirium. Materiales y métodos. Ésta es una revisión sistemática que sigue la guía PRISMA-Diagnostic Test Accuracy. Usando un algoritmo de búsqueda, dos investigadores evaluaron cinco sistemas de indexación científica y buscaron artículos adicionales y bibliografía gris. Otros dos investigadores registraron de forma estandarizada los datos de los trabajos incluidos. Se evaluó la calidad de las traducciones, adaptaciones culturales y validaciones. Resultados. Identificamos 21 trabajos sobre traducción, adaptación cultural o validación de 14 herramientas para: a) evaluación detallada, diagnóstico y cuantificación de la gravedad por parte de expertos; b) evaluación de aspectos concretos del delirium; c) cribado en adultos; d) cribado pediátrico; y e) diagnóstico y ponderación de gravedad por técnicos tratantes. El 78,6% de las traducciones y todas las adaptaciones son de buena calidad. El 52,9% de las validaciones tiene riesgo bajo de sesgo; el 41,2%, riesgo moderado; y sólo el 5,9%, riesgo alto. Conclusiones. Dado que el primer paso para tratar correctamente a los pacientes es un diagnóstico preciso y que la selección de los instrumentos adecuados es fundamental para la validez de cualquier estudio, las herramientas disponibles deben elegirse de acuerdo con las necesidades clínicas y de investigación específicas.

Herramientas disponibles en español para la valoración clínica del delirium. Revisión sistemática / Tools available in Spanish for clinical assessment of delirium. Systematic review

Introducción: La evaluación del delirium es difícil, porque implica la alteración de diferentes funciones mentales en pacientes de cualquier edad con patologías medicoquirúrgicas graves o demencia. Por tanto, se requieren herramientas de evaluación concretas para necesidades específicas. Esta revisión sistemática sintetiza la información sobre las herramientas disponibles en español para la evaluación clínica del delirium. Materiales y métodos: Ésta es una revisión sistemática que sigue la guía PRISMA-Diagnostic Test Accuracy. Usando un algoritmo de búsqueda, dos investigadores evaluaron cinco sistemas de indexación científica y buscaron artículos adicionales y bibliografía gris. Otros dos investigadores registraron de forma estandarizada los datos de los trabajos incluidos. Se evaluó la calidad de las traducciones, adaptaciones culturales y validaciones. Resultados: Identificamos 21 trabajos sobre traducción, adaptación cultural o validación de 14 herramientas para: a) evaluación detallada, diagnóstico y cuantificación de la gravedad por parte de expertos; b) evaluación de aspectos concretos del delirium; c) cribado en adultos; d) cribado pediátrico; y e) diagnóstico y ponderación de gravedad por técnicos tratantes. El 78,6% de las traducciones y todas las adaptaciones son de buena calidad. El 52,9% de las validaciones tiene riesgo bajo de sesgo; el 41,2%, riesgo moderado; y sólo el 5,9%, riesgo alto. Conclusiones: Dado que el primer paso para tratar correctamente a los pacientes es un diagnóstico preciso y que la selección de los instrumentos adecuados es fundamental para la validez de cualquier estudio, las herramientas disponibles deben elegirse de acuerdo con las necesidades clínicas y de investigación específicas.(AU)

Introduction: Delirium assessment is difficult because it involves the alteration of different mental functions in patients of any age who have serious medical-surgical conditions or dementia. Therefore, concrete assessment tools for specific needs are required. This systematic review synthetizes the information about the tools available in Spanish for delirium clinical assessment. Materials and methods: This is a systematic review that follows the PRISMA Diagnostic Test Accuracy guideline. Using a search algorithm, two researchers assessed five scientific indexing systems and searched for additional papers and grey literature. Other two researchers recorded in a standardized way the data of the papers included. The quality of translations, cultural adaptations, and validations were assessed. Results: We identified 21 reports on translation, cultural adaptation, or validation of 14 tools for 1) detailed evaluation, diagnosis, and quantification of severity by experts, 2) assessment of concrete aspects of delirium, 3) screening in adults, 4) pediatric screening, and 5) diagnosis and weighting of severity by treating staff. 78.6% of translations and all adaptations are of good quality. 52.9% of validations have a low risk of bias, 41.2% have a moderate risk, and only 5.9% have a high risk. Conclusions: As the first step to correctly treat patients is an accurate diagnosis, and the selection of the appropriate instruments is essential for the validity of any study, the available.(AU)

Interactions between epiphytes during canopy soil formation: an experiment in a lower montane cloud forest of southeast Mexico.

In several montane forests around the world, epiphytes coexist in mats, sharing the rhizosphere and forming histosol-type soils rich in nutrients. The role of these epiphytes in the formation of canopy soil and the fitness costs that epiphytes face when cohabiting in these mats are unknown. In a lower montane cloud forest in central Veracruz, Mexico, a 2-year factorial experiment was carried out with the presence/absence of ramets of Phlebodium areolatum (Polypodiaceae), Tillandsia kirchhoffiana, T. multicaulis and T. punctulata (Bromeliaceae). We examined (i) which epiphyte species contribute to the formation of canopy soil, (ii) the role of epiphyte composition in the soil nutrient composition, and (iii) the fitness costs faced by epiphytes when cohabiting. Canopy soil formation highest when P. areolatum is present. Soil nutrient content does not change with epiphyte composition, is influenced by the microbiota, and P content decreases with the presence of epiphytes. The fitness costs show that the species compete, decreasing their survival and growth, but the competitive capacity differs between the species. We conclude that P. areolatum is an ecosystem engineer that promotes the creation of canopy soil but is a poor competitor. The results coincide with the model of succession by facilitation. Canopy soil is a slow-created component whose nutrient content does not depend on the epiphytic flora. In epiphyte mats, the dominant interactions are competitive, but there is also facilitation.

Epiphyte associations and canopy soil volume: nutrient capital and factors influencing soil retention in the canopy.

Canopy soil (CS) volume reflect epiphyte community maturity, but little is known about the factors that retain CS or species succession within it. Humus fern species (e.g. Phlebodium areolatum) appear capable of retaining CS. In ten Quercus spp. we sampled 987 epiphyte mats to examine the role of the common epiphyte species and crown traits determining CS volume, in order to infer successional stages and identify pioneer and late successional species. Branch traits (height, diameter and slope), CS volume and cover of the epiphyte species were determined for each mat. Nutrient content was determined in CS random samples of 12 epiphyte associations and sizes (one sample from each size quintile). A total of 60% of the mats lack CS. Cover of P. areolatum was the main variable explaining CS volume, and this species was present in 46.8% of those with CS. Epiphyte composition was highly variable, but pioneer (species appearing in monospecific mats, without CS) and late successional species could be identified. Canopy soil nutrient content was similar among the associations of epiphytes. Magnesium, Ca and pH decreased with CS volume, while P and N increased. Phlebodium areolatum is associated with high CS volumes and could act as a key species in its retention. Monospecific mats of pioneer species lack CS or have low volumes, while CS is much higher in mats with late successional species, but the mechanisms of CS formation and nutrient retention in response to interactions between epiphyte species remain to be tested.

Exploratory survey of initial image quality in new digital mammography units prior to use in patients in Mexico.

In Mexico, previous studies performed to evaluate the image quality in 2D digital mammography facilities show a poor image quality that is not compatible with mammography screening that may modify breast cancer mortality rate. Image quality is lost due to the quality assurance programs are not implemented. We carried out an exploratory survey of thirty-six new (FFDM) units from a single manufacturer installed in several cities of the Mexican Republic with two types of target/filter combination (Mo/Mo and W/Rh). Tests were performed according to NOM-041-SSA1-2011 (Mexico), the regulation indicates that all facilities using digital mammography systems must maintain a QC program equal to the QC program recommended by the manufacturer. However, QC program recommended by the manufacturer meets with FDA and ACR Regulations. Digital mammography units evaluated exceeds quality image standards established by the ACR and FDA, even though, the W/Rh combination achieved a higher performance and reduces the average glandular dose. All mammography units met the quality control standards established by ACR, FDA and Mexican regulations. Then, the objective of this study was to evaluate the initial image quality and compliances with the manufacturer's quality control specifications before use it in patients in new full-field 2D digital mammography (FFDM) units and compares average glandular dose (AGD) with FFDM units using different anode/filter combinations (Mo/Mo and W/Rh).

Context-dependent crypsis: a prey's perspective of a color polymorphic predator.

Many animals use body coloration as a strategy to communicate with conspecifics, prey, and predators. Color is a trade-off for some species, since they should be visible to conspecifics but cryptic to predators and prey. Some flower-dwelling predators, such as crab spiders, are capable of choosing the color of flowers where they ambush flower visitors and pollinators. In order to avoid being captured, visitors evaluate flowers visually before landing. The crab spider Mecaphesa dubia is a polymorphic species (white/purple color morphs), which inhabits the flower heads of a dune plant, Palafoxia lindenii. Using full-spectrum photography of spiders and flowers, we evaluated how honeybees perceived the spiders at different distances. Using visual modeling, we obtained the chromatic and achromatic contrasts of the spiders on flower heads as perceived by honeybees. Purple morphs were found mainly on the receptacle area and white morphs were equally likely to be found in the flowers and receptacle. According to theoretical modeling, white morphs were visible to honeybees from a distance of 10 cm in receptacle area but appeared to be cryptic in the flower area. Purple morphs were cryptic on the receptacle and less so when they were on the flowers. Spiders on flower heads are predicted to be more easily detected by honeybees using chromatic contrast. Our study shows that the conspicuousness of flower dwelling spiders to honeybees depends on the color morph, the distance of observation, and the position of spider on the flower head.

Orchid seed removal by ants in Neotropical ant-gardens.

Most plants that inhabit ant-gardens (AGs) are cultivated by the ants. Some orchids occur in AGs; however, it is not known whether their seeds are dispersed by AG ants because most orchid seeds are tiny and dispersed by wind. We performed in situ seed removal experiments, in which we simultaneously provided Azteca gnava ants with seeds of three AG orchid species and three other AG epiphyte species (Bromeliaceae, Cactaceae and Gesneriaceae), as well as the non-AG orchid Catasetum integerrimum. The seeds most removed were those of the bromeliad Aechmea tillandsioides and the gesneriad Codonanthe uleana, while seeds of AG orchids Coryanthes picturata, Epidendrum flexuosum and Epidendrum pachyrachis were less removed. The non-AG orchid was not removed. Removal values were positively correlated with the frequency of the AG epiphytes in the AGs, and seeds of AG orchids were larger than those of non-AG orchids, which should favour myrmecochory. Our data show that Azt. gnava ants discriminate and preferentially remove seeds of the AG epiphytes. We report for the first time the removal of AG orchid seeds by AG ants in Neotropical AGs.

Association between body mass index and sperm quality and sperm DNA integrity. A large population study.

This study aimed to analyse whether the functional quality of spermatozoa is associated with body mass index (BMI). Semen samples were obtained from 1824 men undergoing fertility evaluation/treatment. Semen analysis was performed using World Health Organization (WHO) criteria, and morphology was evaluated with the motile sperm organelle morphology examination (MSOME). The percentages of sperm DNA fragmentation (using TdT (terminal deoxynucleotidyl transferase)-mediated dUTP nick-end labelling (TUNEL) assays), sperm chromatin packaging/underprotamination (using chromomycin A3/CMA3 ), mitochondrial damage (using MitoTracker Green) and apoptosis (using annexin V) were also assessed. At least 200 spermatozoa were examined in each evaluation. The following BMI values were used as cut-off points: ≤24.9 kg/m2 , 25-29.9 kg/m2 (overweight) and ≥30 kg/m2 (obese). High BMI negatively affects sperm concentration, vitality, motility and morphology (p < .05). Conversely, high BMI does not seem to be associated with impaired sperm DNA integrity, as assessed by DNA fragmentation, sperm protamination and sperm apoptosis (p > .05). However, increased BMI is associated with increased mitochondrial damage in spermatozoa (p < .05). In conclusion, given the adverse consequences of obesity and the possible effect of male BMI on assisted reproduction technology (ART) outcomes, the benefits of weight reduction should be discussed when counselling couples interested in fertility treatment.

Resveratrol treatment rescues hyperleptinemia and improves hypothalamic leptin signaling programmed by maternal high-fat diet in rats.

PURPOSE: Perinatal high-fat diet is associated with obesity and metabolic diseases in adult offspring. Resveratrol has been shown to exert antioxidant and anti-obesity actions. However, the effects of resveratrol on leptinemia and leptin signaling are still unknown as well as whether resveratrol treatment can improve metabolic outcomes programmed by maternal high-fat diet. We hypothesize that resveratrol treatment in male rats programmed by high-fat diet would decrease body weight and food intake, and leptinemia with changes in central leptin signaling. METHODS: Female Wistar rats were divided into two groups: control group (C), which received a standard diet containing 9 % of the calories as fat, and high-fat group (HF), which received a diet containing 28 % of the calories as fat. Dams were fed in C or HF diet during 8 weeks before mating and throughout gestation and lactation. C and HF male offspring received standard diet throughout life. From 150 until 180 days of age, offspring received resveratrol (30 mg/Kg body weight/day) or vehicle (carboxymethylcellulose). RESULTS: HF offspring had increased body weight, hyperphagia and increased subcutaneous and visceral fat mass compared to controls, and resveratrol treatment decreased adiposity. HF offspring had increased leptinemia as well as increased SOCS3 in the arcuate nucleus of the hypothalamus, which suggest central leptin resistance. Resveratrol treatment rescued leptinemia and increased p-STAT3 content in the hypothalamus with no changes in SOCS3, suggesting improvement in leptin signaling. CONCLUSIONS: Collectively, our data suggest that resveratrol could reverse hyperleptinemia and improve central leptin action in adult offspring from HF mothers attenuating obesity.

From dusk till dawn: nocturnal and diurnal pollination in the epiphyte Tillandsia heterophylla (Bromeliaceae).

In order to compare the effectiveness of diurnal and nocturnal pollinators, we studied the reproductive biology and pollinators of Tillandsia heterophylla E. Morren, an epiphytic tank bromeliad endemic to southeastern Mexico. Since anthesis in T. heterophylla is predominantly nocturnal but lasts until the following day, we hypothesised that this bromeliad would receive visits from both diurnal and nocturnal visitors, but that nocturnal visitors would be the most effective pollinators, since they arrive first to the receptive flower, and that bats would be the most frequent nocturnal visitors, given the characteristics of the nectar. Flowering of T. heterophylla began in May and lasted until July. The species is fully self-compatible, with an anthesis that lasts for ca. 15-16 h. Mean volume of nectar produced per flower was 82.21 µl, with a mean sugar concentration of 6.33%. The highest volume and concentration of nectar were found at 20:00 h, with a subsequent decline in both to almost zero over the following 12-h period. T. heterophylla has a generalist pollination system, since at least four different morphospecies of visitors pollinate its flowers: bats, moths, hummingbirds and bees. Most of the pollinating visits corresponded to bats and took place in the early evening, when stigma receptivity had already begun; making bats the probable pollinator on most occasions. However, diurnal pollinators may be important as a 'fail-safe' system by which to guarantee the pollination of T. heterophylla.

Smooth pursuit eye movements and schizophrenia: literature review.

OBJECTIVE: To review the scientific literature about the relationship between impairment on smooth pursuit eye movements and schizophrenia. METHODS: Narrative review that includes historical articles, reports about basic and clinical investigation, systematic reviews, and meta-analysis on the topic. RESULTS: Up to 80% of schizophrenic patients have impairment of smooth pursuit eye movements. Despite the diversity of test protocols, 65% of patients and controls are correctly classified by their overall performance during this pursuit. The smooth pursuit eye movements depend on the ability to anticipate the target's velocity and the visual feedback, as well as on learning and attention. The neuroanatomy implicated in smooth pursuit overlaps to some extent with certain frontal cortex zones associated with some clinical and neuropsychological characteristics of the schizophrenia, therefore some specific components of smooth pursuit anomalies could serve as biomarkers of the disease. Due to their sedative effect, antipsychotics have a deleterious effect on smooth pursuit eye movements, thus these movements cannot be used to evaluate the efficacy of the currently available treatments. CONCLUSION: Standardized evaluation of smooth pursuit eye movements on schizophrenia will allow to use specific aspects of that pursuit as biomarkers for the study of its genetics, psychopathology, or neuropsychology.

Resveratrol prevents hyperleptinemia and central leptin resistance in adult rats programmed by early weaning.

We have previously shown that early weaning in rats increases the risk of obesity and insulin resistance at adulthood, and leptin resistance can be a prime factor leading to these changes. Resveratrol is reported to decrease oxidative stress, insulin resistance, and cardiovascular risk. However, there is no report about its effect on leptin resistance. Thus, in this study we have evaluated resveratrol-preventing effect on the development of visceral obesity, insulin, and leptin resistance in rats programmed by early weaning. To induce early weaning, lactating dams were separated into 2 groups: early weaning (EW)--dams were wrapped with a bandage to interrupt lactation in the last 3 days of lactation and control (C)--dams whose pups had free access to milk during throughout lactation period (21 days). At 150 days-old, EW offspring were subdivided into 2 groups: EW+res--treated with resveratrol solution (30 mg/kg BW/day) or EW--receiving equal volume of vehicle solution, both given by gavage during 30 days. Control group received vehicle solution. Resveratrol prevented the higher body weight, hyperphagia, visceral obesity, hyperleptinemia, hyperglycemia, insulin resistance, and hypoadiponectinemia at adulthood in animals that were early weaned. Leptin resistance, associated with lower JAK2 and pSTAT3 and higher NPY in hypothalamus of EW rats were also normalized by resveratrol. The present results suggest that resveratrol is useful as therapeutic tool in treating obesity, mainly because it prevents the development of central leptin resistance.

Developmental plasticity of endocrine disorders in obesity model primed by early weaning in dams.

Early weaning is associated with changes in the developmental plasticity. Here, we studied the adipocytes morphology, adipokines expression or content in adipose tissue as well as adrenal and thyroid function of neonate and adult offspring primed by early weaning. After birth, lactating rats were divided into 2 groups: EW (early weaning)--dams were wrapped with a bandage to block access to milk during the last 3 days of lactation, and Control--dams whose pups had free access to milk throughout lactation (21 days). At postnatal day (PN) 21, EW pups had lower visceral and subcutaneous adipocyte area (-67.7% and -62%, respectively), body fat mass (-26%), and leptin expression in visceral adipocyte (-64%) but higher leptin expression in subcutaneous adipocyte (2.9-fold increase). Adrenal evaluations were normal, but neonate EW pups presented lower serum T3 (-55%) and TSH (-44%). At PN 180, EW offspring showed higher food intake, higher body fat mass (+21.6%), visceral and subcutaneous adipocyte area (both 3-fold increase), higher leptin (+95%) and ADRß3 (2-fold increase) content in visceral adipose tissue, and higher adiponectin expression in subcutaneous adipose tissue (+47%) but lower in visceral adipose tissue (-40%). Adult EW offspring presented higher adrenal catecholamine content (+31%), but no changes in serum corticosterone or thyroid status. Thus, early weaning primed for hypothyroidism at weaning, which can be associated with the adipocyte hypertrophy at adulthood. The marked changes in catecholamine adrenal content and visceral adipocyte ADRB3 are generally found in obesity, contributing to the development of other cardiovascular and metabolic disturbances.

Time of physical exercise practice after injury in cervical spinal cord-injured men is related to the increase in insulin sensitivity.

OBJECTIVES: Physical exercise has an important role in reducing body fat, risk of chronic disease and systemic inflammation. The aim of this study was to determine serum leptin and insulin concentrations and their relationship to the time of physical exercise after injury in men with cervical spinal cord injury (c-SCI). METHODS: c-SCI subjects with lesion level in C5-C7 (n=25) were divided into two groups: physically active (PA, n=13; those who practiced physical exercise for at least 3 months, three times per week or more, for a total minimum of 150 min of physical activity per week) and non-physically active (N-PA, n=9). Body composition was assessed by dual energy X-ray absorptiometry. Blood samples were obtained 12 h after an overnight fast to measure insulin and leptin in serum, and glucose and C-reactive protein (CRP) in plasma, by validated methods. RESULTS: Comparing the PA and N-PA group, the first presented lower: total body mass (-13%), body mass index (-16%), fat mass (kg -39%, FM% -30%), CRP (-23%), serum insulin (-61%), homeostasis model assessment (HOMA, -35%) and serum leptin (-62%; P<0.05). Both serum insulin (r=-0.561; P<0.05) and HOMA (r=-0.591; P<005) were inversely proportional to the time of practice of physical activity after injury. CONCLUSION: Our results suggest that exercise was able to reduce fat mass and increase insulin sensitivity, decreasing plasma levels of risk factors in c-SCI subjects.

Maternal high-fat diet induces obesity and adrenal and thyroid dysfunction in male rat offspring at weaning.

Maternal nutritional status affects the future development of offspring. Both undernutrition and overnutrition in critical periods of life (gestation or lactation) may cause several hormonal changes in the pups and programme obesity in the adult offspring. We have shown that hyperleptinaemia during lactation results in central leptin resistance, higher adrenal catecholamine secretion, hyperthyroidism, and higher blood pressure and heart rate in the adult rats. Here, we evaluated the effect of a maternal isocaloric high-fat diet on breast milk composition and its impact on leptinaemia, energy metabolism, and adrenal and thyroid function of the offspring at weaning. We hypothesised that the altered source of fat in the maternal diet even under normal calorie intake would disturb the metabolism of the offspring. Female Wistar rats were fed a normal (9% fat; C group) or high-fat diet (29% fat as lard; HF group) for 8 weeks before mating and during pregnancy and lactation. HF mothers presented increased total body fat content after 8 weeks (+27%, P < 0.05) and a similar fat content at the end of lactation. In consequence, the breast milk from the HF group had higher concentration of protein (+18%, P < 0.05), cholesterol (+52%, P < 0.05) and triglycerides (+86%, P < 0.05). At weaning, HF offspring had increased body weight (+53%, P < 0.05) and adiposity (2 fold, P < 0.05), which was associated with lower ß3-adrenoreceptor content in adipose tissue (-40%, P < 0.05). The offspring also presented hyperglycaemia (+30%, P < 0.05) and hyperleptinaemia (+62%, P < 0.05). In the leptin signalling pathway in the hypothalamus, we found lower p-STAT3/STAT3 (-40%, P < 0.05) and SOCS3 (-55%, P < 0.05) content in the arcuate nucleus, suggesting leptin resistance. HF offspring also had higher adrenal catecholamine content (+17%, P < 0.05), liver glycogen content (+50%, P < 0.05) and hyperactivity of the thyroid axis at weaning. Our results suggest that a high fat diet increases maternal body fat and this additional energy is transferred to the offspring during lactation, since at weaning the dams had normal fat and the pups were obese. The higher fat and protein concentrations in the breast milk seemed to induce early overnutrition in the HF offspring. In addition to storing energy as fat, the HF offspring had a larger reserve of glycogen and hyperglycaemia that may have resulted from increased gluconeogenesis. Hyperleptinaemia may stimulate both adrenal medullary and thyroid function, which may contribute to the development of cardiovascular diseases. These early changes induced by the maternal high-fat diet may contribute to development of metabolic syndrome.

[Minor physical abnormalities and clinical features in patients with schizophrenia spectrum disorders]. / Anomalias fisicas menores y caracteristicas clinicas en pacientes con trastornos del espectro de la esquizofrenia.

INTRODUCTION: Minor physical anomalies are nonspecific morphologic variants generated during gestation. They are markers of events (inherited and/or acquired) related with the 'neuroprogression' of the schizophrenia spectrum disorders and may be differentially involved with their symptom profiles. The aim of the study was to explore the relationship of minor physical anomalies with positive syndrome, negative syndrome and general psychopathology in patients with schizophrenia or other functional psychoses. PATIENTS AND METHODS: Cross-sectional study of patients with schizophrenia or other functional psychoses consecutively hospitalized with an acute psychotic episode. Minor physical anomalies were evaluated with the Waldrop scale and clinical characteristics of psychosis were measured with the Positive and Negative Syndrome Scale (PANSS). RESULTS: 41 patients with functional psychoses were evaluated: 32 (78%) with schizophrenia, 9 (21.9%) with psychotic disorder not otherwise specified. There was no relationship between the Waldrop scale score and score on the PANSS, its negative scale and its general psychopathology scale. The positive scale of the PANSS and the Waldrop scale were correlated in the whole sample (Spearman rho = 0.356; p = 0.022). In the group of patients with schizophrenia, the correlation was even greater (Spearman rho = 0.420; p = 0.017). CONCLUSIONS: The path from apparently premorbid stages to specific clinical pictures in patients with schizophrenia spectrum disorders is determined by the neurodevelopment, a dynamic process influenced by genetic inheritance and environmental injuries.

Adjuvant therapy with GnRH agonists/tamoxifen in breast cancer should be a good council for patients with hormone receptor-positive tumours and wish to preserve fertility.

Infertility represents one of the main long-term consequences of the chemotherapy used for the adjuvant treatment of breast cancer. Approximately 60-65% of breast cancers express the nuclear hormone receptor in premenopausal women. Adjuvant endocrine therapy is an integral component of care for patients with hormone receptor-positive (HR+) tumours. The GnRH agonist (GnRHa) alone or in combination with tamoxifen produces results at least similar to those obtained with the different chemotherapy protocols in patients with HR+ breast cancer with respect to recurrence-free survival and overall survival. It is time to indicate adjuvant therapy with GnRHa associated with tamoxifen for patients with breast cancer (HR+ tumours) if they want to preserve their reproductive function. The evaluation of ovarian reserve tests: follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH), inhibin B, antral follicle count (AFC) and ovarian volume 6 months, and 1 year after the end of therapy with GnRHa/tamoxifen must be realised. The recurrence-free survival and overall survival should be analysed. The major implication of this hypothesis will be to avoid adjuvant chemotherapy for patients with breast cancer (HR+ tumours) that request fertility preservation. It is expected that ovarian function should not be altered in almost all cases and subsequent pregnancy a real possibility.

Large nuclear vacuoles are indicative of abnormal chromatin packaging in human spermatozoa.

The aim of this investigation was to determine the presence of abnormal sperm chromatin packaging in spermatozoa with large nuclear vacuoles (LNV) selected via high magnification by analysing the pattern of chromomycin A3 (CMA3) staining. A prospective observational study was designed to analyse semen samples obtained from 66 men undergoing infertility diagnosis and treatment. The numbers of cells with normal (dull yellow staining of the sperm head/CMA3-negative) and abnormal (bright yellow fluorescence of the sperm head/CMA3-positive) chromatin packaging were determined on slides with normal and LNV spermatozoa. The presence of bright yellow fluorescence (CMA3-positive) was significantly higher (p < 0.0001) in spermatozoa with LNV than in normal spermatozoa (719/1351; 53.2% vs. 337/835; 40.3%, respectively), reflecting a higher percentage of abnormal chromatin packaging in spermatozoa with large LNV. Our data support the hypothesis that the presence of LNV reflects the presence of abnormal chromatin packaging, which may facilitate sperm DNA damage. As sperm nuclear vacuoles are evaluated more precisely at high magnifications using motile sperm organelle morphology examination (MSOME), the present results support the use of high-magnification sperm selection for intracytoplasmic sperm injection (ICSI).

Higher white adipocyte area and lower leptin production in adult rats overfed during lactation.

Litter size reduction during lactation is a good model for childhood obesity since it induces overnutrition and programming for obesity at adulthood. Adult offspring develop higher fat mass content, hyperinsulinemia and insulin resistance, hypertension, lower HDL cholesterol, hyperphagia, and leptin resistance. Leptin resistance is often associated with hyperleptinemia. Although we observed higher SOCS3 and lower STAT3 in the hypothalamus of rats raised in small litters featuring a central leptin resistance, they showed unexpected normoleptinemia at 180 days old. Then, to clarify why early overfed rats did not develop hyperleptinemia when adult, we studied the leptin production by the visceral and subcutaneous adipose tissue and skeletal muscle as well as the morphology in the 2 different fat depots. To induce EO, litter size was reduced to 3 pups/litter (SL group) on the 3 (rd) day of life. In controls (NL group), litter size was adjusted to 10 pups/litter. Rats were killed at 180 days old. The programming of adipose tissue morphology by early overnutrition is specific between the different fat depots with hypertrophy only in the visceral compartment. In addition, the visceral adipocyte showed lower leptin content that may indicate a reduced leptin synthesis. These data suggest that adipocytes from SL rats are dysfunctional, since a higher leptin production in larger adipose cells is expected. In conclusion, postnatal nutrition is determinant for future leptin production by different fat depots as well as adipocyte morphology. These changes seem to be related to the severity of obesity and its metabolic consequences.

Relationship between DNA damage and sperm head birefringence.

Birefringence or double refraction is the decomposition of a ray of light into two rays when it passes through an anisotropic material such as quartz. Sperm cells have been demonstrated to be optically anisotropic. The objective of this study was to evaluate the relationship between the pattern of human sperm head birefringence (SHBF) and DNA damage. A total of 26 patients with normal semen were included. DNA damage (fragmentation and denaturation) was evaluated in the sperm head in the context of birefringence, both total (SHBF-T) and partial (SHBF-P), by terminal deoxyribonucleotidyl transferase (TdT)-mediated dUDP nick-end labelling assay and acridine orange fluorescence, respectively. Positive DNA fragmentation in spermatozoa with SHBF-T (205/1053; 19.5%) was significantly higher (P<0.0001) than in spermatozoa that presented SHBF-P (60/820; 7.3%). However, the percentage of denatured DNA in spermatozoa with SHBF-T (824/1256; 65.6%) was not significantly different from the ones with SHBF-P (666/1009; 66.0%). In conclusion, the data support a positive relationship between spermatozoa with total SHBF in their head and increased DNA fragmentation.