Childhood Asthma and Parental Antidepressant Use in a Nationwide Danish Cohort.

Background: Paediatric asthma is associated with caregiver depression, which in turn is associated with poor asthma control. Although sociodemographic risk factors are associated with parental depression among children with asthma, the contribution of these factors to caregiver depression in free-to-access universal healthcare settings is unknown. Methods: The association between childhood asthma and parental antidepressant use was investigated in a Danish nationwide cohort of children aged 2-17 years that redeemed inhaled corticosteroids in 2015. The odds of antidepressant use were estimated in comparison to control families that were matched 1:1 on the number of siblings, residence, income, and education. Results: Among the families of 28,595 children with actively treated asthma, 12% of mothers and 6.2% of fathers were on antidepressant therapy, compared to 9.3% and 5.3% in controls (p<0.001). Paediatric asthma was associated with increased odds of parental antidepressant use (OR 1.29 (1.23-1.35)), even after adjusting for parental asthma. Poor asthma control, but not higher asthma severity, was associated with higher odds of antidepressant use (1.43 (1.31-1.56)). Compared with the controls, families with two or more children with asthma had higher OR (1.42 (1.29-1.56)) than those with a single child (OR 1.27 (1.21-1.34)). Low socioeconomic status was associated with parental antidepressant use. Conclusion: Caregiver depression in a Danish cohort is more prevalent among mothers than among fathers and is associated with poor asthma control in children. Antidepressant use among caregivers was associated with total family asthma burden and was independent of socioeconomic status.

Final Stage of Chronic Kidney Disease with Conservative Kidney Management or Renal Replacement Therapy: A Primary-Care Population Study.

BACKGROUND: Studies focus on the incidence and risk factors (RFs) associated with reaching the final stage of chronic kidney disease (CKD-G5) and receiving kidney replacement therapy (KRT). Analysis of those related to reaching CKD-G5 while receiving conservative kidney management (CKM) has been neglected. METHODS: Retrospective cohort study analysing electronic health records of individuals aged ≥ 50 with eGFR < 60 mL/min/m2. Cumulative incidence rates of CKD-G5, with and without KRT, were calculated. Multinomial regression models determined odds ratios (ORs) for CKD-G5 progression with KRT, CKM, or death. RESULTS: Among 332,164 patients, the cumulative incidence of CKD-G5 was 2.79 cases per 100 person-years. The rates were 1.92 for CKD-G5 with KRT and 0.87 for CKD-G5 with CKM. Low eGFR and albuminuria were the primary RFs. Male gender and uncontrolled blood pressure had a greater impact on KRT (OR = 2.63 CI, 1.63) than on CKD-G5 with CKM (OR = 1.45 CI, 1.31). Increasing age and rurality reduced the probability of KRT but increased the probability of CKD-G5 with CKM. Higher incomes decreased the likelihood of developing CKD-G5 with and without KRT (OR = 0.49 CI). CONCLUSION: One-third of CKD-G5 cases receive CKM. Those are typically older, female, rural residents with lower incomes and with lesser proteinuria or cardiovascular RF. The likelihood of receiving KRT is influenced by location and socioeconomic disparities.

In Vitro Effect of the Cell-Free Supernatant of the Lactobacillus casei Strain IMAU60214 against the Different Pathogenic Properties of Diarrheagenic Escherichia coli.

Enteroaggregative Escherichia coli (EAEC) and enterohemorrhagic E. coli (EHEC) are E. coli pathotypes associated with unmanageable diarrhea in children and adults. An alternative to the treatment of infections caused by these microorganisms is the use of the bacteria of the Lactobacillus genus; however, the beneficial effects on the intestinal mucosa are specific to the strain and species. The interest of this study consisted of analyzing the coaggregation properties of Lactobacillus casei IMAU60214, as well as the effect of cell-free supernatant (CSF) on growth and anti-cytotoxic activity in a cell model of the human intestinal epithelium for an agar diffusion assay (HT-29) and the inhibition of biofilm formation on plates of DEC strains of the EAEC and EHEC pathotypes. The results showed that L. casei IMAU60214 exhibits time-dependent coaggregation (35-40%) against EAEC and EHEC that is similar to the control E. coli ATCC 25922. The CSF showed antimicrobial activity (20-80%) against EAEC and EHEC depending on the concentration. In addition, the formation and dispersion of biofilms of the same strains decrease, and the proteolytic pre-treatment with catalase and/or proteinase K (1 mg/mL) of CSF reduces the antimicrobial effect. When evaluating the effect in HT-29 cells pre-treated with CFS on the toxic activity induced by the EAEC and EHEC strains, a reduction of between 30 and 40% was observed. The results show that L. casei IMAU60214 and its CSF have properties that interfere with some properties associated with the virulence of the EAEC and EHEC strains that cause intestinal infection, which supports their use for the control and prevention of infections caused by these bacteria.

Burden and unmet need for specialist care in poorly controlled and severe childhood asthma in a Danish nationwide cohort.

BACKGROUND: Asthma is a common disease in childhood and adolescence with lifelong consequences particularly among those at risk of severe disease, poor control and/or frequent exacerbations. Specialist care is recommended for at-risk children and adolescents, yet access to specialist management in free-to-access healthcare settings remains poorly understood. METHODS: A Danish nationwide cohort of children and adolescents aged 2-17 years with persistent asthma, defined as repeated redemption of inhaled corticosteroids (ICS) during 2015, were followed for two years, to identify at-risk children and adolescents comprising those with severe asthma (classified according to GINA 2020 guidelines), poor control (defined as use of 400/600 (ages 2-11/12 +) annual doses of short-acting bronchodilators), or frequent exacerbations (defined as use of oral steroids or hospitalization), and access to specialist care. The population is chosen due to detailed medical records in the setting of universal health care. RESULTS: The cohort comprised of 29,851 children and adolescents (59% boys), with a median age of 9 years. While 17% of children were on high dose ICS, 22% were on daily ICS below GINA low dose cut-off. Prevalence of severe asthma (3.0-6.5%) was lower than poor asthma control (6.4-25%); both declined from childhood to adolescence. Exacerbations occurred in 7.1-9.0% of children, with median number of exacerbations being 1 (IQR 1-1). Despite being classified as having mild-to-moderate asthma, 15% had poor asthma control and 3.8% experienced exacerbation(s), respectively. While 61% of children with severe asthma and 58% with exacerbation-prone disease were in specialist care, only 24% with uncontrolled disease were receiving specialist care. Of children and adolescents using high-dose ICS, 71% were managed in primary care, while the use of additional controllers was more common in specialist care. CONCLUSIONS: Throughout childhood and adolescence, there was a high prevalence of severe asthma and poor control, although their prevalence declined with age. We demonstrate a large unmet need for specialist care among children with at-risk asthma, particularly among those with poorly controlled asthma, even in a system with free-to-access, tax-funded healthcare.

Mechanistic Links Between Obesity and Airway Pathobiology Inform Therapies for Obesity-Related Asthma.

Obesity-related asthma is associated with a high disease burden and a poor response to existent asthma therapies, suggesting that it is a distinct asthma phenotype. The proposed mechanisms that contribute to obesity-related asthma include the effects of the mechanical load of obesity, adipokine perturbations, and immune dysregulation. Each of these influences airway smooth muscle function. Mechanical fat load alters airway smooth muscle stretch affecting airway wall geometry, airway smooth muscle contractility, and agonist delivery; weight loss strategies, including medically induced weight loss, counter these effects. Among the metabolic disturbances, insulin resistance and free fatty acid receptor activation influence distinct signaling pathways in the airway smooth muscle downstream of both the M2 muscarinic receptor and the ß2 adrenergic receptor, such as phospholipase C and the extracellular signal-regulated kinase signaling cascade. Medications that decrease insulin resistance and dyslipidemia are associated with a lower asthma disease burden. Leptin resistance is best understood to modulate muscarinic receptors via the neural pathways but there are no specific therapies for leptin resistance. From the immune perspective, monocytes and T helper cells are involved in systemic pro-inflammatory profiles driven by obesity, notably associated with elevated levels of interleukin-6. Clinical trials on tocilizumab, an anti-interleukin antibody, are ongoing for obesity-related asthma. This armamentarium of therapies is distinct from standard asthma medications, and once investigated for its efficacy and safety among children, will serve as a novel therapeutic intervention for pediatric obesity-related asthma. Irrespective of the directionality of the association between asthma and obesity, airway-specific mechanistic studies are needed to identify additional novel therapeutic targets for obesity-related asthma.

Cardiovascular events and mortality in chronic kidney disease in primary care patients with previous type 2 diabetes and/or hypertension. A population-based epidemiological study (KIDNEES).

BACKGROUND: Chronic Kidney Disease (CKD), Type 2 Diabetes (T2D) and Hypertension (HTN) are frequently associated with adverse outcomes. We aimed to estimate the impact of a prior diagnosis of T2D and/or HTN on clinical characteristics, cardiovascular events (CVE) and all-cause mortality (ACM) of patients with CKD. METHODS: We conducted a retrospective cohort study based on primary care electronic health records of people without atherosclerotic cardiovascular disease, aged 18-90 years with incident CKD between January 1, 2007, and December 31, 2017. The association between CKD groups classified according to prior diagnosis of T2D and/or HTN and risk of ACM and CVE at follow-up was evaluated with Cox and Fine-Gray regression models, respectively. RESULTS: 398,477 patients were included. Median age was 74 years and 55.2% were women. Individuals were classified as CKD with HTN (51.9%), CKD with T2D (3.87%), CKD with HTN/T2D (31.4%) and CKD without HTN/T2D (12.9%). In the multivariate analysis, with the CKD without HTN/T2D group as reference, the ACM Hazard Ratio (HR) was 0.74 (95%CI 0.72-0.75) for the CKD with HTN group, 0.81 (95%CI 0.79-0.83) for CKD with HTN/T2D and 1.14 (95%CI 1.10-1.19) for the CKD with T2D group. The sub distribution HRs for CVE were 1.40 (95%CI 1.34-1.47), 1.70 (95%CI 1.61-1.80) and 1.37 (95%CI 1.26-1.48), respectively. CONCLUSION: In patients with CKD, the risk of ACM and CVE differed in patients with previous HTN and/or T2D. These comorbidities can help identify individuals at higher risk of adverse outcomes and improve the management of patients with CKD in primary care.

Lack of Social Support and Its Role on Self-Perceived Health in a Representative Sample of Spanish Adults. Another Aspect of Gender Inequality.

Self-perceived health has been used as a good estimator of health status and receiving affection can be a determining factor for good self-perceived health. The aim of the present study was to assess whether lack of social support (measured through Duke scale, which ranges from 11 to 55) was associated with poorer health status measured as self-perceived health, and whether that association was different between women and men. A cross-sectional study was conducted using data from the 2017 Spanish National Health Survey. A descriptive study was performed, and logistic regression models were applied using self-perceived health as a dependent variable. Mean Duke score was 47.6 for men and 47.9 for women (p = 0.016). Moreover, 36.3% of women and 27.6% of men reported poor self-perceived health (p < 0.001). The multivariate analysis revealed that lower scores in Duke-UNC social support scale were associated with poorer health status. That association was higher in women than in men. Poor self-perceived health was also associated with low level of education and obesity, especially among women. There was gender inequality as regards health status associated with lack of social support. These results can help design prevention strategies to improve health.

Psychological and metabolic risk factors in older adults with a previous history of eating disorder: A cross-sectional study from the Predimed-Plus study.

GOALS: To explore affective and cognitive status, later in life, in individuals with and without previous history of eating disorder (ED), and also its association with higher risk for metabolic syndrome (MetS) symptomatology. METHODS: A cross-sectional analysis of 6756 adults, aged 55-75 years with overweight/obesity and MetS participating in the Predimed-Plus study was conducted. Participants completed self-reported questionnaires to examine lifetime history of ED, according to DSM-5 criteria, and other psychopathological and neurocognitive factors. Anthropometric and metabolic measurements were also collected. RESULTS: Of the whole sample, 24 individuals (0.35%) reported a previous history of ED. In this subsample, there were more women and singles compared to their counterparts, but they also presented higher levels of depressive symptoms and higher cognitive impairment, but also higher body mass index (BMI) and severe obesity, than those without lifetime ED. CONCLUSIONS: This is one of the first studies to analyse the cognitive and metabolic impact of a previous history of ED. The results showed that previous ED was associated with greater affective and cognitive impairment, but also with higher BMI, later in life. No other MetS risk factors were found, after controlling for relevant variables.

Probiotic Properties and Immunomodulatory Activity of Lactobacillus Strains Isolated from Dairy Products.

Lactobacilli species are an effective biotherapeutic alternative against bacterial infections and intestinal inflammatory disorders. However, it is important to evaluate their beneficial properties, before considering them as probiotics for medical use. In this study we evaluated some probiotic properties of Lactobacillus rhamnosus GG, Lactobacillus rhamnosus KLSD, Lactobacillus helveticus IMAU70129, and Lactobacillus casei IMAU60214 previously isolated from dairy products and as control Lactobacillus casei Shirota. Experimental evaluations revealed that all strains expressed hydrophobicity (25-40%), auto-aggregation (55-60%), NaCl tolerance (1-4%), adhesion to Caco-2 cells (25-33%), partial inhibition on adherence of Escherichia coli ATCC 35218, Salmonella Typhimurium ATCC 14028, and Staphylococcus aureus ATCC 23219. Cell-free supernatants (CFS) of Lactobacilli also inhibit growth of these pathogens. In immunomodulatory properties a reduction of interleukin-8 (IL-8) and nitric oxide (NO) release was observed in assays with Caco-2 cells stimulated with interleukin-1ß (1 ng/mL), or lipopolysaccharide (0.1 µg/mL). On the other hand, the damage induced to Caco-2 cells with sodium dodecyl sulfate (SDS) was attenuated when the cultured cells were pretreated with L. rhamnosus KLDS, L. helveticus IMAU70129 and L. casei IMAU60214. These Lactobacilli possess probiotic properties determined by both an antagonistic activity on pathogenic bacteria and reduction in the inflammatory response of cells treated with SDS, a pro-inflammatory stimulant.

Association of Genetic Polymorphisms and Serum Levels of IL-6 and IL-8 with the Prognosis in Children with Neuroblastoma.

There is evidence that high circulating levels of IL-6 and IL-8 are markers of a poor prognosis in various types of cancer, including NB. The participation of these cytokines in the tumor microenvironment has been described to promote progression and metastasis. Our objective was to evaluate the prognostic role of genetic polymorphisms and serum levels of IL-6 and IL-8 in a cohort of Mexican pediatric patients with NB. The detection of the SNPs rs1800795 IL-6 and rs4073 and rs2227306 IL-8 was carried out by PCR-RFLP and the levels of cytokines were determined by the ELISA method. We found elevated circulating levels of IL-8 and IL-6 in NB patients compared to the control group. The genotype frequencies of the rs1800795 IL-6 and rs4073 IL-8 variants were different between the patients with NB and the control group. Likewise, the survival analysis showed that the GG genotypes of rs1800795 IL-6 (p = 0.014) and AA genotypes of rs4073 IL-8 (p = 0.002), as well as high levels of IL-6 (p = 0.009) and IL-8 (p = 0.046), were associated with lower overall survival. We confirmed the impact on an adverse prognosis in a multivariate model. This study suggests that the SNPs rs1800795 IL-6 and rs4073 IL-8 and their serum levels could be promising biomarkers of a poor prognosis, associated with overall survival, metastasis, and a high risk in Mexican children with NB.

(In)Sensitivity to Accuracy? Children's and Adults' Decisions About Who to Trust: The Teacher or the Internet.

Recent research has challenged the extended idea that when presented with conflicting information provided by different sources, children, as do adults, make epistemic judgments based on the past accuracy of each source. Instead, individuals may use relatively simple, but adaptive non-epistemic strategies. Here we examined how primary-school children (N = 114) and undergraduate students (N = 57) deal with conflicting information provided by two key sources of information in their day-to-day lives: their teacher and the Internet. In order to study whether the inaccuracy of a source generated a decline in trust, we manipulated this variable between participants: teacher-wrong and Internet-wrong conditions. For this, we first presented two baseline trials, followed by the accuracy manipulation, and finally, two post-test trials. Analyses were performed on group performance as well as on individual performance, to explore the individual patterns of responses. Results revealed that most participants showed no preference for any source during baseline, with no age differences in their overall choices. Crucially, when a given source provided inaccurate information about a familiar issue, most children and adults did not lose trust on this source. We propose tentative explanations for these findings considering potential differences in the participants' strategies to approach the task, whether or not epistemic.

Heart failure admission across glomerular filtration rate categories in a community cohort of 125,053 individuals over 60 years of age.

A reduced estimated glomerular filtration rate (eGFR) has been described as a predictor of heart failure (HF). However, the increased risk across eGFR categories has not been fully evaluated, which is especially relevant in older individuals in whom both the prevalence of HF and decreased eGFR are higher. Furthermore, this association has not been studied in Mediterranean populations, where coronary heart disease (CHD), a frequent cause of HF, has a low prevalence. We performed a retrospective cohort study using the electronic medical records from primary and hospital settings in northeastern Spain. We included 125,053 individuals ≥60 years old with the determination of creatinine and without diagnosis or previous admission due to HF. The eGFR was calculated according to the CKD-EPI formula and classified by clinical categories. The association between eGFR, as a continuous and categorical variable, and the risk of admission due to HF was assessed by Cox proportional risk analysis, considering death as a competitive risk. During a median follow-up of 38.8 months, 2,176 individuals (1.74%) were hospitalized due to HF. The unadjusted admission rates were 4.02, 13.0, 26.0, and 48.6 per 1000 person-years for eGFR > 60, 45-59, 30-44, and 15-29 ml/min/1.73 m2, respectively. The corresponding hazard ratios (95% confidence interval; reference eGFR 60-89) were 1.38 (95% CI 1.23-1.55), 2.02 (95% CI 1.76-2.32) and 3.46 (95% CI 2.78-4.31). In this Mediterranean community-based cohort of individuals ≥60 years old without previous HF, the risk of admission due to HF gradually increased with decreasing eGFR.

A New Sustained-release, 3-Month Leuprolide Acetate Formulation Achieves and Maintains Castrate Concentrations of Testosterone in Patients With Prostate Cancer.

PURPOSE: This clinical trial investigated the effectiveness, pharmacokinetic properties, and safety profile of leuprolide acetate 22.5-mg depot, a new 3-month leuprolide depot formulation, as androgen deprivation therapy for patients with prostate cancer. METHODS: A Phase III, open-label, multicenter study design for patients with prostate cancer, with patient inclusion assessed by the investigative site as patient's appropriate for androgen deprivation therapy. Patients received 2 separate intramuscular injections of leuprolide acetate 22.5-mg depot for a 3-month depot interval of therapeutic effect. Plasma testosterone concentrations were determined throughout the study. The primary efficacy analysis was the percentage of patients who achieve and maintain castrate testosterone levels (≤50 ng/mL) from days 28-168. Secondary end points included luteinizing hormone, follicle-stimulating hormone, prostate-specific antigen, and safety assessments. A pharmacokinetic study was also conducted in a subset of 30 patients. FINDINGS: All 163 patients enrolled in the study received at least 1 dose of study drug; 162 of them were fully evaluable and 151 completed the study. Castrate levels of testosterone were achieved and maintained from days 28-168 in 96.8% (95% CI, 92.5%-98.7%) of patients. Five patients presented with sporadic testosterone levels >50 ng/dL. By day 28, of the 161 patients, 150 (99.4%) had achieved castrate levels, and 127 (78.9%) had achieved testosterone concentrations ≤20 ng/dL. At study end, 149 of 151 patients (98.7%) patients achieved castrate testosterone levels, with 142 of 151 (94.0%) having testosterone levels ≤20 ng/dL. At study end, mean luteinizing hormone and follicle-stimulating hormone concentrations had decreased from baseline to below the lower limit of quantitation and below baseline levels, respectively, whereas mean serum prostate-specific antigen was reduced by 94.7% from baseline. Most patients (>96%) had no change in their World Health Organization/Eastern Cooperative Oncology Group score, whereby 84.0% of patients had a baseline score of 0. Bone pain, urinary pain, and urinary symptoms were infrequent and remained so throughout the study. After administration, leuprolide concentrations increased rapidly. The peak was followed by a decline up to day 28, maintaining sustained drug levels until the following dose on day 84. The most common related treatment-emergent adverse events, detected in >5% of patients, were hot flushes, fatigue, and injection site pain reported by 77.3%, 9.8%, and 9.2% of patients, respectively. IMPLICATIONS: Leuprolide acetate 22.5-mg depot was effective in achieving and maintaining testosterone suppression. Safety and tolerability profiles were consistent with established profiles of androgen deprivation therapy. Clinical Trials.gov identifier: NCT01415960.

Explorando el papel de la autoeficacia parental en el uso de los servicios sanitarios: revisión de la literatura / xploring the relationship between parental self-efficacy and the use of health services: a literature review

INTRODUCCIÓN: El número de consultas de urgencias pediátricas en los últimos años han experimentado un aumento notable. Muchos son los factores que influyen en el uso de los servicios sanitarios y en el uso que los padres hacen de estos servicios. Se ha demostrado que la autoeficacia parental juega un papel fundamental en el manejo de la salud y la enfermedad de los niños, y puede que también lo esté haciendo en el uso de los servicios de salud. OBJETIVO: Se plantea esta revisión narrativa de la literatura, con el propósito de explorar el papel que la autoeficacia parental tiene en el cuidado de los niños y el uso de los servicios sanitarios. MÉTODO: Se realizó una búsqueda bibliográfica en Pubmed, Cinhal y Psyc-Info. RESULTADOS: No se encontraron estudios que explorasen de manera directa la autoeficacia parental y el uso de los servicios sanitarios. Sin embargo, la relación existente entre el concepto de autoeficacia y el manejo de la salud infantil y las enfermedades menores conduce a pensar que la autoeficacia parental puede estar jugando un papel importante en el uso de los servicios sanitarios. CONCLUSIÓN: Es necesario llevar a cabo estudios que ayuden a explorar la relación entre la autoeficacia parental y el uso de los servicios. Esta información puede ser de gran ayuda para planificar acciones de educación para la salud acordes con las necesidades de esta población y contribuir a la sostenibilidad del sistema, reduciendo las visitas innecesarias a los servicios de urgencias.

INTRODUCTION: The number of visits to emergency departments in recent years has increased significantly. There are many factors that influence the use of health services and the use that parents make of these services. It has been shown that parental self-efficacy plays a fundamental role in the management of children's health and illness and may also be the case in the use of health services. OBJECTIVE: The purpose of this narrative review was to explore the role that parental self-efficacy plays in the care of children and the use of health services. METHODS: To this end, a bibliographic search was carried out in Pubmed, Cinhal and PsycINFO. RESULTS: No studies were found that directly explored parental self-efficacy and the use of health services. However, the relationship between the concept of self-efficacy and the management of children's health and minor illnesses shown in the literature points out towards the idea that parental self-efficacy may be playing an important role in the use of health services. CONCLUSION: Future observational studies are necessary to explore the relationship between parental-self-efficacy and use of service. This information can be of great help in planning health education actions according to the needs of this population and contributing to the sustainability of the system, decreasing unnecessary visits to the emergency departments.

Importancia de una profilaxis dietética en una intervención quirúrgica / No disponible

No disponible

La edad del donante en la evolución de la creatinina plasmática en receptores renales / No disponible

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What Makes Children Defy Majorities? The Role of Dissenters in Chinese and Spanish Preschoolers' Social Judgments.

When many people say the same thing, the individual is more likely to endorse this information than when just a single person says the same. Yet, the influence of consensus information may be modulated by many personal, contextual and cultural variables. Here, we study the sensitivity of Chinese (N = 68) and Spanish (N = 82) preschoolers to consensus in social decision making contexts. Children faced two different types of peer-interaction events, which involved (1) uncertain or ambiguous scenarios open to interpretation (social interpretation context), and (2) explicit scenarios depicting the exclusion of a peer (moral judgment context). Children first observed a video in which a group of teachers offered their opinion about the events, and then they were asked to evaluate the information provided. Participants were assigned to two conditions that differed in the type of consensus: Unanimous majority (non-dissenter condition) and non-unanimous majority (dissenter condition). In the dissenter condition, we presented the conflicting opinions of three teachers vs. one teacher. In the non-dissenter condition, we presented the unanimous opinion of three teachers. The general results indicated that children's sensitivity to consensus varies depending both on the degree of ambiguity of the social events and the presence or not of a dissenter: (1) Children were much more likely to endorse the majority view when they were uncertain (social interpretation context), than when they already had a clear interpretation of the situation (moral judgment context); (2) The presence of a dissenter resulted in a significant decrease in children's confidence in majority. Interestingly, in the moral judgment context, Chinese and Spanish children differed in their willingness to defy a majority whose opinion run against their own. While Spanish children maintained their own criteria regardless of the type of condition, Chinese children did so when an "allied" dissenter was present (dissenter condition) but not when confronting a unanimous majority (non-dissenter condition). Tentatively, we suggest that this difference might be related to culture-specific patterns regarding children's deference toward adults.

A pharmacological mouse model suggests a novel risk pathway for postpartum psychosis.

Postpartum psychosis (PP) is a severe psychiatric disorder affecting a small proportion of new mothers shortly after childbirth. The molecular pathophysiology underlying the disorder is currently poorly understood, and there are no amenable animal models for the condition; maternal deficiency for the enzyme steroid sulfatase has been proposed as a potential risk mechanism. Here we show that inhibition of steroid sulfatase with 667-COUMATE (10mg/kg p.o.) in new mouse mothers results in behavioural abnormalities that can be partially alleviated by the administration of the clinically-efficacious antipsychotic ziprasidone (0.3-1.0mg/kg i.p.). The pattern of behavioural abnormalities in 667-COUMATE-treated mice implicated a genetic substrate at 21-23cM on chromosome 15; of the 17 genes within this chromosomal interval, only one (Nov/Ccn3) was significantly differentially expressed in the brains of vehicle and 667-COUMATE-treated mice. Two additional members of the Ccn family (Ccn2/Ctgf and Ccn4/Wisp1) were also significantly differentially expressed between the two groups, as were three further genes co-expressed with Nov/Ccn3 in brain (Arhgdig) or previously implicated in disorder risk by clinical studies (Adcy8 and Ccl2). The expression of Nov/Ccn3, but not of the other differentially-expressed genes, could be normalised by ziprasidone administration (1.0mg/kg). NOV/CCN3 lies directly under a linkage peak for PP risk at 8q24, and the associated protein possesses numerous characteristics that make it an excellent candidate mediator of PP risk. Our data suggest the 667-COUMATE-treated mouse as a model for PP with some degree of face, construct, and predictive validity, and implicate a novel, and biologically-plausible, molecular risk pathway for PP.

Role of Genetic Polymorphisms of Deoxycytidine Kinase and Cytidine Deaminase to Predict Risk of Death in Children with Acute Myeloid Leukemia.

Cytarabine is one of the most effective antineoplastic agents among those used for the treatment of acute myeloid leukemia. However, some patients develop resistance and/or severe side effects to the drug, which may interfere with the efficacy of the treatment. The polymorphisms of some Ara-C metabolizing enzymes seem to affect outcome and toxicity in AML patients receiving cytarabine. We conducted this study in a cohort of Mexican pediatric patients with AML to investigate whether the polymorphisms of the deoxycytidine kinase and cytidine deaminase enzymes are implicated in clinical response and toxicity. Bone marrow and/or peripheral blood samples obtained at diagnosis from 27 previously untreated pediatric patients with de novo AML were processed for genotyping and in vitro chemosensitivity assay, and we analyzed the impact of genotypes and in vitro sensitivity on disease outcome and toxicity. In the multivariate Cox regression analysis, we found that age at diagnosis, wild-type genotype of the CDA A79C polymorphism, and wild-type genotype of the dCK C360G polymorphism were the most significant prognostic factors for predicting the risk of death.

Síndrome de McCune Albright / McCune–Albright syndrome

El síndrome de McCune-Albright es una enfermedad esporádica de causa genética, no hereditaria, clínicamente caracterizada por displasia fibrosa poliostótica, manchas de color café con leche y desórdenes endocrinos, tales como hipertiroidismo y pubertad precoz. Se reporta el caso de un paciente masculino de 10 años, que presentó múltiples fracturas óseas desde los seis meses de edad, hipertiroidismo y desnutrición severa, que causaron retardo en su crecimiento y desarrollo. El proceso de diagnóstico fue demorado por su inusual forma de presentación, pero su evolución después de iniciar el tratamiento fue favorable. Se presenta el caso por la baja frecuencia de este trastorno, asociado a complicaciones endocrino-metabólicas graves que causan la muerte, si no se diagnostica y se trata precozmente(AU)

The McCune-Albright syndrome is a sporadic disease clinically characterized by polyostotic fibrous dysplasia, café-au-lait cutaneous spots and endocrine disorders, such as precocious puberty and hyperthyroidism. A case of a 10 years old male patient was reported with multiple bone fractures since 6 months of age, hyperthyroidism and severe malnutrition that caused growth and developmental retardment. The diagnosis was delayed by its unusual presentation but the evolution of the disease after treatment was favorable. The publication of this case is interesting due to the low frequency of this disorder associated to serious endocrine metabolic complications that may cause death if it is not diagnosed and precociously treated(AU)