Epidemia COVID. Tras el desconfinamiento ¿qué ocurrió en nuestras consultas de Atención Primaria? / COVID epidemic. After the deconfinement, what happened in our Primary Care consultations?

Introducción: el 11 de marzo de 2020 la Organización Mundial de la Salud (OMS) declaró una pandemia, provocada por un nuevo coronavirus SARS-CoV-2. El rápido aumento de transmisiones obligó a gobiernos y autoridades sanitarias a tomar medidas para frenar el avance de la pandemia. Tras la primera ola epidémica y con un descenso documentado en el número de casos, comenzó la desescalada de las medidas implantadas y el desconfinamiento de la población. En este momento epidemiológico quisimos analizar la actividad asistencial pediátrica llevada a cabo, con objeto de conocer el modelo de consulta realizado (presencial/no presencial), los motivos de consulta atendida y el grado de resolución. Material y métodos: estudio descriptivo, observacional y retrospectivo sobre los pacientes atendidos en las consultas de Pediatría de Atención Primaria en un centro de salud de la ciudad de Madrid, durante el mes de junio de 2020. Resultados: se atendieron un total de 1321 pacientes, 34% menos que el mismo período del año anterior. La modalidad de consulta realizada fue presencial en un 49% y no presencial en el 51%. La consulta telefónica fue la opción mayoritaria como alternativa a la presencial. Un 20,7% del total de motivos de consulta fueron atendidos vía telemática. Conclusiones: tras la crisis sanitaria ocasionada por la COVID-19 la modalidad de atención no presencial ha adquirido protagonismo y mayor grado de resolución en nuestras consultas pediátricas. Pensamos que debe potenciarse mediante la incorporación de herramientas telemáticas, y así coexistir y complementar al modelo habitual de atención presencial (AU)

Introduction: on March 11, 2020, the World Health Organization (WHO) declared the outbreak caused by the novel coronavirus SARS-CoV-2 a pandemic. The rapid increase in cases forced governments and health authorities to take measures to contain the pandemic. After the first wave, when there was evidence of a decline in the number of cases, reopening started with progressive lifting of containment measures and ending the confinement of the population. Our objective was to analyse paediatric care delivery in our primary care centre at this point in the pandemic to determine the modalities of care delivery used (in-person/remote), the reasons for consultation in the total provided services and the degree of successful resolution of the reason for consultation.Material and methods: prospective, observational and descriptive study of the patients managed by the paediatrics clinic of a primary care centre in the city of Madrid, Spain, in June 2020. We collected data from the paediatric primary care electronic health records system of Madrid.Results: a total of 1321 patients were treated, 34% fewer compared to the same period the previous year. Forty-nine percent of consultations were managed in-person at the site and 51% remotely. Telephone consultations were the most frequent alternative to in-person visits. Of all the reasons for consultation, 20.7% were managed remotely.Conclusion: in the wake of the public health emergency brought on by COVID-19, the remote care modality has become prevalent and grown as a means to resolve patient needs and presenting complaints in our paediatric primary care clinic. We believe that this care modality should be reinforced with digital tools so that it can supplement and coexist with the conventional model of in-person care delivery. (AU)

Cannabinoid CB2 Receptor Modulation by the Transcription Factor NRF2 is Specific in Microglial Cells.

Nuclear factor erythroid 2-related factor 2 (NRF2) is a pleiotropic transcription factor that has neuroprotective and anti-inflammatory effects, regulating more than 250 genes. As NRF2, cannabinoid receptor type 2 (CB2) is also implicated in the preservation of neurons against glia-driven inflammation. To this concern, little is known about the regulation pathways implicated in CB2 receptor expression. In this study, we analyze whether NRF2 could modulate the transcription of CB2 in neuronal and microglial cells. Bioinformatics analysis revealed an antioxidant response element in the promoter sequence of the CB2 receptor gene. Further analysis by chemical and genetic manipulations of this transcription factor demonstrated that NRF2 is not able to modulate the expression of CB2 in neurons. On the other hand, at the level of microglia, the expression of CB2 is NRF2-dependent. These results are related to the differential levels of expression of both genes regarding the brain cell type. Since modulation of CB2 receptor signaling may represent a promising therapeutic target with minimal psychotropic effects that can be used to modulate endocannabinoid-based therapeutic approaches and to reduce neurodegeneration, our findings will contribute to disclose the potential of CB2 as a novel target for treating different pathologies.

Neurocognitive Disorders in Heart Failure: Novel Pathophysiological Mechanisms Underpinning Memory Loss and Learning Impairment.

Heart failure (HF) is a major public health issue affecting more than 26 million people worldwide. HF is the most common cardiovascular disease in elder population; and it is associated with neurocognitive function decline, which represent underlying brain pathology diminishing learning and memory faculties. Both HF and neurocognitive impairment are associated with recurrent hospitalization episodes and increased mortality rate in older people, but particularly when they occur simultaneously. Overall, the published studies seem to confirm that HF patients display functional impairments relating to attention, memory, concentration, learning, and executive functioning compared with age-matched controls. However, little is known about the molecular mechanisms underpinning neurocognitive decline in HF. The present review round step recent evidence related to the possible molecular mechanism involved in the establishment of neurocognitive disorders during HF. We will make a special focus on cerebral ischemia, neuroinflammation and oxidative stress, Wnt signaling, and mitochondrial DNA alterations as possible mechanisms associated with cognitive decline in HF. Also, we provide an integrative mechanism linking pathophysiological hallmarks of altered cardiorespiratory control and the development of cognitive dysfunction in HF patients. Graphical Abstract Main molecular mechanisms involved in the establishment of cognitive impairment during heart failure. Heart failure is characterized by chronic activation of brain areas responsible for increasing cardiac sympathetic load. In addition, HF patients also show neurocognitive impairment, suggesting that the overall mechanisms that underpin cardiac sympathoexcitation may be related to the development of cognitive disorders in HF. In low cardiac output, HF cerebral infarction due to cardiac mural emboli and cerebral ischemia due to chronic or intermittent cerebral hypoperfusion has been described as a major mechanism related to the development of CI. In addition, while acute norepinephrine (NE) release may be relevant to induce neural plasticity in the hippocampus, chronic or tonic release of NE may exert the opposite effects due to desensitization of the adrenergic signaling pathway due to receptor internalization. Enhanced chemoreflex drive is a major source of sympathoexcitation in HF, and this phenomenon elevates brain ROS levels and induces neuroinflammation through breathing instability. Importantly, both oxidative stress and neuroinflammation can induce mitochondrial dysfunction and vice versa. Then, this ROS inflammatory pathway may propagate within the brain and potentially contribute to the development of cognitive impairment in HF through the activation/inhibition of key molecular pathways involved in neurocognitive decline such as the Wnt signaling pathway.

Redefining the therapeutic objective in psoriatic patients candidates for biological therapy.

The advances in psoriasis management currently allow achieving a good control of the disease. In particular, with the latest developed molecules, available evidence suggests that it is possible to pose an ambitious therapeutic goal, such as a Dermatology Life Quality Index 0/1, a Physician Global Assessment 0/1, or a Psoriasis Area and Severity Index 90/100 response. However, patients often fail to achieve the complete clearance of their cutaneous lesions or the improvement of disease factors that impair their quality of life. To optimize the treatment of psoriasis, it is not enough to define precisely the therapeutic objective, but also to adapt the therapeutic strategy to make the necessary modifications in case of not achieving it at the time point (at the end of the induction phase, or every 3-6 months) to be agreed with the patient (the so-called treat-to-target approach). In the present report, based on the Delphi methodology, 11 dermatologists from the Spanish Psoriasis Group addressed key issues that could be involved in the achievement and maintenance of the therapeutic goals of patients with moderate to severe psoriasis. The document provides 27 consensus statements intended to support clinical decision-making by healthcare professionals for patients who might be candidates to receive biologic therapy.

Limonene in exhaled breath is elevated in hepatic encephalopathy.

Breath samples were taken from 31 patients with liver disease and 30 controls in a clinical setting and proton transfer reaction quadrupole mass spectrometry (PTR-Quad-MS) used to measure the concentration of volatile organic compounds (VOCs). All patients had cirrhosis of various etiologies, with some also suffering from hepatocellular cancer (HCC) and/or hepatic encephalopathy (HE). Breath limonene was higher in patients with No-HCC than with HCC, median (lower/upper quartile) 14.2 (7.2/60.1) versus 3.6 (2.0/13.7) and 1.5 (1.1/2.3) nmol mol-1 in controls. This may reflect disease severity, as those with No-HCC had significantly higher UKELD (United Kingdom model for End stage Liver Disease) scores. Patients with HE were categorized as having HE symptoms presently, having a history but no current symptoms and having neither history nor current symptoms. Breath limonene in these groups was median (lower/upper quartile) 46.0 (14.0/103), 4.2 (2.6/6.4) and 7.2 (2.0/19.1) nmol mol-1, respectively. The higher concentration of limonene in those with current symptoms of HE than with a history but no current symptoms cannot be explained by disease severity as their UKELD scores were not significantly different. Longitudinal data from two patients admitted to hospital with HE show a large intra-subject variation in breath limonene, median (range) 18 (10-44) and 42 (32-58) nmol mol-1.

Elimination characteristics of post-operative isoflurane levels in alveolar exhaled breath via PTR-MS analysis.

Isoflurane (1-chloro-2,2,2-trifluoroethyl difluoromethyl ether), C3H2ClF5O, is a commonly used inhalation anaesthetic. Using a proton transfer reaction mass spectrometer (PTR-MS) we have detected isoflurane in the breath of patients several weeks following major surgery. That isoflurane is detected in the breath of patients so long after being anaesthetised raises questions about when cognitive function has fully returned to a patient. Temporal profiles of isoflurane concentrations in breath are presented for five patients (F/M 3/2, mean age 50 years, min-max 36-58 years) who had undergone liver transplant surgery. In addition, results from a headspace analysis of isoflurane are presented so that the product ions resulting from the reactions of H3O+ with isoflurane in PTR-MS could be easily identified in the absence of the complex chemical environment of breath. Six product ions were identified. In order of increasing m/z (using the 35Cl isotope where appropriate) these are [Formula: see text] (m/z 51), CHFCl+ (m/z 67), CF3CHCl+ (m/z 117), C3F4OCl+ (m/z 163), C3H2F4OCl+ (m/z 165), and C3F4OCl+ H2O (m/z 183). No protonated parent was detected. For the headspace study both clean air and CO2 enriched clean air (4% CO2) were used as buffer gases in the drift tube of the PTR-MS. The CO2 enriched air was used to determine if exhaled breath would affect the product ion branching ratios. Importantly no significant differences were observed, and therefore for isoflurane the product ion distributions determined in a normal air mixture can be used for breath analysis. Given that PTR-MS can be operated under different reduced electric fields (E/N), the dependence of the product ion branching percentages for isoflurane on E/N (96-138 Td) are reported.

Enhanced mesoscale climate projections in TAR and AR5 IPCC scenarios: a case study in a Mediterranean climate (Araucanía Region, south central Chile).

Climate change scenarios are computed on a large scale, not accounting for local variations presented in historical data and related to human scale. Based on historical records, we validate a baseline (1962-1990) and correct the bias of A2 and B2 regional projections for the end of twenty-first century (2070-2100) issued from a high resolution dynamical downscaled (using PRECIS mesoscale model, hereinafter DGF-PRECIS) of Hadley GCM from the IPCC 3rd Assessment Report (TAR). This is performed for the Araucanía Region (Chile; 37°-40°S and 71°-74°W) using two different bias correction methodologies. Next, we study high-resolution precipitations to find monthly patterns such as seasonal variations, rainfall months, and the geographical effect on these two scenarios. Finally, we compare the TAR projections with those from the recent Assessment Report 5 (AR5) to find regional precipitation patterns and update the Chilean `projection. To show the effects of climate change projections, we compute the rainfall climatology for the Araucanía Region, including the impact of ENSO cycles (El Niño and La Niña events). The corrected climate projection from the high-resolution dynamical downscaled model of the TAR database (DGF-PRECIS) show annual precipitation decreases: B2 (-19.19 %, -287 ± 42 mm) and A2 (-43.38 %, -655 ± 27.4 mm per year. Furthermore, both projections increase the probability of lower rainfall months (lower than 100 mm per month) to 64.2 and 72.5 % for B2 and A2, respectively.

Natural genetic variation profoundly regulates gene expression in immune cells and dictates susceptibility to CNS autoimmunity.

Regulation of gene expression in immune cells is known to be under genetic control, and likely contributes to susceptibility to autoimmune diseases such as multiple sclerosis (MS). How this occurs in concert across multiple immune cell types is poorly understood. Using a mouse model that harnesses the genetic diversity of wild-derived mice, more accurately reflecting genetically diverse human populations, we provide an extensive characterization of the genetic regulation of gene expression in five different naive immune cell types relevant to MS. The immune cell transcriptome is shown to be under profound genetic control, exhibiting diverse patterns: global, cell-specific and sex-specific. Bioinformatic analysis of the genetically controlled transcript networks reveals reduced cell type specificity and inflammatory activity in wild-derived PWD/PhJ mice, compared with the conventional laboratory strain C57BL/6J. Additionally, candidate MS-GWAS (genome-wide association study candidate genes for MS susceptibility) genes were significantly enriched among transcripts overrepresented in C57BL/6J cells compared with PWD. These expression level differences correlate with robust differences in susceptibility to experimental autoimmune encephalomyelitis, the principal model of MS, and skewing of the encephalitogenic T-cell responses. Taken together, our results provide functional insights into the genetic regulation of the immune transcriptome, and shed light on how this in turn contributes to susceptibility to autoimmune disease.

Volatile Biomarkers in Breath Associated With Liver Cirrhosis - Comparisons of Pre- and Post-liver Transplant Breath Samples.

BACKGROUND: The burden of liver disease in the UK has risen dramatically and there is a need for improved diagnostics. AIMS: To determine which breath volatiles are associated with the cirrhotic liver and hence diagnostically useful. METHODS: A two-stage biomarker discovery procedure was used. Alveolar breath samples of 31 patients with cirrhosis and 30 healthy controls were mass spectrometrically analysed and compared (stage 1). 12 of these patients had their breath analysed after liver transplant (stage 2). Five patients were followed longitudinally as in-patients in the post-transplant period. RESULTS: Seven volatiles were elevated in the breath of patients versus controls. Of these, five showed statistically significant decrease post-transplant: limonene, methanol, 2-pentanone, 2-butanone and carbon disulfide. On an individual basis limonene has the best diagnostic capability (the area under a receiver operating characteristic curve (AUROC) is 0.91), but this is improved by combining methanol, 2-pentanone and limonene (AUROC curve 0.95). Following transplant, limonene shows wash-out characteristics. CONCLUSIONS: Limonene, methanol and 2-pentanone are breath markers for a cirrhotic liver. This study raises the potential to investigate these volatiles as markers for early-stage liver disease. By monitoring the wash-out of limonene following transplant, graft liver function can be non-invasively assessed.

Lipopolysaccharide-Induced Ionized Hypocalcemia and Acute Kidney Injury in Carotid Chemo/Baro-Denervated Rats.

The acute kidney injury (AKI) observed during sepsis is due to an uncontrolled release of inflammatory mediators. Septic patients develop electrolytic disturbances and one of the most important is ionized hypocalcemia. AKI adversely affects the function of other organs and hypocalcemia is associated with cardiovascular and respiratory dysfunctions. Since carotid body chemoreceptors modulate the systemic inflammatory response during sepsis syndromes, we used pentobarbitone-anesthetized male Sprague-Dawley rats in control condition (SHAM surgery) and after bilateral carotid neurotomy (carotid chemo/baro-denervated, BCN). We evaluate serum creatinine (CRE), serum neutrophil gelatinase-associated lipocaline (NGAL), ionized calcium (iCa) and cardiac Troponin I (cTnI) 90 min after the IP administration of 15 mg/kg lipopolysaccharide (LPS) or saline. In the SHAM group, LPS failed to induce significant changes CRE, NGAL, or iCa, and increased cTnI. Conversely, in the BCN group LPS increased CRE and NGAL, decreased iCa, and enhanced the increase of cTnI. Our results suggest that carotid chemo/baro-receptors might contribute to the regulation of both renal function and calcemia during sepsis. In addition, results imply that the carotid chemo-baroreceptors serve as an immunosensory organ.

Anterior tuberculous scleritis: A diagnostic challenge.

CASE REPORT: We present the case of a 26 year-old Pakistani male, who after the presumptive diagnosis of anterior tuberculous scleritis (by an atypical clinical appearance and positive epidemiological link), was diagnosed with pulmonary tuberculosis. DISCUSSION: Nodular anterior scleritis is an uncommon presentation of tuberculosis (TB). It is considered a diagnostic challenge because of the difficulty to extract bacilli from the ocular tissue. However, a detailed medical history and eye examination can be the key to an accurate diagnosis and appropriate treatment of the TB.

Dermatomicosis por Candida krusei simulando herpes cutáneo / Candida krusei dermatomycoses simulating cutaneous herpes

Las infecciones fúngicas de la piel suelen producirse por hongos dermatofíticoszoofílicos o antropofílicos con capacidad para colonizar tejidos queratinizados (piel, pelo o uñas).Se denominan genéricamente tiñas y se clasifican de forma topográfica según zona afectada empleando el modo genitivo latino (corporis, capitis, unguis, manus, pedis). La tiña faciei es una variedad de la tiña corporis que interesa exclusivamente a la cara. El género Candida no pertenece a los dermatofitos; se trata de una levadura saprofita de piel y mucosas que, en determinadas condiciones que disminuyen la resistencia del hospedador, se hace prevalente sobre el resto de flora cutánea comensal, produciendo daño más por una disminución de las resistencias del individuo que por su capacidad patogénica per se. La especie habitualmente aislada suele ser C. albicans, pero en algunas situaciones las lesiones cutáneas están producidas por otras especies (denominadas globalmente no-albicans), que suelen ser responsables de cuadros sistémicos. Cuando afectan a piel, las manifestaciones clínicas son más inespecíficas y su diagnóstico puede diferirse; además presentan implicaciones terapéuticas particulares por la pobre respuesta a otros productos que sí son efectivos para C. albicans, de ahí la importancia de un detenido examen físico ante las dermatomicosis (AU)

Fungal skin infections are usually caused by zoofilic or antropophilic dermatophytes with ability for colonizing keratinized tissues (skin, hair, nails).They are generally called tinea and are classified topographically using the Latin genitive mode (corporis, capitis, unguis, manus, pedis). Tinea faciei is a variety of the corporis type where only face is affected. The genus Candida does not belong to dermatophytes, it is a saprohytic yeast of skin and mucous membranes that under certain conditions that decrease host resistance become prevalent over other skin commensal flora and causes damage due to a drop in immunologic individual status more than its pathogenic capacity per se. The commonly isolated species usually is C. albicans, but in some situations the skin lesions are produced by other species (called globalynon-albicans) that usually cause systemic diseases. Clinical manifestations, when skin is affected, are nonspecific and diagnosis can be delayed. Also they have special therapeutic implications due to poor response to other drugs with effectiveness in C. albicans. Hence, a thorough physical examination is of the most importance for dermatomycoses (AU)

Susceptibility of Culicoides species biting midges to deltamethrin-treated nets as determined under laboratory and field conditions in the Balearic Islands, Spain.

Culicoides Latreille (Diptera: Ceratopogonidae) are vectors of several arboviruses, including bluetongue virus (BTV) and African horse sickness virus (AHSV), which cause diseases in, respectively, sheep and cattle, and horses, and have economic repercussions mainly as a result of trade restrictions. Insecticides can be used to reduce vector populations and hence the spread of disease. Despite the economic importance of these diseases, relatively few studies have evaluated the efficacy of commercially available insecticides and the effectiveness of treated nets against Culicoides species. The aim of the present study was to evaluate the insecticidal effect of commercially available polyethylene nets (ZeroVector(®) ) treated with deltamethrin (4.4 g/kg ± 15%) on Culicoides species. Laboratory and field trials were conducted in Culicoides populations collected in Majorca in the Balearic Islands, Spain. The present study shows that deltamethrin-treated nets provoke high and rapid mortality (90-100%) in Culicoides midges under laboratory conditions and increase mortality by 13% when deployed in the field.

Sensitivity of Culicoides obsoletus (Meigen) (Diptera: Ceratopogonidae) to deltamethrin determined by an adapted WHO standard susceptibility test.

Bluetongue is a disease of major economic concern in Europe. Its causative agent, bluetongue virus (BTV), is transmitted by several Culicoides species (mainly Culicoides imicola and Culicoides obsoletus in Europe). The application of insecticides on animals may reduce transmission of BTV, however, no formulation is currently licensed specifically against Culicoides midges. The present study assesses the susceptibility of C. obsoletus to deltamethrin using an adapted World Health Organization (WHO) susceptibility test. Midges were exposed to different dosages of deltamethrin for 1 h, and mortality after 1 h and 24 h was recorded. Results indicated that deltamethrin is highly toxic to C. obsoletus since a dose of 1·33×10(-4)% was enough to kill 50% of the population (LD50) in 24 h. The deltamethrin concentration needed to kill 90% of the population (LD90) was 5·55×10(-4)%. The results obtained in the present work could help to create a system that can be used to assess insecticide resistance and susceptibility of Culicoides biting midges.

Detrimental effect of cypermethrin treated nets on Culicoides populations (Diptera; Ceratopogonidae) and non-targeted fauna in livestock farms.

Bluetongue (BT) is an important disease of ruminants which exhibits its most severe clinical signs on cattle and especially on certain breeds of sheep. The known vectors of BT are small insects of the genus Culicoides (Diptera; Ceratopogonidae). Two species from this genus - Culicoides imicola and Culicoides obsoletus - play the major role in the transmission of the disease in Europe. Several prophylactic methods are used to avoid transmission; however, an easy and cost-effective preventive technique would be very useful for the control of the Culicoides populations near the animals. In the present study, the insecticide effect of cypermethrin treated nets on a Culicoides population was evaluated. A polyethylene net sprayed with 1L cypermethrin solution (1%) surrounding a UV light suction trap was placed at a cattle farm in Majorca (Balearic Islands). Collections of Culicoides and other fauna from the trap and floor around the net were compared with a control. Results showed no significant differences in the collection of Culicoides midges between the insecticide-treated net and the control. However, significant differences were observed in the collection of the non-target fauna between the treated net and the control, indicating that the dose used in the present trial was enough to kill most of the arthropods that contacted the net. The reasons for these equivocal findings and means to improve this technique for the control of Culicoides midges are discussed.

Collection of Culicoides spp. with four light trap models during different seasons in the Balearic Islands.

Bluetongue (BT) is a viral disease that affects ruminants, being especially pathogenic in certain breeds of sheep. Its viral agent (bluetongue virus; BTV) is transmitted by several species of Culicoides biting midges (Diptera: Ceratopogonidae). Different models of suction light traps are being used in a number of countries for the collection of BTV vector species. To determine the relative effectiveness of different light traps under field conditions, four traps (Onderstepoort, Mini-CDC, Rieb and Pirbright) were compared. These traps were rotated between four sites on a cattle farm in Mallorca (Balearic Islands, Spain) for several non-consecutive nights. Results showed remarkable disparities in the efficacy of the traps for the collection of Culicoides midges. The highest number of midges collected in the Onderstepoort trap (x¯±SD=62±94.2) was not significantly different from that collected in the Mini-CDC (x¯±SD=58±139.2). The Rieb trap collected the lowest number of midges (x¯±SD=3±4.0). Significantly higher mean numbers of midges were collected in the Onderstepoort than in either the Pirbright (P=0.002) or Rieb traps (P=0.008). There were also differences in the Culicoides species composition as determine with the various traps. These results indicate that the Onderstepoort or Mini-CDC traps will be more effective than either the Rieb or Pirbright traps for the collection of large numbers of Culicoides midges.

The susceptibility of Culicoides imicola and other South African livestock-associated Culicoides species to infection with bluetongue virus serotype 8.

In 2006, a strain of bluetongue virus serotype 8 (BTV-8) of sub-Saharan origin was responsible for the first outbreaks in recorded history of clinical bluetongue disease (BT) in northern Europe. In this study, we examine the oral susceptibility of Culicoides (Avaritia) imicola Kieffer (Diptera: Ceratopogonidae) and other livestock-associated Culicoides species from southern Africa to infection with several strains of BTV-8. Following feeding using an artificial membrane-based method and incubation, virus was found in <1% of C. imicola individuals tested. Higher rates of susceptibility were found, however, for a variety of other South African species, including Culicoides (Avaritia) bolitinos Meiswinkel. Although these results do not preclude the role of C. imicola as a vector of BTV-8, its low susceptibility to BTV indicates that other less abundant Culicoides species may have the potential to play decisive roles in the epidemiology of this virus and should not be excluded from risk assessment studies.

Modulation of calcium channels by taurine acting via a metabotropic-like glycine receptor.

Taurine is one of the most abundant free amino acids in the central nervous system, where it displays several functions. However, its molecular targets remain unknown. It is well known that taurine can activate GABA-A and strychnine-sensitive glycine receptors, which increases a chloride conductance. In this study, we describe that acute application of taurine induces a dose-dependent inhibition of voltage-dependent calcium channels in chromaffin cells from bovine adrenal medullae. This taurine effect was not explained by the activation of either GABA-A, GABA-B or strychnine-sensitive glycine receptors. Interestingly, glycine mimicked the modulatory action exerted by taurine on calcium channels, although the acute application of glycine did not elicit any ionic current in these cells. Additionally, the modulation of calcium channels exerted by both taurine and glycine was prevented by the intracellular dialysis of GDP-ß-S. Thus, the modulation of voltage-dependent calcium channels by taurine seems to be mediated by a metabotropic-like glycinergic receptor coupled to G-protein activation in a membrane delimited pathway.