Eva María Andrés-Esteban

The anti-inflammatory prostaglandin 15d-PGJ2 and its nuclear receptor PPARgamma are decreased in schizophrenia

A number of findings suggest that inflammation plays a role in the pathophysiology of schizophrenia. Taking into account a physiological balance between pro- and anti-inflammatory mediators, we measured the plasma levels of cyclooxygenase-derived mediators and other key pro- and anti-inflammatory transcription factors in peripheral blood mononuclear cells (PBMC). Forty healthy subjects and 46 treated chronic schizophrenic patients with an acutely exacerbated condition who met DSM-IV criteria were included. COX by-products prostaglandin E2 (PGE2) and 15d-prostaglandin J2 (15d-PGJ2) plasma levels were measured by EIA. Peroxisome proliferator-activated receptor gamma (PPARγ) as well as nuclear factor kappaB (NFκB) activity in nuclear extracts from PBMC and expression of its inhibitory subunit IκBα in cytosolic extracts were determined using ELISA-based kits. Schizophrenic patients showed higher plasma levels of pro-inflammatory PGE2 than age-matched controls (p=0.043). On the contrary, levels of anti-inflammatory 15-d-PGJ2 were lower (p=0.004), correlating with a lower expression of its nuclear target, PPARγ in nuclear extracts from PBMC (p=0.001). Although no changes in NFκB activity were observed between patients and healthy controls, the expression of its inhibitory protein IκBα was lower in the patients compared to the controls (p=0.027). These findings suggest that schizophrenia is associated with a systemic imbalance in the plasma levels of pro-inflammatory/anti-inflammatory prostaglandins in favor of the former. Furthermore, the expression and activity of anti-inflammatory PPARγ are diminished in PBMC, which indicates a state of inflammation and blunted anti-inflammatory counterbalancing mechanisms at systemic level in these patients.

Altered immune function in unaffected first-degree biological relatives of schizophrenia patients

Inflammatory and immune processes have been implicated in the etiopathology of schizophrenia. We demonstrate the existence of immune function alteration, assessed by serum cytokines levels, not only in schizophrenia patients but also in their unaffected first-degree relatives. This finding may provide a new data for considering cytokines as schizophrenic disease biomarkers.

Does open reduction and pinning affect outcome in severely displaced supracondylar humeral fractures in children? A systematic review

Supracondylar fracture of the humerus is the second most common fracture in children (16.6%) and the most common elbow fracture. These fractures are classified using the modified Gartland classification. Type III and type IV are considered to be totally displaced. A totally displaced fracture is one of the most difficult fractures to manage and may lead to proceeding to open procedures to achieve acceptable reductions. Many surgeons are concerned about its outcome compared to closed procedures. We therefore performed a systematic review of the literature to investigate the existing evidence regarding functional and radiological outcomes as well as postsurgical complications of primary open compared to primary closed reduction.

Cardiología preventiva y rehabilitación

La prevencion es la herramienta mas eficaz y eficiente en la enfermedad cardiovascular y, de igual forma, los programas de rehabilitacion cardiaca son los mas eficaces y eficientes en la prevencion secundaria. Conocer la situacion de riesgo cardiovascular en nuestro pais a traves del estudio de la presentacion de los distintos factores de riesgo y de su relacion y asociacion en trabajadores espanoles es el objetivo principal del grupo de trabajo de nuestra seccion sobre sindrome metabolico. A traves de su primero registro y luego estudio denominado MESYAS (MEtabolic SYndrome Active Subjets), nos ha ofrecido importantes e interesantes resultados y sigue produciendo datos que nos ayudan en nuestra practica preventiva diaria. Por otra parte, los programas de rehabilitacion cardiaca y de prevencion secundaria de las enfermedades cardiovasculares son el metodo mas eficaz para disminuir su morbimortalidad. Sin embargo, es preocupante observar que en la asistencia cardiologica hay importantes lagunas en cuanto al seguimiento de las recomendaciones de las sociedades cientificas sobre esa prevencion secundaria. Le hemos pedido al coordinador del grupo de trabajo de rehabilitacion cardiaca que nos informe con los ultimos datos y evidencias del panorama de esta importante actividad preventiva.

Nail involvement can predict enthesopathy in patients with psoriasis

: Although subclinical enthesopathy is a well‐established diagnostic criterion for psoriatic arthritis (PsA), it is frequently overlooked, as many patients are asymptomatic. The possibility of finding a clinical clue predicting enthesopathy would help clinicians establish an early diagnosis of PsA.

Nagelbefall kann bei Patienten mit Psoriasis auf eine Enthesiopathie hinweisen: Enthesiopathie und Nagelbefall

Obwohl subklinische Enthesiopathie ein gut etabliertes diagnostisches Merkmal der Psoriasisarthritis (PsA) ist, wird sie häufig übersehen, da viele Patienten asymptomatisch sind. Gäbe es klinische Hinweise auf das Vorliegen einer Enthesiopathie, würde dies den Klinikern die Möglichkeit eröffnen, eine PsA frühzeitig zu diagnostizieren.