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Challenges and improvement strategies in the hospitalization of chronic multimorbid patients

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World Journal of Clinical Cases 2025年第3期13卷 35-41页

作者： Andres Fontalba-Navas francisco Pozo muñoz Rogelio Garcia Cisneros Maria Jose Garcia Larrosa Maria del Mar Callejon Gil Ignacio Garcia Delgado Maria Belen Jimenez Martinez Antequera Hospital Northern Málaga Integrated Healthcare AreaAntequera 29200AndalusiaSpain Department of Public Health and Psychiatry University of MálagaMálaga 29010Spain Antequera Hospital Northern Málaga Antequera Integrated Healthcare AreaAntequera 29200MálagaSpain

BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot *** diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient *** proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid *** To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital *** The study employed a descriptive longitudinal approach,analyzing data from the Basic Minimum Data Set(BMDS)to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** The study employed a descriptive longitudinal approach,analyzing data from the BMDS to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary *** coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient *** superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of ca

关键词： High complexity unit Chronic multimorbidity Patient-centered care Integrated care Healthcare management

Differential response of injured and healthy retinas to syngeneic and allogeneic transplantation of a clonal cell line of immortalized olfactory ensheathing glia:a double-edged sword

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Neural Regeneration Research 2025年第8期20卷 2395-2407页

作者： María Norte-muñoz María Portela-Lomba Paloma Sobrado-Calvo Diana Simón Johnny Di Pierdomenico Alejandro Gallego-Ortega Mar Pérez JoséMCabrera-Maqueda Javier Sierra Manuel Vidal-Sanz María Teresa Moreno-Flores Marta Agudo-Barriuso Grupo de Investigación Oftalmología Experimental Departamento de OftalmologíaOptometríaOtorrinolaringología y Anatomía PatológicaFacultad de MedicinaUniversidad de MurciaInstituto Murciano de Investigación Biosanitaria(IMIB)Campus de Ciencias de la SaludMurciaSpain Experimental Sciences Faculty Universidad Francisco de VitoriaPozuelo de AlarcónMadridSpain Anatomy Histology and Neuroscience DepartmentMedicine FacultyUniversidad Autónoma de MadridMadridSpain Center of Neuroimmunology Service of NeurologyLaboratory of Advanced Imaging in Neuroimmunological DiseasesHospital Clínic of BarcelonaInstitut d’Investigacions Biomèdiques August Pi i Sunyer(IDIBAPS)and Universitat de BarcelonaBarcelonaSpain Medicine Faculty Universidad Francisco de VitoriaPozuelo de AlarcónMadridSpain

Olfactory ensheathing glia promote axonal regeneration in the mammalian central nervous system,including retinal ganglion cell axonal growth through the injured optic ***,it is unknown whether olfactory ensheathing glia also have neuroprotective *** ensheathing glia express brain-derived neurotrophic factor,one of the best neuroprotectants for axotomized retinal ganglion ***,we aimed to investigate the neuroprotective capacity of olfactory ensheating glia after optic nerve *** ensheathing glia cells from an established rat immortalized clonal cell line,TEG3,were intravitreally injected in intact and axotomized retinas in syngeneic and allogeneic mode with or without microglial inhibition or immunosuppressive *** and gene expression analyses were *** bulb-derived primary olfactory ensheathing glia and TEG3 express major histocompatibility complex classⅡ*** and syngenically transplanted TEG3 cells survived in the vitreous for up to 21 days,forming an *** axotomized retinas,only the allogeneic TEG3 transplant rescued retinal ganglion cells at 7 days but not at 21 *** these retinas,microglial anatomical activation was higher than after optic nerve crush *** intact retinas,both transplants activated microglial cells and caused retinal ganglion cell death at 21 days,a loss that was higher after allotransplantation,triggered by pyroptosis and partially rescued by microglial inhibition or ***,neuroprotection of axotomized retinal ganglion cells did not improve with these *** different neuroprotective properties,different toxic effects,and different responses to microglial inhibitory treatments of olfactory ensheathing glia in the retina depending on the type of transplant highlight the importance of thorough preclinical studies to explore these variables.

关键词： cell therapy immune recognition major histocompatibility complex class II(MHCII) neuroprotection olfactory ensheathing glia retinal ganglion cells

Does wetland watershed land use influence amphibian larval development? A relevant effect of agriculture on biota

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Journal of Oceanology and Limnology 2019年第1期37卷 160-168页

作者： GARCíA-mu?oz Enrique GUERRERO francisco ARECHAGA Garbi?e PARRA Gema Departamento de Biología Animal Biología Vegetal y Ecología Campus de las Lagunillas Centro de Estudios Avanzados en Ciencias de la Tierra Campus de las Lagunillas Departamento de Ciencias de la Salud Campus de las Lagunillas

Agriculture practices have been widely proposed as the major cause of amphibian population decline. However, the majority of these results have been based on laboratory experiments. The present study was conducted to test the repercussion of wetland sediment provenance on amphibian larval *** bufo larvae were used in two dif ferent treatments in an outdoor experiment, the ?rst one using sediment from one wetland surrounded by intensive agricultural practices, and the second using sediment with no record of agrochemical uses. A negative ef fect was observed in the agricultural treatment, from subcellular to individual level. The results showed that the sediment from agricultural practices watershed generates a reduction in survival. Furthermore, individuals that developed under this treatment showed a lower total length and a delay in the time necessary to complete metamorphosis; these features are connected with recruitment success. In the same way, biochemical analysis showed high values of lipid peroxidation in metamorphs developing in sediments from an agricultural area. Finally, the results obtained highlight the importance of considering the sediments, not only the water, as origin treatment, allowing us to understand the consequences on amphibian populations that inhabit areas af fected by intensive agriculture.

关键词： amphibian decline Bufo bufo survival ecotoxicology agricultural practices

Amyloid-beta pathology-induced nanoscale synaptic disruption:the case of the GABA_B-GIRK assembly

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Neural Regeneration Research 2025年第5期20卷 1409-1410页

作者： Rafael Lujan Alejandro Martín-Belmonte Sergi Ferré francisco Ciruela Synaptic Structure Laboratory Instituto de Biomedicina de la UCLM(IB-UCLM)Departamento de Ciencias MédicasInstituto de Investigación en Salud de Castilla-La Mancha(IDISCAM)Facultad de MedicinaUniversidad Castilla-La ManchaCampus BiosanitarioC/AlmansaAlbaceteSpain Integrative Neurobiology Section National Institute on Drug AbuseIntramural Research ProgramNational Institutes of HealthBaltimoreMDUSA Pharmacology Unit Department of Pathology and Experimental TherapeuticsSchool of Medicine and Health SciencesInstitute of NeurosciencesUniversity of BarcelonaNeuropharmacology&Pain GroupNeuroscience ProgramBellvitge Institute for Biomedical ResearchL’Hospitalet de LlobregatSpain

Alzheimer's disease (AD) is characterized by an imbalance between excitatory and inhibitory brain networks,leading to aberrant homeostatic synaptic *** has progressively been recognized as syna ptopathy and syna ptic dysfunction has been identified as a key component of its pathogenesis (Schirinzi et al.,2020).Syna ptic dysfunction is believed to precede synapse loss,a primary biological correlate of cognitive decline in AD,inevita bly associated with neuronal death.

关键词： Alzheimer pathology

Turning carbon dots into selenium bearing nanoplatforms with in vitro GPx-like activity and pro-oxidant activity

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Nano Research 2023年第5期16卷 7784-7791页

作者： Laura Perez-Garrido Mariano Ortega-muñoz Fernando Hernandez-Mateo F.Javier Lopez-Jaramillo francisco Santoyo-Gonzalez Department of Organic Chemistry Biotechnology InstituteSchool of SciencesCampus Fuentenueva snUniversity of Granada18071-GranadaSpain

Selenium(Se)has been defined as the“Janus element”,with one face showing antioxidant activity and the other pro-oxidant *** biological effect of Se depends on both dose and *** nanoparticles are attracting major interest,although their large-scale preparation for biomedical applications is not *** hypothesize that acid anhydride-coated carbon dots(AACD)are an attractive platform for preparing nanoparticles containing chemically defined *** reaction of AA-CD with 3-selenocyanatopropan-1-amine yields carbon dots bearing selenocyanate and carboxylate groups(CD-SeCN)that allow for tuning the ***-SeCN has a Se content of 0.36μmol per mg of nanoparticles,they show the typical photoluminescence of carbon *** selenocyanate groups(SeCN)exhibited glutathione peroxidase-like activity and *** show that antioxidant behavior differs between normal and tumor cells,the evaluation on HEK293 and A549 cells reveals that the toxicity of CD-SeCN depends on dose,time,intracellular glutathione(GSH)*** toxicity of CD-SeCN decreases with the time of incubation and the cell death mechanism switches from necrosis to apoptosis,indicating that CD-SeCN is ***,high levels of intracellular GSH exert a protective *** results support a pharmacological potential in cancers with low levels of intracellular *** use of AA-CD as nanoplatforms is a general strategy that paves the way for the engineering of advanced nanosystems.

关键词： selenium nanoparticles carbon dots glutathione peroxidase-like activity Janus element nanomedicine

Management of recurrent hepatitis C virus after liver transplantation

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World Journal of Gastroenterology 2014年第44期20卷 16409-16417页

作者： Miguel Jiménez-Pérez Rocío González-Grande francisco Javier Rando-mu?oz Liver transplantation and hepatology unit UGC de Aparato Digestivo Hospital Regional Universitario Department of Abdominal Diseases Hospital Nij Smellinghe Ziekenhuis

Chronic hepatitis C virus (HCV) infection is the leading cause of death from liver disease and the leading indication for liver transplantation (LT) in the United States and Western Europe. LT represents the best therapeutic alternative for patients with advanced chronic liver disease caused by HCV or those who develop hepatocarcinoma. Reinfection by HCV of the graft is universal and occurs in 95% of transplant patients. This reinfection can compromise graft function and patient survival. In a few cases, the histological recurrence is minimal and non-progressive; however, in most patients it follows a more rapid course than in immunocompetent persons, and frequently evolves into cirrhosis with graft loss. In fact, the five-year and ten-year survival of patients transplanted because of HCV are 75% and 68%, respectively, compared with 85% and 78% in patients transplanted for other reasons. There is also a pattern of recurrence that is very severe, but rare (< 10%), called fibrosing cholestatic hepatitis, which often involves rapid graft loss. Patients who present a negative HCV viremia after antiviral treatment have better survival. Many studies published over recent years have shown that antiviral treatment of post-transplant HCV hepatitis carried out during the late phase is the best option for improving the prognosis of these patients. Until 2011, PEGylated interferon plus ribavirin was the standard of care, resulting in a sustained virological response in around 30% of recipients. The addition of protease inhibitors, such as boceprevir or telaprevir, to the standard of care, or the use of other direct-acting antiviral drugs may involve therapeutic changes in the context of HCV recurrence. This may result a better prognosis for these patients, particularly those with severe recurrence or factors predicting rapid progression of fibrosis. However, the use of these agents in LT still requires clarification in terms of safety and efficacy.

关键词： Hepatitis C virus Liver transplantation Recurrence Treatment

Reassessing the AMPK-MTORC1 balance in autophagy in the central nervous system

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Neural Regeneration Research 2025年第11期20卷 3209-3210页

作者： Marta García-Juan Mario Villa Irene Benito-Cuesta Lara Ordónez-Gutiérrez francisco Wandosell Centro de Biología Molecular“Severo Ochoa”(CSIC-UAM) Nicolas Cabrera 1Universidad Autónoma de MadridMadridSpain Fisiología Animal Departamento de BiologíaFacultad de CienciasUniversidad Autónoma de MadridMadridSpain Department of Clinical Neuroscience CMM Karolinska Universitetssjukhuset SolnaStockholmSweden Departamento de Bioquímica y Biología Molecular Universidad Complutense de MadridMadridSpain Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas(CIBERNED) MadridSpain

Autophagy is a cellular degradation and recycling system,indispensable for cellular and organ development,homeostasis,and *** cellular process is evolutionarily highly conserved to quality control of many proteins and dysfunctional organelles,which finally recycle components as amino *** process is effective during normal physiology as part of anabolism and plays an additional important role during starvation(Dikic and Elazar,2018).Different types of autophagy have been chara cterized based on their dynamic,mechanism of action,target substrates,and protein *** of them are macroautophagy(hereafter called"autophagy"),microa utophagy,and chape rone-media ted autophagy(Fleming et al.,2022).

关键词： homeostasis system hereafter

Role of serendipity in the discovery of classical antidepressant drugs:Applying operational criteria and patterns of discovery

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World Journal of Psychiatry 2022年第4期12卷 588-602页

作者： francisco López-muñoz Pilar D’Ocón Alejandro Romero JoséA Guerra CecilioÁlamo Faculty of Health University Camilo JoséCelaVillanueva de la Cañada 28692MadridSpain “Hospital 12 de Octubre”Research Institute(i+12) Avda.de Córdobas/nMadrid 28041Spain Department of Pharmacology Faculty of PharmacyUniversity of ValenciaAvda.Vicent Andres Estelless/nValencia 46100Spain Department of Pharmacology and Toxicology Faculty of Veterinary MedicineComplutense UniversityAvda.Puerta de Hierros/nMadrid 28040Spain Department of Pharmacology and Toxicology Faculty of PharmacyComplutense UniversityPl.de Ramón y Cajals/nMadrid 28040Spain Department of Biomedical Sciences(Pharmacology Area) Faculty of Medicine and Health SciencesUniversity of AlcaláCampus Científico-TecnológicoCrta.de Madrid-BarcelonaAlcaláde Henares 28871MadridSpain

The role played by serendipity in the origin of modern psychopharmacology has proven to be controversial in scientific *** its original meaning(Walpole),serendipity refers to discoveries made through a combination of accidents and *** have implemented an operational definition of serendipity based on finding something unexpected or unintended,regardless of the systematic process that led to the accidental observation,and we have established four different patterns of serendipitous *** this paper,we have analyzed the role of serendipity in the discovery and development of classical antidepressant drugs,tricyclic antidepressants and monoamine oxidase inhibitors as well as heterocyclic,“atypical”or“second generation”*** discovery of the antidepressant properties of imipramine and iproniazid,the prototypes of tricyclic antidepressants and monoamine oxidase inhibitors,respectively,fits the mixed type II pattern;initial serendipitous discoveries(imipramine was an antipsychotic and iproniazid was an antituberculosis agent)led secondarily to non-serendipitous *** the other components of these two families of drugs were developed specifically as antidepressants,modifying the chemical structure of the series leaders,thereby allowing all of them to be included in the type IV pattern,characterized by the complete absence of *** the heterocyclic drugs,mianserin(originally developed as an antihistamine)also falls into the type II pattern.

关键词： Serendipity Antidepressants Imipramine Iproniazid Psychopharmacology History of neurosciences

The emerging role of mesenchymal stem cell-derived extracellular vesicles to ameliorate hippocampal NLRP3 inflammation induced by binge-like ethanol treatment in adolescence

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Neural Regeneration Research 2025年第4期20卷 1153-1163页

作者： Susana Mellado María JoséMorillo-Bargues Carla Perpiñá-Clérigues francisco García-García Victoria Moreno-Manzano Consuelo Guerri María Pascual Department of Physiology School of Medicine and DentistryUniversity of ValenciaValenciaSpain Bioinformatics and Biostatistics Unit Príncipe Felipe Research CenterValenciaSpain Neuronal and Tissue Regeneration Laboratory Príncipe Felipe Research CenterValenciaSpain

Our previous studies have reported that activation of the NLRP3(NOD-,LRR-and pyrin domain-containing protein 3)-inflammasome complex in ethanol-treated astrocytes and chronic alcohol-fed mice could be associated with neuroinflammation and brain *** stem cell-derived extracellular vesicles(MSC-EVs)have been shown to restore the neuroinflammatory response,along with myelin and synaptic structural alterations in the prefrontal cortex,and alleviate cognitive and memory dysfunctions induced by binge-like ethanol treatment in adolescent *** the therapeutic role of the molecules contained in mesenchymal stem cell-derived extracellular vesicles,the present study analyzed whether the administration of mesenchymal stem cell-derived extracellular vesicles isolated from adipose tissue,which inhibited the activation of the NLRP3 inflammasome,was capable of reducing hippocampal neuroinflammation in adolescent mice treated with binge *** demonstrated that the administration of mesenchymal stem cell-derived extracellular vesicles ameliorated the activation of the hippocampal NLRP3 inflammasome complex and other NLRs inflammasomes(e.g.,pyrin domain-containing 1,caspase recruitment domain-containing 4,and absent in melanoma 2,as well as the alterations in inflammatory genes(interleukin-1β,interleukin-18,inducible nitric oxide synthase,nuclear factor-kappa B,monocyte chemoattractant protein-1,and C–X3–C motif chemokine ligand 1)and miRNAs(miR-21a-5p,miR-146a-5p,and miR-141-5p)induced by binge-like ethanol treatment in adolescent *** analysis further revealed the involvement of miR-21a-5p and miR-146a-5p with inflammatory target genes and NOD-like receptor signaling *** together,these findings provide novel evidence of the therapeutic potential of MSC-derived EVs to ameliorate the hippocampal neuroinflammatory response associated with NLRP3 inflammasome activation induced by binge drinking in adolescence.

关键词： adolescence binge-like ethanol treatment extracellular vesicles hippocampus mesenchymal stem cells neuroinflammation NOD-,LRR-and pyrin domain-containing protein 3(NLRP3)