Virginia Reverte

Preeclampsia (PE) is a multifactorial hypertensive disorder unique to pregnancy and a leading cause of maternal and fetal morbidity and mortality worldwide. Its pathogenesis involves placental dysfunction and an exaggerated maternal inflammatory response. Uric acid (UA), traditionally regarded as a marker of renal impairment, is increasingly recognized as an active contributor to the development of PE. Elevated UA levels are associated with oxidative stress, endothelial dysfunction, immune activation, and reduced renal clearance. Clinically, UA is measured in the second and third trimesters to assess disease severity and guide obstetric management, with higher levels correlating with early-onset PE and adverse perinatal outcomes. Its predictive accuracy improves when combined with other clinical and biochemical markers, particularly in low-resource settings. Mechanistically, UA and its monosodium urate crystals can activate the NLRP3 inflammasome, a cytosolic multiprotein complex of the innate immune system. This activation promotes the release of IL-1β and IL-18, exacerbating placental, vascular, and renal inflammation. NLRP3 inflammasome activation has been documented in placental tissues, immune cells, and kidneys of women with PE and is associated with hypertension, proteinuria, and endothelial injury. Experimental studies indicate that targeting UA metabolism or inhibiting NLRP3 activation, using agents such as allopurinol, metformin, or MCC950, can mitigate the clinical and histopathological features of PE. These findings support the dual role of UA as both a biomarker and a potential therapeutic target in the management of the disease.

Delay in vaccination schedule may result in increased risk of vaccine-preventable outbreaks. Lack of parental confidence in vaccines and sociodemographic factors could be related to those delays. Vaccine Confidence Index (VCI) is an indicator to estimate confidence in vaccines, composed of simple dimensions about it and evaluated using a 5-point Likert scale. Objectives of this study, conducted in the Region of Murcia, Spain, were to determine which sociodemographic factors were associated with delayed administration in measles, mumps and rubella (MMR) vaccine, both first and second doses, and to evaluate if there were differences in parental vaccine confidence of children who were delayed on MMR vaccine schedule compare to vaccinated on time. The 2019–2020 (first dose) and 2016–2017 (second dose) cohorts were divided into four categories: vaccinated on time, slightly delayed, moderately delayed and highly delayed. Online questionnaire was sent to their parents, followed by a telephone questionnaire for non-responders. Regarding MMR first dose, a significant association was found between delay and birth order and intellectual/motor delay of children. Parental educational status, the main source of vaccine information and the social networks more frequently used by parents were also associated with delay. Suffering motor/intellectual delay and the obstacles to vaccination process derived from caring for other siblings were associated with delay in second MMR dose. The VCI decreased significantly in first dose group as delay increases but did not change in the second one. Confidence in vaccines and sociodemographic factors, respectively, were associated with delaying MMR first and second dose.

High-fat diet (HFD) for 28 wk leads to type 2 diabetes mellitus (T2DM) phenotype, concomitant with increased plasma soluble prorenin receptor (sPRR), nondipping blood pressure, and vascular stiffness in male mice. HFD-fed female mice exhibiting a preserved cardiometabolic phenotype until ovariectomy revealed increased plasma sPRR and blood pressure. Plasma sPRR may indicate the status of systemic renin-angiotensin-aldosterone system (RAAS) activation and the onset of vascular complications during T2DM in a sex-dependent manner.