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The species Sargassumspp., is a macroalgae that in recent years has become a problem on the coasts of the Mexican Caribbean and Florida in the United States. Derived from its chemical composition, Sargassumspp., could be used as a microbial substrate to obtain a bioextract with a greater amount of bioactive compounds, which will improve the germination of tomato seeds. In this work, Sargassumcollected from the Mexican Caribbean was used. The collected sample was divided into washed Sargassumand natural Sargassum, to serve as a substrate in a liquid fermentation process using a strain of Aspergillus niger. The fermented extract was collected, analyzed, and applied in germination bioassays on tomato seeds. The washed Sargassumbioextracts showed increases in the content of protein, sugars, phenols, flavonoids, and tannins, being twice as high as the content of the unwashed Sargassumextract. On the other hand, the use of a high dose (1:1) of unwashed Sargassumbioextract increased the percentage of germination per day, the final percentage of germination, the seedling vigor index, seedling height, and fresh biomass. The treatment of seeds with ferment extracts from both Sargassumtypes, improves germination parameters, and promotes the development of tomato seedlings.

COVID-19 most related glomerular disease to date seems to be collapsing glomerulopathy, mostly in young Afroamerican patients with APOL1 gene risk alleles. However, in our population, predominant in elderly Caucasian patients, most biopsied pathology since the beginning of the pandemic has been IgA nephritis or Schönlein-Henoch purpura.

INTRODUCCIÓN: Actualmente no existe suficiente evidencia sobre el efecto nefroprotector de los bloqueantes del sistema renina-angiotensina-aldosterona (BSRAA) en pacientes añosos con enfermedad renal crónica (ERC) sin proteinuria y sin cardiopatía. El objetivo es evaluar el efecto de los BSRAA en la progresión de la ERC en este grupo poblacional.

The aim of the present study was to determine which oral alterations can be found in patients with head and neck cancer treated with radiotherapy as well as to explore dentist's involvement in treatment of these patients. An exploratory study was conducted in 52 patients who had previously received over 1,000 cGy radiation. A survey was undertaken as well as oral examination of each participant, in order to assess stimulated salivary flow and flavor tests. Results revealed high prevalence of oral alterations in patients with accumulated radiation of 3,001-5,000 cGy. Dry mouth (xerostomia) was the most frequently reported alteration (78.8%). Estimated total salivary secretion rate confirmed a state of hyposalivation in 82.7% of all patients. A statistically significant association was found between cancer location (p < 0.01) and type of tumor with presence of trismus (p < 0.05). Hyposialia was more frequently present in patients with stage IV tumors (50%) in those subjected to combined treatments (p < 0.05). Periodontal assessment was possible in 50% of all patients, Of this proportion, 92% exhibited periodontitis with mainly moderate to severe insertion loss; 84.6% of all participants reported not to have been remitted to dentists either before or after treatment. Findings support high frequency of oral alterations in patients subjected to radiotherapy treatment and dental care inappropriateness to prevent or treat these effects. An alert is raised with respect to the compulsiveness to follow treatment protocols for cancer patients, which should include dental evaluation before, during and after respective treatment.

El objetivo del estudio fue determinar las alteraciones bucales en pacientes con cáncer de cabeza y cuello tratados con radioterapia y explorar la participación del Odontólogo en la atención de estos pacientes. Se realizó un estudio exploratorio en 52 pacientes que habían recibido más de 1,000 cGy de radiación. Se encuestó y realizó examen bucal a cada participante, tasa de flujo salivar estimulado y prueba de sabores. Los resultados muestran alta prevalencia de alteraciones bucales en pacientes con radiación acumulada entre 3,001 y 5,000 cGy. La boca seca (xerostomía) fue la alteración más sentida (78.8%). La tasa de secreción salivar total estimulada confirmó hiposalivación en el 82.7% de los pacientes. Se encontró una asociación estadísticamente significativa entre el lugar del cáncer (p < 0.01) y el tipo de tumor con la presencia de trismus (p < 0.05). La hiposialia se presentó más en los pacientes con tumores en estadio IV (50%) y en aquellos sometidos a tratamientos combinados (p < 0.05). Fue posible realizar la valoración periodontal al 50% de los pacientes, el 92% de ellos presentó periodontitis con pérdida de inserción principalmente severa y moderada. El 84.6% de los participantes manifestaron no haber sido remitidos a odontólogo antes o durante el tratamiento. Los hallazgos ratifican una alta frecuencia de alteraciones bucales en pacientes sometidos a tratamiento de radioterapia e inoportunidad de atención odontológica para prevenir o tratar estos efectos. Se alerta sobre la obligatoriedad de seguir protocolos de manejo del paciente oncológico, incluyendo valoración odontológica antes, durante y después del tratamiento respectivo.

Chronic fluid overload is frequent in hemodialysis patients (P) and it associates with hypertension, left ventricular hypertrophy (LVH) and higher mortality. Moreover, echocardiographic data assessing fluid overload is limited. Our aim was to evaluate the relationship between fluid overload measured by bioimpedance spectroscopy (BIS) and different echocardiographic parameters.

Testosterone deficiency (hypogonadism) is common among men undergoing haemodialysis, but its clinical implications are not well characterized. Testosterone is an anabolic hormone that induces erythrocytosis and muscle synthesis. We hypothesized that testosterone deficiency would be associated with low muscle mass, physical inactivity and higher dosages of erythropoietin-stimulating agents (ESA).

Testosterone deficiency (hypogonadism) is common among men undergoing haemodialysis, but its clinical implications are not well characterized. Testosterone is an anabolic hormone that induces erythrocytosis and muscle synthesis. We hypothesized that testosterone deficiency would be associated with low muscle mass, physical inactivity and higher dosages of erythropoietin-stimulating agents (ESA).

Chronic fluid overload is frequent in hemodialysis patients (P) and it associates with hypertension, left ventricular hypertrophy (LVH) and higher mortality. Moreover, echocardiographic data assessing fluid overload is limited. Our aim was to evaluate the relationship between fluid overload measured by bioimpedance spectroscopy (BIS) and different echocardiographic parameters.

The phenotype associated to reduced physical activity (PA) in dialysis patients is poorly documented. We here evaluate weekly PA in two independent cohorts. Cross-sectional study with PA assessed by the number of steps/day measured by pedometer in two cohorts of prevalent dialysis patients: (1) peritoneal dialysis (PD) patients (n = 64; 62 ± 14 years; 70 % men) from Stockholm, Sweden using the pedometer for 7 consecutive days; (2) hemodialysis (HD) patients (n = 78; 63 ± 12 years; 65 % men) from a single center in Madrid, Spain using the pedometer for 6 consecutive days: 2 HD days, 2 non-HD midweek days and 2 non-HD weekend days. In both cohorts, comorbidities, body composition, nutritional status, and related biomarkers were assessed. Cohorts were not merged; instead data were analyzed separately serving as reciprocal replication analyses. Most patients (63 % of PD and 71 % of HD) were considered sedentary (<5,000 steps/day). PD patients had on average 4,839 ± 3,313 steps/day. HD patients had 3,767 ± 3,370 steps/day on HD-free days, but fewer steps/day on HD days (2,274 ± 2,048 steps/day; p < 0.0001). In both cohorts, and across increasing PA tertiles, patients were younger and had less comorbidities. Higher PA was also accompanied by better nutritional status (depicted by albumin, pre-albumin, creatinine and normalized protein catabolic rate in HD, and by albumin and subjective global assessment [SGA] in PD), higher lean body mass, and lower fat body mass (bioimpedance and/or dual-energy X-ray absorptiometry [DEXA]). Higher levels of PA were accompanied by lower levels of C-reactive protein in PD. Age and lean body mass were the strongest multivariate predictors of PA in both cohorts. There is a high prevalence of sedentary behavior in dialysis patients. Better physical activity was consistently associated with younger age, lower presence of comorbidities and better nutritional status. Pedometers represent a simple and inexpensive tool to objectively evaluate physical activity in this patient population.

AbstractBackground/Aims:Lower serum sodium levels have been associated with increased mortality among patients with chronic kidney disease (CKD). Our aim was to analyze the independent factors associated with lower sodium levels among nondialysis patients with advanced CKD and to evaluate the evolution of these patients in comparison to those with higher plasma sodium over a 1-year period. Methods:We included 72 patients with CKD stages 4 and 5 without clinically evident cardiopathy or liver disease. Bioelectrical impedance and echocardiography were performed to analyze the possible relation between plasma sodium and volume status and subclinical left ventricular (LV) dysfunction. During follow-up, we compared the evolution of patients with lower baseline plasma sodium (low quartile: <138 mEq/l) with that of patients with higher levels over a 1-year period. Results:At baseline, the independent predictors of lower plasma sodium were C-reactive protein (CRP; OR 0.96; 95 CI 0.91-0.99) and body mass index (OR 0.89; 95 CI 0.78-0.99). An inverse correlation between plasma sodium and CRP was observed (r = -0.32; p = 0.01). Plasma sodium did not correlate with extracellular water and was not different between patients with or without echocardiographic data of LV dysfunction (p = 0.7). During follow-up, patients with lower sodium at baseline showed persistently lower sodium values (p = 0.04), higher CRP (p = 0.05), lower serum albumin (p < 0.01) and higher erythropoietin-stimulating agent resistance index (p = 0.05). Conclusions:Our results suggest an association between lower plasma sodium and a microinflammatory state among patients with advanced CKD. Inflammation could be an underlying confounding factor explaining the increased mortality in these patients.© 2014 S. Karger AG, Basel

La patología glomerular más relacionada con enfermedad COVID-19 hasta la fecha parece ser la glomerulopatía colapsante, principalmente en pacientes de raza afroamericana y con alelos de riesgo para el gen APOL1. No obstante, en nuestra población, conformada por pacientes adultos mayores de raza caucásica, la patología más biopsiada desde el inicio de la pandemia ha sido la nefritis IgA o púrpura de Schönlein-Henoch.

IntroductionThe over 75 s make up 20% of our ED attendances. The greatest increase has been in the over 85 s. This very elderly cohort are more likely to be frail and are 10X more likely to require admission than 20–40 year olds and once in hospital have longer stays. There is evidence that multidisciplinary care and early Comprehensive Geriatric Assessment (CGA) improves outcomes for older patients, reducing readmissions, long term care, greater satisfaction and lower costs. The aim of this project was to improve the acute care provided to our older patients at the Front Door of the hospital.Methodology3 month pilot project underpinned by Big Room Quality Improvement methodology. The Frailty Big Room meets weekly and includes input from clinicians, QI experts and a data analyst. This project was driven by the following aims:Frailty Flying Squad to see as many older±frail patients referred for admission as close to the front door as possible.CGA at the front door with discharge planning from first reviewMDT approachExpedited discharge or transfer to other services from ED.Review following day to make sure management plans being followed through or discharge without ward teams having to become involved.Frailty Flying Squad Team:2 Medical Nurse PractitionersPhysiotherapistConsultant geriatricianKey Performance Indicators: Length of StayReadmission within 30 days of initial reviewResults355 patients were seen. 168 (47%) of patients were over 85 and the median Rockwood frailty score for the whole cohort was 6. 209 patients were ED referrals and 85 were GP referrals for admission. 237 (67%) patients were seen in ED, 49 in MAU and 7 in ED obs. During the pilot period, 97 patients who had been referred for admission were discharged direct from ED. 56 (16%) of patients had zero length of stay. A low number (9.4%) of patients were readmitted within 30 days.[Figure][Figure]ConclusionA multidisciplinary Acute Care of the Elderly Team predominantly based in the Emergency department can provide effective early Comprehensive Geriatric Assessment; facilitating discharge home from the Emergency Department, reducing length of stay for those admitted and reducing readmission rates within 30 days.