31 results on '"R Martínez-Gallardo"'
Search Results
2. Design and validation of cyanobacteria-rhizobacteria consortia for tomato seedlings growth promotion
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A. J. Toribio, F. Suárez-Estrella, M. M. Jurado, J. A. López-González, M. R. Martínez-Gallardo, and M. J. López
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Medicine ,Science - Abstract
Abstract The use of rhizobacteria provide great benefits in terms of nitrogen supply, suppression of plant diseases, or production of vitamins and phytohormones that stimulate the plant growth. At the same time, cyanobacteria can photosynthesize, fix nitrogen, synthesize substances that stimulate rhizogenesis, plant aerial growth, or even suppose an extra supply of carbon usable by heterotrophic bacteria, as well as act as biological control agents, give them an enormous value as plant growth promoters. The present study focused on the in vitro establishment of consortia using heterotrophic bacteria and cyanobacteria and the determination of their effectiveness in the development of tomato seedlings. Microbial collection was composed of 3 cyanobacteria (SAB-M612 and SAB-B866 belonging to Nostocaceae Family) and GS (unidentified cyanobacterium) and two phosphate and potassium solubilizing heterotrophic bacteria (Pseudomonas putida-BIO175 and Pantoea cypripedii-BIO175). The results revealed the influence of the culture medium, incubation time and the microbial components of each consortium in determining their success as biofertilizers. In this work, the most compatible consortia were obtained by combining the SAB-B866 and GS cyanobacteria with either of the two heterotrophic bacteria. Cyanobacteria GS promoted the growth of both rhizobacteria in vitro (increasing logarithmic units when they grew together). While Cyanobacteria SAB-B866 together with both rhizobacteria stimulated the growth of tomato seedlings in planta, leading to greater aerial development of the treated seedlings. Parameters such as fresh weight and stem diameter stood out in the plants treated with the consortia (SAB-B866 and both bacteria) compared to the untreated plants, where the values doubled. However, the increase was more discrete for the parameters stem length and number of leaves. These results suggest that the artificial formulation of microbial consortia can have positive synergistic effects on plant growth, which is of enormous agro-biotechnological interest.
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- 2022
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3. Biopriming of cucumber seeds using actinobacterial formulas as a novel protection strategy against Botrytis cinerea
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Macarena M. Jurado, Francisca Suárez-Estrella, Ana J. Toribio, María R. Martínez-Gallardo, María J. Estrella-González, Juan A. López-González, and María J. López
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actinobacteria ,biopriming ,phytostimulant ,biopesticide ,Botrytis cinerea ,Nutrition. Foods and food supply ,TX341-641 ,Food processing and manufacture ,TP368-456 - Abstract
This work highlights the ability of various actinobacterial formulas, to control the incidence of gray-mold caused by Botrytis cinerea in cucumber seedlings. Protocols applied aimed at the preliminary characterization of the actinobacterial collection and the biopolymers used as carriers were very useful for predicting their phytotoxic, phytostimulating and biopesticidal capacity. First, the phytostimulatory or phytotoxic potential of 3 biopolymers at 3 different concentrations and a collection of 10 actinobacteria were analyzed by calculating the germination index in cucumber seeds by seed dipping (biopriming). In general, two-member consortia and independent actinobacteria previously selected reached a phytostimulant effect on cucumber seedlings after their application by biopriming. Likewise, the selected actinobacteria were characterized, sole and in co-cultures, according to its ability to inhibit the growth of B. cinerea by dual culture bioassays. Finally, after selecting the most effective actinobacterial formulas, a preventive gray-mold bioassay was performed based on cucumber seed biopriming. The strains A5 and A7, in axenic and co-culture, showed to be the most efficient strains against the in vitro growth of B. cinerea. Seed biopriming strategy with actinobacterial formulas revealed a remarkable promoter effect in the early stages of plant development and after the infection with the phytopathogen fungus was remained. Definitely, the microbial formulas used in this work showed a phytostimulant and biopesticide character, laying the foundations for subsequent studies that allow a deeper scrutiny of the mechanisms of action that grant the specialization of the effect that occurs between beneficial microorganisms and specific plant hosts.
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- 2023
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4. Development of plastic-degrading microbial consortia by induced selection in microcosms
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Jesús Salinas, Víctor Carpena, María R. Martínez-Gallardo, Martín Segado, María J. Estrella-González, Ana J. Toribio, Macarena M. Jurado, Juan A. López-González, Francisca Suárez-Estrella, and María J. López
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biodegradation ,LLDPE ,microbial consortium ,microcosm ,microplastic ,plastic film ,Microbiology ,QR1-502 - Abstract
The increase in the production of highly recalcitrant plastic materials, and their accumulation in ecosystems, generates the need to investigate new sustainable strategies to reduce this type of pollution. Based on recent works, the use of microbial consortia could contribute to improving plastic biodegradation performance. This work deals with the selection and characterization of plastic-degrading microbial consortia using a sequential and induced enrichment technique from artificially contaminated microcosms. The microcosm consisted of a soil sample in which LLDPE (linear low-density polyethylene) was buried. Consortia were obtained from the initial sample by sequential enrichment in a culture medium with LLDPE-type plastic material (in film or powder format) as the sole carbon source. Enrichment cultures were incubated for 105 days with monthly transfer to fresh medium. The abundance and diversity of total bacteria and fungi were monitored. Like LLDPE, lignin is a very complex polymer, so its biodegradation is closely linked to that of some recalcitrant plastics. For this reason, counting of ligninolytic microorganisms from the different enrichments was also performed. Additionally, the consortium members were isolated, molecularly identified and enzymatically characterized. The results revealed a loss of microbial diversity at each culture transfer at the end of the induced selection process. The consortium selected from selective enrichment in cultures with LLDPE in powder form was more effective compared to the consortium selected in cultures with LLDPE in film form, resulting in a reduction of microplastic weight between 2.5 and 5.5%. Some members of the consortia showed a wide range of enzymatic activities related to the degradation of recalcitrant plastic polymers, with Pseudomonas aeruginosa REBP5 or Pseudomonas alloputida REBP7 strains standing out. The strains identified as Castellaniella denitrificans REBF6 and Debaryomyces hansenii RELF8 were also considered relevant members of the consortia although they showed more discrete enzymatic profiles. Other consortium members could collaborate in the prior degradation of additives accompanying the LLDPE polymer, facilitating the subsequent access of other real degraders of the plastic structure. Although preliminary, the microbial consortia selected in this work contribute to the current knowledge of the degradation of recalcitrant plastics of anthropogenic origin accumulated in natural environments.
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- 2023
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5. Characterization of Thermophilic Lignocellulolytic Microorganisms in Composting
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María J. López, Macarena M. Jurado, Juan A. López-González, María J. Estrella-González, María R. Martínez-Gallardo, Ana Toribio, and Francisca Suárez-Estrella
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culturome ,xylanase ,cellulase ,ligninases ,laccase ,lignin peroxidase ,Microbiology ,QR1-502 - Abstract
Composting involves the selection of a microbiota capable of resisting the high temperatures generated during the process and degrading the lignocellulose. A deep understanding of the thermophilic microbial community involved in such biotransformation is valuable to improve composting efficiency and to provide thermostable biomass-degrading enzymes for biorefinery. This study investigated the lignocellulose-degrading thermophilic microbial culturome at all the stages of plant waste composting, focusing on the dynamics, enzymes, and thermotolerance of each member of such a community. The results revealed that 58% of holocellulose (cellulose plus hemicellulose) and 7% of lignin were degraded at the end of composting. The whole fungal thermophilic population exhibited lignocellulose-degrading activity, whereas roughly 8–10% of thermophilic bacteria had this trait, although exclusively for hemicellulose degradation (xylan-degrading). Because of the prevalence of both groups, their enzymatic activity, and the wide spectrum of thermotolerance, they play a key role in the breakdown of hemicellulose during the entire process, whereas the degradation of cellulose and lignin is restricted to the activity of a few thermophilic fungi that persists at the end of the process. The xylanolytic bacterial isolates (159 strains) included mostly members of Firmicutes (96%) as well as a few representatives of Actinobacteria (2%) and Proteobacteria (2%). The most prevalent species were Bacillus licheniformis and Aeribacillus pallidus. Thermophilic fungi (27 strains) comprised only four species, namely Thermomyces lanuginosus, Talaromyces thermophilus, Aspergillus fumigatus, and Gibellulopsis nigrescens, of whom A. fumigatus and T. lanuginosus dominated. Several strains of the same species evolved distinctly at the stages of composting showing phenotypes with different thermotolerance and new enzyme expression, even not previously described for the species, as a response to the changing composting environment. Strains of Bacillus thermoamylovorans, Geobacillus thermodenitrificans, T. lanuginosus, and A. fumigatus exhibiting considerable enzyme activities were selected as potential candidates for the production of thermozymes. This study lays a foundation to further investigate the mechanisms of adaptation and acquisition of new traits among thermophilic lignocellulolytic microorganisms during composting as well as their potential utility in biotechnological processing.
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- 2021
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6. Effect of Upstream Bioactivation of Plant Residues to Accelerate the Composting Process and Improve Product Quality
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López, María R. Martínez-Gallardo, María J. Estrella-González, Francisca Suárez-Estrella, Juan A. López-González, Macarena M. Jurado, Ana J. Toribio, and María J.
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waste treatment ,lignocellulolytic consortium ,biological activation ,composting - Abstract
Composting is considered an efficient and environmentally friendly alternative for plant waste management, resulting in compost, a high value-added product. During the process, microorganisms play a crucial role as organic matter-degrading agents. However, the highly recalcitrant nature of the lignocellulose present in plant residues sets a challenge to the microorganisms involved in the process. Therefore, the objective of this study was to evaluate the effect of a lignocellulolytic microbial consortium, previously selected in composting processes, to promote and improve the biodegradability of plant residues. For this purpose, a laboratory-scale inoculation strategy was optimized by applying different strains and doses of Bacillus spp., as well as different incubation times. Subsequently, the impact of the application of the consortium on the waste material as a pretreatment of a real composting process was evaluated. Samples from both experiments were subjected to the evaluation of parameters related to the biodegradation of the lignocellulosic fraction, in addition to those related to the stability and maturity of a compost. The inoculum proved to be effective in promoting the bioactivation of the material, favoring a higher respirometric rate and biodegradability during laboratory-scale pretreatment. In this case, inoculation with B. safensis at high doses resulted in AT4 values higher than those observed for the rest of the treatments after ten days of incubation, while B. licheniformis inoculated at lower doses was able to maintain higher AT4 values after ten days, compared to those observed in the rest of the samples analyzed. Additionally, inoculation with both strains resulted in a continuous decrease in the percentage of hemicellulose that could be detected until the end of the incubation period (thirty days), reaching biodegradation rates close to 40%. On the other hand, although the inoculation did not significantly affect the basic conditioning parameters at the beginning of the composting process (organic matter, C/N ratio, and moisture), a change in the dynamics of the lignocellulosic fractions was observed during the process, as well as in the evolution of other stability and maturity parameters, in particular the AT4 index and the lignin/holocellulose ratio, revealing an acceleration of the bio-oxidative phase during the full-scale composting process. Therefore, the treatment of plant waste with lignocellulolytic microorganisms is proposed as an effective alternative to activate the biodegradability of organic waste at the beginning of a composting process, resulting in better-quality products.
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- 2023
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7. Seed priming by application of Microbacterium spp. strains for control of Botrytis cinerea and growth promotion of lettuce plants
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Francisca Suárez-Estrella, Macarena M. Jurado, Juan A. López-González, Ana Toribio, María R. Martínez-Gallardo, María J. Estrella-González, and María J. López
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Horticulture - Published
- 2023
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8. Profile of patients referred to the active rehabilitation unit in the health area of Soria (Spain)
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R. Martínez Gallardo, N. Palomar Ciria, B. Valiente Peña, and N. Hernandez Vicente
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Psychiatry and Mental health - Abstract
Introduction Realizamos un estudio prospectivo en 15 pacientes, diagnosticados de psicosis, según el DSM V, y que son usuarios de una Unidad de Rehabilitación activa, estos pacientes utilizan las modalidades de hospitalización residencial o el programa de hospitalización parcial. Objectives El objetivo principal fue establecer el perfil del paciente (retrato de robot), que utiliza este tipo de dispositivo. Methods Se lleva a cabo un protocolo de evaluación que incluye la entrevista de evaluación psicopatológica (DSMV) y las escalas: impulsividad (Barrat), agresividad (Burke), calidad de vida (Woqol bref ), actitud ante la medicación (DAI), Avd ( RAI), riesgo de suicidio (Plutchick), riesgo de caídas (Downton), funcionalidad (EEAG) y hábitos de consumo (DAU). Results Con todos estos elementos y teniendo en cuenta la edad y sexo de los pacientes, intentamos establecer el tipo de perfil de paciente del área de Rehabilitación activa de nuestro servicio, luego luego de mediciones periódicas de todas estas variables estableceremos la influencia de Terapia de rehabilitación en la mejora o empeoramiento de nuestros pacientes. Conclusions CONCLUSIONES El perfil de tipo del paciente incluido en una Unidad de Rehabilitación Activa está compuesto por un varón de 42 años, con consumo esporádico de toxinas, con rasgos de personalidad donde predomina la agresividad, con un perfil bajo de efectos adversos y con conciencia parcial de la enfermedad. y mala adherencia a la medicación Cabe señalar que sus niveles en la escala de calidad de vida son altos, incluso comparables o en ocasiones superiores a los de la población general según la escala Woqol bref. Disclosure No significant relationships.
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- 2022
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9. Application of sonicated extracts of cyanobacteria and microalgae for the mitigation of bacterial canker in tomato seedlings
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J.A. López-González, María J. López, M.M. Jurado, Maria R. Martínez-Gallardo, Francisca Suárez-Estrella, and A.J. Toribio
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0106 biological sciences ,2. Zero hunger ,Cyanobacteria ,0303 health sciences ,Nostoc ,biology ,Plant physiology ,Plant Science ,Aquatic Science ,biology.organism_classification ,01 natural sciences ,03 medical and health sciences ,Horticulture ,chemistry.chemical_compound ,chemistry ,Germination ,Bioassay ,Clavibacter michiganensis ,Scenedesmus ,Salicylic acid ,030304 developmental biology ,010606 plant biology & botany - Abstract
Microalgae and cyanobacteria could play an important role in crop protection, since they produce bioactive substances that promote plant growth and/or trigger the plant resistance mechanisms. The present study focuses on the control of bacterial canker caused byClavibacter michiganensissubsp.michiganensison tomato plants by using sonicated extracts from cyanobacteria and microalgae of the generaLeptolyngbya,Nostoc,Chlorella, andScenedesmus. For the development of this study, 8 strains were firstly tested for their capacity to inhibit the growth ofC. michiganensissubsp.michiganensisin vitro, as well as to produce cytokinins and salicylic acid. In order to discard those more phytotoxic strains, the germination index was also estimated in watercress seeds.Scenedesmus-677 andLeptolyngbya-1267 strains were selected in this first phase based on their pesticide and phytostimulant capacity in vitro. Subsequent bioassays on tomato seedlings showed that root application ofScenedesmus-677 could be more aimed at controlling the disease caused byC. michiganensissubsp.michiganensis, while foliar and root application ofLeptolyngbya-1267 seems to be more related to the strengthening of the plant through the salicylic acid route. These preliminary results could serve as the basis for a deeper characterization of the biopesticidal and biostimulant effect of both strains, as well as to reveal the benefits derived from the combination of both capacities.
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- 2021
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10. Microbial communities of the olive mill wastewater sludge stored in evaporation ponds: The resource for sustainable bioremediation
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Joaquín Moreno, J.A. López-González, Raúl Moral, María J. López, Francisca Suárez-Estrella, José Antonio López Sáez, Maria R. Martínez-Gallardo, M.M. Jurado, and Maria Dolores Perez‐Murcia
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Environmental Engineering ,0208 environmental biotechnology ,Industrial Waste ,02 engineering and technology ,Wastewater ,010501 environmental sciences ,Management, Monitoring, Policy and Law ,Waste Disposal, Fluid ,01 natural sciences ,Evaporation pond ,Bioremediation ,Olea ,Organic matter ,Ponds ,Olive Oil ,Waste Management and Disposal ,0105 earth and related environmental sciences ,chemistry.chemical_classification ,Sewage ,Microbiota ,General Medicine ,Biodegradation ,Contamination ,Pulp and paper industry ,020801 environmental engineering ,Biodegradation, Environmental ,chemistry ,Microbial population biology ,Environmental science ,Ecotoxicity - Abstract
Olive Mill Wastewater (OMW) is a polluting residue from the olive oil industry. It is usually stored in open-air unprotected evaporation ponds where their sediments accumulate. This study compares the characteristics of OMW sludges stored for long-time in evaporation ponds and assesses their impact on the underlying soil layer. Physicochemical parameters, toxicity bioassays, and full characterization of the microbial community were analyzed. The extension of the polluting effects was assessed by analysis of toxicity, microbial biomass carbon, and respiration. Geostatistics was used to predict their spatial distribution. Organic matter and polyphenol content besides toxicity levels determine variations between OMW sludges and have a high impact on the microbiota they contain. The microbial community was abundant, diverse, and functionally active. However, the biodegradability of the sludges was hindered by the toxicity levels. Toxicity and biomass carbon were higher on the surface of the ponds than in the soil layer revealing a reduced leach flow and depletion of contaminants. The natural microbiota might be biostimulated by means of applying sustainable and feasible biological treatments in order to favor the OMW sludges bioremediation. These results open up the possibility of solving the environmental concern caused by its storage in similar scenarios, which are common in olive oil-producing countries.
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- 2021
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11. Olive mill wastewater-evaporation ponds long term stored: Integrated assessment of in situ bioremediation strategies based on composting and vermicomposting
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Maria R. Martínez-Gallardo, Juan C. Sanchez-Hernandez, María Ángeles Bustamante, Raúl Moral, Joaquín Moreno, Francisco Javier Andreu-Rodríguez, María J. López, M.D. Pérez-Murcia, José Antonio López Sáez, and A. Vico
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Environmental Engineering ,Health, Toxicology and Mutagenesis ,0211 other engineering and technologies ,Industrial Waste ,02 engineering and technology ,In situ bioremediation ,Wastewater ,010501 environmental sciences ,engineering.material ,Waste Disposal, Fluid ,01 natural sciences ,Evaporation pond ,Olea ,Environmental Chemistry ,Ponds ,Olive Oil ,Waste Management and Disposal ,0105 earth and related environmental sciences ,021110 strategic, defence & security studies ,Compost ,Composting ,Human decontamination ,Pulp and paper industry ,Pollution ,Biodegradation, Environmental ,engineering ,Environmental science ,Phytotoxicity ,Ecotoxicity ,Vermicompost - Abstract
During the last two decades, the method most widely used to manage olive mill wastewater (OMW) derived from olive oil production has been its disposal in evaporation ponds. Long-term storage of OMW leads to the accumulation of toxic sediments (OMWS) rich in recalcitrant compounds with phytotoxic and antimicrobial properties, which limit their use for agronomic purpose. The aim of this study was to compare the effect of two in situ bioremediation strategies (composting and a combination of composting followed by vermicomposting) to remove the potential toxicity of the sediments derived from long-term stored OMW. The results obtained showed that the composting method assisted with the earthworms enhanced the depletion of phenolic compounds and OMWS ecotoxicity more than composting, especially during the maturation stage. Moreover, vermicomposting was more effective in the reduction of the OMWS salinity. However, a pre-composting process to the OMWS is necessary prior to vermicomposting to provide the suitable conditions for earthworms survival and activity. Furthermore, the final compost showed a phytostimulating effect. Therefore, these in situ bioremediation strategies can be considered potential tools for decontamination and recovery of long-term stored OMWS in evaporation ponds, which currently poses an unsolved environmental problem.
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- 2021
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12. Bioremediation of Olive Mill Wastewater sediments in evaporation ponds through in situ composting assisted by bioaugmentation
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Joaquín Moreno, José Antonio López Sáez, Raúl Moral, M.M. Jurado, María J. López, J.A. López-González, Maria R. Martínez-Gallardo, and Francisca Suárez-Estrella
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Bioaugmentation ,Environmental Engineering ,010504 meteorology & atmospheric sciences ,Microorganism ,Wastewater ,010501 environmental sciences ,engineering.material ,Waste Disposal, Fluid ,complex mixtures ,01 natural sciences ,Evaporation pond ,Bioremediation ,Olea ,Environmental Chemistry ,Waste Management and Disposal ,0105 earth and related environmental sciences ,Compost ,Composting ,fungi ,Pulp and paper industry ,Pollution ,Biodegradation, Environmental ,engineering ,Environmental science ,Phytotoxicity ,Ecotoxicity ,Water Pollutants, Chemical - Abstract
The common method for the disposal of olive oil mill wastewater (OMW) has been its accumulation in evaporation ponds where OMW sediments concentrate. Due to the phytotoxic and antimicrobial effect of OMW, leaks from ponds can pollute soils and water bodies. This work focuses on the search for microorganisms that can be used as inocula for bioremediation of polluted matrices in OMW ponds by means of in situ composting. Two fungi isolated from OMW sediments, Aspergillus ochraceus H2 and Scedosporium apiospermum H16, presented suitable capabilities for this use as a consortium. Composting eliminated the phyto- and ecotoxicity of OMW sediments by depleting their main toxic components. Inoculation with the fungal consortium improved the bioremediation efficacy of the technique by hastening the decrease of phytotoxicity and ecotoxicity and enhancing phytostimulant property of compost produced. This procedure constitutes a promising strategy for bioremediation of OMW polluted sites.
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- 2020
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13. Relationship between serum phosphorus and the progression of advanced chronic kidney disease
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F, Caravaca, J, Villa, E, García de Vinuesa, C, Martínez del Viejo, R, Martínez Gallardo, R, Macías, F, Ferreira, I, Cerezo, and R, Hernández-Gallego
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Male ,Confounding Factors, Epidemiologic ,Phosphorus ,Middle Aged ,Hyperphosphatemia ,Bicarbonates ,Calcitriol ,Parathyroid Hormone ,Predictive Value of Tests ,Chronic Disease ,Disease Progression ,Humans ,Calcium ,Female ,Kidney Diseases ,Prospective Studies ,Diuretics ,Biomarkers ,Aged ,Chelating Agents ,Follow-Up Studies ,Glomerular Filtration Rate - Abstract
High serum phosphorus (P) has been shown to be associated with a more rapid decline of renal function in patients with chronic kidney disease (CKD).The aim of this study was to determine whether time-averaged serum P levels are associated with the progression of renal failure adjusted for other potential confounders.A prospective observational study of 184 patients with pre-dialysis CKD, stages 3, 4 and 5 (mean GFR=15.2±5.6 ml/min/1.73 m2). The rate of decline in renal function was calculated as the slope of GFR. Median follow-up time was 303 days. Biochemical parameters were analysed as time-averaged concentrations. Multivariate linear regression analysis was used to assess the best determinants of serum P levels, and the relationship between the rate of decline of renal function and the study covariates.The best determinants of serum P levels were: GFR (beta = 0.477), female sex (beta = 0.106), serum calcium (beta = -0.274), serum albumin (beta = -0.112), serum bicarbonate (beta = -0.182), protein catabolic rate (beta = 0.144), and use of diuretics (beta = 0.180). The mean ± standard deviation (SD) slope of GFR was -0.198±0.376 ml/min/month. The best determinants of the slope of GFR were: proteinuria (beta = -0.462), serum P (beta = -0.440), and basal GFR (beta = -0.404). Total urinary P excretion was not significantly associated with the rate of decline of renal function.High serum P levels are strongly and independently associated with a more rapid decline of renal function in patients with advanced CKD.
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- 2011
14. Hydration status assessment by multi-frequency bioimpedance in patients with advanced chronic kidney disease
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F, Caravaca, C, Martínez del Viejo, J, Villa, R, Martínez Gallardo, and F, Ferreira
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Aged, 80 and over ,Male ,Dehydration ,Water-Electrolyte Imbalance ,Middle Aged ,Prognosis ,Cross-Sectional Studies ,Body Water ,Dielectric Spectroscopy ,Chronic Disease ,Hypertension ,Body Composition ,Edema ,Humans ,Kidney Failure, Chronic ,Female ,Kidney Diseases ,Aged ,Follow-Up Studies ,Proportional Hazards Models - Abstract
Body composition assessment has the potential to improve the care of patients with chronic kidney disease (CKD). Whole-body multiple-frequency bioimpedance spectroscopy (BIS) appears to be a useful and appropriate technique for assessing hydration status and body composition in CKD patients.The aims of this study were to determine the hydration status by BIS in patients with advanced CKD, and to analyse the association of body fluid status with common clinical and biochemical characteristics. The prognostic value of the phase angle at 50 KHz (PA) was also evaluated.The study group consisted of 175 patients (66 ± 14 year, 77 females) with eGFR40 ml/min not yet on dialysis. Body composition was assessed by BIS (BCM, Fresenius). Hydration status was expressed as a percentage of the total body water (TBW). Patients were prospectively followed-up for a median of 481 days, and the main determinants of mortality were estimated by Cox regression analysis.The majority of patients (85%) showed a hydration status within ± 5% TBW. Patients with oedemas or uncontrolled arterial hypertension showed mean estimate fluid overload significantly higher than that of the other study patients. Fluid overload was negatively associated with serum albumin levels, body mass index and urinary sodium/potassium ratio; and positively with male gender and diabetes. During the follow-up period, 16 patients died (9%). The main determinants of mortality adjusted for other potential covariates were: Davies comorbidity index (HR = 4.304; P = .001), and PA (per each °; HR = 0.491; P = .026).BIS may help identify changes in hydration status in CKD patients not fully appreciated by clinical or biochemical assessment. PA was a significant predictor of mortality in these patients.
- Published
- 2011
15. [Insulin resistance in chronic kidney disease: its clinical characteristics and prognosis significance]
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F, Caravaca, I, Cerezo, R, Macías, E, García de Vinuesa, C, Martínez del Viejo, J, Villa, R, Martínez Gallardo, F, Ferreira, and R, Hernández-Gallego
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Male ,Comorbidity ,Kaplan-Meier Estimate ,Middle Aged ,Prognosis ,Pulmonary Disease, Chronic Obstructive ,Cardiovascular Diseases ,Neoplasms ,Chronic Disease ,Disease Progression ,Homeostasis ,Humans ,Female ,Kidney Diseases ,Prospective Studies ,Insulin Resistance ,Aged ,Glomerular Filtration Rate ,Proportional Hazards Models - Abstract
Insulin resistance (IR) increases significantly the risk for cardiovascular disease (CV) in the general population. IR is a common metabolic disorder in patients with chronic kidney disease (CKD). However, the influence of IR on the evolution of CKD patients has scarcely been studied.This study aims to determine whether IR is associated with the progression of CKD, the development of new CV events, or all-cause mortality of non-diabetic patients with CKD stage 4 or 5 not yet on dialysis.The study group consisted of 365 non-diabetic patients (63 ± 16 year, 169 females) with GFR30 ml/min. The degree of IR was estimated by the Homeostasis Model Assessment parameter (HOMA). The outcome measures were: progression of CKD (composite of initiation of dialysis or doubling of baseline serum creatinine level), new cardiovascular events, and all-cause mortality. Unadjusted and multivariable-adjusted relative risks were calculated for HOMA either as a continuous or qualitative variable (tertiles), using Cox proportional hazards models.Mean HOMA value (± SD) was 4.28 ± 2.07. HOMA values correlated significantly with body mass index (beta = 0.37; p0.0001), plasma triglycerides (beta = 0.22; p0.0001), plasma albumin (beta = 0.19; p = 0.007), and serum phosphate (beta = 0.17; p = 0.031). Progression of CKD was observed in 234 patients (64%) with a median follow-up of 542 days. Patients with HOMA values in the lower tertile (3.13) showed a slower progression of CKD than that of the rest of study patients (log rank 4.16, p0.05). In adjusted models for age, sex, baseline GFR, body mass index, and proteinuria, HOMA values in the lower tertile entered as an independent variable in the best predictive equation for progression of CKD (HR 0.72, p0.03). Fifty-one patients developed a new CV event and 103 patients died during the study period (median follow-up of 1,103 days). HOMA did not relate to the development of new CV events or all-cause mortality in unadjusted or adjusted models for age, sex, comorbid index, plasma albumin, and C-reactive protein.In conclusion, progression of renal disease was slower in those non-diabetic CKD patients with low HOMA values; however, HOMA values did not relate to the development of new CV events or all-cause mortality.
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- 2010
16. PRIMER REGISTRO DE Eumops perotis (CHIROPTERA: MOLOSSIDAE) EN LA PENÍNSULA DE BAJA CALIFORNIA
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R Martínez-Gallardo, AA Guevara-Carrizales, R Couoh-de la Garza, and E Flores-Rojas
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Eumops perotis ,nuevo registro ,Agrociencias ,Baja California - Abstract
Un espécimen de Eumops perotis se recolectó en Sierra Juárez, Baja California, México. Este registro representa el primero de esta especie para el estado y para la península de Baja California.
- Published
- 2008
17. [Neuropsychological sequelae of deportation to the Nazi concentration camps during the Second World War]
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F, Abalan, R, Martínez-Gallardo, and M, Bourgeois
- Subjects
Stress Disorders, Post-Traumatic ,Warfare ,Survival ,Germany ,Jews ,Prisons ,Concentration Camps ,Humans ,History, 20th Century - Abstract
The essential neuropsychic consequences of the deportation to the nazi concentration camps of adults during the second world war are the "KZ syndrome", the survival syndrome (or persecution syndrome) and reactive schizophrenias. The "KZ syndrome" puts together a psychic asthenia, a progressive intellectual deterioration, anxiety, depressive mood and vegetative disturbances. It is brought about as a consequence of malnutrition and the psychic traumas suffered by those deported. It shows up mainly in the non-jewish deported. The survival syndrome is chronic, puts together anxiety, insomnia and nightmares, repetitive memories relative to the period of persecution, depressive symptoms, somatic complaints, neurovegetative disturbances and hypervigilance. It is observed mainly in those deported that are jewish. It is produced as a consequence of very severe psychic traumas suffered by the jewish deportees. Some reactive schizophrenias described in deported jews seem to be the direct consequence of psychic traumas of an extreme intensity.
- Published
- 1989
18. [Neuropsychic sequelae of deportation to Nazi concentration camps during the Second World War]
- Author
-
F, Abalán, R, Martínez-Gallardo, and M, Bourgeois
- Subjects
Stress Disorders, Post-Traumatic ,Adjustment Disorders ,Warfare ,Political Systems ,Prisons ,Concentration Camps ,Humans ,History, 20th Century - Abstract
The main neuropsychic sequelae in adults of deportation to World War II nazi concentration camps: KZ syndrome, survivor syndrome-persecution syndrome and psychogenic schizophrenia, are described. Functional, organic and psychogenic etiologic conceptions of these syndromes are presented. An interpretation of these sequelae is proposed.
- Published
- 1989
19. Recurrence of immune complex and complement-mediated membranoproliferative glomerulonephritis in kidney transplantation.
- Author
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Caravaca-Fontán F, Polanco N, Villacorta B, Buxeda A, Coca A, Ávila A, Martínez-Gallardo R, Galeano C, Valero R, Ramos N, Allende N, Cruzado-Vega L, Pérez-Sáez MJ, Sevillano Á, González E, Hernández A, Rodrigo E, Fernández-Ruiz M, Aguado JM, Pérez Valdivia MÁ, Pascuall J, Andrés A, and Praga M
- Subjects
- Humans, Antigen-Antibody Complex, Complement System Proteins, Recurrence, Retrospective Studies, Glomerulonephritis complications, Glomerulonephritis, Membranoproliferative, Kidney Failure, Chronic therapy, Kidney Transplantation
- Abstract
Introduction: Membranoproliferative glomerulonephritis (MPGN) represents a histologic pattern of glomerular injury that may be due to several aetiologies. Few studies have comprehensively analysed the recurrence of MPGN according to the current classification system., Methods: We collected a multicentre, retrospective cohort of 220 kidney graft recipients with biopsy-proven native kidney disease due to MPGN between 1981 and 2021 in 11 hospitals. Demographic, clinical and histologic parameters of prognostic interest were collected. The main outcomes were time to kidney failure, time to recurrence of MPGN and disease remission after recurrence., Results: The study group included 34 complement-mediated and 186 immune complex-mediated MPGN. A total of 81 patients (37%) reached kidney failure in a median follow-up of 79 months. The main predictors of this event were the development of rejection episodes and disease recurrence. In all, 54 patients (25%) had a disease recurrence in a median of 16 months after kidney transplantation. The incidence of recurrence was higher in patients with dysproteinaemia (67%) and complement-mediated MPGN (62%). In the multivariable model, complement-mediated MPGN emerged as a predictor of recurrence. A total of 33 patients reached kidney failure after recurrence. The main determinants of no remission were early time to recurrence (<15 months), estimated glomerular filtration rate <30 mL/min/1.73 m2 and serum albumin <3.5 g/dL at the time of recurrence., Conclusions: One-fourth of the patients with native kidney disease due to MPGN developed clinical recurrence in the allograft, especially in cases with complement-mediated disease or in those associated with dysproteinaemia. The kidney outcomes of disease recurrence with currently available therapies are heterogeneous and thus more effective and individualized therapies are needed., (© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.)
- Published
- 2023
- Full Text
- View/download PDF
20. Anti-Glutathione S Transferase T1 Antibodies After Renal Transplant and Their Impact on Graft Outcome.
- Author
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Valencia Pereira R, Barroso Hernández S, Vázquez Araújo MB, Hernández Gallego R, Martínez Gallardo R, and Vargas Pérez ML
- Subjects
- Humans, Cohort Studies, Treatment Outcome, Tissue Donors, Kidney, Antibodies, Kidney Transplantation adverse effects
- Abstract
Objectives: Anti-glutathione S transferase T1 (GSTT1) antibodies, a type of non-HLA antibody, have been associated with chronic hepatic graft rejection. Despite the presence of this enzyme in the kidney, there are not enough studies on the development of anti-GSTT1 antibodies and their impact on renal grafts. Our objective was to evaluate the presence of anti-GSTT1 antibodies after renal transplant and their impact on graft outcomes., Materials and Methods: We conducted an ambispective cohort study. We performed real-time polymerase chain reaction to screen for GSTT1 alleles in 293 recipients and their donors. In null GSTT1 (GSTT1*0) genotype recipients of GSTT1-positive donors, the presence of anti-GSTT1 antibodies was evaluated using indirect immunofluorescence and Luminex assays, and their effects on graft function were evaluated. The median follow-up period was 54.3 months., Results: Of the 293 patients studied, 42 recipients (14.4%) with GSTT1-positive donors did not have the GSTT1 allele (GSTT1-positive donor/GSTT1*0 recipient). Using Luminex assay, we detected antibodies in 16 patients (38.1%), 12 of which were already present at the time of transplant. Of these cases, 37.5% with antibodies had undergone a previous renal transplant. Using indirect immunofluorescence, we found that only 12 patients tested positive, 4 at the time of transplant. Antibody presence did not effect graft glomerular filtration rates or graft loss at 1 year, at 2 years, or end of follow-up., Conclusions: The presence of anti-GSTT1 antibodies is frequent in renal transplant GSTT1*0 recipients of GSTT1-positive donors but has no effects on graft outcome.
- Published
- 2022
- Full Text
- View/download PDF
21. Successful treatment of invasive aspergillosis caused by Aspergillus parafelis in a kidney transplant recipient.
- Author
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Calvo-Cano A, Garduño-Eseverri E, Alastruey-Izquierdo A, Hernández-Gallego R, Martínez-Gallardo R, and Rodríguez-Vidigal FF
- Abstract
Invasive aspergillosis (IA) is associated with a high mortality rate in kidney-transplant recipients. Azole-resistance is increasing in Aspergillus fumigatus . We report a clinical case of a kidney-transplant recipient with cerebellar and pulmonary aspergillosis caused by azole-resistant Aspergillus parafelis (molecular identification through β-tubulin sequence). The patient experienced an effective resolution after three surgical procedures and associated antifungal therapy. This case highlights that azole-resistant aspergillosis should be considered in every patient with IA as long as susceptibility testing results are not known. Therefore, in selected patients with IA and central nervous system involvement, empirical combination antifungal therapy could be considered., Competing Interests: There are none., (© 2020 The Authors. Published by Elsevier B.V. on behalf of International Society for Human and Animal Mycology.)
- Published
- 2020
- Full Text
- View/download PDF
22. Schizophrenia and COVID-19 delirium.
- Author
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Palomar-Ciria N, Blanco Del Valle P, Hernández-Las Heras MÁ, and Martínez-Gallardo R
- Subjects
- Aged, COVID-19, Coronavirus Infections virology, Humans, Male, Pandemics, Pneumonia, Viral virology, SARS-CoV-2, Betacoronavirus, Coronavirus Infections psychology, Delirium virology, Pneumonia, Viral psychology, Schizophrenia virology
- Abstract
Since its outbreak, coronavirus disease 2019 has been producing atypical manifestations aside from fever, coughing and dysnea. One of the most common is delirium, which, however, is highly overlooked. This has consequences in the treatment of patients and also may lead to underdiagnosing the infection. In this work, we present the case of a man diagnosed with schizophrenia, who had been stable for more than 20 years and that presented with an atypical picture of psychotic and confusional symptoms related to COVID-19 infection., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
23. Severe and malignant hypertension are common in primary atypical hemolytic uremic syndrome.
- Author
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Cavero T, Arjona E, Soto K, Caravaca-Fontán F, Rabasco C, Bravo L, de la Cerda F, Martín N, Blasco M, Ávila A, Huerta A, Cabello V, Jarque A, Alcázar C, Fulladosa X, Carbayo J, Anaya S, Cobelo C, Ramos N, Iglesias E, Baltar J, Martínez-Gallardo R, Pérez L, Morales E, González R, Macía M, Draibe J, Pallardó L, Quintana LF, Espinosa M, Barros X, Pereira F, Cao M, Moreno JA, Rodríguez de Córdoba S, and Praga M
- Subjects
- Adult, Antibodies, Monoclonal, Humanized therapeutic use, Atypical Hemolytic Uremic Syndrome genetics, Atypical Hemolytic Uremic Syndrome therapy, Complement Inactivating Agents therapeutic use, Female, Humans, Hypertension, Malignant diagnosis, Hypertension, Malignant genetics, Hypertension, Malignant therapy, Incidence, Male, Middle Aged, Plasmapheresis, Retrospective Studies, Young Adult, Atypical Hemolytic Uremic Syndrome complications, Complement System Proteins genetics, Hypertension, Malignant epidemiology, Severity of Illness Index
- Abstract
Malignant hypertension is listed among the causes of secondary thrombotic microangiopathy, but pathogenic mutations in complement genes have been reported in patients with hypertension-induced thrombotic microangiopathy. Here we investigated the frequency and severity of hypertension in 55 patients with primary atypical hemolytic uremic syndrome (aHUS). A genetic analysis was performed in all patients, and funduscopic examination was performed in all the patients with Grades 2 and 3 hypertension. A cohort of 110 patients with malignant hypertension caused by diseases other than aHUS served as control. Thirty-six patients with aHUS presented Grade 2 or Grade 3 hypertension and funduscopic examination showed malignant hypertension in 19. Genetic abnormalities in complement were found in 19 patients (37% among patients with malignant hypertension). Plasmapheresis was performed in 46 patients and 26 received eculizumab. Renal and hematological responses were significantly lower after plasmapheresis (24%) than after eculizumab (81%). Renal survival was significantly higher in patients treated with eculizumab (85% at one, three and five years) compared to patients who did not receive this treatment (54%, 46% and 41%), respectively. Response to eculizumab was independent of hypertension severity and the presence of complement genetic abnormalities. Among patients with malignant hypertension caused by other diseases the prevalence of thrombotic microangiopathy was very low (5%). Thus, severe and malignant hypertension are common among patients with aHUS and eculizumab treatment leads to a higher renal survival when compared to plasmapheresis. However, thrombotic microangiopathy is uncommon among patients presenting with malignant hypertension caused by diseases other than aHUS., (Copyright © 2019 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
24. During the pre-dialysis stage of chronic kidney disease, which treatment is associated with better survival in dialysis?
- Author
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Caravaca F, Alvarado R, García-Pino G, Martínez-Gallardo R, and Luna E
- Subjects
- Disease Progression, Female, Humans, Male, Middle Aged, Prospective Studies, Survival Analysis, Survival Rate, Renal Dialysis, Renal Insufficiency, Chronic mortality, Renal Insufficiency, Chronic therapy
- Abstract
Introduction: Specialised care of patients in advanced stages of chronic kidney disease (CKD) is associated with better survival in dialysis, but it is not known which treatments specifically favour this outcome., Objectives: To analyse normal treatment in advanced stages of CKD and establish which treatments are associated with better survival in dialysis as well as their relationship with causes of death., Material and Method: Cohort, prospective observational study of 591 patients who started dialysis (491 haemodialysis and 100 peritoneal dialysis), who had previously been monitored in the CKD clinic. The treatments analysed were: antihypertensive treatments, statins, antiplatelet drugs, xanthine oxidase inhibitors, correction of metabolic acidosis, treatment with (calcium or non-calcium) phosphate binders, vitamin D (calcitriol or paricalcitol), erythropoietin and the availability of an internal arteriovenous fistula (IAVF). The independent association of each of these treatments with mortality in dialysis was analysed using Cox regression models adjusted for age, sex, pre-dialysis monitoring time, renal function at the start of dialysis, comorbidity, serum albumin and C-reactive protein, and with stratification of the type of dialysis., Results: With a median follow-up period of 28 months, the total number of patients who died was 191 (32%). In the multivariate models, we observed that, in addition to age, the comorbidity index, serum albumin, pre-dialysis treatment with angiotensin-converting-enzyme inhibitors and/or angiotensin receptor blockers, correction of acidosis with sodium bicarbonate and IAVF at the start of haemodialysis were significantly associated with better survival in dialysis. We did not observe differences in causes of death between the different treatments analysed., Conclusion: These results suggest a potential delayed benefit of some treatments in pre-dialysis stages on the outcome of dialysis. Furthermore, beginning dialysis without an IAVF, resulting in the need for intravenous catheters, worsens prognosis in these patients.
- Published
- 2014
- Full Text
- View/download PDF
25. Increased serum phosphate concentrations in patients with advanced chronic kidney disease treated with diuretics.
- Author
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Caravaca F, García-Pino G, Martínez-Gallardo R, Ferreira-Morong F, Luna E, Alvarado R, Ruiz-Donoso E, and Chávez E
- Subjects
- Aged, Cross-Sectional Studies, Disease Progression, Female, Humans, Male, Diuretics therapeutic use, Phosphates blood, Renal Insufficiency, Chronic blood, Renal Insufficiency, Chronic drug therapy
- Abstract
Background: Serum phosphate concentrations usually show great variability in patients with advanced chronic kidney disease (ACKD) not on dialysis. Diuretics treatment can have an influence over the severity of mineral-bone metabolism alterations related to ACKD, but their effect on serum phosphate levels is less known., Objectives: This study aims to determine whether diuretics are independently associated with serum phosphate levels, and to investigate the mechanisms by which diuretics may affect phosphate metabolism., Material and Method: 429 Caucasian patients with CKD not on dialysis were included in this cross-sectional study. In addition to conventional serum biochemical measures, the following parameters of renal phosphate excretion were assessed: 24-hours urinary phosphate excretion, tubular maximum phosphate reabsorption (TmP), and fractional excretion of phosphate (FEP)., Results: 58% of patients were on treatment with diuretics. Patients on diuretics showed significantly higher mean serum phosphate concentration (4.78 ± 1.23 vs. 4.24 ± 1.04 mg/dl; P<.0001), and higher TmP per GFR (2.77 ± 0.72 vs. 2.43 ± 0.78 mg/dl; P<.0001) than those not treated with diuretics. By multivariate linear and logistic regression, significant associations between diuretics and serum phosphate concentrations or hyperphosphataemia remained after adjustment for potential confounding variables. In patients with the highest phosphate load adjusted to kidney function, those treated with diuretics showed significantly lower FEP than those untreated with diuretics., Conclusions: Treatment with diuretics is associated with increased serum phosphate concentrations in patients with ACKD. Diuretics may indirectly interfere with the maximum renal compensatory capacity to excrete phosphate. Diuretics should be considered in the studies linking the relationship between serum phosphate concentrations and cardiovascular alterations in patients with CKD.
- Published
- 2013
- Full Text
- View/download PDF
26. Congestive heart failure in patients with advanced chronic kidney disease: association with pre-emptive vascular access placement.
- Author
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Martínez-Gallardo R, Ferreira-Morong F, García-Pino G, Cerezo-Arias I, Hernández-Gallego R, and Caravaca F
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Prospective Studies, Arteriovenous Shunt, Surgical adverse effects, Heart Failure etiology, Kidney Failure, Chronic therapy
- Abstract
Introduction: Congestive heart failure (CHF) is a common complication in patients with chronic kidney disease (CKD). In addition to classical risk factors (e.g. age and pre-existing cardiac diseases), other potential reversible abnormalities linked to CKD such as anaemia, volume overload, or vascular access placement may also influence the incidence and severity of acute exacerbations of CHF., Objective: This study aims to determine the incidence and main determinants of CHF in a cohort of patients with stage 4-5 pre-dialysis CKD., Patients and Method: The study group consisted of 562 patients (mean age: 65 +/- 15 years, 260 females, 31% diabetics). Native arteriovenous fistulas (AVF) were created in 160 patients who chose haemodialysis as the initial technique for renal replacement therapy. The main outcome variables were: acute decompensated CHF (defined by standard criteria), dialysis initiation (planned and unplanned), and death before dialysis initiation. In addition to demographics, comorbidities, and clinical and biochemical data, AVF creation was also included as a potential determinant of CHF in multiple logistic regression models., Results: Ninety-five patients (17%) developed at least one episode of acute decompensated CHF, and the incidence rate was 19 episodes per 1000 patient-years. In addition to classical risk factors (age, female sex, obesity, diabetes, and previous history of CHF or coronary artery disease), creation of a successful AVF significantly increased the risk of CHF (OR=9.54, 95% CI: 4.84-18.81, P<.0001). In 47 out of 95 patients who developed CHF, a functioning AVF had previously been created, 92% of which were upper arm native AVF, with a median of 51 days between the surgical procedure and CHF episode. The mortality of patients with CHF was similar to that of the rest of the study patients, although unplanned dialysis initiation was significantly more frequent in those who developed CHF., Conclusions: Acute decompensated CHF episodes are common in pre-dialysis CKD patients. In addition to classical risk factors, pre-emptive AVF placement was strongly associated with the development of CHF.
- Published
- 2012
- Full Text
- View/download PDF
27. Hydration status assessment by multi-frequency bioimpedance in patients with advanced chronic kidney disease.
- Author
-
Caravaca F, Martínez del Viejo C, Villa J, Martínez Gallardo R, and Ferreira F
- Subjects
- Aged, Aged, 80 and over, Chronic Disease, Cross-Sectional Studies, Dehydration diagnosis, Dehydration etiology, Edema diagnosis, Edema etiology, Female, Follow-Up Studies, Humans, Hypertension complications, Kidney Diseases therapy, Kidney Failure, Chronic metabolism, Kidney Failure, Chronic mortality, Kidney Failure, Chronic therapy, Male, Middle Aged, Prognosis, Proportional Hazards Models, Water-Electrolyte Imbalance diagnosis, Water-Electrolyte Imbalance etiology, Body Composition, Body Water metabolism, Dielectric Spectroscopy methods, Kidney Diseases metabolism
- Abstract
Introduction: Body composition assessment has the potential to improve the care of patients with chronic kidney disease (CKD). Whole-body multiple-frequency bioimpedance spectroscopy (BIS) appears to be a useful and appropriate technique for assessing hydration status and body composition in CKD patients., Objective: The aims of this study were to determine the hydration status by BIS in patients with advanced CKD, and to analyse the association of body fluid status with common clinical and biochemical characteristics. The prognostic value of the phase angle at 50 KHz (PA) was also evaluated., Patients and Methods: The study group consisted of 175 patients (66 ± 14 year, 77 females) with eGFR < 40 ml/min not yet on dialysis. Body composition was assessed by BIS (BCM, Fresenius). Hydration status was expressed as a percentage of the total body water (TBW). Patients were prospectively followed-up for a median of 481 days, and the main determinants of mortality were estimated by Cox regression analysis., Results: The majority of patients (85%) showed a hydration status within ± 5% TBW. Patients with oedemas or uncontrolled arterial hypertension showed mean estimate fluid overload significantly higher than that of the other study patients. Fluid overload was negatively associated with serum albumin levels, body mass index and urinary sodium/potassium ratio; and positively with male gender and diabetes. During the follow-up period, 16 patients died (9%). The main determinants of mortality adjusted for other potential covariates were: Davies comorbidity index (HR = 4.304; P = .001), and PA (per each °; HR = 0.491; P = .026)., Conclusions: BIS may help identify changes in hydration status in CKD patients not fully appreciated by clinical or biochemical assessment. PA was a significant predictor of mortality in these patients.
- Published
- 2011
- Full Text
- View/download PDF
28. Relationship between serum phosphorus and the progression of advanced chronic kidney disease.
- Author
-
Caravaca F, Villa J, García de Vinuesa E, Martínez del Viejo C, Martínez Gallardo R, Macías R, Ferreira F, Cerezo I, and Hernández-Gallego R
- Subjects
- Aged, Bicarbonates blood, Biomarkers, Calcitriol therapeutic use, Calcium metabolism, Chelating Agents, Chronic Disease, Confounding Factors, Epidemiologic, Disease Progression, Diuretics therapeutic use, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Hyperphosphatemia epidemiology, Kidney Diseases complications, Kidney Diseases drug therapy, Male, Middle Aged, Parathyroid Hormone blood, Predictive Value of Tests, Prospective Studies, Hyperphosphatemia etiology, Kidney Diseases blood, Phosphorus blood
- Abstract
Introduction: High serum phosphorus (P) has been shown to be associated with a more rapid decline of renal function in patients with chronic kidney disease (CKD)., Objective: The aim of this study was to determine whether time-averaged serum P levels are associated with the progression of renal failure adjusted for other potential confounders., Patients and Methods: A prospective observational study of 184 patients with pre-dialysis CKD, stages 3, 4 and 5 (mean GFR=15.2±5.6 ml/min/1.73 m2). The rate of decline in renal function was calculated as the slope of GFR. Median follow-up time was 303 days. Biochemical parameters were analysed as time-averaged concentrations. Multivariate linear regression analysis was used to assess the best determinants of serum P levels, and the relationship between the rate of decline of renal function and the study covariates., Results: The best determinants of serum P levels were: GFR (beta = 0.477), female sex (beta = 0.106), serum calcium (beta = -0.274), serum albumin (beta = -0.112), serum bicarbonate (beta = -0.182), protein catabolic rate (beta = 0.144), and use of diuretics (beta = 0.180). The mean ± standard deviation (SD) slope of GFR was -0.198±0.376 ml/min/month. The best determinants of the slope of GFR were: proteinuria (beta = -0.462), serum P (beta = -0.440), and basal GFR (beta = -0.404). Total urinary P excretion was not significantly associated with the rate of decline of renal function., Conclusion: High serum P levels are strongly and independently associated with a more rapid decline of renal function in patients with advanced CKD.
- Published
- 2011
- Full Text
- View/download PDF
29. [Insulin resistance in chronic kidney disease: its clinical characteristics and prognosis significance].
- Author
-
Caravaca F, Cerezo I, Macías R, García de Vinuesa E, Martínez del Viejo C, Villa J, Martínez Gallardo R, Ferreira F, and Hernández-Gallego R
- Subjects
- Aged, Cardiovascular Diseases epidemiology, Chronic Disease, Comorbidity, Disease Progression, Female, Glomerular Filtration Rate, Homeostasis, Humans, Kaplan-Meier Estimate, Kidney Diseases mortality, Male, Middle Aged, Neoplasms epidemiology, Prognosis, Proportional Hazards Models, Prospective Studies, Pulmonary Disease, Chronic Obstructive epidemiology, Insulin Resistance, Kidney Diseases metabolism
- Abstract
Introduction: Insulin resistance (IR) increases significantly the risk for cardiovascular disease (CV) in the general population. IR is a common metabolic disorder in patients with chronic kidney disease (CKD). However, the influence of IR on the evolution of CKD patients has scarcely been studied., Objective: This study aims to determine whether IR is associated with the progression of CKD, the development of new CV events, or all-cause mortality of non-diabetic patients with CKD stage 4 or 5 not yet on dialysis., Material and Methods: The study group consisted of 365 non-diabetic patients (63 ± 16 year, 169 females) with GFR < 30 ml/min. The degree of IR was estimated by the Homeostasis Model Assessment parameter (HOMA). The outcome measures were: progression of CKD (composite of initiation of dialysis or doubling of baseline serum creatinine level), new cardiovascular events, and all-cause mortality. Unadjusted and multivariable-adjusted relative risks were calculated for HOMA either as a continuous or qualitative variable (tertiles), using Cox proportional hazards models., Results: Mean HOMA value (± SD) was 4.28 ± 2.07. HOMA values correlated significantly with body mass index (beta = 0.37; p < 0.0001), plasma triglycerides (beta = 0.22; p < 0.0001), plasma albumin (beta = 0.19; p = 0.007), and serum phosphate (beta = 0.17; p = 0.031). Progression of CKD was observed in 234 patients (64%) with a median follow-up of 542 days. Patients with HOMA values in the lower tertile (< 3.13) showed a slower progression of CKD than that of the rest of study patients (log rank 4.16, p < 0.05). In adjusted models for age, sex, baseline GFR, body mass index, and proteinuria, HOMA values in the lower tertile entered as an independent variable in the best predictive equation for progression of CKD (HR 0.72, p < 0.03). Fifty-one patients developed a new CV event and 103 patients died during the study period (median follow-up of 1,103 days). HOMA did not relate to the development of new CV events or all-cause mortality in unadjusted or adjusted models for age, sex, comorbid index, plasma albumin, and C-reactive protein., Conclusions: In conclusion, progression of renal disease was slower in those non-diabetic CKD patients with low HOMA values; however, HOMA values did not relate to the development of new CV events or all-cause mortality.
- Published
- 2010
- Full Text
- View/download PDF
30. [Neuropsychic sequelae of deportation to Nazi concentration camps during the Second World War].
- Author
-
Abalán F, Martínez-Gallardo R, and Bourgeois M
- Subjects
- History, 20th Century, Humans, Political Systems, Warfare, Adjustment Disorders psychology, Concentration Camps, Prisons, Stress Disorders, Post-Traumatic psychology
- Abstract
The main neuropsychic sequelae in adults of deportation to World War II nazi concentration camps: KZ syndrome, survivor syndrome-persecution syndrome and psychogenic schizophrenia, are described. Functional, organic and psychogenic etiologic conceptions of these syndromes are presented. An interpretation of these sequelae is proposed.
- Published
- 1989
31. [Neuropsychological sequelae of deportation to the Nazi concentration camps during the Second World War].
- Author
-
Abalan F, Martínez-Gallardo R, and Bourgeois M
- Subjects
- Germany, History, 20th Century, Humans, Jews, Stress Disorders, Post-Traumatic psychology, Survival, Concentration Camps, Prisons, Stress Disorders, Post-Traumatic etiology, Warfare
- Abstract
The essential neuropsychic consequences of the deportation to the nazi concentration camps of adults during the second world war are the "KZ syndrome", the survival syndrome (or persecution syndrome) and reactive schizophrenias. The "KZ syndrome" puts together a psychic asthenia, a progressive intellectual deterioration, anxiety, depressive mood and vegetative disturbances. It is brought about as a consequence of malnutrition and the psychic traumas suffered by those deported. It shows up mainly in the non-jewish deported. The survival syndrome is chronic, puts together anxiety, insomnia and nightmares, repetitive memories relative to the period of persecution, depressive symptoms, somatic complaints, neurovegetative disturbances and hypervigilance. It is observed mainly in those deported that are jewish. It is produced as a consequence of very severe psychic traumas suffered by the jewish deportees. Some reactive schizophrenias described in deported jews seem to be the direct consequence of psychic traumas of an extreme intensity.
- Published
- 1989
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