Mortality in hemodialysis patients with COVID-19, the effect of paricalcitol or calcimimetics

BACKGROUND: In COVID-19 patients, low serum vitamin D (VD) levels have been associated with severe acute respiratory failure and poor prognosis. In regular hemodialysis (HD) patients, there is VD deficiency and markedly reduced calcitriol levels, which may predispose them to worse outcomes of COVID-19 infection. Some hemodialysis patients receive treatment with drugs for secondary hyperparathyroidism, which have well known pleiotropic effects beyond mineral metabolism. The aim of this study was to evaluate the impact of VD status and the administration of active vitamin D medications, used to treat secondary hyperparathyroidism, on survival in a cohort of COVID-19 positive HD patients. METHODS: A cross-sectional retrospective observational study was conducted from 12 March to 21 May 2020 in 288 HD patients with positive PCR for SARS-CoV2. Patients were from 52 different centers in Spain. RESULTS: The percent of HD patients with COVID-19 was 6.1% (288 out of 4743). Mortality rate was 28.4% (81/285). Three patients were lost to follow-up. Serum 25(OH)D (calcidiol) level was 17.1 [10.6-27.5] ng/mL and was not significantly associated to mortality (OR 0.99 (0.97-1.01), CONCLUSIONS: Our findings suggest that the use of paricalcitol, calcimimetics or the combination of both, seem to be associated with the improvement of survival in HD patients with COVID-19. No correlation was found between serum VD levels and prognosis or outcomes in HD patients with COVID-19. Prospective studies and clinical trials are needed to support these findings

Phosphorus binders: preferences of patients on hemodialysis and its impact on treatment compliance and phosphorus control

Introducción: En la actualidad disponemos de un amplio abanico de captores del fósforo (CF), pero sabemos poco acerca de las preferencias de los pacientes y de su repercusión sobre el cumplimiento del tratamiento y el control de los niveles de fósforo. Objetivo: Estudiar las preferencias y creencias de los pacientes respecto a los CF, y su influencia sobre el cumplimiento del tratamiento y el control de los niveles de fósforo. Pacientes y métodos: Estudio observacional transversal. Se incluyeron 121 pacientes que respondieron un cuestionario genérico de cumplimiento del tratamiento (SMAQ) y a un cuestionario específico sobre cumplimiento del tratamiento con CF, tipo de CF preferido y razones de dicha preferencia. Todos los pacientes entrevistados habían probado dos o tres CF. Las consecuencias de la falta de cumplimiento del tratamiento con CF se estimaron indirectamente analizando los valores promedio de fósforo sérico. Resultados: El 40% de los pacientes era incumplidor según el cuestionario SMAQ; se encontró una asociación estadísticamente significativa entre la falta de cumplimiento en general y no alcanzar el objetivo de fósforo sérico promedio 5,5 mg/dl (OR = 4,7; IC 95%, 1,1-6,5; p = 0,03). Un 43,8% de los pacientes no refirió tener preferencias entre los diferentes tipos de CF; para el resto de pacientes, el CF preferido fue Royen®, seguido de Fosrenol®, Renagel® y Pepsamar®. Las razones expresadas para el desagrado con el Renagel® fueron las siguientes: incomodidad en la toma por su gran tamaño (28,8%), necesidad de tomar muchos comprimidos y gran consumo de agua (57,7%) e intolerancia gástrica (13,3%). En el caso del Fosrenol®: incómodo de tomar (72,7%) e intolerancia gástrica (27,2%); para el Pepsamar®: mal sabor (54,5%) e intolerancia gástrica (45,4%). Sólo al 9,4% no le gustaba el Royen®. Al analizar los conocimientos de los pacientes respecto a la utilidad de los CF, un 42% sabía que servían para controlar el fósforo; un 52% no lo sabía y un 6% tenía ideas equivocadas. En cuanto a su importancia: un 47% no conocía por qué son importantes; un 2% tenía ideas erróneas; un 9% creía que era beneficioso para la salud; un 11% creía que era bueno «porque lo dice el medico»; un 26% porque controla el fósforo y un 5% lo relacionaba con el hueso. Ningún paciente relacionó los CF con la enfermedad cardiovascular. Un 24,4% no se llevaba los CF cuando salía fuera de casa o estaba con los amigos; eran pacientes más jóvenes a quienes se les habían prescrito un mayor número de comprimidos de CF y que presentaban un mayor riesgo de no cumplir el objetivo de fósforo (OR = 10,5; IC 95%, —1,8 a —16,4; p 5,5 mg/dl (OR = 13.3; IC 95%, 1,1-1,5; p = 0,0001). Paradójicamente, los pacientes que no cumplían con el tratamiento demostraban un mejor conocimiento de su uso (OR = 17,3; IC 95%, 2,2-10,1; p 5.5 mg/dl (χ2: 4.7; 95% CI 1.07-6.5; p = 0.03). Paradoxically, non-adherent patients showed greater knowledge of the use (χ2: 17.3; 95% CI -2.2-10.1; p 5.5 mg/dl) (χ2: 13.3; 95% CI -1.1-1.5; p = 0.0001). Calcium acetate was the prefered PB in 47.1% of patients, lanthanum carbonate in 40%, sevelamer in 20.6% and aluminum hydroxide in 19.4%. The reasons claimed by patients for their negative ratings of PB were the type of dosage form, the taste, the number of tablets and gastric intolerance. Gastric intolerance and bad taste were more frequent in aluminum hydroxide patients (19.4% and 22.2%, respectively). Sevelamer received complaints about its dosage form because the tablets were too large and a large number of tablets were required (27.2%). 17.7% of patient who were taking lanthanum carbonate did not like the chewable tablets. Conclusion: patients who were taking binders that they did not like had worse serum P levels and were prescribed higher doses of binders. Knowing patients’ preferences about the drugs prescribed may be a key factor in achieving adequate adherence to treatment

La investigación en educación Matemática en España: los simposios de la SEIEM

En España se realizan un gran número de investigaciones en Educación Matemática y se presentan avances de sus resultados en los simposios de la Sociedad Española de Investigación en Educación Matemática (SEIEM). En este trabajo se presenta un estudio de las actas de dichos simposios. El objetivo de este trabajo es identificar algunos indicadores bibliométricos así como las redes de colaboración institucional y de coautoría. El análisis se realizó con 268 documentos de las actas SEIEM, observándose un bajo porcentaje de colaboración científica entre los investigadores del área. También se obtienen similares resultados en la cooperación internacional

Monitoring of Plant Light/Dark Cycles Using Air-coupled Ultrasonic Spectroscopy

This work presents the application of a technique based on the excitation, sensing and spectral analysis of leaves thickness resonances using air-coupled and wide-band ultrasound to monitor variations in leaves properties due to the plant response along light/dark cycles. The main features of these resonances are determined by the tautness of the cells walls in such a way that small modifications produced by variations in the transpiration rate, stomata aperture or water potential have a direct effect on the thickness resonances that can be measured in a completely non-invasive and contactless way. Results show that it is possible to monitor leaves changes due to variations in light intensity along the diurnal cycle, moreover, the technique reveals differences in the leaf response for different species and also within the same species but for specimens grown under different conditions that present different cell structures at the tissue level.Published43rd Annual UIA Symposium 23—25 April 2014 CSIC Madrid, Spai

Use of the termotherapy in the sport environment

La aplicación del calor con fines terapéuticos (termoterapia) se ha utilizado durante siglos para el tratamiento de enfermedades y lesiones traumáticas. Aunque recientemente, su uso en el tratamiento inmediato de las lesiones músculo-esqueléticas ha sido reemplazado por el frío. Este trabajo pretende describir cual es el uso de la termoterapia superficial y los baños de contraste en el deporte, sus efectos, las diferentes formas de aplicación, indicaciones y contraindicaciones aportadas por la literatura científica. La metodología utilizada es la revisión bibliográfica de monografías y bases de datos científicas como Medline, Isi Web of Science, Cochrane Database of Systematic Reviews, Science Direct. Conclusiones: Tanto el frío como el calor superficial tienen efectos terapéuticos. Por mecanismo diferentes ambos pueden romper el ciclo muscular de dolor-espasmo-dolor y reducir la inflamación Aunque existen diferentes criterios para elegir el método de termoterapia más indicado para cada afección y los parámetros de aplicación difieren de unos autores a otros, es conocido que el calor aumenta la distensibilidad de los tejidos colágenos, disminuye la rigidez articular, reduce el dolor y la inflamación, alivia el espasmo muscular y aumenta el flujo sanguíneo.The heat use with therapeutic aims (thermotherapy) has been used during centuries for the treatment of diseases and traumatic injuries. Recently, the heat use in the immediate treatment of the muscle-skeletal injuries has been replaced by the cold use. This study tries to describe the superficial thermotherapy use and the contrast-water therapy in the sport, his effects, applications, indications and contraindications contributed by scientific literature. Methods: the bibliographical revision of monographs and scientific databases: Medline, Isi Web of Science, Cochrane Database of Systematic Reviews, Science Direct. Conclusion: As much the cold as the superficial heat have therapeutic effects. By different mechanisms both can break the muscular cycle of pain-spasm-pain and reduce inflammation . Although, there are different criteria to choose the method of thermotherapy more suitable for each pathology and the application parameters are different from authors to others, is known that the heat increases the distensibilidad of collagen tissues, diminishes the rigidity to joint, reduces the pain and the inflammation, alleviates muscular spasm and increases to the blood flow.peerReviewe

The Influence of Surgical Mask on Heart Rate, Muscle Saturation of Oxygen, and Hemoglobin during Whole-Body Vibration Exercise

Background: Whole-body vibration (WBV) is a safe and effective exercise system that affects muscle oxygen through several physiological processes, although its effects on different protocols are still unclear. Unfortunately, the COVID-19 pandemic has generated various health problems and controversy or confusion on its possible adverse consequences and impact on performance when wearing a mask during the practice of physical exercise. Aim: To analyze the acute effects of WBV exercise in muscle oxygen variables during different intervention phases with or without a surgical mask and compare protocols that differ in the order of vibration frequencies. Methods: Forty-seven healthy students participated in WBV training. They were randomly assigned to use or not use a mask between the three intervention groups: group A (8, 12.6, and 20 Hz), group B (12.6, 20, and 8 Hz), and group C (20, 8, and 12.6 Hz). Besides the 3 WBV moments, the intervention had a baseline moment, two rest time and a recovery moment. During the whole intervention, the heart rate (HR), muscle oxygen saturation (SatO2), oxyhemoglobin (O2Hb), and deoxyhemoglobin (HHb) were registered. Results: There were no significant differences between the mask use and not use groups. Significant differences were found between the variables during the seven intervention moments and between intervention groups (A, B, or C). Conclusion: HR, SatO2, and Hb were not influenced by the use of a surgical mask, but they reacted differently through the different moments and were sensitive to vibration frequencies and respective order

Interpersonal violence in Spain through national hospital discharge survey.

[ES] Describir la epidemiología de la violencia interpersonal en España. Estudio descriptivo de los casos de pacientes con diagnóstico secundario de agresión registrados en el Conjunto Mínimo Básico de Datos de altas hospitalarias, entre 1999 y 2011, utilizando los códigos E960 a E969 de la Clasificación Internacional de Enfermedades (CIE-9). Se describe la distribución por sexo, edad y tipo de alta y de atención requerida, morbilidad asociada, mortalidad y comunidad autónoma. Se estudia la calidad del registro en función de su variación temporal. El perfil de agresión en hombres (85%) es el de un paciente de entre 15 y 44 años, que en un 93,7% de los casos precisa atención urgente y cuya gravedad es moderada (95% alta a domicilio). El 2,5% de los pacientes reingresa, y se produce la muerte en el 1,1% de las ocasiones. El perfil en las mujeres (15%) difiere ligeramente: edad comprendida entre 31 y 52 años, el 94% requiere atención urgente (si bien el 96% tiene una gravedad moderada), el 3% reingresa y en el 1,7% de las ocasiones la paciente muere. Aunque necesitan ser mejorados para evitar ciertas limitaciones, los sistemas de información sanitaria constituyen una riquísima fuente de datos que pueden ser utilizados para la investigación en salud y, a través de sus resultados, para el desarrollo de planes de prevención e intervención sociosanitaria en temas de violencia. [EN] To describe the epidemiology of interpersonal violence in Spain. Descriptive study of the cases of patients with secondary diagnosis of aggression registered on a national hospital discharge database, between 1999 and 2011, using the codes from E960 to E969 of the ICD-9. The distribution by sex, age and type of discharge, associated morbidity, mortality and by autonomous community is described. The quality of the record is studied according to its temporal variation. The case profile of aggression in men (85%) is of a patient between 15 and 44 years old, who in 93.7% of cases requires urgent care and whose severity is moderate (95% discharge home). Two point five percent of patients are readmitted and death occurs in1.1%. The profile in women (15%) differs slightly, with an age between 31 and 52 years, 94% require urgent attention, although 96% have moderate severity; 3% are readmitted and 1.7% die. Although they need to be improved to avoid certain limitations, health information systems are a rich source of data that can be used for research in health and, through their results, for the development of prevention plans and intervention in matters of violence.S

Impacto de la pandemia por SARS-CoV2 en la actividad asistencial y en la salud del personal de hemodiálisis en las diferentes oleadas

Introducción: Además de las consecuencias del SARS-CoV-2 sobre los pacientes renales infectados, mantener la actividad durante la pandemia ha supuesto todo un reto dada la escasez de personal por las ausencias por enfermedad. Objetivo: Analizar la incidencia de contagios por Covid-19 entre los profesionales de hemodiálisis, sus características y su repercusión en bajas laborales en las diferentes oleadas. Material y Método: Estudio observacional longitudinal desde el 3/03/2020 hasta el 23/04/2022 (776 días) en una media de 406 profesionales sanitarios y no sanitarios de 18 unidades de diálisis y dos unidades administrativas de apoyo de la Fundación Renal Iñigo Álvarez de Toledo. La recogida de datos se realizó a través de la comunicación de las distintas supervisoras al departamento de recursos humanos. Resultados: 179 profesionales de un promedio de 406 (44,1%) se infectaron en el periodo de estudio, siendo el 52% enfermeras, 25% auxiliares, 11% nefrólogos y 12% otros profesionales. Un 40,2% de los casos presentaron síntomas. Un total de 160 contagiados estuvo ausente por enfermedad (89,3%), con una media de 15,9±14,3 días. En el 71,6% se detectó un contacto estrecho (todos fuera de las unidades) y esta identificación de contactos fue creciente según avanzaban las oleadas, pasando de un 6,7% en la 1ª ola a un 40% en la 6ª ola (p=0,016). Conclusiones: La sintomatología ha sido leve, al menos de dos semanas de ausencia por enfermedad; los contactos estrechos detectados han sido fundamentalmente comunitarios, sin registrarse contagios a través de los pacientes renales en las unidades

Induction of more aggressive tumoral phenotypes in LNCaP and PC3 cells by serum exosomes from prostate cancer patients

Prostate cancer (PCa) is the second most frequent and sixth most fatal cancer in men worldwide. Despite its high prevalence, our understanding of its etiology and the molecular mechanisms involved in the progression of the disease is substantially limited. In recent years, the potential participation of exosomes in this process has been suggested. Therefore, we aim to study the effect of exosomes isolated from the serum of patients with PCa on various cellular processes associated with increased tumor aggressiveness in two PCa cell lines: LNCaP-FGC and PC3. The exosomes were isolated by filtration wand ultracentrifugation. Their presence was confirmed by immunodetection of specific markers and their size distribution was analyzed by Dynamic Light Scattering (DLS). The results obtained demonstrated that serum exosomes from PCa patients increased migration of PC3 cells and neuroendocrine differentiation of LNCaP-FGC cells regardless of the grade of the tumor. PCa serum exosomes also enhanced the secretion of enzymes related to invasiveness and resistance to chemotherapeutics, such as extracellular matrix metalloproteases 2 and 9, and gamma-glutamyltransferase in both cell lines. Altogether, these findings support the pivotal participation of exosomes released by tumoral cells in the progression of PCa. Future studies on the molecular mechanisms involved in the observed changes could provide crucial information on this disease and help in the discovery of new therapeutic targets.Instituto de Salud Carlos III (ISCIII) P118/00526, co-funded by European Regional Development Fund (ERDF), A way to make Europe to AM

Contact-less, non-resonant and high-frequency ultrasonic technique: Towards a universal tool for plant leaf study

Plant-based measurements are recognized as key methods to obtain insightful data in the field. In general, they are labor-intensive and expensive. In this context, Non-Contact Resonant Ultrasonic Spectroscopy technique (NC-RUS) emerged as a powerful alternative that enabled plant water status determination in a non-destructive, non-invasive and rapid way. However, NC-RUS is not applicable to all plant species as it depends on the possibility to excite and sense thickness resonances in the leaves. In this work, we propose and test an ultrasonic technique that can be used in all leaves, regardless of the appearance of thickness resonances. This technique is based on the contactless measurement of through transmitted airborne ultrasonic pulses in the leaves at high-frequencies and in the absence of thickness resonances, to obtain the leaf ultrasonic velocity (vair). It benefits from the facts that: i) at sufficiently high frequencies (typically around 1 MHz) all leaves are non-resonant (so the technique can be applied to both resonant and non-resonant leaves), ii) the use of high-frequencies allows a greater time resolution and a further miniaturization, making possible to apply the technique to small and irregular leaves. Three different signal processing techniques were used to determine the time it takes to the ultrasonic pulse to cross the leaves (time-of-flight) from the measured signals. Two of them operate in time domain: cross-correlation, and edge detection, while the third one makes use of the Fast Fourier Transform (FFT) and operates in the frequency domain: phase-slope. If leaf thickness is also measured, ultrasound velocity can then be worked out. As ultrasound velocity is determined by density and elastic modulus, it is then closely related to water content and turgor pressure. Obtained ultrasound velocities were first validated by comparing them with those obtained by well-established and standard ultrasonic methods: water immersion transmission (vwater) and NC-RUS (vres). The conclusions of this comparison permitted us to propose a novel methodology that combines the three signal processing techniques used to improve robustness and accuracy for the measurement of ultrasound velocity in plant leaves. It is of interest to note that a bias towards higher values of vair compared to vres was observed. This behavior is considered the consequence of the different influence of the leaf layered structure in these two measurements, so this feature can be further used for leaf structure analysis.Publishe