Fusarium oxysporum Casein Kinase 1, a Negative Regulator of the Plasma Membrane H+-ATPase Pma1, Is Required for Development and Pathogenicity

Like many hemibiotrophic plant pathogens, the root-infecting vascular wilt fungus Fusarium oxysporum induces an increase in the pH of the surrounding host tissue. How alkalinization promotes fungal infection is not fully understood, but recent studies point towards the role of cytosolic pH (pHc) and mitogen-activated protein kinase (MAPK) signaling. In fungi, pHc is mainly controlled by the essential plasma membrane H+-ATPase Pma1. Here we created mutants of F. oxysporum lacking casein kinase 1 (Ck1), a known negative regulator of Pma1. We found that the ck1Δ mutants have constitutively high Pma1 activity and exhibit reduced alkalinization of the surrounding medium as well as decreased hyphal growth and conidiation. Importantly, the ck1Δ mutants exhibit defects in hyphal chemotropism towards plant roots and in pathogenicity on tomato plants. Thus, Ck1 is a key regulator of the development and virulence of F. oxysporum

Validez y fiabilidad de la versión española de la guía de valoración oral (OAG) en pacientes con cáncer

Fundamento. El instrumento Oral Assessment Guide (OAG) es una herramienta diseñada y ampliamente utilizada para evaluar problemas de la mucosa oral en pacientes con cáncer, sin embargo no está validada en español. El objetivo de este trabajo es traducir y validar al español la escala de la valoración de la cavidad oral (OAG) diseñada por Eilers. Método. El proceso de traducción se realizó utilizando el método de traducción retrotraducción por bilingües. El estudio se llevó a cabo en pacientes con cáncer ambulatorios y hospitalizados del Departamento Onco-hematológico y con enfermeras que trabajaban con pacientes de cáncer. Se evaluaron las siguientes propiedades psicométricas de la OAG: consistencia interna, validez concurrente con la escala de la mucositis de la OMS, la armonía interjueces entre dos enfermeras diferentes. También se recogió la percepción de los pacientes y enfermeras sobre la utilización de la OAG. Resultados. Se obtuvo una adecuada versión española de la OAG. Todos los participantes (n=40) completaron el estudio. La consistencia interna con el alpha de Cronbach fue de 0,71 y la armonía interjueces obtuvo un índice de Kappa moderado y bueno en la mayoría de los ítems (k=0,4-0,81) excepto en “lengua y encía” (k=0,33-0,37). La validez concurrente con la escala de la mucositis de la OMS fue aceptable (r=0,458). Todas las enfermeras (n=6) consideraron que la escala era fácil de entender y útil en la práctica clínica. Los pacientes dijeron que no les pareció incómoda la valoración de la boca con la escala. Conclusiones. La versión española de la OAG es un instrumento válido y fiable en pacientes con cáncer. Es una escala fácil de usar en la práctica clínica y bien aceptada por los pacientes.Background. The Oral Assessment Guide (OAG) is a widely used tool designed for evaluating problems of oral mucous in cancer patients, but it has not been validated in Spanish. The aim of this work is to translate and validate into Spanish the scale of the OAG designed by Eilers. Method. The translation process was carried out using the method of back-translation by bilingual translators. The study was carried out with cancer patients, both outpatient and inpatients, of the Hematology/Oncology Department and with oncology nurses. The following psychometric properties of the OAG were evaluated: internal consistency, concurrent validity with WHO’s mucositis scale, interjudge agreement between two different nurses. The perception of patients and nurses on the use of the OAG was also assessed. Results. An adequate Spanish version of the OAG was obtained. All the participants (n=40) completed the study. Internal consistency measured by Cronbach’s alpha was 0.71 and interjudge agreement obtained a moderate to good Kappa index in the majority of items (k=0.4-0.81), except in “tongue and gums” (k=0.33-0.37). Concurrent validity with WHO mucositis scale was acceptable (r=0.458). All the nurses (n=6) considered that the scale was easy to understand and useful in clinical practice. The patients said that oral evaluation with the scale did not cause them discomfort. Conclusions. The Spanish version of the OAG is a valid and reliable instrument in cancer patients. It is a scale that is easy to use in clinical practice and is well accepted by patients

Análisis molecular de la patogénesis en Fusarium oxysporum

El proceso de infección del hongo Fusarium oxysporum es complejo y requiere algunos mecanismos bien regulados: 1) el reconocimiento de señales de la planta, 2) la adhesión a la superficie de la raíz y la diferenciación de hifas de penetración, 3) la invasión del córtex de la raíz y la degradación de barreras físicas hasta llegar al tejido vascular, 4) adaptación al entorno adverso del tejido vegetal, incluyendo la tolerancia a compuestos antifúngicos, 5) la proliferación de las hifas y producción de conidios en los vasos del xilema y, 6) la secreción de factores de virulencia tales como enzimas, péptidos o fitotoxina

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Caracterización fitoclimática de los sabinares albares

Los sabinares albares (Juniperus thurifera L.) constituyen una de las comunidades vegetales más singulares de la Península Ibérica. Su elevada capacidad de adaptación a territorios con rasgos fisiográficos y ambientales heterogéneos, nos ha llevado a cuestionarnos los factores naturales que explican su localización. Partiendo de una tipología ya conocida (Costa Tenorio et al., 1993) y del análisis de los rasgos ecológicos que rigen en cada uno de los tipos definidos hemos procedido a la caracterización fitoclimática de estas comunidades a fin de determinar los rasgos comunes a los diferentes biotopos donde están instaladas

Caracterización fitoclimática de los sabinares albares

Los sabinares albares (Juniperus thurifera L.) constituyen una de las comunidades vegetales más singulares de la Península Ibérica. Su elevada capacidad de adaptación a territorios con rasgos fisiográficos y ambientales heterogéneos, nos ha llevado a cuestionarnos los factores naturales que explican su localización. Partiendo de una tipología ya conocida (Costa Tenorio et al., 1993) y del análisis de los rasgos ecológicos que rigen en cada uno de los tipos definidos hemos procedido a la caracterización fitoclimática de estas comunidades a fin de determinar los rasgos comunes a los diferentes biotopos donde están instaladas