A randomized clinical trial to determine the effect of angiotensin inhibitors reduction on creatinine clearance and haemoglobin in heart failure patients with chronic kidney disease and anaemia

Trial registration: EudraCT: 2008-008480-10[Abstract] Background. Chronic kidney disease is a common comorbidity in elderly patients with heart failure. Evidence supports the use of angiotensin inhibitors for patients with heart failure. However, there is little evidence with which to assess the risk and benefits of this treatment in elderly patients with renal dysfunction. Objective. To determine the efficacy and safety of angiotensin inhibitor reduction in patients with heart failure, chronic kidney disease and anaemia. Study design. Open randomized controlled clinical trial. Setting. Complexo Hospitalario Universitario A Coruña (Spain). Patients. Patients ≥ 50 years old, with heart failure, haemoglobin (Hb) < 12 mg/dl and creatinine clearance <60 ml/min/1.73 m2 admitted to hospital, in treatment with angiotensin inhibitors. Informed consent and Ethical Review Board approval were obtained. Intervention. A 50% reduction of angiotensin inhibitor dose of the basal treatment on admission (n = 30) in the intervention group. Control group (n = 16) with the standard basal dose. Main outcome measure. Primary outcome was difference in Hb (gr/dl), creatinine clearance (ml/min/1.73 m2) and protein C (mg/dl) between admission and 1–3 months after discharge. Secondary outcome was survival at 6–12 months after discharge. Results. Patients in the intervention group experienced an improvement in Hb (10.62–11.47 g/dl), creatinine clearance (32.5 ml/min/1.73 m2 to 42.9 ml/min/1.73 m2), and a decrease in creatinine levels (1.98–1.68 mg/dl) and protein C (3.23 mg/dl to 1.37 mg/dl). There were no significant differences in these variables in the control group. Survival at 6 and 12 months in the intervention and control group was 86.7% vs. 75% and 69.3% vs. 50%, respectively. Conclusion. The reduction of the dose of angiotensin inhibitors in the intervention group resulted in an improvement in anaemia and kidney function, decreased protein C and an increased survival rate

Estudio para la mejora de la calidad del vino albariño

Premio de Investigación, Real Academia Galega de Ciencias, convocatoria 2009.[EN]Twenty-two clones from Albariño variety (Vitis vinifera L.), from an initial collection of 115 clones, were selected on the basis of their ampelographic, molecular and sanitary characteristics. These selected clones were studied from the agronomic and oenological point of view, and were also quantified for their levels of susceptibility to Powdery Mildew, Oidium and Botrytis. An ecotypic yeast was selected, its use has been patented and it is being exploited. Musts obtained from the previously selected Albariño clones were fermented with this yeast, essentially by increasing the content in volatile substances of interest (terpens: linalool and geraniol; norisoprenoids: α-ionone and β- damascenone), leading to wines with improved fermentative dynamic and sensorial attributes.[ES]En base a características ampelográficas, moleculares y sanitarias, se seleccionaron 22 clones de la variedad Albariño (Vitis vinifera L.), partiendo de 115 iniciales. Sobre los clones seleccionados se ha llevado a cabo un estudio agronómico y enológico, así como la cuantificación de los niveles de susceptibilidad a Mildiu, Oídio y Botrytis. Se ha seleccionado una levadura ecotípica, cuyo uso ha sido patentado y se encuentra en explotación. Con ella se fermentaron los mostos obtenidos a partir de los clones de Albariño previamente seleccionados, dando lugar a vinos con una dinámica fermentativa xPremio de Investigación, Real Academia Galega de Ciencias, convocatoria 2009 y unos atributos sensoriales mejorados, fundamentalmente en base al aumento del contenido en sustancias volátiles de interés (terpenos: linalool y geraniol; norisoprenoides: α-ionona y β- damascenona).La actividad realizada ha sido financiada, además de por la Bodega Terras Gauda S.A., por la Xunta de Galicia (PGIDIT04TAL035E), y por el propio CSIC (PIE 2004 7 0E 214).Peer reviewe

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Effect of malolactic fermentation by Pediococcus damnosus on the composition and sensory profile of Albariño and Caiño white wines

[Aim]: This study was aimed to investigate the influence of malolactic fermentation (MLF) on sensory profile and organoleptic characteristics of Albariño and Caiño white wines. [Methods and Results]: Autochthonous bacteria were isolated from wines after alcoholic fermentation (AF) and further identified as Pediococcus damnosus by 16S rRNA gene sequence analysis. When a commercial Oenococcus oeni starter was inoculated into Albariño and Caiño white wines to perform MLF, which was checked by HPLC quantification of malic and lactic acids, it was shown that autochthonous Ped. damnosus strains were able to predominate over the commercial O. oeni starter and perform MLF in Caiño wine. By contrast, neither commercial strain nor indigenous Pediococcus carried out MLF in Albariño wine. However, MLF was achieved when autochthonous strains that predominated in Caiño were inoculated into Albariño. Sensory analysis showed that after the MLF Albariño increased its body and softness, while Caiño result a more mature wine. [Conclusions]: MLF can positively affect Albariño and Caiño wines giving them new attributes. Pediococci isolated and characterized in this work can successfully perform MLF without negative effects on the wine, because no production of biogenic amines or exopolysaccharides by the selected pediococcus strains was detected. [Significance and Impact of the Study]: The effect of MLF in the sensory profile of Albariño and Caiño wines has never been studied before. Results obtained in this work showed that Ped. damnosus strains can be considered as a new topic of investigation on malolactic starter. © 2013 The Society for Applied Microbiology.Funded by: Bodega Terras Gauda LTD; Xunta de Galicia. Grant Numbers: PGIDIT04TAL035E, 2004-7-OE-242, AGL2006-02558, A36108900, ALIBIRD-CM-S-0505/AGR-0153; CONSOLIDER INGENIO 2010. Grant Number: CSD2007-00063FUN-C-FOOD and BIODATI. Grant Number: DM 16101/7301/08.Peer Reviewe

Influence of locally-selected yeast on the chemical and sensorial properties of Albariño white wines

The use of selected yeast strains with improved or novel properties may promote wines with special and original quality attributes. In this paper, changes in the chemical composition (aroma compounds and polyphenols) and sensorial properties of Albariño white wines elaborated with the same must and selected yeast (named as 1, 2 and 3) have been studied in comparison with wines subjected to non-inoculated fermentation (control wine). The results indicated that yeast strain can significantly influence the aroma and polyphenol composition of the wines. Wines elaborated with strain 1 had a higher concentration of terpenes and norisoprenoids, which are compounds closely associated with the fruity and fresh character of Albariño white wines. These same wines had a lower concentration of flavan-3-ols, closely associated with the astringency and bitterness of the wine and the lowest browning potential. The formal sensory analysis conducted by 8 trained judges showed that wines elaborated with strain 1 were preferred by the tasting panel. Therefore, the selection of yeast strains could offer the possibility to modulate sensorial attributes related with the aroma and phenol composition in Albariño white wines. © 2011 Elsevier Ltd.This work was funded through Projects Bodega Terras Gauda LTD. Xunta de Galicia (PGIDIT04TAL035E), 2004-7-OE-242, AGL2006- 02558, A36108900, ALIBIRD-CM-S-0505/AGR-0153, and CONSOLIDER INGENIO 2010 (CSD2007-00063FUN-C-FOOD).S0505/AGR-0153/ALIBIRDPeer Reviewe