Efectos a corto y largo plazo de un programa de educación nutricional sobre el estado nutricional de pacientes con enfermedad renal crónica avanzada

La Enfermedad Renal Crónica (ERC) se encuentra asociada con mayor riesgo de mortalidad por eventos cardiovasculares. Se caracteriza por la pérdida progresiva de la funcionalidad del riñón. Y se clasifica en 5 estadios en función del filtrado glomerular (FG) y la presencia de proteinuria. Hasta el momento en el que se instaura el fallo renal y es necesario el tratamiento renal sustitutivo (TRS), el tratamiento es farmacológico y nutricional. La prevalencia de malnutrición es elevada, y aumenta a medida que disminuye la función renal. Debido a la elevada prevalencia de malnutrición y a que sus causas son multifactoriales, el Comité de Expertos de la Sociedad Internacional de Metabolismo y Nutrición Renal (ISRNM) propuso el término Protein Energy Wasting (PEW), y su posterior traducción al castellano, Desgaste Proteico Energético (DPE), para definir“aquel estado patológico que se caracteriza por la pérdida progresiva de los depósitos proteicos y energéticos”. El DPE se debe principalmente a la disminución de la ingesta y al hipercatabolismo. El cual es secundario entre otros factores a la inflamación, la acidosis metabólica y a los desordenes hormonales que inhiben parte de las vías anabólicas del organismo. En el caso del TRS, la diálisis es un proceso hipercatabólico per se..

Mundo vegetal y enfermedad renal crónica: ¿riesgo o beneficio?

La alimentación a lo largo de la enfermedad renal se encuentra unida a un gran número de restricciones. Actualmente las recomendaciones nutricionales en los pacientes con enfermedad renal están cambiando, presentando elementos comunes con la población general. Se recomienda disminuir el consumo de alimentos ultraprocesados, al considerarse fuente de sal, grasas y aditivos, de los que muchos de ellos son aditivos fosfóricos y potásicos; estos aditivos presentan una biodisponiblidad del 100%, en comparación con el fósforo y el potasio dietético que se encuentra en los alimentos de origen natural, y cuya absorción se encuentra entre el 50-80%, dependiendo del tipo de alimento. El manejo del potasio dietético es uno de los grandes problemas en la población renal. En la actualidad, se está demostrando que el aumento de sus niveles en sangre, presenta más agentes causales y no sólo la ingesta dietética de potasio, como: la presencia de ayunos prolongados, estreñimiento, mal control metabólico de la glucosa y el consumo de ciertos fármacos, entre otros factores. Estos datos ponen de manifiesto que antes de recurrir a la restricción alimentaria de fuentes de potasio dietético es conveniente considerar nuevos métodos de actuación

Mycovirus Fusarium oxysporum f. sp. dianthi Virus 1 Decreases the Colonizing Efficiency of Its Fungal Host

Mycoviruses that induce hypovirulence in phytopathogenic fungi are interesting because their potential use as biological control agents of the plant diseases caused by their fungal hosts. The recently identified chrysovirus Fusarium oxysporum f. sp. dianthi virus 1 (FodV1) has been associated to the induction of hypovirulence in Fusarium oxysporum f. sp. dianthi, the forma specialis of F. oxysporum that causes vascular wilt in carnation (Dianthus caryophyllus). In this work, we have used confocal laser scanner microscopy and two isogenic GFP-labeled strains of F. oxysporum f. sp. dianthi infected (V+) and not infected (V−) with the Fusarium oxysporum f. sp. dianthi virus 1, respectively, to analyze the effect of mycovirus FodV1 on the plant colonization pattern of its fungal host. Results demonstrate that FodV1-viral infection affects the speed and spatial distribution of fungal colonization into the plant. Initial stages of external root colonization were similar for both strains, but the virus-free strain colonized the internal plant tissues faster than the virus-infected strain. In addition, other differences related to the specific zone colonized and the density of colonization were observed between both F. oxysporum f. sp. dianthi strains. The hyphae of both V− and V+ strains progressed up through the xylem vessels but differences in the number of vessels colonized and of hyphae inside them were found. Moreover, as colonization progressed, V− and V+ hyphae propagated horizontally reaching the central medulla but, while the virus-free strain V− densely colonized the interior of the medulla cells, the virus-infected strain V+ appeared mainly in the intercellular spaces and with a lower density of colonization. Finally, the incidence of FodV1-viral infections in a collection of 221 isolates sampled between 2008 and 2012 in the geographic area where the originally infected isolate was obtained has been also analyzed. The very low (<2%) incidence of viral infections is discussed here. To the best of our knowledge, this work provides the first microscopic evidence about the effect of a hypovirulence-inducing mycovirus on the pattern of plant colonization by its fungal host

Review of intervention programs for students infant and primary with specific language disorder

En el presente estudio se revisan diferentes programas de intervención tanto a nivel internacional como nacional relacionados con el Trastorno Específico del Lenguaje (TEL) en Educación Infantil y Primaria. Para ello, se realizó una búsqueda en las bases de datos ProQuest, Dialnet, CSIC y Psicodoc sobre intervenciones realizadas desde el año 2012 al 2015. Se observan que existen, entre los artículos revisados, variaciones en cuanto a los objetivos, actividades y resultados, pero todos ellos muestran unas características comunes a la hora de elaborar programas en este ámbito, convenientes de tener en cuenta para posibles investigaciones e intervenciones futuras con el fin de mejorar el rendimiento académico del alumnado.In the present study are reviewed some intervention programs both at international and national related to the specific language disorder (TEL) in early childhood education and elementary. For this aim, it carried out a search in the databases ProQuest, Dialnet, CSIC and Psicodoc on interventions since 2012 to 2015. It is observed, among the articles reviewed, variations in the objectives, activities and results, but all of them show some common features when it comes to developing programs in this area, which it convenient to take into account for future interventions and research to improve the academic performance.Universidad de Granada. Departamento de Psicología Social. Proyecto de Innovación Docente ReiDoCre

Star formation and nuclear activity in luminous infrared galaxies: an infrared through radio review

Nearby galaxies offer unique laboratories allowing multi-wavelength spatially resolved studies of the interstellar medium, star formation and nuclear activity across a broad range of physical conditions. In particular, detailed studies of individual local luminous infrared galaxies (LIRGs) are crucial for gaining a better understanding of these processes and for developing and testing models that are used to explain statistical studies of large populations of such galaxies at high redshift for which it is currently impossible to reach a sufficient physical resolution. Here, we provide an overview of the impact of spatially resolved infrared, sub-millimetre and radio observations in the study of the interstellar medium, star formation and active galactic nuclei as well as their interplay in local LIRGs. We also present an overview of the modelling of their spectral energy distributions using state-of-the-art radiative transfer codes. These contribute necessary and powerful 'workhorse' tools for the study of LIRGs (and their more luminous counterparts) at higher redshifts which are unresolved in observations. We describe how spatially-resolved time-domain observations have recently opened a new window to study the nuclear activity in LIRGs. We describe in detail the observational characteristics of Arp 299 which is one of the best studied local LIRGs and exemplifies the power of the combination of time-domain and high-resolution observations at infrared to radio wavelengths together with radiative transfer modelling used to explain the spectral energy distributions of its different components. We summarise the previous achievements obtained using high-spatial resolution observations and provide an outlook into what we can expect to achieve with future facilities

Nearby normal and luminous infrared galaxies with the SKA

The SKA will routinely provide µJy sensitivity and sub-arcsecond angular resolutions at radio wavelengths. Planned SKA surveys will image vast numbers of nearby galaxies, which are expected to provide a cornerstone in our understanding of star-formation and accretion activity in the local Universe. Here, we outline some of the key continuum and molecular line studies of local galaxies, where the SKA will have a significant scientific impact and where the Spanish astrophysical community is particularly active.MAPT, AA, and RHI acknowledge support from the Spanish Ministerio de Economía y Competitividad (MINECO) through grant AYA2012-38491-C02-02. S.G.B. acknowledges support from the Spanish MINECO through grants AYA2010-15169, AYA2012-32295, and program CONSOLIDER INGENIO 2010, under grant Molecular Astrophysics: The Herschel and ALMA EraASTROMOL (ref CSD2009-00038). S.G.B also acknowledges support from the Junta de Andalucia through TIC-114 and the Excellence Project P08-TIC-03531. A.A.H. and LC acknowledge support from the Spanish MINECO through grants AYA-2012-31447 and AYA-2012-32295. JHK acknowledges financial support to the DAGAL network from the People Programme (Marie Curie Actions) of the European Unions Seventh Framework Programme FP7/2007-2013/ under REA grant agreement number PITNGA-2011-289313, and from the Spanish MINECO under grant number AYA2013-41243-P.Peer Reviewe

Optimization of a Rabbit Dry Eye Model Induced by Topical Instillation of Benzalkonium Chloride

Purpose. To optimize a rabbit dry eye model induced by topical instillation of benzalkonium chloride (BAC), reduce the days of instillation of the original model by increasing the concentration of BAC from 0.1% to 0.2%. Materials and Methods. An experimental, prospective, and randomized study was performed on 10 male New Zealand white rabbits, divided into two groups, considering both eyes: 5 rabbits as control (n = 10) and 5 rabbits with 0.2% BAC treatment (n = 10). Saline solution (control) and 0.2% BAC were instilled for 5 consecutive days, twice daily. Tear secretion with and without anesthesia, tear breakup time, tear osmolarity, corneal staining, conjunctival hyperemia, density of goblet cells, height of mucin cloud, and transcript levels of IL-6 were measured before and after the treatment. Results. After the instillation of 0.2% BAC for 5 consecutive days, there was a significant increase in tear secretion without anesthesia (P < 0.001), corneal staining (P < 0.001), conjunctival hyperemia (P < 0.001), and levels of IL-6 mRNA (P = 0.005) compared to the control group. Conversely, there was a decrease in tear secretion with anesthesia (P < 0.001), tear breakup time (P = 0.007), tear osmolarity (P < 0.001), density of goblet cells (P < 0.001), and height of mucin cloud (P < 0.001). Conclusions. )e topical instillation of 0.2% BAC for 5 consecutive days, twice daily, was a proper procedure to induce a rabbit dry eye model, reducing the number of days of instillation compared to the original model (14 days)

Protein-energy wasting syndrome in advanced chronic kidney disease: Prevalence and specific clinical characteristics

Introduction: Protein-energy wasting (PEW) is associated with increased mortality and differs depending on the chronic kidney disease (CKD) stage and the dialysis technique. The prevalence in non-dialysis patients is understudied and ranges from 0 to 40.8%. Objective: To evaluate the nutritional status of a group of Spanish advanced CKD patients by PEW criteria and subjective global assessment (SGA). Patients and methods: Cross-sectional study of 186 patients (101 men) with a mean age of 66.1 ± 16 years. The nutritional assessment consisted of: SGA, PEW criteria, 3-day dietary records, anthropometric parameters and bioelectrical impedance vector analysis. Results: The prevalence of PEW was 30.1%, with significant differences between men and women (22.8 vs. 33.8%, p &lt; 0.005), while 27.9% of SGA values were within the range of malnutrition. No differences were found between the 2 methods. Men had higher proteinuria, percentage of muscle mass and nutrient intake. Women had higher levels of total cholesterol, HDL and a higher body fat percentage. The characteristics of patients with PEW were low albumin levels and a low total lymphocyte count, high proteinuria, low fat and muscle mass and a high Na/K ratio. The multivariate analysis found PEW to be associated with: proteinuria (OR: 1.257; 95% CI: 1.084–1.457, p = 0.002), percentage of fat intake (OR: 0.903; 95% CI: 0.893–0.983, p = 0.008), total lymphocyte count (OR: 0.999; 95% CI: 0.998–0.999, p = 0.001) and cell mass index (OR: 0.995; 95% CI: 0.992–0.998). Conclusion: Malnutrition was identified in Spanish advanced CKD patients measured by different tools. We consider it appropriate to adapt new diagnostic elements to PEW criteria.Introducción: El desgaste proteico energético (DPE) se asocia a mayor mortalidad y difieredependiendo del estadio de la enfermedad renal y de la técnica de diálisis. Su prevalenciaen pacientes sin diálisis se encuentra poco estudiada y oscila entre el 0 y el 40,8%.Objetivo: Evaluar el estado nutricional según criterios de DPE y por valoración global subje-tiva (VGS) de un colectivo de pacientes espa˜noles con enfermedad renal crónica avanzada(ERCA).Pacientes y métodos: Estudio transversal de 186 pacientes (101 hombres) con edad media de66,1 ± 16 a˜nos. Se realizó evaluación nutricional mediante: VGS, criterios de DPE, registrodietético de 3 días, parámetros antropométricos y bioimpedancia vectorial.Resultados: Un 30,1% presentaba DPE, con diferencias significativas entre hombres y mujeres(22,8 vs. 33,8%; p < 0,005) y un 27,9% tenía valores de VGS en rangos de desnutrición. Sindiferencia entre los 2 métodos estudiados. Los hombres presentaron mayores niveles deproteinuria, porcentaje de masa muscular e ingesta de nutrientes. Las mujeres tuvieronmayores niveles de colesterol total, HDL y porcentaje de masa grasa. Las característicasde los pacientes con DPE fueron: bajos valores de albúmina y recuento total de linfocitos,elevada proteinuria, baja masa grasa, baja masa muscular y cociente Na/K elevado.El análisis multivariante mostró asociación de DPE con proteinuria (OR: 1,257; IC 95%:1,084-1,457; p = 0,002), porcentaje de ingesta lipídica (OR: 0,903; IC 95%: 0,893-0,983; p = 0,008),recuento total de linfocitos (OR: 0,999; IC 95%: 0,998-0,999; p = 0,001) y el índice de masacelular (OR: 0,995; IC 95%: 0,992-0,998)

Sub-arcsecond imaging of Arp\,299-A at 150 MHz with LOFAR: Evidence for a starburst-driven outflow

We report on the first sub-arcsecond (0.44 $\times$ 0.41 arcsec$\rm ^2$) angular resolution image at 150 MHz of the A-nucleus in the Luminous Infrared Galaxy Arp$\,$299, from International Low Frequency Array (LOFAR) Telescope observations. The most remarkable finding is that of an intriguing two-sided, filamentary structure emanating from A-nucleus, which we interpret as an outflow that extends up to at least 14 arcseconds from the A-nucleus in the N-S direction ($\approx$ 5 kpc deprojected size) and accounts for almost 40% of the extended emission of the entire galaxy system. We also discuss HST/NICMOS [FeII] 1.64 $\rm \mu m$ and H$\rm_2$ 2.12 $\rm \mu m$ images of Arp$\,$299-A, which show similar features to those unveiled by our 150 MHz LOFAR observations, thus giving string morphological support for the outflow scenario. Finally, we discuss unpublished NaI D spectra that confirm the outflow nature of this structure. From energetic arguments, we rule out the low-luminosity active galactic nucleus in Arp$\,$299-A as a driver for the outflow. On the contrary, the powerful, compact starburst in the central regions of Arp$\,$299-A provides plenty of mechanical energy to sustain an outflow, and we conclude that the intense supernova (SN) activity in the nuclear region of Arp299-A is driving the observed outflow. We estimate that the starburst wind can support a mass-outflow rate in the range (11-63) $\rm M_{\odot} yr^{-1}$ at speeds of up to (370 - 890) $\rm km \, s^{-1}$, and is relatively young, with an estimated kinematic age of (3 - 7) Myr. Those results open an avenue to the use of low-frequency (150 MHz), sub-arcsecond imaging with LOFAR to detect outflows in the central regions of local luminous infrared galaxies

Frequency and prognostic impact of blood-circulating tumor mast cells in mastocytosis

Circulating tumor mast cells (CTMCs) have been identified in the blood of a small number of patients with advanced systemic mastocytosis (SM). However, data are limited about their frequency and prognostic impact in patients with MC activation syndrome (MCAS), cutaneous mastocytosis (CM) and nonadvanced SM. We investigated the presence of CTMCs and MC-committed CD34+ precursors in the blood of 214 patients with MCAS, CM, or SM using highly sensitive next-generation flow cytometry. CTMCs were detected at progressively lower counts in almost all patients with advanced SM (96%) and smoldering SM (SSM; 100%), nearly half of the patients (45%) with indolent SM (ISM), and a few patients (7%) with bone marrow (BM) mastocytosis but were systematically absent in patients with CM and MCAS (P < .0001). In contrast to CTMC counts, the number of MC-committed CD34+ precursors progressively decreased from MCAS, CM, and BM mastocytosis to ISM, SSM, and advanced SM (P < .0001). Clinically, the presence (and number) of CTMCs in blood of patients with SM in general and nonadvanced SM (ISM and BM mastocytosis) in particular was associated with more adverse features of the disease, poorer-risk prognostic subgroups as defined by the International Prognostic Scoring System for advanced SM (P < .0001) and the Global Prognostic Score for mastocytosis (P < .0001), and a significantly shortened progression-free survival (P < .0001) and overall survival (P = .01). On the basis of our results, CTMCs emerge as a novel candidate biomarker of disseminated disease in SM that is strongly associated with advanced SM and poorer prognosis in patients with ISM