Alergia a frutos do mar: principais desafios na alimentação e soluções desenvolvidas por alunos do curso de nutrição e gastronomia / Seafood allergy: main challenges in their diet and solutions developed by students of the nutrition and gastronomy course

A alergia alimentar caracteriza-se por uma reação adversa a um determinado alimento, envolvendo um mecanismo imunológico. Uma das alergias mais comuns encontradas atualmente é a alergia a frutos do mar, a qual se baseia em uma hipersensibilidade a animais desse grupo. O objetivo desta pesquisa é identificar os desafios expostos na alimentação de alérgicos a frutos do mar e formular soluções para essa população baseadas em alimentos nutricionalmente substitutos. Sendo realizado em três etapas: investigação inicial, construção de conceitos e planejamento de uma ação com orientações nutricionais. De acordo com as dificuldades encontradas na alimentação dessa parcela populacional, realizaram-se diferentes preparações, com nutrientes como ômega-3, proteínas, vitaminas do complexo B, zinco, ferro, potássio, magnésio, iodo e selênio, os quais também são encontrados nos frutos do mar, a fim de evitar possíveis contaminações cruzadas e garantir seu aporte nutricional em alimentos substitutos. Foi possível concluir que os alérgicos aos frutos do mar não apresentam uma interferência significativa em sua qualidade de vida, tendo um impacto nutricional pequeno, visto que por meio da alimentação existem outras fontes, necessitando somente de alguns cuidados no dia a dia em virtude das consequências de uma possível contaminação.

Food allergy is characterized by an adverse reaction to a given food, involving an immunological mechanism. One of the most common allergies currently found is seafood allergy, which is based on hypersensitivity to animals in this group. The objective of this research is to identify the challenges exposed in the feeding of seafood allergies and formulate solutions for this population based on nutritionally substitute foods. Being carried out in 3 stages, initial investigation, construction of concepts and planning of an action with nutritional guidance. According to the difficulties encountered in feeding this portion of the population, different preparations were carried out, with nutrients such as: ômega-3, proteins, B vitamins, zinc, iron, potassium, magnesium, iodine and selenium. Which are also found in seafood. In order to avoid possible cross-contamination and ensure their nutritional intake in substitute foods. It was possible to conclude that seafood allergies do not present a significant interference in their quality of life, having a small nutritional impact, since through food there are other sources, requiring only some care on a daily basis due to the consequences of possible contamination.

Persistent and serious hyperkalemia after surgery of primary aldosteronism: A case report / 北京大学学报(医学版)

Hyperkalemia was one of the complications after primary aldosteronism surgery. Hyperkalemia after primary aldosteronism surgery was uncommon in clinical practice, especially persistent and serious hyperkalemia was rare. This complication was not attached great importance in clinical work. A case about persistent and serious hyperkalemia after primary aldosteronism adrenal adenoma surgery was reported and the patient was followed-up for fourteen months in this study. This patient had a laparoscopic adrenalectomy due to primary aldosteronism. Hyperkalemia was detected one month after surgery of this patient, the highest level of plasma potassium was 7.0 mmol/L. The patient felt skin itchy, nausea, palpitation. Plasma aldosterone concentration fell to 2.12 ng/dL post-operation from 35.69 ng/dL pre-operation, zona glomerulosa insufficiency was confirmed by hormonal tests in this patient after surgery. And levels of 24 hours urinary potassium excretion declined. Decrease of aldosterone levels after surgery might be the cause of hyperkalemia. Hyperkalemia lasted for 14 months after surgery and kalemia-lowering drugs were needed. A systemic search with "primary aldosteronism", "hyperkalemia", "surgical treatment" was performed in PubMed and Wanfang Database for articles published between January 2009 and December 2019. Literature review indicated that the incidence of hyperkalemia after primary aldosteronism surgery was 6% to 29%. Most of them was mild to moderator hyperkalemia (plasma potassium 5.5 to 6.0 mmol/L) and transient. 19% to 33% in hyperkalemia patients was persistent hyperkalemia. Previous studies in the levels of plasma potassium reached the level as high as 7 mmol/L in our case were rare. Whether hypoaldosteronemia was the cause of hyperkalemia was not consistent in the published studies. Risk factors of hyperkalemia after primary aldosteronism surgery included kidney dysfunction, old age, long duration of hypertention. This paper aimed to improve doctors' aweareness of hyperkalemia complication after primary aldosteronism surgery. Plasma potassium should be monitored closely after primary aldosteronism surgery, especially in the patients with risk factors. Some patients could have persistent and serious hyperkalemia, and need medicine treatment.

The mechanism of blood pressure regulation by high potassium diet in the kidney / 生理学报

Hypertension is one of the strongest risk factors for cardiovascular diseases, cerebral stroke, and kidney failure. Lifestyle and nutrition are important factors that modulate blood pressure. Hypertension can be controlled by increasing physical activity, decreasing alcohol and sodium intake, and stopping tobacco smoking. Chronic kidney disease patients often have increased blood pressure, which indicates that kidney is one of the major organs responsible for blood pressure homeostasis. The decrease of renal sodium reabsorption and increase of diuresis induced by high potassium intake is critical for the blood pressure reduction. The beneficial effect of a high potassium diet on hypertension could be explained by decreased salt reabsorption by sodium-chloride cotransporter (NCC) in the distal convoluted tubule (DCT). In DCT cells, NCC activity is controlled by with-no-lysine kinases (WNKs) and its down-stream target kinases, Ste20-related proline-alanine-rich kinase (SPAK) and oxidative stress-responsive 1 (OSR1). The kinase activity of WNKs is inhibited by intracellular chloride ([Cl-]i) and WNK4 is known to be the major WNK positively regulating NCC. Based on our previous studies, high potassium intake reduces the basolateral potassium conductance, decreases the negativity of DCT basolateral membrane (depolarization), and increases [Cl-]i. High [Cl-]i inhibits WNK4-SPAK/OSR1 pathway, and thereby decreases NCC phosphorylation. In this review, we discuss the role of DCT in the blood pressure regulation by dietary potassium intake, which is the mechanism that has been best dissected so far.

Can Routine Blood Biochemistry Parameters be Predictive Prognostic Marker(s) in Operated Patients with Meningioma WHO Grade 1?

Background Today, there is a need for new and independent additional advanced markers that can predict the prognosis of meningioma patients, postoperatively. The present study aimed to find out postoperative short-term prognostic markers in patients with meningioma using their demographic data and routine blood biochemistry findings evaluated preoperatively. Methods The Glasgow Coma Scale (GCS), and Glasgow Outcome Scale (GOS) scores of the patients were recorded. Additionally, preoperatively obtained serum glucose, Creactive protein (CRP), sodium, potassium, creatinine, blood urea nitrogen, aspartate aminotransferase (AST), alanine aminotransferase, and hemoglobin level values, platelet, leukocyte, neutrophil, lymphocyte, eosinophil, basophil, andmonocyte count results, erythrocyte sedimentation rate (ESR), neutrophil-lymphocyte ratio, plateletlymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) values were evaluated. Results In the present study, 23 operated patients with meningioma World Health Organization (WHO) grade 1 (17 females, 6 males) were included. Correlation test results revealed that the GCS score, platelet count, and serum potassium level values could directly predict the short-term prognosis of these patients. Additionally, these test results suggested that the lymphocyte, monocyte, and eosinophil count values, PLR, LMR, ESR, serum glucose, CRP, and AST level values could be indirect markers in predicting the short-term prognosis. However, likelihood ratio test results revealed that only monocyte count value, LMR value, and serum CRP level value could be the markers for prediction of the short-term prognosis. Conclusion At the end of the present study, it was concluded that the monocyte count value, LMR value, and serum CRP level value could be the best markers in predicting the short-term prognosis of the operated meningioma patients.

Correlación entre sodio, cloro y potasio del cuerpo vítreo y el intervalo postmortem sobre los 2. 850 msnm / Correlation between sodium, chlorine and potassium of the vitreous body and the postmortem interval above 2. 850 msnm

RESUMEN: El intervalo Postmortem (IPM) es un importante desafío por resolver en la patología forense, y consiste en poder determinar el tiempo transcurrido desde la muerte hasta el momento de la autopsia. Dada la poca confiabilidad de algunos métodos por la gran influencia de factores externos y propios del cadáver, la bioquímica forense ha recibido considerable atención por sus niveles de seguridad. La ciudad de Quito se ubica en la cordillera de Los Andes a 2850 msnm, sin embargo, en la literatura no existen reportes de medición de estos parámetros a una altura como ésta. El objetivo fue establecer una correlación entre sodio (Na+), cloro (Cl-) y potasio (K+) del humor vítreo del cuerpo vítreo y el IPM a la altura de la ciudad de Quito. Para el estudio se utilizaron 128 muestras de cuerpo vítreo provenientes de 16 autopsias practicadas en la Unidad de Medicina Legal Zona 9, en IPM de 6, 12, 24, 48, 72, 96, 120 y 144 horas. Para la obtención del humor vítreo se siguió el método convencional, se dividió para las 8 alícuotas y se llevó a congelación -20 °C hasta el momento de su análisis. La cuantificación de la concentración de electrolitos Na+, Cl- y Potasio+ se realizó mediante analizador ISE de Roche Cobas (Roche Diagnostics) C501, calibrado para uroanálisis, y no fue necesaria la dilución. Durante la calibración y cada tres muestras, se midió un estándar interno para corregir los efectos de la desviación sistemática en la calibración. El enfoque estadístico se basó en un análisis de correlación lineal, utilizando el coeficiente de correlación de Spearman. La correlación entre las horas postmortem y las concentraciones de los diferentes electrolitos, fueron estadísticamente significativas. Se pudo corroborar una correlación lineal significativa entre el IPM y el aumento del K+ en el HV.

SUMMARY: The postmortem interval (PMI) is an important challenge to be solved in forensic pathology, and it consists of being able to determine the time elapsed from death to the moment of autopsy. Given the unreliability of some methods due to the great influence of external factors and those specific to the corpse, forensic biochemistry has received considerable attention for its levels of safety. The city of Quito is located in the Andes mountain range at 2850 meters above sea level, however, in the literature there are no reports of measurement of these parameters at a height like this. The objective was to establish a correlation between sodium (Na+), chlorine (Cl-) and potassium (K+) of the vitreous humor and the MPI at a height of 2,850 masl. For the study, 128 samples of vitreous humor were used from 16 autopsies performed in the Zone 9 Legal Medicine Unit, in IPM of 6, 12, 24, 48, 72, 96, 120 and 144 hours. To obtain the vitreous humor, the conventional method was followed, it was divided for the 8 aliquots and it was frozen at -20 ° C until the moment of its analysis. The quantification of the concentration of electrolytes Na+, Cl- and K+ was carried out using an ISE analyzer from Roche Cobas (Roche Diagnostics) C501, calibrated for urinalysis, and no dilution was necessary. During calibration and every third sample, an internal standard was measured to correct for the effects of systematic deviation on the calibration. The statistical approach was based on a linear correlation analysis, using the Spearman correlation coefficient. The correlation between the postmortem hours and the concentrations of the different electrolytes were statistically significant. A significant linear correlation between the PMI and the increase in K+ in vitreous humor could be corroborated.

Paralisia Periódica Hipocalêmica Tireotóxica: relato de caso / Thyrotoxic Hypokalemic Periodic Paralysis: case report

A paralisia periódica hipocalêmica tireotóxica é uma complicação rara do hipertireoidismo. Caracteriza-se por episódios de fraqueza muscular recorrente, associado à tireotoxicose e hipocalemia. Ocorre frequentemente em pacientes do sexo masculino e de origem asiática. Nesse contexto, o objetivo deste estudo é descrever o relato de caso de um paciente acometido por paralisia periódica hipocalêmica tireotóxica com redução acentuada da qualidade de vida e internações recorrentes devido a quadro agudo de tetraparesia flácida ascendente associado a hipocalemia grave por não adesão ao tratamento do hipertireoidismo. A paralisia periódica hipocalêmica tireotóxica apresenta evolução favorável quando reconhecida e tratada com controle inicial dos sintomas para normalização sérica do potássio e posterior resolução do quadro tireotóxico.

Thyrotoxic hypokalemic periodic paralysis is a rare complication of hyperthyroidism. The issue has been characterized by episodes of recurrent muscle weakness associated with thyrotoxicosis and hypokalemia. It occurs most often in male patients of Asian origin. This study aims on describing the case report of a patient affected by thyrotoxic hypokalemic periodic paralysis with intense reduction in life quality and recurrent hospitalizations due to ascending acute flaccid tetraparesis associated with severe hypokalemia due to non-adherence to treatment of hyperthyroidism. Thyrotoxic hypokalemic periodic paralysis presents a favorable evolution when identified and treated with initial symptom control for serum potassium normalization and subsequent resolution of the thyroid toxicity.

A novel proline-rich M-superfamily conotoxin that can simultaneously affect sodium, potassium and calcium currents

Background Conotoxins have become a research hotspot in the neuropharmacology field for their high activity and specificity in targeting ion channels and neurotransmitter receptors. There have been reports of a conotoxin acting on two ion channels, but rare reports of a conotoxin acting on three ion channels. Methods Vr3a, a proline-rich M-superfamily conotoxin from a worm-hunting Conus varius, was obtained by solid-phase synthesis and identified by mass spectrometry. The effects of synthesized Vr3a on sodium, potassium and calcium currents were tested on rat DRG cells by patch clamp experiments. The further effects of Vr3a on human Cav1.2 and Cav2.2 currents were tested on HEK293 cells. Results About 10 μM Vr3a has no effects on the peak sodium currents, but can induce a ~10 mV shift in a polarizing direction in the current-voltage relationship. In addition, 10 μM Vr3a can increase 19.61 ± 5.12% of the peak potassium currents and do not induce a shift in the current-voltage relationship. An amount of 10 μM Vr3a can inhibit 31.26% ± 4.53% of the peak calcium currents and do not induce a shift in the current-voltage relationship. The IC50 value of Vr3a on calcium channel currents in rat DRG neurons is 19.28 ± 4.32 μM. Moreover, 10 μM Vr3a can inhibit 15.32% ± 5.41% of the human Cav1.2 currents and 12.86% ± 4.93% of the human Cav2.2 currents. Conclusions Vr3a can simultaneously affect sodium, potassium and calcium currents. This novel triple-target conotoxin Vr3a expands understanding of conotoxin functions.(AU)

Clinical assessment of acid-base balance in Netherland Dwarf rabbit / Avaliação clínica do equilíbrio ácido-básico em coelhos Anã Holandês

Pet rabbits have increased their popularity in a lot of countries. However, most of the laboratory profiles in rabbit medicine come from the observations made in rabbit as biomodels or meat production. So that further researches are necessary to obtain reference values for hematology and biochemical profiles in pet rabbits and the different breeds, especially, in relation to acid-base balance. The aim of this report was to offer the mean values of the main parameters connected with acid-base profile in Netherland Dwarf breed. Thirty-five healthy rabbits (15 males and 20 females) were studied. Venous blood sample from lateral saphenous vein was analyzed to measure: haematocrit, haemoglobin, blood urea nitrogen, glucose, blood pH, partial pressure of CO2 (pCO2), total CO2, ions bicarbonate, chloride, sodium, potassium, base excess and anion Gap. Results showed a shorter range that those reported by different researchers. Moreover, differences between genders were showed in pCO2, its values were higher in males. It may be associated with a greater cellular metabolism. Values obtained in this research should be taken into account by veterinary clinicians for this breed in their clinical assessments. Besides, these values provide new results in parameters with few reference values.

A popularidade de coelhos como animais de estimação aumentou em muitos países. No entanto, a maioria dos perfis de laboratório em medicina de coelhos advém das observações de biomodelos animais ou da produção de carne. Assim, são necessárias pesquisas adicionais para obter valores de referência para hematologia e perfis bioquímicos em coelhos de estimação, e das diferentes raças, especialmente, em relação ao equilíbrio ácido-base. O objetivo deste relatório foi oferecer os valores médios dos principais parâmetros ligados ao perfil ácido-base na raça Anã Holandês. Trinta e cinco coelhos saudáveis ​​(15 machos e 20 fêmeas) foram estudados. A amostra de sangue venoso da veia safena lateral foi analisada para mensuração: hematócrito, hemoglobina, nitrogênio ureico sanguíneo, glicose, pH sanguíneo, pressão parcial de CO2 (pCO2), CO2 total, íons bicarbonato, cloreto, sódio, potássio, excesso de base e ânion Gap. Os resultados apresentaram um intervalo menor do que aqueles relatados por diferentes pesquisadores. Além disso, as diferenças entre os gêneros foram mostradas na pCO2, seus valores foram maiores no sexo masculino. Pode estar associado a um maior metabolismo celular. Os valores obtidos nesta pesquisa devem ser levados em consideração pelos clínicos veterinários para esta raça em suas avaliações clínicas. Além disso, esses valores fornecem novos resultados em parâmetros com poucos valores de referencia.

Long non-coding RNA potassium voltage-gated channel subfamily Q member 1 overlapping transcript 1 regulates the proliferation and osteogenic differentiation of human periodontal ligament stem cells by targeting miR-24-3p / 华西口腔医学杂志

OBJECTIVES@#This study aims to explore the effect and molecular mechanism of long non-coding RNA (lncRNA) potassium voltage-gated channel subfamily Q member 1 overlapping transcript 1 (KCNQ1OT1) on proliferation and osteogenic differentiation in human periodontal ligament stem cells (hPDLSCs).@*METHODS@#The hPDLSCs of normal periodontal tissues were isolated and cultured. The mineralized solution induced the osteoblast differentiation of hPDLSCs. The down-regulation of lncRNA KCNQ1OT1, the overexpression of anti-miR-24-3p on the proliferation and the levels of osteocalcin (OCN), osteopontin (OPN) and alkaline phosphatase (ALP) of hPDLSCs were investigated. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the levels of lncRNA KCNQ1OT1, miR-24-3p, OCN, OPN, and ALP. Methyl thiazolyl tetrazolium (MTT) method was used to detect cell viability and activity. Cell proliferation was evaluated by MTT. Western blot was used to detect protein expression. The targeted relationship between lncRNA KCNQ1OT1 and miR-24-3p was detected by double-luciferase experiment.@*RESULTS@#The expression level of lncRNA KCNQ1OT1 increased, and that of miR-24-3p decreased during the osteogenesis of hPDLSCs (@*CONCLUSIONS@#Down-regulation of lncRNA KCNQ1OT1 inhibited the proliferation and osteogenic differentiation of hPDLSCs by targeting the up-regulated expression of miR-24-3p.

Screening and identification of potassium-dissolving bacteria from different rhizosphere soil of Paris polyphylla var. yunnanensis / 中国中药杂志

The study aiming at exploring the potassium-dissolving capacity of rhizosphere potassium-dissolving bacteria from diffe-rent sources and screen the strains with high potassium-dissolving ability, so as to lay a theoretical foundation for cultivation and quality improvement of Paris polyphylla var. yunnanensis sources. The rhizosphere soil of 10 wild and transplanted species from Yunnan, Sichuan and Guizhou provinces was used as the research object. Potassium-dissolving bacteria were isolated and purified, and their potassium-dissolving capacity was determined by flame spectrophotometry, and identified by physiological, biochemical and molecular biological methods. Twenty-six potassium-dissolving bacteria were purified and 13 were obtained from wild and transplanted strains respectively. It was found through the determination of potassium-dissolving capacity that the potassium-dissolving capacity of 26 strains was significantly different, and the mass concentration of K~+ in the fermentation broth were 1.04-2.75 mg·L~(-1), the mcentration of potassium were 0.01-1.82 mg·L~(-1). The strains were identified as Bacillus, Agrobacterium rhizome and Staphylococcus by physiological, biochemical and 16 S rDNA molecular methods, among them Bacillus amylolyticus(4 strains) was the dominant bacterium of Bacillus. The physiology and biochemistry of rhizosphere potassium-dissolving bacteria in P. polyphylla var. yunnanensis rhizosphere were diffe-rent, and the living environment were different, so the potassium-dissolving capacity also changed. Strain Y4-1 with the highest potassium decomposability was Bacillus amylolytic with a potassium increase of 1.82 mg·L~(-1). The potassium-dissolving ability and the distribution of potassium-dissolving bacteria were different in various habitats. The screening of potassium-dissolving bacteria provided a new strain for the preparation of microbial fertilizer. It is expected that B. amyloidococcus Y4-1 can be used as an ideal strain to cultivate mycorrhizal seedlings of P. polyphylla var. yunnanensis.

Cosinor-rhythmometry for 24-h urinary sodium, potassium, creatinine excretion in the Chinese adult population / 中华医学杂志(英文版)

BACKGROUND@#The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels. The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion, possibly due to the circadian rhythm in urinary excretion. This study aimed to explore the circadian rhythm, characteristics, and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.@*METHODS@#Eighty-five participants (mean age 32.4 years) completed the 24-h urine collection by successively collecting each of the single-voided specimens within 24 h. The concentrations of the urinary sodium, potassium, and creatinine for each voided specimen were measured. Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium, potassium, and creatinine excretion. The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.@*RESULTS@#The metabolism of urinary sodium, potassium, and creatinine showed different patterns of circadian rhythm, although the urinary sodium excretion showed non-significant parameters in the cosinor model. A significant circadian rhythm of urinary creatinine excretion was observed, while the circadian rhythm of sodium was less significant than that of potassium. The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent, which had a nocturnal peak and fell to the lowest around noon to afternoon. In contrast, the peak of potassium was observed in the morning and dropped to the lowest point in the evening. The hourly urinary excretion followed a similar circadian rhythm.@*CONCLUSION@#It is necessary to consider the circadian rhythm of urinary sodium, potassium, and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.

Study on Proficiency Testing of Determination Potassium in Serum / 中国医疗器械杂志

OBJECTIVE@#To evaluate the capacity of laboratories participated in the proficiency testing (PT) of determination potassium in serum and improve the quality of testing, and put forward technical suggestions for unsatisfied laboratories.@*METHODS@#According to the requirements of CNAS related documents, the homogeneity and stability of the real PT sample were evaluated by one-way ANOVA and t test, respectively. The values of real PT samples were assigned by reference method which was used in PT results assay. It is required that the deviation of value of real PT samples (code:2, 3, 5) between the measured value and the assigned value shall be within ±15.0%. The precision of values for all samples should not be greater than 3.0%.@*RESULTS@#All the laboratories submitted valid data according to the requirements. Only one laboratory did not meet the requirements, and the satisfaction rate was 90.9%.@*CONCLUSIONS@#The ability of most of laboratories are accurate and reliable.

No inferioridad entre dos agentes de bajo volumen (picosulfato de sodio/citrato de magnesio frente al sulfato de sodio/potasio/magnesio) en la preparación del colon para procedimientos diagnósticos: estudio observacional / Non-inferiority between two low-volume agents (sodium picosulfate/magnesium citrate vs. sodium sulfate/potassium/magnesium) to prepare the bowel for diagnostic procedures: an observational study

Resumen Introducción: el cáncer colorrectal es un problema de salud pública; sin embargo, la detección temprana reduce su morbimortalidad. La colonoscopia es el procedimiento de elección para detectar lesiones premalignas y el éxito depende de una limpieza adecuada. El objetivo es evaluar el desempeño de dos preparaciones de bajo volumen empleados en un hospital de alto nivel. Materiales y métodos: estudio prospectivo en adultos que asistieran a colonoscopia en la Fundación Santa Fe de Bogotá, Colombia. Las preparaciones se evaluaron con la escala de Boston, con puntaje ≥ 6 puntos para una limpieza adecuada. Se realizó un análisis de regresión logística para establecer la efectividad de los medicamentos con un cálculo de no inferioridad del 3 %-5 %. Resultados: 598 pacientes fueron evaluados. El 49 % (293) fue expuesto al picosulfato de sodio/citrato de magnesio y el 51 % (305) fue expuesto al sulfato de sodio/potasio/magnesio. Con un promedio de Boston de 6,98 ± 1,86 (78 % con puntaje de Boston ≥ 6) y 7,39 ± 1,83 (83 %), respectivamente (p = 0,649). Según el análisis de la presencia y frecuencia de síntomas no deseados, el picosulfato fue mejor tolerado (p < 0,001). Conclusiones: los estudios de preparación intestinal en pacientes de un escenario real son muy escasos. Los medicamentos de bajo volumen obtuvieron una efectividad global y por segmento de colon similar, confirmando la no-inferioridad; el picosulfato de sodio/citrato de magnesio fue mejor tolerado. Un estudio de costo-efectividad podría definir esto según las necesidades de la población de estudio.

Abstract Introduction: Colorectal cancer is a public health problem; however, early detection reduces morbidity and mortality. Colonoscopy is the procedure of choice for detecting precancerous lesions, and success depends on proper bowel cleansing. Objective: To evaluate the performance of two low-volume agents used in a high-level hospital. Materials and methods: Prospective study in adults who underwent colonoscopy at the Fundación Santa Fe in Bogotá, Colombia. Preparations were evaluated using the Boston Bowel Preparation Scale. A score ≥6 points indicated adequate preparation. A logistic regression analysis was carried out to establish the effectiveness of the medicines with a non-inferiority ratio of 3-5%. Results: 598 patients were evaluated. 49% (293) received sodium picosulfate/magnesium citrate and 51% (305) received sodium sulfate/potassium/magnesium, with an average Boston score of 6.98±1.86 (78% Boston ≥6) and 7.39±1.83 (83%), respectively (p=0.649). According to the analysis of the presence and frequency of unwanted symptoms, picosulfate was better tolerated (p < 0.001). Conclusions: Bowel preparation studies in patients from a real-life scenario are scarce. Low-volume agents had similar overall and segmental effectiveness in the colon, confirming non-inferiority; sodium picosulfate/magnesium citrate was better tolerated. A cost-effectiveness study could establish the best option according to the needs of the study population.

Características clínicas de pacientes con sospecha de síndrome de lisis tumoral. Servicio de Medicina Interna. Hospital General Universitario Dr. Luis Gómez López / Clinical characteristics of patients with suspected tumor lysis syndrome. Internal Medicine Service. General University Hospital Dr. Luis Gómez López

El síndrome de lisis tumoral (SLT) es una complicación potencialmente letal provocada por la liberación masiva de ácidos nucleicos, potasio y fosfato hacia la circulación sistémica lo cual se asocia a graves trastornos del metabolismo hidroelectrolítico. Se realizó una revisión retrospectiva de historias clínicas con el objetivo de describir las características clínicas de los pacientes con sospecha de SLT que ingresaron al Servicio de Medicina Interna del Hospital General Universitario Dr. Luis Gómez López durante el lapso 2017-2018. El 50% de los pacientes tenían una edad comprendida entre 51 y 70 años, siendo el 65% de sexo femenino. Los canceres más frecuentemente encontrados fueron el cáncer de mama (29%), cáncer gástrico (15%) y el linfoma no Hodgkin (12%). Todos los pacientes presentaron al menos tres de las manifestaciones clínicas asociadas al SLT entre las cuales se encuentran náuseas, vómitos, anorexia, debilidad, calambres, hiperreflexia, oliguria, anuria, hematuria, hipotensión, convulsiones y deshidratación. El 46% de los pacientes presentaron hiperpotasemia, mientras que 36% mostraron hipocalcemia y 18% hiperfosfatemia. El 76% de los pacientes cursaron con una creatinina > 1,4 mg/dl. El diagnóstico definitivo de SLT no fue posible realizarlo en ninguno de los pacientes incluidos en este estudio debido a la falta de estudios paraclínicos necesarios para satisfacer los criterios según los lineamientos internacionales(AU)

Tumor lysis syndrome (TLS) is a potentially lethal complication due to massive release of nucleic acids, potassium and phosphate into the systemic circulation which is associated with severe hydroelectrolitic metabolic disorders. A retrospective review of clinical charts was performed in order to describe clinical characteristics of patients with possible TLS that were admitted to the Servicio de Medicina Interna of the Hospital General Universitario Dr. Luis Gómez López during the period 2017-2018. The results show that 50% of patients were between 51 and 70 years old and 65% were female. Breast cancer (29%), stomach cancer (15%) and Non-Hodgkin lymphoma (12%) were more frequent in patients with possible TLS. All patients showed at least three of the clinical features commonly associated with TLS such as nausea, vomiting, anorexia, weakness, cramps, hyperreflexia, oliguria, anuria, hematuria, hypotension, convulsion and dehydration. 46% of patients had hyperkalemia, 36% hypocalcemia and 18% hyperphosphatemia. Creatinine levels > 1,4 mg/dl were seen in 76% of patients. Definitive diagnosis of TLS was not possible in any of the patients included in this study due to the lack of laboratory studies required according to international guidelines(AU)

Wheat growth and nutrient uptake after phosphorus and potassium applications in saline-sodic field of semi-arid region / Crescimento do trigo e absorção de nutrientes após aplicações de fósforo e potássio em campo salino-sódico do semi-árido

Nutrient deficiency is a limiting factor in saline-sodic soils resulting in low crop production. The study investigated wheat response to P and K added to soils. The K was applied at 0 (K0), 75 (K1), 150 (K2) kg K2O ha-1 as K2S04 and at (0 (P0), 60 (P1), 120 (P2) kg P2O5 ha-1 as (NH4)2HPO4 in three replications under two-factorial randomized complete block (RCB) design. Both treatments significantly enhanced wheat grain (118%) and dry matter yield (60%) at P2K2 compared to control. The P treatments significantly affected leaf P, Mg, SO4, Ca:P, SO4:P ratios and soil P, Ca:P, Cl:P and SO4:P ratios, while K on leaf K, Na, Ca, SO4 concentration, K:Na, K:Ca, SO4:P,Ca:P ratios and soil pH, Na, K, Ca, SO4 concentrations, SAR, Na:K, Ca:K and Na:Ca ratios. Leaf Na was decreased to 85.3 mmol (+) kg-1 at K2 compared to 105.3 mmol (+) kg-1at P2K0. Negative correlation (R2=0.906) of leaf K:Na was found with leaf Na concentration. The correlation of dry matter was higher (R2=0.851) with leaf K:Na ratio than grain yield (R2=0.392). It is concluded that the addition of K and P addition shows beneficial effects in improving crop nutrition and wheat yield in the saline-sodic soil environment.

A deficiência de nutrientes é um fator limitante em solos salino-sódicos, resultando em baixa produção agrícola. O estudo investigou a resposta do trigo ao P e K adicionados ao solo. O K foi aplicado em 0 (K0), 75 (K1), 150 (K2) kg K2O ha-1 como K2S04 e em (0 (P0), 60 (P1), 120 (P2) kg P2O5 ha-1 como (NH4)2HPO4 em três repetições sob delineamento de blocos completos casualizados (RCB) de dois fatores. Ambos os tratamentos aumentaram significativamente o rendimento de grãos de trigo (118%) e de matéria seca (60%) em P2K2 em comparação com o controle. Os tratamentos com P afetaram significativamente o P foliar, Mg, SO4, as razões Ca:P, SO4:P e o P do solo, e as razões Ca:P, Cl:P e SO4:P, enquanto K no K foliar, Na, Ca, concentração de SO4, razões K:Na, K:Ca, SO4:P, Ca:P e pH do solo, Na, K, Ca, concentrações de SO4, SAR, razões Na:K, Ca:K e Na:Ca. O Na da folha foi reduzido para 85,3 mmol (+) kg-1 em K2 em comparação com 105,3 mmol (+) kg-1 em P2K0. Correlação negativa (R2 = 0,906) do K:Na na folha foi encontrada com a concentração de Na na folha. A correlação da matéria seca foi maior (R2 = 0,851) com a relação K:Na da folha do que rendimento de grãos (R2 = 0,392). Conclui-se que a adição de K e P apresenta efeitos benéficos na melhoria da nutrição da cultura e na produtividade do trigo em solo salino-sódico

Bacterial strains decrease solubility of potassium in the soil / Estirpes bacterianas reduzem potencial de solubilização de potássio no solo

This study aimed to verify whether inoculation with strains of diazotrophic bacteria, with proven ability to solubilize potassium (K) in vitro, contributes towards the release of K in the soil after fertilization with phonolite rock powder. The experiment was conducted in containers with 0.3 dm-3 of soil containing low potassium content. Fifteen treatments were used, namely, 12 inoculated with the bacterial strains, a control treatment (without phonolite and without inoculation), one containing phonolite without inoculation and one containing KCl, soluble fertilizer, without inoculation. In treatments with phonolite and KCl, the doses of these materials were applied to provide the soil with 195 mg dm-3 of K. A completely randomized design with four replications was used. The soil was incubated during 90 days at room temperature and humidity at about 70% retention capacity. After this period, the content of K+ (Mehlich and resin), pH value and potential acidity (H+Al) were evaluated. Phonolite, associated with inoculation with most bacterial strains, increased the availability of potassium in the soil, pH rate and reduced potential acidity. Among the strains tested, UNIFENAS 100-01, UNIFENAS 100-16, UNIFENAS 100-27, UNIFENAS 100-39 and UNIFENAS 100-93 were the most efficient for the solubilization of K+ of the phonolite. In spite of the observed results, K content released by the bacterial strains in the soil decreased when compared to in vitroconditions, thus justifying the need for studies on bio-solubilization of soil to select the most efficient strains in the process.

O objetivo desse estudo foi avaliar se a inoculação com estirpes de bactérias diazotróficas de comprovada capacidade de solubilizar potássio (K) in vitro, contribui para a liberação de K no solo, após adubação com o pó da rocha fonolito. O experimento foi conduzido em recipientes contendo 0,3 dm-3 de solo contendo baixo teor de potássio. Foram utilizados 15 tratamentos, sendo: 12 com fonolito inoculados com as estirpes bacterianas e 3 tratamentos controle, um sem fonolito e sem inoculação, um contendo fonolito sem inoculação e um contendo KCl, fertilizante solúvel, sem inoculação. Nos tratamentos contendo fonolito e KCl, foi aplicada doses desses materiais para fornecer ao solo 195 mg dm-3 de K. Foi utilizado delineamento inteiramente casualizado com quatro repetições. O solo foi incubado por 90 dias, em temperatura ambiente e a umidade foi mantida a cerca de 70% da capacidade de retenção. Após esse período, foram avaliados o teor de K+ (Mehlich e resina), valor de pH e da acidez potencial (H+Al). A utilização do fonolito, associado a inoculação com a maioria das estirpes bacterianas contribuiu para aumentar a disponibilidade de potássio no solo, o valor de pH e reduzir a acidez potencial. Dentre as estirpes testadas, destacaram-se UNIFENAS 100-01, UNIFENAS 100-16, UNIFENAS 100-27, UNIFENAS 100-39 e UNIFENAS 100-93, que foram as mais eficientes para a solubilização do K+ do fonolito. Apesar dos resultados observados, verificou-se que o teor de K liberado pelas estirpes bacterianas no solo foi reduzido quando comparado às condições in vitro, justificando assim, a necessidade de estudos de biossolubilização no solo visando selecionar as estirpes mais eficientes para desempenhar o processo

Agronomic efficiency for nitrogen, phosphorus, and potassium in bean cultivars / Eficiência agronômica para nitrogênio, fósforo e potássio em cultivares de feijão

The aim of this study was to identify and categorize new bean cultivars regarding their efficiency and responsiveness to nitrogen, phosphorus, and potassium, both individually and simultaneously, as well as to stipulate the cultivars that would suit each niche market based on this classification. Three experiments were conducted in the field separated by nutrients adopting the randomized block design in a factorial scheme (11 x 4) of 11 cultivars in four doses with three replications. Grain yield was the variable investigated and the means were the basis for the classification separated by in four availabilities: low, partial, adequate dose, and nutritional excess. Genetic variability was observed among the bean cultivars for efficiency and responsiveness (agronomic efficiency) to nitrogen, phosphorus, and potassium. The following cultivars: BRS Agreste, BRS Estilo, BRS Notável, and Pérola revealed the greatest values of efficiency and responsive ratings for nitrogen, phosphorus, and potassium, with indications for low and high technological levels. On the contrary, the cultivars BRS Ametista and BRS Sublime based on the efficiency and non-responsive classification showed a low ability to acquire or utilize the nutrients for grain formation. The BRS Pontal cultivar for all three nutrients displayed a high degree of efficiency with a value exceeding the average under different conditions of stress, suggesting that a more rustic cultivar best suits the market niche of small farmers.

O objetivo do trabalho foi identificar e classificar novas cultivares de feijoeiro quanto a eficiência e responsividade ao nitrogênio, fósforo e potássio, de forma individual e simultânea, além de indicar as cultivares para cada nicho de mercado, de acordo com essa classificação. Foram realizados três experimentos em campo, separados por nutriente, com delineamento de blocos casualizados, em esquema fatorial (11 x 4), sendo 11 cultivares em quatro doses, com três repetições. A variável analisada foi a produtividade de grãos e as médias utilizadas para a classificação, separando-se por nutriente, em quatro disponibilidades, sendo baixo, parcial, dose adequada e excesso nutricional. Existe variabilidade genética para eficiência e responsividade (eficiência agronômica) entre os cultivares de feijão, para nitrogênio, fósforo e potássio. As cultivares BRS Agreste, BRS Estilo, BRS Notável e a Pérola são as que possuem maior número de classificações eficientes e responsivas para nitrogênio, fósforo e potássio, sendo indicadas para baixo e alto nível tecnológico. Em sentido oposto, as cultivares BRS Ametista e a BRS Sublime com classificação ineficiente e não-responsiva, com baixa capacidade de adquirir ou utilizar os nutrientes para a formação de grãos. A cultivar BRS Pontal para nitrogênio, fósforo e potássio, apresenta uma eficiência alta ou acima da média sob os diferentes estresses, o que indica que é uma cultivar mais rústica e que atende o nicho de mercado de pequenos produtores.

Severe hypokalemia secondary to abuse of ß-adrenergic agonists in a pediatric patient: Case report / Hipocalemia grave secundária a abuso de agonistas ß-adrenérgicos em paciente pediátrico: relato de caso

ABSTRACT This study reports a case of a 13-year-old male with a 3-year history of severe and intermittent hypokalemia episodes of unknown origin, requiring admission to the intensive care unit (ICU) for long QT syndrome (LQTS), finally diagnosed of redistributive hypokalemia secondary to the abuse of β-adrenergic agonists in the context of a probable factitious disorder.

RESUMO O presente estudo relata o caso de um jovem de 13 anos de idade com histórico, há três anos, de episódios de hipocalemia grave intermitente de origem desconhecida, internado em unidade de terapia intensiva (UTI) por síndrome do QT longo (SQTL). O paciente foi diagnosticado com hipocalemia por redistribuição secundária ao abuso de agonistas β-adrenérgicos, em contexto de provável transtorno factício.

Fruit quality of west indian cherry irrigated with saline waters under combinations of nitrogen/potassium fertilization / Qualidade de frutos de aceroleira irrigada com águas salinas sob combinações de adubação nitrogenada / potássica

West Indian cherry stands out among the fruits cultivated for the pharmacological and alimentary importance, but its quality can be affected by irrigation water salinity and fertilization management. In this context, this study aimed to evaluate the effect of irrigation water of different salinities and combinations of nitrogen and potassium fertilization on the physical and physico-chemical quality of bioactive compounds in West Indian cherry fruits. The experiment was carried out in the field, using lysimeters of 60 L, in the Experimental Area of the Centro de Ciências e Tecnologia Agroalimentar (CCTA) of Universidade Federal de Campina Grande (UFCG), Pombal, PB, in a randomized block design, with treatments arranged in a 5 x 4 factorial scheme, referring to five irrigation water salinities (ECw): 0.3, 1.3, 2.3, 3.3 and 4.3 dS m-1 and four combinations (C) of doses of nitrogen (N) and potassium (K2O): C1 = 70% N + 50% K2O; C2 = 100% N + 75% K2O; C3 = 130% N + 100% K2O and C4 = 160% N + 125% K2O, of the recommended dose for West Indiancherry, with three replicates and one plant per plot consisting of a lysimeter. The cv. Flor Branca grafted on cv. Junco was used in the study. The increase in salinity of irrigation water reduced the size, weight and vitamin C content of the fruits, but, the combinations of N and K fertilization did not affect fruit shape and the content of anthocyanin, carotenoids, pH, titratable acidity, total soluble solids and fruit flavor. Fertilization combinations consisting of C1 and C2 treatments promoted the largest fruit size under irrigation with ECw of up to 1.3 dS m-1 and greater mass accumulation. Fertilization doses above C2 combinations negatively affected fruit quality.

A aceroleira se destaca entre as fruteiras cultivadas pela importância farmacológica e alimentícia de seus frutos, porém sua qualidade pode ser afetada pela salinidade da água de irrigação e o manejo da adubação. Neste sentido, objetivou-se com o trabalho estudar o efeito de diferentes salinidades da água de irrigação e de combinações de adubação nitrogenada e potássica sobre a qualidade física, físico-química e de compostos bioativos em frutos de aceroleira. O experimento foi conduzido em campo, usando lisímetros de 60 L, na Área Experimental do Centro de Ciências e Tecnologia Agroalimentar (CCTA) da Universidade Federal de Campina Grande (UFCG), Pombal, PB, em delineamento de blocos ao acaso e esquema fatorial 5 x 4, referentes a cinco níveis de salinidade da água de irrigação (CEa): 0,3; 1,3; 2,3; 3,3 e 4,3 dS m-1 e quatro combinações (C) de adubação nitrogenada e potássica: C1 = 70% N + 50% K2O; C2 = 100% N + 75% K2O; C3 = 130% N + 100% K2O e C4 = 160% N + 125% K2O da dose recomendada para aceroleira, com três repetições e uma planta por parcela constituída de um lisímetro. Estudou-se a cv. Flor Branca enxertada sobre porta-enxerto da cv. Junco, sendo a qualidade dos frutos avaliada entre 260 e 295 dias após o transplantio. O incremento na salinidade da água de irrigação reduziu o tamanho, o peso e o teor de vitamina C nas acerolas, porém, assim como as combinações de adubação de N e K, não afetaram o formato de frutos e os teores de antocianinas, carotenoides, pH, acidez titulável, sólidos solúveis totais e o sabor dos frutos. As combinações de adubação C1 e C2 proporcionaram o maior tamanho de frutos pela irrigação com CEa de até 1,3 dS m-1 e promoveram maior acúmulo de massa. Doses de fertilização acima da combinação C2 afetaram negativamente a qualidade dos frutos mesmo em plantas irrigadas com água de baixa salinidade.

The retranslocation of boron is influenced by the nutritional status of cherry tomato plants / A retranslocação do boro é influenciada pelo estado nutricional do tomateiro cereja

Boron (B) retranslocation may confer greater tolerance to B deficiency or toxicity, resulting in plants and fruits with better nutritional quality. Most plants do not demonstrate phloem mobility for B; however, some plants have natural mobility and others express it under stress conditions, such as nutritional stress. Therefore, we investigated the phloem mobility of B in cherry tomato plants with different nutritional status. The plants were cultivated in nutrient solution with adequate and insufficient doses of Potassium (K) and B. Furthermore, the plants received foliar fertilization with B in a mature leaf (F) in a localized form. The B content and amount in leaves near F were compared with leaves of the same age and position on control plants. The experiment was carried out in a protected environment and conducted in a randomized complete block design in a subdivided plot scheme with four replicates. Re-translocation of B between neighboring leaves was observed when the plant was without K deficiency and with B deficiency. In this nutritional status, leaves next to fertilized leaf with B (F) showed higher B amount when compared to leaves of the same position of control plants. Evidence suggests that retranslocation of B over relatively short distances (between leaves) can be influenced by the nutritional status the cherry tomato plants.

A retranslocação de Boro (B) pode conferir maior tolerância à deficiência ou toxidez de B, resultando em plantas e frutos com melhor qualidade nutricional. A maioria das plantas não demonstra mobilidade floemática para o B, contudo, algumas plantas possuem mobilidade natural e outras a expressam sob condições de estresse, como o estresse nutricional. Nesse sentido, foi investigada a mobilidade floemática do B em plantas de tomate cereja com diferentes status nutricionais. As plantas foram cultivadas em solução nutritiva com doses adequada e insuficiente de Potássio (K) e B. Adicionalmente, as plantas receberam, de forma localizada, fertilização foliar com B em uma folha madura (F). Os teores e os conteúdos de B nas folhas vizinhas a F foram comparados com folhas de mesma idade e posição de plantas controle. O experimento foi realizado em ambiente protegido e conduzido no delineamento de blocos casualizados em esquema de parcelas subdivididas com quatro repetições. Evidenciou-se retranslocação de B entre folhas vizinhas quando a planta estava sem deficiência de K e com deficiência de B. Neste status nutricional, as folhas vizinhas à folha aplicada (F) apresentaram maiores teores e conteúdos de B quando comparadas às folhas de mesma posição das plantas controle. As evidências sugerem que a retranslocação de B em distâncias relativamente curtas (entre folhas) pode ser influenciada pelo status nutricional de plantas de tomate cereja.