Análisis de fragilidad y riesgo de peritonitis en pacientes ancianos en diálisis peritoneal / Analysis of fragility and risk of peritonitis in elderly patients on peritoneal dialysis

INTRODUCCIÓN: Los pacientes ancianos en diálisis peritoneal tienen mayor riesgo de presentar fragilidad, pérdida de autonomía, comorbilidad y disminución de calidad de vida. OBJETIVO: evaluar la fragilidad, dependencia, depresión y calidad de vida, analizando la repercusión de la fragilidad sobre el tiempo de aprendizaje de la técnica y la aparición del primer episodio de peritonitis. MATERIAL Y MÉTODO: estudio descriptivo retrospectivo. Se incluyeron pacientes mayores de 70 años, desde septiembre 2016 a 2017, las peritonitis hasta final de 2018. Se estudiaron variables demográficas, modalidad dialítica, índices de Charlson, Barthel y escala de depresión de Yesavage Escala de fragilidad clínica, calidad de vida, tiempo de entrenamiento y primera peritonitis. RESULTADOS: Se incluyeron 25 pacientes, 56% hombres, edad media 76,77±5,34 años, el 72% estaban en diálisis peritoneal manual. La media del Charlson 7,88±2,06, del Barthel 88,27±24,66 y del Short form 12 health survey 32,96±8,61. El 40% tenían algún grado de fragilidad, 24% depresión, el 28% precisaban ayuda o estaban institucionalizados. Tiempo medio de entrenamiento en pacientes frágiles fue 16,77±7,93 horas vs no frágiles 15,20±5,06 (p = 0,42). Se recogieron 16 episodios de peritonitis, repartidos al 50%, tiempo medio de aparición frágiles 315,13±212,73 días vs no frágiles 320,25±224,91 (p = 0,44). CONCLUSIONES: La mayoría de los pacientes realizan diálisis peritoneal manual de forma autónoma. Tienen un nivel de fragilidad bajo, no presentan depresión y gozan de buena calidad de vida para su edad. No existe diferencia en el tiempo de aprendizaje entre los dos grupos. Las peritonitis se reparten al 50% en frágiles y no frágiles

INTRODUCTION: Elderly patients on peritoneal dialysis have a higher risk of presenting fragility, loss of autonomy, comorbidity and decreased quality of life. OBJECTIVE: To assess frailty, dependency, depression and quality of life, analysing the repercussion of frailty on the learning time of the technique and the appearance of the first episode of peritonitis. MATERIAL AND METHOD: descriptive retrospective study. Patients older than 70 years were included, from September 2016 to 2017, episodes of peritonitis until the end of 2018. Demographic variables, dialysis modality, Charlson index, Barthel index, Yesavage geriatric depression scale, clinical fragility scale, quality of life scale, training time and first peritonitis were collected. RESULTS: 25 patients were included, 56% men, mean age 76.77±5.34 years, 72% were on manual peritoneal dialysis. The mean value for the Charlson index was 7.88±2.06, for Barthel index 88.27±24.66 and for the Short form 12 health survey 32.96±8.61. 40% had some degree of frailty, 24% depression, 28% needed help or were institutionalized. Average training time in fragile patients was 16.77±7.93 hours versus non-fragile 15.20±5.06 (p = 0.42). 16 episodes of peritonitis were collected, distributed to 50% between both groups. The mean time of appearance of fragile people was 315.13±212.73 days versus 320.25±224.91 days for non-fragile ones (p = 0.44). CONCLUSIONS: Most of the patients perform manual peritoneal dialysis autonomously. They have low frailty levels, no depression and enjoy a good quality of life for their age. There is no difference in learning time between the two groups. Peritonitis is equally distributed in fragile and non-fragile patients

Sexual stages of the female portion in the scallop Nodipecten nodosus (Linné, 1758) and astaxanthin quantity in each stage.

This work describes the gametogenic cycle of the scallop Nodipecten nodosus kept in a culture system. To this end, during one year, samples were taken from the broodstocks every 30 days to be submitted to macroscopic and microscopic analyses and to measure the amount of astaxanthin. To perform the microscopic evaluation, 5 micro slices from the median portion of the female part of the gonad were submitted to the pattern methodology for histological analyses with paraffin and HE coloration. The remaining portion of the female gonad was lyophilised to extract and quantify the levels of astaxanthin using HPLC. The microscopic analyses revealed four well defined stages for the reproductive cycle. Analyses of data taken throughout the year indicated preferential spawning periods from December to January and from July to September. The astaxanthin analyses showed higher amounts of this carotenoid during the advanced pre-spawning and the initial spawning periods than during gametogenesis, initial pre-spawning, advanced spawning, and the spent stages. According to these results, it was possible to establish a descriptive table of the sexual stages of the female portion of the gonad and the amount of astaxanthin in the sexual stage of the scallop Nodipecten nodosus.

Sexual stages of the female portion in the scallop Nodipecten nodosus (Linné, 1758) and astaxanthin quantity in each stage / Estágios sexuais da porção feminina da gônada da vieira Nodipecten nodosus (Linné, 1758) e a quantidade de astaxantina em cada estágio

This work describes the gametogenic cycle of the scallop Nodipecten nodosus kept in a culture system. To this end, during one year, samples were taken from the broodstocks every 30 days to be submitted to macroscopic and microscopic analyses and to measure the amount of astaxanthin. To perform the microscopic evaluation, 5 μ slices from the median portion of the female part of the gonad were submitted to the pattern methodology for histological analyses with paraffin and HE coloration. The remaining portion of the female gonad was lyophilised to extract and quantify the levels of astaxanthin using HPLC. The microscopic analyses revealed four well defined stages for the reproductive cycle. Analyses of data taken throughout the year indicated preferential spawning periods from December to January and from July to September. The astaxanthin analyses showed higher amounts of this carotenoid during the advanced pre-spawning and the initial spawning periods than during gametogenesis, initial pre-spawning, advanced spawning, and the spent stages. According to these results, it was possible to establish a descriptive table of the sexual stages of the female portion of the gonad and the amount of astaxanthin in the sexual stage of the scallop Nodipecten nodosus.

Este trabalho descreve o ciclo gametogênico da vieira Nodipecten nodosus mantida em ambiente de cultivo. Para isto, durante um ano, amostras de indivíduos reprodutores foram coletadas a cada 30 dias e submetidas à avaliação macroscópica e microscópica e à quantificação de astaxantina. Para a avaliação microscópica, secções de 5 μ da porção mediana feminina da gônada foram submetidas à metodologia de análise histológica padrão em parafina e coloração HE. O restante da porção feminina da gônada foi liofilizado para extração e quantificação de astaxantina em HPLC. A avaliação microscópica permitiu a descrição de quatro estágios bem definidos para o ciclo reprodutivo. Na análise ao longo do ano, foram observados períodos preferenciais de desova em dezembro e janeiro e de julho a setembro. A análise da quantidade de astaxantina, mostrou, nos estádios de pré-desova avançada e de desova inicial, uma maior quantidade desse carotenoide em comparação aos estádios de gametogênese, pré-desova inicial, desova avançada e repouso. Em função desses resultados, foi possível estabelecer um quadro descritivo dos estágios sexuais da porção feminina da gônada e quantidade de astaxantina em cada estágio sexual da vieira Nodipecten nodosus.