Symbiotic fungi from a wild grass (Celtica gigantea) increase the growth, grain yield and quality of tritordeum under field conditions.

Plants function in symbiosis with numerous microorganisms, which might contribute to their adaptation and performance. In this study, we tested whether fungal strains in symbiotic interaction with roots of Celtica gigantea, a wild grass adapted to nutrient-poor soils in semiarid habitats, could improve the field performance of the agricultural cereal tritordeum (Triticum durum × Hordeum chilense). Seedlings of tritordeum were inoculated with 12 different fungal strains isolated from roots of Celtica gigantea that were first proved to promote the growth of tritordeum plants under greenhouse conditions. The inoculated seedlings were transplanted to field plots at two locations belonging to different climatic zones in terms of mean temperatures and precipitation in the Iberian Peninsula. Only one strain, Diaporthe iberica T6, had a significant effect on plant height, number of tillers and grain yield in one location. This result showed a substantial divergence between the results of greenhouse and field tests. In terms of grain nutritional quality, several parameters were differentially affected at both locations: Diaporthe T6, Pleosporales T7, Zygomycota T29 and Zygomycota T80 increased the content of total carotenoids, mainly lutein, in the colder location; whereas gluten proteins increased with several treatments in the warmer location. In conclusion, early inoculation of tritordeum plants with fungal symbionts had substantial beneficial effects on subsequent plant growth and development in the field. Regarding grain nutritional quality, the effect of inoculation was affected by the agroclimatic differences between both field locations.

Opportunistic screening for atrial fibrillation versus detecting symptomatic patients aged 65 years and older: A cluster-controlled clinical trial. / Cribado oportunista de fibrilación auricular frente a detección de pacientes sintomáticos de 65 años o más: ensayo clínico controlado por clúster.

OBJECTIVE: The goal of this study was to assess the effectiveness of opportunistic screening through pulse palpation in the early detection of atrial fibrillation in subjects aged≥65 years versus detection through an active search for patients with symptoms and/or complications and sequelae associated. MATERIAL AND METHODS: This was a cluster randomized controlled trial performed in 48 primary care centers of the Spanish National Healthcare System. A total of 368 physicians and nurses were randomized. The researchers in the experimental group (EG) performed opportunistic screening for auricular fibrillation, whereas the researchers in the control group (CG) actively searched for symptomatic patients. An ECG was performed on patients found to have an irregular heartbeat to confirm the diagnosis of auricular fibrillation. RESULTS: A total of 5,465 patients with a mean age of 75.61 years were recruited for the EG, and 1,525 patients with a mean age of 74.07 years were recruited for the CG. Of these, 58.6% were female, without significant differences between groups. Pulse was irregular in 4.3 and 15.0% of the patients in the EG and the CG, respectively (P<.001). A total of 164 new cases of atrial fibrillation were detected (2.3%), 1.1% in the EG and 6.7% in the CG (adjusted OR: 0.29; 95% CI 0.18-0.45). CONCLUSIONS: Case finding for atrial fibrillation in patients aged≥65 years with symptoms or signs suggestive of atrial fibrillation is a more effective strategy than opportunistic screening through pulse palpation in asymptomatic patients. TRIAL REGISTRATION: The trial is registered in ClinicalTrials.gov (NCT01291953; February 8, 2011).

Cribado oportunista de fibrilación auricular frente a detección de pacientes sintomáticos de 65 años o más: ensayo clínico controlado por clúster / Opportunistic screening for atrial fibrillation versus detecting symptomatic patients aged 65 years and older: A cluster-controlled clinical trial

Objetivo: El objetivo de este estudio fue evaluar la eficacia del cribado oportunista a través de la palpación del pulso para la detección de fibrilación auricular en sujetos asintomáticos de edad ≥ 65 años frente a la búsqueda activa de pacientes de la misma edad con síntomas y/o complicaciones y secuelas asociadas. Material y métodos: Se realizó un ensayo clínico controlado aleatorizado por clúster en 48 centros de atención primaria del Sistema Nacional de Salud español. Se aleatorizó a un total de 368 médicos y enfermeras. Los investigadores del grupo experimental (GE) realizaron el cribado oportunista para la fibrilación auricular, mientras que los investigadores del grupo control (GC) realizaron una búsqueda activa en pacientes sintomáticos. Se realizó un ECG en los pacientes que tenían un pulso irregular para confirmar el diagnóstico de fibrilación auricular. Resultados: Un total de 5.465 pacientes con una edad media de 75,61 fueron seleccionados para el GE y 1.525 pacientes para el GC, con una edad media de 74,07 años. El 58,6% eran mujeres, sin diferencias significativas entre los grupos. El pulso era irregular en el 4,3 y el 15% de los pacientes del GE y el GC, respectivamente (p < 0,001). Se detectaron un total de 164 nuevos casos de fibrilación auricular (2,3%), el 1,1% en el GE y el 6,7% en el GC (OR ajustada 0,29; IC 95% 0,18-0,45). Conclusiones: La búsqueda activa, a través de la palpación del pulso, de fibrilación auricular en pacientes de edad ≥ 65 años con síntomas o signos indicativos es una estrategia más eficaz que el cribado oportunista en pacientes asintomáticos. Registro del ensayo clínico: Registrado en ClinicalTrials.gov (NCT01291953; 8 de febrero de 2011) (AU)

Objective: The goal of this study was to assess the effectiveness of opportunistic screening through pulse palpation in the early detection of atrial fibrillation in subjects aged ≥ 65 years versus detection through an active search for patients with symptoms and/or complications and sequelae associated. Material and methods: This was a cluster randomized controlled trial performed in 48 primary care centers of the Spanish National Healthcare System. A total of 368 physicians and nurses were randomized. The researchers in the experimental group (EG) performed opportunistic screening for auricular fibrillation, whereas the researchers in the control group (CG) actively searched for symptomatic patients. An ECG was performed on patients found to have an irregular heartbeat to confirm the diagnosis of auricular fibrillation. Results: A total of 5,465 patients with a mean age of 75.61 years were recruited for the EG, and 1,525 patients with a mean age of 74.07 years were recruited for the CG. Of these, 58.6% were female, without significant differences between groups. Pulse was irregular in 4.3 and 15.0% of the patients in the EG and the CG, respectively (P < .001). A total of 164 new cases of atrial fibrillation were detected (2.3%), 1.1% in the EG and 6.7% in the CG (adjusted OR: 0.29; 95% CI 0.18-0.45). Conclusions: Case finding for atrial fibrillation in patients aged ≥ 65 years with symptoms or signs suggestive of atrial fibrillation is a more effective strategy than opportunistic screening through pulse palpation in asymptomatic patients. Trial registration: The trial is registered in ClinicalTrials.gov (NCT01291953; February 8, 2011) (AU)

Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol.

BACKGROUND: Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers. METHODS/DESIGN: An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis). DISCUSSION: If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines. TRIAL REGISTRATION: The study is registered as NCT01291953 (ClinicalTrials.gob).