Análisis de movimientos periódicos de piernas durante el sueño, presión arterial de 24 horas y frecuencia cardíaca.

Los Movimientos Periódicos de las Piernas durante el Sueño (PLMS), diagnosticados por polisomnografía, se caracterizan por movimientos estereotipados de las piernas que aparecen de forma repetitiva durante la noche. Cada PLMS se asocia a un microdespertar e incrementos de la frecuencia cardiaca, presión arterial y actividad simpática. Objetivos: Analizar asociación entre el índice patológico de PLMS y la PA de 24 horas, en pacientes normotensos. Evaluar la asociación entre índice patológico de PLMS, con alteraciones en la velocidad de onda de pulso y frecuencia cardíaca. Métodos Estudio observacional de casos y controles. Se estudiaron 19 sujetos normotensos mediante Polisomnografía Nocturna y Monitoreo Ambulatorio de la Presión Arterial. Se determinaron las variables: Edad, sexo, peso, índice de masa corporal. La presión arterial y frecuencia cardíaca de 24 hs, diurna y nocturna se evaluaron con monitoreo ambulatorio de presión arterial de 24 h. Se excluyeron pacientes con índice de apneas/hipopneas ≥ 5 e/h. Se describieron las variables y compararon sujetos con y sin PLMS, considerando significativo una p<0,05, además análisis de correlación.   Resultados Se estudiaron a 11 pacientes con PLMS patológico y 7 controles (Índice PLMS 35,6±15 versus 7,9±5 respectivamente). Los pacientes con PLMS fueron más jóvenes 57 ±14 versus 64±6; p=0,284 años. La presión arterial de 24 h, fue menor en el grupo PLMS que en los controles (sistólica 114,2±11 versus 123±11; p=0,095; y diastólica 65,7±5 versus 74,4±11, p=0,027).   Conclusión Encontramos una relación estadísticamente significativa, inversa, no esperada, al correlacionar los movimientos periódicos de piernas durante el sueño, de grado patológico, con la presión arterial sistólica y media de 24 h, la presión arterial sistólica diurna y nocturna, y la presión arterial media nocturna, como así también hallazgos similares en la presión de pulso de 24 horas y la presión de pulso diurna y nocturna que fueron inferiores al grupo control. No encontramos cambios en la frecuencia cardíaca.

Analysis of periodic leg movements during sleep, 24-hour blood pressure and heart rate / [Análisis de movimientos periódicos de piernas durante el sueño, presión arterial de 24 horas y frecuencia cardíaca.]

Los Movimientos Periódicos de las Piernas durante el Sueño (PLMS), diagnosticados por polisomnografía, se caracterizan por movimientos estereotipados de las piernas que aparecen de forma repetitiva durante la noche. Cada PLMS se asocia a un microdespertar e incrementos de la frecuencia cardiaca, presión arterial y actividad simpática. Objetivos: Analizar asociación entre el índice patológico de PLMS y la PA de 24 horas, en pacientes normotensos. Evaluar la asociación entre índice patológico de PLMS, con alteraciones en la velocidad de onda de pulso y frecuencia cardíaca. Métodos: Estudio observacional de casos y controles. Se estudiaron 19 sujetos normotensos mediante Polisomnografía Nocturna y Monitoreo Ambulatorio de la Presión Arterial. Se determinaron las variables: Edad, sexo, peso, índice de masa corporal. La presión arterial y frecuencia cardíaca de 24 hs, diurna y nocturna se evaluaron con monitoreo ambulatorio de presión arterial de 24 h. Se excluyeron pacientes con índice de apneas/hipopneas ≥ 5 e/h. Se describieron las variables y compararon sujetos con y sin PLMS, considerando significativo una p<0,05, además análisis de correlación. Resultados: Se estudiaron a 11 pacientes con PLMS patológico y 7 controles (Índice PLMS 35,6±15 versus 7,9±5 respectivamente). Los pacientes con PLMS fueron más jóvenes 57 ±14 versus 64±6; p=0,284 años. La presión arterial de 24 h, fue menor en el grupo PLMS que en los controles (sistólica 114,2±11 versus 123±11; p=0,095; y diastólica 65,7±5 versus 74,4±11, p=0,027). Conclusión: Encontramos una relación estadísticamente significativa, inversa, no esperada, al correlacionar los movimientos periódicos de piernas durante el sueño, de grado patológico, con la presión arterial sistólica y media de 24 h, la presión arterial sistólica diurna y nocturna, y la presión arterial media nocturna, como así también hallazgos similares en la presión de pulso de 24 horas y la presión de pulso diurna y nocturna que fueron inferiores al grupo control. No encontramos cambios en la frecuencia cardíaca.

Periodic Leg Movements During Sleep (PLMS), diagnosed by polysomnography, is characterized by stereotyped leg movements that appear repetitively at night. Each PLMS is associated with microarousal and increases in heart rate, blood pressure, and sympathetic activity. Objectives: To analyze the association between the pathological index of PLMS and 24-hour BP in normotensive patients.To evaluate the association between the pathological index of PLMS, with alterations in pulse wave velocity and heart rate. Methods: Observational study of cases and controls. 19 normotensive subjects were studied by Nocturnal Polysomnography and Ambulatory Blood Pressure Monitoring. The variables were determined: Age, sex, weight, body mass index. 24-h, diurnal, and nocturnal blood pressure and heart rate were assessed with 24-h ambulatory blood pressure monitoring. Patients with apnea/hypopnea index ≥ 5 e/h were excluded. The variables were described and subjects with and without PLMS were compared, considering significant a p<0.05, in addition to correlation analysis. Results: Eleven patients with pathological PLMS and 7 controls were studied.PLMS Index 35.6±15 versus 7.9±5 respectively. PLMS patients were younger 57±14 versus 64±6; p=0.284. The 24-h blood pressure was lower in the PLMS group than the controls (systolic 114.2±11 versus 123±11; p=0.095; and diastolic 65.7±5 versus 74.4±11, p=0.027). Discussion: We found an unexpected, inverse, statistically significant relationship when correlating pathological-grade periodic leg movements during sleep with 24-hour mean and systolic blood pressure, daytime and nighttime systolic blood pressure, and mean blood pressure. nocturnal, as well as similar findings in the 24-hour pulse pressure and the diurnal and nocturnal pulse pressure that were lower than the control group. We found no changes in heart rate.

[Sleep Disorders and depression in Parkinson's Disease]. / Trastornos del sueno y Depresión en la enfermedad de Parkinson.

OBJECTIVES: Sleep disorders are common in Parkinson's disease (PD). To diagnose sleep disturbances analyzing the sleep macrostructure and other variables in PD. METHOD: The cross-sectional, retrospective study in PD patients. Sociodemographic, clinical/pharmacological variables, Epworth sleepiness scale (ESS), Beck depression index (BDI) and polysomnography of patients with Parkinson's disease. Frequency, mean, standard deviation analysis were obtained. The variables were compared using t test student, univariate ANOVA and chi-square. A p<0.05 was considered significant. SPSS (Chicago SPSS Inc.) 18 was used. The n were 44 patients, 33 men, mean age 71 (range 52-90), ESS 7.7±6 (normal), BDI 13±8 points (pathological). CONCLUSIONS: At older age, the time awake after sleep began (p=0.03) was greater and lower sleep efficiency (p=0.02).The average percentage of stage of N3 sleep was 37.2% in women vs 24.7% in men (p=0.02). Hypopnea apnea index was pathological grade at 79.5% (n=35).We diagnose apnea hypopnea syndrome in the majority, insomnia and REM parasomnias. The increase in the percentage of stage N3 was rarely reported in the literature. At older age were more changes in the macroestructure and more sleep disturbances.

Characterization of Bacteriophages against Pseudomonas Syringae pv. Actinidiae with Potential Use as Natural Antimicrobials in Kiwifruit Plants.

Pseudomonas syringae pv. actinidiae (Psa) is the causal agent of a bacterial canker in kiwifruit plants and has caused economic losses worldwide. Currently, the primary strategies to control this pathogen include the use of copper-based compounds and even antibiotics. However, the emergence of isolates of Psa that are resistant to these agrochemicals has raised the need for new alternatives to control this pathogen. Bacteriophages have been proposed as an alternative to control bacterial infections in agriculture, including Psa. Here, we show the isolation and characterization of 13 phages with the potential to control Psa infections in kiwifruit plants. The phages were characterized according to their host range and restriction fragment length polymorphism (RFLP) pattern. Four phages were selected according to their lytic effect on the bacteria and their tolerance to different environmental conditions of pH (4-7), temperature (4-37 °C), and solar radiation exposure (30 and 60 min). The selected phages (CHF1, CHF7, CHF19, and CHF21) were sequenced, revealing a high identity with the podophage of Psa phiPSA2. In vitro assays with kiwifruit leaf samples demonstrated that the mixture of phages reduced the Psa bacterial load within three hours post-application and was able to reduce the damage index in 50% of cases. Similarly, assays with kiwifruit plants maintained in greenhouse conditions showed that these phages were able to reduce the Psa bacterial load in more than 50% of cases and produced a significant decrease in the damage index of treated plants after 30 days. Finally, none of the selected phages were able to infect the other bacteria present in the natural microbiota of kiwifruit plants. These results show that bacteriophages are an attractive alternative to control Psa infections in kiwifruit plants.

Productive infection and transduction by bacteriophage P1 in the species Salmonella bongori

Background: Horizontal gene transfer (HGT) is the most important mechanism in the evolution of new genetic capabilities in bacteria, including specific degradative pathways, virulence factors, and resistance to antibiotics. Among the processes involved in HGT, transduction is noteworthy. This is a mechanism for gene transmission mediated by a bacteriophage that functions both as a reservoir and as a vector of exogenous genes, which remain protected from environmental effects in the bacteriophage's capsid. Within this context, this investigation aimed to evaluate the ability of the generalized transducing bacteriophage P1 to productively infect and transduce in the bacterial species Salmonella bongori. Results: We could establish that a derivative of bacteriophage P1, P1Cm, infects strains of S. bongori with frequencies of lysogenization in the order of ~10−2 lysogens/UFP. Through thermal induction, infective viral progeny was obtained, and we could show that P1Cm readily formed plaques on S. bongori lawns, a phenomenon thus far not reported for other members of the genus Salmonella. Finally, we showed P1Cm-mediated transduction of the model plasmid RP4 at frequencies of ~10−7 transductants/donor. Conclusion: Therefore, bacteriophage P1 can be used as a tool for the genetic manipulation in the species S. bongori.

Diversification of Vibrio anguillarum Driven by the Bacteriophage CHOED.

Bacteriophages are an important factor in bacterial evolution. Some reports suggest that lytic bacteriophages can select for resistant mutant strains with reduced virulence. The present study explores the role of the CHOED bacteriophage in the diversification and virulence of its host Vibrio anguillarum. Nine phage-resistant strains were analyzed for their phenotype and different virulence factors, showing alterations in their fitness, motility, biofilm formation, lipopolysaccharide profiles and/or protease activity. Seven of the nine phage-resistant strains showed virulence reduction in a Sparus aurata larvae model. However, this is not generalized since two of the resistant strains show equal virulence compared with the parental strain. The genomic analysis of representative resistant strains displayed that the majority of the mutations are specific for each isolate, affecting genes related to lipopolysaccharide biosynthesis, quorum sensing, motility, toxin and membrane transport. The observed mutations were coherent with the phenotypic and virulence differences observed. These results suggest that the CHOED phage acts as a selective pressure on V. anguillarum, allowing proliferation of resistant strains with different genotypes, phenotypes and degrees of virulence, contributing to bacterial diversification.

Características polisomnográficas nocturnas y otras variables relacionadas, en pacientes adultos mayores / Nocturnal polysomnbnographic characteristics and other related variables in elderly patients

Se cree que los ancianos necesitan dormir menos. Sin embargo, no es la necesidad de sueño sino la capacidad de dormir lo que disminuye con la edad, en paralelo a la mayor prevalencia de enfermedades cardiovasculares o metabólicas, o de depresión. Poco se ha descripto sobre los hallazgos polisomnográficos de esta población. En el presente estudio analizamos los hallazgos polisomnográficos en pacientes mayores de 65 años. Se realizó un estudio descriptivo a partir del análisis de una base de datos de 551 pacientes mayores de 65 años evaluados entre junio de 2013 y diciembre de 2014. Todos los sujetos se realizaron una polisomnografía (PSG) nocturna de 6 horas de duración. Las variables analizadas fueron: latencia de sueño (LS), eficacia de sueño (ES), latencia de fase REM (Lat R), % de R, índice de apneas hipopneas (IHA) y movimientos periódicos de piernas durante el sueño (PLMS). Se dividió la población en 3 grupos: G1: de 65 a 70 años; G2: 71 a 75; G3: mayor de 75 años. Se analizaron los datos de la serie general y las diferencias intergrupos. El IHA se incrementó con la edad y resultó más severo en los pacientes mayores de 75 años en relación con el grupo de menor edad. El incremento del IAH no se asoció a un incremento del índice de masa corporal ni a mayor somnolencia diurna. (AU)

It is believed that the elderly need less sleep. However, it is not the need for sleep but the ability to sleep that decreases with age, in parallel to the increasing prevalence of cardiovascular or metabolic disease, or depression. Little has been described about the polysomnographic findings of this population, hypothesizing that there are several alterations that prematurely corrected could improve the quality of life as the years go by. We analyzed the polysomnographic findings in patients over 65 years of age. A descriptive study was carried out based on the analyses of a database of 551 patients over 65 years of age evaluated between June 2013 to December 2014. All subjects underwent nocturnal PSG of 6 hours duration. The polysomnographic variables analyzed were: sleep latency (LS), sleep efficiency (ES), latency R phase (Lat R), % R, Apneas Hypoapneas Index (AHI) and Periodic Limb Movements of Sleep (PLMS). The population was divided into 3 groups: G1: from 65 to 70 years G2: 71 to 75, G3 greater than 75. AHI increased with age, being more severe in patients over 75 years of age in relation to the younger age group. The increase in AHI was not associated with an increase in Body Mass Index (BMI) or greater daytime sleepiness. (AU)

Virulence reduction in bacteriophage resistant bacteria.

Bacteriophages can influence the abundance, diversity, and evolution of bacterial communities. Several bacteriophages have been reported to add virulence factors to their host and to increase bacterial virulence. However, lytic bacteriophages can also exert a selective pressure allowing the proliferation of strains with reduced virulence. This reduction can be explained because bacteriophages use structures present on the bacterial surface as receptors, which can be virulence factors in different bacterial species. Therefore, strains with modifications in these receptors will be resistant to bacteriophage infection and may also exhibit reduced virulence. This mini-review summarizes the reports on bacteriophage-resistant strains with reductions in virulence, and it discusses the potential consequences in phage therapy and in the use of bacteriophages to select attenuated strains for vaccines.

Natural lysogenization and transduction in Salmonella enterica serovar Choleraesuis by bacteriophage P1.

It has been reported that bacteriophage P1 injects DNA into serovar Choleraesuis without evidence of productive infection. However, we found that P1 generates progeny and is capable of transduction in serovar Choleraesuis. This is not the case with other serovars of Salmonella enterica we tested. Therefore, P1 could play a role in serovar Choleraesuis evolution and contribute to its genetic manipulation and analysis.