Physiotherapy applied to palliative care patients: a descriptive practice-based study.

BACKGROUND: Over the last few years, the presence of physiotherapists in Palliative Care Units (PCU) has considerably grown based on evidence from studies supporting the use of non-pharmacological measures as part of Palliative Care (PC) treatments. However, more accumulated data are needed to definitively establish its added value. The present study describes the type of patients receiving physiotherapy in a PCU and the benefits obtained in relation to their degree of functional dependence. METHODS: An observational, prospective, descriptive, practice-based study was undertaken involving patients admitted to the PCU of Fundación Instituto San José (Madrid, Spain), who according to the PCU´s clinical practice, met the criteria for physiotherapy intervention. Daily clinical practice was unchanged for study reasons. Participants were assessed prior to initiating and at the end of the physiotherapy program using the following standard scales: the Barthel Index, the Functional Ambulation Categories scale, the Palliative Performance Scale, and the Braden scale. A descriptive analysis was performed and scale scores prior to and after treatment were compared using the Wilcoxon signed-rank test. Significance was set at 0.05. RESULTS: A total of 63 patients were included (mean age 71.98 ± 12.72; 61.9% males). Fifty-eight patients (92.1%) were oncological patients; of them, 35 (60.3%) had metastases. Prior to treatment, 28 (44.4%) participants had total dependence according to the Barthel index, and 37 (58.7%) were non-functional ambulator according to the FAC scale. At the end of treatment, the number of patients with total dependence decreased to 15 (23.8%) and those non-functional ambulator to 12 (19.0%). CONCLUSIONS: Patients who benefited from physical therapy during their admission to our PCU were predominantly males with oncological processes, mainly lung cancer. PC including physiotherapy improved their functionality, independence and skills for activities of daily living in this sample of PCU patients.

Pigmentary mosaicism as a recurrent clinical manifestation in three new patients with mosaic trisomy 12 diagnosed postnatally: cases report and literature review.

BACKGROUND: To date, only twenty-one cases diagnosed postnatally with mosaic trisomy 12 have been reported. The most frequent phenotypic manifestations are developmental delay, dysmorphic facial features, congenital heart defects, digital alterations, and pigmentary disorders. In the present report, detailed clinical and genetic profiles of three unrelated new patients with mosaic trisomy 12 are described and compared with previously reported cases. CASE PRESENTATION: In the present report, we include the clinical, cytogenetic, and molecular description of three Mexican patients diagnosed postnatally with mosaic trisomy 12. At phenotypic level, the three patients present with developmental delay, dysmorphic facial features, congenital heart defects and skin pigmentary anomalies. Particularly, patient 1 showed unique eye alterations as bilateral distichiasis, triple rows of upper lashes, and digital abnormalities. In patient 2 redundant skin, severe hearing loss, and hypotonia were observed, and patient 3 presented with hypertelorism and telecanthus. Hyperpigmentation with disseminated pigmentary anomalies is a common trait in all of them. The cytogenetic study was carried out under the strict criteria of analysis, screening 50-100 metaphases from three different tissues, showing trisomy 12 mosaicism in at least one of the three different tissues analyzed. With SNParray, the presence of low-level mosaic copy number variants not previously detected by cytogenetics, and uniparental disomy of chromosome 12, was excluded. STR markers allowed to confirm the absence of uniparental disomy as well as to know the parental origin of supernumerary chromosome 12. CONCLUSIONS: The detailed clinical, cytogenetic, and molecular description of these three new patients, contributes with relevant information to delineate more accurately a group of patients that show a heterogeneous phenotype, although sharing the same chromosomal alteration. The possibility of detecting mosaic trisomy 12 is directly associated with the sensitivity of the methodology applied to reveal the low-level chromosomal mosaicism, as well as with the possibility to perform the analysis in a suitable tissue.

PPARα polymorphisms association with total cholesterol and LDL-C levels in a Mexican population.

OBJECTIVE: Peroxisome proliferator-activated receptor alpha (PPARα) is a nuclear transcription factor with a role in gene expression changes associated to lipid metabolism. PPARα polymorphic variants have been previously correlated to serum lipid profile but in Mexico, there is no previous report about that association. For this reason, the aim of this study was to investigate the relationship between PPARα polymorphic variants and lipids level in serum in a Mexican population. PATIENTS AND METHODS: Two-hundred and forty women from the Northeast region of Mexico were included in the study. Anthropometric characteristics and serum lipid profile (such as triglycerides, total cholesterol, LDL cholesterol and HDL cholesterol) were evaluated. Genomic DNA extraction and purification were made from blood samples. Real-time PCR and TaqMan probes were used for genotyping of rs1800206 and rs4253778 single nucleotide polymorphisms (SNPs). RESULTS: Linear regression analysis (adjusted by age and body mass index (BMI)) showed a significant statistical association of rs4253778 with total cholesterol (p=0.034) and LDL cholesterol (p=0.037). Any significant association was found between rs1800206 and lipid levels. CONCLUSIONS: These results suggested that rs4253778 (C allele) is associated with high levels of total cholesterol and LDL in a Mexican women population.

Synthesis and characterization of C60 and C70 acetylace-tone monoadducts and study of their photochemical properties for potential application in solar cells / Síntesis y caracterización de monoaductos de C60 y C70 con acetilacetona y estudio de sus propiedades fotoquímicas para su posible aplicación en células solares / Sínteses e caracterização de monoadutos de C60 e C70 com acetilacetona e estudo das suas propriedades fotoquímicas para a sua possível aplicação em células solares

Abstract We report on the synthesis of C60 and C70 monoadducts at room temperature through the Bingel reaction; employing acetylacetone as ligand; in presence of DBU (1,8-Diazabicyclo [5.4.0] undec-7-ene), carbon tetrabromide (CBr4), and o-dichlorobenzene. Diacetylmethane-[C60-Ih]-fullerene-[5,6] and diacetylmethane-[C70-D5h]-fullerene-[5,6] monoadducts were obtained with yields of 69% and 44%, respectively. The products were purified by column chromatography (CC, on silica gel, using hexane, carbon disulfide, and chloroform as eluents at room temperature) and characterized by Nuclear Magnetic Resonance ('H and 13C), Fourier-Transform Infrared (FT-IR) and UV-Visible spectroscopies, Matrix-assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF) Mass spectrometry, Cyclic Voltammetry (CV), and Osteryoung Square Wave Voltammetry (OSWV). Both compounds showed irreversible reduction peaks controlled by diffusion, with LUMO energy levels of -3.09 eV, -3.13 eV for C60, and C70 monoadducts, respectively. These values are comparable with the -3.99 eV of PC61BM. The synthetized adducts were incorporated into inverted-type perovskite solar cells and were used as electron transporting materials (ETM) obtaining power conversion efficiencies (PCE) of 8.5% and 14.0% for the C60 and C70 monoadducts, respectively. When C60 is replaced by a lower symmetrical fullerene such as C70 an improved light absorption in the visible region is observed.

Resumen Reportamos la síntesis de monoadductos de C60 y C70 a temperatura ambiente a través de la reacción de Bingel, empleando acetilacetona como ligando, en presencia de DBU (1,8-diazabiciclo [5.4.0] undec-7-eno), tetrabromuro de carbono (CBr4) y o-diclorobenceno. Se obtuvieron monoadductos de diacetilmetano-[C -I.]-fullereno-[5,6] y diacetilmetano-[C70-D5h]-fullereno-[5,6] con rendimientos del 69% y 44%, respectivamente. Los productos se purificaron por cromatografía en columna (CC, usando silica gel, hexano, disulfuro de carbono y cloroformo como fase móvil, a temperatura ambiente) y se caracterizaron por resonancia magnética nuclear (1H y 13C), infrarrojo con transformada de Fourier (FT-IR), espectroscopia UV-Visible, espectrometría de masas, desorción/ionización láser asistida por matriz - tiempo de vuelo (MALDI-TOF), voltametría cíclica (CV) y voltametría de onda cuadrada de Osteryoung (OSWV). Ambos compuestos mostraron picos de reducción irreversibles controlados por difusión, con niveles de energía LUMO de -3,09 eV y -3,13 eV para los monoadductos C60 y C70, respectivamente. Estos valores son comparables con el -3,99 eV de PC61BM. Los aductos sintetizados se incorporaron a las células solares de perovskita de tipo inversa y se usaron como materiales de transporte de electrones (ETM) obteniendo eficiencias de conversión de energía (PCE) de 8,5% y 14,0% para los monoaductos C60 y C70, respectivamente. Cuando el C60 se reemplaza por un fullereno menos simétrico como el C70, se observa una absorción de luz mejorada en la región visible.

Resumo Reportamos a sínteses de monoadutos de C60 e C70 a temperatura ambiente através da reação de Bingel, utilizando acetilacetona como ligando, na presença de DBU (1,8-diazabiciclo [5.4.0] undec-7-eno), tetrabromuro de carbono (CBr4) e o-diclorobenzeno. Foram obtidos monoadutos de diacetilmetano-[C60-IJ-fulereno-[5,6] e diacetilmetano-[C70-D5J-fulereno-[5,6] com rendimentos de 69% e 44%, respectivamente. Os produtos se purificaram por cromatografia em coluna (CC, usando sílica gel, hexano, dissulfeto de carbono e clorofórmio como fase móvel à temperatura ambiente ) e se caracterizaram por ressonância magnética nuclear OH e 13C), infra-vermelho com transformada de Fourier (FT-IR), espectroscopia UV-Visível, espectrometria de massas, ionização e dessorção a laser assistida por matriz-tempo de voo (MALDI-TOF), voltametria cíclica (CV) e voltametria de onda quadrada de Osteryoung (OSWV). Ambos compostos mostraram picos de redução irreversíveis controlados por difusão, com níveis de energia LUMO de -3,09 eV, -3,13 eV para os monoadutos C60 e C70, respectivamente. Estos valores são comparáveis com -3,99 eV de PC61BM. Os adutos sintetizados se incorporaram nas células solares de perovskita de tipo inversa e se usaram como materiais de transporte de eletrões (ETM) obtendo eficiências de conversão de energia (PCE) de 8,5% e 14,0% para os monoadutos C60 e C70, respectivamente. Quando o C60 se substitui por um fulereno menos simétrico como o C70, se observa uma absorção de luz melhorado na região visível.

Genetic and clinical characterization of 73 Pigmentary Mosaicism patients: revealing the genetic basis of clinical manifestations.

BACKGROUND: Pigmentary mosaicism constitutes a heterogeneous group of skin pigmentation alterations associated with multisystem involvement. The aim of this study was to establish a complete cytogenetic and molecular characterization of PM patients, emphasizing on searching for possible low chromosomal mosaicism and on establishing an accurate genotype-phenotype correlation. RESULTS: A total of 73 patients were included (3 months to 18 years of age), 52% male and 48% female. Observed in 69 (95%) patients, the most frequent pattern of pigmentation was fine and whorled BL, which was associated with disseminated skin extent in 41 (59%) patients. Central nervous system (84%) alterations were the most frequent observed in the group of patients, followed by the musculoskeletal (53%) and ophthalmologic (27%) alterations. Considering the pattern of pigmentation, no significant differences in association with skin extent or extracutaneous manifestations were detected. Following a strict cytogenetic analysis strategy, screening metaphases from three different tissues (peripheral blood, hyperpigmented and hypopigmented skin) we found that 23/73 patients had chromosomal abnormalities classified as follows: 1) Mosaic with 2 or more different cell lines with structural alterations n = 19; 2) Polyploidy (mosaic) n = 1 and 3) Alterations in all cells in three different tissues n = 3. SNP array, array CGH and FISH were useful for the complete characterization of the chromosomal aberrations, for the detection of microdeletions in patients with normal karyotype but with strong clinical suspicious of chromosomal alteration, and for a better establishment of genotype-phenotype correlation. In 2 patients we found genes associated with some of the extracutaneous manifestations (SHH, MNX1, PPP2R2C). CONCLUSIONS: This group of 73 patients finely described is the largest series of patients with pigmentary mosaicism reported worldwide. As we showed in this study, the followed analysis strategy allowed the detection of cytogenetic and molecular abnormalities, and made possible the establishment of genotype-phenotype associations in some patients. An important limitation of our study was the analysis of fibroblasts cultures instead of melanocytes and keratinocytes. In some cases the direct molecular DNA analysis of skin biopsy could be another choice.

[Correlation between the six-minute walk test and maximal exercise test in patients with type ii diabetes mellitus]. / Correlación entre prueba de marcha de 6 minutos y prueba de esfuerzo máxima en pacientes con diabetes mellitus de tipo ii.

INTRODUCTION: The 6-minute walk test is an exercise test that has been used in diabetic patients to assess the effectiveness of exercise programmes and has been correlated with clinical parameters; however, the correlation with the maximum workload registered during stress testing has not been determined in diabetic patients. OBJECTIVE: To establish the correlation between the 6-minute walk test and the maximum workload registered during a stress test in patients with type ii diabetes mellitus and its association with glycemic control. MATERIALS AND METHODS: We included 42 patients with type ii diabetes mellitus and mean age of 61.1 years, who underwent physical examination, a 6-minute walk test, a treadmill stress test and laboratory studies. RESULTS: The 6-minute walk test had high reproducibility in diabetic patients and showed a moderate-low correlation with maximum workload on the treadmill (r=49, p=0.001). A significant association was found between the 6-minute walk test and glycosylated haemoglobin A1C values (RP 1.57, χ2 <0.05). CONCLUSION: The 6-minute walk test is a highly reproducible test and has a significant correlation with maximum physical workload in the diabetic patients tested. Therefore, it can be used as a test for assessing functional capacity in this population.

The route of Besnoitia besnoiti tachyzoites inoculation does not influence the clinical outcome of the infection in calves.

In a previous attempt, an experimental model of bovine besnoitiosis was established in calves that were intravenously inoculated with different doses of Besnoitia besnoiti tachyzoites. Despite the fact that all infected calves developed the acute stage of disease, only microscopic findings characteristic of chronic besnoitiosis were reported. In the present study, calves were inoculated by subcutaneous and intradermal routes with B. besnoiti tachyzoites with the aim of developing clinical signs and macroscopic lesions characteristic of chronic besnoitiosis. Nine 3-month-old male calves were randomly distributed into three groups of three animals each. Next, 106 tachyzoites were inoculated by either the subcutaneous (G1) or intradermal route (G2). The negative control group (G3) was inoculated with PBS. Daily clinical monitoring and regular blood collection were performed. At 70 days post-infection (pi), animals were euthanized, and tissues were collected to investigate lesions and parasites. Infected animals developed mild-moderate acute besnoitiosis characterized by lymphadenopathy from four days to 47 days pi, and sporadic fever peaks were only observed in one calf from G2. However, other clinical signs and macroscopic lesions characteristic of chronic besnoitiosis were not detected. Only nine tissue samples were B. besnoiti-DNA-positive, eight of which belonged to reproductive and respiratory tracts tissues from G1. Finally, the kinetics of the immune responses were similar in both infected groups. However, delayed and lower cellular and humoral immune responses were observed in G1 followed by G2 and were compared with intravenously inoculated calves. The differences observed among the three inoculation routes could be due to different effector mechanisms of the host early innate immune response against B. besnoiti. Accordingly, the inoculation route of B. besnoiti tachyzoites does not significantly influence the clinical outcome of the infection in calves. Thus, a further refinement of this experimental model of bovine besnoitiosis is needed to reproduce macroscopic lesions characteristic of chronic stage disease.

Correlación entre prueba de marcha de 6 minutos y prueba de esfuerzo máxima en pacientes con diabetes mellitus de tipo II / Correlation between the six-minute walk test and maximal exercise test in patients with type II diabetes mellitus

Introducción: La prueba de marcha de 6 min es una prueba de ejercicio que ha sido utilizada en pacientes diabéticos para valorar la eficacia de los programas de ejercicio y se ha correlacionado con algunos parámetros clínicos; sin embargo, la correlación con la máxima carga de trabajo obtenida en una prueba de esfuerzo no ha sido determinada en pacientes diabéticos. Objetivo: Establecer la correlación entre la prueba de marcha de 6 min y la máxima carga de trabajo medida en prueba de esfuerzo en pacientes con diabetes mellitus de tipo II y su asociación con el control glucémico. Materiales y métodos: Se estudió a 42 pacientes con diagnóstico de diabetes mellitus de tipo II, con edad promedio de 61,1 años, a quienes se les realizó: exploración física, prueba de marcha de 6 min, prueba de esfuerzo en banda sin fin y estudios de laboratorio. Resultados: La prueba de marcha de 6 min tiene alta reproducibilidad en pacientes diabéticos y presenta una correlación moderada-baja con la máxima carga de trabajo en banda sin fin (r=0,49; p=0,001). Además, se encontró una asociación significativa entre la prueba de 6 min y los valores de hemoglobina glucosilada A1C (RP 1,57; χ2 <0,05). Conclusión: La prueba de marcha de 6 min es una prueba altamente reproducible y con una correlación significativa con la máxima carga de trabajo físico en pacientes diabéticos, por lo que puede ser usada como una prueba de valoración de la capacidad funcional en esta población

Introduction: The 6-minute walk test is an exercise test that has been used in diabetic patients to assess the effectiveness of exercise programmes and has been correlated with clinical parameters; however, the correlation with the maximum workload registered during stress testing has not been determined in diabetic patients. Objective: To establish the correlation between the 6-minute walk test and the maximum workload registered during a stress test in patients with type II diabetes mellitus and its association with glycemic control. Materials and methods: We included 42 patients with type II diabetes mellitus and mean age of 61.1 years, who underwent physical examination, a 6-minute walk test, a treadmill stress test and laboratory studies. Results: The 6-minute walk test had high reproducibility in diabetic patients and showed a moderate-low correlation with maximum workload on the treadmill (r=49, p=0.001). A significant association was found between the 6-minute walk test and glycosylated haemoglobin A1C values (RP 1.57, χ2 <0.05). Conclusion: The 6-minute walk test is a highly reproducible test and has a significant correlation with maximum physical workload in the diabetic patients tested. Therefore, it can be used as a test for assessing functional capacity in this population

Analysis of the effectiveness of training school personnel in the management of food allergy and anaphylaxis

Background: Food allergy is a very frequent and increasingly common disease in children and adolescents. It affects quality of life and can even be life-threatening. Given that 10-18% of allergic/anaphylactic food reactions take place in schools, it is essential to provide school personnel with training on the management of reactions. Methods: The Allergy Unit of Hospital Universitario de Fuenlabrada, Spain, organized a conference entitled "Management of Food Allergy in Children and Adolescents in School Centers" during which teachers, cooks, cafeteria monitors, and summer-camp leaders underwent a training course. Attendees filled out a questionnaire with eight questions before and after the course to assess their self-efficacy in management of food allergy and anaphylaxis. The results were compared. Results: A total of 191 people participated (51% dining-room monitors, 24% teachers, 13% cooks, and 12% other professions). The areas in which the attendees presented the lowest confidence before receiving the course were recognition of symptoms and treatment of the reactions/anaphylaxis. The mean score for each of the eight concepts evaluated improved after the training course. This improvement was significant in the management of anaphylaxis. Conclusions: Our study demonstrates the usefulness of a self-efficacy scale in school personnel as a tool to assess the ability to manage food allergy and anaphylaxis. It can help to identify problem areas in which more specific training programs can be implemented

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Analysis of the effectiveness of training school personnel in the management of food allergy and anaphylaxis.

BACKGROUND: Food allergy is a very frequent and increasingly common disease in children and adolescents. It affects quality of life and can even be life-threatening. Given that 10-18% of allergic/anaphylactic food reactions take place in schools, it is essential to provide school personnel with training on the management of reactions. METHODS: The Allergy Unit of Hospital Universitario de Fuenlabrada, Spain, organized a conference entitled "Management of Food Allergy in Children and Adolescents in School Centers" during which teachers, cooks, cafeteria monitors, and summer-camp leaders underwent a training course. Attendees filled out a questionnaire with eight questions before and after the course to assess their self-efficacy in management of food allergy and anaphylaxis. The results were compared. RESULTS: A total of 191 people participated (51% dining-room monitors, 24% teachers, 13% cooks, and 12% other professions). The areas in which the attendees presented the lowest confidence before receiving the course were recognition of symptoms and treatment of the reactions/anaphylaxis. The mean score for each of the eight concepts evaluated improved after the training course. This improvement was significant in the management of anaphylaxis. CONCLUSIONS: Our study demonstrates the usefulness of a self-efficacy scale in school personnel as a tool to assess the ability to manage food allergy and anaphylaxis. It can help to identify problem areas in which more specific training programs can be implemented.

Development and characterization of monoclonal antibodies against Besnoitia besnoiti tachyzoites.

This is the first report on the development and characterization of eight monoclonal antibodies (MABs) generated against whole- and membrane-enriched tachyzoite extracts of the apicomplexan parasite Besnoitia besnoiti. Confocal laser scanning immunofluorescence microscopy was used to localize respective epitopes in B. besnoiti tachyzoites along the lytic cycle. A pattern compatible with dense granule staining was observed with MABs 2.A.12, 2.F.3 and 2.G.4, which could be confirmed by immunogold electron microscopy for MABs 2.A.12 and 2.F.3. In particular, MABs 2.F.3 and 2.G.4 were secreted during early invasion, proliferation and egress phases. MABs 3.10.8 and 5.5.11 labelled the tachyzoite surface, whilst MABs 1.17.8, 8.9.2 and 2.G.A recognized the apical tip, which is reminiscent for microneme localization. Besides, the epitopes recognized by the latter two (MABs 8.9.2 and 2.G.A) exhibited a redistribution from the anterior part across the parasite surface towards the posterior end during invasion. Most MABs developed were genus-specific. Indeed, the MABs cross-reacted neither with T. gondii nor with N. caninum tachyzoites. In summary, we have generated MABs that will be useful to study the key processes in the lytic cycle of the parasite and with additional promising diagnostic value. However, the molecular identity of the antigens recognized remains to be elucidated.

Low concentrations of permethrin and malathion induce numerical and structural abnormalities in KMT2A and IGH genes in vitro.

Pesticides are commonly used worldwide and almost every human is potentially exposed to these chemicals. Exposure to pesticides such as permethrin and malathion has been associated with hematological malignancies in epidemiological studies. However, biological evidence showing if these chemicals induce genetic aberrations involved in the etiology of leukemia and lymphoma is missing. In our previous work, we have shown that a single high exposure (200 µm, 24 hours) of permethrin and malathion induce damage in genes associated with hematological malignancies in peripheral blood mononuclear cells analyzed by interphase fluorescence in situ hybridization (FISH). In the present study, we assessed by FISH whether exposure to low concentrations (0.1 µm, 72 hours) of permethrin and malathion induce aberrations in KMT2A and IGH genes, which are involved in the etiology of leukemia and lymphoma. Peripheral blood mononuclear cells were exposed to the chemicals, and damage in these genes was assessed on interphases and metaphases. We observed that both chemicals at low concentration induced structural aberrations in KMT2A and IGH genes. A higher level of damage was observed in KMT2A gene with malathion treatment and in IGH gene with permethrin exposure. We also observed numerical aberrations induced by these chemicals. The most frequent aberrations detected on interphase FISH were also observed on metaphases. Our results show that permethrin and malathion induce genetic damage in genes associated with hematological cancer, at concentrations biologically relevant. In addition, damage was observed on dividing cells, which suggests that these cells maintain their proliferation capacity in spite of the genetic damage they possess.

Bovine chronic besnoitiosis in a calf: Characterization of a novel B. besnoiti isolate from an unusual case report.

Bovine besnoitiosis, caused by the apicomplexan Besnoitia besnoiti, is a chronic and debilitating disease characterized by cutaneous and systemic manifestations that primarily affects adult beef cattle. Previous studies have reported that clinical besnoitiosisis is rare in calves. However, we isolated B. besnoiti from a chronically infected calf for the first time. The identity of the Besnoitia species was determined after parasite isolation and molecular genotyping. According to the results obtained in vitro the new isolate, named as Bb-Spain3, was characterized in a reproducible in vitro model and was categorized as a low invader and low prolific isolate with a slower lytic cycle compared to Bb-Spain 1 isolate. Specific traits that differentiate isolates obtained from adult animals from those infecting calves were not found. Next, we described the first case report of chronic besnoitiosis in a female calf less than 6 months-old with a low body condition. The disease was confirmed by the presence of specific anti-B. besnoiti antibodies and parasite detection in the skin. At post-mortem examination, tissue samples were collected for histological, immunohistochemical and molecular analyses. DNA-parasite was detected in 31 different calf's tissues, being the most highly parasitized tissues the skin and the respiratory and reproductive tracts. In addition, the parasite was also present in heart, eyes, lymph nodes and brain. The high parasite load, a wide intra-organic parasite distribution and the presence of both viable and degenerated cysts, were indicative of a rapid progression of the disease. This case report underlines the need to include the inspection of young animals in besnoitiosis control.

The recycling endosome protein RAB-10 promotes autophagic flux and localization of the transmembrane protein ATG-9.

Macroautophagy/autophagy involves the formation of an autophagosome, a double-membrane vesicle that delivers sequestered cytoplasmic cargo to lysosomes for degradation and recycling. Closely related, endocytosis mediates the sorting and transport of cargo throughout the cell, and both processes are important for cellular homeostasis. However, how endocytic proteins functionally intersect with autophagy is not clear. Mutations in the DAF-2/insulin-like IGF-1 (INSR) receptor at the permissive temperature result in a small increase in GFP::LGG-1 foci, i.e. autophagosomes, but a large increase at the nonpermissive temperature, allowing us to control the level of autophagy. In a RNAi screen for endocytic genes that alter the expression of GFP::LGG-1 in daf-2 mutants, we identified RAB-10, a small GTPase that regulates basolateral endocytosis. Loss of rab-10 in daf-2 mutants results in more GFP::LGG-1-positive foci at the permissive, but less GFP::LGG-1 or SQST-1::GFP foci at the nonpermissive temperature. As previously reported, loss of rab-10 alone resulted in an increase of GFP:LGG-1 foci. Exposure of rab-10 mutant animals to chloroquine, a known inhibitor of autophagic flux, failed to increase the number of GFP::LGG-1 foci. Moreover, colocalization between LMP-1::tagRFP and GFP::LGG-1 (the lysosome and autophagosome reporters) was decreased in daf-2; rab-10 dauers at the nonpermissive temperature. Intriguingly, RAB-10 was required to maintain the normal size of GFP::ATG-9-positive structures in daf-2 mutants at both the permissive and nonpermissive temperature. Finally, we found that RAB-10 GTPase cycling was required to control the size of GFP::ATG-9 foci. Collectively, our data support a model where rab-10 controls autophagic flux by regulating autophagosome formation and maturation.

Systemic Besnoitiosis in a Juvenile Roe Deer (Capreolus capreolus).

Herein, we report the first incidence of systemic besnoitiosis in a male juvenile roe deer Capreolus capreolus. The animal was found dead in an area where bovine besnoitiosis is endemic and showed cachexia and multiple skin erosions in the metacarpal and metatarsal areas. Moreover, round and elevated white structures suggestive of Besnoitia spp. tissue cysts were also present. Twenty-eight tissue samples from different anatomical locations were collected for microscopic lesion and parasite detection through histopathology and PCR. Immunohistochemistry was performed to confirm Besnoitia-positive reaction in the tissue cysts. In addition, the identity of Besnoitia spp. in PCR-positive tissue samples was also investigated using microsatellite (MS) markers, and the comparison of protein disulphide isomerase gene sequences (BbPDI) of B. besnoiti and B. tarandi isolated from cattle and reindeer, respectively. Besnoitia cysts were detected in the skin (several parts), respiratory and upper digestive tracts, eyes, kidney, liver, testicle, cardiac muscle and lymphoid tissue. Remarkably, the presence of tissue cysts in the brain confirmed the capacity of Besnoitia spp. to form tissue cysts in the central nervous system (CNS). Finally, the Besnoitia species detected showed the same MS genotype as B. besnoiti, and BbPDI sequences from roe deer and two B. besnoiti isolates were genetically identical throughout multiple sequence alignment. Thus, for the first time, there is evidence that roe deer might act as an intermediate host of B. besnoiti. Further molecular analyses and parasite isolations are needed to corroborate these findings.

Estimation of temporal gait parameters using Bayesian models on acceleration signals.

The purpose of this study is to develop a system capable of performing calculation of temporal gait parameters using two low-cost wireless accelerometers and artificial intelligence-based techniques as part of a larger research project for conducting human gait analysis. Ten healthy subjects of different ages participated in this study and performed controlled walking tests. Two wireless accelerometers were placed on their ankles. Raw acceleration signals were processed in order to obtain gait patterns from characteristic peaks related to steps. A Bayesian model was implemented to classify the characteristic peaks into steps or nonsteps. The acceleration signals were segmented based on gait events, such as heel strike and toe-off, of actual steps. Temporal gait parameters, such as cadence, ambulation time, step time, gait cycle time, stance and swing phase time, simple and double support time, were estimated from segmented acceleration signals. Gait data-sets were divided into two groups of ages to test Bayesian models in order to classify the characteristic peaks. The mean error obtained from calculating the temporal gait parameters was 4.6%. Bayesian models are useful techniques that can be applied to classification of gait data of subjects at different ages with promising results.

Higher levels of physical fitness are associated with a reduced risk of suffering sarcopenic obesity and better perceived health among the elderly: the EXERNET multi-center study.

OBJECTIVE: To evaluate the associations between physical fitness levels, health related quality of life (HRQoL) and sarcopenic obesity (SO) and to analyze the usefulness of several physical fitness tests as a screening tool for detecting elderly people with an increased risk of suffering SO. DESIGN: Cross-sectional analysis of a population-based sample. SETTING: Non-institutionalized Spanish elderly participating in the EXERNET multi-centre study. PARTICIPANTS: 2747 elderly subjects aged 65 and older. MEASUREMENTS: Body weight, height and body mass index were evaluated in each subject. Body composition was measured by bioelectrical impedance. Four SO groups were created based on percentage of body fat and relative muscle mass; 1) normal group, 2) sarcopenic group, 3) obesity group and 4) SO group. Physical fitness was evaluated using 8 tests (balance, lower and upper body strength, lower and upper body flexibility, agility, walking speed and aerobic capacity). Three tertiles were created for each test based on the calculated scores. HRQoL was assessed using the EuroQol visual analogue scale. RESULTS: Participants with SO showed lower physical fitness levels compared with normal subjects. Better balance, agility, and aerobic capacity were associated to a lower risk of suffering SO in the fittest men (odds ratio < 0.30). In women, better balance, walking speed, and aerobic capacity were associated to a lower risk of suffering SO in the fittest women (odds ratio < 0.21) Superior perceived health was associated with better physical fitness performance. CONCLUSIONS: Higher levels of physical fitness were associated with a reduced risk of suffering SO and better perceived health among elderly. SO elderly people have lower physical functional levels than healthy counterparts.

¿Son la anemia y la transfusión de glóbulos rojos factores de riesgo para enterocolitis necrotizante en prematuros? / Are anemia and red blood cell transfusion risk factors for necrotizing enterocolitis in premature infants?

Introducción: La enterocolitis necrotizante es una emergencia gastrointestinal en prematuros debido a la necrosis transmural del intestino, cuya etiología sigue siendo desconocida. Metodología: Para identificar la asociación entre enterocolitis necrotizante, anemia y transfusión de glóbulos rojos en prematuros menores de 34 semanas de edad gestacional, se realizó un estudio de casos y controles, donde se compararon 45 prematuros con enterocolitis necrotizante estadio II o mayor según criterios de Bell modificados con 90 controles sin enterocolitis necrotizante. Se creó una regresión logística para evaluar el efecto sobre el riesgo. Resultados: A través de una regresión logística multivariable, controlando Apgar al 5° minuto, sepsis, síndrome de dificultad respiratoria, alimentación completa, SNAP-PE II como factores de confusión, se identificó que la presencia de hematocrito menor de 30% incrementa el riesgo de enterocolitis necrotizante en prematuros menores de 34 semanas (OR: 1,5; 95% IC 1,0-9,5; p = 0,01); además, el riesgo de enterocolitis necrotizante se incrementó en 2,1 veces (95% IC 1,7-6,4; p = 0,04) con transfusión de glóbulos rojos en las 48 horas previas al diagnóstico. El grupo control recibió 1 ± 1 transfusiones y el grupo con enterocolitis necrotizante recibió 3 ± 1 transfusiones de glóbulos rojos antes del diagnóstico (OR: 3,2; 95% IC 2,3-8,6; p < 0,01). Conclusión: La anemia puede incrementar el riesgo de desarrollo de enterocolitis necrotizante en prematuros, este riesgo se incrementa significativamente en las 48 horas posteriores a la transfusión y después de un aumento en la frecuencia de transfusiones de glóbulos rojos

Introduction: Necrotizing enterocolitis is an emergency gastrointestinal disease in neonates due to transmural necrosis of the bowel, whose etiology remains unknown. Methodology: To determine association of anemia and red blood cell transfusions with necrotizing enterocolitis in preterm infants, a study of cases and controls was designed, were compared 45 infants with necrotizing enterocolitis stage II or greater than stage II on the modified Bell’s criteria with 90 controls without necrotizing enterocolitis. A logistic regression model was created to evaluate the effect on the risk of necrotizing enterocolitis. Results: Through multivariate logistic regression corrected for Apgar score at 5° minute, sepsis, respiratory difficulty syndrome, full feeds achieved, SNAP-PE II as confounding factors, was identified the presence of hematocrit less than 30% increased risk of necrotizing enterocolitis in infants less than 34 weeks (OR: 1.5; 95% CI 1.0-9.5, p = 0.01); also, the risk of necrotizing enterocolitis increased 2.1 times (95% CI 1.7-6.4, p = 0.04) with transfusion 48 hours before the necrotizing enterocolitis diagnosis. The control group received 1 ± 1 transfusions, and the necrotizing enterocolitis group received 3 ± 1 red blood cell transfusions before the necrotizing enterocolitis diagnosis (OR: 3.2; 95% CI 2.3-8.6, p < 0.01). Conclusion: Anemia may increase the risk of developing necrotizing enterocolitis in preterm infants. The risk for necrotizing enterocolitis increased significantly with increased transfusion frequency before the necrotizing enterocolitis diagnosis or during the 48 hours after red blood cell transfusion

[Polymedication in institutionalized elderly and its effect on vitamin B12, folate, and homocysteine levels]. / La polimedicación en mayores institucionalizados: su efecto sobre los niveles de vitamina B12, folato y homocisteína.

AIM: To determine drug consumption in institutionalized elderly living in the Region of Madrid (Spain) and to assess the relationship between drug intake and biochemical parameters for vitamin B12 (Cobalamin and Holotranscobalamin), serum folate (SF) and homocysteine (Hcy). METHODS: 167 subjects (32% men), mean age 83 ± 7 years, were classified according to biochemical parameter levels (in or out of reference range) and drugs were classified according to ATC system. The relationship between drug intake and biochemical levels was studied by means of the Fisher exact test. RESULTS: The daily mean drug intake was 5. Psicoleptic and antiacid drugs were the most consumed (both 53%). Cobalamin (median 158.2 pg/mL; 10.7% of individuals), SF (5.3 ng/mL; 52.1%) and holotranscobalamin (11.76 pmoL/L; 7.8%) deficiencies were observed. Hyperhomocysteinaemia (19.4 µmoL/L) was present in 65% of population. Antiaenemic drug intake normalized cobalamin, urologic drug and corticosteroids SF and psicoanaleptics holotranscobalamin levels. Drugs against pulmonar obstruction increased Hcy concentration (all p < 0.05). CONCLUSION: There is a high prevalence of SF deficiency and hyperhomocysteinaemia in the studied population. The elevated number of drugs taken simultaneously by each subject makes it difficult to analyze which drugs are responsible for those alterations.

Informe de la Sociedad Española de Ultrasonidos (SEUS) sobre delegación y transferencia de competencias en ecografía a los técnicos de radiología / Report of the Spanish Society of Ultrasound (SEUS) about the delegation and transfer of responsibility in ultrasonography to radiology technologists

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