Kidney sequelae in 281 Shiga toxin-producing Escherichia coli-hemolytic uremic syndrome patients after a median follow-up of 12 years.

BACKGROUND: A substantial proportion of patients with Escherichia coli-hemolytic uremic syndrome (STEC-HUS) evolve to chronic kidney disease (CKD). The objectives of this study were to evaluate long-term kidney outcomes and to identify CKD predictors. METHODS: In this single-center retrospective study, long-term outcomes of patients were analyzed according to the presence of complete recovery (CR) or CKD at last visit. Then, they were grouped into favorable (CR + CKD1) or poor (CKD2-5) outcome to compare predictors at diagnosis (sex, age, leukocytes, creatinine, hemoglobin, HUS severity score), dialysis duration, and follow-up time between them. RESULTS: Of 281 patients followed up for a median of 12 years, 139 (49%) had CR, 104 (37%) CKD1, 27 (10%) CKD2-4, and 11 (4%) CKD5. Thirty-eight patients progressed to CKD2-5 after a median of 4.8 years, 7% in the first 5 years, increasing to 8%, 10%, and 14% after 5-10 years, 10-15 years, and > 15 years, respectively. They were younger, had higher baseline hemoglobin and leukocytes, and required longer dialysis and follow-up than those with favorable outcome. By multivariate analysis, days of dialysis and follow-up time remained as independent predictors of poor outcome. The best cutoff for days of dialysis was 10 days. After 5 years, 20% of those dialyzed ≥ 10 days evolved to CKD2-5 versus 1% of those non-dialyzed or dialyzed < 10 days. CONCLUSIONS: Fifty-one percent of patients evolved to CKD after 12 years of follow-up and 14% to CKD2-5. Ten days of dialysis was the best cutoff to recognize outcomes. In some cases, kidney damage was evident after 15 years of surveillance, highlighting the need for follow-up until adulthood in all STEC-HUS patients.

[Engel's coefficient and dietary quality in Argentine households inhabited by older adults (2004-2018)]. / Coeficiente de Engel y calidad dietaria en hogares argentinos habitados por adultos mayores (2004-2018).

BACKGROUND AND OBJECTIVES: To determine if there were alterations in the proportion of spending that Argentine households of older adults spend on the purchase of food (Engel's coefficient) and other goods and services, as well as to evaluate the dietary quality of the members of these households. MATERIALS AND METHODS: From the last three waves of the National Household Expenditure Survey (2004-2005, 2012-2013 and 2017-2018) those households in the province of Buenos Aires inhabited by older adults are filtered and carried out. Median difference tests for the proportion of spending these households spend on food and other goods and services. In turn, the per capita quantities acquired from 17 food groups are compared with the quantities recommended in the dietary guidelines for the Argentine population. RESULTS: A statistically significant reduction is found in the median of the proportion of spending that older adults in the province of Buenos Aires spend on the purchase of food, in combination with a statistically significant increase in the proportion of spending directed to equipment and operation home, education and various services. However, the amounts purchased of milk and yogurt and vegetables A and B are insufficient in relation to those recommended, while the consumption of meat is excessive. CONCLUSIONS: Although economic theory would interpret a reduction in the Engel coefficient as an indication of improved well-being, it should be taken into account that these households might not be following an optimal diet if they consumed the amounts of food that they claim to buy.

Efecto inhibidor de Lactobacillus casei 206/1 contra Escherichia coli O157:H7 / Inhibiting effect of Lactobacillus casei 206/1 against Escherichia coli O157:H7

Se ha investigado, mediante estudios de cinética de muerte celular, el efecto inhibidor de una cepa de Lactobacillus casei, aislada de un alimento cárnico fermentado producido en la región santafesina (Argentina), y de su sobrenadante libre de células (SLC), frente a tres cepas de Escherichia coli O157:H7. La cepa de L. casei 206/1 se seleccionó sobre la base de resultados obtenidos en estudios previos donde, aplicando la técnica de agar spot, se determinó que su SLC produjo el mayor efecto inhibitorio sobre E. coli O157:H7. En los ensayos de cinética de muerte celular se observó una reducción significativa de las cepas de E. coli O157:H7 estudiadas, tanto en cocultivos como en el ensayo con el SLC, no detectándose bacterias viables luego de 24 horas de incubación. Estos resultados demuestran que cepas de bacterias ácido lácticas aisladas a partir de un determinado ecosistema regional, pueden convertirse en una herramienta biotecnológica útil para controlar a E. coli O157:H7 en alimentos.

Through the study of cell death kinetics, we have analyzed the inhibiting effect of a Lactobacillus casei strain isolated from a fermented meat product produced at the Santa Fe region in Argentina, and of its cell-free supernatant (CFS), against three Escherichia coli O157:H7 strains. The L. casei 206/1 strain was selected on the basis of results obtained in previous studies where using the agar spot technique, it was determined that CFS produced the greatest inhibitory effect over E. coli O157:H7. The studies of cell death kinetics showed a significant reduction of the E. coli O157:H7 strains tested, both in cocultures and in assays with CFS, and no viable bacteria were detected after 24-hours of incubation. These results show that lactic acid bacterial strains isolated from a determined regional ecosystem, can become a useful biotechnological tool for controlling E. coli O157:H7 in food.