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Purpose: Over the last decade, ultrasonography has taken on an increasingly important role in the daily management of critically patients and has recently been suggested for measuring muscle volume and architecture. The aims of this study were to assess the accuracy of ultrasound for measuring quadriceps femoris muscle thickness in mechanically ventilated pediatric patients and examine if demographic and clinical factors impact muscle loss in critically unwell children. Methods: Prospective, observational, single-center study. All the children admitted to our Pediatric Intensive Care Unit requiring mechanical ven­tilation for more than 48 hours were included. Two trained clinicians measured the thickness of the quadriceps using a 12 MHz linear ultrasound transducer. Results: In the entire cohort, quadriceps femoris muscle thickness decreased 4.67% (-13.4 to -0.59) between the first two assessments and 13% when considering the final measurement performed (-24% to -0.5%) or 1.57%/day (p < 0.001). Approximately half of all the children (23/41; 56%) experienced muscle atrophy (defined a priori as a >10% decrease in thickness). Bivariate analyses revealed that increasing age, being a child (vs. infant), cumulative energy and protein deficit, highest C-reactive protein value, exposure to neuromuscular blockers , and a longer stay in the Pediatric Intensive Care Unit predicted a greater decrease in thickness. In a multivariate linear regression, exposure to NMB was linked with greater muscle loss. Conclusions: In mechanically ventilated children, point-of-care ultrasonography can identify skeletal muscle atrophy. Limb muscle loss is strongly associated with the use of neuromuscular blockers. Ultrasound-based evaluation of the quadriceps femoris is a clinically useful tool for assessing muscle mass and it can serve as a surrogate for nutritional status and guide rehabilitation

AIMS: To describe the main characteristics of patients who were readmitted to hospital within 1 month after an index episode for acute decompensated heart failure (ADHF).METHODS AND RESULTS: This is a nested case-control study in the ReIC cohort, cases being consecutive patients readmitted after hospitalization for an episode of ADHF and matched controls selected from those who were not readmitted. We collected clinical data and also patient-reported outcome measures, including dyspnea, Minnesota Living with Heart Failure Questionnaire (MLHFQ), Tilburg Frailty Indicator (TFI) and Hospital Anxiety and Depression Scale scores, as well as symptoms during a transition period of 1 month after discharge. We created a multivariable conditional logistic regression model.Despite cases consulted more than controls, there were no statistically significant differences in changes in treatment during this first month. Patients with chronic decompensated heart failure were 2.25 [1.25, 4.05] more likely to be readmitted than de novo patients. Previous diagnosis of arrhythmia and time since diagnosis ≥3 years, worsening in dyspnea, and changes in MLWHF and TFI scores were significant in the final model.CONCLUSION: We present a model with explanatory variables for readmission in the short term for ADHF. Our study shows that in addition to variables classically related to readmission, there are others related to the presence of residual congestion, quality of life and frailty that are determining factors for readmission for heart failure in the first month after discharge.ClinicalTrials.gov Identifier: NCT03300791. First registration: 03/10/2017

BACKGROUND AND AIMS The interactions of both organs in Cardiorenal Syndrome (CRS) exacerbate the damage and determine a worse prognosis in these patients [1]. The aim of our study is to compare the development and prognosis of CRS patients compared with control patients. METHOD: In a retrospective fashion, we assigned 60 patients with CRS who underwent dialysis, and we compared them with a control population of 60 patients without CRS in dialysis. We analyzed baseline characteristics of the patients and the dialysis parameters. Survival rates at 1 and 5 years were determined. RESULTS The baseline characteristics were similar between groups. The mean age was 72 ± 9 years in CRS and 68 ± 12 years in the control group. Men were more prevalent in both groups CRS (55%) and control (53%). Charlson's Score was 8 ± 2 points in the CRS group and 7 ± 3 points in the control group. Diabetic nephropathy was the most frequent etiology of end-stage renal disease in CRS patients (37%), followed by nephroangiosclerosis (20%). In the control group, the most common etiologies were nephroangiosclerosis (32%), diabetic (22%) and interstitial nephropathy (11%). CRS patients had more diabetes mellitus (55% versus 35%; P Haemodialysis was the most common technique in both groups CRS (98%) and control (95%). The use of permanent tunneled catheters as definite vascular access was more common in CRS patients (60% versus 26%; P The median time in dialysis was inferior in the CRS group [24 (8–42) versus 61 (26–106) months; P The main cause of death was the cardiovascular events in both groups (35% versus 20%; P = 0.06). However, tumor as a cause of death was superior in the control group (18% versus 0%; P CONCLUSION CRS patients have more cardiovascular risk factors and cardiovascular disease as expected, as well as more hospitalizations caused by heart failure before starting dialysis. They have more frequent use of a permanent tunneled catheter. It could be explained because of worse tolerance to the use of arteriovenous fistula in these patients. - The survival rates at 1 and 5 years are significantly inferior in the CRS group, which highlights the poor prognosis of these patients [2,3]. - The tumor as a cause of death was superior in the control group due to greater time in dialysis of these patients compared with CRS patients

BACKGROUND AND AIMS The coronavirus disease 2019 (COVID-19) has affected our patients not only in renal replacement therapy (RRT), but also in advanced chronic kidney disease (ACKD) consultation. Our aim is to assess the impact of COVID-19 in a group of patients of our ACKD consultation. METHOD Retrospective observational study in our centre of patients from ACKD consultation with hospitalization due to COVID-19 infection in the period from March to December 2020. We have studied demographic parameters, characteristics during hospitalization, analytics values (3 months before and 1, 3, 6 and 12 months after infection) and final status at the end of follow-up on 31 December 2021. A value comparison is made with the Wilcoxon test for paired data. RESULTS In an ACKD consultation with 90 patients, 12 (13%) required hospitalization due to COVID-19. 75% were male, with a mean age of 77.6 years (SD 7) (range 59–89 years) and 25% due to Diabetic Kidney Disease. Mean time in consultation 28 months (SD 14) (range 12–58). Mean Comorbidity Charlson Index 8.2 (SD 1.2) (range 7–11), all hypertensive, 42% treatment with insulin, 25% ischemic heart disease and 42% chronic obstructive pulmonary disease. In COVID-19 hospitalizations, 83% they had pneumonia, 50% steroid treatment, 75% hydroxychloroquine, 92% several antibiotics, 33% low molecular weight heparin, only two required tocilizumab, and none required admission to the intensive care unit. During hospitalization, 3 (25%) patients died, and one died during follow-up, all were males. The consequences after infection: 42% pneumology (cough, varying degrees of shortness of breath), 8% neurological (headaches, varying degrees of memory loss) and 8% loss of smell (from 1 to 6 moths). At the follow-up, only one patient needs RRT with haemodialysis (at 19 months after COVID-19). Table 1 shows analytics comparison before and after COVID. From 6 months after COVID, the results are like 3 months after the disease. CONCLUSION With the important limitation of few patients and without a control group, ACKD patients with hospitalization to COVID-19 show similar patterns to those with RRT: more frequent in males, advanced age, lung comorbidity and diabetics, elevation of inflammatory parameters, anemia and increase in creatinine during hospitalization. Recovery to values prior to admission occurs from the first month after infection.

A 3-month-old male infant was admitted to our unit due to acute decompensation of chronic kidney disease of unknown etiology. Further investigation led to the diagnosis of primary hyperoxaluria type 1. As the patient did not recover, hemodialysis was initiated with a non-tunneled femoral catheter. A tunneled Hickman catheter was placed in the internal jugular vein. The patient experienced moderate intradialytic exit-site bleeding and catheter malfunction, which initially responded to pressure and postural changes. During the third session, the patient suffered cardiopulmonary arrest. After stabilization, a chest hematoma was identified. Fluoroscopy revealed a catheter breakage. Despite initial stabilization, the patient developed septic shock due to Pseudomonas aeruginosa and died several days later. Hemodialysis is sometimes necessary in children under 24 months with chronic kidney disease. Vascular access is a major challenge in these patients due to lack of appropriate catheter sizes and high complication rates. Hemodialysis catheter fracture is an uncommon complication, and diagnosis can be difficult when the breakage involves the subcutaneous segment. Persistent intradialytic bleeding and mechanical malfunction should raise suspicion of this complication and should elicit catheter revision under fluoroscopy. Without prompt diagnosis, catheter breakage may have fatal consequences, as in our case.

The implementation and validation of anti-SARS-CoV-2 IgG serological assays are reported in this paper. S1 and RBD proteins were used to coat ELISA plates, and several secondary antibodies served as reporters. The assays were initially validated with 50 RT-PCR positive COVID-19 sera, which showed high IgG titers of mainly IgG1 isotype, followed by IgG3. Low or no IgG2 and IgG4 titers were detected. Then, the RBD/IgG assay was further validated with 887 serum samples from RT-PCR positive COVID-19 individuals collected at different times, including 7, 14, 21, and 40 days after the onset of symptoms. Most of the sera were IgG positive at day 40, with seroconversion happening after 14–21 days. A third party conducted an additional performance test of the RBD/IgG assay with 406 sera, including 149 RT-PCR positive COVID-19 samples, 229 RT-PCR negative COVID-19 individuals, and 28 sera from individuals with other viral infections not related to SARS-CoV-2. The sensitivity of the assay was 99.33%, with a specificity of 97.82%. All the sera collected from individuals with infectious diseases other than COVID-19 were negative. Given the robustness of this RBD/IgG assay, it received approval from the sanitary authority in Mexico (COFEPRIS) for production and commercialization under the name UDISTEST-V2G®.

La patología glomerular más relacionada con enfermedad COVID-19 hasta la fecha parece ser la glomerulopatía colapsante, principalmente en pacientes de raza afroamericana y con alelos de riesgo para el gen APOL1. No obstante, en nuestra población, conformada por pacientes añosos de raza caucásica, la patología más biopsiada desde el inicio de la pandemia ha sido la nefritis IgA o púrpura de Schönlein-Henoch. Desde la descripción del primer caso de esta entidad tras infección por SARS-CoV-2 por nuestro grupo de investigación hemos objetivado otros tres, los cuales se describen a continuación. En contraste con el resto de los casos publicados de vasculitis IgA, nuestros pacientes presentaban mayor deterioro de función renal y todos requirieron tratamiento inmunosupresor. Además, algunos presentaron recuperación incompleta de función renal. Esta serie de casos afianza la posibilidad de que la infección por SARS-CoV-2 sea un desencadenante más de esta patología.

COVID-19 most related glomerular disease to date seems to be collapsing glomerulopathy, mostly in young Afroamerican patients with APOL1 gene risk alleles. However, in our population, predominant in elderly Caucasian patients, most biopsied pathology since the beginning of the pandemic has been IgA nephritis or Schönlein-Henoch purpura. Since the description of the first case of this entity after SARS-CoV-2 infection by our research group, three more cases have arisen, which are described in the following article. In contrast to the rest of IgA vasculitis cases reported, our patients presented more renal function deterioration and all of them required immunosupresive therapy. Moreover, some showed incomplete recovery of renal function. This case series strengthens the hypothesis that SARS-CoV-2 infection may be another trigger of this pathology.

Background and Aims Due to COVID-19 pandemic we must continue attending in our hospital consultations and, at the same time, avoid transfers and visit that involve risks to our patients. For this reason, we implemented new forms of care. Mainly electronic consultation (eConsult) using institutional email as way of contact between Primary Care Providers (PCPs) and nephrologist, trying to decrease in-person visit. Objective To analyze the results of the creation in June 2020 of a Nephrology electronic consultation in our hospital. Method Retrospective observational study of eConsults made to our department, which serves a population of 200.000 people, with total of 9 primary care centers. The study period was June 10, 2020 to December 31, 2020. We have studied the number of eConsults, response time, type of consult made, problem resolution and subsequent follow up. Results Of 141 workdays, in 61 days (43%) there was eConsult, total 80 eConsults, mean 1.3 and median 1 daily (range 1 to 3). All primary care centers used this communication way, as well as 50 PCPs. Median response time for eConsult was 1 day (range 1-4). 55% patient was male, mean age 70.8 years (SD 13.9) (range 16-95 years). 64% it was his first assessment for Nephrology. The most frequent causes of eConsult: increase of creatinine (41.3%), uncontrolled blood pressure (12.5%), sodium and potassium disturbances (11.3%), treatment adjustment (11.3%) and changes in previous appointment (8.8%). After assessment eConsult, to 55% of patients was treatment adjustment, 22.5% were converted to an in-person visit, 11% they didn´t need any action but only 1 patient was referred to the emergency room. 44% patient is subsequent follow up by PCPs, 39% by nephrologist, 15% joint assessment PCP and nephrologist and 2% by other specialists. Only 2 patients (2.5%) made second eConsult. Conclusion The eConsult is an important help to PCPs to solve doubts quickly, avoid unnecessary the travels to hospital the patients, treatment adjustment above all in control of hypertension an ionic disturbance, and guide in handling of chronic kidney disease. The diffusion and empowerment of this type of consultation in a next future may decrease, partly, the usual saturation of face-to-face visit and optimize the patient population being seen by nephrologist.

The development of biotherapeutics requires continuous improvement in analytical methodologies for the assessment of their quality attributes. A subset of biotherapeutics is designed to interact with specific antigens that are exposed on the membranes of target cells or circulating in a soluble form, and effector functions are achieved via recognition of their Fc region by effector cells that induce mechanisms such as antibody-dependent cell-mediated cytotoxicity (ADCC). Thus, ADCC induction is a critical quality attribute (CQA) that must be evaluated to ensure biotherapeutic efficacy. Induction of ADCC can be evaluated by employing effector cells from different sources, such as peripheral blood mononuclear cells (PBMC) and genetically modified cell lines (e.g., transfected NKs or Jurkat cells), and different approaches can be used for detection and results interpretation depending on the type of effector cells used. In this regard, validation of the assays is relevant to ensure the reliability of the results according to the intended purpose. Herein, we show the standardization and validation of ADCC assays to test the potency of three biotherapeutic proteins using primary NK cells obtained from fresh blood as effector cells and detecting cell death by flow cytometry. The advantage of using primary NKs instead of modified cells is that the response is closer to that occurring in vivo since cytotoxicity is evaluated in a direct manner. Our results indicate that in all cases, the assays exhibited a characteristic sigmoidal dose/response curve complying with accurate, precise and specific parameters. Thereby, the validated ADCC assay is an appropriate alternative to evaluate the biological activities of these type of biotherapeutics.

Immune cell counts in blood in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection may be useful prognostic biomarkers of disease severity, mortality, and response to treatment.To analyze sub-populations of lymphocytes at hospital admission in survivors and deceased from severe pneumonia due to coronavirus disease-2019 (COVID-19).We conducted a cross-sectional study of healthcare workers confirmed with SARS-CoV-2 in convalescents (control group) and healthy controls (HC) diagnosed with severe COVID-19. Serum samples were taken at hospital admission and after recovery. Serum samples ≥ 25 days after onset of symptoms were analyzed for lymphocyte subpopulations through flow cytometry. Descriptive statistics, Kruskall-Wallis test, receiver operating characteristic curve, calculation of sensitivity, specificity, predictive values, and Kaplan-Meier analysis were performed.We included 337 patients: 120 HC, 127 convalescents, and 90 severe COVID-19 disease patients (50 survivors, 40 deceased). For T cells, total lymphocytes ≥ 800/μL, CD3+ ≥ 400/μL, CD4+ ≥ 180/μL, CD8+ ≥ 150/μL, B cells CD19+ ≥ 80/μL, and NK ≥ 34/μL subsets were associated with survival in severe COVID-19 disease patients. All subtypes of lymphocytes had higher concentrations in survivors than deceased, but similar between HC and convalescents. Leukocytes ≥ 10.150/μL or neutrophils ≥ 10,000/μL were associated with increased mortality. The neutrophil-to-lymphocyte ratio (NLR) ≥ 8.5 increased the probability of death in severe COVID-19 (odds ratio 11.68).Total lymphocytes; NLR; and levels of CD3+, CD4+, CD8+, and NK cells are useful as biomarkers of survival or mortality in severe COVID-19 disease and commonly reach normal levels in convalescents.

Background More than 3 million infections were attributed to Chikungunya virus (CHIKV) in the 2014–2016 outbreak in Mexico, Central and South America, with over 500 deaths directly or indirectly related to this viral disease. CHIKV outbreaks are recurrent and no vaccine nor approved therapeutics exist to prevent or treat CHIKV infection. Reliable and robust diagnostic methods are thus critical to control future CHIKV outbreaks. Direct CHIKV detection in serum samples via highly specific and high affinity anti-CHIKV antibodies has shown to be an early and effective clinical diagnosis. Methods To isolate highly specific and high affinity anti-CHIKV, Chikungunya virions were isolated from serum of a patient in Veracruz, México. After purification and characterization via electron microscopy, SDS-PAGE and binding to well-characterized anti-CHIKV antibodies, UV-inactivated particles were utilized as selector in a solid-phase panning in combination with ALTHEA Gold Libraries™, as source of antibodies. The screening was based on ELISA and Next-Generation Sequencing. Results The CHIKV isolate showed the typical morphology of the virus. Protein bands in the SDS-PAGE were consistent with the size of CHIKV capsid proteins. UV-inactivated CHIKV particles bound tightly the control antibodies. The lead antibodies here obtained, on the other hand, showed high expression yield, > 95% monomeric content after a single-step Protein A purification, and importantly, had a thermal stability above 75 °C. Most of the antibodies recognized linear epitopes on E2, including the highest affinity antibody called C7. A sandwich ELISA implemented with C7 and a potent neutralizing antibody isolated elsewhere, also specific for E2 but recognizing a discontinuous epitope, showed a dynamic range of 0.2–40.0 mg/mL of UV-inactivated CHIKV purified preparation. The number of CHIKV particles estimated based on the concentration of E2 in the extract suggested that the assay could detect clinically meaningful amounts of CHIKV in serum. Conclusions The newly discovered antibodies offer valuable tools for characterization of CHIKV isolates. Therefore, the strategy here followed using whole viral particles and ALTHEA Gold Libraries™ could expedite the discovery and development of antibodies for detection and control of emergent and quickly spreading viral outbreaks.

Resumen: Introducción: Desde hace muchos siglos, la mujer no ha estado bien considerada, no solo en el deporte sino también en varias tareas de la vida cotidiana, por esto las mujeres llevan luchando mucho tiempo para que no vuelva a ocurrir, para poder vivir en una sociedad donde la igualdad esté presente en todos los ámbitos. Por ello hay que educar desde la escuela en valores como la igualdad y la no discriminación y que mejor forma que hacerlo desde una profesión tan bonita y desde una persona tan referente para los niños como es el profesor. Objetivos: Investigar sobre los estereotipos de género que se dan dentro de las clases de educación física tanto por parte del profesor como por los actos que tienen los niños a la hora de realizar la práctica de esta materia. Métodos: Investigación y desarrollo a través de métodos de información (revistas, libros, artículos…) y mediante una encuesta realizada a docentes. Resultados y discusión: Con los resultados obtenidos de la encuesta más los contenidos investigados podemos decir que aún hay discriminación en las clases de educación física ya que los profesores tienden a separar los deportes, con respecto a años anteriores se ha producido una mejora en cuanto al pensamiento de igualdad y método de impartir las clases. Conclusiones: El papel de la mujer en el deporte cada vez se está considerando más importante e igualitario. Queda mucho camino por delante para conseguir una igualdad completa y equitativa., Introduction: For many centuries, women have not been well considered, not only in sport but also in various tasks of daily life, for this reason women have been fighting for a long time so that it does not happen again, to be able to live in a society where equality is present in all áreas. That is why we must educate from school on values such as equality and non-discrimination and what better way to do it than from such a beautiful profession and from such a reference person for children as the teacher. Aim: Research on the gender stereotypes in physical education classes, both on the part of the teacher and the actions of children in the practice of this subject. Methods: Research and development through information methods (journals, books, articles) and through a survey of teachers. Results & discussion: With the results obtained from the survey plus the contents investigated we can say that there is still discrimination in physical education classes as teachers tend to separate sports, there has been an improvement over previous years in the thinking of equality and the method of teaching. Conclusions: The role of women in sport is increasingly seen as important and egalitarian. There is still a long way to go to achieve complete and equitable equality., Resumo: Introdução: Desde há muitos séculos, a mulher não tem sido bem considerada, não só no desporto mas também em várias tarefas da vida quotidiana, por isso as mulheres têm lutado muito tempo para que não volte a acontecer, para poder viver numa sociedade onde a igualdade esteja presente em todos os âmbitos. Por isso, há que educar a partir da escola em valores como a igualdade e a não discriminação e que melhor forma do que fazê-lo a partir de uma profissão tão bonita e desde uma pessoa tão referente para as crianças como é o professor. Objectivos: Investigar sobre "os estereótipos de gênero" que se dão dentro das aulas de educação física tanto por parte do professor como pelos atos que têm as crianças na realização da prática desta matéria. Métodos: Pesquisa e desenvolvimento através de métodos de informação (revistas, livros, artigos…) e mediante um inquérito realizado a docentes. Resultados e discussão: Com os resultados obtidos da pesquisa mais os conteúdos pesquisados podemos dizer que ainda há discriminação nas classes de educação física já que os professores tendem a separar os esportes, Em comparação com anos anteriores, registou-se uma melhoria no que se refere ao pensamento de igualdade e ao método de ensino. Conclusões: O papel das mulheres no desporto está a ser considerado cada vez mais importante e igual. Há ainda um longo caminho a percorrer para se alcançar uma igualdade plena e equitativa.

Introduction: Neopterin and biopterin are subproducts of redox reactions, which act as cofactor of enzymes responsible for nitric oxide production. We hypothesized that plasma neopterin suffers different evolution during the first days of a critically ill child. Methods: Single-center prospective observational study in patients 7 days to 14 years admitted to our PICU and that met SIRS criteria. Neopterin and biopterin levels as well as other acute phase reactants were collected at admission and at 24 h. Results: A total of 28 patients were included, 78.9% male, median age 5.04 years (interquartile range [IQR] 1.47–10.26), PRISM II 2.0% (IQR 1.1–5.0). Mechanical ventilation (MV) in 90% of patients, median duration of 6.0 h (IQR 3.7–102.0); median PICU length of stay 5.0 days (IQR 2.7–18.7), maximum VIS through 0 (IQR 0–14). Baseline neopterin level 2.3 ± 1.2 nmol/l and at 24 h 2.3 ± 1.4 nmol/l. Baseline biopterin is 1.3 ± 0.5 nmol/l and 1.4 ± 0.4 nmol/l at 24 h. Neopterin levels significantly higher in patients with PICU length of stay >6 days (p = .02), patients who needed MV >24 h (p = .023) and those who developed complications (p = .05). Neopterin correlates directly and statistically significant with the duration of MV (rho = .6, p = .011), PICU length of stay (rho = .75, p 24 h), duración de VM de 6,0 h (RIQ 3,7–102,0), ingreso en UCIP de 5,0 días (RIQ 2,7–18,7), media de VIS máximo de 0 (RIQ 0–14). La neopterina inicial fue de 2,3 ± 1,2 nmol/l y a las 24 h de 2,3 ± 1,4 nmol/l. La biopterina basal fue 1,3 ± 0,5 nmol/l y a las 24 h 1,4 ± 0,4 nmol/l. La neopterina fue significativamente mayor en estancia >6 días (p = 0,02), VM > 24 h (p = 0,023) y con complicaciones (p = 0,05). La neopterina se correlaciona de forma directa con la duración de VM (rho = 0,6; p = 0,011), la estancia en UCIP (rho = 0,75; p

Resumen: Introducción: La neopterina y biopterina, subproductos de reacciones redox, son cofactores en la producción de óxido nítrico. Hipótesis: La neopterina y biopterina plasmáticas sufren evolución diferente durante los primeros días de una enfermedad crítica en pediatría. Métodos: Estudio prospectivo observacional monocéntrico en pacientes de 7 días-14 años ingresados en UCIP con criterios de SRIS. Se recogieron, al ingreso y a las 24 h, los niveles de neopterina y biopterina, otros reactantes de fase aguda y datos clínicos. Resultados: Se analizó a 28 pacientes, el 78,9% varones, de 5,04 años (RIQ 1,47-10,26), con PRISM II 2,0% (RIQ 1,1-5,0), ventilación mecánica (VM) en 90% (36,8% >24 h), duración de VM de 6,0 h (RIQ 3,7-102,0), ingreso en UCIP de 5,0 días (RIQ 2,7-18,7), media de VIS máximo de 0 (RIQ 0-14). La neopterina inicial fue de 2,3 ± 1,2 nmol/l y a las 24 h de 2,3 ± 1,4 nmol/l. La biopterina basal fue 1,3 ± 0,5 nmol/l y a las 24 h 1,4 ± 0,4 nmol/l. La neopterina fue significativamente mayor en estancia >6 días (p = 0,02), VM > 24 h (p = 0,023) y con complicaciones (p = 0,05). La neopterina se correlaciona de forma directa con la duración de VM (rho = 0,6; p = 0,011), la estancia en UCIP (rho = 0,75; p 6 days (P=.02), patients who needed MV >24 h (P=.023), and those who developed complications (P=.05). Neopterin correlates directly and is statistically significant with the duration of MV (rho=.6, P=.011), PICU length of stay (rho=.75, P

Corn-lime-cooking-liquor (nejayote), which is a pollutant wastewater from the corn-tortilla-industry, contains valuable products, such as arabinoxylans (AXs) and phenolics. Recently, an innovative process that employs enzymatic and ultrafiltration processes for recovering and purifying AXs from nejayote was described, although neither the drying methods nor the physicochemical and rheological properties of the recovered AXs by this method at the pilot plant scale have been studied. Nejayote from a batch artisanal process (NBAP) and from a continuous industrial process (NCIP) were compared with a corn-bran-hydrolysate (CBH) as sources for AXs obtention. Freeze drying (FD), spray drying (SD) and solvent drying (SoD) were assessed as processes for drying purified and concentrated AXs solutions. Regardless of the process, AXs obtained from nejayote contain 3 times less (0.30 mg/g) esterified ferulic acid (EFA) than did AXs from corn bran (1.01 mg/g) and thus fail to yield elastic gels upon oxidative cross-linking. Molecular weight distribution (MwD) and dynamic viscosity data show that AXs from nejayote are shorter than AXs from corn bran. In general, the drying method had no effect on the physicochemical and rheological properties of AXs, although additional purification using ethanol precipitation and SoD, eliminated low molecular weight oligosaccharides and residual salts resulting from the neutralization of the corn-lime-cooking-liquor. Spray drying seems to be the most cost-effective unit operation for the industrial production of AXs from nejayote without affecting their physicochemical characteristics.

Resumen: Objetivos: Determinar la prevalencia y factores de riesgo del déficit de vitamina D (VDD) en una unidad de cuidados intensivos pediátricos (UCIP), así como su relación con la morbimortalidad durante el ingreso. Material y métodos: Estudio observacional prospectivo realizado en la UCIP de un hospital terciario en 2 fases: i: estudio de cohortes, y ii: estudio de prevalencia. Se incluyó a 340 niños > 6 meses, excluyendo a aquellos con enfermedad renal crónica, trastornos paratiroideos y suplementación con vitamina D. Se realizó medición de 25-hidroxivitamina D total (25[OH]D) en las primeras 48 h del ingreso, parathormona (PTH), calcio, fósforo, gasometría venosa, hemograma, proteína C reactiva y procalcitonina. Se registraron datos sociodemográficos, características del episodio y complicaciones. Resultados: La prevalencia de VDD (< 20 ng/ml) fue del 43,8%, con media de 22,28 (IC del 95%, 21,15-23,41) ng/ml. Los pacientes con déficit fueron de mayor edad (61 vs. 47 meses, p = 0,039), sus padres tenían un mayor nivel académico (36,5% vs. 20%, p = 0,016), ingresaron más frecuentemente en invierno y primavera, obtuvieron mayor puntuación PRISM-III (6,8 vs. 5,1, p = 0,037), mayor estancia (3 vs. 2 días, p = 0,001) y morbilidad (61,1% vs. 30,4%, p

Background: Chronic fluid overload is frequent in hemodialysis patients (P) and it associates with hypertension, left ventricular hypertrophy (LVH) and higher mortality. Moreover, echocardiographic data assessing fluid overload is limited. Our aim was to evaluate the relationship between fluid overload measured by bioimpedance spectroscopy (BIS) and different echocardiographic parameters. Methods: Cross-sectional observational study including 76 stable patients. Dry weight was clinically assessed. BIS and echocardiography were performed. Weekly time-averaged fluid overload (TAFO) and relative fluid overload (FO/ECW) were calculated using BIS measurements. Results: Based on TAFO three groups were defined: A- dehydrated, TAFO < -0.25 L 32 P (42%); B- normohydrated, TAFO between -0.25 and 1.5 l: 26 (34%); C- overhydrated, TAFO>1.5 l: 18 (24%). We found significant correlation between TAFO and left atrial volume index (LAVI) (r: 0.29; p = 0.013) but not with FO/ECW (r: 0.06; p = 0.61). TAFO, but not FO/ECW kept a significant relationship with LAVI (p = 0.03) using One-Way ANOVA test and linear regression methods. LVH was present in 73.7% (concentric 63.2%, eccentric in 10.5%). No differences between groups in the presence of LVH or left ventricular mass index were found. Conclusions: We found that left atrial volume index determined by echocardiographic Area-length method, but not left ventricle hypertrophy or dimensions of cavities, are related on hydration status based on bioimpedance measured time-averaged fluid overload (TAFO), and not with FO/ECW.

A new species of Strengeriana Pretzmann, 1971, is described from the El Jardín Natural Reserve, Quindío Department, Colombia, on the western slope of the Central Andes. The genus is endemic to Colombia and is distributed in the Sierra Nevada de Santa Marta, and the Western and Central Andes, at elevations ranging from 700 to 2400 m. With the addition of the new species, Strengeriana now includes 17 species. Strengeriana quindiensis n. sp. is distinguished from its congeners mainly by the exopod of the third maxilliped being 0.92 times the length of the ischium and by the morphology of the first male gonopod, particularly the shapes of the mesial and lateral processes.

OBJECTIVES: Food-based products such as common bean peptides may contribute to reduce the risk of complications associated with obesity. The objective of this research was to produce and characterize peptides from common bean protein isolates and evaluate their potential to prevent adipogenesis. METHODS: Protein hydrolysates of raw common black bean (BBPH) were generated using a simulated gastrointestinal digestion by either pepsin/pancreatin (p/p) or a protease: alcalase. SDS-PAGE was performed for visualization of the protein profile and the generated peptides were characterized using LC-ESI-MS/MS. Bioactive peptides potential was evaluated using BIOPEP database. The antiadipogenic potential was evaluated by the pancreatic lipase (triglyceride lipases, EC 3.1.1.3) inhibition assay. Determination of lipid accumulation in 3T3-L1 adipocytes was evaluated with Oil Red lipid staining. RESULTS: Hydrolysates either with pepsin/pancreatin or alcalase showed strong inhibitory activity against pancreatic lipase with no statistical differences between them (IC50 = 3.21 and 1.23 mg/mL, respectively). Results from the SDS-PAGE indicate both BBPH had an average size of

Background. Predicting the progression of kidney failure in patients with chronic kidney disease is difficult. The aim of this study was to assess the predictors of rapid kidney decline in a cohort of patients referred to a single outpatient nephrology clinic. Design. Longitudinal, prospective cohort study with a median follow-up of 3.39 years. Methods. Data were obtained from 306 patients with chronic renal failure based on serum creatinine-estimated glomerular filtration rate (eGFRcreat) < 90 mL/min/1.73 m2. After excluding patients who died (n=30) and those who developed end-stage renal failure (n=6), 270 patients were included. This population was grouped according to the rate of kidney function decline. Rapid kidney function decline was defined as an annual eGFRcreat loss > 4 mL/min/1.73 m2. We recorded nonfatal cardiovascular events at baseline and during follow-up in addition to biochemical parameters. Results. The mean loss in renal function was 1.22 mL/min/1.73 m2 per year. The mean age was 75 ± 8.8 years old, and the mean baseline eGFRcreat was 42 ± 14 mL/min/1.73 m2. Almost one-fourth of the sample (23.3% [63 patients]) suffered a rapid decline in renal function. In a logistic regression model with rapid decline as the outcome, baseline characteristics, lower serum albumin (OR: 0.313, 95% CI: 0.114–0.859), previous cardiovascular disease (OR: 1.903 95% CI: 1.028–3.523), and higher proteinuria (g/24 h) (OR: 1.817 CI 95%: 1.213–2.723) were the main predictors of rapid kidney decline. On multivariate analysis, including baseline and follow-up data, we obtained similar adjusted associations of rapid kidney decline with baseline serum albumin and proteinuria. The follow-up time was also shorter in the group with rapid rates of decline in renal function. Conclusion. Renal function remained stable in the majority of our population. Previous cardiovascular disease and cardiovascular incidents, lower serum albumin, and higher proteinuria at baseline were the main predictors of rapid kidney decline in our population.

Physicochemical and structural properties of proteins used as active pharmaceutical ingredients of biopharmaceuticals are determinant to carry out their biological activity. In this regard, the assays intended to evaluate functionality of biopharmaceuticals provide confirmatory evidence that they contain the appropriate physicochemical properties and structural conformation. The validation of the methodologies used for the assessment of critical quality attributes of biopharmaceuticals is a key requirement for manufacturing under GMP environments. Herein we present the development and validation of a flow cytometry-based methodology for the evaluation of adalimumab’s affinity towards membrane-bound TNFα (mTNFα) on recombinant CHO cells. This in vitro methodology measures the interaction between an in-solution antibody and its target molecule onto the cell surface through a fluorescent signal. The characteristics evaluated during the validation exercise showed that this methodology is suitable for its intended purpose. The assay demonstrated to be accurate (r 2 = 0.92, slope = 1.20), precise (%CV ≤ 18.31) and specific (curve fitting, r 2 = 0.986–0.997) to evaluate binding of adalimumab to mTNFα. The results obtained here provide evidence that detection by flow cytometry is a viable alternative for bioassays used in the pharmaceutical industry. In addition, this methodology could be standardized for the evaluation of other biomolecules acting through the same mechanism of action.