Bone density, microarchitecture, and material strength in chronic kidney disease patients at the time of kidney transplantation.

Bone health is assessed by bone mineral density (BMD). Other techniques such as trabecular bone score and microindentation could improve the risk of fracture's estimation. Our chronic kidney disease (CKD) patients presented worse bone health (density, microarchitecture, mechanical properties) than controls. More than BMD should be done to evaluate patients at risk of fracture. INTRODUCTION: BMD measured by dual-energy X-ray absorptiometry (DXA) is used to assess bone health in end-stage renal disease (ESRD) patients. Recently, trabecular bone score (TBS) and microindentation that can measure microarchitectural and mechanical properties of bone have demonstrated better correlation with fractures than DXA in different populations. We aimed to characterize bone health (BMD, TBS, and strength) and calcium/phosphate metabolism in a cohort of 53 ESRD patients undergoing kidney transplantation (KT) and 94 controls with normal renal function. METHODS: Laboratory workout, lumbar spine/hip BMD measurements (using DXA), lumbar spine TBS, and bone strength were carried out. The latter was assessed with an impact microindentation device, standardized as percentage of a reference value, and expressed as bone material strength index (BMSi) units. Multivariable linear regression was used to study differences between cases and controls adjusted by age, gender, and body mass index. RESULTS: Among cases, serum calcium was 9.6 ± 0.7 mg/dl, phosphorus 4.4 ± 1.2 mg/dl, and intact parathyroid hormone 214 pg/ml [102-390]. Fourteen patients (26.4%) had prevalent asymptomatic fractures in spinal X-ray. BMD was significantly lower among ESRD patients compared to controls: lumbar 0.966 ± 0.15 vs 0.982 ± 0.15 (adjusted p = 0.037), total hip 0.852 ± 0.15 vs 0.902 ± 0.13 (adjusted p < 0.001), and femoral neck 0.733 ± 0.15 vs 0.775 ± 0.12 (adjusted p < 0.001), as were TBS (1.20 [1.11-1.30] vs 1.31 [1.19-1.43] (adjusted p < 0.001)) and BMSi (79 [71.8-84.2] vs 82. [77.5-88.9] (adjusted p = 0.005)). CONCLUSIONS: ESRD patients undergoing transplant surgery have damaged bone health parameters (density, microarchitecture, and mechanical properties) despite acceptably controlled hyperparathyroidism. Detecting these abnormalities may assist in identifying patients at high risk of post-transplantation fractures.

Ketomethylene and methyleneamino pseudopeptide analogues of insect allatostatins inhibit juvenile hormone and vitellogenin production in the cockroach Blattella germanica.

Metabolic studies on insect allatostatins have suggested that the dipeptide Leu-Tyr may be a target for endopeptidases. In order to increase resistance to degradation, methyleneamino psi [CH2NH] and ketomethylene psi [COCH2] peptide bond surrogates have been introduced at the position Leu3-Tyr4 of the allatostatin Asp-Arg-Leu-Tyr-Ser-Phe-Gly-Leu-amide (BLAST-2), and Leu3-Phe4 of [Phe4]BLAST-2, respectively. Assays of inhibition of juvenile hormone (JH) synthesis in vitro by corpora allata from the cockroach Blattella germanica showed that both analogues were similarly active to the respective model peptides. The methyleneamino analogue was further tested in vivo as an inhibitor of JH synthesis, and in vivo and in vitro as an inhibitor of vitellogenin production by the fat body of B. germanica. The analogue was less active than BLAST-2 when tested in vitro, but more active than it when tested in vivo.

[Delay in the acquisition of sucking-swallowing-breathing in the preterm; efects of early stimulation]. / Retraso de la adquisición de la succión-deglución-respiración en el pretérmino; efectos de una estimulación precoz.

INTRODUCTION: Premature baby's oral feeding is not possible until the reflex of sucking-swallowing-breathing adquisition. Its delay extends hospital stay and increases the incidence of oral motor disorders in early childhood. AIMS: To analyze the transition from enteral to oral nutrition, the comorbidity associated with its delay and the impact of an early suction stimulation in a cohort of premature babies. PATIENTS AND METHODS: Retrospective checking of 95 infants less than 32 gestation weeks (GW) admitted to a neonatal ICU in the last 4 years. It was revised the gestational age, anthropometric at birth and discharge, comorbidity, duration of mechanical ventilation, oxygen requirements, time of beginning and end of enteral/oral nutrition, beginning of Kangaroo method and the suction stimulation and the daily weight gain average. RESULTS: Suction stimulation began between weeks 29 and 40 GW (average and median 32 GW). Oral nutrition was initiated between 31-40 GW (average and median 33 GW) and completed between 33-44 GW (average and median 35 GW). Oral nutrition was delayed in patients who required longer mechanical ventilation and oxygen therapy. There was a positive correlation between the beginning of suction stimulation and the time of acquisition of a complete oral nutrition (84% Spearman correlation test) and length of hospital stay (80% Spearman correlation test). CONCLUSIONS: [corrected] Early suction stimulation in a preterm patient seems to facilitate full oral nutrition at an early stage and it is associated with a hospital stay decrease and the improvement in the daily weight gain average.

Modulation of cardiac rhythm by allatostatins in the cockroach Blattella germanica (L.) (Dictyoptera, Blattellidae).

Cardiac rhythm was measured in Blattella germanica females during the reproductive cycle. The rate increased from day 0 to 1, remained constant during the vitellogenic period and fell by about 20% during the period of oothecal transport. The effects of allatostatins, allatostatin analogues and corazonin were tested on semi-isolated heart preparations. Allatostatins showed a rapid, reversible and dose-dependent cardioinhibitory activity. Blattella allatostatin 1 (BLAST-1: LYDFGL-NH(2)), was the most active, eliciting 76% inhibition at 10(-7) M and even 19% inhibition at 10(-9) M. BLAST-2 (DRLYSFGL-NH(2)), BLAST-3 (AGSDGRLYSFGL-NH(2)) and BLAST-4 (APSSAQRLYGFGL-NH(2)) were less active. An analogue of BLAST-2 with C-terminus in acid form and a pseudopeptide analogue of BLAST-2 with a methyleneamino Psi[CH(2)NH] peptide bond surrogate between residues L(3) and Y(4) were inactive. Corazonin elicited rapid, reversible and dose-dependent cardioacceleratory activity. When tested together with BLAST-1, corazonin overrode the cardioinhibitory effect of allatostatin. Our previous results had shown that high levels of allatostatin were maintained during the period of oothecal transport. This and the fact that physiological concentrations of allatostatins produce physiological levels of inhibition, suggest that allatostatins are involved in the modulation of cardiac rhythm in this cockroach.