ABSTRACT
Quercus pyrenaica is a woody species of high landscape value, however, its forests show an advanced state of degradation in the Iberian Peninsula. Afforestation typically has low success, thus, it is necessary to improve the fitness of oaks plantlets to be transplanted, for instance, by inoculating beneficial microorganisms. In adding microorganisms to ecosystems, there must be balanced efficacy with potential effects on native microbial communities. We addressed changes in diversity, richness, composition and co-occurrence networks of prokaryotic communities in the rhizosphere of inoculated and control trees outplanted to three different sites located in the Sierra Nevada National and Natural Park (Spain). After 18 months in wild conditions, we did not detect changes due to the inoculation in the richness, diversity and structure in none of the sites. However, we observed an increase in the complexity of the co-occurrence networks in two experimental areas. Modularization of the networks changed as a result of the inoculation, although the sense of the change depended on the site. Although it was impossible to unravel the effect of bacterial inoculation, our results highlighted that inoculation alters the association of rhizosphere bacteria without entailing other changes, so networks should be analysed prior to inoculating the plantlets.
Subject(s)
Microbiota , Quercus , Rhizosphere , Trees , Forests , Soil MicrobiologyABSTRACT
AIM: To evaluate layperson (university student) ability to use an automated external defibrillator (AED). DESIGN: A repeated measures quasi-experimental study with non-probabilistic sampling and a control group was carried out. SCOPE: Teacher training degree students at the University of Santiago de Compostela (Spain). PARTICIPANTS: The sample consisted of 129 subjects (69% women and 31% men), between 19-47 years of age (mean 23.2±4.7 years). As inclusion criterion, the subjects were required to have no previous knowledge of AED. INTERVENTIONS: Times to apply defibrillation with an AED to a mannequin were recorded untrained (T0), after a theoretical and practice explanation lasting less than one minute (T1), and 6 months after the training process (T2). MAIN VARIABLES OF INTEREST: The primary endpoint was the time taken to deliver a defibrillation discharge. The "improvement effect" variable was defined by the absolute time difference between T1 and T0, while the "degree of forgetfulness effect" variable was defined as the absolute difference between T1 and T2. RESULTS: The mean times were T0=67.7s; T1=44.2s; T2=45.9s. The time to apply defibrillation was reduced after explanation training (T1Subject(s)
Defibrillators/psychology
, First Aid
, Students/psychology
, Teacher Training
, Adult
, Educational Measurement
, Electric Countershock/instrumentation
, Electric Countershock/methods
, Female
, Humans
, Male
, Manikins
, Memory
, Middle Aged
, Surveys and Questionnaires
, Universities
, Young Adult
ABSTRACT
In recent decades, gout became the most common inflammatory arthritis and one in which pathogenesis and risk factors are best understood. One of the treatment objectives in current guidelines is "cure". However, audits show that minority of patients with gout receive adequate advice and treatment. Doctors often focus on managing acute attacks rather than viewing gout as a chronic progressive crystal deposition disease. Accordingly, urate-lowering treatment is underprescribed and often underdosed. The recent introduction of a panel of new treatments of gout and a better understanding of epidemiologic factors (such as the fructose) may improve management of this easily diagnosed and curable form of potentially severe arthritis, worsening probably the cardiovascular prognostic.
Subject(s)
Gout/therapy , Diet , Disease Management , Gout Suppressants/therapeutic use , HumansABSTRACT
Muskuloskeletal ultrasound has been incorporated by rheumatologist to the clinical practice over the past decade. The technical improvements of the devices allowed the production of high quality images contributing to better identification of joint inflammation and structural damage. In this review, we highlight the applications of ultrasound in the study of different rheumatic conditions.
Subject(s)
Rheumatic Diseases/diagnostic imaging , Humans , Musculoskeletal System/diagnostic imaging , UltrasonographyABSTRACT
OBJECTIVE: The antimicrobial resistance is a significant public health threat, particularly for healthcare-associated infections caused by carbapenem-resistant Gram-negative pathogens which are increasingly reported worldwide. The aim of this study was to provide data on the in vitro antimicrobial activity of cefiderocol and that of commercially available comparator antibiotics against a defined collection of recent clinical multi-drug resistant (MDR) microorganisms, including carbapenem resistant Gram-negative bacteria collected from different regions in Spain and Portugal. METHODS: A total of 477 clinical isolates of Enterobacterales, Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia were prospectively (n=265) and retrospectively (n=212) included (2016-2019). Susceptibility testing was performed using standard broad microdilution and results were interpreted using CLSI-2021 and EUCAST-2021 criteria. RESULTS: Overall, cefiderocol showed a good activity against Enterobacterales isolates, being 99.5% susceptible by CLSI and 94.5% by EUCAST criteria. It also demonstrated excellent activity against P. aeruginosa and S. maltophilia isolates, all being susceptible to this compound considering CLSI breakpoints. Regarding A. baumannii (n=64), only one isolate was resistant to cefiderocol. CONCLUSIONS: Our results are in agreement with other studies performed outside Spain and Portugal highlighting its excellent activity against MDR gram-negative bacteria. Cefiderocol is a therapeutic alternative to those available for the treatment of infections caused by these MDR bacteria.
Subject(s)
Cefiderocol , Cephalosporins , Humans , Cephalosporins/pharmacology , Cephalosporins/therapeutic use , Spain/epidemiology , Portugal/epidemiology , Retrospective Studies , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Gram-Negative Bacteria , Carbapenems , Pseudomonas aeruginosa , Intensive Care Units , Microbial Sensitivity TestsABSTRACT
OBJECTIVES: In order to inform and anticipate potential strategies aimed at combating KPC-producing Klebsiella pneumoniae infections, we analysed imipenem/relebactam and ceftazidime/avibactam single-step mutant frequencies, resistance development trajectories, differentially selected resistance mechanisms and their associated fitness cost using four representative high-risk K. pneumoniae clones. METHODS: Mutant frequencies and mutant preventive concentrations were determined using agar plates containing incremental concentrations of ß-lactam/ß-lactamase inhibitor. Resistance dynamics were determined through incubation for 7 days in 10 mL MH tubes containing incremental concentrations of each antibiotic combination up to their 64 × baseline MIC. Two colonies per strain from each experiment were characterized by antimicrobial susceptibility testing, whole genome sequencing and competitive growth assays (to determine in vitro fitness). KPC variants associated with imipenem/relebactam resistance were characterized by cloning and biochemical experiments, atomic models and molecular dynamics simulation studies. RESULTS: Imipenem/relebactam prevented the emergence of single-step resistance mutants at lower concentrations than ceftazidime/avibactam. In three of the four strains evaluated, imipenem/relebactam resistance development emerged more rapidly, and in the ST512/KPC-3 clone reached higher levels compared to baseline MICs than for ceftazidime/avibactam. Lineages evolved in the presence of ceftazidime/avibactam showed KPC substitutions associated with high-level ceftazidime/avibactam resistance, increased imipenem/relebactam susceptibility and low fitness costs. Lineages that evolved in the presence of imipenem/relebactam showed OmpK36 disruption, KPC modifications (S106L, N132S, L167R) and strain-specific substitutions associated with imipenem/relebactam resistance and high fitness costs. Imipenem/relebactam-selected KPC derivatives demonstrated enhanced relebactam resistance through important changes affecting relebactam recognition and positioning. CONCLUSIONS: Our findings anticipate potential resistance mechanisms affecting imipenem/relebactam during treatment of KPC-producing K. pneumoniae infections.
ABSTRACT
The analysis of curated genomic, metagenomic and proteomic data is of paramount importance in the fields of biology, medicine, education, and bioinformatics. Although this type of data is usually hosted in raw format on free international repositories, the full access requires lots of computing power and large storage disk space for the domestic user. The purpose of the study is to offer a comprehensive set of microbial genomic and proteomic reference databases in an accessible and easy-to-use form to the scientific community and demonstrate its advantages and usefulness. Also, we present a case study on the applicability of the sketched data, for the determination of overall genomic coherence between two members of the Brucellacea family, which suggests they belong to the same genomospecies that remain as discrete ecotypes. A representative set of genomes, proteomes (from type material), and metagenomes were directly collected from the NCBI Assembly database and Genome Taxonomy Database (GTDB), associated with the major groups of Bacteria, Archaea, Virus, and Fungi. Sketched databases were subsequently created and stored on handy reduced representations by using the MinHash algorithm implemented in Mash software. The obtained dataset contains more than 133 GB of space disk reduced to 883.25 MB and represents 125,110 genomics/proteomic records from eight informative contexts, which have been prefiltered to make them accessible, usable, and user-friendly with limited computational resources. Potential uses of these sketched databases are discussed, including but not limited to microbial species delimitation, estimation of genomic distances and genomic novelties, paired comparisons between proteomes, genomes, and metagenomes; phylogenetic neighbor's exploration and selection, among others.
Subject(s)
Proteome , Proteomics , Phylogeny , Genomics , Computational BiologyABSTRACT
We present new high angular resolution interferometer observations of the υ = 0 J = 14 - 13 and 15 - 14 SiS lines towards IRC+10216, carried out with CARMA and ALMA. The maps, with angular resolutions of ≃0â â³25and0â â³55, reveal (1) an extended, roughly uniform, and weak emission with a size of ≃0â â³5, (2) a component elongated approximately along the East-West direction peaking at ≃0â â³13and0â â³17 at both sides of the central star, and (3) two blue- and red-shifted compact components peaking around 0â â³07 to the NW of the star. We have modeled the emission with a 3D radiation transfer code finding that the observations cannot be explained only by thermal emission. Several maser clumps and one arc-shaped maser feature arranged from 5 to 20Râ from the central star, in addition to a thin shell-like maser structure at ≃ 13Râ are required to explain the observations. This maser emitting set of structures accounts for 75% of the total emission while the other 25% is produced by thermally excited molecules. About 60% of the maser emission comes from the extended emission and the rest from the set of clumps and the arc. The analysis of a time monitoring of these and other SiS and 29SiS lines carried out with the IRAM 30 m telescope from 2015 to present suggests that the intensity of some spectral components of the maser emission strongly depends on the stellar pulsation while other components show a mild variability. This monitoring evidences a significant phase lag of ≃ 0.2 between the maser and NIR light-curves.
ABSTRACT
Giant cell arteritis (GCA) is the most common vasculitis in Western countries in individuals over the age of 50. The diagnosis is relatively straightforward when typical features, such as headache, jaw claudication or other ischemic complications are present. Although atypical presentations of GCA have been described, herein we report for first time low back pain as the presenting manifestation of this vasculitis. We also emphasize the importance of considering the use of positron emission tomography (PET) in the evaluation of GCA patients presenting without "overt" cranial ischemic manifestations.
Subject(s)
Aorta, Abdominal/pathology , Aorta, Thoracic/pathology , Aortitis/pathology , Giant Cell Arteritis/pathology , Low Back Pain/pathology , Administration, Oral , Aortitis/complications , Aortitis/drug therapy , Aspirin/therapeutic use , Drug Therapy, Combination , Female , Fluorodeoxyglucose F18 , Giant Cell Arteritis/complications , Giant Cell Arteritis/drug therapy , Glucocorticoids/therapeutic use , Humans , Low Back Pain/drug therapy , Low Back Pain/etiology , Methylprednisolone/therapeutic use , Middle Aged , Positron-Emission Tomography , Prednisolone/therapeutic use , Remission Induction , Treatment OutcomeABSTRACT
The main goal of this study was to assess the effect of the inoculation of four autochthonous shrub species with the arbuscular mycorrhizal (AM) fungus Rhizophagus intraradices on the rhizosphere bacterial community and to ascertain whether such an effect is dependent on the host plant species. Additionally, analysis of rhizosphere soil chemical and biochemical properties was performed to find relationships between them and the rhizosphere bacterial communities. Non-metric multidimensional scaling analysis and subsequent permutational multivariate analysis of variance revealed differences in bacterial community composition and structure between non-inoculated and inoculated rhizospheres. Moreover, an influence of the plant species was observed. Different bacterial groups were found to be indicator taxonomic groups of non-inoculated and inoculated rhizospheres, Gemmatimonadetes and Anaerolineaceae, respectively, being the most notable indicators. As shown by distance based redundancy analysis, the shifts in bacterial community composition and structure mediated by the inoculation with the AM fungus were mainly related to changes in plant nutrients and growth parameters, such as the shoot phosphorus content. Our findings suggest that the AM fungal inoculum was able to modify the rhizosphere bacterial community assemblage while improving the host plant performance.
Subject(s)
Agricultural Inoculants , Bacteria/classification , Mycorrhizae/physiology , Rhizosphere , Soil Microbiology , Asteraceae , Ecosystem , Lavandula , Plant Roots/microbiology , Salvia , Soil/chemistry , Spain , Thymus PlantABSTRACT
Introduction: Dietary fiber is an important component of human diet. Since each fiber type has specific metabolic and gastrointestinal function effects, in each specific pathology we will have to choose the optimum type of fiber, considering its chemical, physical and physiological properties. Objective:to put partially hydrolyzed guar gum in its place in the complex framework of dietary fiber, to review its physicochemical properties and possible mechanisms of action; as well as its potential usefulness in different clinical situations in adult patients. Methods: non-systematic review in Medline. Results: Partially hydrolyzed guar gum (PHGG) is obtained from a partial enzymatic hydrolysis of guar gum by the enzyme ß-endo-mannanase. It is a soluble, highly fermentable fiber with low viscosity. The fermentation of GGPH in colon produces short chain fatty acids, implicated in the main pathophysiological mechanisms responsible for their clinical effects. Its use in enteral nutrition associated diarrhea is supported by several studies and by the recommendations of scientific societies such as the European Society for Clinical Nutrition and Metabolism and the American Society for Parenteral and Enteral Nutrition. The usefulness of GGPH has been studied in many other clinical situations, such as diabetes, hypercholesterolemia, bacterial overgrowth, etc. with promising results. Conclusions: GGPH is useful in the management of enteral nutrition associated diarrhea. In other clinical situations, more quality studies would be necessary in order to make concrete recommendations.
Introducción: la fibra dietética es un componente importante de la dieta humana. Cada tipo de fibra tiene efectos específicos a nivel metabólico y en el funcionamiento gastrointestinal, por lo que en cada patología concreta habremos de elegir la fibra óptima teniendo en cuenta sus propiedades químicas, físicas y fisiológicas. Objetivo: encuadrar la goma guar parcialmente hidrolizada en su lugar en el complejo marco de la fibra dietética, revisar sus propiedades físico-químicas y posibles mecanismos de acción; así como su potencial utilidad en distintas situaciones clínicas en pacientes adultos. Métodos: revisión no sistemática en Medline. Resultados: la goma guar parcialmente hidrolizada (GGPH) se obtiene a partir de una hidrólisis enzimática parcial de la goma guar mediantela enzima ß-endo-mananasa. Se trata de una fibra soluble, altamente fermentable y de baja viscosidad. La fermentación de la GGPH a nivel colónico produce ácidos grasos de cadena corta, implicados en los principales mecanismos fisiopatólogicos responsables de sus efectos a nivel clínico. Su uso en la diarrea asociada a la nutrición enteral está avalada por diversos estudios y por la recomendaciones de sociedades científicas como la European Society for Clinical Nutrition and Metabolism y la American Society for Parenteral and Enteral Nutrition. Se ha estudiado la utilidad de la GGPH en otras muchas situaciones clínicas, como diabetes, hipercolesterolemia, sobrecrecimiento bacteriano, etc. con resultados prometedores. Conclusiones: la GGPH es útil en el manejo de la diarrea asociada a nutrición enteral. Respecto a otras situaciones clínicas, serían necesarios más estudios de calidad para poder hacer recomendaciones concretas.
Subject(s)
Galactans/therapeutic use , Mannans/therapeutic use , Plant Gums/therapeutic use , Diarrhea/etiology , Diarrhea/prevention & control , Dietary Fiber/pharmacology , Enteral Nutrition/adverse effects , Galactans/pharmacology , Humans , Hydrolysis , Mannans/pharmacology , Plant Gums/pharmacologyABSTRACT
Due to the depletion of fossil fuel reserves and the environmental issues derived from their use, biomass seems to be an excellent source of renewable energy. In this work, the kinetics of the pyrolysis and combustion of three different biomass waste samples (two dairy manure samples before (Pre) and after (Dig R) anaerobic digestion and one swine manure sample (SW)) was studied by means of thermogravimetric analysis. In this work, three iso-conversional methods (Friedman, Flynn-Wall-Ozawa (FWO) and Kissinger-Akahira-Sunose (KAS)) were compared with the Coats-Redfern method. The Ea values of devolatilization stages were in the range of 152-170kJ/mol, 148-178kJ/mol and 156-209kJ/mol for samples Pre, Dig R and SW, respectively. Concerning combustion process, char oxidation stages showed lower Ea values than that obtained for the combustion devolatilization stage, being in the range of 140-175kJ/mol, 178-199kJ/mol and 122-144kJ/mol for samples Pre, Dig R and SW, respectively. These results were practically the same for samples Pre and Dig R, which means that the kinetics of the thermochemical processes were not affected by anaerobic digestion. Finally, the distributed activation energy model (DAEM) and the pseudo-multi component stage model (PMSM) were applied to predict the weight loss curves of pyrolysis and combustion. DAEM was the best model that fitted the experimental data.
ABSTRACT
We present high spectral resolution mid-IR observations of SiS towards the C-rich AGB star IRC+10216 carried out with the Texas Echelon-cross-Echelle Spectrograph mounted on the NASA Infrared Telescope Facility. We have identified 204 ro-vibrational lines of 28Si32S, 26 of 29Si32S, 20 of 28Si34S, and 15 of 30Si32S in the frequency range 720 - 790 cm-1. These lines belong to bands v = 1 - 0, 2 - 1, 3 - 2, 4-3, and 5-4, and involve rotational levels with Jlow â² 90. About 30 per cent of these lines are unblended or weakly blended and can be partially or entirely fitted with a code developed to model the mid-IR emission of a spherically symmetric circumstellar envelope composed of expanding gas and dust. The observed lines trace the envelope at distances to the star â² 35Râ(≃ 0â³.7). The fits are compatible with an expansion velocity of 1+2.5(r/Râ -1) km s-1 between 1 and 5Râ, 11 km s-1 between 5 and 20Râ, and 14.5 km s-1 outwards. The derived abundance profile of 28Si32S with respect to H2 is 4.9 × 10-6 between the stellar photosphere and 5Râ, decreasing linearly down to 1.6 × 10-6 at 20Râ and to 1.3 × 10-6 at 50Râ. 28Si32S seems to be rotationally under LTE in the region of the envelope probed with our observations and vibrationally out of LTE in most of it. There is a red-shifted emission excess in the 28Si32S lines of band v = 1 - 0 that cannot be found in the lines of bands v = 2 - 1, 3 - 2, 4 - 3, and 5 - 4. This excess could be explained by an enhancement of the vibrational temperature around 20Râ behind the star. The derived isotopic ratios 28Si/29Si, and 32S/34S are 17 and 14, compatible with previous estimates.
ABSTRACT
The valorization of three different manure samples via pyrolysis and combustion processes was evaluated. Dairy manure (sample Pre) was biologically pretreated by anaerobic digestion (sample Dig R) whereas swine manure (sample SW) was pretreated by a biodrying process. Thermal behavior of manure samples were studied by means of thermogravimetric analysis coupled with mass spectrometry (TGA-MS). These processes could be divided into four general stages: dehydration, devolatilization, char transformation (oxidation for combustion) and inorganic matter decomposition. The main differences observed among the samples were attributed to their different composition and pretreatment. The economic feasibility, energetic and environmental impacts of pyrolysis and combustion technologies for dairy samples were carried out by means of life cycle assessment (LCA) methodology. Four different scenarios were analyzed. The economic feasibility of the pyrolysis process was demonstrated, being sample Dig R the best environmental option. However, the combustion of sample Pre was the best energetic option.
Subject(s)
Biofuels , Environment , Manure , Agriculture/economics , Animals , Biomass , Carbon Dioxide/analysis , Dairying , Greenhouse Effect , Hydrogen/analysis , Manure/analysis , Mass Spectrometry/methods , Methane/analysis , Swine , Thermogravimetry/methods , Waste Management/economics , Waste Management/methodsABSTRACT
Two respiratory membrane-bound nitrate reductase (NR) isoenzymes, NRI and NRII, have been purified for the first time from one single microorganism. Triton X-100-solubilized NRs were purified by a three-step procedure of differential centrifugation, Q-Sepharose chromatography, and gel filtration on Sephacryl S-300. Both isoenzymes were purified to homogeneity by the criteria of NR activity staining in polyacrylamide gels run under non-denaturating conditions and coincident staining of the protein band by silver nitrate. NRI is composed of three subunits of 116 kDa, 68 kDa, and 56 kDa, whereas NRII is composed of four subunits of 116 kDa, 68 kDa, 59 kDa, and 56 kDa. The 116-kDa subunit of NRI and the 59-kDa subunit of NRII exhibited immunological cross-reactivity with the respiratory NR of Pseudomonas stutzeri strain ZoBell.
Subject(s)
Isoenzymes/isolation & purification , Nitrate Reductases/isolation & purification , Rhizobiaceae/enzymology , Blotting, Western , Cell Membrane , Isoenzymes/metabolism , Nitrate Reductases/metabolismABSTRACT
Experimental data suggest that blood components from patients with CJD may carry infectivity. However, most of the studies have been made on the classic form of CJD. Further studies are needed to discern whether infectivity levels in blood from patients with the nvCJD differ from those with the classic form. Possibility of transmission of CJD by blood or blood products can not be excluded and therefore adequate surveillance should be implemented. People who have been exposed to contaminated blood should be followed, while recommendations are being adapted according to new scientific data on infectivity.
Subject(s)
Creutzfeldt-Jakob Syndrome/transmission , Transfusion Reaction , Creutzfeldt-Jakob Syndrome/etiology , Humans , Prion Diseases/transmission , Risk FactorsABSTRACT
Streptococcus pneumoniae is a common pathogen in children that in recent years has shown a progressive rise in resistance to the usual antibiotics and also to the new third generation cephalosporins. We report a review of Streptococcus pneumoniae strains isolated at our hospital from pediatrics patients in whom we observed an increased incidence of resistance to cefotaxime significantly related with the rise in resistance to penicillin. The resistance of penicillin-resistant strains to various antibiotics was analyzed and the following results were obtained: cefotaxime, 0% susceptible, 83% intermediate and 17% resistant; erythromycin, 16,7% susceptible, 8,3& intermediate and 75% resistant; vancomycin, 100% susceptible; chloramfenicol, 16,7% susceptible and 83,3% resistant; and cotrimoxazole, 100% resistant.
Subject(s)
Streptococcus pneumoniae/drug effects , Child , Drug Resistance, Microbial , Humans , Microbial Sensitivity Tests/statistics & numerical data , Respiratory System/microbiology , Streptococcus pneumoniae/isolation & purificationABSTRACT
UNLABELLED: OBJECTIVE AND MATERIAL: We are carried out a retrospective study of 43 patients, 21 males and 22 women entered during the period of infancy in the Service of Neurology of our hospital and with diagnostic of any type of partial seizure, in an intent to correlate a series of clinical parameters, electroneurophysiologics and initial therapeutics with their factors follow-up periods. RESULTS: They are a half age of 7.11 months (1-19), consecutive being controlled for a period of time of 40 months (6-96). We have settled down a relationship between the drugs utilized in the first seizure and that other that they remained in their last revision, the current state of the critical manifestations, and the existence or not of an agreement between the e diagnosis emitted to the discharge and the development of the illness. CONCLUSION: After the present study, we thought that the current classification of the epileptic seizures is insufficient in the age of the infant, with presages much more complexes.
Subject(s)
Epilepsies, Partial/diagnosis , Anticonvulsants/therapeutic use , Brain/abnormalities , Disease Progression , Electroencephalography , Epilepsies, Partial/drug therapy , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Magnetic Resonance Imaging , Male , Retrospective StudiesABSTRACT
The purpose of the present study was to assess an retrospective analysis on 167 children with chronic or severe headache, ranged in age from 2 to 14 years (7.19 +/- 2.36 years old) who were referred to the pediatric neurology service of Virgen del Rocio Hospital of Sevilla from december 1992 to december 1994. The most common type of headache was migraine which constituted 43.91% of all these cases. Tension headache accounted for 27.71%. A family history of headache, primarily maternal, was found in 114 patients in whom it could be evaluated. Children with migraine had a greater proportion of mothers with a history of migraine than those with tension headache. No significant variations were observed between chronic evolution and acute. We conclude that headache is not uncommon in children and it treatment must be individualized and requires more than just the use of pharmacotherapy.
Subject(s)
Headache/diagnosis , Adolescent , Brain/physiopathology , Child , Child, Preschool , Female , Headache/genetics , Headache/physiopathology , Humans , Male , Retrospective StudiesABSTRACT
Diabetic nephropathy is an important complication of diabetes. Established nephropathy is preceded by a long silent phase of incipient nephropathy characterized by a subclinical increase in albumin excretion know as microalbuminuria (30-300 mg/d). There is evidence that the progression of nephropathy and its associated mortality can be ameliorated by a number of interventions if started at a nearly stage: glycaemic control, that should be optimized as far as possible, and hypertension control. Angiotensin-converting enzyme (ACE) inhibitors are promoted as first-line agent for treating hypertension in diabetic patients; as well as their systemic hypotensive action, these drugs may have an additional beneficial effect in reducing intraglomerular pressure.