Selenium bioactive compounds produced by beneficial microbes.

Selenium (Se) is an essential trace element present as selenocysteine (SeCys) in selenoproteins, which have an important role in thyroid metabolism and the redox system in humans. Se deficiency affects between 500 and 1000 million people worldwide. Increasing Se intake can prevent from bacterial and viral infections. Se deficiency has been associated with cancer, Alzheimer, Parkinson, decreased thyroid function, and male infertility. Se intake depends on the food consumed which is directly related to the amount of Se in the soil as well as on its availability. Se is unevenly distributed on the earth's crust, being scarce in some regions and in excess in others. The easiest way to counteract the symptoms of Se deficiency is to enhance the Se status of the human diet. Se salts are the most toxic form of Se, while Se amino acids and Se-nanoparticles (SeNPs) are the least toxic and most bio-available forms. Some bacteria transform Se salts into these Se species. Generally accepted as safe selenized microorganisms can be directly used in the manufacture of selenized fermented and/or probiotic foods. On the other hand, plant growth-promoting bacteria and/or the SeNPs produced by them can be used to promote plant growth and produce crops enriched with Se. In this chapter we discuss bacterial Se metabolism, the effect of Se on human health, the applications of SeNPs and Se-enriched bacteria, as well as their effect on food fortification. Different strategies to counteract Se deficiency by enriching foods using sustainable strategies and their possible implications for improving human health are discussed.

Effects of Nordic walking training on functional parameters in Parkinson's disease: a randomized controlled clinical trial.

We compare the effects of Nordic walking training (NW) and Free walk (FW) on functional parameters (motor symptoms, balance) and functional mobility (Timed Up and Go at Self-selected Speed - TUGSS, and at forced speed, TUGFS; Self-selected Walking Speed, SSW; locomotor rehabilitation index, LRI) of Parkinson's disease (PD) patients. The study included 33 patients with clinical diagnosis of idiopathic PD, and staging between 1 and 4 in the Hoehn and Yahr scale (H&Y) randomized into two groups: NW (N = 16) and FW (N = 17) for 6 weeks. Baseline characteristics were compared trough a one-way ANOVA. Outcomes were analyzed using the Generalized Estimation Equations (GEE) with a Bonferroni post-hoc. Data were analyzed using SPSS v.20.0. Improvements in UPDRS III (P < 0.001), balance scores (P < 0.035), TUGSS distance (P < 0.001), TUGFS distance (P < 0.001), SSW (P < 0.001), and LRI (P < 0.001) were found for both groups. However, the NW group showed significant differences (P < 0.001) when compared to the FW group for the functional mobility. We conclude the NW improves functional parameters and walking mobility demonstrating that NW is as effective as the FW, including benefits for FW on the functional mobility of people with PD.

The C677T polymorphism in the MTHFR gene is associated with the toxicity of methotrexate in a Spanish rheumatoid arthritis population.

OBJECTIVE: Methotrexate (MTX) is the first-choice drug for the treatment of rheumatoid arthritis (RA) patients. However, 30% of RA patients discontinue therapy within 1 year, usually because of adverse effects. Previous studies have reported conflicting results on the association of polymorphisms in the MTHFR gene with the toxicity of MTX in RA. The aim of this study was to assess the involvement of the C677T and A1298C polymorphisms in the MTHFR gene in the toxicity of MTX in a Spanish RA population. METHODS: The study included retrospectively 468 Spanish RA patients treated with MTX. Single nucleotide polymorphism (SNP) genotyping was performed using the oligonucleotide microarray technique. Allele and genotype association analyses with regard to MTX toxicity and a haplotype association test were also performed. RESULTS: Eighty-four out of the 468 patients (18%) had to discontinue therapy due to adverse effects or MTX toxicity. The C677T polymorphism (rs1801133) was associated with increased MTX toxicity [odds ratio (OR) 1.42, 95% confidence interval (CI) 1.01-1.98, p = 0.0428], and the strongest association was shown in the recessive model (OR 1.95, 95% CI 1.08-3.53, p = 0.0246). The A1298C polymorphism (rs1801131) was not associated with increased MTX toxicity (OR 0.94, 95% CI 0.65-1.38, p = 0.761). A borderline significant risk haplotype was found: 677T-1298A (OR 1.40, 95% CI 1.00-1.96, p = 0.0518). CONCLUSION: These results demonstrate that the C677T polymorphism in the MTHFR gene is associated with MTX toxicity in a Spanish RA population.

Clinical features of late onset psoriatic arthritis.

The aim of this work is to compare the clinical and radiological manifestations of patients presenting late onset psoriatic arthritis (PsA) with early onset PsA. An overall of 96 consecutive PsA patients were studied over an 8-month-period. Clinical, laboratory and radiographic signs were assessed. Of the 96 patients studied, 84 had their earliest symptoms before the age of 60 (Group I) and 12 after it (Group II). In Group II the mean age was 65.7 years (range 60-73), the sex ratio (male/female) was 9/3. All patients were HLA-B27 negative; the clinical forms observed were: polyarticular (6 patients; 50%), oligoarticular (4 patients; 33%) and spondyloarthropathy (SpA) (2 patients; 17%). Only two patients had asymmetric sacroiliitis and three had history of dactylitis episodes. In conclusion, we found distinct clinical manifestations in late onset PsA. Peripheral affection was found predominant. The male/female ratio was higher than other age groups.

[Atypical presentation and clinical course in mesangial lupus nephritis]. / Presentación atípica y evolución clínina de la nefropatía lúpica mesangial. Estudio de 20 pacientes.

Mesangial lupus nephritis (type II according to the WHO classification) is usually considered a benign variant. Its clinical manifestations are minimal: hematuria and proteinuria, normal sediment, and normal renal function. To evaluate the clinical manifestations and course in mesangial nephritis, we studied 20 patients with a histological diagnosis of type II lupus nephritis who attended our clinic. We found that clinical presentation was atypical in a significant proportion of these patients. Data from the two groups of patients were compared: those with classical presentation and those with atypical presentation. The results were analyzed with descriptive and inferential statistics. Twenty patients (19 women and 1 man) were included. The mean age at nephritis onset was 33.9 years and the mean length of follow-up was 4.2 years. Clinical presentation was atypical in 17 patients, with active urinary sediment in 12, urine protein>1 g/24 h in 7, and reduction in creatinine clearance in 14. Clinical remission was achieved with treatment in 16 patients, with subsequent flares in 8. All flares responded well to treatment. Biopsies in 5 patients with flares showed progression to type III and IV nephritis. At the end of the follow-up period, 4 patients had chronic renal failure. Some of our patients with mesangial lupus nephritis did not have the benign course that is usually described. Despite a good initial response, 20% of the patients progressed to chronic renal failure. Initial hyperlipidemia and proteinuria seem to correlate with a more aggressive course.

Presentación atípica y evolución clínina de la nefropatía lúpica mesangial. Estudio de 20 pacientes / Atypical presentation and clinical course in mesangial lupus nephritis

La nefropatía lúpica mensangial (NL II) suele considerarse como de evolución benigna. Se caracteriza por hematuria y proteinuria mínimas, sedimento urinario y valores de depuración de creatinina (DCr) normales. Para evaluar las características clínicas y la evolución de la NL II se estudió a 20 pacientes del Servicio de Reumatología de nuestro centro, con este tipo de nefritis. Encontramos que un porcentaje significativo de estos pacientes no tenía la presentación clínica esperada. Comparamos los datos obtenidos entre los pacientes con presentación considerada clásica y los que tuvieron una presentación atípica. Para la evaluación de los resultados se empleó un análisis estadístico descriptivo y uno inferencial. Los pacientes eran 19 mujeres y 1 varón, con una edad promedio al diagnóstico de la nefropatía de 33,9 años y un tiempo de seguimiento de 4,2 años. Diecisiete de los pacientes tuvieron presentación clínica inusual caracterizada por sedimento urinario anormal (12 pacientes), proteinuria mayor de 1 g/día (7) y disminución en la DCr (14). Dieciséis pacientes presentaron remisión con el tratamiento, con recidiva posterior de la nefritis en 8, que nuevamente respondió al tratamiento. En 5 pacientes se demostró modificación histológica en la nefropatía a NL III y NL IV. Al final del seguimiento, 4 pacientes progresaron a insuficiencia renal crónica. En nuestro grupo de pacientes la NL II no tuvo un comportamiento inicial tan benigno como se describe habitualmente. A pesar de la buena respuesta inicial, el 20% evolucionó a daño renal crónico. La proteinuria inicial y la hiperlipidemia parecen implicar riesgo de evolución más agresiva(AU)

Mesangial lupus nephritis (type II according to the WHO classification) is usually considered a benign variant. Its clinical manifestations are minimal: hematuria and proteinuria, normal sediment, and normal renal function. To evaluate the clinical manifestations and course in mesangial nephritis, we studied 20 patients with a histological diagnosis of type II lupus nephritis who attended our clinic. We found that clinical presentation was atypical in a significant proportion of these patients. Data from the two groups of patients were compared: those with classical presentation and those with atypical presentation. The results were analyzed with descriptive and inferential statistics. Twenty patients (19 women and 1 man) were included. The mean age at nephritis onset was 33.9 years and the mean length of follow-up was 4.2 years. Clinical presentation was atypical in 17 patients, with active urinary sediment in 12, urine protein > 1 g/24 h in 7, and reduction in creatinine clearance in 14. Clinical remission was achieved with treatment in 16 patients, with subsequent flares in 8. All flares responded well to treatment. Biopsies in 5 patients with flares showed progression to type III and IV nephritis. At the end of the follow-up period, 4 patients had chronic renal failure. Some of our patients with mesangial lupus nephritis did not have the benign course that is usually described. Despite a good initial response, 20% of the patients progressed to chronic renal failure. Initial hyperlipidemia and proteinuria seem to correlate with a more aggressive course(AU)