Análisis de la relación entre la fragilidad y la calidad de vida relacionada con la salud en pacientes en diálisis peritoneal continua ambulatoria / Analysis of the relationship between frailty and health-related quality of life in patients undergoing continuous ambulatory peritoneal dialysis

Introducción: El síndrome de fragilidad en pacientes en diá-lisis puede deteriorar la calidad de vida relacionada con la salud.Objetivo: Analizar la asociación entre el síndrome de fragili-dad y la calidad de vida relacionada con la salud en pacientes en diálisis peritoneal continua ambulatoria.Material y Método: Estudio descriptivo de corte transversal, realizado en la Ciudad de México. La muestra por convenien-cia incluyó a 106 pacientes del programa de diálisis perito-neal, de los cuales 62% eran hombres. Se registraron edad, estado civil, ocupación, escolaridad, índice de masa corporal, creatinina y albumina. La calidad de vida relacionada con la salud se evaluó con KDQOL SF-36 y la fragilidad mediante la Batería Corta de Rendimiento Físico (BCRF).Resultados: Las puntuaciones de la BCRF mostraron corre-lación significativa con ciertas categorías de KDQOL SF-36, como efectos de la enfermedad renal, carga de la enfermedad renal y componente físico. Las puntuaciones de la prueba de velocidad de marcha no se asociaron a ninguna categoría de KDQOL SF-36. Tampoco hubo asociaciones entre las puntua-ciones obtenidos en el componente mental de KDQOL SF-36 y los de las pruebas de la BCRF. La calidad de vida relacionada con la salud fue menor en los pacientes con fragilidad, edad avanzada o hipoalbuminemia, Conclusiones: Los pacientes en diálisis peritoneal tienen una alta prevalencia del síndrome de fragilidad y disminución de la calidad de vida. Además, la alta tasa de fragilidad está aso-ciada a peor calidad de vida, especialmente en el rendimiento físico.(AU)

Introduction: The frailty syndrome in dialysis patients can deteriorate the health-related quality of life.Objective: To analyze the association between frailty syndrome and health-related quality of life in patients undergoing continuous ambulatory peritoneal dialysis.Materials and Method: A descriptive cross-sectional study was conducted in Mexico City. The convenience sample included 106 patients from the peritoneal dialysis program, of which 62% were male. Age, marital status, occupation, education level, body mass index, creatinine, and albumin were recorded. Health-related quality of life was assessed using KDQOL SF-36 and frailty syndrome through the Short Physical Performance Battery (SPPB).Results: SPPB scores showed a significant correlation with certain categories of KDQOL SF-36, such as kidney disease effects, kidney disease burden, and physical components. Gait speed test scores were not associated with any category of KDQOL SF-36. There were also no associations between the scores obtained in the mental component of KDQOL SF-36 and those of the SPPB tests. Health-related quality of life was lower in patients with frailty, advanced age, or hypoalbuminemia.Conclusions: Patients undergoing peritoneal dialysis have a high prevalence of frailty syndrome and decreased quality of life. Furthermore, the high frailty rate is associated with poorer quality of life, especially in physical performance.(AU)

Host mitochondrial transcriptome response to SARS-CoV-2 in multiple cell models and clinical samples.

SARS-CoV-2 induces a muted innate immune response compared to other respiratory viruses. Mitochondrial dynamics might partially mediate this effect of SARS-CoV-2 on innate immunity. Polypeptides encoded by open reading frames of SARS-CoV and SARS-CoV-2 have been shown to localize to mitochondria and disrupt Mitochondrial Antiviral Signaling (MAVS) protein signaling. Therefore, we hypothesized that SARS-CoV-2 would distinctly regulate the mitochondrial transcriptome. We analyzed multiple publicly available RNASeq data derived from primary cells, cell lines, and clinical samples (i.e., BALF and lung). We report that SARS-CoV-2 did not dramatically regulate (1) mtDNA-encoded gene expression or (2) MAVS expression, and (3) SARS-CoV-2 downregulated nuclear-encoded mitochondrial (NEM) genes related to cellular respiration and Complex I.

Mitochondrial-derived peptides in aging and age-related diseases.

A decline in mitochondrial quality and activity has been associated with normal aging and correlated with the development of a wide range of age-related diseases. Here, we review the evidence that a decline in the levels of mitochondrial-derived peptides contributes to aging and age-related diseases. In particular, we discuss how mitochondrial-derived peptides, humanin and MOTS-c, contribute to specific aspects of the aging process, including cellular senescence, chronic inflammation, and cognitive decline. Genetic variations in the coding region of humanin and MOTS-c that are associated with age-related diseases are also reviewed, with particular emphasis placed on how mitochondrial variants might, in turn, regulate MDP expression and age-related phenotypes. Taken together, these observations suggest that mitochondrial-derived peptides influence or regulate a number of key aspects of aging and that strategies directed at increasing mitochondrial-derived peptide levels might have broad beneficial effects.

Mito-Omics and immune function: Applying novel mitochondrial omic techniques to the context of the aging immune system.

Recent advancements in genomic, transcriptomic, proteomic, and metabolomic techniques have prompted fresh inquiry in the field of aging. Here, we outline the application of these techniques in the context of the mitochondrial genome and suggest their potential for use in exploring the biological mechanisms of the aging immune system.

Qualitative real-time analysis by nurses of sublingual microcirculation in intensive care unit: the MICRONURSE study.

INTRODUCTION: We aimed to determine i) the feasibility of nurses taking bedside measurements of microcirculatory parameters in real time in intensive care patients; and ii) whether such measurements would be comparable to those obtained by the classical delayed semi quantitative analysis made by a physician. METHODS: This prospective observational study was conducted in a university hospital and was approved by our local Institutional Review Board (IRB 00006477). After ICU admission and study inclusion, a set of measurements of macrocirculatory and microcirculatory parameters was taken by the nurse in charge of the patient every 4 h within the first 12 h after admission and before and after every hemodynamic therapeutic intervention. Seventy-four sublingual microvascular measurements were performed with incident dark field illumination (IDF) microscopy in 20 mechanically ventilated patients hospitalized in the ICU. RESULTS: There were no significant differences between the microvascular flow index (MFI) taken in real time by the nurses and the delayed evaluation by the physician. In fact, the nurses' real-time measurement of MFI demonstrated good agreement with the physician's delayed measurement. The mean difference between the two MFIs was -0.15, SD = 0.28. The nurses' real-time MFI assessment showed 97 % sensitivity (95 % CI: 84-99 %) and 95 % specificity (95 % CI: 84-99 %) at detecting a MFI <2.5 obtained by a physician upon delayed semiquantitative measurement. Concerning the density, 81 % of the paramedical qualitative density measurements corresponded with the automatized total vessel density (TVD) measurements. The nurses' real-time TVD assessment showed 77 % sensitivity (95 % CI: 46-95 %) and 100 % specificity (95 % CI: 89-100 %) at detecting a TVD <8 mm/mm(2). CONCLUSION: A real-time qualitative bedside evaluation of MFI by nurses showed good agreement with the conventional delayed analysis by physicians. The bedside evaluations of MFI and TVD were highly sensitive and specific for detecting impaired microvascular flow and low capillary density. These results suggest that this real-time technique could become part of ICU nurse routine surveillance and be implemented in algorithms for hemodynamic resuscitation in future clinical trials and regular practice. These results are an essential step to demonstrate whether these real-time measurements have a clinical impact in the management of ICU patients.

Use of three-dimensional power Doppler sonography in the diagnosis of uterine arteriovenous malformation and follow-up after uterine artery embolization: Case report and brief review of literature.

Arteriovenous malformations (AVM) of the uterus can cause life-threatening hemorrhage. Unexplained, heavy vaginal bleeding in a reproductive age woman should raise suspicion for an AVM. Here a 37-year-old woman had increasingly severe vaginal bleeding for 15 days. Serum ß-hCG was elevated. Two-dimensional transvaginal ultrasound suggested retained products of conception. Before dilation and curettage (D&C), color Doppler and three-dimensional (3D) power Doppler demonstrated findings indicative of uterine AVM. A bilateral uterine artery embolization was performed without complications. Three months after uterine artery embolization, 3D power Doppler ultrasonography found complete resolution of the AVM. This case illustrates the importance of assessing both gray-scale and 3D power Doppler, and the ability of postprocedure Doppler to assess resolution.