Mioclonías positivas y negativas en paciente con enfermedad renal crónica / Positive and negative myoclonus in a patient with end stage renal disease

Introducción: Las mioclonías son contracciones musculares paroxísticas de corta duración o pérdida abrupta del tono muscular, denominadas mioclonías positivas y negativas, respectivamente. Se presenta un caso clínico de mioclonías positivas y negativas generalizadas y se pretende describir los múltiples mecanismos fisiopatológicos y etiologías que lo desencadenan. Presentación del caso: Hombre de 35 años, con diabetes mellitus tipo 1 complicada con enfermedad renal diabética en hemodiálisis, desarrolló una bacteriemia asociada a catéter por Staphylococcus aureus y presentó mioclonías positivas y negativas. Se identificaron como posibles desencadenantes la uremia, la infección y los fármacos con potencial promioclónico; el hallazgo incidental de una lesión isquémica en núcleo caudado no explicaba la semiología encontrada en el paciente. Se hizo el control y retiro de todos los factores promioclónicos enunciados, junto a manejo farmacológico con levetiracetam, y con ello se logró el control de los síntomas. Discusión: Los pacientes con enfermedad renal crónica son susceptibles a la acumulación de productos tóxicos de tipo guanidinas, que tienen potencial para producir mioclonías. Además, las infecciones, el uso de fármacos con potencial promioclónico y lesiones estructurales como las isquemias corticales son etiologías que deben considerarse en el diagnóstico diferencial. El mayor impacto en los síntomas se observa con el control del factor desencadenante, y, en caso de persistir, la terapia farmacológica proporciona buenos resultados. Conclusión: Las mioclonías son trastornos del movimiento relativamente comunes en la enfermedad renal crónica. La identificación del desencadenante es crucial para su manejo junto al uso de fármacos con actividad antimioclónica.

Introduction: Myoclonus are paroxysmal muscle contractions of short duration or abrupt loss of muscle tone, called positive and negative myoclonus respectively. A clinical case of generalized positive and negative myoclonus is presented and the aim is to describe the multiple pathophysiological mechanisms and etiologies that trigger it. Case presentation: A 35-year-old man with type 1 diabetes mellitus complicated by diabetic kidney disease on hemodialysis developed catheter-associated bacteremia due to Staphylococcus aureus and presented positive and negative myoclonus. Uremia, infection, and drugs with pro-myoclonic potential were identified as possible triggers; The incidental finding of an ischemic lesion in the caudate nucleus did not explain the semiology found in the patient. The control and removal of all the pro-myoclonic factors mentioned was carried out, along with pharmacological management with levetiracetam, thus achieving control of the symptoms. Discussion: Patients with chronic kidney disease are susceptible to the accumulation of guanidine-type toxic products, which have the potential to produce myoclonus. Furthermore, infections, the use of drugs with pro-myoclonic potential and structural lesions such as cortical ischemia are etiologies that should be considered in the differential diagnosis. The greatest impact on symptoms is observed with the control of the triggering factor and if it persists, pharmacological therapy provides good results. Conclusion: Myoclonus are relatively common movement disorders in chronic kidney disease. Identification of the trigger is crucial for its management along with the use of drugs with anti-myoclonic activity.

Essential Oils and Antagonistic Microorganisms as Eco-Friendly Alternatives for Coffee Leaf Rust Control.

Coffee leaf rust (CLR) is caused by the biotrophic fungus Hemileia vastatrix Berk. & Br., a disease of economic importance, reducing coffee yield up to 60%. Currently, CLR epidemics have negatively impacted food security. Therefore, the objective of the present research study is to show a current framework of this disease and its effects on diverse areas, as well as the biological systems used for its control, mode of action, and effectiveness. The use of essential plant oils and antagonistic microorganisms to H. vastatrix are highlighted. Terpenes, terpenoids, and aromatic compounds are the main constituents of these oils, which alter the cell wall and membrane composition and modify the basic cell functions. Beneficial microorganisms inhibit urediniospore germination and reduce disease incidence and severity. The antagonistic microorganisms and essential oils of some aromatic plants have great potential in agriculture. These biological systems may have more than one mechanism of action, which reduces the possibility of the emergence of resistant strains of H. vastatrix.

Policy evaluation using model over-fitting: the Nordic case.

The interest of this article is to better understand the effects of different public policy alternatives to handle the COVID-19 pandemic. In this work we use the susceptible, infected, recovered (SIR) model to find which of these policies have an actual impact on the dynamic of the spread. Starting with raw data on the number of deceased people in a country, we over-fit our SIR model to find the times ti at which the main parameters, the number of daily contacts and the probability of contagion, require adjustments. For each ti, we go to historic records to find policies and social events that could explain these changes. This approach helps to evaluate events through the eyes of the popular epidemiological SIR model, and to find insights that are hard to recognize in a standard econometric model.

Deficiencia de hierro en enfermedad renal crónica

Contexto: la deficiencia de hierro es un trastorno frecuentemente observado en pacientes con enfermedad renal crónica (ERC), sobre todo en estadios avanzados. Su presencia se asocia a una mayor morbilidad y mortalidad. La deficiencia de hierro puede ser absoluta o funcional. La deficiencia absoluta se refiere a una ausencia o una reducción de las reservas de hierro, mientras que la deficiencia funcional se define por la presencia de depósitos de hierro adecuados pero con una disponibilidad insuficiente de hierro para su incorporación en los precursores eritroides. Varios factores de riesgo contribuyen a la deficiencia absoluta y funcional de hierro en ERC, incluyendo pérdidas hemáticas, absorción alterada de hierro e inflamación crónica. Objetivo: con esta revisión narrativa se pretende presentar las definiciones, los aspectos fisiopatológicos, los criterios diagnósticos y las medidas terapéuticas en el paciente con diagnóstico de ERC con deficiencia de hierro. Metodología: se realizó una revisión no sistemática de la literatura en la base de datos PubMed, incluyendo además las guías internacionales más utilizadas que abordan el tema de deficiencia de hierro en ERC. Resultados: se incluyeron un total de 30 referencias bibliográficas. La deficiencia de hierro puede ser absoluta o relativa y el déficit absoluto de hierro se produce con valores de ferritina 100 mcg/l, pero con una TSAT < 20 %. El tratamiento del déficit absoluto consta de reposición de hierro oral o endovenoso y en pacientes que aún no reciben diálisis, se puede hacer una prueba terapéutica con hierro oral, de no haber respuesta se optará por hierro endovenoso, mientras que en pacientes que sí reciben diálisis, la medida ideal es el hierro endovenoso, preferiblemente en preparaciones que permitan esquemas de altas dosis y bajas frecuencias de administración. Las metas propuestas por las distintas guías presentan variaciones entre 500 y 700 mcg/l de ferritina. Conclusiones: el déficit de hierro debe buscarse activamente en pacientes con ERC, ya que su presencia y la falta de intervención conlleva a un incremento en los desenlaces adversos. La terapia con hierro es el pilar del tratamiento y la elección del agente a utilizar dependerá de las características individuales del paciente y de la disponibilidad de las preparaciones de hierro oral o endovenoso.

Background: Iron deficiency is a disorder frequently observed in patients with chronic kidney disease (CKD), especially in advanced stages. Its presence is associated with increased morbidity and mortality. Iron deficiency can be absolute or functional. Absolute deficiency refers to absent or reduced iron stores, while functional deficiency is defined by the presence of adequate iron stores but insufficient iron availability for incorporation into erythroid precursors. Several risk factors contribute to absolute and functional iron deficiency in CKD, including blood fi, impaired iron absorption, and chronic inflammation. Purpose: With this narrative review, it is intended to present the details, pathophysiological aspects, diagnostic criteria and therapeutic options in patients diagnosed with chronic kidney disease with iron deficiency. Methodology: A non-systematic review of the fi ron ra was carried out, in the PubMed database, also including the most used international guidelines that address the issue fi ron deficiency in chronic kidney disease. Results: A total of 30 bibliographical references were included. Iron deficiency can be absolute or relative. The absolute iron deficiency occurs with ferritin values 100 mcg/l but with a TSAT <20 % Treatment of absolute deficiency consists of oral or intravenous iron replacement. In a patient who is not yet receiving dialysis, a therapeutic trial with oral iron can be done, if there is no response, intravenous iron will be chosen. In patients receiving dialysis, the ideal measure is intravenous iron, preferably in preparations that allow high-dose schemes and low frequencies of administration. The goals proposed by the different guidelines present variations between 500 and 700 mcg/l d ferritin. Conclusions: iron deficiency should be actively sought in patients with CKD, since its presence and lack of intervention leads to an increase in adverse outcomes. Iron therapy is the mainstay of treatment; the choice of the agent to be used depends on the individual characteristics of the patient and the availability of oral or intravenous iron preparations.

Melanin Induction Restores the Pathogenicity of Gaeumannomyces graminis var. tritici in Wheat Plants.

One of the most challenging aspects of long-term research based on microorganisms is the maintenance of isolates under ex situ conditions, particularly the conservation of phytopathological characteristics. Our research group has worked for more than 10 years with Gaumannomyces graminis var. tritici (Ggt), the main biotic factor affecting wheat. In this sense we preserved the microorganisms in oil overlaid. However, several strains preserved for a long time lost their pathogenicity. These strains show white and non-infective mycelia. In this sense, we hypothesized that this is attributable to low melanin content. Melanin is a natural pigment mainly involved in UV protection, desiccation, salinity, oxidation, and fungal pathogenicity. Therefore, understanding the melanin role on Ggt pathogenicity is fundamental to developing melanin activation strategies under laboratory studies. In this study, we induce melanin activation by UV-A light chamber, 320 to 400 nm (T1) and temperature changes of 30 °C, 15 °C, and 20 °C (T2). Fungal pathogenicity was evaluated by determination of blackening roots and Ggt was quantified by real-time PCR in inoculated wheat plants. Results revealed that Ggt grown under UV-A (T1) conditions showed around 40% higher melanin level with a concomitant effect on root infection (98% of blackened roots) and 4-fold more Ggt genome copy number compared with the control (non-infective mycelia) being T1, a more inductor factor compared with T2. These findings would support the role of melanin in pathogenicity in darkly pigmented fungi such as Ggt and could serve as a basis for activating pathogenicity under laboratory conditions.

Divergent Synthesis of Ultrabright and Dendritic Xanthenes for Enhanced Click-Chemistry-Based Bioimaging.

Biorthogonal labelling with fluorescent small molecules is an indispensable tool for diagnostic and biomedical applications. In dye-based 5-ethynyl-2'-deoxyuridine (EdU) cell proliferation assays, augmentation of the fluorescent signal entails an overall enhancement in the sensitivity and quality of the method. To this end, a rapid, divergent synthetic procedure that provides ready-to-click pH-insensitive rhodamine dyes exhibiting outstanding brightness was established. Compared to the shortest available synthesis of related high quantum-yielding rhodamines, two fewer synthetic steps are required. In a head-to-head imaging comparison involving copper(I)-catalyzed azide alkyne cycloaddition reactions with in vitro administered EdU, our new 3,3-difluoroazetidine rhodamine azide outperformed the popular 5-TAMRA-azide, making it among the best available choices when it comes to fluorescent imaging of DNA. In a further exploration of the fluorescence properties of these dyes, a set of bis-MPA dendrons carrying multiple fluorescein or rhodamine units was prepared by branching click chemistry. Fluorescence self-quenching of fluorescein- and rhodamine-functionalized dendrons limited the suitability of the dyes as labels in EdU-based experiments but provided new insights into these effects.

Actinomycete Potential as Biocontrol Agent of Phytopathogenic Fungi: Mechanisms, Source, and Applications.

Synthetic fungicides have been the main control of phytopathogenic fungi. However, they cause harm to humans, animals, and the environment, as well as generating resistance in phytopathogenic fungi. In the last few decades, the use of microorganisms as biocontrol agents of phytopathogenic fungi has been an alternative to synthetic fungicide application. Actinomycetes isolated from terrestrial, marine, wetland, saline, and endophyte environments have been used for phytopathogenic fungus biocontrol. At present, there is a need for searching new secondary compounds and metabolites of different isolation sources of actinomycetes; however, little information is available on those isolated from other environments as biocontrol agents in agriculture. Therefore, the objective of this review is to compare the antifungal activity and the main mechanisms of action in actinomycetes isolated from different environments and to describe recent achievements of their application in agriculture. Although actinomycetes have potential as biocontrol agents of phytopathogenic fungi, few studies of actinomycetes are available of those from marine, saline, and wetland environments, which have equal or greater potential as biocontrol agents than isolates of actinomycetes from terrestrial environments.

Plant Growth-Promoting Rhizobacteria Improve Growth and Fruit Quality of Cucumber under Greenhouse Conditions.

Cucumber fruit is rich in fiber, carbohydrates, protein, magnesium, iron, vitamin B, vitamin C, flavonoids, phenolic compounds, and antioxidants. Agrochemical-based production of cucumber has tripled yields; however, excessive synthetic fertilization has caused problems in the accumulation of salts in the soil and has increased production costs. The objective of this study was to evaluate the effect of three strains of plant growth-promoting rhizobacteria (PGPR) on cucumber fruit growth and quality under greenhouse conditions. The rhizobacteria Pseudomonas paralactis (KBendo6p7), Sinorhizobium meliloti (KBecto9p6), and Acinetobacter radioresistens (KBendo3p1) was adjusted to 1 × 108 CFU mL-1. The results indicated that the inoculation with PGPR improved plant height, stem diameter, root length, secondary roots, biomass, fruit size, fruit diameter, and yield, as well as nutraceutical quality and antioxidant capacity, significantly increasing the response of plants inoculated with A.radioresistens and S.meliloti in comparison to the control. In sum, our findings showed the potential functions of the use of beneficial bacteria such as PGPR for crop production to reduce costs, decrease pollution, and achieve world food safety and security.

CuO-NPs Improve Biosynthesis of Bioactive Compounds in Lettuce.

The application of metallic nanoparticles improves the yield and content of bioactive compounds in plants. The aim of the present study was to determine the effects of the foliar application of copper nanoparticles (CuO-NPs) in the yield and content of bioactive compounds in lettuce. Different concentrations of CuO-NPs (0, 0.5, 1, 2, 4, and 6 mg mL-1) were applied in lettuce. The yield, nutraceutical quality, and enzymatic activity were determined. Foliar spraying of CuO-NPs induced an increase in the biosynthesis of bioactive compounds. In addition to an increase in the activity of the enzymes superoxide dismutase (SOD) and catalase (CAT) in lettuce plants, there were no negative effects on yield. Therefore, with the application of CuO-NPs, better quality lettuces are produced for the human diet due to the higher production of bioactive compounds.

Debaryomyces hansenii, Stenotrophomonas rhizophila, and Ulvan as Biocontrol Agents of Fruit Rot Disease in Muskmelon (Cucumis melo L.).

The indiscriminate use of synthetic fungicides has led to negative impact to human health and to the environment. Thus, we investigated the effects of postharvest biocontrol treatment with Debaryomyces hansenii, Stenotrophomonas rhizophila, and a polysaccharide ulvan on fruit rot disease, storability, and antioxidant enzyme activity in muskmelon (Cucumis melo L. var. reticulatus). Each fruit was treated with (1) 1 × 106 cells mL-1 of D. hansenii, (2) 1 × 108 CFU mL-1 of S. rhizophila, (3) 5 g L-1 of ulvan, (4) 1 × 106 cells mL-1 of D. hansenii + 1 × 108 CFU mL-1 of S. rhizophila, (5) 1 × 108 CFU mL-1 of S. rhizophila + 5 g L-1 of ulvan, (6) 1 × 106 cells mL-1 of D. hansenii + 1 × 108 CFU mL-1 of S. rhizophila + 5 g L-1 of ulvan, (7) 1000 ppm of benomyl or sterile water (control). The fruits were air-dried for 2 h, and stored at 27 °C ± 1 °C and 85-90% relative humidity. The fruit rot disease was determined by estimating the disease incidence (%) and lesion diameter (mm), and the adhesion capacity of the biocontrol agents was observed via electron microscopy. Phytopathogen inoculation time before and after adding biocontrol agents were also recorded. Furthermore, the storability quality, weight loss (%), firmness (N), total soluble solids (%), and pH were quantified. The antioxidant enzymes including catalase, peroxidase, superoxide dismutase, and phenylalanine ammonium lyase were determined. In conclusion, the mixed treatment containing D. hansenii, S. rhizophila, and ulvan delayed fruit rot disease, preserved fruit quality, and increased antioxidant activity. The combined treatment is a promising and effective biological control method to promote the shelf life of harvested muskmelon.

Dipeptidyl Peptidase-4 Inhibitors and Diabetic Kidney Disease: A Narrative Review.

Diabetic kidney disease is one of the most frequent complications in patients with diabetes mellitus and affects morbidity and mortality. The recent therapies include oral hypoglycemic drugs that, in addition to optimizing glycemic control and reducing the risk of hypoglycemia, may affect the development and progression of diabetic kidney disease; these novel therapies include inhibitors of the enzyme dipeptidyl peptidase 4 (DPP-4), a group of oral hypoglycemic therapeutic agents that act at the level of the incretin system. DPP-4 inhibitors show additional pleiotropic effects in in vitro models, reducing inflammation, fibrosis, and oxidative damage, further suggesting potential kidney protective effects. Although existing trials suggest a possible benefit in the progression of diabetic kidney disease, further studies are needed to demonstrate kidney-specific benefits of DPP-4 inhibitors.

A Sustainable Alternative for Postharvest Disease Management and Phytopathogens Biocontrol in Fruit: Antagonistic Yeasts.

Postharvest diseases of fruits caused by phytopathogens cause losses up to 50% of global production. Phytopathogens control is performed with synthetic fungicides, but the application causes environmental contamination problems and human and animal health in addition to generating resistance. Yeasts are antagonist microorganisms that have been used in the last years as biocontrol agents and in sustainable postharvest disease management in fruits. Yeast application for biocontrol of phytopathogens has been an effective action worldwide. This review explores the sustainable use of yeasts in each continent, the main antagonistic mechanisms towards phytopathogens, their relationship with OMIC sciences, and patents at the world level that involve yeast-based-products for their biocontrol.

Gastrostomía endoscópica percutánea en paciente con catéter de diálisis peritoneal. Reporte de caso / Percutaneous endoscopic gastrostomy in a patient with a peritoneal dialysis catheter. Case report

Resumen La gastrostomía endoscópica percutánea (GEP), descrita por primera vez en la década de 1980, es un procedimiento universalmente utilizado para asegurar la alimentación enteral en pacientes que conservan la función del tracto digestivo, pero que por alguna condición médica o quirúrgica no pueden ingerir alimentos sólidos o líquidos. La realización de una GEP en pacientes con diálisis peritoneal (DP) sigue siendo controvertida, ya que muchos autores la consideran una contraindicación absoluta debido al alto riesgo de morbimortalidad asociada a infección intraperitoneal. Se presenta el caso de un paciente de 70 años, con antecedente de enfermedad renal crónica en estadio terminal y portador de catéter de DP, quien requirió GEP. Se socializa la estrategia utilizada en este caso particular.

Abstract Percutaneous endoscopic gastrostomy (PEG), described in the 1980s, is a procedure universally used to ensure enteral feeding in patients who retain digestive tract function, but who cannot eat solid or liquid foods due to any medical or surgical condition. The performance of PEG in patients with peritoneal dialysis (PD) remains controversial, being considered an absolute contraindication for many authors, taking into account the high risk of morbidity and mortality associated with intraperitoneal infection. We present the case of a 70-year-old patient, with a history of chronic end-stage renal disease with a peritoneal dialysis catheter, who required PEG; and we propose a management protocol for this type of patient.

Terapias de purificación sanguínea en COVID-19 / Blood purification therapies in COVID-19

Resumen Introducción: el COVID-19 es una enfermedad causada por un nuevo beta coronavirus (SARS-CoV-2), cuyo espectro incluye casos severos con neumonía y complicaciones sistémicas que se dan como consecuencia de una liberación exagerada de mediadores inflamatorios conocida como "tormenta de citoquinas". En este tipo de pacientes las terapias de purificación sanguínea, incluyendo la hemoadsorción y la terapia plasmática podrían tener un beneficio clínico importante y evitar las complicaciones como disfunción multiorgánica y muerte. Objetivo: revisar toda la literatura disponible acerca de las terapias de purificación sanguínea y sus beneficios en los pacientes con COVID-19. Materiales y métodos: se realizó una búsqueda de la literatura en las bases de datos ClinicalKey, Embase, PubMed y Ovid con los términos "COVID-19", "SARS-CoV-2", "Tormenta de citoquinas", "terapias de purificación sanguínea", "sepsis", "hemoadsorción" y "CytoSorb". Resultados: se encontraron 246 referencias y luego de aplicar los filtros, se seleccionaron 61 publicaciones con contenido relevante para la presente revisión. Conclusión: teniendo en cuenta su gran evidencia científica en el manejo de la tormenta de citoquinas en otros escenarios, las terapias de purificación sanguínea, que incluyen técnicas difusivas, convectivas, de hemoadsorción y terapia plasmática, pueden ser herramientas de tratamiento muy prometedoras en pacientes con COVID-19.

Abstract Introduction: COVID-19 is a disease caused by a new beta coronavirus (SARS-CoV-2), whose spectrum includes severe cases with pneumonia and systemic complications that occur as a consequence of an exaggerated release of inflammatory mediators known as "cytokine storm". In this type of patients, blood purification therapies, including hemoadsorption and plasma therapy, could have an important clinical benefit and avoid complications such as multiple organ dysfunction and death. Objective: to review all available literature about blood purification therapies and their benefits in patients with COVID-19. Materials and methods: a literature search was conducted in the ClinicalKey, Embase, PubMed and Ovid databases using the terms "COVID-19", "SARS-CoV-2", "Tormenta de citoquinas", "terapias de purificación sanguínea", "sepsis", "hemoadsorción" and "CytoSorb". Results: 246 references were found and after applying filters, 61 publications with relevant content for the present review were selected. Conclusion: taking into account the great scientific evidence in the management of the cytokine storm in other scenarios, blood purification therapies, including diffusive, convective, hemoadsorption and plasma therapy techniques, could be very promising treatment tools for patients with COVID-19.

Anticoagulación en pacientes con infección por SARS-CoV-2/COVID-19 / Anticoagulation in patients with SARS-CoV-2 Infection/COVID-19

Resumen Introducción: El COVID-19 es una enfermedad infecciosa ocasionada por el virus RNA SARS-CoV-2, con una alta tasa de contagio y con un curso clínico heterogéneo. Existe evidencia que en fase avanzada de COVID-19 hay un riesgo aumentado de coagulación intravascular diseminada. Por lo tanto, el manejo con heparinas debe ser considerado como una estrategia terapéutica. Objetivos: Nuestro objetivo principal es mostrar la literatura más relevante disponible, con referencia a la utilidad de la anticoagulación en el manejo de la hipercoagulabilidad en los pacientes con COVID-19 graves. Metodología: Se realizó una revisión narrativa a partir de la búsqueda avanzada con los términos DeSC: Infecciones por Coronavirus; SARS-CoV; Coagulación Sanguínea; Coagulación Intravascular Diseminada; Disfunción orgánica múltiple; Sepsis; Síndrome de respuesta inflamatoria sistémica; Lesión renal aguda. Se utilizaron los motores de búsqueda Clinical Key, Embase, PubMed y Ovid, obteniendo un total de 143 resultados, entre artículos originales, reportes de casos, series de casos y revisiones de la literatura, se seleccionaron un total de 56 artículos que fueron utilizados para la elaboración de la presente revisión de tema. Conclusiones: El manejo con heparinas debe ser considerado como una estrategia terapéutica. Continuamos con la necesidad de futuros estudios que indaguen interrogantes en el paciente COVID-19 hospitalizado, especialmente que definan, evaluando riesgo/beneficio, que se justifica o no con respecto a la anticoagulación plena en algunos pacientes específicos con COVID-19.

Abstract Introduction: COVID-19 is an infectious disease caused by the RNA SARS-CoV-2 virus, with a high rate of infection and a heterogeneous clinical course. There is evidence that in the advanced phase of COVID-19 there is an increased risk of disseminated intravascular coagulation. Therefore, heparin management should be considered as a therapeutic strategy. Objectives: Our main objective is to show the most relevant literature available, with reference to the usefulness of anticoagulation in the management of hypercoagulability in patients with COVID-19 and severe manifestations. Methodology: A narrative review was performed from the advanced search with the terms DeSC: Coronavirus Infections; SARS-CoV; Blood Coagulation; Disseminated intravascular coagulation; Multiple organic dysfunction; Sepsis; Systemic inflammatory response syndrome; Acute kidney injury. The Clinical Key, Embase, PubMed and Ovid search engines were used, obtaining a total of 143 results, among original articles, case reports, case series and literature reviews, a total of 56 articles were selected that were used to the preparation of this topic review. Conclusions: Heparin management should be considered as a therapeutic strategy. We continue with the need for future studies that investigate questions in the hospitalized COVID-19 patient, especially defining, evaluating risk / benefit, which is justified or not with respect to full anticoagulation in some specific patients with COVID-19.

About Disgust: a brief introduction

The use of repulsive substances, often consisting of human or animal excrement, to treat numerous diseases was quite common in primitive and ar-chaic cultures. Historical research has given this phenomenon the name of Dreck Apotheke or "excremental pharmacopoeia",and it is precisely this term that is the title of a medical text published in 1699 by a German physician, Christian Franz Paullini: Heylsame Dreck-Apotheke (Salubrious excremental pharmacopoeia). This paper aims to explain, to the extent possible, the inopportune proposal of treating human diseases using feces and urine in an age when most doctors were against said doctrine

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Salubrious disgust: excrement therapy in Eighteenth-century Medicine

The use of repulsive substances, often consisting of human or animal excrement, to treat numerous diseases was quite common in primitive and ar-chaic cultures. Historical research has given this phenomenon the name of Dreck Apotheke or "excremental pharmacopoeia", and it is precisely this term that is the title of a medical text published in 1699 by a German physician, Christian Franz Paullini: Heylsame Dreck-Apotheke (Salubrious excremental pharmacopoeia). This paper aims to explain, to the extent possible, the inopportune proposal of treating human diseases using feces and urine in an age when most doctors were against said doctrine

No disponible

Plasmaféresis como opción terapéutica en infección por COVID-19 / Plasmapheresis as a therapeutic option in COVID-19 infection

Resumen Introducción: El COVID-19, es una neumonía ocasionada por el nuevo coronavirus SARS-CoV-2, que se puede presentar con cuadros severos, distrés respiratorio agudo (SDRA), disfunción orgánica múltiple y muerte; como consecuencia de una respuesta inflamatoria alterada denominada "tormenta de citoquinas". La plasmaféresis se propone como una estrategia de tratamiento prometedora para el manejo de este tipo de complicaciones. Objetivo: nuestro objetivo principal es mostrar toda la bibliografía disponible, referente a la utilidad de la plasmaféresis en el manejo de la tormenta de citoquinas en pacientes con COVID-19 grave; evaluar su posible beneficio y proponer realizar nuevos ensayos clínicos que avalen el uso rutinario de esta terapia. Metodología: Se realizó una búsqueda avanzada con los términos DeSC "Infecciones por Coronavirus; SARS-CoV; Plasmaféresis; Recambio plasmático; Disfunción orgánica múltiple; Sepsis; Síndrome de respuesta inflamatoria sistémica; Lesión renal aguda". A través de los motores de búsqueda Clinical Key, Embase, PubMed y Ovid, obteniendo un total de 156 resultados, entre artículos originales, reportes de casos, series de casos y revisiones de la literatura, se seleccionaron un total de 54 artículos que fueron utilizados para la elaboración de la presente revisión de la literatura. Conclusiones: La terapia de recambio plasmático se podría utilizar como tratamiento complementario, con el objetivo de reducir carga inflamatoria y viral, reduciendo así el daño de órgano blanco. Sin embargo, hace falta la realización de ensayos clínicos controlados y con buenos diseños metodológicos, que nos ayuden a demostrar la efectividad de este tipo de terapias en pacientes con COVID-19 grave.

Abstract Introduction: COVID-19 is a pneumonia caused by the new SARS-CoV-2 coronavirus, which can present with severe symptoms, acute respiratory distress (ARDS), multiple organ dysfunction and death; as a consequence of a dysregulated inflammatory response called "cytokine storm". Plasmapheresis is proposed as a promising treatment strategy for the management of this type of complications. Objective: our main objective is to show all the available bibliography, referring to the utility of plasmapheresis in the management of cytokine storm in patients with severe COVID-19; evaluate its possible benefit and propose new clinical trials to support the routine use of this therapy. Methodology: An advanced search was performed with the DeSC terms "Coronavirus Infections; SARS-CoV; Plasmapheresis; Plasma exchange; Multiple organic dysfunction; Sepsis; Systemic inflammatory response syndrome; Acute kidney injury ". Through the search engines Clinical Key, Embase, PubMed and Ovid, obtaining a total of 156 results, among original articles, case reports, case series and literature reviews, a total of 54 articles were selected and used for the preparation of this literature review. Conclusions: Plasma replacement therapy could be used as a complementary treatment, with the aim of reducing inflammatory and viral loads, thus reducing target organ damage. However, it is necessary to carry out controlled clinical trials with good methodological designs that help us demonstrate the effectiveness of this type of therapy in patients with severe COVID-19.

Effect of Marine Bacteria and Ulvan on the Activity of Antioxidant Defense Enzymes and the Bio-Protection of Papaya Fruit against Colletotrichum gloeosporioides.

Anthracnose, caused by Colletotrichum gloeosporioides, is one of the most important diseases in papaya fruit. Its control has been achieved with synthetic fungicides, but the application of marine bacteria and the sulphated polysaccharide ulvan (structural description: ß[1,4]-D-GlcA-α[1,4]-L-Rha 3 sulfate, ß[1,4]-L-IdoA-α[1,4]-L-Rha 3 sulfate, ß[1,4]-D-Xyl-α[1,4]-L-Rha 3 sulfate, and ß[1,4]-D-Xyl 2-sulfate-α[1,4]-L-Rha 3 sulfate) from Ulva sp. can be an alternative in the use of agrochemicals. Thus, the objective of this study was to assess the effect in vitro and in vivo of two marine bacteria, Stenotrophomonas rhizophila and Bacillus amyloliquefaciens, and ulvan in papaya fruit's bio-protection against C. gloeosporioides. The capacity of marine bacteria to inhibit mycelial growth and phytopathogen spore germination in vitro through volatile organic compounds (VOCs) and carbohydrate competition was evaluated. Fruit was inoculated with bacteria, ulvan, and C. gloeosporioides and incubated at 25 °C and 90% of relative humidity (RH) for seven days. Disease incidence (%), lesion diameter (mm), and antioxidant defense enzyme activity (such as superoxide dismutase (SOD), catalase (CAT), and peroxidase (POD) were quantified. In vitro, C. gloeosporioides was inhibited by S. rhizophila and B. amyloliquefaciens. In vivo, disease incidence and the lesion diameter of anthracnose on papaya fruit were significantly reduced by marine bacteria and ulvan. Antioxidant defense enzyme activity played an important role in fruit bio-protection against C. gloeosporioides. The application of marine bacteria and ulvan can be an alternative in the sustainable postharvest management of papaya.

Evaluation of Glycosyl-Hydrolases, Phosphatases, Esterases and Proteases as Potential Biomarker for NaCl-Stress Tolerance in Solanum lycopersicum L. Varieties.

Salinity stress limited the production in over 30% of irrigated crops and 7% of dryland agriculture worldwide. The objective was to evaluate the effects of NaCl-stress on the enzymatic activity in tomato. Two experiments were carried out in germination and early vegetative growth stages. The activity of proline and peroxidase of eight varieties (Missouri, Yaqui, Vita, Feroz, Rio Grande, Tropic, Ace, and Floradade) submitted to NaCl concentrations (0, 50, 100, 150 and 200 mM de NaCl) and the semi-quantitative activity of 19 enzymes APY ZYM® were measured under a completely randomized design with four replications. Data were analyzed using univariate-multivariate analysis of variance, Tukey's HSD (p = 0.05), canonical discriminant and cluster analysis. The results showed significant differences between varieties and NaCl in proline content. Proline increased as the NaCl concentration increased. Peroxidase did no show significant differences. Eight enzymes were included within the model to properly classify the varieties and NaCl. In shoots, varieties and NaCl showed that enzymatic activity was higher in the order of alkaline-phosphatase > leucine arylamidase > acid phosphatase > naphthol-AS-BI-phosphohydrolase > n-acetyl-ß-glucosaminidase > ß-galactosidase, while in roots was higher in the order of alkaline-phosphatase > naphthol-AS-BI-phosphohydrolase > acid phosphatase > n-acetyl-ß-glucosaminidase. Acid and alkali phosphatase, lipase, esterase, ß-galactosidase, and trypsin can be a potential biomarker for NaCl-stress tolerance in tomato.