Effects of ascorbic acid addition on the oxidative stress response of Oryza sativa L. plants to As(V) exposure.

Accumulation of noxious elements in the edible part of crops and its impact on food safety is of increasing concern. Rice is one of the major staple food crops worldwide, including arsenic (As)-polluted areas, in which dietary As exposure is becoming a widespread health threat. Plant chemical priming has been shown to be an effective strategy to enhance tolerance to environmental stresses, including metal(loid) exposure. The priming effect of ascorbic acid (AsA) was assessed in rice seedlings exposed to As(V) in a hydroponics experiment. AsA treatment (co-addition to the growing media concomitantly (t0) or 24 h in advance (t24)) prevented an excessive accumulation of As in the roots (that decreased âˆ¼ 60%) and stimulated the activities of photosynthetic and antioxidant attributes (∼1.2-fold) in the aerial part of the plants. The increase in proline levels in both shoots (∼2.1-fold) and roots (∼2.4-fold) was found to be the most sensitive stress parameter, and was able to reflect the AsA-induced reduction of As toxic effects (concentrations back to Control levels, both simultaneously added or added as a pretreatment) in the aerial part of the plants. However, the phytotoxic effects related to As exposure were not fully prevented by priming with AsA, and further research is needed to find alternative priming approaches.

Response of Phragmites australis to increasing As(V) concentrations: Accumulation and speciation of As, and plant oxidative stress.

The use of macrophytes has been proposed recently as a suitable option for the phytostabilization or rhizofiltration of soils or waters contaminated by trace elements. As one of the most representative species of this type of plant, common reed (Phragmites australis (Cav.) Trin. ex Steud.) has shown tolerance to high concentrations of potentially hazardous elements, as is the case of arsenic. However, a deeper knowledge of how these plants deal with this toxicity, including their oxidative response, is needed for the optimum utilization of this species in phytoremediation procedures. In fact, little is known about how common reed plants react to As toxicity or the tolerance limits and accumulation potential of this species. In this work, common reed plants were exposed to a range of As(V) mass concentrations (0.5-10 mg L-1) in a hydroponic experiment, and the performance of the plants (growth, photosynthetic pigments, and oxidative stress related parameters) was evaluated and related to the major As species present in the different parts of the plants. The plants did not show any apparent symptom of toxicity and no significant effects were found for any of the different plant parameters analyzed. Arsenic was mostly accumulated as As(III) in the roots of the plants, and almost no translocation to the aerial part of the plants was observed for any of the As species analyzed. Common reed has shown a high capacity for As accumulation in its roots with no signs of toxicity, despite small nutrient imbalances. Thus, it can be considered to be a good candidate for use in the rhizofiltration and phytostabilization of As contaminated waters and soils, respectively.

Differential response of Oryza sativa L. and Phragmites australis L. plants in trace elements contaminated soils under flooded and unflooded conditions.

Drastic changes in the water regime of trace elements (TEs) contaminated soils under semiarid conditions, from completely dry to flooding situations, may alter the solubility of the contaminants and, therefore, their potential mobility and availability to plants. Certain macrophyte species have shown a promising suitability for their use in the phytoremediation of TEs contaminated soils under fluctuating flooded-unflooded conditions, as a consequence of their high resistance and tolerance to contamination. Similarly, different water conditions occur during rice (Oryza sativa) cultivation, a species often used as a model plant for TEs toxicity studies. The aim of this work was to study the tolerance and oxidative response to TEs of common reed (Phragmites australis) and rice grown in contaminated mining soils, when exposed to different water saturation conditions. Both species (common reed and rice) were cultivated in three different contaminated soils from the Sierra Minera of La Unión-Cartagena (SE-Spain) under contrasting water saturation conditions (flooded and unflooded) in a pot experiment. Soil EC and elevated metal (mainly Cd and Zn) soluble concentrations conditioned the survival of the plants. Whereas, As accumulation in the aerial part of both species influenced the most oxidative stress homeostasis. Common reed showed to be a good candidate for its use in the phytostabilization of TEs contaminated soils under both flooded and unflooded conditions.

Major As species, lipid peroxidation and protein carbonylation in rice plants exposed to increasing As(V) concentrations.

Arsenic (As) uptake by plants is mainly carried out as arsenate (As(V)), whose chemical analogy with phosphate is largely responsible for its elevated toxicity. Arsenate is known to stimulate reactive oxygen species (ROS) formation in plants that provoke oxidative stress. This manuscript reports the results of a hydroponics study using rice (Oryza sativa L.) seedlings as a test plant, where the effects of increasing arsenate concentrations (0-10 mg L-1) on both lipid and protein oxidation, as well as As accumulation and speciation in plant roots and shoots were examined. Plant yield was negatively affected by increasing As concentration. Accumulation in plant roots was higher than in shoots at low arsenate doses (0.5-2.5 mg L-1), while root to shoot transport was drastically enhanced at the highest doses (5 and 10 mg L-1). Moreover, As(V) was the dominating species in the shoots and As(III) in the roots. Rice leaves in the 10 mg As L-1 treatment showed the highest lipid peroxidation damage (malondialdehyde concentration), whilst protein oxidation was not remarkably influenced by As dose. Lipid peroxidation seems to be therefore conditioned by As accumulation in rice plants, particularly by the presence of high As(V) concentrations in the aerial part of the plants as a consequence of unregulated translocation from roots to shoots above a threshold concentration (1.25-2.5 mg L-1) in the growing media. These results provide relevant information regarding As(V) toxic concentrations for rice plants, highlight the importance of major As species analysis in plant tissues regarding As toxicity and contribute to better understand plants response to elevated As concentrations in the growing media.

Frailty, Falls and Osteoporosis: Learning in Elderly Patients Using a Theatrical Performance in the Classroom.

OBJECTIVE: To ascertain the usefulness of a simulated clinical scene with actors in the classroom (theatrical performance) as a teaching tool for the management of falls and their related injuries. DESIGN: Experimental design of two related groups. SETTING: Spain. PARTICIPANTS: A group of 12 students attended a seminar in which the approach to a clinical case was made using a simulated scene with actors in the classroom (scene group); a non-scene group of 34 students attended the seminar, without a theatrical performance (the same clinical case was read and presented in a traditional manner, oral presentation). MEASUREMENTS: Before and after the seminar, students answered a questionnaire [five questions on theoretical knowledge of falls and osteoporosis (score 0-10) and two on subjective learning perception (linear scale: 0-10) (score 0-20)]. In the scene group were two further questions included at the end on their opinion of the scene and on the seminar overall. RESULTS: Both groups significantly improved in all questionnaire scores after the seminar (p=0.001). The scene group had a greater rise in mean points of the questionnaire before and after the seminar than the non-scene group: theoretical knowledge [3.81±1.69 versus 2.75±1.33 (p=0.033)], subjective questions [6.08±4.10 versus 4.97±2.24 (p=0.247)], and the questionnaire overall [9.89±4.98 versus 7.72±2.66 (p=0.060)]. The scene group had a very good opinion of the usefulness of the scene and of the overall opinion of the seminar: 9.08±0.95 and 9.41±0.79. CONCLUSIONS: Theatrical performance in the classroom seems to promote better learning than classic oral presentation, providing qualitative value by adding creativity and different approaches to the teaching of medicine.

Different ways to present clinical cases in a classroom: video projection versus live representation of a simulated clinical scene with actors.

BACKGROUND: Use of the video digital format in the classroom is a common way to present clinical cases to stimulate discussion and increase learning. A simulated live performance with actors, also in the classroom, could be an alternative way to present cases that may be more attractive to arouse students' interest and attention. The aim of the present study was to compare the learning process between a group of students who saw a clinical case as a simulated live scene in the classroom and others seeing the same clinical case projected by video. METHOD: One hundred and thirty-one students (69 from physiotherapy and 62 from medicine) attended an interactive seminar on delirium in older people. Each group was subdivided into two groups: one saw the clinical case as a theatrical performance in the classroom (scene group; n = 68), while the other saw the same case projected on video (video group; n = 63). Before and after attending the seminar, students answered a questionnaire [four questions on theoretical knowledge of delirium (score 0-7) and two on subjective learning perception (linear scale: 0-10) (score 0-20)]. At the end, a further question was included on the usefulness of the scene or a video in the learning process (linear scale: 0-10). RESULTS: Students in both groups (live scene and video) significantly improved in all questionnaire scores after the seminar (p = 0.001) with a large Effect Size (ES > 0.80). Students of the scene group obtained higher scores on theoretical delirium knowledge [6.41 ± 0.73 vs 5.93 ± 1.31 (p = 0.05)], subjective learning perception questions (what they thought they knew about delirium) (16.28 ± 3.51 versus 15.92 ± 2.47 (p = 0.072)], and the overall questionnaire (22.45 ± 4.15 versus 21.48 ± 2.94 (p = 0.027)] than the video group. Students of the scene group opined that live scene was very useful for learning with a mean score of 9.04 ± 1.16 (range 0-10), and opinion in the student's video group scored 8.21 ± 1.22 (p = 0.001). CONCLUSIONS: All students improved significantly their knowledge but those who saw the theatrical performance obtained slightly better results, which suggest that this form of clinical case presentation in the classroom may be an alternative at least as effective as traditional video projections.

Trends in AIDS Mortality, Retention in Opioid Agonist Therapy, and HIV RNA Suppression in HIV-Infected People Who Injected Drugs from 2000 to 2015.

AIDS is a major cause of preventable mortality in HIV-infected people who inject drugs (HIV-PWID). An observational study was conducted to examine trends in AIDS mortality and related factors among HIV-infected individuals who died between 2000 and 2015 at an urban hospital. Overall HIV-mortality was 6.5% (413/6307) with no changes over time (p 0.76). AIDS mortality dropped in HIV-PWID (p 0.02) although it represented 26.4% at the end of study period. Age (per one-year increase) [odds ratio (OR) 0.95], third study period (2010-2015) (OR 0.54), HIV-PWID on opioid agonist therapy (OAT) (OR 0.39), and HIV RNA suppression (OR 0.15) were associated with AIDS mortality. OAT was reported in 58.3% (161/276) and RNA suppression in 30.9% (85/276) of HIV-PWID. OAT non-retention was due to drop-outs [85.2% (98/115)] and rejection [14.8% (17/115)] in HIV-PWID. Therefore, additional strategies are required to improve OAT retention and HIV RNA suppression to continue reducing AIDS mortality.

[Study of the expression of neural stem cell markers in neuroblastoma tumor samples and correlation with prognostic factors]. / Estudio de expresión de marcadores de células madre neurales en neuroblastoma y correlación con factores pronóstico.

INTRODUCTION: The existence of cancer stem cells (CSC) in neuroblastoma (NB) has been associated with the development of metastasis, resistance to chemotherapy and recurrence. Our objective is to analyze the expression of proliferation and differentiation markers of neural progenitor cells in NB samples, and to correlate this expression with clinical variables such as histology, genetics and response to conventional therapy. MATERIAL AND METHODS: We performed a retrospective-experimental study with neuroblastoma samples obtained from biopsies or tumor resections between 2010-2012 in our Hospital. Fluorescence immunohistochemistry was used to analyze the expression of the different markers: CD44, CD74, CD133, tyrosine hydroxylase, endothelin receptors type A (ETA) and B (ETB), p75, nestina y and Phox2b, all of them related to neural stem cell biology. The level of expression of the markers was then correlated with clinical variables. RESULTS: Nestin expression was positive in 72.2% of samples and ETA in 66.7%. PHOX2B and CD74 expression were lower, being positive in less than 30%. The markers CD44, ETB and PHOX2B were expressed in more aggressive tumors. ETA expression correlated significantly with unfavorable histology tumors (p= 0.01), N-myc amplification (p= 0.05) and recurrence/progression (p= 0.05). CONCLUSION: The expression of CD44, ETB and ETA was associated with more aggressive tumors and poor prognostic factors. These markers are in the membrane of neural stem cells and may be useful to identify and isolate by flow cytometry CSCs of NB for the study of new therapeutic targets.

Ganglio centinela en cáncer de mama: ¿histológico o molecular? Estudio diagnóstico comparativo multicéntrico español. Grupo de Estudios Senológicos / Nodisponible

Introducción: La biopsia del ganglio centinela (GC) estáaceptada como el procedimiento estándar para la cirugía conservadorade la axila en el cáncer de mama, pero la gran variabilidadexistente en los protocolos de estudio anatomopatológicoshan impedido una correcta estandarizacióndiagnóstica.Objetivo: Comparar los resultados de un nuevo métodomolecular (“One-step-Nucleic-Acid-Amplification”, OSNA)con los resultados de los procedimientos habituales y evaluar sies posible la implementación del OSNA como procedimientode elección para el diagnóstico intraoperatorio.Material y métodos: Se estudió una serie de 181 GC procedentesde seis hospitales. De cada ganglio, se realizaron seccionesde 2 mm de espesor hasta agotar el ganglio. Se incluyerontodas las secciones de manera alternativa “a” y “c” paraestudio histológico, y “b” y “d” para OSNA.Resultados: Se obtuvo un nivel de concordancia entre elprocedimiento histológico y el molecular del 99,45%.Conclusiones: El estudio multicéntrico demuestra que elOSNA es un procedimiento altamente sensible, específico yreproducible y que permite la estandarización del diagnósticointraoperatorio del GC en cáncer de mama(AU)

Background: The biopsy of the sentinel node (SN) hasbeen established as the standard procedure for conservativeaxillary surgery but its adequate diagnostic standardization hasnot yet been achieved since the protocols for histopathologicstudy have been highly variable.Objective: Our goal is to compare the results of this newmethod with the results of conventional histological tests, toevaluate the feasibility of this procedure for the intra-operativestudy of SN in breast cancer surgery and to evaluate it as away to standardize the sentinel node procedure.Material and methods: The study included 181 cases. Parallel,2 mm-thick sections were performed to drain the lymphnode which were then processed alternately for histologicalanalysis (“a” and “c”) and the others (“b” and d”) following theOSNA procedure.Results: A concordance level of 99.45% was found betweenthe histological and the molecular procedure.Conclusions: Our multicentric OSNA assay for sentinelnode in breast cancer demonstrates that this is a highly sensitive,specific and reproducible technique that allows the standardizationof the diagnostic procedure, a needed and up tonow unresolved question(AU)

Comorbidity and clinical features in elderly patients with dementia: differences according to dementia severity.

OBJECTIVES: To evaluate comorbidity and clinical features in elderly patients with dementia to determine differences according to dementia severity. DESIGN: Observational study with medical record review. SETTING: Eight hospitals in the Barcelona area. PARTICIPANTS: 515 consecutive admissions aged > 64 years with dementia, 89.1% of whom lived in the community. MEASUREMENTS: We collected data on sociodemographic variables, type of dementia, Barthel Index (BI), Lawton and Brody Index (LI), Mini-Mental State Examination (MMSE), Charlson Index and the total number of drugs chronically prescribed. We stratified the population into two groups according to disease severity with the Global Deterioration Scale (GDS): mild-moderate (GDS 3-5) and severe (GDS 6-7). RESULTS: There were a total of 515 participants of which 364 females (70%) and 151 males with a mean age of 81 +/- 6 years old. The total number of chronic prescription drugs was 5.6 +/- 2.4. The mean Charlson Index score was 2 +/- 1.2. The 270 (52.5%) patients with a GDS score of 3-5 were compared with the 245 patients with a GDS score of 6-7. In the multivariate analysis, a GDS score of 6-7 was associated with poorer LI, BI, and MMSE scores and greater neuroleptic therapy. CONCLUSIONS: Important comorbidity conditions are common in elderly individuals with dementia. The patients with more severe dementia had poor functional status and higher frequency of neuroleptic use. Medical comorbidities should be taken into account in the management of patients with dementia.

[Features differentiating comorbidity in elderly patients with Alzheimer-type dementia or with vascular dementia]. / Aspectos diferenciales de comorbilidad en pacientes ancianos con demencia tipo Alzheimer o con demencia vascular.

INTRODUCTION: Alzheimer's disease (AD) and vascular dementia (VD) are the two most common forms of dementia. In the elderly subjects with dementia, there is a significant comorbidity associated and often cause greater morbidity and mortality. AIM: To investigate some aspects of comorbidity in the patients with these two types of dementia in order to analyze possible differences. PATIENTS AND METHODS: A total of 365 patients > 64 years old were prospectively evaluated. Of them 289 patients (79.1%) had probable AD, and 76 patients probable VD. Data were collected on sociodemographic variables, Barthel index, Lawton index), Minimental State Examination, total number of drugs, history of high blood pressure (HBP), diabetes mellitus (DM), dyslipidemia (DL), heart failure (HF), chronic obstructive pulmonary disease (COPD) and cancer. RESULTS: The sample consisted of 264 women (72.3%) and 101 men. Mean age was 81.1 +/- 6 years. Patients were taken an average of 5.5 +/- 2.5 drugs. 54% had HBP, 26.6% DM, 25.8% DL, 12.1% HF, 13.7% COPD and 8.2% cancer. When in multivariate analysis differences were analyzed according the type of dementia, we found a higher percentage of men, taken more than three drugs and lower percentage of taken specific dementia therapy in the VD group. CONCLUSIONS: Our results showed the presence of high comorbidity and chronic drugs prescription in elderly people with dementia. There are some differences according the type of dementia, highlighting a higher percentage of polypharmacy in patients with vascular dementia group.

Aspectos diferenciales de comorbilidad en pacientes ancianos con demencia tipo Alzheimer o con demencia vascular / Features differentiating comorbidity in elderly patients with Alzheimer-type dementia or with vascular dementia

La enfermedad de Alzheimer (EA) y la demencia vascular (DV) son los dos tipos más frecuentes dedemencia. En los ancianos con demencia existe una importante comorbilidad asociada que frecuentemente ocasionará una mayor morbimortalidad. Objetivo. Evaluar algunos aspectos de la comorbilidad en pacientes con ambos tipos de demencia para analizar posibles diferencias. Pacientes y métodos. Se evaluaron prospectivamente 365 pacientes mayores de 64 años.De ellos, 289 (79,1%) tenían EA probable, y 76 DV, probable. Se recogieron variables sociodemográficas, tipo de demencia, índice de Barthel, índice de Lawton, test minimental, número total de medicamentos, antecedentes de hipertensión (HTA), diabetesmellitus (DM), dislipemia, insuficiencia cardíaca, enfermedad pulmonar obstructiva crónica (EPOC) y neoplasia. Resultados. Se trataba de 264 mujeres (72,3%) y 101 varones. La edad media era de 81,1 ± 6 años. La media de medicamentos fue de 5,5 ± 2,5. El 54% recibía tratamiento para la HTA, el 26,6% para la DM y el 25,8% para la dislipemia. En el 12,1% delos pacientes existía el diagnóstico de insuficiencia cardíaca, en el 13,7% de EPOC y en el 8,2% coexistía el diagnóstico de neoplasia. En el análisis multivariable se objetivaron algunas diferencias significativas según el tipo de demencia; así, en el grupo de pacientes con DV había predominio de varones, mayor porcentaje de pacientes con más de tres medicamentos y menorporcentaje de ellos con tratamiento específico para su demencia. Conclusiones. Los pacientes ancianos con demencia tienen alta comorbilidad e importante consumo de fármacos de prescripción crónica. Existen algunas variaciones en los pacientesmayores según el tipo de demencia, y destaca un mayor porcentaje de pacientes con polifarmacia en el grupo de demencia vascular

Alzheimer’s disease (AD) and vascular dementia (VD) are the two most common forms of dementia.In the elderly subjects with dementia, there is a significant comorbidity associated and often cause greater morbidity and mortality. Aim. To investigate some aspects of comorbidity in the patients with these two types of dementia in order to analyzepossible differences. Patients and methods. A total of 365 patients > 64 years old were prospectively evaluated. Of them 289 patients (79.1%) had probable AD, and 76 patients probable VD. Data were collected on sociodemographic variables, Barthelindex, Lawton index), Minimental State Examination, total number of drugs, history of high blood pressure (HBP), diabetes mellitus (DM), dyslipidemia (DL), heart failure (HF), chronic obstructive pulmonary disease (COPD) and cancer. Results. The sample consisted of 264 women (72.3%) and 101 men. Mean age was 81.1 ± 6 years. Patients were taken an average of 5.5 ± 2.5 drugs. 54% had HBP, 26.6% DM, 25.8% DL, 12.1% HF, 13.7% COPD and 8.2% cancer. When in multivariate analysis differences were analyzed according the type of dementia, we found a higher percentage of men, taken more thanthree drugs and lower percentage of taken specific dementia therapy in the VD group. Conclusions. Our results showed the presence of high comorbidity and chronic drugs prescription in elderly people with dementia. There are some differences according the type of dementia, highlighting a higher percentage of polypharmacy in patients with vascular dementia group

[Medical comorbidity in elderly patients with dementia. Differences according age and gender]. / Aspectos de comorbilidad en pacientes ancianos con demencia. Diferencias por edad y género.

BACKGROUND: Prevalence of dementia in elderly patients is high. The goal of the study was to assess some aspects of comorbidity in the patients with dementia. We also analyzed comorbidity differences according to age and gender. PATIENTS AND METHODS: A total of 311 patients older than 64 years old with dementia were prospectively evaluated. Data were collected on sociodemographic endpoints, type of dementia, Barthel Index (BI), Lawton Index (LO), Mini-Mental State Examination (MMSE), Charlson Index, total number of drugs, history of high blood pressure (HT), diabetes (DM), dyslipidemia (DL), heart failure (HF), chronic obstructive pulmonary disease (COPD) and cancer. RESULTS: The sample consisted of 222 women (71.4%) and 89 men. Mean age (standard deviation [SD]) was 80.6 (6) years. Patients were taking an average of 5.8 (2.6) drugs. The mean of Charlson Index was of 2.1 (1.3). Fifty-one percent had HT, 24% DM, 24% DL, 13% HF, 11% COPD and 8% cancer. We found better scores in the MMSE, higher comorbidity and percentage of married people and prevalence of vascular dementia in men with respect to women, who had higher percentage of Alzheimer disease, and widowers. When differences were analyzed according to age, we found a higher percentage of widowers and HF diagnosis, a lower LI values and DL percentage in the patients older than 84 years with respect to younger subjects. CONCLUSIONS: Our results showed the presence of high comorbidity and chronic drugs prescription in elderly people with dementia. There are some differences in comorbidity according to age and gender that must be taken into account.

Previous cognitive impairment and failure to thrive syndrome in patients who died in a geriatric convalescence hospitalization unit.

Cognitive impairment and depression are commonly associated with poor outcomes in geriatric patients. Both are part of the "failure to thrive syndrome" (FTS), that is a combined group of symptoms as a result from progressive functional, mental and nutritional impairment status in older patients. This paper was aimed at evaluating the presence of FTS in the patients who died in a geriatric convalescence unit (GCU) (intermediate care facility) and comparing the characteristics of patients with primary FTS (not associated with an evident identifiable disease) and secondary FTS (associated with an evident identifiable disease). Finally, we wanted to analyze if the presence of cognitive impairment before admission was associated with the type of FTS. We analyzed 78 patients retrospectively. The presence of the next three conditions was necessary to define the FTS: (i) Impaired functional status and malnutrition. (ii) Cognitive impairment and/or depression. (iii) Absence of improvement, after a specific geriatric intervention program during the hospitalization. Functional status for basic and instrumental activities of daily living (ADL and IADL) and the presence of symptoms cognitive impairment before admission were evaluated. Of the 78 analyzed patients, there were 30 (38.4%) with symptoms of FTS. Seventeen of them (56.6%) had a secondary FTS and 13 (43.3%) a primary one. This last group of patients had a significantly higher mean age (84.7 +/- 5.8 vs. 78.6 +/- 7.2; p < 0.02) and before admission they were significantly more dependent for ADL: 10 patients (76.9%) vs. 7 (41.0%) chi2 = 3.833, p < 0.05. A higher proportion of subjects with cognitive impairment before admission was found in the group of patients with primary FTS, than in those secondary FTS, although this difference did not reach statistical significance. Patients with primary FTS seem to be older and more dependent for ADL before admission, than those with secondary FTS.