Estado nutricional y uso de recursos sanitarios tras la implementación de un programa de nutrición enteral por sonda PEG para pacientes neurológicos con hospitalización domiciliaria / Nutritional status and use of health resources following the implementation of a PEG tube nutrition program for neurological patients in home hospitalization

Objetivo: el objetivo de este estudio es demostrar que la implantación de una nutrición enteral por sonda de gastrostomía por parte de la Unidad de Hospitalización a Domicilio (UHD) en pacientes afectos de enfermedades neurológicas que impiden su correcta nutrición, mejora significativamente su estado nutricional en términos de los parámetros tanto antropométricos como analíticos. Métodos: se recogieron datos de ingresos, días de estancia hospitalaria, visitas a Urgencias y parámetros nutricionales durante los 6 meses previos y los 6 meses posteriores a la colocación de una sonda de gastrostomía endoscópica percutánea (PEG) en 100 pacientes de la UHD del Hospital General Universitario de Elda (Alicante). Resultados: se incluyeron en el estudio un total de 100 pacientes neurológicos, el 58 % de ellos mujeres y con una edad media (desviación estándar, DE) de 78,3 (13,3) años, siendo el 60 % de los pacientes > 80 años. El seguimiento y tratamiento domiciliario de estos pacientes por parte de la UHD del Hospital General Universitario de Elda supuso una mejora de la calidad de vida y los parámetros nutricionales (peso, índice de masa corporal, proteínas, albúmina, prealbúmina, creatinina y hemoglobina), así como una disminución del número de complicaciones derivadas del manejo nutricional del paciente en su domicilio, y una importante reducción en el número de ingresos (90,27 %) y días de estancia hospitalaria (94,05 %), así como en el de visitas a los servicios de urgencias (79,47 %), con la consiguiente reducción de costes sanitarios. Conclusiones: la implantación de un programa de seguimiento domiciliario de pacientes portadores de PEG por una UHD mejora su estado nutricional y reduce los costes sanitarios generados (AU)

Objective: the objective of this study was to demonstrate that implementation of enteral nutrition by gastrostomy tube by the Home Hospitalization Unit (HHU) in patients suffering from neurological diseases, significantly improves their nutritional status, both in terms of anthropometric and analytical parameters. Methods: data on admissions, days of hospital stay, emergency room visits and nutritional parameters were collected during the 6 months before and 6 months after placement of a percutaneous endoscopic gastrostomy (PEG) tube in 100 patients from the UHD at General University Hospital in Elda (Alicante). Results: a total of 100 neurological patients were included in the study; 58 % of them were women and with a mean age (standard deviation, SD) of 78.3 (13.3) years, with 60 % of the patients being > 80 years. The monitoring and home treatment of these patients by the HHU of General University Hospital in Elda led to improvement in quality of life and nutritional parameters (weight, body mass index, proteins, albumin, prealbumin, creatinine, and hemoglobin), as well as a decrease in the number of complications derived from the nutritional management of patients at their home, and a significant reduction in number of admissions (90.27 %) and days of hospital stay (94.05 %), as well as of visits to emergency services (79.47 %), with a consequent reduction in healthcare costs. Conclusions: the implementation of a home-based monitoring program for patients with PEG by a HHU improves their nutritional status and reduces healthcare costs (AU)

Bromelain, a cysteine protease from pineapple (Ananas comosus) stem, is an inhibitor of fungal plant pathogens.

AIM: This study aimed to evaluate the effect of bromelain, a cysteine protease isolated from pineapple (Ananas comosus), on growth of several agronomically important fungal pathogens. METHODS AND RESULTS: Purification of bromelain from pineapple stems was carried out by chromatography techniques, and its antimicrobial activity was tested against the fungal pathogens Fusarium verticillioides, Fusarium oxysporum and Fusarium proliferatum by broth microdilution assay. A concentration of 0.3 µmol l(-1) of bromelain was sufficient for 90% growth inhibition of F. verticillioides. The capability of bromelain to inhibit fungal growth is related to its proteolytic activity. CONCLUSIONS: The study demonstrates that stem bromelain exhibits a potent antifungal activity against phytopathogens and suggests its potential use as an effective agent for crop protection. SIGNIFICANCE AND IMPACT OF THE STUDY: The results support the use of a natural protease that accumulates at high levels in pineapple stems as alternative to the use of chemical fungicides for crop protection.

Identification and characterization of a hexapeptide with activity against phytopathogenic fungi that cause postharvest decay in fruits.

A hexapeptide of amino acid sequence Ac-Arg-Lys-Thr-Trp-Phe-Trp-NH2 was demonstrated to have antimicrobial activity against selected phytopathogenic fungi that cause postharvest decay in fruits. The peptide synthesized with either all D- or all L-amino acids inhibited the in vitro growth of strains of Penicilium italicum, P. digitatum, and Botrytis cinerea, with MICs of 60 to 80 microM and 50% inhibitory concentration (IC50) of 30 to 40 microM. The inhibitory activity of the peptide was both sequence- and fungus-specific since (i) sequence-related peptides lacked activity (including one with five residues identical to the active sequence), (ii) other filamentous fungi (including some that belong to the genus Penicllium) were insensitive to the peptide's antifungal action, and (iii) the peptide did not inhibit the growth of several yeast and bacterial strains assayed. Experiments on P. digitatum identified conidial germination as particularly sensitive to inhibition although mycelial growth was also affected. Our findings suggest that the inhibitory effect is initially driven by the electrostatic interaction of the peptide with fungal components. The antifungal peptide retarded the blue and green mold diseases of citrus fruits and the gray mold of tomato fruits under controlled inoculation conditions, thus providing evidence for the feasibility of using very short peptides in plant protection. This and previous studies with related peptides indicate some degree of peptide amino acid sequence and structure conservation associated with the antimicrobial activity, and suggest a general sequence layout for short antifungal peptides, consisting of one or two positively charged residues combined with aromatic amino acid residues.

Trends in suicide in the elderly in Asturias (Spain).

Data from elderly suicides was obtained from two previous studies of community suicides in two localities of Northern Spain, namely, Oviedo between 1983 and 1990, and Gijón between 1975 and 1986. Data from the two localities were obtained by the revision of court register cases. A retrospective study on elderly suicide (over 60 years of age) was carried out. Mean annual specific rates for the elderly in Oviedo for 1982-1991 were 37.7 (58.1 for men and 23.3 for women) and for those in Gijón for the period 1975-1986, 23.4 (40 for men and 11.5 for women). A marked increase was seen in the rates for Gijón from the first (1975-1978) to the last period (1983-1986). This was particularly marked in men. The greatest increase in the rate was seen in men over 75 from Gijón and in those between 1970-1974 from Oviedo. In contrast a decrease was seen in the 65-69 age group rates for both men and women. A tendency for the rates to increase was seen but no important increase for elderly suicides was evident.