Abordaje del anciano en el servicio de urgencias de un hospital de agudos

Elderly people use often and in an appropriate way the Emergency Department (ED). However, we don’t dispose of evidences that demonstrate utility of a specific model of geriatric assessment (GA) applied in ED. Nowadays; GA in ED should be used being adapted to the environment and with some clear objectives that allow to carry out a multidimensional diagnosis and to establish therapeutic priorities. GA contributes benefits in the continuity of care on the part of the Primary Attention when elderly people are discharged from an ED.     

Karyotype Rearrangements in a Wine Yeast Strain by rad52-Dependent and rad52-Independent Mechanisms

Yeast strains isolated from the wild may undergo karyotype changes during vegetative growth, a characteristic that compromises their utility in genetic improvement projects for industrial purposes. Karyotype instability is a dominant trait, segregating among meiotic derivatives as if it depended upon only a few genetic elements. We show that disrupting the RAD52 gene in a hypervariable strain partially stabilizes its karyotype. Specifically, RAD52 disruption eliminated recombination at telomeric and subtelomeric sequences, had no influence on ribosomal DNA rearrangement rates, and reduced to 30% the rate of changes in chromosomal size. Thus, there are at least three mechanisms related to karyotype instability in wild yeast strains, two of them not requiring RAD52-mediated homologous recombination. When utilized for a standard sparkling-wine second fermentation, Δrad52 strains retained the enological properties of the parental strain, specifically its vigorous fermentation capability. These data increase our understanding of the mechanisms of karyotype instability in yeast strains isolated from the wild and illustrate the feasibility and limitations of genetic remediation to increase the suitability of natural strains for industrial processes.     

Evidence for a role of exogenous or endogenous hyperlactatemia in insulin secretion in the dog.

Various types of experimental hyperlactatemia were induced in the normal anesthetized dog, and the changes in insulin secretion were measured in the pancreatico-duodenal vein. Hyperlactatemia was induced in the absence or in the presence of an infusion of sodium dichloroacetate (DCA), which activates pyruvate dehydrogenase. 1. Exogenous hyperlactatemia: The infusion of sodium L(+)lactate resulted in a strong increase in blood lactate level which was accompanied by a significant increase in the insulin output from the pancreatico-duodenal vein. The administration of DCA did not counteract the increase in lactate level and did not modify insulin output either. 2. Endogenous hyperlactatemia: This was induced either by pharmacological means: the subcutaneous injection of an antidiabetic biguanide, phenformin (20 mg/kg), or by physiological means: intense muscular work. In both cases an increase in the lactate level and in insulin output was recorded. The administration of DCA suppressed the hyperlactatemia and counteracted the increase in insulin output. These results show that there is a relationship between lactate level and insulin secretion, and give evidence for a role of endogenous lactate in the regulation of insulin secretion.