Francisco Cano - Academia.edu (original) (raw)

Papers by Francisco Cano

Research paper thumbnail of Variation in photosynthetic performance and hydraulic architecture across European beech (Fagus sylvatica L.) populations supports the case for local adaptation to water stress

Tree physiology, 2015

The aim of this study was to provide new insights into how intraspecific variability in the respo... more The aim of this study was to provide new insights into how intraspecific variability in the response of key functional traits to drought dictates the interplay between gas-exchange parameters and the hydraulic architecture of European beech (Fagus sylvatica L.). Considering the relationships between hydraulic and leaf functional traits, we tested whether local adaptation to water stress occurs in this species. To address these objectives, we conducted a glasshouse experiment in which 2-year-old saplings from six beech populations were subjected to different watering treatments. These populations encompassed central and marginal areas of the range, with variation in macro- and microclimatic water availability. The results highlight subtle but significant differences among populations in their functional response to drought. Interpopulation differences in hydraulic traits suggest that vulnerability to cavitation is higher in populations with higher sensitivity to drought. However, the...

Research paper thumbnail of Continuous EPO receptor activator therapy of anemia in children under peritoneal dialysis

The short half-life of erythropoietin (rHuEPO) leads to repeated fluctuations in hemoglobin level... more The short half-life of erythropoietin (rHuEPO) leads to repeated fluctuations in hemoglobin levels and the need for frequent administration. Continuous erythropoietin receptor activator (CERA) therapy has been approved for once or twice a month in adult dialysis patients. To evaluate the efficacy and safety of CERA therapy in the management of anemia in pediatric peritoneal dialysis (PD) stable PD children under twice-a-week EPO were converted to a subcutaneous CERA, scheduled every 2 weeks. The follow-up was 6 months. The primary efficacy parameter was hemoglobin > 11 g/dL. The exclusion criteria were ferritin <100 ng/ml and Hb saturation <20%. Sixteen children, aged 9.75 ± 3.6 years, including 11 boys, participated in the study. Mean Hb level at month 0 was 10.8 ± 1.9 g/dL. A decrease in hemoglobin to 10.38 ± 1 g/dL at month 2 was observed. The CERA dose was increased from 0.86 ± 0.33 to 1.67 ± 0.4 μg/kg at month 3. The target Hb level was reached by the 3rd month. The Hb level and CERA dose were 12.2 ± 1.2 and 1.6 ± 0.67 μg/kg respectively at the end of the study. No adverse events were observed during the protocol. CERA is an effective and safe therapy for maintaining hemoglobin levels when administered twice, up to once a month, in PD children. Doses required to reach target Hb were higher than published experiences in adult populations.

Research paper thumbnail of Adequacy and nutrition in pediatric peritoneal dialysis

Advances in peritoneal dialysis. Conference on Peritoneal Dialysis, 2003

Outcomes for pediatric peritoneal dialysis (PD) patients are closely related to dialysis adequacy... more Outcomes for pediatric peritoneal dialysis (PD) patients are closely related to dialysis adequacy and nutrition, which need to be measured frequently using a number of laboratory parameters. Although the critical meaning of adequacy and nutrition in the long-term prognosis of dialyzed children is well-documented, PD prescriptions are still largely empirical. Our objective was to evaluate nutritional and dialytic parameters in PD children (urea, creatinine, and albumin excretion in dialysate and urine, and daily protein intake); to measure peritoneal equilibration test (PET) results, Kt/V, normalized equivalent of protein nitrogen appearance (nPNA) and nitrogen balance; and to study the correlations between those variables. We performed 59 prospective laboratory measurements in 15 stable PD patients (7 boys; mean age: 6.7 years; age range: 1.1-14.8 years) during 6 months of follow-up. Creatinine, urea, total protein, and albumin were measured in plasma, urine, and dialysate. We calcu...

Research paper thumbnail of Diagnostic efficacy and discriminatory capacity of positron emission tomography combined with axial tomography of adrenal lesions

Cirugía Española (English Edition), 2010

Efectividad diagnó stica de la tomografía por emisió n de positrones con 18 fluorodeoxiglucosa as... more Efectividad diagnó stica de la tomografía por emisió n de positrones con 18 fluorodeoxiglucosa asociada a tomografía axial en la discriminació n de benignidad o malignidad de las lesiones suprarrenales $

Research paper thumbnail of Complicaciones infecciosas en diálisis peritoneal crónica

Revista chilena de pediatría, 2008

1. Nefrología Infantil, Complejo Asistencial Dr. Sótero del Río, Santiago. 2. Nefrólogo Infantil,... more 1. Nefrología Infantil, Complejo Asistencial Dr. Sótero del Río, Santiago. 2. Nefrólogo Infantil, Hospital Exequiel González Cortés, Santiago. 3. Nefrólogo Infantil, Hospital Roberto del Río, Santiago 4. Nefrólogo Infantil, Hospital Dr. Hernán Henríquez, Temuco. 5. Nefrólogo ...

Research paper thumbnail of Calcitriol oral pulse therapy in children with renal osteodystrophy

Pediatric Nephrology, 1995

A 6-month protocol of oral pulse calcitriol was used in nine uraemic children (2-14 years old) on... more A 6-month protocol of oral pulse calcitriol was used in nine uraemic children (2-14 years old) on dialysis who presented with renal osteodystrophy, Calcitriol was administered twice a week, 4 ~tg per dose for patients over 30 kg and 3 gg for patients less than 30 kg. Plasma levels of parathyroid hormone, calcium, phosphorus and alkaline phosphatase were carefully controlled during the study. Parathyroid hormone levels decreased by 68% and 56% by the 2nd and 6th months of treatment in seven patients, while they remained unchanged in two patients with focal segmental glomerulosclerosis and massive proteinuria. Eight hypercalcaemic episodes from 77 determinations were observed, all of them recovered after 1 week of vitamin D withdrawal. We conclude that oral calcitriol pulse therapy is a good alternative for renal osteodystrophy in uraemic children. Careful monitoring of plasma parathyroid hormone and calcium is needed during follow-up when using this approach in paediatric patients.

Research paper thumbnail of Focal segmental glomerulosclerosis relapse after transplantation: treatment with high cyclosporine doses and a short plasmaphaeresis course

Pediatric Nephrology, 1994

Research paper thumbnail of Enalapril and prednisone in children with nephrotic-range proteinuria

Pediatric Nephrology, 2000

The effect of enalapril and low prednisone doses on the urinary protein electrophoretic pattern w... more The effect of enalapril and low prednisone doses on the urinary protein electrophoretic pattern was studied in 13 pediatric patients with glomerular diseases and steroid-resistant nephrotic syndrome. Enalapril was administred at doses of 0.2-0.6 mg/kg per day for 24-84 months, and prednisone was introduced 2 months later in 11 patients at doses of 30 mg/m 2 on alternate days. The urine protein electrophoretic pattern showed a reduction of 80% and 70% in the total protein and albumin, respectively, after enalapril. Total urinary protein decreased from 5.46 to 1.1 g/m 2 per day (P<0.001). A marked change from a pattern of non-selective urinary protein loss to an albumin-selective proteinuria was observed. Mean total plasma proteins increased from 4.7 to 5.43 g/dl (P<0.001). Four patients became free of proteinuria 24 months after enalapril was started, but only 2 remained free of proteinuria at 48 months of follow-up. The other 11 patients had persistent albuminuria of between 0.5 and 2.6 g/m 2 per day with a selective urinary electrophoretic pattern. No additional decrease was observed after steroids were introduced. A clinical improvement in edema was observed in all children. Three patients developed transient acute renal failure, during the course of an infectious disease; 2 developed peritonitis and 1 pneumopathy. In these patients withdrawal of enalapril was necessary until a complete recovery of renal function was observed. Four patients were hypertensive on admission, achieving normal blood pressure 1 month after enalapril was started. No episodes of systemic arterial hypotension were seen. Creatinine clearance and serum potassium showed no statistically significant change.

Research paper thumbnail of The short peritoneal equilibration test in pediatric peritoneal dialysis

Pediatric Nephrology, 2010

The peritoneal equilibration test (PET) is the gold standard method for defining peritoneal membr... more The peritoneal equilibration test (PET) is the gold standard method for defining peritoneal membrane permeability and for prescribing peritoneal dialysis (PD) therapy on an individual basis. However, it is laborious, consumes nursing time, and requires many hours to be performed. Therefore, several authors have attempted to validate a short PET protocol, with controversial results. To evaluate the concordance between the 2-h (short) and 4-h (classical) peritoneal equilibrium test, a prospective observational protocol was applied in three PD centers (Mexico, Chile, and Uruguay) between July 1, 2008 and July 31 2009. PET protocol: the night prior to the test, each patient received five exchanges, 1 h each, at the same glucose concentration as previously used. Afterwards, a 2.5% glucose dialysis solution was used for a dwell time of 4 h. Exchange fill volume was 1,100 ml/m2 body surface area. The next morning, the 4-h dwell was drained, and Dianeal 2.5% was infused. Three dialysate samples at 0, 2, and 4 h were obtained. A single blood sample was obtained at 120 min. Creatinine D/P and glucose D/D0 ratios were calculated at hours 0, 2, and 4. Patients were categorized as low, low average, high average, or high transporters according creat D/P and gluc D/D0 results. Pearson and Kappa test were used for numerical and categorical correlations, respectively, and p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05 was considered significant. Eighty-seven PET studies were evaluated in 74 patients, 33 males, age 11.1+/-5.05 years old. A positive linear correlation of 92% between 2 and 4-h creat D/P and 80% between 2 and 4-h gluc D/D0 (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) was founded. The Kappa test showed a significant concordance between creat D/P and gluc D/D0 categories at 2 and 4 h (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). When analyzing cut-off-value categories, creat D/P was founded to be lower and gluc D/D0 higher than other experiences. This multicentric prospective study strongly suggests that PET obtained at 2 h and 4 h, based on either creatinine or glucose transport, provides identical characterization of peritoneal membrane transport capacity in PD children.

Research paper thumbnail of Early steroid withdrawal in pediatric renal transplant: five years of follow-up

Pediatric Nephrology, 2011

Research paper thumbnail of Short PET in pediatric peritoneal dialysis

Pediatric Nephrology, 2008

Peritoneal equilibration test (PET) is a common technique used in children to evaluate peritoneal... more Peritoneal equilibration test (PET) is a common technique used in children to evaluate peritoneal membrane transport capacity and adequate the dialysis regimen. Considering that this is a laborious test, a shortened version has been proposed. Our goal was to evaluate the concordance between the 2-h (short) and 4-h (classical) PET values to determine whether the short PET could be used in the clinical setting. Eighty-one PET corresponding to 81 peritoneal dialysis patients from two pediatric nephrology centers were retrospectively analyzed. Peritoneal transport capacity was evaluated using the dialysate to plasma ratio (D/P) of creatinine and the ratio of dialysate glucose to baseline dialysate glucose (D/D 0 ) at 2 and 4 h. The mean [± standard deviation (SD)] creatinine D/P ratio at 2 and 4 h were 0.41±0.13 and 0.66± 0.17, respectively, and the mean (± SD) D/D 0 glucose were 0.64±0.11 and 0.39±0.12 at the same times. Applying McNemar χ 2 test to evaluate the association between the categories obtained at 2 and 4 h, we found no relationship between the 2-and 4-h PET for both D/P and D/D 0 (p> 0.05). These results suggest that the use of this abbreviated test is probably not reliable for estimating the transport capacity of the peritoneal membrane in the pediatric population.

Research paper thumbnail of Continuous EPO receptor activator therapy of anemia in children under peritoneal dialysis

Pediatric Nephrology, 2011

The short half-life of erythropoietin (rHuEPO) leads to repeated fluctuations in hemoglobin level... more The short half-life of erythropoietin (rHuEPO) leads to repeated fluctuations in hemoglobin levels and the need for frequent administration. Continuous erythropoietin receptor activator (CERA) therapy has been approved for once or twice a month in adult dialysis patients. To evaluate the efficacy and safety of CERA therapy in the management of anemia in pediatric peritoneal dialysis (PD) stable PD children under twice-a-week EPO were converted to a subcutaneous CERA, scheduled every 2 weeks. The follow-up was 6 months. The primary efficacy parameter was hemoglobin &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 11 g/dL. The exclusion criteria were ferritin &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;100 ng/ml and Hb saturation &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;20%. Sixteen children, aged 9.75 ± 3.6 years, including 11 boys, participated in the study. Mean Hb level at month 0 was 10.8 ± 1.9 g/dL. A decrease in hemoglobin to 10.38 ± 1 g/dL at month 2 was observed. The CERA dose was increased from 0.86 ± 0.33 to 1.67 ± 0.4 μg/kg at month 3. The target Hb level was reached by the 3rd month. The Hb level and CERA dose were 12.2 ± 1.2 and 1.6 ± 0.67 μg/kg respectively at the end of the study. No adverse events were observed during the protocol. CERA is an effective and safe therapy for maintaining hemoglobin levels when administered twice, up to once a month, in PD children. Doses required to reach target Hb were higher than published experiences in adult populations.

Research paper thumbnail of Functional performance of oak seedlings naturally regenerated across microhabitats of distinct overstorey canopy closure

New Forests, 2010

The extent to which seedling recruitment is limited by summer drought in Mediterranean-type ecosy... more The extent to which seedling recruitment is limited by summer drought in Mediterranean-type ecosystems depends on the light microsite, yet the relationship between light availability and water status, functional performance, and survival of seedlings in these systems is still unclear. Over a 3-year period, we studied the pattern of survival and functional performance of seedlings of Quercus petraea (Matt.) Liebl. and Quercus pyrenaica Willd. in a montane forest in central Spain, which is the southern edge of the natural range of Q. petraea. After a mast year of the two species, 72 plots were established in six microhabitats spanning a range of overstorey canopy closure: closed, partial and open canopies dominated by either Q. petraea or Q. pyrenaica adult trees. Seedlings of each species naturally emerged beneath the conspecific-dominated canopies. The second and third years of study were extremely dry. Three years after emergence, the greatest seedling survival occurred beneath the partial canopy of Q. pyrenaica trees (8%) and the lowest (0%) beneath the closed canopies of Q. pyrenaica and Q. petraea. Survival for Q. pyrenaica increased linearly with understorey light across the range of 10-35% Global Site Factor. Plant water deficit (estimated by leaf water potential) was high across microhabitats, and increased with light availability for Q. pyrenaica. Potential for photosynthesis (estimated by the electron transport rate of photosystem II) decreased with canopy closure; and potential for light harvesting (e.g. specific leaf area (SLA) and chlorophyll concentration) increased with closure. Extreme water deficit could be the main contributor to seedling death in the more open microhabitats, whereas light level was insufficient to maintain carbon balance under the water-stressful conditions existing beneath the closed tree canopies. Seedling establishment appears to be a limiting factor for the recruitment of both oaks within this forest in a wide range of microhabitats, especially for the more drought-sensitive Q. petraea. Moderate reductions of tree canopy cover can improve seedling establishment, but extreme summer droughts can prevent the success of any silvicultural practice made.

Research paper thumbnail of Metabolomics demonstrates divergent responses of two Eucalyptus species to water stress

Metabolomics, 2012

Past studies of water stress in Eucalyptus spp. generally highlighted the role of fewer than five... more Past studies of water stress in Eucalyptus spp. generally highlighted the role of fewer than five ''important'' metabolites, whereas recent metabolomic studies on other genera have shown tens of compounds are affected. There are currently no metabolite profiling data for responses of stress-tolerant species to water stress. We used GC-MS metabolite profiling to examine the response of leaf metabolites to a long (2 month) and severe (W predawn \ -2 MPa) water stress in two species of the perennial tree genus Eucalyptus (the mesic Eucalyptus pauciflora and the semi-arid Eucalyptus dumosa). Polar metabolites in leaves were analysed by GC-MS and inorganic ions by capillary electrophoresis. Pressure-volume curves and metabolite measurements showed that water stress led to more negative osmotic potential and increased total osmotically active solutes in leaves of both species. Water stress affected around 30-40% of measured metabolites in E. dumosa and 10-15% in E. pauciflora. There were many metabolites that were affected in E. dumosa but not E. pauciflora, and some that had opposite responses in the two species. For example, in E. dumosa there were increases in five acyclic sugar alcohols and four lowabundance carbohydrates that were unaffected by water stress in E. pauciflora. Re-watering increased osmotic potential and decreased total osmotically active solutes in E. pauciflora, whereas in E. dumosa re-watering led to further decreases in osmotic potential and increases in total osmotically active solutes. This experiment has added several extra dimensions to previous targeted analyses of water stress responses in Eucalyptus, and highlights that even species that are closely related (e.g. congeners) may respond differently to water stress and re-watering.

Research paper thumbnail of Efficacy and tolerability of miglitol in the treatment of patients with non—insulin-dependent diabetes mellitus

Current Therapeutic Research, 1995

The efficacy of miglitol in improving postprandial glucose levels and its relationship to carbohy... more The efficacy of miglitol in improving postprandial glucose levels and its relationship to carbohydrate metabolism and absorption has been shown in several in vivo and in vitro studies. A multicenter (10 centers), randomized, double-blind, parallel-group study was designed to evaluate long-term efficacy and tolerability of miglitol versus placebo in patients with non-insulin-dependent diabetes mellitus (NIDDM). A total of 102 patients were recruited and randomized (89 assessable patients); after a run-in placebo period of 4 weehs, patients received miglitol or placebo 100 mg thrice daily for 18 weeks. Fasting blood glucose, cholesterol, and triglyceride levels were determined every 6 weeks; glycosylated hemoglobin HbA,, levels were determined at the beginning and at the end of the study. No significant differences appeared in baseline values of efficacy variables. The primary efficacy analysis showed that miglitol was significantly more effective in reducing HbA,, levels than placebo (P = 0.0158). Miglitol was also significantly more effective in reducing fasting blood glucose levels (P = 0.0012). No statistically significant differences were found in cholesterol or triglyceride levels. Meteor&m, diarrhea, and flatulence were the most common adverse events and occurred more frequently in the miglitol group (49.0% of miglitol patients vs 36.7% of placebo patients). Hypoglycemic episodes occurred in 7 patients (2 in the miglitol group and 5 in the placebo group). Miglitol appears to be useful in the treatment of patients with NIDDM as it significantly reduces HbA,, and fasting blood glucose levels.

Research paper thumbnail of Epistemological beliefs and approaches to learning: their change through secondary school and their influence on academic performance

The British journal of educational psychology, 2005

In recent decades, two lines of research, phenomenographic and meta-cognitive, have examined stud... more In recent decades, two lines of research, phenomenographic and meta-cognitive, have examined students' approaches and epistemological beliefs about learning. To date there has been very little research describing the change in epistemological beliefs in European secondary students, or analysing interrelationships between epistemological beliefs and approaches in order to explain their influence on academic performance. The first aim of this investigation is to analyse the change in epistemological beliefs and learning approaches in secondary students as they progress through their studies. The second aim is to examine the effects of epistemological beliefs on learning approaches, and learning approaches on academic performance. About 1,600 Spanish students, boys and girls, from several secondary schools took part in the study. They were between 12 and 20 years old and their average age was 14.79 years. Measures of epistemological beliefs (EQ: Epistemological Questionnaire), lear...

Research paper thumbnail of Mutations in the Tight-Junction Gene Claudin 19 (CLDN19) Are Associated with Renal Magnesium Wasting, Renal Failure, and Severe Ocular Involvement

Claudins are major components of tight junctions and contribute to the epithelial-barrier functio... more Claudins are major components of tight junctions and contribute to the epithelial-barrier function by restricting free diffusion of solutes through the paracellular pathway. We have mapped a new locus for recessive renal magnesium loss on chromosome 1p34.2 and have identified mutations in CLDN19, a member of the claudin multigene family, in patients affected by hypomagnesemia, renal failure, and severe ocular abnormalities. CLDN19 encodes the tight-junction protein claudin-19, and we demonstrate high expression of CLDN19 in renal tubules and the retina. The identified mutations interfere severely with either cell-membrane trafficking or the assembly of the claudin-19 protein. The identification of CLDN19 mutations in patients with chronic renal failure and severe visual impairment supports the fundamental role of claudin-19 for normal renal tubular function and undisturbed organization and development of the retina.

Research paper thumbnail of The learning approaches and epistemological beliefs of university students: a cross‐sectional and longitudinal study

Studies in Higher Education, 2007

Two studies, a cross‐sectional (173 first‐year and 215 final‐year participants) and a longitudina... more Two studies, a cross‐sectional (173 first‐year and 215 final‐year participants) and a longitudinal (81 participants), examined whether two aspects of the learning experience of student teachers (epistemological beliefs and learning approaches), and the interrelations between them changed as a result of their tertiary education. Between the first and final years of studies, these two aspects seemed to move in the

Research paper thumbnail of Occupational accidents model based on risk–injury affinity groups

Safety Science, 2011

This article sets outs a generalized utility model for the diagnosis and prediction of accidents ... more This article sets outs a generalized utility model for the diagnosis and prediction of accidents among the Spanish workforce. Based on observational data classified into a risk-injury contingency table (19 Â 19), we have summarized the accident rate of all Spanish companies over an 11-year period (75,19,732 accidents). By using correspondence analysis a structure composed of three axes can be obtained, the combination of which identifies three separate risk and injury groups, which we use as a general Spanish pattern. The relationships of greater affinity or likelihood amongst the risks and injuries identified in the pattern facilitate decision-making at the risk-assessment stage in Spanish companies. Each risk-injury group has its own characteristics, interpretable within the phenomenological framework of the accident.

Research paper thumbnail of The epistemological beliefs, learning approaches and study orchestrations of university students

Studies in Higher Education, 2006

This study examined the learning experience (learning approaches, study orchestrations and episte... more This study examined the learning experience (learning approaches, study orchestrations and epistemological beliefs) of 388 university students. Data analysis revealed two main results. First, the different aspects of students’ learning experience were related: learning approaches and epistemological beliefs (two pairs of canonical variates accounted for the significant relationships), and epistemological beliefs and study orchestrations (sophisticated beliefs emerged mainly in those

Research paper thumbnail of Variation in photosynthetic performance and hydraulic architecture across European beech (Fagus sylvatica L.) populations supports the case for local adaptation to water stress

Tree physiology, 2015

The aim of this study was to provide new insights into how intraspecific variability in the respo... more The aim of this study was to provide new insights into how intraspecific variability in the response of key functional traits to drought dictates the interplay between gas-exchange parameters and the hydraulic architecture of European beech (Fagus sylvatica L.). Considering the relationships between hydraulic and leaf functional traits, we tested whether local adaptation to water stress occurs in this species. To address these objectives, we conducted a glasshouse experiment in which 2-year-old saplings from six beech populations were subjected to different watering treatments. These populations encompassed central and marginal areas of the range, with variation in macro- and microclimatic water availability. The results highlight subtle but significant differences among populations in their functional response to drought. Interpopulation differences in hydraulic traits suggest that vulnerability to cavitation is higher in populations with higher sensitivity to drought. However, the...

Research paper thumbnail of Continuous EPO receptor activator therapy of anemia in children under peritoneal dialysis

The short half-life of erythropoietin (rHuEPO) leads to repeated fluctuations in hemoglobin level... more The short half-life of erythropoietin (rHuEPO) leads to repeated fluctuations in hemoglobin levels and the need for frequent administration. Continuous erythropoietin receptor activator (CERA) therapy has been approved for once or twice a month in adult dialysis patients. To evaluate the efficacy and safety of CERA therapy in the management of anemia in pediatric peritoneal dialysis (PD) stable PD children under twice-a-week EPO were converted to a subcutaneous CERA, scheduled every 2 weeks. The follow-up was 6 months. The primary efficacy parameter was hemoglobin &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 11 g/dL. The exclusion criteria were ferritin &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;100 ng/ml and Hb saturation &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;20%. Sixteen children, aged 9.75 ± 3.6 years, including 11 boys, participated in the study. Mean Hb level at month 0 was 10.8 ± 1.9 g/dL. A decrease in hemoglobin to 10.38 ± 1 g/dL at month 2 was observed. The CERA dose was increased from 0.86 ± 0.33 to 1.67 ± 0.4 μg/kg at month 3. The target Hb level was reached by the 3rd month. The Hb level and CERA dose were 12.2 ± 1.2 and 1.6 ± 0.67 μg/kg respectively at the end of the study. No adverse events were observed during the protocol. CERA is an effective and safe therapy for maintaining hemoglobin levels when administered twice, up to once a month, in PD children. Doses required to reach target Hb were higher than published experiences in adult populations.

Research paper thumbnail of Adequacy and nutrition in pediatric peritoneal dialysis

Advances in peritoneal dialysis. Conference on Peritoneal Dialysis, 2003

Outcomes for pediatric peritoneal dialysis (PD) patients are closely related to dialysis adequacy... more Outcomes for pediatric peritoneal dialysis (PD) patients are closely related to dialysis adequacy and nutrition, which need to be measured frequently using a number of laboratory parameters. Although the critical meaning of adequacy and nutrition in the long-term prognosis of dialyzed children is well-documented, PD prescriptions are still largely empirical. Our objective was to evaluate nutritional and dialytic parameters in PD children (urea, creatinine, and albumin excretion in dialysate and urine, and daily protein intake); to measure peritoneal equilibration test (PET) results, Kt/V, normalized equivalent of protein nitrogen appearance (nPNA) and nitrogen balance; and to study the correlations between those variables. We performed 59 prospective laboratory measurements in 15 stable PD patients (7 boys; mean age: 6.7 years; age range: 1.1-14.8 years) during 6 months of follow-up. Creatinine, urea, total protein, and albumin were measured in plasma, urine, and dialysate. We calcu...

Research paper thumbnail of Diagnostic efficacy and discriminatory capacity of positron emission tomography combined with axial tomography of adrenal lesions

Cirugía Española (English Edition), 2010

Efectividad diagnó stica de la tomografía por emisió n de positrones con 18 fluorodeoxiglucosa as... more Efectividad diagnó stica de la tomografía por emisió n de positrones con 18 fluorodeoxiglucosa asociada a tomografía axial en la discriminació n de benignidad o malignidad de las lesiones suprarrenales $

Research paper thumbnail of Complicaciones infecciosas en diálisis peritoneal crónica

Revista chilena de pediatría, 2008

1. Nefrología Infantil, Complejo Asistencial Dr. Sótero del Río, Santiago. 2. Nefrólogo Infantil,... more 1. Nefrología Infantil, Complejo Asistencial Dr. Sótero del Río, Santiago. 2. Nefrólogo Infantil, Hospital Exequiel González Cortés, Santiago. 3. Nefrólogo Infantil, Hospital Roberto del Río, Santiago 4. Nefrólogo Infantil, Hospital Dr. Hernán Henríquez, Temuco. 5. Nefrólogo ...

Research paper thumbnail of Calcitriol oral pulse therapy in children with renal osteodystrophy

Pediatric Nephrology, 1995

A 6-month protocol of oral pulse calcitriol was used in nine uraemic children (2-14 years old) on... more A 6-month protocol of oral pulse calcitriol was used in nine uraemic children (2-14 years old) on dialysis who presented with renal osteodystrophy, Calcitriol was administered twice a week, 4 ~tg per dose for patients over 30 kg and 3 gg for patients less than 30 kg. Plasma levels of parathyroid hormone, calcium, phosphorus and alkaline phosphatase were carefully controlled during the study. Parathyroid hormone levels decreased by 68% and 56% by the 2nd and 6th months of treatment in seven patients, while they remained unchanged in two patients with focal segmental glomerulosclerosis and massive proteinuria. Eight hypercalcaemic episodes from 77 determinations were observed, all of them recovered after 1 week of vitamin D withdrawal. We conclude that oral calcitriol pulse therapy is a good alternative for renal osteodystrophy in uraemic children. Careful monitoring of plasma parathyroid hormone and calcium is needed during follow-up when using this approach in paediatric patients.

Research paper thumbnail of Focal segmental glomerulosclerosis relapse after transplantation: treatment with high cyclosporine doses and a short plasmaphaeresis course

Pediatric Nephrology, 1994

Research paper thumbnail of Enalapril and prednisone in children with nephrotic-range proteinuria

Pediatric Nephrology, 2000

The effect of enalapril and low prednisone doses on the urinary protein electrophoretic pattern w... more The effect of enalapril and low prednisone doses on the urinary protein electrophoretic pattern was studied in 13 pediatric patients with glomerular diseases and steroid-resistant nephrotic syndrome. Enalapril was administred at doses of 0.2-0.6 mg/kg per day for 24-84 months, and prednisone was introduced 2 months later in 11 patients at doses of 30 mg/m 2 on alternate days. The urine protein electrophoretic pattern showed a reduction of 80% and 70% in the total protein and albumin, respectively, after enalapril. Total urinary protein decreased from 5.46 to 1.1 g/m 2 per day (P<0.001). A marked change from a pattern of non-selective urinary protein loss to an albumin-selective proteinuria was observed. Mean total plasma proteins increased from 4.7 to 5.43 g/dl (P<0.001). Four patients became free of proteinuria 24 months after enalapril was started, but only 2 remained free of proteinuria at 48 months of follow-up. The other 11 patients had persistent albuminuria of between 0.5 and 2.6 g/m 2 per day with a selective urinary electrophoretic pattern. No additional decrease was observed after steroids were introduced. A clinical improvement in edema was observed in all children. Three patients developed transient acute renal failure, during the course of an infectious disease; 2 developed peritonitis and 1 pneumopathy. In these patients withdrawal of enalapril was necessary until a complete recovery of renal function was observed. Four patients were hypertensive on admission, achieving normal blood pressure 1 month after enalapril was started. No episodes of systemic arterial hypotension were seen. Creatinine clearance and serum potassium showed no statistically significant change.

Research paper thumbnail of The short peritoneal equilibration test in pediatric peritoneal dialysis

Pediatric Nephrology, 2010

The peritoneal equilibration test (PET) is the gold standard method for defining peritoneal membr... more The peritoneal equilibration test (PET) is the gold standard method for defining peritoneal membrane permeability and for prescribing peritoneal dialysis (PD) therapy on an individual basis. However, it is laborious, consumes nursing time, and requires many hours to be performed. Therefore, several authors have attempted to validate a short PET protocol, with controversial results. To evaluate the concordance between the 2-h (short) and 4-h (classical) peritoneal equilibrium test, a prospective observational protocol was applied in three PD centers (Mexico, Chile, and Uruguay) between July 1, 2008 and July 31 2009. PET protocol: the night prior to the test, each patient received five exchanges, 1 h each, at the same glucose concentration as previously used. Afterwards, a 2.5% glucose dialysis solution was used for a dwell time of 4 h. Exchange fill volume was 1,100 ml/m2 body surface area. The next morning, the 4-h dwell was drained, and Dianeal 2.5% was infused. Three dialysate samples at 0, 2, and 4 h were obtained. A single blood sample was obtained at 120 min. Creatinine D/P and glucose D/D0 ratios were calculated at hours 0, 2, and 4. Patients were categorized as low, low average, high average, or high transporters according creat D/P and gluc D/D0 results. Pearson and Kappa test were used for numerical and categorical correlations, respectively, and p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05 was considered significant. Eighty-seven PET studies were evaluated in 74 patients, 33 males, age 11.1+/-5.05 years old. A positive linear correlation of 92% between 2 and 4-h creat D/P and 80% between 2 and 4-h gluc D/D0 (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) was founded. The Kappa test showed a significant concordance between creat D/P and gluc D/D0 categories at 2 and 4 h (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). When analyzing cut-off-value categories, creat D/P was founded to be lower and gluc D/D0 higher than other experiences. This multicentric prospective study strongly suggests that PET obtained at 2 h and 4 h, based on either creatinine or glucose transport, provides identical characterization of peritoneal membrane transport capacity in PD children.

Research paper thumbnail of Early steroid withdrawal in pediatric renal transplant: five years of follow-up

Pediatric Nephrology, 2011

Research paper thumbnail of Short PET in pediatric peritoneal dialysis

Pediatric Nephrology, 2008

Peritoneal equilibration test (PET) is a common technique used in children to evaluate peritoneal... more Peritoneal equilibration test (PET) is a common technique used in children to evaluate peritoneal membrane transport capacity and adequate the dialysis regimen. Considering that this is a laborious test, a shortened version has been proposed. Our goal was to evaluate the concordance between the 2-h (short) and 4-h (classical) PET values to determine whether the short PET could be used in the clinical setting. Eighty-one PET corresponding to 81 peritoneal dialysis patients from two pediatric nephrology centers were retrospectively analyzed. Peritoneal transport capacity was evaluated using the dialysate to plasma ratio (D/P) of creatinine and the ratio of dialysate glucose to baseline dialysate glucose (D/D 0 ) at 2 and 4 h. The mean [± standard deviation (SD)] creatinine D/P ratio at 2 and 4 h were 0.41±0.13 and 0.66± 0.17, respectively, and the mean (± SD) D/D 0 glucose were 0.64±0.11 and 0.39±0.12 at the same times. Applying McNemar χ 2 test to evaluate the association between the categories obtained at 2 and 4 h, we found no relationship between the 2-and 4-h PET for both D/P and D/D 0 (p> 0.05). These results suggest that the use of this abbreviated test is probably not reliable for estimating the transport capacity of the peritoneal membrane in the pediatric population.

Research paper thumbnail of Continuous EPO receptor activator therapy of anemia in children under peritoneal dialysis

Pediatric Nephrology, 2011

The short half-life of erythropoietin (rHuEPO) leads to repeated fluctuations in hemoglobin level... more The short half-life of erythropoietin (rHuEPO) leads to repeated fluctuations in hemoglobin levels and the need for frequent administration. Continuous erythropoietin receptor activator (CERA) therapy has been approved for once or twice a month in adult dialysis patients. To evaluate the efficacy and safety of CERA therapy in the management of anemia in pediatric peritoneal dialysis (PD) stable PD children under twice-a-week EPO were converted to a subcutaneous CERA, scheduled every 2 weeks. The follow-up was 6 months. The primary efficacy parameter was hemoglobin &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 11 g/dL. The exclusion criteria were ferritin &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;100 ng/ml and Hb saturation &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;20%. Sixteen children, aged 9.75 ± 3.6 years, including 11 boys, participated in the study. Mean Hb level at month 0 was 10.8 ± 1.9 g/dL. A decrease in hemoglobin to 10.38 ± 1 g/dL at month 2 was observed. The CERA dose was increased from 0.86 ± 0.33 to 1.67 ± 0.4 μg/kg at month 3. The target Hb level was reached by the 3rd month. The Hb level and CERA dose were 12.2 ± 1.2 and 1.6 ± 0.67 μg/kg respectively at the end of the study. No adverse events were observed during the protocol. CERA is an effective and safe therapy for maintaining hemoglobin levels when administered twice, up to once a month, in PD children. Doses required to reach target Hb were higher than published experiences in adult populations.

Research paper thumbnail of Functional performance of oak seedlings naturally regenerated across microhabitats of distinct overstorey canopy closure

New Forests, 2010

The extent to which seedling recruitment is limited by summer drought in Mediterranean-type ecosy... more The extent to which seedling recruitment is limited by summer drought in Mediterranean-type ecosystems depends on the light microsite, yet the relationship between light availability and water status, functional performance, and survival of seedlings in these systems is still unclear. Over a 3-year period, we studied the pattern of survival and functional performance of seedlings of Quercus petraea (Matt.) Liebl. and Quercus pyrenaica Willd. in a montane forest in central Spain, which is the southern edge of the natural range of Q. petraea. After a mast year of the two species, 72 plots were established in six microhabitats spanning a range of overstorey canopy closure: closed, partial and open canopies dominated by either Q. petraea or Q. pyrenaica adult trees. Seedlings of each species naturally emerged beneath the conspecific-dominated canopies. The second and third years of study were extremely dry. Three years after emergence, the greatest seedling survival occurred beneath the partial canopy of Q. pyrenaica trees (8%) and the lowest (0%) beneath the closed canopies of Q. pyrenaica and Q. petraea. Survival for Q. pyrenaica increased linearly with understorey light across the range of 10-35% Global Site Factor. Plant water deficit (estimated by leaf water potential) was high across microhabitats, and increased with light availability for Q. pyrenaica. Potential for photosynthesis (estimated by the electron transport rate of photosystem II) decreased with canopy closure; and potential for light harvesting (e.g. specific leaf area (SLA) and chlorophyll concentration) increased with closure. Extreme water deficit could be the main contributor to seedling death in the more open microhabitats, whereas light level was insufficient to maintain carbon balance under the water-stressful conditions existing beneath the closed tree canopies. Seedling establishment appears to be a limiting factor for the recruitment of both oaks within this forest in a wide range of microhabitats, especially for the more drought-sensitive Q. petraea. Moderate reductions of tree canopy cover can improve seedling establishment, but extreme summer droughts can prevent the success of any silvicultural practice made.

Research paper thumbnail of Metabolomics demonstrates divergent responses of two Eucalyptus species to water stress

Metabolomics, 2012

Past studies of water stress in Eucalyptus spp. generally highlighted the role of fewer than five... more Past studies of water stress in Eucalyptus spp. generally highlighted the role of fewer than five ''important'' metabolites, whereas recent metabolomic studies on other genera have shown tens of compounds are affected. There are currently no metabolite profiling data for responses of stress-tolerant species to water stress. We used GC-MS metabolite profiling to examine the response of leaf metabolites to a long (2 month) and severe (W predawn \ -2 MPa) water stress in two species of the perennial tree genus Eucalyptus (the mesic Eucalyptus pauciflora and the semi-arid Eucalyptus dumosa). Polar metabolites in leaves were analysed by GC-MS and inorganic ions by capillary electrophoresis. Pressure-volume curves and metabolite measurements showed that water stress led to more negative osmotic potential and increased total osmotically active solutes in leaves of both species. Water stress affected around 30-40% of measured metabolites in E. dumosa and 10-15% in E. pauciflora. There were many metabolites that were affected in E. dumosa but not E. pauciflora, and some that had opposite responses in the two species. For example, in E. dumosa there were increases in five acyclic sugar alcohols and four lowabundance carbohydrates that were unaffected by water stress in E. pauciflora. Re-watering increased osmotic potential and decreased total osmotically active solutes in E. pauciflora, whereas in E. dumosa re-watering led to further decreases in osmotic potential and increases in total osmotically active solutes. This experiment has added several extra dimensions to previous targeted analyses of water stress responses in Eucalyptus, and highlights that even species that are closely related (e.g. congeners) may respond differently to water stress and re-watering.

Research paper thumbnail of Efficacy and tolerability of miglitol in the treatment of patients with non—insulin-dependent diabetes mellitus

Current Therapeutic Research, 1995

The efficacy of miglitol in improving postprandial glucose levels and its relationship to carbohy... more The efficacy of miglitol in improving postprandial glucose levels and its relationship to carbohydrate metabolism and absorption has been shown in several in vivo and in vitro studies. A multicenter (10 centers), randomized, double-blind, parallel-group study was designed to evaluate long-term efficacy and tolerability of miglitol versus placebo in patients with non-insulin-dependent diabetes mellitus (NIDDM). A total of 102 patients were recruited and randomized (89 assessable patients); after a run-in placebo period of 4 weehs, patients received miglitol or placebo 100 mg thrice daily for 18 weeks. Fasting blood glucose, cholesterol, and triglyceride levels were determined every 6 weeks; glycosylated hemoglobin HbA,, levels were determined at the beginning and at the end of the study. No significant differences appeared in baseline values of efficacy variables. The primary efficacy analysis showed that miglitol was significantly more effective in reducing HbA,, levels than placebo (P = 0.0158). Miglitol was also significantly more effective in reducing fasting blood glucose levels (P = 0.0012). No statistically significant differences were found in cholesterol or triglyceride levels. Meteor&m, diarrhea, and flatulence were the most common adverse events and occurred more frequently in the miglitol group (49.0% of miglitol patients vs 36.7% of placebo patients). Hypoglycemic episodes occurred in 7 patients (2 in the miglitol group and 5 in the placebo group). Miglitol appears to be useful in the treatment of patients with NIDDM as it significantly reduces HbA,, and fasting blood glucose levels.

Research paper thumbnail of Epistemological beliefs and approaches to learning: their change through secondary school and their influence on academic performance

The British journal of educational psychology, 2005

In recent decades, two lines of research, phenomenographic and meta-cognitive, have examined stud... more In recent decades, two lines of research, phenomenographic and meta-cognitive, have examined students' approaches and epistemological beliefs about learning. To date there has been very little research describing the change in epistemological beliefs in European secondary students, or analysing interrelationships between epistemological beliefs and approaches in order to explain their influence on academic performance. The first aim of this investigation is to analyse the change in epistemological beliefs and learning approaches in secondary students as they progress through their studies. The second aim is to examine the effects of epistemological beliefs on learning approaches, and learning approaches on academic performance. About 1,600 Spanish students, boys and girls, from several secondary schools took part in the study. They were between 12 and 20 years old and their average age was 14.79 years. Measures of epistemological beliefs (EQ: Epistemological Questionnaire), lear...

Research paper thumbnail of Mutations in the Tight-Junction Gene Claudin 19 (CLDN19) Are Associated with Renal Magnesium Wasting, Renal Failure, and Severe Ocular Involvement

Claudins are major components of tight junctions and contribute to the epithelial-barrier functio... more Claudins are major components of tight junctions and contribute to the epithelial-barrier function by restricting free diffusion of solutes through the paracellular pathway. We have mapped a new locus for recessive renal magnesium loss on chromosome 1p34.2 and have identified mutations in CLDN19, a member of the claudin multigene family, in patients affected by hypomagnesemia, renal failure, and severe ocular abnormalities. CLDN19 encodes the tight-junction protein claudin-19, and we demonstrate high expression of CLDN19 in renal tubules and the retina. The identified mutations interfere severely with either cell-membrane trafficking or the assembly of the claudin-19 protein. The identification of CLDN19 mutations in patients with chronic renal failure and severe visual impairment supports the fundamental role of claudin-19 for normal renal tubular function and undisturbed organization and development of the retina.

Research paper thumbnail of The learning approaches and epistemological beliefs of university students: a cross‐sectional and longitudinal study

Studies in Higher Education, 2007

Two studies, a cross‐sectional (173 first‐year and 215 final‐year participants) and a longitudina... more Two studies, a cross‐sectional (173 first‐year and 215 final‐year participants) and a longitudinal (81 participants), examined whether two aspects of the learning experience of student teachers (epistemological beliefs and learning approaches), and the interrelations between them changed as a result of their tertiary education. Between the first and final years of studies, these two aspects seemed to move in the

Research paper thumbnail of Occupational accidents model based on risk–injury affinity groups

Safety Science, 2011

This article sets outs a generalized utility model for the diagnosis and prediction of accidents ... more This article sets outs a generalized utility model for the diagnosis and prediction of accidents among the Spanish workforce. Based on observational data classified into a risk-injury contingency table (19 Â 19), we have summarized the accident rate of all Spanish companies over an 11-year period (75,19,732 accidents). By using correspondence analysis a structure composed of three axes can be obtained, the combination of which identifies three separate risk and injury groups, which we use as a general Spanish pattern. The relationships of greater affinity or likelihood amongst the risks and injuries identified in the pattern facilitate decision-making at the risk-assessment stage in Spanish companies. Each risk-injury group has its own characteristics, interpretable within the phenomenological framework of the accident.

Research paper thumbnail of The epistemological beliefs, learning approaches and study orchestrations of university students

Studies in Higher Education, 2006

This study examined the learning experience (learning approaches, study orchestrations and episte... more This study examined the learning experience (learning approaches, study orchestrations and epistemological beliefs) of 388 university students. Data analysis revealed two main results. First, the different aspects of students’ learning experience were related: learning approaches and epistemological beliefs (two pairs of canonical variates accounted for the significant relationships), and epistemological beliefs and study orchestrations (sophisticated beliefs emerged mainly in those