Social Vulnerability Predicts Frailty: Towards a Distinction between Fragility and Frailty?

BACKGROUND: All definitions of frailty converge in two aspects: the notion of loss or decline and the ability to predict negative health outcomes. Numerous factors were reported to be associated with frailty among which biological, psychological, economic and social factors. Whether the latter contribute at the same level is a relevant question, as social vulnerability does not refer to an ongoing process of decline leading a person to become frail but rather to a relativity stable state making the person fragile. Thus, social vulnerability should increase the risk of frailty. OBJECTIVES: This study aims at assessing whether social vulnerability increases the risk of incident frailty. METHODS: 1531 participants aged 65 or older from the PAQUID cohort study were included. Cox regression models tested the association between social vulnerability index (SVI, based on 28 social items) and frailty index (FI, based on 25 health-related items) over the 27 years of follow-up. RESULTS: Adjusted for age and sex, higher SVI was associated with increased risk of incident frailty (HR=3.85, 95% CI=1.87-7.94, p<.001). After additional control for IADL disability and comorbidities, higher SVI was associated with increased risk of frailty (HR=3.40, 95% CI=1.63-7.07, p<.05). The association remained significant after controlling for MMSE (HR=2.34, 95% CI=1.08-5.07, p<.05). DISCUSSION: Poor social status is a risk factor of frailty. From a conceptual point of view, our results claim for a distinction between the concepts of frailty and fragility, the first one being the consequence of an ongoing decline, the other one related to a relatively stable condition of fragility, mainly explained by unfavorable social conditions.

Evaluating the effect of CFH-12® and Phoslock® on phosphorus dynamics during anoxia and resuspension in shallow eutrophic lakes.

Laboratory experiments with intact sediment cores from a hypertrophic very windy exposed shallow lake were conducted to assess the combined effect of anoxia and sediment resuspension on phosphorus (P) dynamics after adding different P adsorbents (CFH-12® and Phoslock®). In this study we hypothesize that the addition of geoengineering materials will increase P retention in the sediment even at the worst physic-chemical conditions such as anoxia and sediment resuspension. Both adsorbents significantly reduced the P release from the sediments after a 54 days-anoxic incubation period (CFH-12® by 85% and Phoslock® by 98%) and even after resuspension events (CFH-12® by 84% and Phoslock® by 88%), indicating that both adsorbents are suitable P inactivating agents for restoring shallow eutrophicated lakes under such circumstances. CFH-12® did not release dissolved Fe to the water column neither after the anoxic period nor after resuspension events compared to Control (no adsorbents addition). The La concentration was significantly higher in Phoslock® (3.5-5.7 µg L-1) than in Control at all sampling days but it was not affected by resuspension. The high efficiency in P removal under anoxia and resuspension, the low risk of toxicity and the high maximum adsorption capacity makes CFH-12® a promising adsorbent for lake restoration. Nevertheless, further research about the influence of other factors (i.e. pH, alkalinity, interfering substances or strict anoxia) on the performance of CFH-12® is needed.

A chronic high-fat diet causes sperm head alterations in C57BL/6J mice.

A chronic-positive energetic balance has been directly correlated with infertility in men, but the involved mechanisms remain unknown. Herein we investigated weather in a mouse model a chronic feeding with a diet supplemented with chicken fat affects sperm head morphology. To accomplish this, we fed mice for 16 weeks with either control food (low-fat diet, LFD) or control food supplemented with 22% chicken fat (high-fat diet, HFD). At the end of the feeding regimen, we measured: redox and inflammatory changes, cholesterol accumulation in testis and analyzed testicular morphological structure and ultra-structure and liver morphology. We found that the mice fed HFD resembled some features of the human metabolic syndrome, including systemic oxidative stress and inflammation, this group showed an increment in the following parameters; central adiposity (adiposity index: 1.07 ± 0.10 vs 2.26 ± 0.17), dyslipidemia (total cholesterol: 153.3 ± 2.6 vs 175.1 ± 8.08 mg/dL), insulin resistance (indirect Insulin resistance index, TG/HDL-c: 2.94 ± 0.33 vs 3.68 ± 0.15) and fatty liver. Increased cholesterol content measured by filipin was found in the testicles from HFD (fluorescence intensity increase to 50%), as well as an alteration of spermiogenesis. Most remarkably, a disorganized manchette-perinuclear ring complex and an altered morphology of the sperm head were observed in the spermatozoa of HFD-fed mice. These results add new information to our understanding about the mechanisms by which systemic oxidative stress and inflammation may influence sperm-head morphology and indirectly male fertility.

ODF1, sperm flagelar protein is expressed in kidney collecting ducts of rats.

ODF1 has been described as an exclusively expressed testicular protein and is located in the outer dense fibers along the sperm tail. ODF1 has been involved in the sperm motility and in the development of the flagellum, but the function of ODF1 is not already clear. Other ODF proteins, such as ODF2 have been characterized in other tissues like the basal body of the kidney primary cilium, but so far only the mRNA of ODF1 has been described in other tissues. These observations let us to hypothesize that the expression of the protein ODF1 could not be limited to the testis. Therefore, in the present work we proposed to evaluate if the ODF1 protein could also be present in tissues other than the testis. Here we demonstrated through western blot, immunofluorescence, and RT-PCR techniques that the protein and mRNA of ODF1 have been identified in the rat kidney. Finally, the presence of ODF1 in kidney has also been confirmed through proteomic analysis using mass spectrometry. The results derived from these different complementary approaches indicate that, to our knowledge and for the first time, ODF1 is demonstrated to be present in an additional organ different to testis. This results raise new questions about potential other functions and locations of the ODF1 protein.

Do magnetic phosphorus adsorbents used for lake restoration impact on zooplankton community?

Magnetic microparticles (MPs) have been recently proposed as innovative and promising dissolved inorganic phosphorus (DIP) adsorbents. However, before using them in a whole-lake restoration project, it is essential to assess their toxicological effects (direct and indirect) on aquatic biota. In the present study we hypothesized that zooplankton community is affected by MPs used for lake restoration. To test our hypothesis we designed a microcosms experiment (n = 15) containing lake water and surface sediment from a hypertrophic lake. Temporal changes (70 days) on physico-chemical conditions and on zooplankton structure (rotifers, copepods and branchiopods) were monitored under different scenarios. In particular, three different treatments were considered: no addition of MPs (control) and MPs addition (1.4 g MPs L-1) on the surface water layer (T-W) and on the sediment (T-S). After 24 h of contact time, MPs were removed with a magnetic rake. A total of 15 zooplankton species (12 rotifers, 1 branchiopod and 2 copepods) were recorded and a high abundance of zooplankton was registered during the experiment for all treatments. No significant differences (RM-ANOVA test; p > 0.05) in total abundance, species richness and species diversity among treatments were found. The absence of any effect of MPs on zooplankton can be explained because MPs did not significantly alter any of its physico-chemical (e.g. temperature, pH, O2) or biological (e.g. food quantity and quality) drivers. These results confirm the suitability of MPs as a promising tool for removing DIP in eutrophic aquatic ecosystems.

Determining major factors controlling phosphorus removal by promising adsorbents used for lake restoration: A linear mixed model approach.

Phosphorus (P) removal from lake/drainage waters by novel adsorbents may be affected by competitive substances naturally present in the aqueous media. Up to date, the effect of interfering substances has been studied basically on simple matrices (single-factor effects) or by applying basic statistical approaches when using natural lake water. In this study, we determined major factors controlling P removal efficiency in 20 aquatic ecosystems in the southeast Spain by using linear mixed models (LMMs). Two non-magnetic -CFH-12® and Phoslock®- and two magnetic materials -hydrous lanthanum oxide loaded silica-coated magnetite (Fe-Si-La) and commercial zero-valent iron particles (FeHQ)- were tested to remove P at two adsorbent dosages. Results showed that the type of adsorbent, the adsorbent dosage and color of water (indicative of humic substances) are major factors controlling P removal efficiency. Differences in physico-chemical properties (i.e. surface charge or specific surface), composition and structure explain differences in maximum P adsorption capacity and performance of the adsorbents when competitive ions are present. The highest P removal efficiency, independently on whether the adsorbent dosage was low or high, were 85-100% for Phoslock and CFH-12®, 70-100% for Fe-Si-La and 0-15% for FeHQ. The low dosage of FeHQ, compared to previous studies, explained its low P removal efficiency. Although non-magnetic materials were the most efficient, magnetic adsorbents (especially Fe-Si-La) could be proposed for P removal as they can be recovered along with P and be reused, potentially making them more profitable in a long-term period.

Synthesis and characterization of magnetic chitosan microspheres as low-density and low-biotoxicity adsorbents for lake restoration.

We propose a novel magnetic adsorbent for optimal Phosphorus (P) removal from the upper sediment layers. For this aim, magnetic chitosan microparticles were prepared using a reverse-phase suspension cross-linking technique. The resulting particles and suspensions were characterized using scanning electron microscopy, X-ray powder diffraction, Fourier transform infrared spectroscopy, magnetometry, thermogravimetric analysis, electrophoretic mobility and turbidity measurements. The hybrids are multicore particles consisting of well dispersed magnetite nanoparticles (approx. 10% w/w) homogeneously distributed within the biopolymer matrix. These microparticles can be easily separated from the water column and sediment using magnetic field gradients. Their P adsorption capacity is evaluated in batch conditions resulting in a maximum P adsorption capacity of ML = 4.84 mg g-1 at pH = 7. We demonstrate that these particles are excellent candidates to remove P from water column and also P mobile from the upper sediment layers due to two main reasons: they sediment slower and present lower potential toxicity (due to a their larger size) than conventional iron/iron oxide microparticles previously proposed for lake restoration.

A microcosm experiment to determine the consequences of magnetic microparticles application on water quality and sediment phosphorus pools.

This study used microcosms to evaluate the effects of adding iron (Fe) magnetic microparticles (MPs) on water quality, focusing on P concentrations in the water column and sediment. Two treatments were considered for a constant 85:1 MP:PMobile molar ratio: T-W, applying MPs on the surface water layer; and T-S, applying MPs on the sediment. MP addition reduced P concentrations in lake water and sediment, with both treatments producing a mean reduction of 68±6% in dissolved inorganic P concentration (DIP) over a 70-day oxic period and reductions of 80±8% (T-W) and 80±4% (T-S) over a 5-day anoxic period. MPs also decreased reactive silicate (Si) concentrations by around 50% in both periods, but dissolved organic carbon (DOC) was reduced by only 15% at 24h after MP addition. Despite the marked decrease in DIP concentration due to MP addition, there was no reduction in chlorophyll a (Chla), because post-treatment total P concentrations (>200µgL-1vs. >700µgL-1 before treatments) remained higher than required for changes in the biological community (0.05-0.1mgL-1). With T-S treatment, there was a reduction of 15% in P bound to Al oxides, clay minerals, and humic substances (P→NaOH) and of 12% in labile organic P (Org-PLabile) versus controls. P bound to humic substances (P→NaOH, Humic) was reduced by 11-22% in both treatments. Finally, T-W rather than T-S treatments are recommended for future whole-lake applications to achieve more effective P removal from water and sediment and a higher percentage MP recovery.

Acute and chronic effects of magnetic microparticles potentially used in lake restoration on Daphnia magna and Chironomus sp.

Magnetic microparticles (MPs) have been recently proposed as a new and promising tool for restoring eutrophicated waters. In this study, we analyzed the acute (immobilization) and chronic effects of iron (Fe) MPs on Daphnia magna and on the benthic macroinvertebrate Chironomus sp. In the chronic toxicity tests the offspring production (male and female) in D. magna and the mortality of larvae and pupae, and adult emergence in Chironomus sp. experiments were used as the endpoints. The concentration of MPs that caused 50% of immobilized individuals (EC50) in the acute toxicity test was much higher in D. magna (0.913g MPs l-1) than in Chironomus sp. (0.445g MPs l-1). The results of chronic toxicity tests in D. magna showed that in presence of dissolved Fe (dFe), parthenogenetic reproduction was significantly affected, while no significant effect on mortality of larvae and pupae and on adult emergence was detected in Chironomus sp. test. Taking into account both that long-term exposure is not likely to occur and the regular dose of MPs potentially used in a restoration plan, we conclude that MPs is a riskless (no toxic effect on planktonic and benthic organisms) and efficient (high P adsorption capacity) tool for lake restoration.

Magnetic microparticles as a new tool for lake restoration: A microcosm experiment for evaluating the impact on phosphorus fluxes and sedimentary phosphorus pools.

In the last decades, magnetic particles (MPs) as adsorbents have gained special attention due to their high adsorption capacity and the possibility of recovering them by applying a magnetic separation gradient. For the first time MPs have been tested as P adsorbents in a microcosm experiment in a context of lake restoration. MPs were added to sediment cores from a hypertrophic lake, at Fe:PMobile molar ratio of 285:1 and 560:1 under both, oxic and anoxic conditions. We have found that, under anoxic conditions (anoxic), MPs are able to reduce P release rate from the sediment to the overlying water and to reduce sedimentary PMobile concentration (a 22-25% reduction within 0-4 cm depth compared to controls). Under oxic conditions, the addition of MPs do not affect P fluxes across the sediment and water interface since the lake sediment is naturally rich in iron oxides. However a measured reduction in sedimentary PMobile concentration (12-16% reduction in 0-10 cm depth) contributes to a potential reduction in long-term P efflux.

The influence of pH on manganese removal by magnetic microparticles in solution.

An extensive experimental work is reported that aims to assess the efficiency in manganese (Mn) removal from aqueous solution by carbonyl iron microparticles using magnetic separation techniques. A set of batch experiments are performed to explore the effect of pH, adsorbent concentration, surface coating and contact time for achieving the highest Mn removal efficiency. Mn removal efficiency is extremely high (>98%) for pH values larger than 9 as a result of the chemisorption of Mn oxides onto magnetic microparticles. In contrast, Mn removal efficiency for pH < 9 was significantly reduced as Mn remains as a soluble cation. In this manuscript we demonstrate that the efficiency clearly increases when increasing the adsorbent concentration and when using MnOx(s) coated magnetic particles instead of bare particles. Desorption rates from Mn-loaded magnetic particles at different pHs were always lower than 15%. Furthermore, Mn removal efficiency remained at a very high value (>95%) when reused particles were employed in the adsorption process.

Some factors affecting the number of days open in Argentinean dairy herds.

The objective of this study was to estimate the relative contribution of factors affecting how quickly cattle become pregnant in Argentine dairy herds. Data from 76,401 cows from 249 dairy herds were analyzed. A hazard model was used to explore days open (DO). The factors considered were milk yield, lactation number, calving season, and breeding technique (i.e., type of service: artificial insemination [AI], or combined service). Cows with lower milk yield had 1.09 to 1.38 higher likelihood to become pregnant than those with higher milk yield (P < 0.0001). The number of DO increased linearly with an increasing number of lactations (P < 0.0001). Cows calving in fall-winter had a shorter interval to conception than those calving in summer. The hazard rate for combined service was 1.27; therefore, cows with combined service were more likely to become pregnant during the observation period than those bred by AI. The difference in DO between cows of high versus low milk yield was smaller when dairies used AI as the main breeding technique than when they used combined service. Furthermore, dairies using mainly combined service had lower milk yield (5693.7 L) than those using mainly AI (7684.4 L). Although lactation number and calving season contributed to explain the number of DO, the influence of production level, the type of service, and the interaction between them was also associated with reproductive efficiency in Argentine dairy herds.

Necrolytic migratory erythema: a cutaneous clue to glucagonoma syndrome.

Necrolytic migratory erythema (NME) is a cutaneous manifestation of the glucagonoma syndrome. We present a case with a pancreatic glucagon-secreting tumour, skin eruption and a good response to treatment.

[Guillain-Barre syndrome. Experience in a third level hospital]. / Síndrome de Guillain-Barré. Experiencia en un hospital de tercer nivel.

INTRODUCTION: Acute peripheral neuropathy represents a medical emergency. The causes of it are diverse and plentiful. The most common cause of acute paralytic peripheral neuropathy is the Guillain-Barré syndrome (GBS). As many as 85% of those affected can be expected to make an excellent recovery. OBJECTIVE: To describe the principal risk factors associated, clinical manifestations, treatment, evolution and complications of 28 cases of Guillain-Barré syndrome (GBS) in the "Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán". METHODS: We search in our computer records all files under diagnostic of GBS, during the last ten years. We found 28 cases that were available to study. RESULTS: Mean age was 37 years old (SD 17.2). Fifteen patients were female (54%) and 13 were male (46%). Nine patients (32%) were preceded by a superior via infection, 5 (18%) by a diarrhea illness and 14 patients had not a predisposing factor. The duration of symptoms before diagnostic has a median of 7 days (2-15). Twenty-six patients (93%) had an ascending paralysis and 18 had paresthesias (64%). The most frequent subtype was acute inflammatory-demyelinating polyneuropathy (AIDP) in 18 patients (64%), acute motor-sensory axonal neuropathy (AMSAN) in 5 (18%), acute motor axonal neuropathy (AMAN) in 3 (11%) and 2 patients (7%) had the Fisher-Miller syndrome. Fifteen patients (54%) developed respiratory involvement requiring mechanical ventilation. Twenty-four patients (86%) had cerebrospinal fluid proteins elevated. Twenty patients (72%) had a total recovery, 6 (21%) had a partial recovery and 2 had not any response (7%). DISCUSSION: GBS is a particularly highstakes illness in that its onset is sudden and paralysis is frequently extreme (requiring assisted respiration), however, as many as 85% of those affected can be expected to make an excellent recovery. In our study the majority of patients (54%) develop respiratory involvement requiring mechanical ventilation but in this group the majority had a favorable outcome (71%).

Novel ATP7B mutations causing Wilson disease in several Israeli ethnic groups.

We characterized microsatellite marker haplotypes and identified mutations in members of 19 ethnically diverse Israeli families affected by Wilson disease (WD). Eighteen unique haplotypes were derived from allelic combinations for four marker loci spanning the WD gene, ATP7B, at chromosome 13q14.3: D13S133, D13S296, D13S301 and D13S295. Most of these haplotypes are population specific and vary among and even within different ethnic groups. Intrafamilial variability of WD haplotypes was observed in two large consanguineous families in which a single origin of WD was expected. In contrast, some WD haplotypes were identified in more than one group. Five novel and four previously described mutations were detected in our sample. The novel mutations include two deletions (845delT and 1639delC) and three missense mutations (E1064A, M645R, and G1213V). Mutations were identified for 11 of the 18 WD haplotypes, suggesting that other mutations may reside in noncoding regions of the ATP7B gene. Identification of all WD mutations will undoubtedly increase our understanding of the normal function of ATP7B as well as lead to more accurate prognosis and genetic counseling.

Intraoperative fine needle aspiration cytology of pancreatic lesions. A study of 90 cases.

Undiagnosed masses in the pancreas represent a problem at laparotomy. Intraoperative biopsy of pancreatic lesions frequently fails to detect carcinoma and may cause severe complications. The aim of the present study was to determine the diagnostic accuracy of intraoperative fine needle aspiration cytology (FNAC) of pancreatic lesions. Ninety patients were studied from January 1988 to June 1992. The cytologic diagnoses were correlated with histology, autopsy results or clinical follow-up. Aspirates were reported as benign, suspicious, malignant or unsatisfactory. Final diagnosis of malignant pancreatic disease (MPD) was established in 60 patients and of benign pancreatic disease in 30. Among the 60 cases with MPD, the cytologic diagnosis was concordant in 42 and interpreted as suspicious in 4. Seven patients with benign cytology and 7 with unsatisfactory cytology later proved to have malignant disease. A total of 30 patients had benign disease; 26 of them had benign cytology. The remaining four had "unsatisfactory" cytologic reports. No false positives were reported. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for intraoperative FNAC results were 80%, 100%, 100%, 70% and 91%, respectively. No complications followed the procedure. Intraoperative FNA of the pancreas is a safe and highly accurate diagnostic method for pancreatic lesions at laparotomy.

Separation of haemoglobins using a monodisperse cation exchanger.

In order to separate haemoglobin variants in one step, a chromatographic method using Mono S (Pharmacia) monodisperse cation exchanger was developed The separation of haemoglobins (A, S, E, D, C and F) on a short analytical column (50 X 5 mm I.D.) was accomplished in 30 min, including the regeneration, using linear buffer gradient elution (lithium chloride in 0.01 M sodium malonate, 0 to 100%). For haemoglobin A, two peaks, probably corresponding to different molecular forms, were found. This systematic double peak affected the recognition and the measurement of haemoglobins. By filling the test-tube with carbon monoxide before injecting the haemolysate, we obtained reproducible results with regard to both retention times and peak shape, and also great stability. The long-term stability and the high speed of the separation seem to be adequate for automation, making the method suitable for routine clinical laboratory-use.